Science.gov

Sample records for central service prise

  1. Super Kitchen Centralizes Food Service

    ERIC Educational Resources Information Center

    Modern Schools, 1975

    1975-01-01

    To centralize food service within the entire Pittsburgh school district, a 90,000-square-foot food service preparation building contains cranes and monorails to move 500-pound capacity vats throughout the kitchen. (Author/MLF)

  2. Developing a Performance Measurement System for University Central Administrative Services

    ERIC Educational Resources Information Center

    Arena, Marika; Arnaboldi, Michela; Azzone, Giovanni; Carlucci, Paola

    2009-01-01

    Central administrative services have recently received increasing attention from practitioners and academics due to the challenging need to both manage scarce resources and provide high-quality services. In this context, performance measurement systems (PMSs) may assume a central role, although an unresolved debate remains on the claimed benefits…

  3. PRISE Reporter. Volume 12, 1980-81.

    ERIC Educational Resources Information Center

    PRISE Reporter, 1981

    1981-01-01

    The document consists of six issues of the "PRISE (Pennsylvania Resources and Information Center for Special Education) Reporter" which cover issues and happenings in the education of the mentally retarded, learning disabled, emotionally disturbed, physically handicapped, visually handicapped, and speech/hearing impaired. Lead articles include the…

  4. Health and health services in Central America.

    PubMed

    Garfield, R M; Rodriguez, P F

    1985-08-16

    Despite rapid economic growth since World War II, health conditions improved only slowly in most of Central America. This is a result of poor medical, social, and economic infrastructure, income maldistribution, and the poor utilization of health investments. The economic crisis of the 1980s and civil strife have further endangered health in the region. Life expectancy has fallen among men in El Salvador and civil strife has become the most common cause of death in Guatemala, Nicaragua, and El Salvador. Large-scale US assistance has done little to improve conditions, and refugees continue to pour into North America. It is estimated that there are more than a million refugees within Central America, while a million have fled to the United States. Costa Rica and Nicaragua are partial exceptions to this dismal health picture. An effective approach to the many health problems in Central America will require joint planning and cooperation among all countries in the region.

  5. Health and health services in Central America.

    PubMed

    Garfield, R M; Rodriguez, P F

    1985-08-16

    Despite rapid economic growth since World War II, health conditions improved only slowly in most of Central America. This is a result of poor medical, social, and economic infrastructure, income maldistribution, and the poor utilization of health investments. The economic crisis of the 1980s and civil strife have further endangered health in the region. Life expectancy has fallen among men in El Salvador and civil strife has become the most common cause of death in Guatemala, Nicaragua, and El Salvador. Large-scale US assistance has done little to improve conditions, and refugees continue to pour into North America. It is estimated that there are more than a million refugees within Central America, while a million have fled to the United States. Costa Rica and Nicaragua are partial exceptions to this dismal health picture. An effective approach to the many health problems in Central America will require joint planning and cooperation among all countries in the region. PMID:4021026

  6. 77 FR 24946 - Central Vermont Public Service Corporation; Notice of Application for Amendment of License and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-26

    ... Energy Regulatory Commission Central Vermont Public Service Corporation; Notice of Application for..., 2012, and Supplemented on April 10, 2012. d. Applicant: Central Vermont Public Service Corporation. e..., Generation Asset Manager, Central Vermont Public Service Corporation, 77 Grove Street, Rutland, VT...

  7. Assessing the relationship between volume and outcome in hospital services: implications for service centralization.

    PubMed

    Harrison, Anthony

    2012-02-01

    Proposals for centralizing services are often justified on the basis of studies linking the volume of activity to the outcomes achieved. However, the evidence of such studies is far from demonstrating a causal link between volume and outcome. This article assesses the main reasons why volume and outcome studies do not in themselves demonstrate a causal link, and therefore do not provide adequate support for proposals for centralizing hospital services. It then sets out a number of precepts to guide those responsible for proposing centralization of services.

  8. Prise en charge des traumatismes graves du rein

    PubMed Central

    Lakmichi, Mohamed Amine; Jarir, Redouane; Sadiki, Bader; Zehraoui; Bentani; Wakrim, Bader; Dahami, Zakaria; Moudouni; Sarf, Ismail

    2015-01-01

    Les traumatismes graves du rein de grade III, IV et V selon la classification de l'Amercan Society for Surgery For Trauma (ASST) sont plus rares et se retrouvent dans 5% des cas en moyenne. Leur prise en charge est souvent délicate, nécessitant alors des centres expérimentés dotés de moyen adéquats d'imagerie (scanner spiralé). Cependant, durant ces dernières années, la prise en charge de ces traumatismes a évolué vers une attitude de moins en moins chirurgicale grâce à l’évolution des techniques de la radiologie interventionnelle, de l'endourologie et des moyens de surveillance aux urgences et de réanimation. L'objectif de cette étude est d’évaluer notre expérience dans la prise en charge des traumatismes rénaux de haut grade. Notre étude rétrospective porte sur 25 cas de traumatismes grave du rein de grade III, IV et V selon la classification de l'ASST, colligés entre Janvier 2002 et Juin 2009 au service d'urologie du centre Hospitalier Universitaire Mohammed VI, Université Cadi Ayyad de Marrakech, Maroc. Nous avons étudié les données épidémiologiques, les signes cliniques et biologiques à l'admission (état de choc hémorragique, taux d'hémoglobine), les données radiologiques (échographie et scanner), les lésions associées, la prise en charge thérapeutique et les complications. L’âge moyen de nos patients était de 24,9 ans 15 et 58 ans, avec une prédominance masculine (sex-ratio = 7, 3). Le rein droit était intéressé dans 15 cas (60%). Le traumatisme rénal était fermé dans 15 cas, et ouvert par arme blanche dans 10 cas. Huit patients se sont présentés en état de choc hémorragique (32%). Une anémie inférieur à 10g /100ml a été observée dans 10 cas (40%). L'uroscanner fait systématiquement à l'admission a retrouvé un grade III (10 cas), grade IV (13 cas) et grade V (2 cas). La prise en charge a consisté en une exploration chirurgicale avec néphrectomie chez 2 cas de Grade IV pour une instabilité h

  9. Centralization of a regional clinical microbiology service: The Calgary experience

    PubMed Central

    Church, Deirdre L; Hall, Paula

    1999-01-01

    Diagnostic laboratory services in Alberta have been dramatically restructured over the past five years. In 1994, Alberta Health embarked on an aggressive laboratory restructuring that cut back approximately 30% of the overall monies previously paid to the laboratory service sector in Calgary. A unique service delivery model consolidated all institutional and community-based diagnostic testing in a company called Calgary Laboratory Services (CLS) in late 1996. CLS was formed by a public/private partnership between the Calgary Regional Health Care Authority (CRHA) and MDS-Kasper Laboratories. By virtue of its customer service base and scope of testing, CLS provides comprehensive regional laboratory services to the entire populace. Regional microbiology services within CLS have been successfully consolidated over the past three years into a centralized high volume laboratory (HVL). Because the HVL is not located in a hospital, rapid response laboratories (RRLs) are operated at each acute care site. Although the initial principle behind the proposed test menus for the RRLs was that only procedures requiring a clinical turnaround time of more than 2 h stay on-site, many other principles had to be used to develop and implement an efficient and clinically relevant RRL model for microbiology. From these guiding principles, a detailed assessment of the needs of each institution and extensive networking with user groups, the functions of the microbiology RRLs were established and a detailed implementation plan drawn up. The experience at CLS with regards to restructuring a regional microbiology service is described herein. A post-hoc analysis provides the pros and cons of directing and operating a regionalized microbiology service. PMID:22346397

  10. La Prise en Charge des Brulures Electriques: a Propos de 30 Cas

    PubMed Central

    Bakkali, H.; Ababou, K.; Bellamari, H.; Ennouhi, A.; Nassim Sabah, T.; Achbouk, A.; Moussaoui, A.; Fouadi, F.Z.; Siah, S.; Ihrai, H.

    2009-01-01

    Summary Les brûlures électriques sont rares mais graves nécessitant une prise en charge urgente et adéquate car l'évolution peut être émaillée de complications graves, notamment cardiaques, neurologiques et rénales, et les séquelles sont importantes. A travers une étude analytique et rétrospective de janvier 2000 à novembre 2007 ayant inclus 30 patients admis au Service des Brûlés de l'Hôpital Militaire d'Instruction Mohamed V de Rabat, Maroc, pour prise en charge de brûlures électriques, il a été relaté les mécanismes des brûlures électriques, comme aussi les complications, la morbidité et la mortalité, dues aux brûlures électriques, tout en insistant sur les modalités de prise en charge initiale chez ces patients. La prévention reste le point capital pour réduire l'incidence de ces accidents. Cette prévention se base sur la surveillance des enfants et l'élimination de facteurs de risque à la maison, par la maintenance des installations électriques et par l'information et l'éducation du public. PMID:21991148

  11. Centralized Authorization Using a Direct Service, Part II

    SciTech Connect

    Wachsmann, A

    2004-06-09

    Authorization is the process of deciding if entity X is allowed to have access to resource Y. Determining the identity of X is the job of the authentication process. One task of authorization in computer networks is to define and determine which user has access to which computers in the network. On Linux, the tendency exists to create a local account for each single user who should be allowed to logon to a computer. This is typically the case because a user not only needs login privileges to a computer but also additional resources like a home directory to actually do some work. Creating a local account on every computer takes care of all this. The problem with this approach is that these local accounts can be inconsistent with each other. The same user name could have a different user ID and/or group ID on different computers. Even more problematic is when two different accounts share the same user ID and group ID on different computers: User joe on computer1 could have user ID 1234 and group ID 56 and user jane on computer2 could have the same user ID 1234 and group ID 56. This is a big security risk in case shared resources like NFS are used. These two different accounts are the same for an NFS server so that these users can wipe out each other's files. The solution to this inconsistency problem is to have only one central, authoritative data source for this kind of information and a means of providing all your computers with access to this central source. This is what a ''Directory Service'' is. The two directory services most widely used for centralizing authorization data are the Network Information Service (NIS, formerly known as Yellow Pages or YP) and Lightweight Directory Access Protocol (LDAP).

  12. Human resources data collection--Central Information Service.

    PubMed

    Teodosijevic, Nada; Rikanovic, Sasa

    2010-01-01

    The Central Information Service--(CIS) is located at the Institute of Public Health of Serbia, which maintains and upgrades it. CIS has been developed through the Serbia Health Project, a project developed by the Ministry of Health and funded by the World Bank loan. Through its web portal CIS ensures that all health institutions enter and maintain HR and other resource data, at the same time enabling all users of the system (Ministry of Health, Health Insurance Fund, Institutions of Public Health, all health institutions) to use CIS data in accordance with the pre-established rights. In the following period CIS will offer its services to the private sector as well, and it shall be a basis for the establishment of Serbia e-Health portal for citizens.

  13. 75 FR 4546 - Central Vermont Public Service Corporation; Notice of Application for Amendment of License and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... Energy Regulatory Commission Central Vermont Public Service Corporation; Notice of Application for...: December 7, 2009. d. Applicant: Central Vermont Public Service Corporation. e. Name of Project: Lamoille... Contact: Mr. Michael Scarzello, P.E., Central Vermont Public Service Corporation, 77 Grove Street,...

  14. Forecasting the Future Food Service World of Work. Final Report. Volume II. Centralized Food Service Systems. Service Management Reports.

    ERIC Educational Resources Information Center

    Powers, Thomas F., Ed.; Swinton, John R., Ed.

    Volume II of a three-volume study on the future of the food service industry considers the effects that centralized food production will have on the future of food production systems. Based on information from the Fair Acres Project and the Michigan State University Vegetable Processing Center, the authors describe the operations of a centralized…

  15. Intérêt des prothèses métalliques expansives dans la prise en charge de l’occlusion tumorale colique: expérience d’un service hospitalier Marocain

    PubMed Central

    Rouibaa, Fedoua; Bakkar, Meriem; Seddik, Hassan; Addioui, Tarik; Filali, Fatima Zahra; Akka, Rachid; Desla, Hanane; Aourarh, Aourarh

    2013-01-01

    Le traitement de l’obstruction colique d’origine tumorale s’est modifié ces dernières années grâce à l’apport des endoprothèses coliques. Elles constituent une alternative thérapeutique reconnue au traitement chirurgical dans 2 indications: la levée en urgence de l’occlusion colique aigue avant une chirurgie curatrice ou pour le traitement palliatif de l’obstruction colique chez les patients inopérables ou ayant une maladie localement avancée ou métastatique. Il s’agit de 12 observations de syndrome occlusif colique d’origine tumorale traitées par endoprothèses coliques au sein du service de Gastro-entérologie 1 de l’hôpital militaire d’instruction Mohammed V. L’âge moyen était de 53 ans. Il existait une prédominance masculine (9 hommes - 3 femmes). Tous les patients présentaient un syndrome occlusif avec arrêt des matières et des gaz. L’abdomen sans préparation montrait des niveaux hydro-aériques chez tous les patients. La tomodensitométrie objectivait un processus colique sténosant avec dilatation des anses en amont. Tous les patients ont bénéficié de la mise en place d’une endoprothèse par colonoscopie sous anesthésie générale. Le succès technique immédiat et clinique était noté dans 95% des cas. La migration de la prothèse a été notée dans un cas. Les endoprothèses coliques constituent une alternative de choix au traitement chirurgical des sténoses tumorales coliques symptomatiques, soit pour permettre de préparer au traitement curatif chirurgical “à froid”, soit dans un but palliatif avant de débuter une éventuelle chimiothérapie. PMID:23565315

  16. 76 FR 72697 - Central Vermont Public Service Corporation; Notice of License Application Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-25

    ... license transfer from Vermont Marble Power Division of Omya Inc., to Central Vermont Public Service... opportunities with interpretive signage for public education about the historic Vermont Marble buildings...

  17. 29 CFR 779.118 - Employees providing central services for multi-unit organizations.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Apply: Basic Principles and Individual Coverage Employees Engaged in Commerce Or in the Production of Goods for Commerce § 779.118 Employees providing central services for multi-unit organizations. Employees providing central services for a multiunit organization may be engaged both “in commerce” and...

  18. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Economic feasibility of centralized services. 101-5.104 Section 101-5.104 Public Contracts and Property Management Federal Property... FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.104 Economic feasibility of centralized services....

  19. The myth of patient centrality in integrated care: the case of back pain services

    PubMed Central

    Louise Howarth, Michelle; Haigh, Carol

    2007-01-01

    Purpose The purpose of this paper is to critically examine the extent of patient centrality within integrated chronic back pain management services and compare policy rhetoric with practice reality. Context Integrated chronic back pain management services. Data sources We have drawn on theories of integration and context specific journals related to integration and pain management between 1966 and 2006 to identify evidence of patient centrality within integrated chronic pain management services. Discussions Despite policy rhetoric and guidelines which promote ‘patient centrality’ within multidisciplinary services, we argue that evaluations of these services are scant. Many papers have focussed on the assessment of pain in multidisciplinary services as opposed to the patients' experience of these services. Conclusions A latent measure of the reality of its magnitude needs to be captured through analysis of the patient's perspectives. Capturing patients' thoughts about integrated services will promote patient centrality and support the reality rather than endorse the rhetoric. PMID:17786176

  20. A Study of University of Central Texas Student Opinions Concerning Academic and Service Programs.

    ERIC Educational Resources Information Center

    Dixon, Terry P.

    As part of a larger campus-wide study, a student survey was developed to assess student perceptions of programs and services at the University of Central Texas (UCT) in Killeen. The survey focused on: (1) student financial needs, (2) student perceptions of academic and service programs, (3) student attitudes towards programs and services, and (4)…

  1. 13 CFR 120.954 - Central Servicing Agent.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... the orderly flow of funds among Borrowers, CDCs, and SBA. The CDC and Borrower must enter into an individual Servicing Agent Agreement with the CSA for each 504 loan, constituting acceptance by the CDC and... loan. At SBA's direction, the CSA must pay to the CDC servicing each loan the interest accruing in...

  2. 13 CFR 120.954 - Central Servicing Agent.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... the orderly flow of funds among Borrowers, CDCs, and SBA. The CDC and Borrower must enter into an individual Servicing Agent Agreement with the CSA for each 504 loan, constituting acceptance by the CDC and... loan. At SBA's direction, the CSA must pay to the CDC servicing each loan the interest accruing in...

  3. 13 CFR 120.954 - Central Servicing Agent.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the orderly flow of funds among Borrowers, CDCs, and SBA. The CDC and Borrower must enter into an individual Servicing Agent Agreement with the CSA for each 504 loan, constituting acceptance by the CDC and... loan. At SBA's direction, the CSA must pay to the CDC servicing each loan the interest accruing in...

  4. 13 CFR 120.954 - Central Servicing Agent.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... the orderly flow of funds among Borrowers, CDCs, and SBA. The CDC and Borrower must enter into an individual Servicing Agent Agreement with the CSA for each 504 loan, constituting acceptance by the CDC and... loan. At SBA's direction, the CSA must pay to the CDC servicing each loan the interest accruing in...

  5. 13 CFR 120.954 - Central Servicing Agent.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... the orderly flow of funds among Borrowers, CDCs, and SBA. The CDC and Borrower must enter into an individual Servicing Agent Agreement with the CSA for each 504 loan, constituting acceptance by the CDC and... loan. At SBA's direction, the CSA must pay to the CDC servicing each loan the interest accruing in...

  6. How Did States in the Central Region Evaluate Supplemental Educational Services in 2007?

    ERIC Educational Resources Information Center

    Barley, Zoe; Wegner, Sandra K.

    2009-01-01

    In state needs assessment meetings held in late June 2008, the leadership of two Central Region state departments of education, South Dakota and Missouri, asked Regional Educational Laboratory (REL) Central to determine how the states in the region evaluate their supplemental educational service (SES) providers. Specifically, these SEA staff…

  7. Customer Service Training for Public Services Staff at Temple University's Central Library System.

    ERIC Educational Resources Information Center

    Arthur, Gwen

    Arguing that good interpersonal interactions between library staff and their patrons is a major determinant of overall patron satisfaction, this paper describes Temple University's customer service training program for its public services staff. Dubbed the "A+ Service" program, the program focuses on six aspects of library service: (1) importance…

  8. Alternative Models of Service, Centralized Machine Operations. Phase II Report. Volume II.

    ERIC Educational Resources Information Center

    Technology Management Corp., Alexandria, VA.

    A study was conducted to determine if the centralization of playback machine operations for the national free library program would be feasible, economical, and desirable. An alternative model of playback machine services was constructed and compared with existing network operations considering both cost and service. The alternative model was…

  9. Strategic Advancement: How a Centralized Services Department Can Do More than Just Support Fund Raisers.

    ERIC Educational Resources Information Center

    Hardy, Roger

    1991-01-01

    Advancement services, the group of functions that support fundraising and alumni relations, has evolved to include donor relations and stewardship, data processing analysis and programing, budget development and analysis, and event management. Centralizing these services under a single manager can lead to greater productivity. (MSE)

  10. University of Cincinnati, Central Library, Computerized Bibliographic Retrieval Services: Evaluative Report, July 1979-August 1980.

    ERIC Educational Resources Information Center

    Roberts, Randall L.; And Others

    This 2-part report describes the present scope of the University of Cincinnati Central Library bibliographic database retrieval service. The first section discusses searcher training, records maintenance, search aids, expansion of database service, searcher time, user satisfaction, and promotion. The second presents statistical data related to…

  11. Lessons for major system change: centralization of stroke services in two metropolitan areas of England

    PubMed Central

    Ramsay, Angus; Perry, Catherine; Boaden, Ruth; McKevitt, Christopher; Morris, Stephen; Pursani, Nanik; Rudd, Anthony; Tyrrell, Pippa; Wolfe, Charles; Fulop, Naomi

    2016-01-01

    Objectives Our aim was to identify the factors influencing the selection of a model of acute stroke service centralization to create fewer high-volume specialist units in two metropolitan areas of England (London and Greater Manchester). It considers the reasons why services were more fully centralized in London than in Greater Manchester. Methods In both areas, we analysed 316 documents and conducted 45 interviews with people leading transformation, service user organizations, providers and commissioners. Inductive and deductive analyses were used to compare the processes underpinning change in each area, with reference to propositions for achieving major system change taken from a realist review of the existing literature (the Best framework), which we critique and develop further. Results In London, system leadership was used to overcome resistance to centralization and align stakeholders to implement a centralized service model. In Greater Manchester, programme leaders relied on achieving change by consensus and, lacking decision-making authority over providers, accommodated rather than challenged resistance by implementing a less radical transformation of services. Conclusions A combination of system (top-down) and distributed (bottom-up) leadership is important in enabling change. System leadership provides the political authority required to coordinate stakeholders and to capitalize on clinical leadership by aligning it with transformation goals. Policy makers should examine how the structures of system authority, with performance management and financial levers, can be employed to coordinate transformation by aligning the disparate interests of providers and commissioners. PMID:26811375

  12. 76 FR 63921 - Central Vermont Public Service Corporation; Notice of Proposed Restricted Service List for a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-14

    ... Energy Regulatory Commission [Project No. 2558-029--Illinois Otter Creek Hydroelectric Project Central... properties included in, or eligible for inclusion in, the National Register of Historic Places at the Otter Creek Hydroelectric Project (Otter Creek Project). \\2\\ 16 USC section 470 (2006) et seq. \\3\\ 36 CFR...

  13. 75 FR 64303 - Vermont Marble Power, Division of Omya Inc.; Central Vermont Public Service Corporation; Notice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-19

    ... Relicensing Regulations Under the Federal Power Act (54 FR 23,756 FERC Stats. and Regs., Regs. Preambles 1986... Energy Regulatory Commission Vermont Marble Power, Division of Omya Inc.; Central Vermont Public Service... Soliciting Comments and Motions To Intervene October 12, 2010. On August 31, 2010, Vermont Marble...

  14. Central Services PREP (A Curriculum for Sterilization Technicians in the Workplace). Final Report.

    ERIC Educational Resources Information Center

    Tri-County Opportunities Industrialization Center, Inc., Harrisburg, PA.

    A workplace literacy curriculum for entry-level hospital workers who sterilize medical equipment for doctors and nurses was developed, tested, and published in Harrisburg, Pennsylvania. An assessment was conducted to identify the needs of the hospital's management and the literacy skills needed by its central services prep department, and…

  15. Access to Supplemental Educational Services in the Central Region States. Issues & Answers. REL 2007-No. 007

    ERIC Educational Resources Information Center

    Barley, Zoe; Wegner, Sandra K.

    2007-01-01

    The Central Region states (Colorado, Kansas, Missouri, Nebraska, North Dakota, South Dakota, and Wyoming) lag behind the nation in the rate of participation in supplemental educational services that schools failing to make adequate progress for three consecutive years must offer to eligible students under the No Child Left Behind Act. This study…

  16. 77 FR 22568 - Central Vermont Public Service Corporation; Notice of Authorization for Continued Project Operation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF ENERGY Federal Energy Regulatory Commission Central Vermont Public Service Corporation; Notice of Authorization for... the Otter Creek Hydroelectric Project, filed an Application for a New License pursuant to the...

  17. "Feed from the Service": Corruption and Coercion in State-University Relations in Central Eurasia

    ERIC Educational Resources Information Center

    Osipian, Ararat L.

    2009-01-01

    Education in Central Eurasia has become one of the services most affected by corruption. Corruption in academia, including bribery, extortion, embezzlement, nepotism, fraud, cheating, and plagiarism, is reflected in the region's media and addressed in a few scholarly works. This article considers corruption in higher education as a product of…

  18. 29 CFR 779.118 - Employees providing central services for multi-unit organizations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... organizations. 779.118 Section 779.118 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION... Apply: Basic Principles and Individual Coverage Employees Engaged in Commerce Or in the Production of.... Employees providing central services for a multiunit organization may be engaged both “in commerce” and...

  19. 18 CFR 366.23 - FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ..., Annual reports of centralized service companies, and FERC-61, Narrative description of service company... companies, and FERC-61, Narrative description of service company functions. (a) General. (1) FERC Form No... 1 each year thereafter, a narrative description, FERC-61, of the service company's functions...

  20. 18 CFR 366.23 - FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ..., Annual reports of centralized service companies, and FERC-61, Narrative description of service company... companies, and FERC-61, Narrative description of service company functions. (a) General. (1) FERC Form No... 1 each year thereafter, a narrative description, FERC-61, of the service company's functions...

  1. 18 CFR 366.23 - FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ..., Annual reports of centralized service companies, and FERC-61, Narrative description of service company... companies, and FERC-61, Narrative description of service company functions. (a) General. (1) FERC Form No... 1 each year thereafter, a narrative description, FERC-61, of the service company's functions...

  2. 18 CFR 366.23 - FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ..., Annual reports of centralized service companies, and FERC-61, Narrative description of service company... companies, and FERC-61, Narrative description of service company functions. (a) General. (1) FERC Form No... 1 each year thereafter, a narrative description, FERC-61, of the service company's functions...

  3. Prise en Charge du Syndrome de Lyell ou Necrolyse Epidermique Toxique

    PubMed Central

    Siah, S.; Baite, A.; Bakkali, H.; Atmani, M.; Ababou, K.; Ihrai, H.

    2009-01-01

    Summary Le syndrome de Lyell ou nécrolyse épidermique toxique (NET) est une pathologie très grave des dermatoses bulleuses d'étiologie médicamenteuse. Il se caractérise par une nécrose aiguë de l'épiderme sur toute la hauteur du corps muqueux. L'aspect clinique de la NET est celui d'une brûlure étendue du deuxième degré profond. A ce tableau s'associent constamment des lésions muqueuses et une atteinte multiviscérale qui aggrave le pronostic. Nous rapportons deux cas de NET qui illustrent l'importance d'une prise en charge précoce et multidisciplinaire de ces patients atteints au sein d'un service de réanimation des brûlés, dont les fondements reposent sur l'asepsie rigoureuse, l'apport hydroélectrolytique et nutritionnel, la prévention de l'infection et son traitement par une antibiothérapie adaptée, et un nursing et des soins locaux. L'efficacité supposée des immunoglobulines intraveineuses ne repose que sur des cas isolés et il n'y a pas encore d'études randomisées. PMID:21991170

  4. 78 FR 41954 - TA-W-82,634, Prudential Global Business Technology Solutions Central Security Services Dresher...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

    ... Employment and Training Administration TA-W-82,634, Prudential Global Business Technology Solutions Central Security Services Dresher, Pennsylvania; TA-W-82,634A, Prudential Global Business Technology Solutions Central Security Services Iselin, New Jersey; TA-W-82,634B, Prudential Global Business...

  5. Mapping ecosystem services for land use planning, the case of Central Kalimantan.

    PubMed

    Sumarga, Elham; Hein, Lars

    2014-07-01

    Indonesia is subject to rapid land use change. One of the main causes for the conversion of land is the rapid expansion of the oil palm sector. Land use change involves a progressive loss of forest cover, with major impacts on biodiversity and global CO2 emissions. Ecosystem services have been proposed as a concept that would facilitate the identification of sustainable land management options, however, the scale of land conversion and its spatial diversity pose particular challenges in Indonesia. The objective of this paper is to analyze how ecosystem services can be mapped at the provincial scale, focusing on Central Kalimantan, and to examine how ecosystem services maps can be used for a land use planning. Central Kalimantan is subject to rapid deforestation including the loss of peatland forests and the provincial still lacks a comprehensive land use plan. We examine how seven key ecosystem services can be mapped and modeled at the provincial scale, using a variety of models, and how large scale ecosystem services maps can support the identification of options for sustainable expansion of palm oil production.

  6. Mapping ecosystem services for land use planning, the case of Central Kalimantan.

    PubMed

    Sumarga, Elham; Hein, Lars

    2014-07-01

    Indonesia is subject to rapid land use change. One of the main causes for the conversion of land is the rapid expansion of the oil palm sector. Land use change involves a progressive loss of forest cover, with major impacts on biodiversity and global CO2 emissions. Ecosystem services have been proposed as a concept that would facilitate the identification of sustainable land management options, however, the scale of land conversion and its spatial diversity pose particular challenges in Indonesia. The objective of this paper is to analyze how ecosystem services can be mapped at the provincial scale, focusing on Central Kalimantan, and to examine how ecosystem services maps can be used for a land use planning. Central Kalimantan is subject to rapid deforestation including the loss of peatland forests and the provincial still lacks a comprehensive land use plan. We examine how seven key ecosystem services can be mapped and modeled at the provincial scale, using a variety of models, and how large scale ecosystem services maps can support the identification of options for sustainable expansion of palm oil production. PMID:24794194

  7. La prise en charge des troubles de santé mentale par les omnipraticiens du Québec

    PubMed Central

    Fleury, Marie-Josée; Farand, Lambert; Aubé, Denise; Imboua, Armelle

    2012-01-01

    services (ressources; coordination formalisée) et l’environnement (politiques). Conclusion Le rôle clé des omnipraticiens et leur soutien à la prise en charge des TM ont été démontrés, spécifiquement pour les TMC. Pour une prise en charge optimale des soins primaires de santé mentale, des stratégies à composantes multiples, dont les soins partagés, devraient être davantage déployées.

  8. The inability to pay for health services in Central and Eastern Europe: evidence from six countries

    PubMed Central

    Pavlova, Milena; Rechel, Bernd; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

    2014-01-01

    Background: Out-of-pocket payments for health services constitute a major financial burden for patients in Central and Eastern European (CEE) countries. Individuals who are unable to pay use different coping strategies (e.g. borrowing money or foregoing service utilization), which can have negative consequences on their health and social welfare. This article explores patients’ inability to pay for outpatient and hospital services in six CEE countries: Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine. Methods: The analysis is based on quantitative data collected in 2010 in nationally representative surveys. Two indicators of inability to pay were considered: the need to borrow money or sell assets and foregoing service utilization. Statistical analyses were applied to investigate associations between the indicators of inability to pay and individual characteristics. Results: Patient payments are most common in Bulgaria, Ukraine, Romania and Lithuania and often include informal payments. Romanian and, particularly, Ukrainian patients most often face difficulties to pay for health services (with approximately 40% of Ukrainian payers borrowing money or selling assets to cover hospital payments and approximately 60% of respondents who need care foregoing services). Inability to pay mainly affects those with poor health and low incomes. Conclusion: Widespread patient payments constitute a major financial barrier to health service use in CEE. There is a need to formalize them where they are informal and to take measures to protect vulnerable population groups, especially those with limited possibilities to deal with payment difficulties. PMID:24065370

  9. Interactive distance education service (IDES) using the Centralized Access Node System (CANS)

    NASA Astrophysics Data System (ADS)

    Moon, Phil J.; Choi, Mun K.; Jun, Mun S.; Lee, Chul H.

    1995-02-01

    The successes of B-ISDN project depend on attractive application services. Thus, it is very important to analyze application services which users desire, and to study the customer access network for applications. Especially, because the cost of the constructions for the customer access network need high, it is very important to configure this network economically and effectively. We recognize the importance how to provide B-ISDN application services and to configure the customer access network. This paper describes the Interactive Distance Education Service (IDES) requirements in the user and network aspects. The requirements include the service definition, reference configuration, procedure and Quality Of Service. And also this paper proposes the configuration of customer access network for providing IDES using the Centralized Access Node system which is a kind of the B-NT system. There are many applications area in IDES, we describe the three scenarios--for rural area, between the major and minor campus and for joint education including the university, research institute and enterprise.

  10. Who Benefits from Ecosystem Services? A Case Study for Central Kalimantan, Indonesia.

    PubMed

    Suwarno, Aritta; Hein, Lars; Sumarga, Elham

    2016-02-01

    There is increasing experience with the valuation of ecosystem services. However, to date, less attention has been devoted to who is actually benefiting from ecosystem services. This nevertheless is a key issue, in particular, if ecosystem services analysis and valuation is used to support environmental management. This study assesses and analyzes how the monetary benefits of seven ecosystem services are generated in Central Kalimantan Province, Indonesia, are distributed to different types of beneficiaries. We analyze the following ecosystem services: (1) timber production; (2) rattan collection; (3) jelutong resin collection; (4) rubber production (based on permanent agroforestry systems); (5) oil palm production on three management scales (company, plasma farmer, and independent smallholder); (6) paddy production; and (7) carbon sequestration. Our study shows that the benefits generated from these services differ markedly between the stakeholders, which we grouped into private, public, and household entities. The distribution of these benefits is strongly influenced by government policies and in particular benefit sharing mechanisms. Hence, land-use change and policies influencing land-use change can be expected to have different impacts on different stakeholders. Our study also shows that the benefits generated by oil palm conversion, a main driver for land-use change in the province, are almost exclusively accrued by companies and at this point in time are shared unequally with local stakeholders.

  11. Who Benefits from Ecosystem Services? A Case Study for Central Kalimantan, Indonesia

    NASA Astrophysics Data System (ADS)

    Suwarno, Aritta; Hein, Lars; Sumarga, Elham

    2016-02-01

    There is increasing experience with the valuation of ecosystem services. However, to date, less attention has been devoted to who is actually benefiting from ecosystem services. This nevertheless is a key issue, in particular, if ecosystem services analysis and valuation is used to support environmental management. This study assesses and analyzes how the monetary benefits of seven ecosystem services are generated in Central Kalimantan Province, Indonesia, are distributed to different types of beneficiaries. We analyze the following ecosystem services: (1) timber production; (2) rattan collection; (3) jelutong resin collection; (4) rubber production (based on permanent agroforestry systems); (5) oil palm production on three management scales (company, plasma farmer, and independent smallholder); (6) paddy production; and (7) carbon sequestration. Our study shows that the benefits generated from these services differ markedly between the stakeholders, which we grouped into private, public, and household entities. The distribution of these benefits is strongly influenced by government policies and in particular benefit sharing mechanisms. Hence, land-use change and policies influencing land-use change can be expected to have different impacts on different stakeholders. Our study also shows that the benefits generated by oil palm conversion, a main driver for land-use change in the province, are almost exclusively accrued by companies and at this point in time are shared unequally with local stakeholders.

  12. Ecosystem services from a degraded peatland of Central Kalimantan: implications for policy, planning, and management.

    PubMed

    Law, Elizabeth A; Bryan, Bretr A; Meijaard, Erik; Mallawaarachchi, Thilak; Struebig, Matthew; Wilson, Kerrie A

    2015-01-01

    Increasingly, landscapes are managed for multiple objectives to balance social, economic, and environmental goals. The Ex-Mega Rice Project (EMRP) peatland in Central Kalimantan, Indonesia provides a timely example with globally significant development, carbon, and biodiversity concerns. To inform future policy, planning, and management in the EMRP, we quantified and mapped ecosystem service values, assessed their spatial interactions, and evaluated the potential provision of ecosystem services under future land-use scenarios. We focus on key policy-relevant regulating (carbon stocks and the potential for emissions reduction), provisioning (timber, crops from smallholder agriculture, palm oil), and supporting (biodiversity) services. We found that implementation of existing land-use plans has the potential to improve total ecosystem service provision. We identify a number of significant inefficiencies, trade-offs, and unintended outcomes that may arise. For example, the potential development of existing palm oil concessions over one-third of the region may shift smallholder agriculture into low-productivity regions and substantially impact carbon and biodiversity outcomes. While improved management of conservation zones may enhance the protection of carbon stocks, not all biodiversity features will be represented, and there will be a reduction in timber harvesting and agricultural production. This study highlights how ecosystem service analyses can be structured to better inform policy, planning, and management in globally significant but data-poor regions. PMID:26255358

  13. Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal

    PubMed Central

    Pandey, Srijana; Karki, Supendra

    2014-01-01

    Background/Objective: The importance of maternal health services in lessening maternal mortality and morbidity as well as neonatal deaths has received substantial recognition in the past decade. The lack of antenatal care has been identified as a risk factor for maternal mortality and other adverse pregnancy outcomes. The purpose of this study was to determine the factors affecting attendance of antenatal care services in Nepal. Methods: This is a cross-sectional descriptive study carried out in Central Nepal. Using semi-structured questionnaire, interviews were conducted with married women aged between 15-49 years, who had delivered their babies within one year. Systematic random sampling method was used to select the sample. Results were obtained by frequency distribution and cross-tabulation of the variables. Results: More than half of the women were not aware of the consequences of lack of antenatal care. Age, education, income, type of family were strongly associated with the attendance at antenatal care service. Conclusions and Public Health Implications: In Nepal and in other developing countries, maternal mortality and morbidity continue to pose challenges to the health care delivery system. Variety of factors including socio-demographic, socio-economic, cultural and service availability as well as accessibility influences the use of maternal health services.

  14. Ecosystem services from a degraded peatland of Central Kalimantan: implications for policy, planning, and management.

    PubMed

    Law, Elizabeth A; Bryan, Bretr A; Meijaard, Erik; Mallawaarachchi, Thilak; Struebig, Matthew; Wilson, Kerrie A

    2015-01-01

    Increasingly, landscapes are managed for multiple objectives to balance social, economic, and environmental goals. The Ex-Mega Rice Project (EMRP) peatland in Central Kalimantan, Indonesia provides a timely example with globally significant development, carbon, and biodiversity concerns. To inform future policy, planning, and management in the EMRP, we quantified and mapped ecosystem service values, assessed their spatial interactions, and evaluated the potential provision of ecosystem services under future land-use scenarios. We focus on key policy-relevant regulating (carbon stocks and the potential for emissions reduction), provisioning (timber, crops from smallholder agriculture, palm oil), and supporting (biodiversity) services. We found that implementation of existing land-use plans has the potential to improve total ecosystem service provision. We identify a number of significant inefficiencies, trade-offs, and unintended outcomes that may arise. For example, the potential development of existing palm oil concessions over one-third of the region may shift smallholder agriculture into low-productivity regions and substantially impact carbon and biodiversity outcomes. While improved management of conservation zones may enhance the protection of carbon stocks, not all biodiversity features will be represented, and there will be a reduction in timber harvesting and agricultural production. This study highlights how ecosystem service analyses can be structured to better inform policy, planning, and management in globally significant but data-poor regions.

  15. Characteristics of Students Receiving Special Education Services in a Central Minnesota School District According to Setting, Classification, and Level of Service.

    ERIC Educational Resources Information Center

    Ittenbach, Richard F.; And Others

    The records of 1,231 preschool, elementary, and secondary students receiving special education services in a central Minnesota school district were evaluated to provide information on differences according to setting, classification, and level of service. Data were analyzed within the context of four broad domains: demographics (age, race, gender,…

  16. La prise en charge de la douleur chez l'enfant cancéreux

    PubMed Central

    Moukhlissi, Mohamed; Aitidir, Malika; Bouamama, Imane; Maani, Khadija; Hachim, Jamila

    2015-01-01

    C'est une étude prospective étalée sur une année (Juin 2007 à Mai 2008) portant sur une série de 140 malades (84 garçons et 56 filles), hospitalisés à l'unité d'hémato-oncologie du service de pédiatrie III à l'hôpital d'enfant de Casablanca. L'objectif de l’étude est de reconnaître la douleur chez l'enfant, l’évaluer en fonction des échelles internationales, et d’ assurer sa prise en charge globale en rapportant l'expérience du service. L’évaluation de la douleur a concerné différentes pathologies cancéreuses: quatre vingt enfants avaient des leucémies aigues lymphoblastiques (57%), 24 enfants présentaient des lymphomes (17%), 10 enfants avaient des neuroblastomes (7%) et 10 autres des néphroblastomes (7%). Parmi les 140 malades évalués, 100 présentaient des douleurs et qui ont fait l'objet de notre étude, donc on peut estimer la prévalence de la douleur ressentie au cours de l'hospitalisation à 71,4%. Plusieurs types d’échelles en fonction de l’âge de l'enfant, et de sa capacité à exprimer par lui-même, ou non, sa douleur, ont été mises à la disposition pour une mesure chiffrée et reproductible mais aussi une base à l'adaptation du traitement antalgique et pour assurer un suivi évolutif sous traitement. Le Traitement anticancéreux reçu par les malades à but curatif: dix malades soit 7,2% ont bénéficié d'une chirurgie curative et une chimiothérapie, cent vingt cinq enfants (89,2%) ont reçu une chimiothérapie seule et cinq malades (3,6%) ont bénéficié d'une association chirurgie, chimiothérapie et radiothérapie. La douleur ressentie avait en lien direct avec la maladie cancéreuse chez 30% des cas (30 enfants), secondaire au traitement anticancéreux chez 30% (30 enfants), et elle était surtout induite par des actes invasifs à visée diagnostique ou thérapeutique chez 40% des cas (40 enfants). Le traitement antalgique a été instauré en fonction de l’évaluation clinique: 67% des patients

  17. Willingness and ability to pay for physician services in six Central and Eastern European countries.

    PubMed

    Danyliv, Andriy; Groot, Wim; Gryga, Irena; Pavlova, Milena

    2014-07-01

    Patient charges for physician services are implemented in high-income countries and often are considered in the Central and Eastern Europe (CEE). However, there is no evidence on the potential consumption effects of service charges in these countries. This study provides evidence on the potential impact of patient charges on the consumption of specialized physician services in six CEE countries: Bulgaria, Hungary, Lithuania, Poland, Romania, and Ukraine. We apply a semi-parametric survival analysis to stated willingness and ability to pay (WATP) in order to identify potential demand pools and their price, income and age semi-elasticity. Data are collected through a survey held in 2010 among representative samples of about 1000 respondents in each country. Our results suggest that median WATP in the studied countries is comparable to the cost of the services. The obtained demand pools appear to be theoretically valid and externally consistent. They provide information on the shares of population that would be WATP certain fee levels, and their heterogeneity across socio-demographic groups gives an idea about the population groups that will need to be exempted. PMID:24630780

  18. Prise de decision a partir de donnees sequentielles

    NASA Astrophysics Data System (ADS)

    Gingras, Francois

    Cette thèse propose des méthodes statistiques et des algorithmes pour la prise de décision à partir d'observations séquentielles. Nous proposons d'utiliser les erreurs de généralisation des modèles construits pour effectuer diverses tâches afin d'obtenir des estimés non biaisés de statistiques qui intéressent les utilisateurs de modèles pour résoudre des problèmes pratiques. Nous présentons un algorithme qui permet, en utilisant les concepts de la théorie de l'apprentissage, de gérer les données manquantes. Cette situation peut survenir soit dans des problèmes statiques, où l'ordre des données n'est pas important, soit dans des situations où l'ordre des données importe. Nous montrons que cet algorithme peut permettre d'accroître la qualité des décisions concernant des problèmes où les données sont connues à différentes fréquences. Les valeurs manquantes ne sont pas nécessairement comblées par le meilleur estimé de la vraie valeur, mais plutôt par la valeur qui maximise le critère que l'utilisateur a choisi. Nous proposons aussi un algorithme de type EM (Expectation-Maximization) s'appliquant à une mixture de mixtures de gaussiennes où certains paramètres sont partagés entre plusieurs gaussiennes. Le partage de paramètres est introduit ici en tenant compte des connaissances a priori que nous avons sur les données et afin de réduire l'espace des solutions possibles. Nous appliquons l'algorithme à un problème de reconnaissance et de classification d'états d'un réacteur nucléaire. L'algorithme s'applique notamment dans le cas où les étiquettes des états à classifier n'est pas strictement identifiées. Nous étudions une statistique basée sur les erreurs de généralisation et nous construisons des tests d'hypothèses reposant sur cette statistique. Nous utilisons la statistique hors- échantillon pour comparer les conclusions des résultats fournis des méthodes traditionnelles (en utilisant tout l

  19. A centralized cardiovascular risk service to improve guideline adherence in private primary care offices

    PubMed Central

    Carter, Barry L.; Levy, Barcey T.; Gryzlak, Brian; Chrischilles, Elizabeth A.; Weg, Mark W. Vander; Christensen, Alan J.; James, Paul A.; Moss, Carol A.; Parker, Christopher P.; Gums, Tyler; Finkelstein, Rachel J; Xu, Yinghui; Dawson, Jeffrey D.; Polgreen, Linnea A.

    2015-01-01

    Background Many large health systems now employ clinical pharmacists in team-based care to assist patients and physicians with management of cardiovascular (CV) diseases. However, small private offices often lack the resources to hire a clinical pharmacist for their office. The purpose of this study is to evaluate whether a centralized, web-based CV risk service (CVRS) managed by clinical pharmacists will improve guideline adherence in primary care medical offices in rural and small communities. Methods This study is a cluster randomized prospective trial in 12 primary care offices. Medical offices were randomized to either the CVRS intervention or usual care. The intervention will last for 12 months and all subjects will have research visits at baseline and 12 months. Primary outcomes will include adherence to treatment guidelines and control of key CV risk factors. Data will also be abstracted from the medical record at 30 months to determine if the intervention effect is sustained after it is discontinued. Conclusions This study will enroll subjects through 2015 and results will be available in 2018. This study will provide information on whether a distant, centralized CV risk service can improve guideline adherence in medical offices that lack the resources to employ clinical pharmacists. PMID:25952471

  20. 18 CFR 366.23 - FERC Form No. 60, Annual reports of centralized service companies, and FERC-61, Narrative...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... company system, including a special-purpose company (e.g., a fuel supply company or a construction company..., Annual reports of centralized service companies, and FERC-61, Narrative description of service company... COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005,...

  1. A Climate Information Portal for Copernicus: a central portal for European climate services?

    NASA Astrophysics Data System (ADS)

    Juckes, Martin; Swart, Rob; Thysse, Peter; Som de Cerff, Wim; Groot, Annemarie; Bennett, Victoria; Costa, Luis; Lückenkötter, Johannes; Callaghan, Sarah

    2015-04-01

    The FP7 project "Climate Information Portal for Copernicus" (CLIPC) is developing a demonstration portal for the Copernicus Climate Change Service (C3S). This project is one of a suite of FP7 research activities which are administratively independent of Copernicus, focussed on creating the technical and scientific building blocks needed for the service. It is to be expected that at EGU 2015 there will be many presentations describing portals delivering new and innovative ranges of services. It would be unwise to seek to replace all this creative activity with a single portal -- instead CLIPC is designing a portal to make distributed resources more accessible through flexible discovery systems. CLIPC needs to deliver more than a directory of resources: resources need to be presented in common protocols so that users can access multiple datasets. More information about the project objectives is available at www.clipc.eu. The gulf between the climate science communities and the end user communities is a central challenge being addressed in the project. It is important to understand that there is significant diversity and multiple communication barriers within these two sets of communities as well as between them. The CLIPC services must presentation will provide a review of progress towards this ambitious goal, through a discussion of user requirements activities, an overview of the proposed architecture, work on assessing and adjusting model biasses, and a discussion of the climate impact indicators which will be provided through the portal. When looking at the usability of data for the various users, CLIPC will implement a set of services functioning as a "knowledge base" supplying information to users about the data, including definitions of terminology used, quality of datasets, versioning, and user annotations.

  2. Socioeconomic marginality and health services utilization among Central Harlem substance users.

    PubMed

    Van Ness, Peter H; Davis, W Rees; Johnson, Bruce D

    2004-01-01

    The article examines whether decrements in socioeconomic measures in a poor, substance using population predict changes in health services utilization. The sample consisted of 658 "hard drug" (crack, powder cocaine, and heroin) users drawn from Central Harlem in New York City during 1998 and 1999. Chain referral and social networking were used in order to gain access to hidden users. The sample was stratified according to operational measures indicating socioeconomic marginality, one calculated using indices of income, education, and employment and another designed to measure lived homelessness. Rates of self-reported utilization of 10 health services were compared across strata. In this sample socioeconomic marginality reflected by low levels of income, education, and employment sometimes predicts greater rates of health services utilization and, in other cases, it predicts lower rates. When the sample is stratified according to an operational measure of homelessness, the gradient of greater utilization and self-reported morbidity for the homeless is more marked and consistent. Results are supportive of a public health model of drug user treatment that recommends that it occur as part of an integrated strategy addressing poverty, homelessness, violence, and related social problems.

  3. Exploring the potential offered by legacy soil databases for ecosystem services mapping of Central African soils

    NASA Astrophysics Data System (ADS)

    Verdoodt, Ann; Baert, Geert; Van Ranst, Eric

    2014-05-01

    Central African soil resources are characterised by a large variability, ranging from stony, shallow or sandy soils with poor life-sustaining capabilities to highly weathered soils that recycle and support large amounts of biomass. Socio-economic drivers within this largely rural region foster inappropriate land use and management, threaten soil quality and finally culminate into a declining soil productivity and increasing food insecurity. For the development of sustainable land use strategies targeting development planning and natural hazard mitigation, decision makers often rely on legacy soil maps and soil profile databases. Recent development cooperation financed projects led to the design of soil information systems for Rwanda, D.R. Congo, and (ongoing) Burundi. A major challenge is to exploit these existing soil databases and convert them into soil inference systems through an optimal combination of digital soil mapping techniques, land evaluation tools, and biogeochemical models. This presentation aims at (1) highlighting some key characteristics of typical Central African soils, (2) assessing the positional, geographic and semantic quality of the soil information systems, and (3) revealing its potential impacts on the use of these datasets for thematic mapping of soil ecosystem services (e.g. organic carbon storage, pH buffering capacity). Soil map quality is assessed considering positional and semantic quality, as well as geographic completeness. Descriptive statistics, decision tree classification and linear regression techniques are used to mine the soil profile databases. Geo-matching as well as class-matching approaches are considered when developing thematic maps. Variability in inherent as well as dynamic soil properties within the soil taxonomic units is highlighted. It is hypothesized that within-unit variation in soil properties highly affects the use and interpretation of thematic maps for ecosystem services mapping. Results will mainly be based

  4. Principal factors of soil spatial heterogeneity and ecosystem services at the Central Chernozemic Region of Russia

    NASA Astrophysics Data System (ADS)

    Vasenev, Ivan; Valentini, Riccardo

    2013-04-01

    The essential spatial heterogeneity is mutual feature for most natural and man-changed soils at the Central Chernozemic Region of Russia which is not only one of the biggest «food baskets» in RF but very important regulator of ecosystem principal services at the European territory of Russia. The original spatial heterogeneity of dominated here forest-steppe and steppe Chernozems and the other soils has been further complicated by a specific land-use history and different-direction soil successions due to environmental changes and more than 1000-year history of human impacts. The carried out long-term researches of representative natural, rural and urban landscapes in Kursk, Orel, Tambov and Voronezh oblasts give us the regional multi-factorial matrix of elementary soil cover patterns (ESCP) with different land-use practices and history, soil-geomorphologic features, environmental and microclimate conditions. The validation and ranging of the limiting factors of ESCP regulation and development, ecosystem principal services, land functional qualities and agroecological state have been done for dominating and most dynamical components of ESCP regional-typological forms - with application of regional and local GIS, soil spatial patterns mapping, traditional regression kriging, correlation tree models. The outcomes of statistical modeling show the essential amplification of erosion, dehumification and CO2 emission, acidification and alkalization, disaggregation and overcompaction processes due to violation of agroecologically sound land-use systems and traditional balances of organic matter, nutrients, Ca and Na in agrolandscapes. Due to long-term intensive and out-of-balance land-use practices the famous Russian Chernozems begin to lose not only their unique natural features of (around 1 m of humus horizon, 4-6% of Corg and favorable agrophysical features), but traditional soil cover patterns, ecosystem services and agroecological functions. Key-site monitoring

  5. La prise en charge d’une clientèle

    PubMed Central

    Roy, Andréanne; Breton, Mylaine; Loslier, Julie

    2016-01-01

    Résumé Objectif Analyser les facteurs qui incitent les médecins de famille nouvellement autorisés à faire de la prise en charge d’une clientèle en première ligne. Type d’étude Devis mixte séquentiel : questionnaire en ligne auto-administré auprès de médecins de famille, suivi d’entrevues individuelles. Contexte La Montérégie, qui est la deuxième région la plus populeuse du Québec, et qui présente des zones rurales et urbaines. Participants Tous les médecins de famille détenant un poste en Montérégie et ayant moins de 10 années d’expérience ont été sollicités, soit 366 médecins. Parmi eux, 118 ont complété le questionnaire en ligne (taux de réponse de 32,2 %). Parmi les répondants, 10 médecins ayant des profils de prise en charge variés ont été sélectionnés pour les entrevues individuelles. Principaux paramètres à l’étude Le pourcentage de temps de travail consacré à la prise en charge, analysé en parallèle avec différents facteurs facilitants et barrières à la prise en charge aux niveaux contextuel, organisationnel, du médecin de famille et de la clientèle. Résultats Les principaux facteurs facilitant la prise en charge sont la relation médecin-patient, l’intérêt pour les activités cliniques liées à la prise en charge, les modèles de rôles positifs, la collaboration avec une infirmière et l’accès adéquat aux ressources, notamment en santé mentale. Les principales barrières sont l’ampleur des tâches administratives, l’intérêt pour une pratique polyvalente, l’expérience négative de la prise en charge lors de la formation, un sentiment n’inaptitude à l’égard de la prise en charge, la lourdeur de la clientèle et le manque de soutien en début de pratique. Conclusion Certaines pistes de solution pour inciter les nouveaux médecins de famille à prendre en charge une clientèle sont proposées. Des points d’amélioration au niveau de la formation médicale, du soutien

  6. Performance Enhancing Diets and the PRISE Protocol to Optimize Athletic Performance

    PubMed Central

    Arciero, Paul J.; Ward, Emery

    2015-01-01

    The training regimens of modern-day athletes have evolved from the sole emphasis on a single fitness component (e.g., endurance athlete or resistance/strength athlete) to an integrative, multimode approach encompassing all four of the major fitness components: resistance (R), interval sprints (I), stretching (S), and endurance (E) training. Athletes rarely, if ever, focus their training on only one mode of exercise but instead routinely engage in a multimode training program. In addition, timed-daily protein (P) intake has become a hallmark for all athletes. Recent studies, including from our laboratory, have validated the effectiveness of this multimode paradigm (RISE) and protein-feeding regimen, which we have collectively termed PRISE. Unfortunately, sports nutrition recommendations and guidelines have lagged behind the PRISE integrative nutrition and training model and therefore limit an athletes' ability to succeed. Thus, it is the purpose of this review to provide a clearly defined roadmap linking specific performance enhancing diets (PEDs) with each PRISE component to facilitate optimal nourishment and ultimately optimal athletic performance. PMID:25949823

  7. 17 CFR 256.01-4 - Construction or service contracts, and centralized procurement accounting.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... services performed by the service company in connection with the procurement of goods for associate... COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 General Instructions... or service contracts, under which the service company undertakes projects to construct...

  8. Reforming sanitary-epidemiological service in Central and Eastern Europe and the former Soviet Union: an exploratory study

    PubMed Central

    2010-01-01

    Background Public health services in the Soviet Union and its satellite states in Central and Eastern Europe were delivered through centrally planned and managed networks of sanitary-epidemiological (san-epid) facilities. Many countries sought to reform this service following the political transition in the 1990s. In this paper we describe the major themes within these reforms. Methods A review of literature was conducted. A conceptual framework was developed to guide the review, which focused on the two traditional core public health functions of the san-epid system: communicable disease surveillance, prevention and control and environmental health. The review included twenty-two former communist countries in the former Soviet Union (fSU) and in Central and Eastern Europe (CEE). Results The countries studied fall into two broad groups. Reforms were more extensive in the CEE countries than in the fSU. The CEE countries have moved away from the former centrally managed san-epid system, adopting a variety of models of decentralization. The reformed systems remain mainly funded centrally level, but in some countries there are contributions by local government. In almost all countries, epidemiological surveillance and environmental monitoring remained together under a single organizational umbrella but in a few responsibilities for environmental health have been divided among different ministries. Conclusions Progress in reform of public health services has varied considerably. There is considerable scope to learn from the differing experiences but also a need for rigorous evaluation of how public health functions are provided. PMID:20663198

  9. JAliEn - A new interface between the AliEn jobs and the central services

    NASA Astrophysics Data System (ADS)

    Grigoras, A. G.; Grigoras, C.; Pedreira, M. M.; Saiz, P.; Schreiner, S.

    2014-06-01

    Since the ALICE experiment began data taking in early 2010, the amount of end user jobs on the AliEn Grid has increased significantly. Presently 1/3 of the 40K CPU cores available to ALICE are occupied by jobs submitted by about 400 distinct users, individually or in organized analysis trains. The overall stability of the AliEn middleware has been excellent throughout the 3 years of running, but the massive amount of end-user analysis and its specific requirements and load has revealed few components which can be improved. One of them is the interface between users and central AliEn services (catalogue, job submission system) which we are currently re-implementing in Java. The interface provides persistent connection with enhanced data and job submission authenticity. In this paper we will describe the architecture of the new interface, the ROOT binding which enables the use of a single interface in addition to the standard UNIX-like access shell and the new security-related features.

  10. Assessing the value of the Central Everglades Planning Project (CEPP) in Everglades restoration: an ecosystem service approach

    USGS Publications Warehouse

    Richardson, Leslie A.; Keefe, Kelly; Huber, Christopher C.; Racevskis, Laila; Gregg, Reynolds; Thourot, Scott; Miller, Ian

    2014-01-01

    This study identifies a full range of ecosystem services that could be affected by a restoration project in the central Everglades and monetizes the economic value of a subset of these services using existing data. Findings suggest that the project will potentially increase many ecosystem services that have considerable economic value to society. The ecosystem services monetized within the scope of this study are a subset of the difference between the future-with the Central Everglades Planning Project (CEPP) and the future-without CEPP, and they totaled ~ $1.8 billion USD at a 2.5% discount rate. Findings suggest that the use of ecosystem services in project planning and communications may require acknowledgment of the difficulty of monetizing important services and the limitations associated with using only existing data and models. Results of this study highlight the need for additional valuation efforts in this region, focused on those services that are likely to be impacted by restoration activities but were notably challenging to value in this assessment due to shortages of data.

  11. Approche de prise en charge du trouble du spectre de l’autisme

    PubMed Central

    Lee, Patrick F.; Thomas, Roger E.; Lee, Patricia A.

    2015-01-01

    Résumé Objectif Se pencher sur les critères diagnostiques du trouble du spectre de l’autisme (TSA) comme les définit le Manuel diagnostique et statistique des troubles mentaux, cinquième édition (DSM-V), et concevoir une approche de prise en charge du TSA à l’aide du cadre CanMEDS–Médecine familiale (CanMEDS-MF). Sources d’information Le DSM-V, publié par l’American Psychiatric Association en mai 2013, énonce de nouveaux critères diagnostiques du TSA. Le cadre CanMEDS-MF du Collège des médecins de famille du Canada fournit un plan d’orientation pour la prise en charge complexe du TSA. Nous avons utilisé des données recueillies par le Centers for Disease Control and Prevention afin de déterminer la prévalence du TSA, ainsi que la revue systématique et méta-analyse détaillée effectuée par le National Institute for Health and Care Excellence du R.-U. pour ses lignes directrices sur le TSA dans le but d’évaluer les données probantes issues de plus de 100 interventions. Message principal Selon les données du Centers for Disease Control and Prevention, la prévalence du TSA se chiffrait à 1 sur 88 en 2008 aux États-Unis. La classification du TSA dans la quatrième édition du DSM incluait l’autisme, le syndrome d’Asperger, le trouble envahissant du développement et le trouble désintégratif de l’enfance. La dernière révision du DSM-V réunit tous ces troubles sous la mention TSA, avec différents niveaux de sévérité. La prise en charge du TSA est complexe; elle exige les efforts d’une équipe multidisciplinaire ainsi que des soins continus. Les rôles CanMEDS-MF fournissent un cadre de prise en charge. Conclusion Les médecins de famille sont au cœur de l’équipe de soins multidisciplinaire pour le TSA, et le cadre CanMEDS-MF tient lieu de plan détaillé pour guider la prise en charge d’un enfant atteint de TSA et aider la famille de cet enfant.

  12. Wait and consult times for primary healthcare services in central Mozambique: a time-motion study

    PubMed Central

    Wagenaar, Bradley H.; Gimbel, Sarah; Hoek, Roxanne; Pfeiffer, James; Michel, Cathy; Cuembelo, Fatima; Quembo, Titos; Afonso, Pires; Gloyd, Stephen; Lambdin, Barrot H.; Micek, Mark A.; Porthé, Victoria; Sherr, Kenneth

    2016-01-01

    Background We describe wait and consult times across public-sector clinics and identify health facility determinants of wait and consult times. Design We observed 8,102 patient arrivals and departures from clinical service areas across 12 public-sector clinics in Sofala and Manica Provinces between January and April 2011. Negative binomial generalized estimating equations were used to model associated health facility factors. Results Mean wait times (in minutes) were: 26.1 for reception; 43.5 for outpatient consults; 58.8 for antenatal visits; 16.2 for well-child visits; 8.0 for pharmacy; and 15.6 for laboratory. Mean consultation times (in minutes) were: 5.3 for outpatient consults; 9.4 for antenatal visits; and 2.3 for well-child visits. Over 70% (884/1,248) of patients arrived at the clinic to begin queuing for general reception prior to 10:30 am. Facilities with more institutional births had significantly longer wait times for general reception, antenatal visits, and well-child visits. Clinics in rural areas had especially shorter wait times for well-child visits. Outpatient consultations were significantly longer at the smallest health facilities, followed by rural hospitals, tertiary/quaternary facilities, compared with Type 1 rural health centers. Discussion The average outpatient consult in Central Mozambique lasts 5 min, following over 40 min of waiting, not including time to register at most clinics. Wait times for first antenatal visits are even longer at almost 1 h. Urgent investments in public-sector human resources for health alongside innovative operational research are needed to increase consult times, decrease wait times, and improve health system responsiveness. PMID:27580822

  13. 2 CFR Appendix V to Part 200 - State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 2 Grants and Agreements 1 2014-01-01 2014-01-01 false State/Local Government and Indian Tribe-Wide Central Service Cost Allocation Plans V Appendix V to Part 200 Grants and Agreements Office of Management..., App. V Appendix V to Part 200—State/Local Government and Indian Tribe-Wide Central Service...

  14. [The Public Health Services Port-folio in the National Health System: the contribution of the Central Government of Spain].

    PubMed

    Villalbí, Joan R; Carreras, Fernando; Martín-Moreno, José M; Hernández-Aguado, Ildefonso

    2010-01-01

    This paper concentrates on the port folio of public health services in the National Health System, with an inventory of those provided by the central level of government in the currently decentralized context of Spain. There is an important activity in public health, with some dispersion among different bodies and organisations. Most of the current activities of the central level of government concentrate in monitoring health levels and their determinants, managing information systems and health alerts and warnings, but with an involvement in policy development, both as a counterpart of the European Union and as an active agent with both regional levels of government and other organisations influencing public health. Besides, this level of government assures some essential services with little visibility for the general population as they are mostly delivered to other public administrations or to professional groups.

  15. Mobile Phones, in Combination with a Computer Locator System, Improve the Response Times of Emergency Medical Services in Central London

    PubMed Central

    Gossage, JA; Frith, DP; Carrell, TWG; Damiani, M; Terris, J; Burnand, KG

    2008-01-01

    INTRODUCTION The aim of this study was to determine whether mobile phones and mobile phone locating devices are associated with improved ambulance response times in central London. PATIENTS AND METHODS All calls from the London Ambulance Service database since 1999 were analysed. In addition, 100 consecutive patients completed a questionnaire on mobile phone use whilst attending the St Thomas's Hospital Emergency Department in central London. RESULTS Mobile phone use for emergencies in central London has increased from 4007 (5% of total) calls in January 1999 to 21,585 (29%) in August 2004. Ambulance response times for mobile phone calls were reduced after the introduction of the mobile phone locating system (mean 469 s versus 444 s; P = 0.0195). The proportion of mobile phone calls made from mobile phones for life-threatening emergencies was higher after injury than for medical emergencies (41% versus 16%, P = 0.0063). Of patients transported to the accident and emergency department by ambulance, 44% contacted the ambulance service by mobile phone. Three-quarters of calls made from outside the home or work-place were by mobile phone and 72% of patients indicated that it would have taken longer to contact the emergency services if they had not used a mobile. CONCLUSIONS Since the introduction of the mobile phone locating system, there has been an improvement in ambulance response times. Mobile locating systems in urban areas across the UK may lead to faster response times and, potentially, improved patient outcomes. PMID:18325208

  16. Evaluating Religious Influences on the Utilization of Maternal Health Services among Muslim and Christian Women in North-Central Nigeria

    PubMed Central

    Al-Mujtaba, Maryam; Cornelius, Llewellyn J.; Galadanci, Hadiza; Erekaha, Salome; Okundaye, Joshua N.; Adeyemi, Olusegun A.; Sam-Agudu, Nadia A.

    2016-01-01

    Introduction. Uptake of antenatal services is low in Nigeria; however, indicators in the Christian-dominated South have been better than in the Muslim-dominated North. This study evaluated religious influences on utilization of general and HIV-related maternal health services among women in rural and periurban North-Central Nigeria. Materials and Methods. Targeted participants were HIV-positive, pregnant, or of reproductive age in the Federal Capital Territory and Nasarawa. Themes explored were utilization of facility-based services, provider gender preferences, and Mentor Mother acceptability. Thematic and content approaches were applied to manual data analysis. Results. Sixty-eight (68) women were recruited, 72% Christian and 28% Muslim. There were no significant religious influences identified among barriers to maternal service uptake. All participants stated preference for facility-based services. Uptake limitations were mainly distance from clinic and socioeconomic dependence on male partners rather than religious restrictions. Neither Muslim nor Christian women had provider gender preferences; competence and positive attitude were more important. All women found Mentor Mothers highly acceptable. Conclusion. Barriers to uptake of maternal health services appear to be minimally influenced by religion. ANC/PMTCT uptake interventions should target male partner buy-in and support, healthcare provider training to improve attitudes, and Mentor Mother program strengthening and impact assessment. PMID:27006944

  17. A Study of the Roles, Relationships, Services and Funding of the Library Agencies in the South Central Library System with Emphasis on Dane County. The Final Report of the Joint Library Services Planning Committee of the Library Boards of the Dane County Library Service, the Madison Public Library, and the South Central Library System.

    ERIC Educational Resources Information Center

    Wisconsin State Dept. of Public Instruction, Madison.

    Based on a study of roles, organizational relationships, services and funding of the Dane County Library Service, the Madison Public Library, and the South Central Library System, this report establishes recommendations for the three library agencies as developed by a joint planning committee. The background, composition, methodology, and…

  18. Soil and water related forest ecosystem services and resilience of social ecological system in the Central Highlands of Ethiopia

    NASA Astrophysics Data System (ADS)

    Tekalign, Meron; Muys, Bart; Nyssen, Jan; Poesen, Jean

    2014-05-01

    In the central highlands of Ethiopia, deforestation and forest degradation are occurring and accelerating during the last century. The high population pressure is the most repeatedly mentioned reason. However, in the past 30 years researchers agreed that the absence of institutions, which could define the access rights to particular forest resources, is another underlying cause of forest depletion and loss. Changing forest areas into different land use types is affecting the biodiversity, which is manifested through not proper functioning of ecosystem services. Menagesha Suba forest, the focus of this study has been explored from various perspectives. However the social dimension and its interaction with the ecology have been addressed rarely. This research uses a combined theoretical framework of Ecosystem Services and that of Resilience thinking for understanding the complex social-ecological interactions in the forest and its influence on ecosystem services. For understanding the history and extent of land use land cover changes, in-depth literature review and a GIS and remote sensing analysis will be made. The effect of forest conversion into plantation and agricultural lands on soil and above ground carbon sequestration, fuel wood and timber products delivery will be analyzed with the accounting of the services on five land use types. The four ecosystem services to be considered are Supporting, Provisioning, Regulating, and Cultural services as set by the Millennium Ecosystem Assessment. A resilience based participatory framework approach will be used to analyze how the social and ecological systems responded towards the drivers of change that occurred in the past. The framework also will be applied to predict future uncertainties. Finally this study will focus on the possible interventions that could contribute to the sustainable management and conservation of the forest. An ecosystem services trade-off analysis and an environmental valuation of the water

  19. Effects of Drought and Water Resource Management on Biophysical and Sociocultural Ecosystem Services in South-Central United States

    NASA Astrophysics Data System (ADS)

    Julian, J.; Castro, A.; Vaughn, C.; Atkinson, C.

    2014-12-01

    South-Central United States is one of the fastest growing regions in the nation; however, it is experiencing water supply limitations. In response, multiple interests have focused on the Kiamichi River watershed in southeast Oklahoma as a future inter-basin water supply. The Kiamichi River provides many ecosystem services, including freshwater provision to 19 cities/towns, outdoor recreation hub for the South-Central U.S., cultural capital of the Choctaw Indian Nation, and a national biodiversity hotspot. With multiple recent stressors, these ecosystem services are highly threatened. Here we present how drought and water management have impacted these benefits over the past 20 years. First, we assessed the river's sensitivity to drought (which is cyclical) and water regulation (which has increased over the past three decades). Second, we analyzed how these hydrologic changes have impacted freshwater habitat, focusing on mussels because of their sensitivity to flow alterations and because they provide additional ecosystem services such as biofiltration, nutrient recycling/storage, and cultural resources. Third, we performed a sociocultural valuation for a suite of ecosystem services provided by the Kiamichi River watershed, including 505 interviews of five different ecosystem services beneficiary (ESB) groups. We obtained ESB perceptions on how ecosystem services changed with different flow conditions and water management strategies. Analyses revealed that increased regulation (fewer dam releases) has caused the Kiamichi River to have long no flow periods during droughts (e.g. 176 days with no flow in 2006). These long dry periods have been the main culprit for a 60% decline in mussel biomass over the past 20 years, and subsequent large losses in biofiltration and nutrient recycling. Interestingly, ESBs perceived similar losses of ecosystem services. Without being provided any information on flow, more than half of the ESBs believed that water supply, freshwater

  20. Utilization rates and perceptions of (VCT) services in Kisii Central District, Kenya.

    PubMed

    Epule, Epule Terence; Mirielle, Moto Wase; Peng, Changhui; Nguh, Balgah Sounders; Nyagero, Josephat M; Lakati, Alice; Mafany, Ndiva Mongoh

    2012-11-01

    Voluntary counseling and testing (VCT) services have been set up in most Districts in Kenya due to the rising surge of HIV/AIDS. However, the use of these services among married persons has not been fully explored. In Kissi, the issue of VCT is pressing as the rate of HIV prevalence is close to 3%. In 2006, about 20 000 clients came for VCT services in Kenya yet only 165 of these were married persons. In the Keumbu sub-district hospital, of the more than 1000 clients that came for VCT services, approximately 29% were married persons. This paper therefore aims at determining the utilization of VCT services by married persons in the study area. The qualitative data was obtained principally through two focus group discussions (FGDs) in which the respondents were asked to comment on their use of VCT services while the quantitative data was obtained from interviews with 245 respondents. The qualitative data was analyzed through verbatim transcription while for the quantitative data; the responses were coded and populated into SPSS from which the frequencies and percentages were calculated. The results show that actual use of the VCT services is low (28.1%) but slightly higher among female respondents than males. The low usage may be attributed to (a) fear of results, (b) death anxiety, (c) lack of confidentiality and lastly, (d) fear of stigmatization. Female respondents were found to have a greater awareness of VCT and thus its potential use.

  1. Institutional Innovation and Public Extension Services Provision: The Marche Regional Administration Reform in Central Italy

    ERIC Educational Resources Information Center

    Pascucci, Stefano; De Magistris, Tiziana

    2011-01-01

    This paper describes how Marche Regional Administration (MRA) introduced an innovative institutional reform of an Agricultural Knowledge and Information System (AKIS) in central Italy. In order to study the main features of the MRA reform we used a methodological approach based on three steps: (i) first we applied a desk analysis to sketch the…

  2. "Feed from the Service": Corruption and Coercion in the State--University Relations in Central Eurasia

    ERIC Educational Resources Information Center

    Osipian, Ararat L.

    2007-01-01

    Education in Central Eurasia has become one of the industries, most affected by corruption. Corruption in academia, including bribery, extortions, embezzlement, nepotism, fraud, cheating, and plagiarism, is reflected in the region's media and addressed in few scholarly works. This paper considers corruption in higher education as a product of…

  3. Assessing the efficacy of LGBT cultural competency training for aging services providers in California's central valley.

    PubMed

    Leyva, Valerie L; Breshears, Elizabeth M; Ringstad, Robin

    2014-01-01

    This study reviews the outcomes of a cultural competency training for aging services providers regarding lesbian, gay, bisexual, and transgender (LGBT) older adults. Results indicate that participants significantly increased their knowledge, skills, and positive attitudes about working with LGBT older adults, with men and non-LGBT individuals reporting the most gain. Recommendations for future research include determining which factors influence the enduring effects of this type of training and developing a standardized instrument for measuring such success. Legislative and policy changes targeted at requiring this type of cultural competency training for all direct service providers are considered.

  4. Facilitating complementary inputs and scoping economies in the joint supply of health and environmental services in Aboriginal central Australia.

    PubMed

    Campbell, David; Davies, Jocelyn; Wakerman, John

    2008-01-01

    Two concerns of national relevance in central Australia are the continuing decline in Aboriginal health status relative to the rest of the Australian population, and the loss of environmental services. We draw on literature from a number of disciplines to show that not only are these two concerns interrelated but that dealing with them is inextricably connected through consideration of the psychosocial determinants of health. Involvement by Aboriginal people in land management can promote the joint supply of environmental and health services. We show that Aboriginal control of land management can result in economies through the joint supply of environmental and health services. However, because Aboriginal people derive little benefit from the provision of public goods generated through land management, they have little incentive to provide a socially optimal supply of these goods. The policy issue for government is the selection of the appropriate policy tools to facilitate the involvement of Aboriginal people in land management and the optimal supply of health and environmental services. The cost-effectiveness plane is used to provide a simple framework to guide the selection of an appropriate policy tool.

  5. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... activities. In addition, for pension and post-retirement health insurance plans, the following information... funds c. Self-insurance funds d. Fringe benefits 4. Required certification F. Negotiation and Approval... Health and Human Services entitled “A Guide for State and Local Government Agencies: Cost Principles...

  6. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... activities. In addition, for pension and post-retirement health insurance plans, the following information... funds c. Self-insurance funds d. Fringe benefits 4. Required certification F. Negotiation and Approval... Health and Human Services entitled “A Guide for State and Local Government Agencies: Cost Principles...

  7. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... activities. In addition, for pension and post-retirement health insurance plans, the following information... funds c. Self-insurance funds d. Fringe benefits 4. Required certification F. Negotiation and Approval... Health and Human Services entitled “A Guide for State and Local Government Agencies: Cost Principles...

  8. 50 CFR 80.53 - Are costs of State central services eligible for funding?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... eligible for funding? 80.53 Section 80.53 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR (CONTINUED) FINANCIAL ASSISTANCE-WILDLIFE SPORT FISH RESTORATION PROGRAM ADMINISTRATIVE REQUIREMENTS, PITTMAN-ROBERTSON WILDLIFE RESTORATION AND DINGELL-JOHNSON SPORT FISH...

  9. 29 CFR 779.118 - Employees providing central services for multi-unit organizations.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., employees who regularly and recurrently correspond and maintain records of activities of out-of-State stores..., DEPARTMENT OF LABOR STATEMENTS OF GENERAL POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS THE FAIR LABOR STANDARDS ACT AS APPLIED TO RETAILERS OF GOODS OR SERVICES Employment to Which the Act...

  10. 29 CFR 779.118 - Employees providing central services for multi-unit organizations.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., employees who regularly and recurrently correspond and maintain records of activities of out-of-State stores..., DEPARTMENT OF LABOR STATEMENTS OF GENERAL POLICY OR INTERPRETATION NOT DIRECTLY RELATED TO REGULATIONS THE FAIR LABOR STANDARDS ACT AS APPLIED TO RETAILERS OF GOODS OR SERVICES Employment to Which the Act...

  11. Recidivism at the Kumasi Central Prison: A Look into Guidance and Counselling Services

    ERIC Educational Resources Information Center

    Afari, Sarah Aba; Osei, Mavis; Adu-Agyem, Joe

    2015-01-01

    Recidivism is on the increase as ex-convicts who are expected by the society to be reformed in prison and reintegrated to lead meaningful lives, only return to crime shortly after their release and find themselves back into prison in spite of the harsh punishment and counselling services received while incarcerated. The study aimed to identify the…

  12. Marketing Informal Education Institutions in Israel: The Centrality of Customers' Active Involvement in Service Development

    ERIC Educational Resources Information Center

    Oplatka, Izhar

    2004-01-01

    The current paper outlines a unique marketing perspective that prevails in some informal education institutions in Israel parallel with "traditional modes of marketing", such as promotion, public relations and the like. Based on a case study research in five community centres, a service development based on active participation of the potential…

  13. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... cost allocations or billings for are allowable in accordance with the requirements of 2 CFR Part 225... cycle to the next. Charges by an internal service activity to provide for the establishment and... allowable. A working capital reserve as part of retained earnings of up to 60 days cash expenses for...

  14. Prise en charge de l’infection gonococcique chez les adultes et les jeunes

    PubMed Central

    Pogany, Lisa; Romanowski, Barbara; Robinson, Joan; Gale-Rowe, Margaret; Latham-Carmanico, Cathy; Weir, Christine; Wong, Tom

    2015-01-01

    Résumé Objectif Présenter des recommandations sur la prise en charge de l’infection gonococcique chez les adultes et les jeunes. Qualité des données Les recommandations thérapeutiques des lignes directrices canadiennes sur les infections transmissibles sexuellement reposent sur une recherche documentaire de même que sur des catégories de recommandations et des niveaux de qualité de données déterminés par au moins 2 évaluateurs. Les recommandations ont été revues par des pairs et sont en instance d’approbation par le groupe de travail d’experts. Message principal Les nouvelles recommandations portant sur la prise en charge de l’infection gonococcique chez les adultes et les jeunes préconisent les cultures à titre d’outil diagnostique lorsqu’elles sont pratiques, le traitement par antibiothérapie combinée (ceftriaxone associée à l’azithromycine) et le signalement sans délai de tous les cas dont le traitement a échoué aux autorités de santé publique. Conclusion Si elles sont suivies, ces nouvelles recommandations pourraient réduire l’échec thérapeutique, contribuer à une surveillance plus étroite des tendances à la résistance de Neisseria gonorrhoeae aux antibiotiques et contribuer à prévenir la transmission de gonorrhée résistante à plusieurs médicaments.

  15. A Cluster-randomized Trial of a Centralized Clinical Pharmacy Cardiovascular Risk Service to Improve Guideline Adherence

    PubMed Central

    Carter, Barry L.; Coffey, Christopher S.; Chrischilles, Elizabeth A.; Ardery, Gail; Ecklund, Dixie; Gryzlak, Brian; Vander Weg, Mark W.; James, Paul A.; Christensen, Alan J.; Parker, Christopher P.; Gums, Tyler; Finkelstein, Rachel J; Uribe, Liz; Polgreen, Linnea A.

    2015-01-01

    Background Numerous studies have demonstrated the value of including pharmacists in team-based care to improve adherence to cardiovascular (CV) guidelines, medication adherence and risk factor control but there is limited information on whether these models can be successfully implemented more widely in diverse settings and populations. The purpose of this study is to evaluate whether a centralized, web-based CV risk service (CVRS) managed by clinical pharmacists will improve guideline adherence in multiple primary care medical offices with diverse geographic and patient characteristics. Methods This study is a prospective trial in 20 primary care offices stratified by the percent of under-represented minorities and then randomized to either the CVRS intervention or usual care. The intervention will last for 12 months and all subjects will have research visits at baseline and 12 months. The primary outcome is the difference in guideline adherence between groups. Data will also be abstracted from the medical record at 24 months to determine if the intervention effect is sustained after it is discontinued. Conclusions This study expects to enroll subjects through 2016 with results expected in 2019. This study will provide information on whether a distant, centralized CV risk service can be implemented in large numbers of medical offices, if it is effective in diverse populations, and if the effect can be sustained long-term. PMID:26111939

  16. Natural regeneration in two central Idaho grand fir habitat types. Forest Service research paper

    SciTech Connect

    Geier-Hayes, K.

    1994-03-01

    Natural regeneration of five conifer species was surveyed in two central Idaho grand fir habitat types. The habitat types range from warm, dry (grand fir/white spirea) to mesic (Grand fir/Mountain Maple). Four harvest-regeneration methods and four site preparation techniques were sampled. Recommendations for obtaining natural regeneration vary primarily by habitat type. Conifer seedlings in the warm, dry grand fir white spirea habitat type require site protection for establishment. In the mesic grand fir/mountain maple habitat type, tall shrub potential can reduce the opportunity to establish early seral conifer species.

  17. Stand hazard rating for central idaho forests. Forest Service general technical report

    SciTech Connect

    Steele, R.; Williams, R.E.; Weatherby, J.C.; Reinhardt, E.D.; Hoffman, J.T.

    1996-03-01

    Growing concern over sustainability of central Idaho forests has created a need to assess the health of forest stands on a relative basis. A stand hazard rating was developed as a composite of 11 individual ratings to compare the health hazards of different stands. The composite rating includes Douglas-fire bettle, mountain pine beetle, western pine beetle, spruce beetle, Douglas-fire tussock moth, western spruce budworm, dwarf mistletoes, annosus root disease, Swhweinitzii root and butt rot, and wildfire. The interacting effects of these agents were also considered.

  18. Applying an ecosystem service approach to unravel links between ecosystems and society in the coast of central Chile.

    PubMed

    de Juan, Silvia; Gelcich, Stefan; Ospina-Alvarez, Andres; Perez-Matus, Alejandro; Fernandez, Miriam

    2015-11-15

    Ecosystem-based management implies understanding feedbacks between ecosystems and society. Such understanding can be approached with the Drivers-Pressures-State change-Impacts-Response framework (DPSIR), incorporating stakeholders' preferences for ecosystem services to assess impacts on society. This framework was adapted to six locations in the central coast of Chile, where artisanal fisheries coexist with an increasing influx of tourists, and a set of fisheries management areas alternate with open access areas and a no-take Marine Protected Area (MPA). The ecosystem services in the study area were quantified using biomass and species richness in intertidal and subtidal areas as biological indicators. The demand for ecosystem services was elicited by interviews to the principal groups of users. Our results evidenced decreasing landings and a negative perception of fishermen on temporal trends of catches. The occurrence of recreational fishing was negligible, although the consumption of seafood by tourists was relatively high. Nevertheless, the consumption of organisms associated to the study system was low, which could be linked, amongst other factors, to decreasing catches. The comparison of biological indicators between management regimens provided variable results, but a positive effect of management areas and the MPA on some of the metrics was observed. The prioritising of ecosystem attributes by tourists was highly homogenous across the six locations, with "scenic beauty" consistently selected as the preferred attribute, followed by "diversity". The DPSIR framework illustrated the complex interactions existing in these locations, with weak linkages between society's priorities, existing management objectives and the state of biological communities. Overall, this work improved our knowledge on relations between components of coastal areas in central Chile, of paramount importance to advance towards an ecosystem-based management in the area.

  19. Results from a National Central Auditory Processing Disorder Service: A Real-World Assessment of Diagnostic Practices and Remediation for Central Auditory Processing Disorder.

    PubMed

    Cameron, Sharon; Glyde, Helen; Dillon, Harvey; King, Alison; Gillies, Karin

    2015-11-01

    This article describes the development and evaluation of a national service to diagnose and remediate central auditory processing disorder (CAPD). Data were gathered from 38 participating Australian Hearing centers over an 18-month period from 666 individuals age 6, 0 (years, months) to 24, 8 (median 9, 0). A total of 408 clients were diagnosed with either a spatial processing disorder (n = 130), a verbal memory deficit (n = 174), or a binaural integration deficit (n = 104). A hierarchical test protocol was used so not all children were assessed on all tests in the battery. One hundred fifty clients decided to proceed with deficit-specific training (LiSN & Learn or Memory Booster) and/or be fitted with a frequency modulation system. Families were provided with communication strategies targeted to a child's specific listening difficulties and goals. Outcomes were measured using repeat assessment of the relevant diagnostic test, as well as the Client Oriented Scale of Improvement measure and Listening Inventories for Education teacher questionnaire. Group analyses revealed significant improvements postremediation for all training/management options. Individual posttraining performance and results of outcome measures also are discussed. PMID:27587910

  20. Planning and implementation of a computerized inventory system in central service.

    PubMed

    Russ, A M

    1993-05-01

    The computerization of any manual system must be carefully planned before a computer system is selected. An adequate record-keeping system must exist before conversion to a computerized system takes place. Once selected, the computer vendor must be able to provide what the customer requires. More importantly, the computer vendor must be able to provide support services after the system is implemented. User capabilities and acceptance must be considered, and each step of the implementation phase must be thoroughly communicated to all who will be affected. Finally, to provide the most accurate real-time information, files must be maintained and updated as changes occur. PMID:10125281

  1. Financial aspects of partial cutting practices in central Appalachian hardwoods. Forest Service research paper (Final)

    SciTech Connect

    Miller, G.W.

    1993-06-01

    Unveven-aged silvicultural practices can be used to regenerate and manage many eastern hardwood stands. Single-tree selection methods are feasible in stands where a desirable shade-tolerant commercial species can be regenerated following periodic harvests. A variety of partial cutting practices, including single-tree selection and diameter-limit cutting have been used for 30 years or more to manage central Appalachian hardwoods on the Fernow Experimental Forest near Parsons, West Virginia. Results from these research areas are presented to help forest managers evaluate financial aspects of partial cutting practices. Observed volume growth, product yields, changes in species composition, and changes in residual stand quality are used to evaluate potential financial returns. Also, practical economic considerations for applying partial cutting methods are discussed.

  2. Strengthening patient education for ORT services in the Central African Republic.

    PubMed

    Naimoli, J F; Endsley, S; Roungou, J B; Parker, K; Bryce, J; Doutizonga, R; Gbadjamo, M

    1996-03-01

    This paper describes the design and implementation of a health worker training program in diarrhea case management and its effect on patient education in health facilities in the Central African Republic (C.A.R.). In 1989, a facility-based assessment of health worker practices in managing diarrheal disease in children under 5 years of age documented serious deficiencies in patient education as performed by health workers. Based on these results, the Ministry of Health (MOH) designed an inservice training program that promoted education as an integral component of curative care. The training program was implemented in all five health regions of the country. An evaluation of the training's impact on the delivery of patient education indicated dramatic increases in the number of messages health workers communicated to mothers. This experience demonstrated that the patient education practices of health workers can be improved through inservice training that integrates the teaching of clinical and communication skills. Additional study in C.A.R. is needed to (1) further improve the quality of patient education for diarrhea and other childhood communicable diseases, (2) determine the impact of patient education on the care provided by mothers in the home following a clinic visit, and (3) assess how operational research can be conducted within the limitations of inservice training programs and routine clinical operations. PMID:8788345

  3. Complications of central venous catheter in patients transplanted with hematopoietic stem cells in a specialized service

    PubMed Central

    Barretta, Lidiane Miotto; Beccaria, Lúcia Marinilza; Cesarino, Cláudia Bernardi; Pinto, Maria Helena

    2016-01-01

    Abstract Objective: to identify the model, average length of stay on site and complications of central venous catheter in patients undergoing transplant of hematopoietic stem cells and verify the corresponding relationship between the variables: age, gender, medical diagnosis, type of transplant, implanted catheter and insertion site. Method: a retrospective and quantitative study with a sample of 188 patients transplanted records between 2007 and 2011. Results: the majority of patients used Hickman catheter with an average length of stay on site of 47.6 days. The complication fever/bacteremia was significant in young males with non-Hodgkin's lymphoma undergoing autologous transplant, which remained with the device for a long period in the subclavian vein. Conclusion: nurses should plan with their team the minimum waiting time, recommended between the catheter insertion and start of the conditioning regimen, as well as not to extend the length of time that catheter should be on site and undertake their continuing education, focusing on the prevention of complications. PMID:27276021

  4. Impact of water management interventions on hydrology and ecosystem services in Garhkundar-Dabar watershed of Bundelkhand region, Central India

    NASA Astrophysics Data System (ADS)

    Singh, Ramesh; Garg, Kaushal K.; Wani, Suhas P.; Tewari, R. K.; Dhyani, S. K.

    2014-02-01

    Bundelkhand region of Central India is a hot spot of water scarcity, land degradation, poverty and poor socio-economic status. Impacts of integrated watershed development (IWD) interventions on water balance and different ecosystem services are analyzed in one of the selected watershed of 850 ha in Bundelkhand region. Improved soil, water and crop management interventions in Garhkundar-Dabar (GKD) watershed of Bundelkhand region in India enhanced ET to 64% as compared to 58% in untreated (control) watershed receiving 815 mm annual average rainfall. Reduced storm flow (21% vs. 34%) along with increased base flow (4.5% vs. 1.2%) and groundwater recharge (11% vs. 7%) of total rainfall received were recorded in treated watershed as compared to untreated control watershed. Economic Water productivity and total income increased from 2.5 to 5.0 INR m-3 and 11,500 to 27,500 INR ha-1 yr-1 after implementing integrated watershed development interventions in GKD watershed, respectively. Moreover IWD interventions helped in reducing soil loss more than 50% compared to control watershed. The results demonstrated that integrated watershed management practices addressed issues of poverty in GKD watershed. Benefit to cost ratio of project interventions was found three and pay back period within four years suggest economic feasibility to scale-up IWD interventions in Bundelkhend region. Scaling-up of integrated watershed management in drought prone rainfed areas with enabling policy and institutional support is expected to promote equity and livelihood along with strengthening various ecosystem services, however, region-specific analysis is needed to assess trade-offs for downstream areas along with onsite impact.

  5. An Institutional Research for the Purpose of Measuring the Effectiveness of Instructional, Curricular, and Personnel Services to the Transfer Students at Olney Central College.

    ERIC Educational Resources Information Center

    Emrick, Raymond T.

    During 1971-72, graduates of Olney Central College (OCC) who had transferred to a four-year school were asked to rate OCC's instructional, curricular, and personnel services, to determine how adequately the college meets the needs of its students. Students' reactions to thirty-eight statements about the college were registered on a Likert-type…

  6. 48 CFR 225.7704 - Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Afghanistan. 225.7704 Section 225.7704 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS... Operations in Iraq or Afghanistan 225.7704 Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in Afghanistan....

  7. 48 CFR 225.7704 - Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Afghanistan. 225.7704 Section 225.7704 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS... Operations in Afghanistan 225.7704 Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in Afghanistan....

  8. 48 CFR 225.7704 - Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Afghanistan. 225.7704 Section 225.7704 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS... Operations in Iraq or Afghanistan 225.7704 Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in Afghanistan....

  9. 48 CFR 225.7704 - Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Afghanistan. 225.7704 Section 225.7704 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS... Operations in Afghanistan 225.7704 Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in Afghanistan....

  10. [Modern referral-information service in the Central Medical Library of the University of Zagreb Medical School].

    PubMed

    Hadjina, G; Granić, D; Bekavac, A

    1990-01-01

    New technologies in information and retrieval services of the Central Medical Library are presented, as well as comparison between traditional search of biomedical literature and search of biomedical bases available on CD-ROM and on-line. MeSH thesaurus represents the basis for all modes of searches, either through published indexes (Index Medicus, Biomedicina Iugoslavica), searches through on-line, or via CD-ROM technology. Experience in indexing according to MeSH structure helps us to search and retrieve biomedical literature on new media too. Great interest in new media for search and retrieval of biomedical literature among our users (100%) justifies their introduction into the Library. In the period of four months, 75% of our users chose CD-ROM technology in their search, 25% chose on-line search, and both technologies were combined by 33% of the users. Having these new media in our library we have reached the point from which we join the world biomedical information network and successfully meet the growing need for information in the field of biomedicine.

  11. [Environmental services of the forest: an essay in an European Atlantic river basin based on a Central American experience].

    PubMed

    Orrantia Albizu, Oreina; Ortega Hidalgo, M Mercedes; Quirós Madrigal, Olman; Loidi Arregui, Javier

    2008-12-01

    A Conservation Interest Index (CI) was designed to numerically assess the natural quality or value of a given terrestrial area. This CI has been applied along the Golako River Watershed (Biosphere Reserve, Basque Country, Spain). The area, although benefiting from some protection, is strongly influenced by human activities (forestry and cattle breeding). The CI is based on both available cartographic information about vegetation and fieldwork, the later needed to provide estimations for the various descriptors included in this index: in this way, a particular vegetation fragment received a final score on a scale from 0 to 1000. A set of 9 Vegetation Units has been defined to analyze the current vegetation profile and, a ten plot (500 x 500 m) uniformly distributed sampling design has been implemented. Landscape homogenization is high where main land use relies on timbering, contrasting with the more heterogeneous and fragmented profile related to rural activities. At a height of more than 150 m forest appears to be dominant while human occupation becomes patchy, whereas abruptness restraints farms to locations below 100 m. Concerning the index performance, gradual differences have been displayed by the forest, which appears as the only vegetation unit attaining values above 500 (50% in the index scale), mature forest ranking highest (860), followed closely by the riparian forest. We have developed a formula to translate environmental value into economic benefit to promote conservation work at private property level, imitating the initial work undergone in Central American countries, where environmental services are rewarded irrespective of their conservation status.

  12. Two-tier charging in Maputo Central Hospital: Costs, revenues and effects on equity of access to hospital services

    PubMed Central

    2011-01-01

    Background Special services within public hospitals are becoming increasingly common in low and middle income countries with the stated objective of providing higher comfort services to affluent customers and generating resources for under funded hospitals. In the present study expenditures, outputs and costs are analysed for the Maputo Central Hospital and its Special Clinic with the objective of identifying net resource flows between a system operating two-tier charging, and, ultimately, understanding whether public hospitals can somehow benefit from running Special Clinic operations. Methods A combination of step-down and bottom-up costing strategies were used to calculate recurrent as well as capital expenses, apportion them to identified cost centres and link costs to selected output measures. Results The results show that cost differences between main hospital and clinic are marked and significant, with the Special Clinic's cost per patient and cost per outpatient visit respectively over four times and over thirteen times their equivalent in the main hospital. Discussion While the main hospital cost structure appeared in line with those from similar studies, salary expenditures were found to drive costs in the Special Clinic (73% of total), where capital and drug costs were surprisingly low (2 and 4% respectively). We attributed low capital and drug costs to underestimation by our study owing to difficulties in attributing the use of shared resources and to the Special Clinic's outsourcing policy. The large staff expenditure would be explained by higher physician time commitment, economic rents and subsidies to hospital staff. On the whole it was observed that: (a) the flow of capital and human resources was not fully captured by the financial systems in place and stayed largely unaccounted for; (b) because of the little consideration given to capital costs, the main hospital is more likely to be subsidising its Special Clinic operations, rather than the

  13. La place de la thoracoscopie dans la prise en charge des pathologies thoraciques: à propos de 104 cas

    PubMed Central

    Lakranbi, Marwane; Rabiou, Sani; Ghalimi, Jamal; Issoufou, Ibrahim; Ouadnouni, Yassine; Smahi, Mohamed

    2015-01-01

    Introduction La thoracoscopie est l'exploration endoscopique de la cavité pleurale, des organes avoisinants (diaphragme, péricarde, médiastin) et du poumon. Le but de ce travail se veut d'abord didactique; décrivant la thoracoscopie, ses techniques ainsi que sa place dans la prise en charge de la pathologie thoracique (indications et perspectives thérapeutiques) et informatif en rapportant l'expérience de notre équipe. Méthodes Il s'agit d'une étude rétrospective intéressant 104 thoracoscopies à visée diagnostique et/ou thérapeutique réalisées au service de chirurgie thoracique du Centre Hospitalier Universitaire Hassan II de Fès, sur une période de 04 ans (Août 2008-décembre 2012). Nous avons exclu de notre étude les cas ayant bénéficié d'une médiastinoscopie ainsi que les cas ayant bénéficié d'une thoracoscopie dans le cadre des traumatismes fermés du thorax ou des plaies thoraciques. Résultats L’ âge moyen des patients est de 47 ans, avec des extrêmes allant de 18 à 80 ans, et une légère prédominance masculine à 54%. La thoracoscopie est d'ordre pleural chez 86 patients, pulmonaire chez 10 patients et médiastinale chez 8 patients. La thoracoscopie avait une indication à visée diagnostique chez 87 cas et thérapeutique chez 52 patients (talcage dans 45 cas, décortication pleuropulmonaire dans 2 cas, résection de kystepleuro-péricardique dans 2 cas, cure de pneumothorax dans 2 cas et une fenêtre péricardique). L’évolution post opératoire etait marquée par une amélioration clinico-radiologique chez 40 malades, 11 ont présenté une amélioration clinique seule, 6 ont présenté une persistance ou une récidive de l’épanchement. Conclusion La thoracoscopie représente un réel gain en matière de diagnostic de certaines pathologies intra-thoraciques. Son intérêt thérapeutique limité doit être éventuellement étendu grâce à la chirurgie thoracique vidéo assistée, qui est une technique récente fiable

  14. Prise en charge diagnostique et thérapeutique de la tuberculose ganglionnaire en Tunisie

    PubMed Central

    Ben Brahim, Hajer; Kooli, Ikbel; Aouam, Abir; Toumi, Adnene; Loussaief, Chawki; Koubaa, Jamel; Chakroun, Mohamed

    2014-01-01

    La tuberculose ganglionnaire est la localisation extra-pulmonaire la plus fréquente de la tuberculose. Nous nous proposons dans ce travail d’étudier les modalités diagnostiques, thérapeutiques et évolutives de cette localisation. Il s'agit d'une étude rétrospective portant sur 100 cas de tuberculose ganglionnaire. L’âge moyen était de 35 ± 15 ans (15-85 ans). Aucun malade n’était VIH positif. L'aire cervicale était la plus touchée (93 cas). L'intradermo-réaction à la tuberculine était positive dans 76/91 cas (83,5%). L'examen bactériologique des prélèvements au niveau des ganglions atteints avait mis en évidence des bacilles acido-alcoolo-résistants à l'examen direct dans 2/31 cas (6,4%) et la culture avait isolé Mycobacteruim tuberculosis dans 1/31 cas (3,2%). La cytoponction ganglionnaire (FNAC) était évocatrice de tuberculose dans 35/42 cas (83,3%). La biopsie ganglionnaire était réalisée dans 69 cas et avait permis de retenir le diagnostic de tuberculose dans tous les cas. La FNAC, comparativement à la biopsie, avait permis de raccourcir significativement le délai de la prise en charge (15,1 vs 22,8 jours; p=0,001) et la durée d'hospitalisation (17,3 vs 24,6; p=0,004). La durée moyenne du traitement antituberculeux était de 9,8 ± 4,6 mois (7 à 44 mois). Le traitement chirurgical initial avait raccourci significativement la durée du traitement médical. Il n'avait pas d'impact sur le taux de guérison. Nous avons noté 10 cas de réponse paradoxale aux antituberculeux, quatre cas de résistance clinique et une rechute dans deux cas. La tuberculose ganglionnaire pose un problème diagnostique et thérapeutique. La microbiologie est d'un faible apport. La FNAC est un moyen diagnostique très utiles dans les pays endémiques et à faibles ressources. Un traitement médical seul permet d’éviter les inconvénients de la chirurgie. PMID:25829976

  15. Services

    ERIC Educational Resources Information Center

    Environmental Science and Technology, 1972

    1972-01-01

    Alphabetical listing of companies which offer analytical sampling and testing services for pollution control and abatement; consultants that also manufacture and distribute products. List of book publishers included. (LK)

  16. Major Douglas-fir habitat types of central Idaho: A summary of succession and management. Forest Service general technical report

    SciTech Connect

    Steele, R.; Geier-Hayes, K.

    1995-12-01

    The report summarizes important successional aspects of seven central Idaho Douglas-fir habitat types. The habitat types and phases are grouped geographically into west-central and east-central Idaho to differentiate site potential based on ponderosa pine occurrence. The role of fire and other management activities and their influence on common seral shrubs and herbs are discussed. Common seral tree species are included with discussions of natural and planted conifer regeneration and tree growth capability.

  17. Consensus formalisé: recommandations de pratiques cliniques pour la prise en charge de la migraine du patient adulte africain

    PubMed Central

    Ahmed, Mahmoud Ait Kaci; Haddad, Monia; Kouassi, Beugré; Ouhabi, Hamid; Serrie, Alain

    2016-01-01

    La migraine est une céphalée primaire (selon les derniers critères de l'International Headache Society) qui affecte environ 8% de la population africaine. Les femmes sont plus fréquemment touchées que les hommes et les crises apparaissent le plus souvent avant l’âge de 40 ans. Bien qu'un certain nombre de traitements, de mesure hygiéno-diététiques, et d'autres méthodes non pharmacologiques permettent de limiter l'intensité et la fréquence des crises, la prise en charge médicamenteuse de la crise de migraine est très souvent nécessaire. La disponibilité des traitements et l'accès aux soins diffèrent sur le continent africain et ont conduit à la réalisation du 1er consensus d'experts pour la prise en charge du patient adulte africain. Destiné aux praticiens, ce travail collaboratif multinational a pour objectif de fournir 16 recommandations de pratiques cliniques simples, fondées sur les preuves, et adaptées aux conditions de l'exercice médical en Afrique. PMID:27642420

  18. Towards secondary use of heterogeneous radio-oncological data for retrospective clinical trials: service-oriented connection of a central research database with image analysis tools

    NASA Astrophysics Data System (ADS)

    Bougatf, Nina; Bendl, Rolf; Debus, Jürgen

    2015-03-01

    Our overall objective is the utilization of heterogeneous and distributed radio-oncological data in retrospective clinical trials. Previously, we have successfully introduced a central research database for collection of heterogeneous data from distributed systems. The next step is the integration of image analysis tools in the standard retrieval process. Hence, analyses for complex medical questions can be processed automatically and facilitated immensely. In radiation oncology recurrence analysis is a central approach for the evaluation of therapeutic concepts. However, various analysis steps have to be performed like image registration, dose transformation and dose statistics. In this paper we show the integration of image analysis tools in the standard retrieval process by connecting them with our central research database using a service-oriented approach. A concrete problem from recurrence analysis has been selected to prove our concept exemplarily. We implemented service-oriented data collection and analysis tools to use them in a central analysis platform, which is based on a work flow management system. An analysis work flow has been designed that, at first, identifies patients in the research database fulfilling the inclusion criteria. Then the relevant imaging data is collected. Finally the imaging data is analyzed automatically. After the successful work flow execution, the results are available for further evaluation by a physician. As a result, the central research database has been connected successfully with automatic data collection and image analysis tools and the feasibility of our service-oriented approach has been demonstrated. In conclusion, our approach will simplify retrospective clinical trials in our department in future.

  19. Prise en charge d’un afflux massif de brûles lors d’une situation de catastrophe par incendie au Maroc

    PubMed Central

    Siah, S.; Hatimi, E.M.; Ihrai, H.; Drissi Kamili, N.

    2012-01-01

    Summary La brûlure est l’une des lésions les plus fréquemment rencontrées lors de catastrophes naturelles ou lors de catastrophes d’origine humaine (incendies de lieux publics d’origine accidentelle, ou en temps de guerre ou encore lors d’attentats terroristes). La prise en charge et le triage de brûlés en nombre reste un problème difficile; ceci souligne la nécessité d’une réflexion et de prévisions de ces crises en insistant sur la formation des médecins et des soignants. Les défis à relever sont multiples: les soins aux brûlés requièrent un nombre important de personnel qualifié; les évacuations doivent être planifiées en fonction de la gravité de la brûlure et des lésions associées; les stocks et lots de dotation (en particulier en topiques anti-infectieux et en cristalloïdes) doivent être suffisants et adéquats. Les services hospitaliers de l’Hôpital Militaire d’Instruction Mohammed V de Rabat doivent pouvoir être rapidement adaptés pour accueillir et surtout isoler ces patients. L’hypothèse d’une catastrophe par incendie avec afflux massif de brûlés à l’hôpital militaire d’instruction Mohammed V de Rabat ne doit laisser place à aucune improvisation. PMID:23467075

  20. The National Oceanic and Atmospheric Administration (NOAA) Climate Services Portal: A New Centralized Resource for Distributed Climate Information

    NASA Astrophysics Data System (ADS)

    Burroughs, J.; Baldwin, R.; Herring, D.; Lott, N.; Boyd, J.; Handel, S.; Niepold, F.; Shea, E.

    2010-09-01

    With the rapid rise in the development of Web technologies and climate services across NOAA, there has been an increasing need for greater collaboration regarding NOAA's online climate services. The drivers include the need to enhance NOAA's Web presence in response to customer requirements, emerging needs for improved decision-making capabilities across all sectors of society facing impacts from climate variability and change, and the importance of leveraging climate data and services to support research and public education. To address these needs, NOAA (during fiscal year 2009) embarked upon an ambitious program to develop a NOAA Climate Services Portal (NCS Portal). Four NOAA offices are leading the effort: 1) the NOAA Climate Program Office (CPO), 2) the National Ocean Service's Coastal Services Center (CSC), 3) the National Weather Service's Climate Prediction Center (CPC), and 4) the National Environmental Satellite, Data, and Information Service's (NESDIS) National Climatic Data Center (NCDC). Other offices and programs are also contributing in many ways to the effort. A prototype NCS Portal is being placed online for public access in January 2010, http://www.climate.gov. This website only scratches the surface of the many climate services across NOAA, but this effort, via direct user engagement, will gradually expand the scope and breadth of the NCS Portal to greatly enhance the accessibility and usefulness of NOAA's climate data and services.

  1. Implementing a multifaceted intervention to decrease central line-associated bloodstream infections in SEHA (Abu Dhabi Health Services Company) intensive care units: the Abu Dhabi experience.

    PubMed

    Latif, Asad; Kelly, Bernadette; Edrees, Hanan; Kent, Paula S; Weaver, Sallie J; Jovanovic, Branislava; Attallah, Hadeel; de Grouchy, Kristin K; Al-Obaidli, Ali; Goeschel, Christine A; Berenholtz, Sean M

    2015-07-01

    OBJECTIVE To determine whether implementation of a multifaceted intervention would significantly reduce the incidence of central line-associated bloodstream infections. DESIGN Prospective cohort collaborative. SETTING AND PARTICIPANTS Intensive care units of the Abu Dhabi Health Services Company hospitals in the Emirate of Abu Dhabi. INTERVENTIONS A bundled intervention consisting of 3 components was implemented as part of the program. It consisted of a multifaceted approach that targeted clinician use of evidence-based infection prevention recommendations, tools that supported the identification of local barriers to these practices, and implementation ideas to help ensure patients received the practices. Comprehensive unit-based safety teams were created to improve safety culture and teamwork. Finally, the measurement and feedback of monthly infection rate data to safety teams, senior leaders, and staff in participating intensive care units was encouraged. The main outcome measure was the quarterly rate of central line-associated bloodstream infections. RESULTS Eighteen intensive care units from 7 hospitals in Abu Dhabi implemented the program and achieved an overall 38% reduction in their central line-associated bloodstream infection rate, adjusted at the hospital and unit level. The number of units with a quarterly central line-associated bloodstream infection rate of less than 1 infection per 1,000 catheter-days increased by almost 40% between the baseline and postintervention periods. CONCLUSION A significant reduction in the global morbidity and mortality associated with central line-associated bloodstream infections is possible across intensive care units in disparate settings using a multifaceted intervention.

  2. Prise en charge péri opératoire des urgences chirurgicales abdominales chez l’adulte au CHU Aristide Le Dantec

    PubMed Central

    Gaye, Ibrahima; Leye, Pape Alassane; Traoré, Mamadou Mour; Ndiaye, Pape Ibrahima; Ba, El Hadji Boubacar; Bah, Mamadou Diawo; Fall, Mouhamed Lamine; Diouf, Elisabeth

    2016-01-01

    La prise en charge périopératoire des urgences chirurgicales abdominales reste une préoccupation majeure des anesthésistes du fait des désordres hémodynamiques et/ou métaboliques souvent présents en préopératoire; mais également des complications postopératoires auxquelles elles sont exposées. Les objectifs de ce travail étaient d'étudier les aspects épidémiologiques, diagnostiques, thérapeutiques et pronostiques des urgences abdominales. Etude rétrospective descriptive sur une période de 6 mois portant sur les patients âgés de plus de 16 ans opérés d'une urgence abdominale à l'hôpital Aristide Le Dantec. Les paramètres étudiés portaient sur les aspects épidémiologiques, diagnostiques, thérapeutiques et pronostiques des urgences chirurgicales abdominales. Nous avions colligé 161 cas, près de 20% de l'activité du service. L'âge moyen était de 41 ans [16, 80 ans]. Le sex ratio était de 2, 9. Le délai moyen de consultation était de 4,6 jours. Les péritonites étaient les pathologies les plus fréquentes (25,5%). La fréquence cardiaque moyenne des patients était de 92 bpm (battements/min)et 97 bpm pour ceux ayant eu une préparation hémodynamique préopératoire. La moyenne de la PAM était de 9,66 cmhg et 8,61 cmhg chez les patients préparés. 49,1% des patients étaient de la classe ASA1, 39,9% ASA2, 8,7% ASA3, 2,5% ASA4 et 0,6% ASA5. Une antibioprophylaxie était faite chez 46,30% des patients et 53,41% d'entre eux avaient eu une antibiothérapie.95,6% des patients avaient eu une anesthésie générale et 4,4% une rachianesthésie. La fréquence des incidents peropératoires était de 11,08%. La morbidité était de 4,3% et la mortalité 4,96%. La prise en charge des urgences chirurgicales abdominales doit être multidisciplinaire impliquant anesthésistes, chirurgiens et biologistes afin de réduire davantage le taux de morbimortalité qui reste de nos jours non négligeable. PMID:27795787

  3. Protein-Pacing and Multi-Component Exercise Training Improves Physical Performance Outcomes in Exercise-Trained Women: The PRISE 3 Study.

    PubMed

    Arciero, Paul J; Ives, Stephen J; Norton, Chelsea; Escudero, Daniela; Minicucci, Olivia; O'Brien, Gabe; Paul, Maia; Ormsbee, Michael J; Miller, Vincent; Sheridan, Caitlin; He, Feng

    2016-01-01

    The beneficial cardiometabolic and body composition effects of combined protein-pacing (P; 5-6 meals/day at 2.0 g/kg BW/day) and multi-mode exercise (resistance, interval, stretching, endurance; RISE) training (PRISE) in obese adults has previously been established. The current study examines PRISE on physical performance (endurance, strength and power) outcomes in healthy, physically active women. Thirty exercise-trained women (>4 days exercise/week) were randomized to either PRISE (n = 15) or a control (CON, 5-6 meals/day at 1.0 g/kg BW/day; n = 15) for 12 weeks. Muscular strength (1-RM bench press, 1-RM BP) endurance (sit-ups, SUs; push-ups, PUs), power (bench throws, BTs), blood pressure (BP), augmentation index, (AIx), and abdominal fat mass were assessed at Weeks 0 (pre) and 13 (post). At baseline, no differences existed between groups. Following the 12-week intervention, PRISE had greater gains (p < 0.05) in SUs, PUs (6 ± 7 vs. 10 ± 7, 40%; 8 ± 13 vs. 14 ± 12, 43% ∆reps, respectively), BTs (11 ± 35 vs. 44 ± 34, 75% ∆watts), AIx (1 ± 9 vs. -5 ± 11, 120%), and DBP (-5 ± 9 vs. -11 ± 11, 55% ∆mmHg). These findings suggest that combined protein-pacing (P; 5-6 meals/day at 2.0 g/kg BW/day) diet and multi-component exercise (RISE) training (PRISE) enhances muscular endurance, strength, power, and cardiovascular health in exercise-trained, active women. PMID:27258301

  4. Protein-Pacing and Multi-Component Exercise Training Improves Physical Performance Outcomes in Exercise-Trained Women: The PRISE 3 Study †

    PubMed Central

    Arciero, Paul J.; Ives, Stephen J.; Norton, Chelsea; Escudero, Daniela; Minicucci, Olivia; O’Brien, Gabe; Paul, Maia; Ormsbee, Michael J.; Miller, Vincent; Sheridan, Caitlin; He, Feng

    2016-01-01

    The beneficial cardiometabolic and body composition effects of combined protein-pacing (P; 5–6 meals/day at 2.0 g/kg BW/day) and multi-mode exercise (resistance, interval, stretching, endurance; RISE) training (PRISE) in obese adults has previously been established. The current study examines PRISE on physical performance (endurance, strength and power) outcomes in healthy, physically active women. Thirty exercise-trained women (>4 days exercise/week) were randomized to either PRISE (n = 15) or a control (CON, 5–6 meals/day at 1.0 g/kg BW/day; n = 15) for 12 weeks. Muscular strength (1-RM bench press, 1-RM BP) endurance (sit-ups, SUs; push-ups, PUs), power (bench throws, BTs), blood pressure (BP), augmentation index, (AIx), and abdominal fat mass were assessed at Weeks 0 (pre) and 13 (post). At baseline, no differences existed between groups. Following the 12-week intervention, PRISE had greater gains (p < 0.05) in SUs, PUs (6 ± 7 vs. 10 ± 7, 40%; 8 ± 13 vs. 14 ± 12, 43% ∆reps, respectively), BTs (11 ± 35 vs. 44 ± 34, 75% ∆watts), AIx (1 ± 9 vs. −5 ± 11, 120%), and DBP (−5 ± 9 vs. −11 ± 11, 55% ∆mmHg). These findings suggest that combined protein-pacing (P; 5–6 meals/day at 2.0 g/kg BW/day) diet and multi-component exercise (RISE) training (PRISE) enhances muscular endurance, strength, power, and cardiovascular health in exercise-trained, active women. PMID:27258301

  5. Grossesse dans une corne rudimentaire: difficultés diagnostiques et prise en charge thérapeutique

    PubMed Central

    Mamouni, Nisrine; Ghazal, Nabil; Erraghay, Sanaa; Bouchikhi, Chahrazed; Banani, Abdelaziz

    2016-01-01

    La survenue d'une grossesse dans une corne utérine rudimentaire est une situation obstétricale extrêmement rare et potentiellement grave, menaçant le pronostic materno-fœtal. Les auteurs rapportent cinq observations de grossesse dans une corne utérine rudimentaire, à travers lesquelles, ils relatent les difficultés sur le plan diagnostique ainsi que la prise en charge thérapeutique de cette entité pathologique, soulignant l'intérêt de l’échographie endovaginale, de l'IRM pelvienne et de la cœlioscopie dans le diagnostic précoce de ce type de malformation uterine. PMID:27583078

  6. Integrating ecosystem services analysis into scenario planning practice: accounting for street tree benefits with i-Tree valuation in Central Texas.

    PubMed

    Hilde, Thomas; Paterson, Robert

    2014-12-15

    Scenario planning continues to gain momentum in the United States as an effective process for building consensus on long-range community plans and creating regional visions for the future. However, efforts to integrate more sophisticated information into the analytical framework to help identify important ecosystem services have lagged in practice. This is problematic because understanding the tradeoffs of land consumption patterns on ecological integrity is central to mitigating the environmental degradation caused by land use change and new development. In this paper we describe how an ecosystem services valuation model, i-Tree, was integrated into a mainstream scenario planning software tool, Envision Tomorrow, to assess the benefits of public street trees for alternative future development scenarios. The tool is then applied to development scenarios from the City of Hutto, TX, a Central Texas Sustainable Places Project demonstration community. The integrated tool represents a methodological improvement for scenario planning practice, offers a way to incorporate ecosystem services analysis into mainstream planning processes, and serves as an example of how open source software tools can expand the range of issues available for community and regional planning consideration, even in cases where community resources are limited. The tool also offers room for future improvements; feasible options include canopy analysis of various future land use typologies, as well as a generalized street tree model for broader U.S. application.

  7. Socio-cultural and service delivery dimensions of maternal mortality in rural central India: a qualitative exploration using a human rights lens

    PubMed Central

    Jat, Tej Ram; Deo, Prakash R.; Goicolea, Isabel; Hurtig, Anna-Karin; San Sebastian, Miguel

    2015-01-01

    Background Despite the avoidable nature of maternal mortality, unacceptably high numbers of maternal deaths occur in developing countries. Considering its preventability, maternal mortality is being increasingly recognised as a human rights issue. Integration of a human rights perspective in maternal health programmes could contribute positively in eliminating avertable maternal deaths. This study was conducted to explore socio-cultural and service delivery–related dimensions of maternal deaths in rural central India using a human rights lens. Design Social autopsies were conducted for 22 maternal deaths during 2011 in Khargone district in central India. The data were analysed using thematic analysis. The factors associated with maternal deaths were classified by using the ‘three delays’ framework and were examined by using a human rights lens. Results All 22 women tried to access medical assistance, but various factors delayed their access to appropriate care. The underestimation of the severity of complications by family members, gender inequity, and perceptions of low-quality delivery services delayed decisions to seek care. Transportation problems and care seeking at multiple facilities delayed reaching appropriate health facilities. Negligence by health staff and unavailability of blood and emergency obstetric care services delayed receiving adequate care after reaching a health facility. Conclusions The study highlighted various socio-cultural and service delivery–related factors which are violating women's human rights and resulting in maternal deaths in rural central India. This study highlights that, despite the health system's conscious effort to improve maternal health, normative elements of a human rights approach to maternal health (i.e. availability, accessibility, acceptability, and quality of maternal health services) were not upheld. The data and analysis suggest that the deceased women and their relatives were unable to claim their

  8. Calculating the ecosystem service of water storage in isolated wetlands using LiDAR in north central Florida, USA (presentation)

    EPA Science Inventory

    This study used remotely-sensed Light Detection and Ranging (LiDAR) data to estimate potential water storage capacity of isolated wetlands in north central Florida. The data were used to calculate the water storage potential of >8500 polygons identified as isolated wetlands. We f...

  9. Calculating the ecosystem service of water storage in isolated wetlands using LIDAR in north central Florida, USA

    EPA Science Inventory

    This study used remotely-sensed Light Detection and Ranging (LiDAR) data to estimate potential water storage capacity of isolated wetlands in north central Florida. The data were used to calculate the water storage potential of >8500 polygons identified as isolated wetlands. We ...

  10. Optimizing PMTCT service delivery in rural North-Central Nigeria: protocol and design for a cluster randomized study.

    PubMed

    Aliyu, Muktar H; Blevins, Meridith; Audet, Carolyn; Shepherd, Bryan E; Hassan, Adiba; Onwujekwe, Obinna; Gebi, Usman I; Kalish, Marcia; Lindegren, Mary Lou; Vermund, Sten H; Wester, C William

    2013-09-01

    Nigeria has more HIV-infected women who do not receive needed services for the prevention of mother-to-child transmission of HIV (PMTCT) than any other nation in the world. To meet the UNAIDS/WHO goal of eliminating mother-to-child HIV transmission by 2015, multiple interventions will be required to scale up PMTCT services, especially to lower-level, rural health facilities. To address this, we are conducting a cluster-randomized controlled study to evaluate the impact and cost-effectiveness of a novel, family-focused integrated package of PMTCT services. A systematic re-assignment of patient care responsibilities coupled with the adoption of point-of-care CD4 + cell count testing could facilitate the ability of lower-cadre health providers to manage PMTCT care, including the provision and scale-up of antiretroviral therapy (ART) to pregnant women in rural settings. Additionally, as influential community members, male partners could support their partners' uptake of and adherence to PMTCT care. We describe an innovative approach to scaling up PMTCT service provision that incorporates considerations of where and from whom women can access services (task-shifting), ease of obtaining a CD4 + cell count result (point-of-care testing), the degree of HIV service integration for HIV-infected women and their infants, and the level of family and community involvement (specifically male partner involvement). This systematic approach, if proven feasible and effective, could be scaled up in Nigeria and similar resource-limited settings as a means to accelerate progress toward eliminating mother-to-child transmission of HIV and help women with HIV infection take ART and live long, healthy lives (Trial registration: NCT01805752). PMID:23816493

  11. Optimizing PMTCT service delivery in rural North-Central Nigeria: protocol and design for a cluster randomized study.

    PubMed

    Aliyu, Muktar H; Blevins, Meridith; Audet, Carolyn; Shepherd, Bryan E; Hassan, Adiba; Onwujekwe, Obinna; Gebi, Usman I; Kalish, Marcia; Lindegren, Mary Lou; Vermund, Sten H; Wester, C William

    2013-09-01

    Nigeria has more HIV-infected women who do not receive needed services for the prevention of mother-to-child transmission of HIV (PMTCT) than any other nation in the world. To meet the UNAIDS/WHO goal of eliminating mother-to-child HIV transmission by 2015, multiple interventions will be required to scale up PMTCT services, especially to lower-level, rural health facilities. To address this, we are conducting a cluster-randomized controlled study to evaluate the impact and cost-effectiveness of a novel, family-focused integrated package of PMTCT services. A systematic re-assignment of patient care responsibilities coupled with the adoption of point-of-care CD4 + cell count testing could facilitate the ability of lower-cadre health providers to manage PMTCT care, including the provision and scale-up of antiretroviral therapy (ART) to pregnant women in rural settings. Additionally, as influential community members, male partners could support their partners' uptake of and adherence to PMTCT care. We describe an innovative approach to scaling up PMTCT service provision that incorporates considerations of where and from whom women can access services (task-shifting), ease of obtaining a CD4 + cell count result (point-of-care testing), the degree of HIV service integration for HIV-infected women and their infants, and the level of family and community involvement (specifically male partner involvement). This systematic approach, if proven feasible and effective, could be scaled up in Nigeria and similar resource-limited settings as a means to accelerate progress toward eliminating mother-to-child transmission of HIV and help women with HIV infection take ART and live long, healthy lives (Trial registration: NCT01805752).

  12. Biomass and nutrient distributions in central Oregon second-growth ponderosa pine ecosystems. Forest Service research paper

    SciTech Connect

    Little, S.N.; Shainsky, L.J.

    1995-03-01

    We investigated the distributioin of biomass and nurtrients in second-growth ponderosa pine (Pinus ponderosa Dougl. ex Laws.) ecosystems in central Oregon. Destructive sampling of aboveground and belowground tree biomass was carried out at six sites in the Deschutes National Forest; three of these sites also were intensively sampled for biomass and nutrient concentrations of the soil, forest floor, residue, and shrub components. Tree biomass equations were developed that related component biomass to diameter at breast height and total tree height.

  13. Central ESEA Title I Remedial Services for Eligible Nonpublic School Pupils; Corrective Reading Component, 1975-1976.

    ERIC Educational Resources Information Center

    Miller, Harry L.

    This document presents a description and an evaluation of the Corrective Reading Services Program, a component within the ESEA Title I nonpublic school program. This component was designed to serve approximately 12,000 eligible, educationally deprived children in 229 schools in New York City during the 1975-76 school year. The purpose of the…

  14. An Analysis of Minimum Service Standards (MSS) in Basic Education: A Case Study at Magelang Municipality, Central Java, Indonesia

    ERIC Educational Resources Information Center

    Haryati, Sri

    2014-01-01

    The study aims at analyzing the achievement of Minimum Service Standards (MSS) in Basic Education through a case study at Magelang Municipality. The findings shall be used as a starting point to predict the needs to meet MMS by 2015 and to provide strategies for achievement. Both primary and secondary data were used in the study investigating the…

  15. Centralize Printing, and Save.

    ERIC Educational Resources Information Center

    McCormick, Kathleen

    1984-01-01

    Describes the operations of a centralized printing office in a California school district. Centralization greatly increased the efficiency and lowered the cost of generating publications, information services, newsletters, and press releases throughout the school year. (TE)

  16. Willingness to pay for public health services in rural Central Java, Indonesia: methodological considerations when using the contingent valuation method.

    PubMed

    Shono, Aiko; Kondo, Masahide; Ohmae, Hiroshi; Okubo, Ichiro

    2014-06-01

    In the health sectors of low- and middle-income countries, contingent valuation method (CVM) studies on willingness to pay (WTP) have been used to gather information on demand variation or financial perspectives alongside price setting, such as the introduction of user fees and valuation of quality improvements. However, WTP found in most CVM studies have only explored the preferences that consumers express through their WTP without exploring whether they are actually able to pay for it. Therefore, this study examines the issues pertaining to WTP estimation for health services using the conventional CVM. We conducted 202 household interviews in 2008, in which we asked respondents about three types of public health services in Indonesia and assessed WTP estimated by the conventional CVM as well as in the scenario of "resorting to debt" to recognize their budget constraints. We find that all the demand curves for both WTP scenarios show gaps. Furthermore, the gap for midwife services is negatively affected by household income and is larger for the poor. These results prove that CVM studies on WTP do not always reveal WTP in the latter scenario. Those findings suggest that WTP elicited by the conventional CVM is different to that from the maximum price that prevents respondents from resorting to debt as their WTP. In order to bridge this gap in the body of knowledge on this topic, studies should improve the scenarios that CVM analyses use to explore WTP. Furthermore, because valuing or pricing health services based on the results of CVM studies on WTP alone can exacerbate the inequity of access to these services, information provided by such studies requires careful interpretation when used for this purpose, especially for the poor and vulnerable sections of society.

  17. Timed-daily ingestion of whey protein and exercise training reduces visceral adipose tissue mass and improves insulin resistance: the PRISE study.

    PubMed

    Arciero, Paul J; Baur, Daniel; Connelly, Scott; Ormsbee, Michael J

    2014-07-01

    The present study examined the effects of timed ingestion of supplemental protein (20-g servings of whey protein, 3×/day), added to the habitual diet of free-living overweight/obese adults and subsequently randomized to either whey protein only (P; n = 24), whey protein and resistance exercise (P + RT; n = 27), or a whey protein and multimode exercise training program [protein and resistance exercise, intervals, stretching/yoga/Pilates, endurance exercise (PRISE); n = 28]. Total and regional body composition and visceral adipose tissue (VAT) mass (dual-energy X-ray absorptiometry), insulin sensitivity [homeostasis model assessment-estimated insulin resistance (HOMA-IR)], plasma lipids and adipokines, and feelings of hunger and satiety (visual analog scales) were measured before and after the 16-wk intervention. All groups lost body weight, fat mass (FM), and abdominal fat; however, PRISE lost significantly (P < 0.01) more body weight (3.3 ± 0.7 vs. 1.1 ± 0.7 kg, P + RT) and FM (2.8 ± 0.7 vs. 0.9 ± 0.5 kg, P + RT) and gained (P < 0.05) a greater percentage of lean body mass (2 ± 0.5 vs. 0.9 ± 0.3 and 0.6 ± 0.4%, P + RT and P, respectively). Only P + RT (0.1 ± 0.04 kg) and PRISE (0.21 ± 0.07 kg) lost VAT mass (P < 0.05). Fasting glucose decreased only in P + RT (5.1 ± 2.5 mg/dl) and PRISE (15.3 ± 2.1 mg/dl), with the greatest decline occurring in PRISE (P < 0.05). Similarly, HOMA-IR improved (0.6 ± 0.3, 0.6 ± 0.4 units), and leptin decreased (4.7 ± 2.2, 4.7 ± 3.1 ng/dl), and adiponectin increased (3.8 ± 1.1, 2.4 ± 1.1 μg/ml) only in P + RT and PRISE, respectively, with no change in P. In conclusion, we find evidence to support exercise training and timed ingestion of whey protein added to the habitual diet of free-living overweight/obese adults, independent of caloric restriction on total and regional body fat distribution, insulin resistance, and adipokines. PMID:24833780

  18. Timed-daily ingestion of whey protein and exercise training reduces visceral adipose tissue mass and improves insulin resistance: the PRISE study.

    PubMed

    Arciero, Paul J; Baur, Daniel; Connelly, Scott; Ormsbee, Michael J

    2014-07-01

    The present study examined the effects of timed ingestion of supplemental protein (20-g servings of whey protein, 3×/day), added to the habitual diet of free-living overweight/obese adults and subsequently randomized to either whey protein only (P; n = 24), whey protein and resistance exercise (P + RT; n = 27), or a whey protein and multimode exercise training program [protein and resistance exercise, intervals, stretching/yoga/Pilates, endurance exercise (PRISE); n = 28]. Total and regional body composition and visceral adipose tissue (VAT) mass (dual-energy X-ray absorptiometry), insulin sensitivity [homeostasis model assessment-estimated insulin resistance (HOMA-IR)], plasma lipids and adipokines, and feelings of hunger and satiety (visual analog scales) were measured before and after the 16-wk intervention. All groups lost body weight, fat mass (FM), and abdominal fat; however, PRISE lost significantly (P < 0.01) more body weight (3.3 ± 0.7 vs. 1.1 ± 0.7 kg, P + RT) and FM (2.8 ± 0.7 vs. 0.9 ± 0.5 kg, P + RT) and gained (P < 0.05) a greater percentage of lean body mass (2 ± 0.5 vs. 0.9 ± 0.3 and 0.6 ± 0.4%, P + RT and P, respectively). Only P + RT (0.1 ± 0.04 kg) and PRISE (0.21 ± 0.07 kg) lost VAT mass (P < 0.05). Fasting glucose decreased only in P + RT (5.1 ± 2.5 mg/dl) and PRISE (15.3 ± 2.1 mg/dl), with the greatest decline occurring in PRISE (P < 0.05). Similarly, HOMA-IR improved (0.6 ± 0.3, 0.6 ± 0.4 units), and leptin decreased (4.7 ± 2.2, 4.7 ± 3.1 ng/dl), and adiponectin increased (3.8 ± 1.1, 2.4 ± 1.1 μg/ml) only in P + RT and PRISE, respectively, with no change in P. In conclusion, we find evidence to support exercise training and timed ingestion of whey protein added to the habitual diet of free-living overweight/obese adults, independent of caloric restriction on total and regional body fat distribution, insulin resistance, and adipokines.

  19. Douglas-fir/white spirea habitat type in central Idaho: Succession and management. Forest Service general technical report

    SciTech Connect

    Steele, R.; Geier-Hayes, K.

    1994-04-01

    The report describes a taxonomic system for classifying plant succession in the Douglas-fir/white spirea habitat type in central Idaho. A total of 10 potential tree layer types, 35 shrub types, and 45 herb layer types are categorized. Diagonostic keys based on indicator species assist field identification of the types. Discussion of management implications includes pocket gopher populations, success of planted and natural tree seedlings, big-game and livestock forage preferences, and responses of major shrub and herb layer species to disturbances.

  20. Douglas-fir/pinegrass habitat type in central Idaho: Succession and management. Forest Service general technical report

    SciTech Connect

    Steele, R.; Geier-Hayes, K.

    1993-05-01

    The report includes a taxonomic system for classifying plant succession in the Douglas-fir/Pinegrass habitat type in central Idaho. A total of 10 potential tree layer types, 32 shrub layer types, and 60 herbaceous layer types are categorized. Diagnostic keys based on indicator species provide for field identification of the types. The discussion of management implications includes pocket gopher populations, success of planted and natural tree seedlings, big-game and livestock forage preferences, and responses of major shrub and herb layer species to disturbance.

  1. Evaluation and demonstration of decentralized space and water heating versus centralized services for new and rehabilitated multifamily buildings. Final report

    SciTech Connect

    Belkus, P.; Tuluca, A.

    1993-06-01

    The general objective of this research was aimed at developing sufficient technical and economic know-how to convince the building and design communities of the appropriateness and energy advantages of decentralized space and water heating for multifamily buildings. Two main goals were established to guide this research. First, the research sought to determine the cost-benefit advantages of decentralized space and water heating versus centralized systems for multifamily applications based on innovative gas piping and appliance technologies. The second goal was to ensure that this information is made available to the design community.

  2. Prise en charge en soins primaires des troubles liés à l’usage d’alcool et de la consommation à risque

    PubMed Central

    Spithoff, Sheryl; Kahan, Meldon

    2015-01-01

    Résumé Objectif Présenter aux médecins de soins primaires des renseignements et des conseils fondés sur des données probantes concernant la prise en charge de la consommation à risque et des troubles liés à l’usage d’alcool (TUA). Sources des données Nous avons entrepris une recherche documentaire non systématique à l’aide d’expressions de recherche en anglais, notamment primary care; screening, interventions, management et treatment; et at-risk drinking, alcohol use disorders, alcohol dependence et alcohol abuse; ainsi que des interventions spécifiques en médecine et en counseling pertinentes aux soins primaires. Principaux messages Dans le cas de patients ayant une consommation à risque ou un TUA, les médecins devraient offrir du counseling et, au besoin (p. ex. les patients dont le TUA est de modéré à grave), prescrire et connecter. Counseling : Offrir à tous les patients ayant une consommation à risque une brève séance de counseling et un suivi. Offrir à tous les patients ayant un TUA des séances de counseling et un suivi constant (fréquent et régulier). Prescrire : Offrir des médicaments (disulfiram, naltrexone, acamprosate) à tous les patients ayant un TUA de modéré à grave. Connecter : Encourager les patients souffrant d’un TUA à suivre des programmes de counseling de jour ou en résidence et d’adhérer à des groupes d’entraide. S’il est indiqué de le faire, demander une consultation pour le patient auprès d’un spécialiste en médecine des dépendances, de services concurrents en santé mentale et en toxicomanie ou une thérapie spécialisée pour traumatisme. Conclusion Les médecins de famille peuvent prendre en charge efficacement les patients qui ont une consommation à risque ou des TUA.

  3. Prise en charge conservatrice des hématomes puerpéraux de gros volume: à propos de 3 cas

    PubMed Central

    Kehila, Mehdi; Khedher, Sonia Ben; Zeghal, Dorra; Mahjoub, Sami

    2013-01-01

    L'hématome puerpéral est une complication rare parfois grave du post-partum. Sa prise en charge reste encore non consensuelle. L'objectif de notre travail est de discuter la possibilité et l'intérêt d'une prise en charge conservatrice en cas d'hématome de gros volume sous couvert de certaines conditions. Ainsi nous rapportons 3 cas d'hématomes péri- génitaux de taille supérieure à 8cm pour lesquels un traitement conservateur a été préconisé. L'évolution était favorable pour les 3 patientes. PMID:24570780

  4. Place de la laparoscopie dans la prise en charge des anomalies de différenciation sexuelle: à propos de 4 cas

    PubMed Central

    Goultaiene, Aissam; Elmortaji, Khalid; Sentissi, Reda; Moataz, Amine; Rabii, Redouane; Aboutaib, Rachid; Dakir, Mohammed; Debbagh, Adil; Meziane, Fethi

    2016-01-01

    Les troubles de la différenciation sexuelle sont à l'origine d'une discordance entre le sexe proprement dit (phénotypique) et le sexe génétique (génotypique) ce qui pose un problème de détermination du sexe. Dans les pays de faible niveau socio-économique où le diagnostic anténatal est souvent absent et les plateaux techniques insuffisants, la prise en charge médico-chirurgicale est difficile. Le but de ce travail est de préciser la place de la laparoscopie dans la prise en charge de l'ambiguïté sexuelle à travers l'observation de 4 cas et une revue de la littérature. PMID:27303583

  5. Etude critique de la prise en charge de 159 personnes âgées en consultation de psychiatrie

    PubMed Central

    Ben Thabet, Jihène; Ammar, Yousra; Charfi, Nada; Zouari, Lobna; Zouari, Nasreddine; Gaha, Lotfi; Maalej, Mohamed

    2014-01-01

    Introduction Le phénomène de vieillissement des populations est associé à une augmentation de la prévalence de la morbidité liée à l’âge. La prescription des psychotropes chez le sujet âgé est de plus en plus fréquente dans les institutions, les doses sont de plus en plus élevées, avec un recours fréquent à une poly pharmacothérapie. Nous nous sommes proposé de décrire les conduites thérapeutiques chez le sujet âgé consultant en psychiatrie, en vue de les confronter aux dernières recommandations en la matière. Méthodes L’étude était de type rétrospectif et descriptif. Elle a concerné les sujets âgés d'au moins 60 ans ayant consulté pour la première fois en psychiatrie, au CHU Hédi Chaker à Sfax, en 2010 ou 2011. Résultats Nous avons colligé 159 dossiers. L’âge moyen était de 73 ans. La démence et les troubles de l'humeur étaient les diagnostics les plus fréquents. Sur le plan thérapeutique, une poly thérapie faite d'au moins deux psychotropes de familles différentes a été prescrite pour 55,9%. Chez 60.3% des sujets, le traitement a été prescrit d'emblée à dose complète. Aucun dossier ne faisait état d'une prise en charge psychothérapeutique. Conclusion La prise en charge des malades de notre étude n’était pas conforme aux recommandations, notamment en matière d'association médicamenteuse, de progression des doses et d'association de la psychothérapie à la pharmacothérapie. L'information des médecins et leur sensibilisation aux particularités du sujet âgé contribuerait à optimiser les soins qui leur sont prodigués, y compris en psychiatrie. PMID:25120873

  6. Willingness to pay for publicly financed health care services in Central and Eastern Europe: evidence from six countries based on a contingent valuation method.

    PubMed

    Tambor, Marzena; Pavlova, Milena; Rechel, Bernd; Golinowska, Stanisława; Sowada, Christoph; Groot, Wim

    2014-09-01

    The increased interest in patient cost-sharing as a measure for sustainable health care financing calls for evidence to support the development of effective patient payment policies. In this paper, we present an application of a stated willingness-to-pay technique, i.e. contingent valuation method, to investigate the consumer's willingness and ability to pay for publicly financed health care services, specifically hospitalisations and consultations with specialists. Contingent valuation data were collected in nationally representative population-based surveys conducted in 2010 in six Central and Eastern European (CEE) countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine) using an identical survey methodology. The results indicate that the majority of health care consumers in the six CEE countries are willing to pay an official fee for publicly financed health care services that are of good quality and quick access. The consumers' willingness to pay is limited by the lack of financial ability to pay for services, and to a lesser extent by objection to pay. Significant differences across the six countries are observed, though. The results illustrate that the contingent valuation method can provide decision-makers with a broad range of information to facilitate cost-sharing policies. Nevertheless, the intrinsic limitations of the method (i.e. its hypothetical nature) and the context of CEE countries call for caution when applying its results. PMID:25016327

  7. Distribution of biomass and nutrients in lodgepole pine/bitterbrush ecosystems in central Oregon. Forest Service research paper

    SciTech Connect

    Little, S.N.; Shainsky, L.J.

    1992-09-01

    The authors investigated the distribution of biomass and nutrients in lodgepole pine (Pinus contorta var. murryana Dougl.) ecosystems on pumice soils in south-central Oregon. Sixty-three trees were sampled to develop equations for estimating dry weights of tree crowns, boles, bark, and coarse roots from diameter at breast height and height. The concentrations of total carbon, nitrogen, phosphorus, and sulfur were determined for each of these components. Biomass, nutrient concentrations, and nutrient contents of the associated vegetation, forest floor, woody debris, fine roots, and soil horizons also were determined. An example stand illustrates the use of these data for determining the effects of bole versus whole-tree harvesting on nutrient capital in a lodgepole pine ecosystem.

  8. Coordination and establishment of centralized facilities and services of the University of Alaska ERTS survey of the Alaskan environment

    NASA Technical Reports Server (NTRS)

    Belon, A. E. (Principal Investigator); Miller, J. M.

    1973-01-01

    The author has identified the following significant results. The objective of this project is to provide a focus for the entire University of Alaska ERTS-1 effort (12 projects covering 10 disciplines and involving 8 research institutes and science departments). Activities have been concentrated on the implementation of the project's three primary functions: (1) coordination and management of the U of A ERTS-1 program, including management of the flow of data and data products; (2) acquisition, installation, test, operation, and maintanence of centralized facilities for processing ERTS-1, aircraft, and ground truth data; and (3) development of photographic and digital techniques for processing and interpreting ERTS-1 and aircraft data. With minor exceptions these three functions are now well-established and working smoothly.

  9. Epidémiologie et prise en charge des infections du per-partum à la maternité du centre hospitalier départemental de l'Ouémé-Plateau au Bénin

    PubMed Central

    Saizonou, Jacques; Ouédraogo, Laurent; Paraiso, Moussiliou Noël; Ayélo, Paul; Kpozèhouen, Alphonse; Daraté, René; Traoré, Esther

    2014-01-01

    Introduction La présente étude avait pour objectif de mesurer l'ampleur des infections du per-partum à la maternité du Centre Hospitalier Départemental de l'Ouémé-Plateau d'analyser les conditions de survenue et de prise en charge dans la perspective de l'amélioration des soins et services maternels et néonataux. Méthodes Une étude descriptive et analytique a été conduite de Août 2009 à Février 2010 et a impliqué 110 mères victimes d'infections du per-partum; elles ont été soumises à un questionnaire durant tout leur séjour hospitalier; des observations des pratiques de prise en charge des prestataires de soins ont été menées et des registres et autres supports de données sanitaires ont été exploités. L'analyse des données a été effectuée à l'aide du logiciel Epi Info 6.4 dans sa version française. Résultats L'incidence des infections du per-partum était de 5,9 pour 100 accouchements (110/ 1875); les types d'infections les plus incriminés étaient les endométrites (27,3%), les chorioamniotites (18,2%), les infections du site opératoire (12,7%) et les infections urinaires (2,7%). Les examens cliniques ont été relativement acceptables. En revanche, les examens biologiques ont été très insuffisants expliquant l'imprécision importante au niveau des diagnostics. L'antibiothérapie a été instaurée systématiquement. Le taux de mortinaissance était de 25,6% et les enfants de petit poids représentaient 23,2%. Conclusion L'incidence des infections du per-partum dans la présente étude était assez élevée. Des efforts de préventions et de dépistage de ces infections sont nécessaire afin d'améliorer la qualité des soins PMID:25120854

  10. Analyse de la prise en charge du nouveau-né dans le cadre de la stratégie nationale de subvention des accouchements et des soins obstétricaux et néonatals d'urgence au Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou (Burkina Faso)

    PubMed Central

    Ouédraogo, Solange Odile Yugbaré; Yougbaré, Nestor; Kouéta, Fla; Dao; Ouédraogo, Moussa; Lougué, Claudine; Ludovic, Kam; Traoré, Ramata Ouédraogo; Yé, Diarra

    2015-01-01

    Introduction Il s'agit d'analyser la prise en charge du nouveau-né dans le cadre de la stratégie na-tionale de subvention des accouchements et des soins obstétricaux et néonatals d'urgence mis en place par le gouvernement du Burkina Faso en 2006. Méthodes Nous avons menée une étude à visée descriptive et analytique comportant un volet ré-trospectif du 01 janvier 2006 au 31 décembre 2010 portant sur les paramètres épidémiologiques, cliniques des nouveau-nés hospitalisés et un volet prospectif du 3 octobre 2011 au 29 février 2012 par une entrevue des accompagnateurs des nouveau-nés et des prestataires des services de santé. Résultats Les hospitalisations ont augmenté de 43,65% entre 2006 à 2010 Le taux de mortalité néo-natale hospitalière qui était de 11,04% a connu une réduction moyenne annuelle de 3,95%. L'entrevue a porté sur 110 accompagnateurs et 76 prestataires. La majorité des prestataires (97,44%) et des ac-compagnateurs (88,18%) étaient informés de la stratégie mais n'avait pas une connaissance exacte de sa définition. Les prestataires (94,74%) ont signalé des ruptures de médicaments, consommables médicaux et des pannes d’ appareils de laboratoire et d'imagerie. Parmi les accompagnateurs (89%) disaient être satisfaits des services offerts et (72,89%) trouvaient les coûts abordables mais évoquaient les difficultés du transport. Conclusion: La subvention a amélioré la prise en charge du nou-veau-né mais son optimisation nécessiterait une meilleur information et implication de tous les acteurs. Conclusion La subvention a amélioré la prise en charge du nouveau-né mais son optimisation nécessiterait une meilleur information et implication de tous les acteurs. PMID:26161166

  11. Le syndrome des brides amniotiques et ses difficultés diagnostiques et de prise en charge au Burkina Faso

    PubMed Central

    Nagalo, Kisito; Badiel, Roger; Kouéta, Fla; Tall, François Housséini; Yé, Diarra

    2015-01-01

    Le syndrome des brides amniotiques est une embryo-foetopathie rare, d’étiopathogénie encore inconnue, caractérisé par des malformations crânio-faciales, thoraco-abdominales, des membres et des extrémités. Afin de discuter des difficultés diagnostiques et thérapeutiques du syndrome des brides amniotiques, nous rapportons cinq cas de ce syndrome. Ces cas représentaient autant de phénotypes de la maladie mais avec quelques singularités. Les deux premiers étaient des cas de maladie des brides amniotiques caractérisés l'un par une amputation d'un membre inférieur associée à des lésions cutanées et à une surdité, l'autre par des strictions avec amputation des doigts associées à une fente labio-palatine, une cataracte congénitale et un strabisme. Les trois autres cas correspondaient à des formes létales du Limb Body Wall Complex dont deux avec attache placento-crânienne et un avec attache placento-abdominale. Le renforcement du diagnostic anténatal, l'instauration du conseil génétique et la mise en place d'un registre national des malformations devraient permettre d'améliorer la prise en charge des cas du syndrome des brides amniotiques. PMID:26113939

  12. Soil cover patterns and SOC dynamics impacts on the soil processes, land management and ecosystem services in Central Region of Russia

    NASA Astrophysics Data System (ADS)

    Vasenev, Ivan; Chernikov, Vladimir; Yashin, Ivan; Geraskin, Mikhail; Morev, Dmitriy

    2014-05-01

    In the Central Region of Russia (CRR) the soil cover patterns usually play the very important role in the soil forming and degradation processes (SFP & SDP) potential and current rates, soil organic carbon (SOC) dynamics and pools, greenhouse gases (GHG) emissions and soluble SOC fluxes that we need take into attention for better assessment of the natural and especially man-changed ecosystems' services and for best land-use practices development. Central Region of Russia is the biggest one in RF according to its population and role in the economy. CRR is characterized by high spatial variability of soil cover due to as original landscape heterogeneity as complicated history of land-use practices during last 700 years. Our long-term researches include the wide zonal-provincial set of representative ecosystems and soil cover patterns with different types and history of land-use (forest, meadow-steppe and agricultural ones) from middle-taiga to steppe zones with different level of continentality. The carried out more than 30-years region- and local-scale researches of representative natural and rural landscapes in Tver', Yaroslavl', Kaluga, Moscow, Vladimir, Saransk (Mordovia), Kursk, Orel, Tambov, Voronezh and Saratov oblasts give us the interregional multi-factorial matrix of elementary soil cover patterns (ESCP) with different soil forming and degradation processes rates and soil organic carbon dynamics due to regionally specific soil-geomorphologic features, environmental and dominated microclimate conditions, land-use current practices and history. The validation and ranging of the limiting factors of SFP and SDP develop¬ment, soil carbon dynamics and sequestration potential, ecosystem (agroecosystem) principal services, land functional qualities and agroecological state have been done for dominating and most dynamical components of ESCP regional-typological forms - with application of SOC structure analysis, regional and local GIS, soil spatial patterns detail

  13. Détection et prise en charge efficace à l’urgence d’une luxation de Lisfranc à faible vélocité

    PubMed Central

    Mayich, D. Joshua; Mayich, Michael S.; Daniels, Timothy R.

    2012-01-01

    Résumé Objectif Améliorer la capacité des médecins de soins primaires de reconnaître les mécanismes et les présentations courantes des luxations de Lisfranc à basse vélocité (LLF) et mieux faire comprendre le rôle de l’imagerie et les principes des soins primaires dans les cas de LLF à basse vélocité. Sources des données Une recension des ouvrages spécialisés dans MEDLINE a été effectuée et les résultats ont été résumés, concernant notamment l’anatomie et les mécanismes, les diagnostics cliniques et par imagerie et les principes de la prise en charge en milieu de soins primaires. Message principal Les LLF à basse vélocité sont le résultat de divers mécanismes et, à l’examen clinique et à l’imagerie, les signes révélateurs sont très peu perceptibles. Il faut donc un fort degré de suspicion et de prudence dans la prise en charge de ce type de blessure. Conclusion Si on met en pratique quelques principes thérapeutiques dans la prise en charge des LLF à basse vélocité, qui sont potentiellement dévastatrices si elles ne sont pas reconnues, et ce, dès leur présentation, il est possible d’optimiser l’issue de telles blessures.

  14. Abcès encéphaliques: prise en charge, à propos d'une série de 82 cas

    PubMed Central

    Hassani, Fahd Derkaoui; El Fatemi, Nizare; Moufid, Faycal; YassadOudrhiri, Mohammed; Gana, Rachid; El Maaqili, Rachid; Bellakhdar, Fouad

    2014-01-01

    Les auteurs proposent des options thérapeutiques dans la prise en charge des abcès encéphaliques, en fonction des paramètres cliniques et radiologiques des patients, en dégageant des facteurs pronostiques à long terme. Il s'agit d'une étude rétrospective incluant tous les abcès encéphaliques pris en charge, sur une période 13 ans, au service de Neurochirurgie de l'Hôpital Ibn Sina de Rabat. L'analyse a porté sur: le Glasgow coma scale (GCS), la présence de déficit neurologique, l'imagerie cérébrale avec contraste, et la recherche d'une porte d'entrée; le traitement a compris chirurgie et antibiothérapie, et le pronostic a été évalué à long terme. 82 cas d'abcès ont été analysés, un score de GCS inférieur à 12 a été trouvé dans 24%. La porte d'entrée a été d'origine ORL dans 45%. La trépanoponction seule a été décidée dans 34% des cas en situation d'urgence avec troubles de conscience. Elle a été suivie d'une exérèse de la coque dans 16% des cas lors de persistance ou récidive de la collection. La ponction stéréotaxiques a été réalisée dans 10% des cas lors de localisations éloquentes et l'exérèse d'emblée dans 38% des cas avec abcès collecté non menaçant. La mortalité opératoire a été de 1,22%, la morbidité de 19,30%. Les facteurs de bon pronostic à long terme ont été l’âge jeune, un GCS supérieur à 12 à l'admission, et la trépanoponction suivie de l'exérèse da la coque. L'amélioration du pronostic passe par le diagnostic précoce, un geste neurochirurgical précis et antibiothérapie adaptée, et le traitement des portes d'entrée. PMID:25404970

  15. Prise en charge en soins primaires des troubles liés à l’usage d’alcool et de la consommation à risque

    PubMed Central

    Spithoff, Sheryl; Kahan, Meldon

    2015-01-01

    Résumé Objectif Fournir aux médecins de soins primaires de l’information et des conseils fondés sur des données probantes sur le dépistage et l’évaluation de la consommation d’alcool à risque et des troubles liés à l’usage d’alcool (TUA). Sources des données Nous avons effectué une recherche documentaire non systématique en utilisant des expressions de recherche portant sur les soins primaires, les TUA, la dépendance à l’alcool, l’abus d’alcool, l’usage abusif d’alcool, la consommation d’alcool néfaste pour la santé, ainsi que le dépistage, la détermination et l’évaluation dans le contexte des soins primaires. Principaux messages Les médecins de famille devraient faire passer un test validé de dépistage de l’abus d’alcool à tous les patients, au moins une fois par année. Dépister les patients qui se présentent avec des problèmes médicaux ou psychosociaux pouvant être reliés à l’usage d’alcool. Déterminer si les patients qui obtiennent des résultats positifs lors du dépistage sont des consommateurs d’alcool à risque ou s’ils ont des TUA. Si les patients ont des TUA, déterminer si les troubles sont légers, modérés ou sévères en utilisant les critères de la 5e édition du Manuel diagnostique et statistique des troubles mentaux. Communiquer le diagnostic aux patients et leur offrir de l’aide. Effectuer une évaluation plus approfondie des patients ayant des TUA. Procéder à un dépistage de la consommation d’autres substances, des troubles concomitants et des traumatismes. Déterminer s’il est nécessaire de rapporter le cas aux services de protection de l’enfance ou au ministère des Transports. Déterminer les besoins en matière de prise en charge médicale du sevrage alcoolique. Effectuer un bref examen physique et prescrire l’exécution de tests de laboratoire pour évaluer la formule sanguine complète et les taux de transaminases hépatiques, comprenant les

  16. Preferences for Expansion of Public Services in Five West Central Wisconsin Counties. Report No. 8 of a Series on Quality of Life and Development in Northwestern Wisconsin, February 1976.

    ERIC Educational Resources Information Center

    Lambert, Virginia

    As part of a study of the quality of life in northwestern Wisconsin, 1974 sample populations (N=150 residents per county) from each of 4 west central counties (Dunn, Clark, Eau Claire, and Polk) were presented with a list of public service programs and asked if they should be "expanded", "kept the same", or "cut back". Percentages on comparable…

  17. Identification et prise en charge des femmes ayant des antécédents familiaux de cancer du sein

    PubMed Central

    Heisey, Ruth; Carroll, June C.

    2016-01-01

    Résumé Objectif Résumer les meilleures données portant sur les stratégies d’identification et de prise en charge des femmes qui présentent des antécédents familiaux de cancer du sein. Sources d’information Une recherche a été effectuée sur PubMed à l’aide des mots-clés anglais suivants : breast cancer, guidelines, risk, family history, management et magnetic resonance imaging screening, entre 2000 et 2016. La plupart des données sont de niveau II. Message principal Une bonne anamnèse familiale est essentielle lors de l’évaluation du risque de cancer du sein afin d’identifier les femmes qui sont candidates à une recommandation en counseling génétique pour un éventuel test génétique. On peut sauver des vies en offrant aux femmes porteuses d’une mutation au gène BRCA des interventions chirurgicales de réduction des risques (mastectomie bilatérale prophylactique, salpingo-ovariectomie bilatérale). Il faut encourager toutes les femmes qui présentent des antécédents familiaux de cancer du sein à demeurer actives et à limiter leur consommation d’alcool à moins de 1 verre par jour; certaines femmes sont admissibles à la chimioprévention. Il faut offrir aux femmes dont le risque à vie de cancer du sein est de 20 à 25 % ou plus un dépistage poussé par imagerie par résonance magnétique en plus d’une mammographie. Conclusion Une vie saine et la chimioprévention (chez les candidates) pourraient réduire l’incidence du cancer du sein; le dépistage poussé pourrait entraîner une détection plus précoce. Le fait d’aiguiller des femmes porteuses d’une mutation au BRCA vers la chirurgie de réduction des risques sauve des vies. PMID:27737991

  18. Consensus formalisé: recommandations de pratiques cliniques pour la prise en charge de la lombalgie aiguë du patient africain

    PubMed Central

    Elleuch, Mohamed; El Maghraoui, Abdellah; Griene, Brahim; Nejmi, Mati; Ndongo, Souhaibou; Serrie, Alain

    2015-01-01

    La lombalgie aiguë est la pathologie rhumatismale la plus fréquente en Afrique. L’épidémiologie et la présentation clinique ne diffèrent pas de celles observées sur les autres continents. En revanche, les aspects psycho-sociaux, la disponibilité des traitements, l'accès aux soins et le poids culturel des médecines traditionnelles sont autant de spécificités qui ont conduit à la réalisation du 1er consensus d'experts en rhumatologie pour la prise en charge du patient africain. Destiné aux praticiens, ce travail collaboratif multinational a pour objectif de fournir 11 recommandations de pratiques cliniques simples, fondées sur les preuves, et adaptées aux conditions de l'exercice médical en Afrique. Leur ambition est d'améliorer la prise en charge de la lombalgie aigue par une évaluation initiale clinique pertinente, une diminution des examens radiologiques inutiles, une prescription médicamenteuse adéquate et l'abandon de procédures invasives inappropriées. PMID:26955427

  19. Les conseils et la prise en charge en prévision d’une très grande prématurité

    PubMed Central

    Jefferies, Ann L; Kirpalani, Haresh M

    2012-01-01

    RÉSUMÉ En cas de très grande prématurité (accouchement entre la 220/7 et la 256/7 semaine d’âge gestationnel [AG]), les parents doivent souvent faire des choix complexes sur les soins de leur nourrisson. Les professionnels de la santé ont un rôle important à jouer en matière d’information, d’orientation et de soutien. Les parents qui font face à la naissance d’un très grand prématuré doivent avoir la possibilité de rencontrer les dispensateurs de soins obstétricaux et pédiatriques ou néonatals pour recevoir de l’information exacte sur le pronostic de leur nourrisson, transmise avec clarté et compassion. La prise de décision entre les parents et les professionnels de la santé doit découler d’un processus éclairé et partagé, et toutes les décisions de prise en charge doivent être consignées. Il est important de consulter un centre périnatal de soins tertiaires et d’y prévoir le transfert de la mère et du fœtus afin d’assurer leurs soins. Puisque la survie des nourrissons venus au monde avant 22 semaines complètes d’AG demeure rare, il est recommandé de ne pas intervenir, mais à 23, 24 et 25 semaines d’AG, il faut adapter les conseils sur les issues et la prise de décision à chaque nourrisson et à sa famille, compte tenu des facteurs qui influent sur le pronostic. Il faut prodiguer des soins palliatifs compatissants à tous les grands prématurés qui ne sont pas réanimés ou qui ne répondent pas à la réanimation.

  20. La prévention et la prise en charge de la douleur et du stress chez le nouveau-né

    PubMed Central

    2000-01-01

    Le présent énoncé est destiné aux professionnels de la santé qui s’occupent de nouveau-nés (prématurés ou à terme, jusqu’à un mois de vie). Il vise à sensibiliser les professionnels au fait que les nouveau-nés ressentent de la douleur, à fournir les assises physiologiques de la douleur néonatale ainsi que de l’examen et de la prise en charge du stress par les professionnels de la santé, à faire des recommandations pour réduire l’exposition des nouveau-nés aux stimulus nuisibles et pour réduire au minimum les résultats indésirables associés, ainsi qu’à recommander des interventions efficaces et sécuritaires qui soulagent la douleur et le stress.

  1. Prise en charge de l’ostéoporose dans les unités de courte durée gériatriques

    PubMed Central

    Champoux, Nathalie; Lafleur, Martine; Bertrand, Benoît; Gilbert, Suzanne; Latour, Judith; Kergoat, Marie Jeanne

    2010-01-01

    RÉSUMÉ OBJECTIF Identifier dans les guides de pratique canadiens et américains sur la prise en charge de l’ostéoporose, les recommandations applicables aux personnes âgées vulnérables admises en unité de courte durée gériatrique (UCDG). TYPE D’ÉTUDE Delphi modifié selon la méthode RAND/UCLA. CONTEXTE Les membres du panel d’experts proviennent de diverses régions du Québec. PARTICIPANTS Le panel est composé de 6 médecins, 5 pharmaciens et 3 nutritionnistes reconnus par leurs pairs pour leur expertise en UCDG. MÉTHODE Onze recommandations émanant de lignes directrices nord-américaines ont été soumises au panel d’experts afin d’identifier les plus appropriées pour la prise en charge de l’ostéoporose en UCDG. Le degré d’accord de chaque expert avec les recommandations et le degré d’accord entre les experts ont servi à en évaluer la pertinence. RÉSULTATS Un consensus a été atteint pour chacune des 11 recommandations. Sept recommandations ont été jugées appropriées dans le contexte de la prise en charge de l’ostéoporose auprès de personnes âgées vulnérables admises en UCDG. La mesure de la densité osseuse en tant que paramètre de suivi est la seule recommandation jugée inappropriée dans ce contexte. Les experts sont demeurés incertains par rapport à 3 recommandations: le dépistage systématique de l’ostéoporose par la mesure de la densité minérale osseuse, le dépistage ou l’évaluation systématique des facteurs de risque de fractures et la prévention pharmacologique auprès des personnes âgées vulnérables ayant un risque accrû de fracture. CONCLUSION Certaines recommandations émises dans les lignes directrices nord-américaines semblent moins appropriées pour la prise en charge de l’ostéoporose chez les personnes âgées vulnérables admises en UCDG. Les recommandations retenues dans cette étude pourraient s’avérer utiles pour standardiser les interventions prodiguées à cette client

  2. Faculty Perspectives on the Challenges and Benefits of Providing Service-Learning Pedagogy in Higher Education: An Historical Study of Ten Diverse Central Maryland Colleges and Universities

    ERIC Educational Resources Information Center

    MacKenzie, Diane E.

    2013-01-01

    Although service-learning is considered to be a fairly new pedagogy in U.S. institutions of higher education, its origins can be traced back to the mid-nineteenth century philosopher John Dewey and his "learn by doing" approach to education. Service-learning has gained popularity as a form of applied learning that helps increase…

  3. The centrality of laboratory services in the HIV treatment and prevention cascade: The need for effective linkages and referrals in resource-limited settings.

    PubMed

    Alemnji, George; Fonjungo, Peter; Van Der Pol, Barbara; Peter, Trevor; Kantor, Rami; Nkengasong, John

    2014-05-01

    Strong laboratory services and systems are critical for delivering timely and quality health services that are vital to reduce patient attrition in the HIV treatment and prevention cascade. However, challenges exist in ensuring effective laboratory health systems strengthening and linkages. In particular, linkages and referrals between laboratory testing and other services need to be considered in the context of an integrated health system that includes prevention, treatment, and strategic information. Key components of laboratory health systems that are essential for effective linkages include an adequate workforce, appropriate point-of-care (POC) technology, available financing, supply chain management systems, and quality systems improvement, including accreditation. In this review, we highlight weaknesses of and gaps between laboratory testing and other program services. We propose a model for strengthening these systems to ensure effective linkages of laboratory services for improved access and retention in care of HIV/AIDS patients, particularly in low- and middle-income countries. PMID:24742299

  4. Evaluation of input and process components of quality of child health services provided at 24 × 7 primary health centers of a district in Central Gujarat

    PubMed Central

    Chavda, Paragkumar; Misra, Shobha

    2015-01-01

    Context: With the critical Indian challenge on child survival and health, time is ripe to initiate focus on quality of services apart from measuring coverage, to bring about improvements. Aims: To assess the quality of child health services provided at 24 × 7 Primary Health Centers of Vadodara District in Gujarat in terms of Input and Process Indicators. Settings and Design: The study was carried out in 12 randomly chosen 24 × 7 Primary Health Centers (PHCs) of Vadodara district using a modified quality assessment checklist of the Program on District Quality Assurance for Reproductive and Child Health (RCH) services with use of scores from May 2010 to June 2011. Subjects and Methods: Inputs assessment was done by facility survey. Process assessment for the four child health service components used actual observation of service, review of records and interview of service providers and clients. Results: The mean obtained score for facilities in Input section was 65%. Highest score was obtained for Drugs and Consumables (86%) followed by Equipments and Supplies (74%). The score obtained for Infrastructure facility was 65%, Personnel and training was 56% and Essential protocols and guidelines scored 43%. The mean obtained score in the process section was 55%. Highest scores were obtained for immunization at 76%. This was followed by newborn care (52%), growth monitoring (52%). management of sick child (41%). Conclusion: Quality improvement efforts should focus not only on resource-intensive structural improvements, but also on cost-effective measures at improving service delivery process, especially adherence to service guidelines by providers. PMID:26288773

  5. Comparison of Central Appalachian In-Service Elementary and Middle School Teachers' Understanding of Selected Light and Force and Motion Concepts

    ERIC Educational Resources Information Center

    Krall, Rebecca McNall; Christopher, John E.; Atwood, Ronald K.

    2009-01-01

    This descriptive study investigated whether elementary and middle school teachers in the Central Appalachian region were prepared to teach selected standards-based light, force and motion concepts they could reasonably be expected to teach. The study also sought to compare their preparedness for teaching these concepts. (Contains 7 figures and 7…

  6. Validation d’indicateurs de la prise en charge des atteintes des fonctions cognitives dans les unités d’évaluation gériatrique

    PubMed Central

    Payot, Isabelle; Latour, Judith; Massoud, Fadi; Kergoat, Marie-Jeanne

    2007-01-01

    RÉSUMÉ OBJECTIF Analyser et adapter des indicateurs de qualité pour l’évaluation et la prise en charge des personnes avec atteinte des fonctions cognitives, dont la prévalence est très élevée dans les unités d’évaluation gériatrique au Québec. DEVIS Une méthode de type Delphi-modifiée. CONTEXTE Province de Québec. PARTICIPANTS Sept praticiens de milieux hospitaliers affiliés à 3 universités du Québec choisis pour leur compétence reconnue en démence et soins gériatriques. MÉTHODE Parmi les indicateurs développés en 2001 par la méthode RAND, 22 items sélectionnés pour leur pertinence au cours du processus d’évaluation et de prise en charge d’une atteinte des fonctions cognitives ont été adaptés aux conditions de pratique du milieu hospitalier québécois. Les indicateurs, accompagnés d’évidences de la littérature, ont été soumis, par la poste, à un panel d’experts. Chaque expert a coté, sur une échelle de 1 à 9, son degré d’accord à des affirmations concernant la validité, la qualité et la nécessité d’être inscrit dans le dossier médical. Pour qu’un indicateur soit retenu, il devait faire consensus selon les valeurs médianes, être situé dans le tertile supérieur et recevoir l’agrément des experts. Les indicateurs incertains étaient modifiés en fonction des commentaires des experts, puis soumis au même panel pour un second tour. RÉSULTATS Des 22 indicateurs soumis au premier tour, 21 ont été validés. Ils prenaient en compte le dépistage, l’investigation, l’évaluation, le traitement et le suivi. L’indicateur considéré comme incertain a été modifié puis accepté lors du second tour. CONCLUSION Cette étude a identifié 22 indicateurs pertinents pour l’évaluation et la prise en charge de l’atteinte des fonctions cognitives dans une unité d’évaluation gériatrique. Ils serviront de base à l’appréciation de la problématique de la démence, dans une étude ayant cours

  7. Les pneumopathies aigues du nourrisson en Côte d'Ivoire: apport de la radiographie thoracique dans la recherche étiologique et la prise en charge précoce

    PubMed Central

    Nágoan, Kouamé; Nágoan-Domoua, Anne-Marie; Alihonou, Sétchéou; Konan, Anhum Nicaise

    2012-01-01

    Introduction Identifier les tableaux radio-cliniques actuels des pneumopathies aiguës du nourrisson rencontrés en Côte d'Ivoire et démontrer le rôle de la radiographie thoracique dans leur prise en charge. Méthodes Etude rétrospective de 24 mois ayant concerné l'analyse de 165 radiographies thoraciques (RT) de face réalisées chez des nourrissons âgés de 1 à 24 mois, hospitalisés dans le service de pédiatrie du CHU de Yopougon (Abidjan-Côte d'Ivoire) pour pneumopathies aigues. Les éléments épidémio-cliniques, thérapeutiques et évolutifs ont été obtenus à partir du dossier médical des nourrissons. Résultats L'âge moyen des nourrissons était de 9 mois avec des extrêmes entre 3 et 22 mois. Le sex-ratio était égal à 1,2. Les syndromes radiographiques étaient dominés par le syndrome alvéolaire (70,3%) suivi par l'association syndrome alvéolaire-syndrome bronchique (29,7%). Les signes radiographiques de gravité étaient présents dans 61,8%. Les entités radio-cliniques étaient représentées par les pneumopathies massives (32,7%), la pneumonie franche lobaire aigue (4,2%), les abcès du poumon (7,3%), les staphylococcies pleuro-pulmonaires (4,2%), les pleuro-pneumopathies (13,3%), le pyo-pneumothorax (4,9%), les broncho-pneumopathies (29,7%) et la primo-infection tuberculeuse (3,7%). Conclusion A travers la mise en parallèle des entités radio-cliniques avec les éléments épidémiologiques et cliniques, la RT a permis de préjuger de l'étiologie des pneumopathies et de mettre en route immédiatement le traitement spécifique. A l'ère de la pandémie du VIH-SIDA, cette étude montre que la tuberculose pulmonaire est paradoxalement l'entité radio-clinique la plus rare. PMID:23319234

  8. De l'hémoglobine SS à SF: intérêt de l'hydroxyurée dans la prise en charge de la drépanocytose chez 2 enfants congolais et revue de la literature

    PubMed Central

    Nkashama, Gayllord Mutoke; Wakamb, Gray Kanteng A; Mulangu, Augustin Mutombo; Nkashama, Georges Mutoke; Kupa, Boniface Kabeya; Numbi, Oscar Luboya

    2015-01-01

    La drépanocytose est une maladie grave par ses complications et par les difficultés liées à sa prise en charge, notamment en milieu sous-équipé. Les auteurs rapportent l'effet bénéfique de l'hydroxyurée dans la prise en charge de deux patients drépanocytaires, au prix cependant d'une surveillance hématologique rigoureuse. Une revue de la littérature étaye par ailleurs les modalités d'administration de ce médicament et les perspectives ultérieures d'un tel traitement dans la drépanocytose. PMID:26327961

  9. Geographic variation in speed of seed germination in central Oregon ponderosa pine ( pinus ponderosa' dougl. ex laws). Forest Service research paper

    SciTech Connect

    Weber, J.C.; Sorensen, F.C.

    1992-03-01

    Variation in speed of seed germination was investigated among ponderosa pine trees representing 225 locations in central Oregon. Results suggested that at least some of the geographic variation is related to the severity of summer drought. In general, germination speed was greater in locations with short, drought-limited growing seasons. Levels of geographic variation were highest in the region having the steepest precipitation gradients. Most of the variation occurred, however, within locations.

  10. Establishment and maintenance of regulating ecosystem services in a dryland area of Central Asia: the Kökyar Protection Forest, Aksu, NW China, as an example

    NASA Astrophysics Data System (ADS)

    Missall, S.; Welp, M.; Thevs, N.; Abliz, A.; Halik, Ü.

    2014-12-01

    The city of Aksu, situated at the northern fringe of the Taklimakan Desert in the northwest of China, is exposed to periodic severe dust and sand storms. In 1986, local authorities decided to establish a peri-urban shelterbelt plantation, the so-called Kökyar Protection Forest. It was realised as a patchwork of poplar shelterbelts and orchards. The total area of the plantation reached 3800 ha in 2005. This endeavour was made possible by the annual mass mobilisation of Aksu citizens, based on the Chinese regulation of the "National Compulsory Afforestation Campaigns". Establishment costs amounted to ca. CNY 60 000 ha-1 (ca. USD 10 000 ha-1). The regulating ecosystem services provided by Kökyar Protection Forest clearly reduce dust and sand storm impacts on Aksu City. Permanent maintenance of the plantation is facilitated by leasing orchard plots to private fruit farmers. This system ensures forest tending, reduces government expenses, and provides incomes to farmers. From the perspective of the local economy, annual farming net benefits generated by Kökyar fruit farmers more than compensate annual government grants for maintenance, resulting in an overall monetary net benefit of at least CNY 10 500 ha-1 (ca. USD 1600 ha-1) on the long-term average. The intended regulating ecosystem services can thus be provided to the citizens of Aksu without payments for ecosystem services or other financial burdens. For a more complete understanding of Kökyar Protection Forest, future research should be directed towards quantifying the effect of its regulating ecosystem services, and on investigating the negative downstream consequences of its water consumption.

  11. To designate the facility of the United States Postal Service located at 787 State Route 17M in Monroe, New York, as the "National Clandestine Service of the Central Intelligence Agency NCS Officer Gregg David Wenzel Memorial Post Office".

    THOMAS, 112th Congress

    Rep. Hayworth, Nan A. S. [R-NY-19

    2011-12-07

    08/29/2012 Committee on Homeland Security and Governmental Affairs referred to Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  12. Establishment and maintenance of regulating ecosystem services in a dryland area of central Asia, illustrated using the Kökyar Protection Forest, Aksu, NW China, as an example

    NASA Astrophysics Data System (ADS)

    Missall, S.; Welp, M.; Thevs, N.; Abliz, A.; Halik, Ü.

    2015-06-01

    The city of Aksu, situated at the northern fringe of the Taklimakan Desert in northwest China, is exposed to severe periodic dust and sand storms. In 1986, local authorities decided to establish a peri-urban shelterbelt plantation, the so-called Kökyar Protection Forest, with the aim of reducing dust and sand storm impacts on Aksu City by the regulating ecosystem services provided by the plantation. It was realised as a patchwork of poplar shelterbelts and orchards. The total area of the plantation reached 3800 ha in 2005. The Kökyar Protection Forest is used as a case study to answer the following question: under which institutional frameworks and to which financial conditions can peri-urban shelterbelts be established and maintained? The endeavour of planting the shelterbelt was made possible by the annual mass mobilisation of Aksu citizens, based on the Chinese regulation of the "National Compulsory Afforestation Campaigns". Establishment costs amounted to ca. CNY 60 000 ha-1 (ca. USD 10 000 ha-1). Permanent maintenance of the plantation is facilitated by leasing orchard plots to private fruit farmers. From the perspective of the local economy, annual farming net benefits generated by Kökyar fruit farmers more than compensate for annual government grants for maintenance, resulting in an average overall monetary net benefit of at least CNY 10 500 ha-1 (ca. USD 1600 ha-1) in the long term. For a more complete understanding of Kökyar Protection Forest, future research should be directed towards quantifying the effect of its regulating ecosystem services and on investigating the negative downstream consequences of its water consumption.

  13. Lignes directrices sur la prise en charge en soins primaires des céphalées chez l’adulte

    PubMed Central

    Becker, Werner J.; Findlay, Ted; Moga, Carmen; Scott, N. Ann; Harstall, Christa; Taenzer, Paul

    2015-01-01

    Résumé Objectif Accroître l’utilisation d’approches éclairées par des données probantes pour diagnostiquer, investiguer et traiter en soins primaires les céphalées des patients. Qualité des données Une recherche documentaire exhaustive a été effectuée pour trouver des lignes directrices et des révisions systématiques publiées entre janvier 2000 et mai 2011. La grille d’évaluation de la qualité des recommandations pour la pratique clinique AGREE a servi à l’analyse critique des lignes directrices. Les 6 guides de pratique clinique de la plus grande qualité ont servi de base dans le processus d’adaptation. Message principal Un groupe d’élaboration multidisciplinaire de professionnels des soins primaires ont formulé 91 recommandations précises à l’aide d’un processus consensuel. Les recommandations portent sur le diagnostic, l’investigation et la prise en charge de la migraine, de la céphalée de tension, de la céphalée due à une surmédication et de la céphalée vasculaire de Horton. Conclusion Un guide de pratique clinique adapté au contexte des soins de santé au Canada a été produit en suivant un processus d’adaptation de lignes directrices dans le but d’aider les professionnels de toutes les disciplines des soins primaires à dispenser des soins éclairés par des données probantes aux patients souffrant de céphalées.

  14. Epithéliomas basocellulaires de la face: prise en charge chirurgicale, à propos de 45 cas et revue de la literature

    PubMed Central

    Ennouhi, Mohamed Amine; Moussaoui, Abdenacer

    2014-01-01

    L’épithélioma basocellulaire est de loin la tumeur épithéliale maligne la plus répandue. L'atteinte faciale représente plus de 65% des cas et constitue un facteur de risque de récidive. L'objectif de notre travail est de rappeler les principes et modalités du traitement chirurgical. Sur une période de douze mois, nous avons pris en charge quarante-cinq patients atteints de carcinomes basocellulaires de la face. Le traitement chirurgical comprend deux volets: -carcinologique: emportant la tumeur et une marge de tissu sain; -et une chirurgie réparatrice faisant appel à la suture cutanée directe; greffes ou lambeaux loco -régionaux. L'examen histologique systématique des pièces opératoires permet la confirmation du diagnostic, le typage histologique et l'appréciation de la qualité de l'exérèse chirurgicale. Les résultats esthétiques sont jugés satisfaisants. Quant aux résultats carcinologiques, nous déplorons quatre récidives. Le traitement chirurgical des épithéliomas basocellulaires est le seul garant de la guérison. Au niveau de la face, il faut trouver le meilleur compromis entre impératifs carcinologiques et esthétiques. L'amélioration des résultats passe par: la prévention, le dépistage précoce des lésions, la collaboration étroite des anatomo-pathologistes et la création de comités de concertation pluri -disciplinaire pour la prise en charge des cas difficiles. PMID:25709738

  15. Epidémiologie et prise en charge de l'insuffisance cardiaque dans un centre marocain

    PubMed Central

    Kheyi, Jamal; Benelmakki, Abdelilah; Bouzelmat, Hicham; Chaib, Ali

    2016-01-01

    Il s'agit d'une étude observationnelle prospective colligée dans le service des soins intensifs et rythmologie de l'Hôpital militaire d'instruction Mohammed V de Rabat, entre décembre 2008 et décembre 2014, portant sur 424 patients hospitalisés pour insuffisance cardiaque. L’âge moyen était de 60,91±12,77 Les principaux facteurs de risque cardiovasculaires rencontrés étaient: l'hypertension artérielle (46%), le tabagisme (45%), et le diabète (43%). Cliniquement, 63% des patients ont été admis pour insuffisance cardiaque gauche. Le ventricule gauche était dilaté dans 58% des cas, avec une fraction d’éjection moyenne estimée à 36,33±13,5%. L’étiologie dominante était la cardiopathie ischémique (254 cas). En plus d'un traitement médical optimal, 14.4% de nos patients ont fait l'objet d'une resynchronisation cardiaque avec ou sans système de défibrillation. L’évolution intra-hospitalière sous traitement médical était marquée par 26 décès.la durée moyenne d'hospitalisation était de 12,1±6,6 jours. PMID:27642424

  16. Apport de l’IRM dans la prise en charge des compressions médullaires lentes non traumatiques

    PubMed Central

    Badji, Nfally; Deme, Hamidou; Akpo, Geraud; Ndong, Boucar; Toure, Mouhamadou Hamine; Diop, Sokhna Ba; Niang, El Hadji

    2016-01-01

    Les compressions médullaires lentes sont dues au développement dans le canal médullaire d’une lésion expansive. C’est une pathologie très fréquente dont le diagnostic est essentiellement clinique. L’imagerie par résonnance magnétique occupe une place incontournable dans le diagnostic de localisation et la recherche étiologique. En Europe l’étiologie tumorale est prépondérante. Le but de cette étude était de décrire les aspects IRM des compressions médullaires lentes et de déterminer le profil étiologique. Il s’agit d’une étude rétrospective portant sur 97 observations colligées au service de radiologie du CHUN de Fann sur une période de 30 mois (du 08/03/10 au 29/09/12). On été inclus dans l’étude, tous les patients adressés pour un tableau de compression médullaire lente survenu dans un contexte non traumatique. L’âge moyen des patients était de 42,6 ans avec des extrêmes compris entre 04 mois et 85 ans. Nous avons étudié la topographie des lésions (étage rachidien, compartiments canalaires) leur rehaussement et les critères d’orientation étiologique. Le protocole d’examen permettait la réalisation de séquence pondérées T1 sans avec injection de gado, T2, STIR et T2 DRIVE centrées sur les niveaux lésionnels ou les zones suspectes. L’IRM a permis de préciser le siège exact et l’étendue des lésions. L’atteinte du rachis dorsal représentait 42% des cas, suivi du rachis cervical avec 32% des cas. Les atteintes lombo-sacrées et pluri-étagées représentaient respectivement 18% et 08% des cas. Les lésions extradurales représentaient 87% des cas, suivi des lésions intradurales extramédullaires avec 08% des cas et des lésions intramédullaires dans 05% des cas. La particularité du profil étiologique de notre étude est la prédominance des épidurites infectieuses et la fréquence relative des épidurites métastatiques comparée aux séries occidentales. L’IRM vertébro-médullaire occupe

  17. Effect of drying time, ambient temperature and pre-soaks on prion-infected tissue contamination levels on surgical stainless steel: concerns over prolonged transportation of instruments from theatre to central sterile service departments.

    PubMed

    Lipscomb, I P; Pinchin, H; Collin, R; Keevil, C W

    2007-01-01

    Iatrogenic transmission of prions through use of surgical instruments has been shown both experimentally and clinically. In addition, recent discoveries of prion protein accumulation in peripheral tissues such as appendix and muscle, and evidence suggesting human-to-human blood-borne transmission, have led to a concern that any residual soiling containing this agent may remain infectious even after sterile service processing. Removal of all proteinaceous material from surgical devices is extremely important for effective sterilization. This removal can be severely hampered if the contaminant is allowed to dry onto the instrument surface for any length of time. The current move to centralize sterile service centres and the inevitable lengthening of transport time between theatres and re-processing makes it necessary to minimize the amount of residual soiling adhering to an instrument before sterilization. This investigation simulates the period between the application of surgical instruments in theatre and their initial pre-wash by a washer/disinfector. The aim was to investigate the kinetics of drying at different temperatures, and the application of different commercially available pre-soak solutions in situ. The findings show that all pre-soaks significantly reduce (by up to 96%) the prion-infected tissue contamination, and that controlling the temperature whilst in transit between theatres and cleaning facilities may allow an increase in time before high protein adsorption levels occur. PMID:17145104

  18. Prise en charge en cabinet des lésions cérébrales traumatiques légères chez les enfants et les adolescents

    PubMed Central

    Garcia-Rodriguez, Juan Antonio; Thomas, Roger E.

    2014-01-01

    Résumé Objectif Fournir aux médecins de famille de l’information à jour, pratique et factuelle sur les lésions cérébrales traumatiques légères et les commotions cérébrales dans la population pédiatrique. Sources d’information Une recherche a été effectuée dans MEDLINE (de 1950 à février 2013), la base de données des revues systématiques Cochrane (de 2005 à 2013), le registre central Cochrane des essais contrôlés (de 2005 à 2013) et DARE (2005 à 2013) à l’aide de mots-clés liés aux commotions cérébrales et aux traumatismes crâniens. Des lignes directrices, énoncés de position, articles et rapports de recherche originaux pertinents aux lésions cérébrales traumatiques légères ont été sélectionnés. Message principal Le traumatisme est la cause principale de décès chez les enfants de plus d’un an et, dans ce groupe, le traumatisme crânien est la cause la plus fréquente d’incapacité et de décès. Neuf pour cent des blessures sportives rapportées chez les élèves du secondaire sont associées à une lésion cérébrale traumatique légère. Les médecins de famille doivent effectuer une anamnèse ciblée et un examen physique et neurologique, utiliser les instruments d’évaluation standardisés (Échelle de Glasgow; Outil d’évaluation des commotions cérébrales dans le sport, version 3; version pédiatrique de l’Outil d’évaluation des commotions cérébrales dans le sport; et échelle BESS [Balance Error Scoring System]), expliquer aux parents comment surveiller leurs enfants, décider des circonstances où les soignants ne sont pas une ressource dûment responsable, faire un suivi prompt auprès des patients, guider le retour sécuritaire au jeu ou à l’école et décider dans quelles circonstances un test neuropsychologique est nécessaire au suivi à long terme. Conclusion La prise en charge par le médecin de famille des lésions cérébrales traumatiques légères chez les enfants repose sur une

  19. Estimates of future water demand for selected water-service areas in the Upper Duck River basin, central Tennessee; with a section on Methodology used to develop population forecasts for Bedford, Marshall, and Maury counties, Tennessee, from 1993 through 2050

    USGS Publications Warehouse

    Hutson, S.S.; Schwarz, G.E.

    1996-01-01

    Estimates of future water demand were determined for selected water-service areas in the upper Duck River basin in central Tennessee through the year 2050. The Duck River is the principal source of publicly-supplied water in the study area providing a total of 15.6 million gallons per day (Mgal/d) in 1993 to the cities of Columbia, Lewisburg, Shelbyville, part of southern Williamson County, and several smaller communities. Municipal water use increased 19 percent from 1980 to 1993 (from 14.5 to 17.2 Mgal/d). Based on certain assumptions about socioeconomic conditions and future development in the basin, water demand should continue to increase through 2050. Projections of municipal water demand for the study area from 1993 to 2015 were made using econometric and single- coefficient (unit-use) requirement models of the per capita type. The models are part of the Institute for Water Resources-Municipal and Industrial Needs System, IWR-MAIN. Socioeconomic data for 1993 were utilized to calibrate the models. Projections of water demand in the study area from 2015 to 2050 were made using a single- coefficient requirement model. A gross per capita use value (unit-requirement) was estimated for each water-service area based on the results generated by IWR-MAIN for year 2015. The gross per capita estimate for 2015 was applied to population projections for year 2050 to calculate water demand. Population was projected using the log-linear form of the Box-Cox regression model. Water demand was simulated for two scenarios. The scenarios were suggested by various planning agencies associated with the study area. The first scenario reflects a steady growth pattern based on present demographic and socioeconomic conditions in the Bedford, Marshall, and Maury/southern Williamson water-service areas. The second scenario considers steady growth in the Bedford and Marshall water-service areas and additional industrial and residential development in the Maury/southern Williamson water-service

  20. Central line infections - hospitals

    MedlinePlus

    ... infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired infection - central line infection; Patient safety - central ...

  1. Evaluation de la qualité de la prise en charge de la dyspnée par les médecins généralistes à Parakou en 2013

    PubMed Central

    Codjo, Léopold Houétondji; Dohou, Serge Hugues; Agbodandé, Anthèlme; Karimou, Bastu Mohamed; Wanvoegbe, Armand Finangnon; Attinsounon, Angelo Cossi; Alassani, Adébayo Cossi; Houénassi, Martin Dèdonougbo

    2015-01-01

    Introduction La dyspnée est un symptôme qui peut être l'expression de pathologies potentiellement grave et urgentes. Notre objectif était d’évaluer la qualité de la prise en charge de la dyspnée en milieu hospitalier à Parakou. Méthodes Il s'agissait d’étude rétrospective portant sur tous les patients admis dans les centres hospitaliers de Parakou pour dyspnée non traumatique entre le 1er Février 2012 et le 31 Mai 2013. Les recommandations tunisiennes sur la prise en charge de la dyspnée aux urgences ont été utilisées comme référentiel d’évaluation. Chaque étape de la démarche médicale a été notée et la prise en charge était bonne lorsque la note obtenue au score était entre 51 et 100. Les autres variables utilisées étaient la qualification du soignant principal, les antécédents du patient et les données cliniques et paracliniques. Résultats Sur les 11101 patients reçus aux urgences on a dénombré 328 cas de dyspnée (2,9%). La PEC était assuré principalement par les cardiologues (55,9%) et les médecins généralistes (29,2%). La qualité de la prise en charge par les généralistes était bonne chez 73,2%. Les facteurs associés à la bonne qualité de PEC étaient: la recherche des antécédents médicaux (84,4% vs 15,6%; p < 10-4), la description des caractéristiques cliniques de la dyspnée (94,1% vs 5,9%; p < 10-4) et la réalisation de l'examen physique complet (86,8% vs 13,2%; p < 10-4). Conclusion A Parakou en 2013 près d'un généraliste sur trois gère mal la dyspnée. Cette mauvaise gestion est liée à une mauvaise démarche médicale. PMID:26985268

  2. Options for Braille Centralization. Study I--Implementation Study of Centralized Braille Book Storage and Distribution System. Part 1--Options for Braille Centralization. Final Report.

    ERIC Educational Resources Information Center

    ManTech Technical Services Corp., Fairfax, VA.

    This final report presents results of the first phase of an effort to develop in detail the resource requirements, operating procedures, and estimated costs for several centralized braille service options at the Library of Congress. Existing procedures and services were analyzed, and three models for centralized braille services were formulated.…

  3. Les recommandations de prise en charge des complications métaboliques associées aux antipsychotiques de deuxième génération chez les enfants et les adolescents

    PubMed Central

    Ho, Josephine; Panagiotopoulos, Constadina; McCrindle, Brian; Grisaru, Silviu; Pringsheim, Tamara

    2012-01-01

    HISTORIQUE : Les antipsychotiques de deuxième génération s’associent souvent à des complications métaboliques. Ces médicaments sont utilisés plus souvent pour le traitement des troubles de santé mentale chez les enfants, ce qui a requis l’élaboration de lignes directrices officielles sur la surveillance de leur innocuité et de leur efficacité. Des lignes directrices ont déjà été élaborées pour surveiller les complications métaboliques et neurologiques. Afin d’aider les praticiens qui effectuent ces interventions de surveillance, une série de recommandations thérapeutiques complémentaires a été élaborée pour les cas où l’on observe des mesures ou des résultats anormaux. OBJECTIF : Créer des recommandations probantes afin de contribuer à la prise en charge des complications métaboliques chez les enfants traités au moyen d’antipsychotiques de deuxième génération. MÉTHODOLOGIE : Les auteurs ont procédé à une analyse systématique des publications sur les complications métaboliques des antipsychotiques de deuxième génération chez les enfants. Les membres du groupe consensuel ont évalué l’information recueillie grâce à l’analyse bibliographique systématique et ont fait appel à un processus de groupe nominal pour parvenir à un consensus à l’égard de recommandations thérapeutiques. Dans la mesure du possible, ils se sont reportés aux lignes directrices existantes sur l’évaluation et le traitement des anomalies métaboliques chez les enfants. RÉSULTATS : Des recommandations probantes sont présentées pour contribuer à la prise en charge des complications métaboliques, y compris la prise de poids, l’augmentation du tour de taille, l’élévation des taux de prolactine, de cholestérol, de triglycérides et de glucose, les épreuves de fonction hépatique anormales et les études thyroïdiennes anormales. CONCLUSION : Il faut recourir à des mesures de surveillance convenables lorsqu’on prescrit

  4. Maximizing Financial and Operating Benefits of a Comprehensive Central Plant.

    ERIC Educational Resources Information Center

    Bhan, Chander

    2001-01-01

    Discusses the organizational and contractual concepts behind making a school's central plant's production more reliable and cost effective. A description of the Energy Services Coalition's contribution to the process and its services are highlighted. (GR)

  5. Hématome vulvaire massif du post-partum: à propos d'un cas à l'Hôpital Central de Yaoundé (Cameroun)

    PubMed Central

    Fouelifack, Florent Ymele; Fouogue, Jovanny Tsuala; Fouedjio, Jeanne Hortence; Sando, Zacharie; Mbu, Robinson Enow

    2014-01-01

    Les hématomes puerpéraux sont une cause rare d'hémorragie du post partum. Leur prise en charge adéquate nécessite une compétence et un plateau technique particulier. A notre connaissance, aucun cas n'a été publié au Cameroun. Nous rapportons le cas d'une femme de 37 ans, G3P2013, référée d'un dispensaire vers la maternité de l'hôpital Central de Yaoundé, en état de choc hémorragique survenu une heure après un accouchement facilité par des manœuvres digitales de dilatation vaginale. Elle a été prise en charge chirurgicalement pour un hématome vulvaire expansif. Ce cas nous permet d'attirer l'attention des praticiens sur la gravité et la singularité de cette pathologie hautement morbide qui pourrait être due à des manœuvres de dilatation digitale du vagin pendant le travail. PMID:25810803

  6. The EMBRACE web service collection

    PubMed Central

    Pettifer, Steve; Ison, Jon; Kalaš, Matúš; Thorne, Dave; McDermott, Philip; Jonassen, Inge; Liaquat, Ali; Fernández, José M.; Rodriguez, Jose M.; Partners, INB-; Pisano, David G.; Blanchet, Christophe; Uludag, Mahmut; Rice, Peter; Bartaseviciute, Edita; Rapacki, Kristoffer; Hekkelman, Maarten; Sand, Olivier; Stockinger, Heinz; Clegg, Andrew B.; Bongcam-Rudloff, Erik; Salzemann, Jean; Breton, Vincent; Attwood, Teresa K.; Cameron, Graham; Vriend, Gert

    2010-01-01

    The EMBRACE (European Model for Bioinformatics Research and Community Education) web service collection is the culmination of a 5-year project that set out to investigate issues involved in developing and deploying web services for use in the life sciences. The project concluded that in order for web services to achieve widespread adoption, standards must be defined for the choice of web service technology, for semantically annotating both service function and the data exchanged, and a mechanism for discovering services must be provided. Building on this, the project developed: EDAM, an ontology for describing life science web services; BioXSD, a schema for exchanging data between services; and a centralized registry (http://www.embraceregistry.net) that collects together around 1000 services developed by the consortium partners. This article presents the current status of the collection and its associated recommendations and standards definitions. PMID:20462862

  7. 75 FR 14436 - Ameren Corporation, Illinois Power Company, Central Illinois Light Company, Central Illinois...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-25

    ... Energy Regulatory Commission Ameren Corporation, Illinois Power Company, Central Illinois Light Company, Central Illinois Public Service Company, Ameren Energy Resources Company, LLC, AmerenEnergy Resources Generating Company; Notice of Filing March 18, 2010. Take notice that on March 15, 2010, Ameren...

  8. Prise en charge d'une menace d'accouchement prématuré sur béance cervico-utérine au moyen d'un pessaire-cerclage obstétrical

    PubMed Central

    Nohuz, Erdogan; Albaut, Maël; Brunel, Angélique; Champel, Nadine; Pellizzaro, Julie; Gallot, Denis; Lemery, Didier; Vendittelli, Françoise

    2015-01-01

    Nous rapportons le recours efficace à un pessaire dans la prise en charge d'une menace d'accouchement prématuré. Une patiente de 28 ans, G2P1, ayant présenté une fausse-couche tardive à 20 semaines d'aménorrhée (SA) un an auparavant, bénéficiait d'un cerclage cervical à 15 SA. L’échographie endovaginale réalisée à 24 SA (sensation de pesanteur pelvienne) révélait un funnelling majeur et une longueur cervicale à 7 mm. Un pessaire obstétrical permettait la poursuite de la grossesse jusqu'au terme de 36 SA. Ce dispositif semble intéressant chez des patientes présentant une béance cervico-isthmique et chez qui un cerclage cervical s'est révélé inefficace. PMID:26161207

  9. 22 CFR 94.3 - Functions of the Central Authority.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Functions of the Central Authority. 94.3 Section 94.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION § 94.3 Functions of the Central Authority. The U.S. Central Authority shall cooperate with...

  10. 22 CFR 94.3 - Functions of the Central Authority.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Functions of the Central Authority. 94.3 Section 94.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION § 94.3 Functions of the Central Authority. The U.S. Central Authority shall cooperate with...

  11. 22 CFR 94.3 - Functions of the Central Authority.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Functions of the Central Authority. 94.3 Section 94.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION § 94.3 Functions of the Central Authority. The U.S. Central Authority shall cooperate with...

  12. 22 CFR 94.3 - Functions of the Central Authority.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Functions of the Central Authority. 94.3 Section 94.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION § 94.3 Functions of the Central Authority. The U.S. Central Authority shall cooperate with...

  13. 22 CFR 94.3 - Functions of the Central Authority.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Functions of the Central Authority. 94.3 Section 94.3 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION § 94.3 Functions of the Central Authority. The U.S. Central Authority shall cooperate with...

  14. Central venous line - infants

    MedlinePlus

    CVL - infants; Central catheter - infants - surgically placed ... plastic tube that is put into a large vein in the chest. WHY IS A ... central catheter (PICC) or midline central catheter (MCC). A CVL ...

  15. Ancillary services

    SciTech Connect

    Hirst, E.; Kirby, B

    1996-01-01

    Ancillary services are those functions performed by electrical generating, transmission, system-control, and distribution-system equipment and people to support the basic services of generating capacity, energy supply, and power delivery. The Federal Energy Regulatory Commission defined ancillary services as ``those services necessary to support the transmission of electric power from seller to purchaser given the obligations of control areas and transmitting utilities within those control areas to maintain reliable operations of the interconnected transmission system.`` FERC identified six ancillary services reactive power and voltage control, loss compensation, scheduling and dispatch, load following, system protection, and energy imbalance. Our earlier work identified 19 ancillary services Here we offer a revised set of seven ancillary services and mention several other services that merit consideration. In preparing its final rule on open-access transmission service, we suggest that FERC consider splitting its system-protection service into its two primary pieces, reliability reserve and supplemental-operating reserve. We also suggest that FERC define more sharply all of the ancillary services. especially load-following reserve and energy imbalance. Finally, we suggest that FERC consider other services and their provision in a restructured electricity industry; these services include black-start capability, time correction, standby service. planning reserve, redispatch. transmission services, power quality, and planning and engineering services.

  16. The Emotional Component of Service-Learning

    ERIC Educational Resources Information Center

    Carson, Russell L.; Domangue, Elizabeth A.

    2013-01-01

    The interest in and acceptance of service-learning has insufficiently addressed the inextricable emotional linkage to all of its functions. Utilizing Coles' (1993) conceptualization of the intricate role of emotion in service-learning, this study explored how and why emotion and feeling are central to college students' service-learning…

  17. Service Learning in the Rural Community College.

    ERIC Educational Resources Information Center

    Holton, Nicholas

    Service learning is a pedagogical model that connects community service experiences with academic course learning. Large urban centers are often the leaders in developing service learning programs, due to the central locations of both institutions of higher education and community needs. This paper argues that rural areas have the same problems…

  18. Trusted Translation Services

    NASA Astrophysics Data System (ADS)

    Atif, Yacine; Serhani, Mohamed Adel; Campbell, Piers; Mathew, Sujith Samuel

    Administering multilingual Web sites and applications reliably, involves interconnected and multipart tasks, where trust in the involved parties and content translation sources is paramount. Published Web sites may reflect content from databases, content management systems and other repositories to manage related Web content. But a Web site mirrored wholly or selectively onto a target language version requires streamlined trusted processes. Traditionally, files are translated and transferred via FTP, e-mail, or other communication means. Similarly, translation instructions are communicated between involved parties through verbal instruction, e-mail, and instruction files lead to a variety of inconsistencies and lack of trust in the translation process. This paper proposes a Web service approach to streamline the translation processes and an integration of trust properties in the proposed translation Web services. Web Services have been instrumental in handling problems inherent to systems integration, allowing web-based systems to converse and communicate data automatically. The OASIS Translation Web Services Technical Committee has released a standard way for Web Services to serve the translation and localization business. This article proposes a framework to centralize translation services at a reputable source providing a workflow and a mechanism to quantify service trust. An implementation of the framework is also described in the context of a localization case study.

  19. Prising open the 'black box': An epistemological critique of discursive constructions of scaling up the provision of mental health care in Africa.

    PubMed

    Cooper, Sara

    2015-09-01

    Global mental health research is increasingly highlighting the high levels of untreated mental illness in Africa and calling for the scaling-up of services in order to redress this situation. A particular model of care is being strongly advocated for such scale-up, and a recent explosion of research is providing guidelines for its implementation. This article seeks to open up the 'black box' of international research on scaling up the provision of mental health care in Africa, unearthing the hidden assumptions and power dynamics underpinning the knowledge produced. It insists that gaining a better understanding of care provision demands that we not only fill the gaps in knowledge but also problematize the assumptions upon which existing knowledge is based. This article demonstrates how two interrelated paradigms are strongly mediating research in this area - those of 'scientific evidence' and 'human rights'. Drawing on recent research within the sociology of scientific knowledge, and strands of postcolonial thought, it demonstrates how these paradigms are both underpinned by several contentious epistemological assumptions, assumptions which are deeply inserted within the epistemological order of Western modernity. The main argument is that through their shared ideological undertones of 'objectivity', 'universalism' and 'rationalism', these paradigms are potentially marginalizing other possibly important ways of thinking about care in Africa, ways which might not originate from modernist forms of consciousness. This article makes a plea for a more inclusive and plural archive of knowledge on scaling up mental health care in Africa, one which is more hospitable to diverse epistemological politics and moral landscapes.

  20. Prising open the 'black box': An epistemological critique of discursive constructions of scaling up the provision of mental health care in Africa.

    PubMed

    Cooper, Sara

    2015-09-01

    Global mental health research is increasingly highlighting the high levels of untreated mental illness in Africa and calling for the scaling-up of services in order to redress this situation. A particular model of care is being strongly advocated for such scale-up, and a recent explosion of research is providing guidelines for its implementation. This article seeks to open up the 'black box' of international research on scaling up the provision of mental health care in Africa, unearthing the hidden assumptions and power dynamics underpinning the knowledge produced. It insists that gaining a better understanding of care provision demands that we not only fill the gaps in knowledge but also problematize the assumptions upon which existing knowledge is based. This article demonstrates how two interrelated paradigms are strongly mediating research in this area - those of 'scientific evidence' and 'human rights'. Drawing on recent research within the sociology of scientific knowledge, and strands of postcolonial thought, it demonstrates how these paradigms are both underpinned by several contentious epistemological assumptions, assumptions which are deeply inserted within the epistemological order of Western modernity. The main argument is that through their shared ideological undertones of 'objectivity', 'universalism' and 'rationalism', these paradigms are potentially marginalizing other possibly important ways of thinking about care in Africa, ways which might not originate from modernist forms of consciousness. This article makes a plea for a more inclusive and plural archive of knowledge on scaling up mental health care in Africa, one which is more hospitable to diverse epistemological politics and moral landscapes. PMID:25406137

  1. Aspects cliniques des cancers bronchopulmonaires primitifs au service d'oncologie du CHUA-HUJRA Antananarivo

    PubMed Central

    Refeno, Valéry; Hasiniatsy, Nomeharisoa Rodrigue Emile; Andrianandrasana, Ny Ony Tiana Florence; Ramahandrisoa, Andriatsihoarana Voahary Nasandratriniavo; Rakotonarivo, Jean Marc; Maevazaka, Joée Larissa; Rakotovao, Hanitrala Jean Louis; Rafaramino, Florine

    2015-01-01

    Le retard de diagnostic des cancers broncho-pulmonaires est l'une des sources du retard de leur prise en charge dans les pays en développement. A notre connaissance, l'aspect clinique des cancers broncho-pulmonaires au Centre Hospitalier Universitaire d'Antananarivo-Hôpital Universitaire Joseph Ravoahangy Andrianavalona (CHUA-HUJRA) n'a jamais été étudié. L'objectif était de décrire les aspects cliniques des cancers broncho-pulmonaires primitifs dans le plus grand centre de cancérologie de Madagascar. C'est une étude rétrospective et descriptive des patients atteints de cancers broncho-pulmonaires primitifs vus au service d'oncologie du CHUA-HUJRA du 1er janvier 2008 au 31 décembre 2013. Nous avons recensé 101 patients (80 hommes et 21 femmes). Les circonstances de découverte sont principalement la toux chronique (n = 29), la dyspnée (n = 16) et l'association d'une hémoptysie à la toux chronique (n = 12). Soixante et onze patients avaient un index de performans status ≥ à 2 au moment du diagnostic. On a retrouvé des bacilles de Koch actives dans le crachat de deux patients. Le délai moyen entre l'apparition des premiers signes et la première consultation était de 11 mois. Le délai moyen entre la première consultation et le diagnostic anatomopathologique était de 3 mois. Le cancer broncho-pulmonaire peut avoir des manifestations cliniques non spécifiques parfois trompeuses qui peuvent retarder leur prise en charge. De ce fait, il doit être recherché devant tout signe respiratoire persistant. Par ailleurs, le délai de prise en charge pré-hospitalière et hospitalière de ces cancers doit être amélioré. PMID:26958134

  2. Les facteurs prédictifs de malignité dans la prise en charge des tumeurs parotidiennes: à propos de 76 cas

    PubMed Central

    Bouaity, Brahim; Darouassi, Youssef; Chihani, Mehdi; Touati, Mohamed Mliha; Ammar, Haddou

    2016-01-01

    La pathologie tumorale de la glande parotide est complexe et pose un problème diagnostique et thérapeutique. Une bonne analyse des facteurs prédictifs de malignité de ces tumeurs parotidiennes semble actuellement nécessaire en vue d'une meilleure planification thérapeutique. Le but de ce travail est d’étudier les facteurs prédictifs de malignité dans les tumeurs parotidiennes à travers une étude rétrospective sur 76 cas de tumeurs de la parotide traités au service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale de l'hôpital militaire Avicenne de Marrakech entre janvier 2000 et décembre 2012. Il s'agit de 40 femmes et 36 hommes. L’âge moyen était de 44 ans pour les tumeurs bénignes alors qu'il était de 50 ans pour les tumeurs malignes. Le délai moyen de consultation était de 24 mois pour les tumeurs bénignes et de 16 mois pour les tumeurs malignes. La tuméfaction de la région parotidienne a été un signe révélateur constant chez tous les malades. La malignité est évoquée cliniquement devant la douleur, la paralysie faciale, la fixité par rapport au plan superficiel ou profond et la présence d'adénopathie. L'IRM constitue désormais l'examen de choix dans l'exploration des masses tumorales parotidiennes avec une bonne valeur diagnostique de malignité ou de bénignité. La cytoponction à l'aiguille fine n'a pas de valeur que si elle est positive. La parotidectomie exploratrice avec examen anatomopathologique extemporané demeure la clé du diagnostic positif. Les tumeurs parotidiennes bénignes représentent l'entité la plus fréquente (80%) et l'adénome pléomorphe demeure le type histologique prédominant (61%). Quant aux tumeurs malignes, elles sont plutôt rares, dominées essentiellement par les carcinomes muco épidermoides (6,5%). Le traitement chirurgical est l'option de choix souvent associée à un curage ganglionnaire et une radiothérapie pour les tumeurs malignes. La paralysie faciale est la complication

  3. Central venous catheters - ports

    MedlinePlus

    Central venous catheter - subcutaneous; Port-a-Cath; InfusaPort; PasPort; Subclavian port; Medi - port; Central venous line - port ... Catheters are used when you need medical treatment over a long period of time. For example, you ...

  4. Survey: National Environmental Satellite Service

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The national Environmental Satellite Service (NESS) receives data at periodic intervals from satellites of the Synchronous Meteorological Satellite/Geostationary Operational Environmental Satellite series and from the Improved TIROS (Television Infrared Observational Satellite) Operational Satellite. Within the conterminous United States, direct readout and processed products are distributed to users over facsimile networks from a central processing and data distribution facility. In addition, the NESS Satellite Field Stations analyze, interpret, and distribute processed geostationary satellite products to regional weather service activities.

  5. Fishing for Novel Approaches to Ecosystem Service Forecasts

    EPA Science Inventory

    The ecosystem service concept provides a powerful framework for conserving species and the environments they depend upon. Describing current distributions of ecosystem services and forecasting their future distributions have therefore become central objectives in many conservati...

  6. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES § 242.6 Central point of contact. The Assistant Dean for Academic Support, USUHS,...

  7. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES § 242.6 Central point of contact. The Assistant Dean for Academic Support, USUHS,...

  8. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES § 242.6 Central point of contact. The Assistant Dean for Academic Support, USUHS,...

  9. Central African Republic.

    PubMed

    1989-11-01

    The Central African Republic contains 242,000 square miles, which rolling terrain almost 2000 feet above sea level. The climate is tropical, and it has a population of 2.8 million people with a 2.5% growth rate. There are more than 80 ethnic groups including Baya 34%, Banda 28%, Sara 10%, Mandja 9%, Mboum 9%, and M'Baka 7%. The religions are traditional African 35%, protestant 25%, Roman Catholic 25%, and Muslim 15%, and the languages are French and Sangho. The infant mortality rate is 143/1000, with expectancy at 49 years and a 40% literacy rate. The work force of 1 million is 70% agricultural, industry 6% and commerce and service 6% and government 3%. The government consists of a president assisted by cabinet ministers and a single party. Natural resources include diamonds, uranium, timber, gold, and oil, and major industries are beverages, textiles, and soap. Agricultural products feature coffee, cotton, peanuts, tobacco, food crops and livestock. Most of the population live in rural areas and most of the 80 ethnic groups have their own language. This is one of the world's least developed countries, with a per capita income of $375/year. The main problems with development are the poor transportation infrastructure, and the weak internal and international marketing systems. The US and various international organizations have aided in agriculture development, health programs, and family planning. US investment is mainly in diamond and gold mining, and although oil drilling has been successful it is not economically feasible at current prices.

  10. Profil épidémiologique et prise en charge des exacerbations d'asthme chez l'enfant à l'hôpital d'enfants de Rabat au Maroc

    PubMed Central

    Boubkraoui, Mohamed El Mahdi; Benbrahim, Fadoua; Assermouh, Abdellah; El Hafidi, Naima; Benchekroun, Soumia; Mahraoui, Chafiq

    2015-01-01

    Introduction L'exacerbation d'asthme est un phénomène paroxystique qui peut mettre en jeu le pronostic vital. Le but de l’étude est d’évaluer le profil épidémiologique et les modalités de prise en charge de l'exacerbation d'asthme chez les enfants âgés de 2 à 15 ans dans l'unité de pneumoallergologie pédiatrique de l'hôpital d'enfants de Rabat au Maroc. Méthodes Il s'agit d'une étude rétrospective qui a concerné 1461 enfants hospitalisés pour exacerbation d'asthme modérée à sévère durant une période d'un an allant de décembre 2011 à novembre 2012, les exacerbations légères étant traitées en ambulatoire. Résultats Les hospitalisations pour exacerbation d'asthme chez les enfants ont représenté 34% de l'ensemble des hospitalisations avec trois pics en mai, septembre et décembre. L’âge moyen de survenue était de 3 ans et demi avec une prédominance masculine nette. L'exacerbation d'asthme était inaugurale dans 22% des cas. Les infections respiratoires virales dominaient les facteurs déclenchants des exacerbations d'asthme. Le séjour hospitalier était en moyenne de 3 jours. Un transfert en réanimation a été nécessaire dans 2% des cas. L’évolution sous traitement a toujours été favorable et la mortalité a été nulle. Conclusion La prévalence des hospitalisations pour exacerbation d'asthme suit un profil saisonnier lié aux effets environnementaux. La plupart de ces hospitalisations pourraient cependant être évitées grâce à un meilleur contrôle de l'asthme et à l'amélioration de l’éducation thérapeutique de l'enfant asthmatique et de son entourage. PMID:26090031

  11. Service-Learning: Motivations for K-12 Teachers

    ERIC Educational Resources Information Center

    Krebs, Marjori M.

    2006-01-01

    The purpose of this dissertation is to describe the essence of the service-learning experience for K-12 teachers in central and northwest Ohio, specifically exploring teacher motivations for initiating service-learning in the classroom. Service-learning is defined as an educational methodology that incorporates student preparation, service to the…

  12. Planning National Radiotherapy Services

    PubMed Central

    Rosenblatt, Eduardo

    2014-01-01

    Countries, states, and island nations often need forward planning of their radiotherapy services driven by different motives. Countries without radiotherapy services sponsor patients to receive radiotherapy abroad. They often engage professionals for a feasibility study in order to establish whether it would be more cost-beneficial to establish a radiotherapy facility. Countries where radiotherapy services have developed without any central planning, find themselves in situations where many of the available centers are private and thus inaccessible for a majority of patients with limited resources. Government may decide to plan ahead when a significant exodus of cancer patients travel to another country for treatment, thus exposing the failure of the country to provide this medical service for its citizens. In developed countries, the trigger has been the existence of highly visible waiting lists for radiotherapy revealing a shortage of radiotherapy equipment. This paper suggests that there should be a systematic and comprehensive process of long-term planning of radiotherapy services at the national level, taking into account the regulatory infrastructure for radiation protection, planning of centers, equipment, staff, education programs, quality assurance, and sustainability aspects. Realistic budgetary and cost considerations must also be part of the project proposal or business plan. PMID:25505730

  13. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM... Central office—transmission. This account shall be used by Class B companies to record the original...

  14. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM... Central office—transmission. This account shall be used by Class B companies to record the original...

  15. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM... Central office—transmission. This account shall be used by Class B companies to record the original...

  16. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Central office transmission expense. 32.6230 Section 32.6230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office transmission expense. Class B telephone companies shall use this account for expenses...

  17. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Central office transmission expense. 32.6230 Section 32.6230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office transmission expense. Class B telephone companies shall use this account for expenses...

  18. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Central office transmission expense. 32.6230 Section 32.6230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office transmission expense. Class B telephone companies shall use this account for expenses...

  19. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Central office transmission expense. 32.6230 Section 32.6230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office transmission expense. Class B telephone companies shall use this account for expenses...

  20. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Central marketing area. 1032.2 Section 1032.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL MARKETING AREA Order...

  1. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Central marketing area. 1032.2 Section 1032.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL MARKETING AREA Order...

  2. 25 CFR 273.26 - Submitting application to Central Office.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 false Submitting application to Central Office. 273.26 Section... Submitting application to Central Office. When services under the proposed contract will be provided to... submitted to the Commissioner through the respective Area Offices....

  3. 25 CFR 273.26 - Submitting application to Central Office.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Submitting application to Central Office. 273.26 Section... Submitting application to Central Office. When services under the proposed contract will be provided to... submitted to the Commissioner through the respective Area Offices....

  4. Central line complications

    PubMed Central

    Kornbau, Craig; Lee, Kathryn C; Hughes, Gwendolyn D; Firstenberg, Michael S

    2015-01-01

    Central venous access is a common procedure performed in many clinical settings for a variety of indications. Central lines are not without risk, and there are a multitude of complications that are associated with their placement. Complications can present in an immediate or delayed fashion and vary based on type of central venous access. Significant morbidity and mortality can result from complications related to central venous access. These complications can cause a significant healthcare burden in cost, hospital days, and patient quality of life. Advances in imaging, access technique, and medical devices have reduced and altered the types of complications encountered in clinical practice; but most complications still center around vascular injury, infection, and misplacement. Recognition and management of central line complications is important when caring for patients with vascular access, but prevention is the ultimate goal. This article discusses common and rare complications associated with central venous access, as well as techniques to recognize, manage, and prevent complications. PMID:26557487

  5. Information Service.

    ERIC Educational Resources Information Center

    Scofield, James

    Newspaper librarians discussed the public use of their newspapers' libraries. Policies run the gamut from well-staffed public information services, within or outside the newspaper library, to no service at all to those outside the staff of the paper. Problems of dealing with tax and law enforcement agencies were covered, as well as cooperative…

  6. Leisure Services.

    ERIC Educational Resources Information Center

    Iowa Univ., Iowa City. Recreation Education Program.

    Presented are duplications of the responses given by Leisure Services of the State Technical Institute and Rehabilitation Center (Plainwell, Michigan) as part of a project to collect, share, and compile information about, and techniques in the operation of 18 community action models for recreation services to the disabled. Model programs are…

  7. Cleaning Services.

    ERIC Educational Resources Information Center

    Sharpton, James L.

    This curriculum guide provides cleaning services instructional materials for a ninth- and tenth-grade Coordinated Vocational Education and Training: Home and Community Services program. It includes 2 sections and 11 instructional units. Each unit of instruction consists of eight basic components: performance objectives, teacher activities,…

  8. Oncoplastic central quadrantectomies

    PubMed Central

    Pasta, Vittorio; D’Orazi, Valerio; Merola, Raffaele; Frusone, Federico; Amabile, Maria Ida; Buè, Rosanna; Monti, Marco

    2016-01-01

    Tumors localized in the central quadrant (centrally located breast tumors) have always represented a challenge for the surgeon because of the critical aesthetical matters related to the nipple-areola complex (NAC). Many years of experience with breast cancer patients treated by using various oncoplastic techniques, has allowed us to develop the modified hemibatwing for the treatment of central breast tumors, where the NAC is involved. Modified hemibatwing—along with the removal of the NAC—is a useful oncoplastic technique and it represents an ideal option for the treatment of central tumors because it assures oncological safety, a reduced surgical timetable and greater aesthetical results. PMID:27563564

  9. Oncoplastic central quadrantectomies.

    PubMed

    Pasta, Vittorio; D'Orazi, Valerio; Merola, Raffaele; Frusone, Federico; Amabile, Maria Ida; De Luca, Alessandro; Buè, Rosanna; Monti, Marco

    2016-08-01

    Tumors localized in the central quadrant (centrally located breast tumors) have always represented a challenge for the surgeon because of the critical aesthetical matters related to the nipple-areola complex (NAC). Many years of experience with breast cancer patients treated by using various oncoplastic techniques, has allowed us to develop the modified hemibatwing for the treatment of central breast tumors, where the NAC is involved. Modified hemibatwing-along with the removal of the NAC-is a useful oncoplastic technique and it represents an ideal option for the treatment of central tumors because it assures oncological safety, a reduced surgical timetable and greater aesthetical results. PMID:27563564

  10. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Deadline for Central Office action. 23.35 Section 23.35 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR HUMAN SERVICES INDIAN CHILD WELFARE ACT Grants to Off-Reservation Indian Organizations for Title II Indian Child and Family Service Programs §...

  11. Toward Understanding Non-Centralized Technology Support in Higher Education

    ERIC Educational Resources Information Center

    Jackson, Robert Jonathan

    2009-01-01

    The focus of this research is an examination of service quality provided by non-centralized technology personnel, Local Technical Support Providers (LSPs), at a southern research university. The SERVQUAL instrument was selected to measure service quality of LSPs within the Academic Affairs Division. The rationale for selecting and testing SERVQUAL…

  12. AAS Career Services

    NASA Astrophysics Data System (ADS)

    Marvel, Kevin B.

    2012-08-01

    The American Astronomical Society provides substantial programs in the area of Career Services.Motivated by the Society's mission to enhance and share humanity's understanding of the Universe, the AAS provides a central resource for advertising positions, interviewing opportunities at its annual winter meeting and information, workshops and networks to enable astronomers to find employment.The programs of the Society in this area are overseen by an active committee on employment and the AAS Council itself.Additional resources that help characterize the field, its growth and facts about employment such as salaries and type of jobs available are regularly summarized and reported on by the American Institute of Physics.

  13. Centralized surveillance and control of satellite networks

    NASA Astrophysics Data System (ADS)

    Rzewnicki, S. E.; McBeath, J. W.; Brostrup-Jensen, P.

    Satellite based services and networks are increasing in number. This paper describes how such networks can be operated efficiently using software based systems to do satellite transmission surveillance and remote earth station status, alarm and control monitoring at a centralized operations control center. Arrangements are available to accomplish real time, customer controlled configuration of space segments and earth station equipment. Application of the system elements satellite transmission surveillance, alarm and control central, earth station remote, and customer control terminals - to a number of typical networks is described.

  14. Organizational centralization in radiology.

    PubMed

    Aas, I H Monrad

    2006-01-01

    Traditionally, hospitals have a radiology department, where images are taken and interpretation occurs. Teleradiology makes it possible to capture images in one location and transmit them elsewhere for interpretation. Organizational centralization of radiology interpretations is therefore of interest. Empirical data have been collected in qualitative interviews of 26 resource persons with substantial experience with picture archiving and communication systems and teleradiology, from 12 departments of radiology in Norway. The response rate was 90%. A total of 21 theoretically possible types of centralization of image interpretation were identified, representing combinations of three categories of geographical centralization, and seven categories of centralization according to function. Various advantages and disadvantages of centralization were identified. Organizational changes may be decisive for the future of teleradiology, but it may be wise to plan for change in small steps, since we know little about how broad future organizational changes based on teleradiology will be, or what will decide how far particular organizations will go. PMID:16438776

  15. 38 CFR 21.150 - Reader service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Special Rehabilitation Services § 21.150 Reader service. (a) Limitations on vision. A veteran considered... vision is 20/200 in both eyes; (2) Whose central vision is greater than 20/200 but whose field of vision... greater than 20 degrees; or (3) With impaired vision, whose condition or prognosis indicates that...

  16. 38 CFR 21.150 - Reader service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Special Rehabilitation Services § 21.150 Reader service. (a) Limitations on vision. A veteran considered... vision is 20/200 in both eyes; (2) Whose central vision is greater than 20/200 but whose field of vision... greater than 20 degrees; or (3) With impaired vision, whose condition or prognosis indicates that...

  17. 38 CFR 21.150 - Reader service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Special Rehabilitation Services § 21.150 Reader service. (a) Limitations on vision. A veteran considered... vision is 20/200 in both eyes; (2) Whose central vision is greater than 20/200 but whose field of vision... greater than 20 degrees; or (3) With impaired vision, whose condition or prognosis indicates that...

  18. 38 CFR 21.150 - Reader service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Special Rehabilitation Services § 21.150 Reader service. (a) Limitations on vision. A veteran considered... vision is 20/200 in both eyes; (2) Whose central vision is greater than 20/200 but whose field of vision... greater than 20 degrees; or (3) With impaired vision, whose condition or prognosis indicates that...

  19. Developing Multiprofessional Teamwork for Integrated Children's Services

    ERIC Educational Resources Information Center

    Anning, Angela; Cottrell, David; Frost, Nick; Green, Josephine; Robinson, Mark

    2006-01-01

    Multiprofessional practice in the delivery of services is a central government imperative in the UK and other countries. This book offers a practical resource to professionals charged with conceptualising, planning, implementing and evaluating multiprofessional practice in children's services. Discussion of dilemmas facing multiprofessional teams…

  20. Improving Circulation Services through Staff Involvement

    ERIC Educational Resources Information Center

    Kisby, Cynthia M.; Kilman, Marcus D.

    2007-01-01

    The Circulation Services Department at the University of Central Florida Libraries reports on leadership and training initiatives that resulted in a number of service-enhancing projects implemented by a highly motivated and involved staff. Key elements in reinvigorating the department included a change in leadership philosophy, increased…

  1. Community Resources Guide for Central Florida = Una Guia de Recursos en la Comunidad de Florida Central.

    ERIC Educational Resources Information Center

    Medina, Linda, Comp.

    Designed to orient Hispanic refugees to the services that are available in Central Florida, this bilingual guide consists of a section of general information on living and working in the United States and a section devoted to various public and private agencies. Provided first are addresses and phone numbers of various government agencies:…

  2. HIS Central and the Hydrologic Metadata Catalog

    NASA Astrophysics Data System (ADS)

    Whitenack, T.; Zaslavsky, I.; Valentine, D. W.

    2008-12-01

    The CUAHSI Hydrologic Information System project maintains a comprehensive workflow for publishing hydrologic observations data and registering them to the common Hydrologic Metadata Catalog. Once the data are loaded into a database instance conformant with the CUAHSI HIS Observations Data Model (ODM), the user configures ODM web service template to point to the new database. After this, the hydrologic data become available via the standard CUAHSI HIS web service interface, that includes both data discovery (GetSites, GetVariables, GetSiteInfo, GetVariableInfo) and data retrieval (GetValues) methods. The observations data then can be further exposed via the global semantics-based search engine called Hydroseek. To register the published observations networks to the global search engine, users can now use the HIS Central application (new in HIS 1.1). With this online application, the WaterML-compliant web services can be submitted to the online catalog of data services, along with network metadata and a desired network symbology. Registering services to the HIS Central application triggers a harvester which uses the services to retrieve additional network metadata from the underlying ODM (information about stations, variables, and periods of record). The next step in HIS Central application is mapping variable names from the newly registered network, to the terms used in the global search ontology. Once these steps are completed, the new observations network is added to the map and becomes available for searching and querying. The number of observations network registered to the Hydrologic Metadata Catalog at SDSC is constantly growing. At the time of submission, the catalog contains 51 registered networks, with estimated 1.7 million stations.

  3. Creative pricing strategies for medical services.

    PubMed

    Tellis, G J

    1987-01-01

    This paper discusses the strategic role of the pricing of medical services. Strategic pricing is a creative process that can be a vital means of defining marketing segments, differentiating services, and gaining a competitive advantage. The central issue in strategic pricing is creatively using the principle of cross-subsidies or shared economies over consumer groups, service sets, or competitors. This principle yields a rich set of pricing strategies that can be used in response to various environments.

  4. Imaging central pain syndromes.

    PubMed

    Veldhuijzen, Dieuwke S; Greenspan, Joel D; Kim, Jong H; Coghill, Robert C; Treede, Rolf-Detlef; Ohara, Shinji; Lenz, Frederick A

    2007-06-01

    Anatomic, functional, and neurochemical imaging studies have provided new investigative tools in the study of central pain. High-resolution imaging studies allow for precise determination of lesion location, whereas functional neuroimaging studies measure pathophysiologic consequences of injury to the central nervous system. Additionally, magnetic resonance spectroscopy evaluates lesion-induced neurochemical changes in specific brain regions that may be related to central pain. The small number of studies to date precludes definitive conclusions, but the recent findings provide information that either supports or refutes current hypotheses and can serve to generate new ideas.

  5. ASNT central certification program

    NASA Astrophysics Data System (ADS)

    Spring, Robert W.; Snell, John R., Jr.

    1997-04-01

    The American Society of Nondestructive Testing (ASNT) has recently established a new central certification program. This program will allow individuals who meet the requirements to receive a 'portable' certificate. Augmenting the existing employer-based certification, this program will have significant impact on industries that may ultimately require nondestructive testing (NDT) personnel to have central certification. This paper explains show ASNT has structured central certification and when and how it will effect thermal/infrared thermography (T/IRT) personnel. The paper also discusses the industry specific certification process.

  6. Geothermal initiatives in Central America

    SciTech Connect

    Hanold, R.J.; Loose, V.W.; Laughlin, A.W.; Wade, P.E.

    1986-01-01

    The US Agency for International Development is supporting a new project in energy and resources exploitation for Central America. One of the largest components of the project involves exploration and reservoir development investigations directed at enhancing the production of electricity from the region's geothermal resources. An assessment of the geothermal resources of Honduras is in progress, and interesting geothermal regions in the Guanacaste Province of Costa Rica are being explored. Well-logging activities are in progress in the production wells at the Miravalles geothermal field in Costa Rica, and preparations are being made for logging critical wells at Ahuachapan in El Salvador. A self-contained logging truck, complete with high-temperature logging cable and logging tools designed for geothermal service, is being fabricated and will be made available for dedicated use throughout Central America. Geochemical and isotopic analyses of water samples collected in Panama are being evaluated to select a high-priority geothermal site in that country. Application of low- and medium-enthalpy geothermal fluids for industrial and agricultural processes is being investigated in Guatemala.

  7. Prise en charge hospitalière de la malnutrition aigue sévère chez l'enfant avec des préparations locales alternatives aux F-75 et F-100: résultats et défis

    PubMed Central

    Nguefack, Félicitée; Adjahoung, Chritoph Akazong; Keugoung, Basile; Kamgaing, Nelly; Dongmo, Roger

    2015-01-01

    Introduction La mise en œuvre des directives de l'OMS permettrait de réduire significativement la mortalité hospitalière due à la malnutrition sévère. Cependant, elle n'est pas effective et la pénurie en aliments thérapeutiques est l'une des principales causes. L’étude décrit notre expérience sur la prise en charge hospitalière de la malnutrition aigue sévère avec des laits alternatifs aux F75 et F100 composés localement. Méthodes Il s'agissait d'un essai clinique non randomisé. La prise en charge des patients utilisait les laits composés localement et une évaluation quotidienne du gain pondéral était faite. Résultats L’étude a porté sur 41 sujets âgés de 6 à 59 mois. Au total, 73,2% avaient le kwashiorkor-marasmique, 17,0% le kwashiorkor, 9,8% le marasme et 41,5% étaient infectés par le VIH. Nous avons noté une prise progressive du poids d'environ 10 g/kg/jour vers le 7ème jour et de 15 à 20 g/kg/jour en fin d'hospitalisation. Le taux de mortalité était de 21,9% soit une réduction de 8,4% des chiffres antérieurs. Conclusion Malgré les obstacles financiers liés au coût des ingrédients, les préparations lactées alternatives aux standards F75 et F100, sont adaptables dans notre contexte. En l'absence des formules standards de l'OMS et lorsque la référence vers une structure qui en disposent n'est pas possible, les préparations locales permettraient de réhabiliter efficacement les patients. D'autres recherches pointues permettraient de tirer les ingrédients uniquement de notre environnement. Elles contribueraient ainsi à minimiser les couts des préparations et de favoriser la pérennisation des laits thérapeutiques locaux. PMID:26587175

  8. Focus on: Good Samaritan Hospital Biomedical Services Department.

    PubMed

    Shreve, R B

    1987-01-01

    The Biomedical Services Department of the Good Samaritan Hospital, located in Central Pennsylvania, has responsibility for preventive maintenance, safety and regulation compliance (appropriate to a biomedical department) and repairs for the Hospital. These services have resulted in substantial cost savings. In addition, the Department's Shared Service activity has produced alternative revenue sources. The combined hospital and shared service inventory of approximately 1100 instruments is serviced by the Department Staff, which consists of one Director and two technicians. PMID:10280990

  9. Central nervous system

    MedlinePlus

    The central nervous system is composed of the brain and spinal cord. Your brain and spinal cord serve as the main "processing center" for your entire nervous system. They control all the workings of your body.

  10. Central ballast tanker design

    SciTech Connect

    1997-01-01

    The purpose of this paper is to present the CENTRAL BALLAST TANKER Design. This design is intended to reduce the volume of oil spilled from tankers by giving the crew a tanker properly designed and equipped to allow large quantities of oil from ruptured tank(s) to flow safely to a fully-inerted central ballast tank. In addition to reducing the volume of oil spilled, the design also addresses many of the shortcomings of the DOUBLE HULL DESIGN which are increasingly becoming a concern. The following is a brief review of the development of the CENTRAL BALLAST TANKER. The simple operational features, stability, low cost and ease of maintenance of the single hull tanker were important and can be retained with the CENTRAL BALLAST DESIGN.

  11. [Central autonomic failures].

    PubMed

    Senard, Jean-Michel; Despas, Fabien; Pathak, Atul

    2012-11-01

    Autonomic nervous system (ANS) modulates the function of all body organs through both parasympathetic and sympathetic fibers. Orthostatic hypotension is frequently observed in the course of central nervous system diseases including cortical (stroke, epilepsy, dementias), neurodegenerative (Parkinson's disease, multisystem atrophies) and spinal cord diseases. In some cases, the mechanism of orthostatic hypotension associated with central nervous system diseases involves a dysfunction of peripheral ANS fibers.

  12. Balanced Centrality of Networks.

    PubMed

    Debono, Mark; Lauri, Josef; Sciriha, Irene

    2014-01-01

    There is an age-old question in all branches of network analysis. What makes an actor in a network important, courted, or sought? Both Crossley and Bonacich contend that rather than its intrinsic wealth or value, an actor's status lies in the structures of its interactions with other actors. Since pairwise relation data in a network can be stored in a two-dimensional array or matrix, graph theory and linear algebra lend themselves as great tools to gauge the centrality (interpreted as importance, power, or popularity, depending on the purpose of the network) of each actor. We express known and new centralities in terms of only two matrices associated with the network. We show that derivations of these expressions can be handled exclusively through the main eigenvectors (not orthogonal to the all-one vector) associated with the adjacency matrix. We also propose a centrality vector (SWIPD) which is a linear combination of the square, walk, power, and degree centrality vectors with weightings of the various centralities depending on the purpose of the network. By comparing actors' scores for various weightings, a clear understanding of which actors are most central is obtained. Moreover, for threshold networks, the (SWIPD) measure turns out to be independent of the weightings. PMID:27437494

  13. Balanced Centrality of Networks

    PubMed Central

    Sciriha, Irene

    2014-01-01

    There is an age-old question in all branches of network analysis. What makes an actor in a network important, courted, or sought? Both Crossley and Bonacich contend that rather than its intrinsic wealth or value, an actor's status lies in the structures of its interactions with other actors. Since pairwise relation data in a network can be stored in a two-dimensional array or matrix, graph theory and linear algebra lend themselves as great tools to gauge the centrality (interpreted as importance, power, or popularity, depending on the purpose of the network) of each actor. We express known and new centralities in terms of only two matrices associated with the network. We show that derivations of these expressions can be handled exclusively through the main eigenvectors (not orthogonal to the all-one vector) associated with the adjacency matrix. We also propose a centrality vector (SWIPD) which is a linear combination of the square, walk, power, and degree centrality vectors with weightings of the various centralities depending on the purpose of the network. By comparing actors' scores for various weightings, a clear understanding of which actors are most central is obtained. Moreover, for threshold networks, the (SWIPD) measure turns out to be independent of the weightings. PMID:27437494

  14. Conservation Planning for Ecosystem Services

    PubMed Central

    Chan, Kai M. A; Shaw, M. Rebecca; Cameron, David R; Underwood, Emma C; Daily, Gretchen C

    2006-01-01

    Despite increasing attention to the human dimension of conservation projects, a rigorous, systematic methodology for planning for ecosystem services has not been developed. This is in part because flows of ecosystem services remain poorly characterized at local-to-regional scales, and their protection has not generally been made a priority. We used a spatially explicit conservation planning framework to explore the trade-offs and opportunities for aligning conservation goals for biodiversity with six ecosystem services (carbon storage, flood control, forage production, outdoor recreation, crop pollination, and water provision) in the Central Coast ecoregion of California, United States. We found weak positive and some weak negative associations between the priority areas for biodiversity conservation and the flows of the six ecosystem services across the ecoregion. Excluding the two agriculture-focused services—crop pollination and forage production—eliminates all negative correlations. We compared the degree to which four contrasting conservation network designs protect biodiversity and the flow of the six services. We found that biodiversity conservation protects substantial collateral flows of services. Targeting ecosystem services directly can meet the multiple ecosystem services and biodiversity goals more efficiently but cannot substitute for targeted biodiversity protection (biodiversity losses of 44% relative to targeting biodiversity alone). Strategically targeting only biodiversity plus the four positively associated services offers much promise (relative biodiversity losses of 7%). Here we present an initial analytical framework for integrating biodiversity and ecosystem services in conservation planning and illustrate its application. We found that although there are important potential trade-offs between conservation for biodiversity and for ecosystem services, a systematic planning framework offers scope for identifying valuable synergies. PMID

  15. Refrigeration Servicing.

    ERIC Educational Resources Information Center

    Hamilton, Donald L.; And Others

    This self-study course is designed to familiarize Marine enlisted personnel with the services required to be performed on refrigeration equipment. The course contains four study units. Each study unit begins with a general objective, which is a statement of what the student should learn from the unit. The study units are divided into numbered work…

  16. Testing Services

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Trace Laboratories is an independent testing laboratory specializing in testing printed circuit boards, automotive products and military hardware. Technical information from NASA Tech Briefs and two subsequent JPL Technical Support packages have assisted Trace in testing surface insulation resistance on printed circuit board materials. Testing time was reduced and customer service was improved because of Jet Propulsion Laboratory technical support packages.

  17. Virtual Queue in a Centralized Database Environment

    NASA Astrophysics Data System (ADS)

    Kar, Amitava; Pal, Dibyendu Kumar

    2010-10-01

    Today is the era of the Internet. Every matter whether it be a gather of knowledge or planning a holiday or booking of ticket etc everything can be obtained from the internet. This paper intends to calculate the different queuing measures when some booking or purchase is done through the internet subject to the limitations in the number of tickets or seats. It involves a lot of database activities like read and write. This paper takes care of the time involved in the requests of a service, taken as arrival and the time involved in providing the required information, taken as service and thereby tries to calculate the distribution of arrival and service and the various measures of the queuing. This paper considers the database as centralized database for the sake of simplicity as the alternating concept of distributed database would rather complicate the calculation.

  18. Service Provision to Students: Where the Gown Best Fits

    ERIC Educational Resources Information Center

    Schulz, Lucy; Szekeres, Judy

    2008-01-01

    One of the challenges facing those responsible for service provision in universities is ensuring that service is provided at the right point in the organisation. Service delivery points can exist at the school/department level, faculty/division level or central unit/university wide level. This does not always follow organisational logic, common…

  19. College Makes New Connections with Service-Learning Program

    ERIC Educational Resources Information Center

    Ashburn, Elyse

    2009-01-01

    The service learning movement has gained new energy with the election of President Obama, who has made increasing service a central plank of his higher-education agenda. But across the board, colleges and universities struggle with service learning's twin goals of providing meaningful help to the community and academic rigor to students. The…

  20. Geospatial Services in Special Libraries: A Needs Assessment Perspective

    ERIC Educational Resources Information Center

    Barnes, Ilana

    2013-01-01

    Once limited to geographers and mapmakers, Geographic Information Systems (GIS) has taken a growing central role in information management and visualization. Geospatial services run a gamut of different products and services from Google maps to ArcGIS servers to Mobile development. Geospatial services are not new. Libraries have been writing about…

  1. Graduate Student Services: A Study of the Delivery of Services at the Location Where Students Matriculate

    ERIC Educational Resources Information Center

    Burlison, John G.

    2010-01-01

    This dissertation investigates and explores the best method for the delivery of graduate student services. Essentially, there are two methods for delivery of these services. They can be delivered by virtue of centralization or decentralization. Decentralized delivery, for the purpose of this dissertation is the delivery of graduate student…

  2. EVALUATION OF SERVICE ACTIVITIES UNDERTAKEN BY THE EDUCATIONAL SERVICE CENTER FOR THE PERIOD SEPTEMBER 1, 1966 TO JULY 1, 1967.

    ERIC Educational Resources Information Center

    HOMAN, LARRY E.; KELLY, PATRICK J.

    THE EDUCATIONAL SERVICE CENTER (ESC) SUPPLIES VARIOUS SERVICES TO 28 SCHOOL DISTRICTS IN CENTRAL, WESTERN, AND NORTHERN NEW MEXICO. STATISTICAL INFORMATION IS PRESENTED CONCERNING THE VARIETY AND DISTRIBUTION OF THESE SERVICES (CURRICULUM DEVELOPMENT, PSYCHOLOGICAL TESTING AND GUIDANCE, ADULT EDUCATION AND COMMUNITY DEVELOPMENT, SCHOOL EVALUATION…

  3. 7 CFR 1951.136 - Procedures for Department of Treasury offset and cross-servicing for the Rural Housing Service...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... centralized administrative offset (TOP), Internal Revenue Service offset administered through TOP and Treasury... exclusion criteria, may be excluded from TOP or Cross-Servicing. (b) A 60 day due process notice will be sent to borrowers subject to TOP or Cross-Servicing. The borrower will be given 60 days to resolve...

  4. Context: a central concept.

    PubMed

    Fantino, E

    2001-05-01

    Seminal research in several areas has underscored the central role played by context in the control of behavior. Landmark studies in classical conditioning (with both conditioned suppression and autoshaping procedures) and in conditioned reinforcement (using the observing paradigm) are reviewed. The role of context also proved central in the study of choice (including the matching law and delay-reduction theory). This latter work contributed to the development of experimental analogs to foraging behavior. Research on foraging has also highlighted the importance of context and has led to some counterintuitive predictions that are mediated by context.

  5. ORIC central region calculations

    SciTech Connect

    Bailey, J.D.; Dowling, D.T.; Lane, S.N.; Mosko, S.W.; Olsen, D.K.; Tatum, B.A.

    1995-12-31

    The central region for the K = 100 Oak Ridge Isochronous Cyclotron, ORIC, will be modified to provide better orbit centering, focusing of orbits in the axial direction, and phase selection, in order to improve extraction efficiency, and reduce radioactive activation of cyclotron components. The central region is specifically designed for the acceleration of intense light ion beams such as 60 MeV protons and 15--100 MeV alphas. These beams will be used in the production of radioactive atoms in the Radioactive Ion Beam Project at Oak Ridge National Laboratory.

  6. Integrating tuberculosis and HIV services in rural Kenya: uptake and outcomes.

    PubMed

    Owiti, P; Zachariah, R; Bissell, K; Kumar, A M V; Diero, L; Carter, E J; Gardner, A

    2015-03-21

    Contexte : Dix-sept structures de santé publique rurales dans l’ouest du Kenya qui ont introduit trois modèles de prise en charge intégrée de la tuberculose (TB) et du virus de l’immunodéficience humaine (VIH).Objectif : Evaluer l’utilisation et le moment du traitement préventif par cotrimoxazole (CPT) et du traitement antirétroviral (ART) ainsi que les résultats du traitement de la TB chez des patients tuberculeux infectés par le VIH pendant une période avant (mars–octobre 2010) et après (mars–octobre 2012) l’introduction de la prise en charge intégrée TB-VIH.Schéma : Etude de cohorte avant/après basée sur les données des programmes.Résultats : Sur 501 patients tuberculeux VIH positifs, 357 (71%) ont débuté le CPT et 178 (39%) l’ART pendant la période précédant l’introduction du traitement intégré TB-VIH. Après l’intégration des services, sur 323 patients infectés par le VIH, 316 (98%) ont reçu le CPT et 196 (61%) l’ART (P < 0,001). Le délai médian de mise en œuvre du CPT et de l’ART est passé de 7 à 3 jours et de 42 à 34 jours respectivement dans les phases pré- et post-intégration. Le taux global de succès du traitement de la TB n’a pas varié avec l’intégration ni avec le type de modèle mis en œuvre.Conclusions: L’intégration des services de TB et de VIH a accru le recours au CPT et à l’ART et réduit le délai de mise en route dans les structures de santé rurales. Il est nécessaire d’accélérer ces efforts.

  7. Retiring the central executive.

    PubMed

    Logie, Robert H

    2016-10-01

    Reasoning, problem solving, comprehension, learning and retrieval, inhibition, switching, updating, or multitasking are often referred to as higher cognition, thought to require control processes or the use of a central executive. However, the concept of an executive controller begs the question of what is controlling the controller and so on, leading to an infinite hierarchy of executives or "homunculi". In what is now a QJEP citation classic, Baddeley [Baddeley, A. D. (1996). Exploring the central executive. Quarterly Journal of Experimental Psychology, 49A, 5-28] referred to the concept of a central executive in cognition as a "conceptual ragbag" that acted as a placeholder umbrella term for aspects of cognition that are complex, were poorly understood at the time, and most likely involve several different cognitive functions working in concert. He suggested that with systematic empirical research, advances in understanding might progress sufficiently to allow the executive concept to be "sacked". This article offers an overview of the 1996 article and of some subsequent systematic research and argues that after two decades of research, there is sufficient advance in understanding to suggest that executive control might arise from the interaction among multiple different functions in cognition that use different, but overlapping, brain networks. The article concludes that the central executive concept might now be offered a dignified retirement.

  8. Retiring the central executive.

    PubMed

    Logie, Robert H

    2016-10-01

    Reasoning, problem solving, comprehension, learning and retrieval, inhibition, switching, updating, or multitasking are often referred to as higher cognition, thought to require control processes or the use of a central executive. However, the concept of an executive controller begs the question of what is controlling the controller and so on, leading to an infinite hierarchy of executives or "homunculi". In what is now a QJEP citation classic, Baddeley [Baddeley, A. D. (1996). Exploring the central executive. Quarterly Journal of Experimental Psychology, 49A, 5-28] referred to the concept of a central executive in cognition as a "conceptual ragbag" that acted as a placeholder umbrella term for aspects of cognition that are complex, were poorly understood at the time, and most likely involve several different cognitive functions working in concert. He suggested that with systematic empirical research, advances in understanding might progress sufficiently to allow the executive concept to be "sacked". This article offers an overview of the 1996 article and of some subsequent systematic research and argues that after two decades of research, there is sufficient advance in understanding to suggest that executive control might arise from the interaction among multiple different functions in cognition that use different, but overlapping, brain networks. The article concludes that the central executive concept might now be offered a dignified retirement. PMID:26821744

  9. Central Exclusive Dijet Production

    SciTech Connect

    Dechambre, A.; Cudell, J. R.; Ivanov, I. P.; Hernandez, O.

    2008-08-29

    The ingredients of central exclusive production cross section include large perturbative corrections and soft quantities that must be parametrized and fitted to data. In this talk, we summarize the results of a study of the uncertainties coming from these ingredients, in the case of exclusive dijet production.

  10. Postexercise Hypotension: Central Mechanisms

    PubMed Central

    Chen, Chao-Yin; Bonham, Ann C.

    2010-01-01

    A single bout of exercise can lead to a postexercise decrease in blood pressure in hypertensive individuals, called postexercise hypotension. Compelling evidence suggests that the central baroreflex pathway plays a crucial role in the development of postexercise hypotension. This review focuses on the exercise-induced changes in brainstem nuclei involved in blood pressure regulation. PMID:20577060

  11. Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers

    PubMed Central

    2014-01-01

    Background Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Methods Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women’s health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Results Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion

  12. 75 FR 76394 - Central Electric Power Cooperative, Inc.: Notice of Intent To Prepare an Environmental Impact...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... Rural Utilities Service Central Electric Power Cooperative, Inc.: Notice of Intent To Prepare an Environmental Impact Statement and Extend Scoping Comment Period AGENCY: Rural Utilities Service, USDA. ACTION...: The Rural Utilities Service (RUS) intends to prepare an Environmental Impact Statement (EIS) to...

  13. PhEDEx Data Service

    NASA Astrophysics Data System (ADS)

    Egeland, Ricky; Wildish, Tony; Huang, Chih-Hao

    2010-04-01

    The PhEDEx Data Service provides access to information from the central PhEDEx database, as well as certificate-authenticated managerial operations such as requesting the transfer or deletion of data. The Data Service is integrated with the "SiteDB" service for fine-grained access control, providing a safe and secure environment for operations. A plug-in architecture allows server-side modules to be developed rapidly and easily by anyone familiar with the schema, and can automatically return the data in a variety of formats for use by different client technologies. Using HTTP access via the Data Service instead of direct database connections makes it possible to build monitoring web-pages with complex drill-down operations, suitable for debugging or presentation from many aspects. This will form the basis of the new PhEDEx website in the near future, as well as providing access to PhEDEx information and certificate-authenticated services for other CMS dataflow and workflow management tools such as CRAB, WMCore, DBS and the dashboard. A PhEDEx command-line client tool provides one-stop access to all the functions of the PhEDEx Data Service interactively, for use in simple scripts that do not access the service directly. The client tool provides certificate-authenticated access to managerial functions, so all the functions of the PhEDEx Data Service are available to it. The tool can be expanded by plug-ins which can combine or extend the client-side manipulation of data from the Data Service, providing a powerful environment for manipulating data within PhEDEx.

  14. [CENTRAL ANTICHOLINERGIC... SYNDROME?].

    PubMed

    Danilov, M S; Lebedinskii, K M

    2015-01-01

    While reading special literature in diferent languages the authors noted surprising fact: the term and concept of "central anticholinergic syndrome" is well-known as common anaesthesia complication in German (abbr: ZAS) and partially Spanish sources, but in Russian, English or French literature is used only in toxicological context. Describing etiology, pathogenesis, symptoms, diagnosis and treatment of the complication manifesting with comatose, agitated or shivering forms, the authors analyzing the reasons for such a noticeably diferent approaches to the situation reaching 10% of all the general anaesthesia cases. Probably, ZAS isn't nosologically clearly defined syndrome, but just adverse appearance of one of the fundamental general anaesthesia mechanisms? Anyway, the problem of central cholinergic activity suppression, excessive by its amplitude and/or duration, exists all over the world. German concept of ZAS allows the anaesthesiologist to resolve it on pathogenically generalized basis, while in other professional communities various symptomatic approaches seem to be more common. PMID:27025142

  15. [Central apnea in newborns].

    PubMed

    van Putten, M J; Bosman-Vermeeren, J M; Brouwer, O F

    1999-02-27

    Three neonates had diverse kinds of central apnoea. The first child, a girl aged 3 weeks, had an upper respiratory tract infection caused by the respiratory syncytial virus; she was intubated and needed ventilatory support for three days. The second patient, a boy of 17 days, had an Arnold-Chiari-malformation with apnoeas treated with a carbonic anhydrase inhibitor (acetazolamide). The third patient, a boy of 5 days, had central apnoeas of epileptic origin and was treated with phenobarbital. All three recovered well. If in an infant with apnoeas no paediatric explanation is found, and the child is neurologically at risk, it is advisable to make an EEG to determine if an epileptic substrate is present, even in the absence of motor phenomena. PMID:10221119

  16. Central Mechanisms of Itch.

    PubMed

    Carstens, Earl; Akiyama, Tasuku

    2016-01-01

    This chapter summarizes recent findings regarding the central transmission of acute and chronic itch. Itch is transduced by cutaneous pruriceptors that transmit signals to neurons in the superficial spinal cord. Spinal itch-signaling circuits utilize several neuropeptides whose receptors represent novel targets to block itch transmission. Itch is relieved by scratching, which activates spinal interneurons to inhibit itch-transmitting neurons. Spinal itch transmission is also thought to be modulated by descending pathways. Itch is transmitted rostrally via ascending pathways to activate a variety of brain regions involved in sensory discrimination of affective and motor responses to itch. The pathophysiological mechanisms of chronic itch are poorly understood but likely involve sensitization of itch-signaling pathways and/or dysfunction of itch-inhibitory circuits. Improved understanding of central itch mechanisms has identified a number of novel targets for the development of antipruritic treatment strategies. PMID:27578065

  17. Central Florida, USA

    NASA Technical Reports Server (NTRS)

    1982-01-01

    This view of central Florida, USA (28.0N, 81.5W) shows both coasts of the Florida peninsula with Cape Canaveral and the Kennedy Space Center readily visible in the center on the Atlantic coast. Other features on the Earth which are visible through the clouds include Tampa Bay, several lakes and the Gulf of Mexico on Florida's east coast. The space shuttle's tail fin and both orbital maneuvering systems (OMS) pods are seen in the foreground.

  18. FNAL central email systems

    SciTech Connect

    Schmidt, Jack; Lilianstrom, Al; Pasetes, Ray; Hill, Kevin; /Fermilab

    2004-10-01

    The FNAL Email System is the primary point of entry for email destined for an employee or user at Fermilab. This centrally supported system is designed for reliability and availability. It uses multiple layers of protection to help ensure that: (1) SPAM messages are tagged properly; (2) All mail is inspected for viruses; and (3) Valid mail gets delivered. This system employs numerous redundant subsystems to accomplish these tasks.

  19. West and Central Africa.

    PubMed

    Lydie, N; Robinson, N J

    1998-01-01

    This article reviews scientific and other literature during the 1990s that links migration and mobility with the spread of sexually transmitted diseases (STDs), including HIV/AIDS. The focus is on key population groups linked to the spread of HIV and STDs in West and Central Africa: migrant laborers, truck drivers, itinerant traders, commercial sex workers (CSWs), and refugees. Countries with high emigration and immigration tend to have high levels of HIV infection, with the exception of Senegal. The main destination of immigrants are Senegal, Nigeria, and Cote d'Ivoire in West Africa and Cameroon, Congo, Gabon, and Congo in Central Africa. The risk of infection and the spread of HIV is variable among migrants. There is little in the literature that substantiates hypotheses about the strong association between migration and HIV-positive status. Information is needed on the duration, frequency of return visits, living conditions, sexual activities with multiple partners, and information before departure, along the routes, at final destination, and at the time of returns. Action-based research in five West African countries (Burkina Faso, Cote d'Ivoire, Mali, Niger, and Senegal) should produce results in late 1998. Comparable studies in Central Africa are unknown. Regional studies should be complemented by local studies. Prevention would benefit from studies on the relative size of these five population groups by geographic location.

  20. Central respiratory chemoreception.

    PubMed

    Guyenet, Patrice G; Stornetta, Ruth L; Bayliss, Douglas A

    2010-10-01

    By definition central respiratory chemoreceptors (CRCs) are cells that are sensitive to changes in brain PCO(2) or pH and contribute to the stimulation of breathing elicited by hypercapnia or metabolic acidosis. CO(2) most likely works by lowering pH. The pertinent proton receptors have not been identified and may be ion channels. CRCs are probably neurons but may also include acid-sensitive glia and vascular cells that communicate with neurons via paracrine mechanisms. Retrotrapezoid nucleus (RTN) neurons are the most completely characterized CRCs. Their high sensitivity to CO(2) in vivo presumably relies on their intrinsic acid sensitivity, excitatory inputs from the carotid bodies and brain regions such as raphe and hypothalamus, and facilitating influences from neighboring astrocytes. RTN neurons are necessary for the respiratory network to respond to CO(2) during the perinatal period and under anesthesia. In conscious adults, RTN neurons contribute to an unknown degree to the pH-dependent regulation of breathing rate, inspiratory, and expiratory activity. The abnormal prenatal development of RTN neurons probably contributes to the congenital central hypoventilation syndrome. Other CRCs presumably exist, but the supportive evidence is less complete. The proposed locations of these CRCs are the medullary raphe, the nucleus tractus solitarius, the ventrolateral medulla, the fastigial nucleus, and the hypothalamus. Several wake-promoting systems (serotonergic and catecholaminergic neurons, orexinergic neurons) are also putative CRCs. Their contribution to central respiratory chemoreception may be behavior dependent or vary according to the state of vigilance. PMID:20737591

  1. Implementation of harm reduction in Central and Eastern Europe and Central Asia.

    PubMed

    Sarang, Anya; Stuikyte, Raminta; Bykov, Roman

    2007-03-01

    Harm reduction (HR) interventions began in Central-Eastern Europe and Central Asia in the mid-1980s with the establishment of substitution treatment (ST) in Yugoslavia. In the mid-1990s, the first needle and syringe programmes (NSPs) opened in selected countries following the outbreaks of HIV among injecting drug users (IDUs). The number of NSPs continues to increase via a combination of international and state funding with large expansions made possible via the Global Fund to Fight AIDS, Tuberculosis and Malaria. While ST is still unaccepted in several countries, others have made some progress which is especially visible in South Eastern and Central Europe and the Baltic States. Development of regional networking including Central and Eastern European HR Network and a number of national networks helped to coordinate joint advocacy effort and in some cases sustain HR services. Activism of drug users and people living with HIV (PLWH) increased in the region in the last several years and helped to better link HR with the affected communities. Still a number of challenges remain important for the movement today such as repressive drug policies; stigma and discrimination of IDUs, PLWH, sex workers and inmates, including poor access to prevention and treatment; lack of important components of HR work such as naloxone distribution and hepatitis B vaccination, prevention in prisons; issues of quality control; sustaining services after finishing of major international projects; reaching of adequate coverage and others.

  2. Centralization vs. Decentralization in Medical School Libraries

    PubMed Central

    Crawford, Helen

    1966-01-01

    Does the medical school library in the United States operate more commonly under the university library or the medical school administration? University-connected medical school libraries were asked to indicate (a) the source of their budgets, whether from the central library or the medical school, and (b) the responsibility for their acquisitions and cataloging. Returns received from sixtyeight of the seventy eligible institutions showed decentralization to be much the most common: 71 percent of the libraries are funded by their medical schools; 79 percent are responsible for their own acquisitions and processing. The factor most often associated with centralization of both budget and operation is public ownership. Decentralization is associated with service to one or two rather than three or more professional schools. Location of the medical school in a different city from the university is highly favorable to autonomy. Other factors associated with these trends are discussed. PMID:5945568

  3. Central portion of north side (front), showing central entry stair ...

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

    Central portion of north side (front), showing central entry stair and "Puller Hall" sign - U.S. Naval Base, Pearl Harbor, Enlisted Men's Barracks & Mess Hall, Marine Barracks, Neville Way, Pearl City, Honolulu County, HI

  4. Design of a photovoltaic central power station

    SciTech Connect

    Not Available

    1984-02-01

    Photovoltaic central power station designs have been developed for both high-efficiency flat-panel arrays and two-axis tracking concentrator arrays. Both designs are based on a site adjacent to the Saguaro Power Station of Arizona Public Service. The plants are 100 MW each, made of 5 MW subfields. The site specific designs allow detailed cost estimate for site preparation, installation, and engineering. These designs are summarized and cost estimates analyzed. Provided also are recommendations for future work to reduce system cost for each plant design.

  5. Le domaine des co-infections et des maladies concomitantes du Réseau canadien pour les essais VIH des IRSC : lignes directrices canadiennes pour la prise en charge et le traitement de la co-infection par le VIH et l’hépatite C chez les adultes

    PubMed Central

    Hull, Mark; Giguère, Pierre; Klein, Marina; Shafran, Stephen; Tseng, Alice; Côté, Pierre; Poliquin, Marc; Cooper, Curtis

    2014-01-01

    HISTORIQUE : De 20 % à 30 % des Canadiens qui vivent avec le VIH sont co-infectés par le virus de l’hépatite C (VHC), lequel est responsable d’une morbidité et d’une mortalité importantes. La prise en charge du VIH et du VHC est plus complexe en raison de l’évolution accélérée de la maladie hépatique, du choix et des critères d’initiation de la thérapie antirétrovirale et du traitement anti-VHC, de la prise en charge de la santé mentale et des toxicomanies, des obstacles socioéconomiques et des interactions entre les nouvelles thérapies antivirales à action directe du VHC et les antirétroviraux OBJECTIF : Élaborer des normes nationales de prise en charge des adultes co-infectés par le VHC et le VIH dans le contexte canadien. MÉTHODOLOGIE : Le Réseau canadien pour les essais VIH des Instituts de recherche en santé du Canada a réuni un groupe d’experts possédant des compétences cliniques en co-infection par le VIH et le VHC pour réviser les publications à jour ainsi que les lignes directrices et les protocoles en place. Après une vaste sollicitation afin d’obtenir des points de vue, le groupe de travail a approuvé des recommandations consensuelles, qu’il a caractérisées au moyen d’une échelle de qualité des preuves fondée sur la classe (bienfaits par rapport aux préjudices) et sur la catégorie (degré de certitude). RÉSULTATS : Toutes les personnes co-infectées par le VIH et le VHC devraient subir une évaluation en vue de recevoir un traitement du VHC. Les personnes qui ne sont pas en mesure d’entreprendre un traitement du VHC devraient être soignées pour le VIH afin de ralentir l’évolution de la maladie hépatique. La norme de traitement du VHC de génotype 1 est un régime comprenant de l’interféron pégylé et de la ribavirine dosée en fonction du poids, associés à un inhibiteur de la protéase du VHC. Pour les génotypes 2 ou 3, une bithérapie classique est recommandée pendant 24 semaines s

  6. Central effects of fingolimod.

    PubMed

    Cruz, Vítor T; Fonseca, Joaquim

    2014-08-01

    Introduccion. El fingolimod, un modulador del receptor de la esfingosina-1-fosfato (S1P) dotado de un mecanismo de accion novedoso, fue el primer tratamiento oral aprobado para la esclerosis multiple remitente recurrente. Su union a los receptores S1P1 de los linfocitos promueve la retencion selectiva de los linfocitos T virgenes y de memoria central en los tejidos linfoides secundarios, lo que impide su salida hacia el sistema nervioso central (SNC). Asimismo, el fingolimod atraviesa con facilidad la barrera hematoencefalica, y diversos estudios le atribuyen un efecto neuroprotector directo en el SNC. Objetivo. Revisar la informacion disponible acerca de los efectos centrales del fingolimod. Desarrollo. El desequilibrio entre los procesos lesivos y reparadores constituye un reflejo de la desmielinizacion cronica, la degeneracion axonal y la gliosis, y parece contribuir a la discapacidad que la esclerosis multiple acarrea. La facilidad con la que el fingolimod atraviesa la barrera hematoencefalica le permite actuar directamente sobre los receptores S1P localizados en las celulas del SNC. Una vez en el interior del SNC, ocupa los receptores S1P de los oligodendrocitos y de sus celulas precursoras, de los astrocitos, los microgliocitos y las neuronas, fomentando la remielinizacion, la neuroproteccion y los procesos endogenos de regeneracion. La eficacia evidenciada en los ensayos clinicos concuerda con un mecanismo de accion que incluiria efectos directos sobre las celulas del SNC. Conclusiones. Los datos disponibles indican que la eficacia del fingolimod en el tratamiento de la esclerosis multiple se debe a su ambivalencia como molecula inmunomoduladora y moduladora directa de los receptores S1P del SNC. Tanto es asi que estudios recientes le atribuyen efectos neuroprotectores en varios modelos que suscitan expectativas en torno a su posible aplicacion terapeutica en la enfermedad de Alzheimer, el paludismo cerebral y el neuroblastoma, asi como en la neuroproteccion

  7. Central hypothyroidism in children.

    PubMed

    García, Marta; Fernández, Ana; Moreno, José C

    2014-01-01

    Central congenital hypothyroidism (CCH) is an underdiagnosed disorder poorly described in childhood and adolescence. Congenital defects in thyroid-stimulating hormone (TSH) synthesis, secretion or bioactivity may lead to a state of 'regulatory' hypothyroidism expressed through aberrantly low or normal TSH levels and low thyroxine (T4), a hormonal pattern undetectable by TSH-based neonatal screening programs for congenital hypothyroidism (CH) implemented in most countries worldwide. CCH is more prevalent than previously thought, reaching 1 in 16,000 neonates in countries consistently identifying CCH through T4-based CH screening strategies. Neonatal detection and early treatment of CCH would prevent the risk of developing mental retardation secondary to late diagnosis of infantile hypothyroidism. CCH is frequently associated with other pituitary defects causing life-threatening situations (like e.g. adrenocorticotropic hormone deficiency) which could benefit from the early detection of CCH, avoiding considerable morbidity and mortality. CCH is not easy to identify clinically, and therefore few children are investigated for the disorder. The current knowledge on the genetic bases of CCH is also scarce. At the hypothalamic level no gene defects causing CCH have yet been identified in humans, but pituitary (thyrotrope)-selective genes encoding the TSH-releasing hormone (TRH) receptor (TRHR), the TSH β-subunit (TSHB) and, recently, the immunoglobulin superfamily factor 1 (IGSF1) are genes involved in isolated central hypothyroidism. Moreover, central hypothyroidism is a complex condition where many regulatory signals are implicated and converge to finely modulate the activity of the hypothalamic-pituitary-thyroid axis. This review focuses on novel pathogenic mechanisms and their implications to understand human CCH and improve the identification and the therapeutic handling of this elusive disease in the pediatric age. PMID:25231446

  8. Flooding in Central Siberia

    NASA Technical Reports Server (NTRS)

    2002-01-01

    A mixture of snowmelt and ice jams in late May and June of this year caused the Taz River (left) and the Yenisey River (right) in central Siberia to overflow their banks. The flooding can be seen in this image taken on June 11, 2002, by the MODIS (Moderate Resolution Imaging Spectroradiometer) instrument aboard the Terra satellite. Normally, the rivers would resemble thin black lines in MODIS imagery. In the false-color images sage green and rusty orange is land, and water is black. Clouds are white and pink. Credit: Image courtesy Jacques Descloitres, MODIS Land Rapid Response Team at NASA GSFC

  9. Floods in Central China

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This pair of true- and false-color images from the Moderate resolution Imaging Spectroradiometer (MODIS) shows flooding in central China on July 4, 2002. In the false-color image vegetation appears orange and water appears dark blue to black. Because of the cloud cover and the fact that some of the water is filled with sediment, the false-color image provides a clearer picture of where rivers have exceeded their banks and lakes have risen. The river in this image is the Yangtze River, and the large lake is the Poyang Hu. Credits: Jacques Descloitres, MODIS Land Rapid Response Team, NASA/GSFC

  10. Fires in Central Africa

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Hundreds of fires are set every year during the dry season in Central Africa. This true color image from the Sea-viewing Wide Field-of-view Sensor (SeaWiFS) shows dozens of smoke plumes in the Democratic Republic of the Congo on June 29, 2000. Residents burn away scrub and brush annually in the woody savanna to clear land for farming and grazing. For more information, visit the SeaWiFS Home Page, Global Fire Monitoring Fact Sheet, and 4km2 Fire Data Image Provided by the SeaWiFS Project, NASA/Goddard Space Flight Center, and ORBIMAGE

  11. Central receiver technology

    SciTech Connect

    Holl, R.L. )

    1989-09-01

    The research and development described in this document was conducted within the US Department of Energy's (DOE) Solar Thermal Technology Program. The goal of this program is to advance the engineering and scientific understanding of solar thermal technology and to establish the technology base from which private industry can develop solar thermal power production options for introduction into the competitive energy market. This report describes central receiver technology: its accomplishments to date, its current technology status, and the efforts still necessary to fully exploit it.

  12. [Central anticholinergic syndrome].

    PubMed

    Fernández Urretavizcaya, P; Cenoz Osinaga, J C; Jáuregui Garía, M L; Gállego Culleré, J

    1991-10-01

    Two new cases of anticolinergic central syndrome are described. The first case, a 8 year old girl, suffered a severe encefalopathy after topical application of mydriatic cholirio as an aid in a rutine study of ocular refraction. The second case, 67 year old man presented a severe neurological picture after accidental intake of a silvester plantground (Atropa belladonna). His neurological condition returned quickly to normal whith administration of physostigmine. Differents aspects of the etiology, clinical picture and diagnosis are discussed with special emphasis in patients with delirium or acute confusional states. Finally, attention is drawn in the necessity of a properly use of anticholinergic drugs overcoat in aged or children.

  13. Central American resource studies

    SciTech Connect

    Van Eeckhout, E.; Laughlin, A.W.

    1989-01-01

    Los Alamos National Laboratory has been working with five Central American countries to assist in the development of their energy and mineral resources. Since 1985, mineral resources in Costa Rica, peat resources in Costa Rica and Panama, geothermal energy resources in Honduras and Guatemala, and geothermal field development in El Salvador and Costa Rica have been topics of study. This paper presents an overview of this work -- within these proceedings are papers that deal with specific aspects of each topic, and these will be duly noted. 15 refs., 4 figs.

  14. Central ignition scenarios for TFTR

    SciTech Connect

    Zweben, S.J.; Redi, M.H.; Bateman, G.

    1986-03-01

    The possibility of obtaining ignition in TFTR by means of very centrally peaked density profiles is examined. It is shown that local central alpha heating can be made to exceed local central energy losses (''central ignition'') under global conditions for which Q greater than or equal to 1. Time dependent 1-D transport simulations show that the normal global ignition requirements are substantially relaxed for plasmas with peaked density profiles. 18 refs., 18 figs.

  15. A physiotherapy triage service for orthopaedic surgery: an effective strategy for reducing wait times.

    PubMed

    Napier, Christopher; McCormack, Robert G; Hunt, Michael A; Brooks-Hill, Alexandra

    2013-01-01

    Objectif : Étudier l'efficacité d'un service de triage en physiothérapie pour aiguillages vers la chirurgie orthopédique provenant de médecins de premier recours. Méthodes : On a utilisé un concept d'observation prospective des patients référés à un chirurgien orthopédiste dans deux petites localités urbaines de la Colombie-Britannique. On a déterminé le niveau d'entente entre le physiothérapeute et le chirurgien en établissant une statistique kappa pondérée (weighted kappa, κw) comportant un IC à 95%. On a administré aux patients un questionnaire sur leur satisfaction et calculé un taux de conversion chirurgicale (TCC) afin d'évaluer le niveau des références appropriées. Résultats : L'analyse a révélé une convergence importante (κw=0,77; IC à 95%, 0,60 à 0,94) entre le chirurgien et le physiothérapeute sur le plan des décisions relatives à la prise en charge chirurgicale. Tous les patients se sont dits « satisfaits » ou « très satisfaits » des soins généraux qu'ils ont reçus du physiothérapeute. Le TCC des patients référés par le physiothérapeute au chirurgien s'est établi à 91% contre 22% chez les patients référés par un généraliste ou un urgentiste. Conclusion : Plus de trois quarts des patients référés à un chirurgien orthopédiste par des médecins de premier recours n'ont pas eu à consulter un chirurgien et ont été pris en charge par un physiothérapeute orthopédiste chevronné. Ce modèle de triage pourrait avoir un effet considérable sur les temps d'attente en orthopédie au Canada en réduisant au minimum les aiguillages inutiles. Le modèle pourrait aussi promouvoir une prise en charge rapide et conservatrice de problèmes non chirurgicaux par des physiothérapeutes.

  16. The Unfit Majority: A Research Study of the Rehabilitation of Selective Service Rejectees in South Carolina. Final Report for: Experimental Demonstration Project for Servicing Selective Service Rejectees.

    ERIC Educational Resources Information Center

    Clements, Hubert M.; And Others

    A 3-year demonstration project focused on the vocational rehabilitation rehabilitation of selective service rejectees in a five-county area in Central South Carolina. In 1962, over 50 percent of South Carolina's young men who were examined for military service were rejected for failure to meet physical and/or mental requirements. Of 1,450…

  17. The Agua Salud Project, Central Panama

    NASA Astrophysics Data System (ADS)

    Stallard, R. F.; Elsenbeer, H.; Ogden, F. L.; Hall, J. S.

    2007-12-01

    The Agua Salud Project utilizes the Panama Canal's central role in world commerce to focus global attention on the ecosystem services provided by tropical forests. It will be the largest field experiment of its kind in the tropics aimed at quantifying the environmental services (water, carbon, and biodiversity) provided by tropical forests. The Agua Salud Watershed is our principal field site. This watershed and the headwaters of several adjacent rivers include both protected mature forests and a wide variety of land uses that are typical of rural Panama. Experiments at the scale of entire catchments will permit complete water and carbon inventories and exchanges for different landscape uses. The following questions will be addressed: (1) How do landscape treatments and management approaches affect ecosystem services such as carbon storage, water quality and quantity, dry- season water supply, and biodiversity? (2) Can management techniques be designed to optimize forest production along with ecosystem services during reforestation? (3) Do different tree planting treatments and landscape management approaches influence groundwater storage, which is thought to be critical to maintaining dry-season flow, thus insuring the full operation of the Canal during periods of reduced rainfall and severe climatic events such as El Niño. In addition we anticipate expanding this project to address biodiversity, social, and economic values of these forests.

  18. The International Laser Ranging Service

    NASA Astrophysics Data System (ADS)

    Pearlman, M. R.; Degnan, J. J.; Bosworth, J. M.

    2002-07-01

    The International Laser Ranging Service (ILRS) was established in September 1998 to support programs in geodetic, geophysical, and lunar research activities and to provide the International Earth Rotation Service (IERS) with products important to the maintenance of an accurate International Terrestrial Reference Frame (ITRF). Now in operation for nearly two years, the ILRS develops (1) the standards and specifications necessary for product consistency, and (2) the priorities and tracking strategies required to maximize network efficiency. The Service collects, merges, analyzes, archives and distributes satellite and lunar laser ranging data to satisfy a variety of scientific, engineering, and operational needs and encourages the application of new technologies to enhance the quality, quantity, and cost effectiveness of its data products. The ILRS works with (1) new satellite missions in the design and building of retroreflector targets to maximize data quality and quantity, and (2) science programs to optimize scientific data yield. The ILRS is organized into permanent components: (1) a Governing Board, (2) a Central Bureau, (3) Tracking Stations and Subnetworks, (4) Operations Centers, (5) Global and Regional Data Centers, and (6) Analysis, Lunar Analysis, and Associate Analysis Centers. The Governing Board, with broad representation from the international Satellite Laser Ranging (SLR) and Lunar Laser Ranging (LLR) community, provides overall guidance and defines service policies, while the Central Bureau oversees and coordinates the daily service activities, maintains scientific and technological data bases, and facilitates communications. Active Working Groups in (1) Missions, (2) Networks and Engineering, (3) Data Formats and Procedures, (4) Analysis, and (5) Signal Processing provide key operational and technical expertise to better exploit current capabilities and to challenge the ILRS participants to keep pace with evolving user needs. The ILRS currently

  19. Physiology of central pathways.

    PubMed

    Cullen, K E

    2016-01-01

    The relative simplicity of the neural circuits that mediate vestibular reflexes is well suited for linking systems and cellular levels of analyses. Notably, a distinctive feature of the vestibular system is that neurons at the first central stage of sensory processing in the vestibular nuclei are premotor neurons; the same neurons that receive vestibular-nerve input also send direct projections to motor pathways. For example, the simplicity of the three-neuron pathway that mediates the vestibulo-ocular reflex leads to the generation of compensatory eye movements within ~5ms of a head movement. Similarly, relatively direct pathways between the labyrinth and spinal cord control vestibulospinal reflexes. A second distinctive feature of the vestibular system is that the first stage of central processing is strongly multimodal. This is because the vestibular nuclei receive inputs from a wide range of cortical, cerebellar, and other brainstem structures in addition to direct inputs from the vestibular nerve. Recent studies in alert animals have established how extravestibular signals shape these "simple" reflexes to meet the needs of current behavioral goal. Moreover, multimodal interactions at higher levels, such as the vestibular cerebellum, thalamus, and cortex, play a vital role in ensuring accurate self-motion and spatial orientation perception. PMID:27638060

  20. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 2 2012-07-01 2012-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF...

  1. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Central point of contact. 242.6 Section 242.6 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF...

  2. 4. VIEW LOOKING WEST DOWN CENTRAL AVENUE AT THE INTERSECTION ...

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

    4. VIEW LOOKING WEST DOWN CENTRAL AVENUE AT THE INTERSECTION WITH SEVENTH STREET. THE PLANT HAS MOST OF THE AMENITIES OF A SMALL TOWN - WATER SUPPLY, WASTE WATER TREATMENT, POLICE FORCE, FIRE DEPARTMENT, FOOD SERVICES, HOSPITAL, COMMUNICATIONS NETWORK, STEAM GENERATION, VEHICLE MAINTENANCE, TRANSPORTATION, AND A GOVERNMENT. - Rocky Flats Plant, Bounded by Indiana Street & Routes 93, 128 & 72, Golden, Jefferson County, CO

  3. INTERIOR VIEW, NORTHWEST ATTIC CHAMBER FROM THE CENTRAL PASSAGE. (NOTE ...

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

    INTERIOR VIEW, NORTHWEST ATTIC CHAMBER FROM THE CENTRAL PASSAGE. (NOTE THE LEFT JAMB OF THE ARCHITRVE MOLDING AROUND THE DOOR. ALL OF THE SERVICE SPACES THROUGHOUT THE WOODLANDS INCLUDED THIS DEGREE OF REFINEMENT - The Woodlands, 4000 Woodlands Avenue, Philadelphia, Philadelphia County, PA

  4. 75 FR 11195 - Central Arkansas National Wildlife Refuge Complex, Arkansas

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-10

    ... a notice in the Federal Register on January 3, 2007 (72 FR 142). For more about the process, please... for 30 days, as announced in the Federal Register on August 27, 2009 (74 FR 43716). A total of 24... Fish and Wildlife Service Central Arkansas National Wildlife Refuge Complex, Arkansas AGENCY: Fish...

  5. 22 CFR 94.2 - Designation of Central Authority.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Designation of Central Authority. 94.2 Section 94.2 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION... Convention and the International Child Abduction Remedies Act upon such authorities....

  6. 22 CFR 94.2 - Designation of Central Authority.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Designation of Central Authority. 94.2 Section 94.2 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION... Convention and the International Child Abduction Remedies Act upon such authorities....

  7. 22 CFR 94.2 - Designation of Central Authority.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Designation of Central Authority. 94.2 Section 94.2 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION... Convention and the International Child Abduction Remedies Act upon such authorities....

  8. 22 CFR 94.2 - Designation of Central Authority.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Designation of Central Authority. 94.2 Section 94.2 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION... Convention and the International Child Abduction Remedies Act upon such authorities....

  9. 22 CFR 94.2 - Designation of Central Authority.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Designation of Central Authority. 94.2 Section 94.2 Foreign Relations DEPARTMENT OF STATE LEGAL AND RELATED SERVICES INTERNATIONAL CHILD ABDUCTION... Convention and the International Child Abduction Remedies Act upon such authorities....

  10. 47 CFR 32.2210 - Central office-switching.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Central office-switching. 32.2210 Section 32.2210 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Balance Sheet Accounts §...

  11. 47 CFR 32.2210 - Central office-switching.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Central office-switching. 32.2210 Section 32.2210 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Balance Sheet Accounts §...

  12. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Balance Sheet Accounts §...

  13. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Central office-transmission. 32.2230 Section 32.2230 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES UNIFORM SYSTEM OF ACCOUNTS FOR TELECOMMUNICATIONS COMPANIES Instructions for Balance Sheet Accounts §...

  14. NASA Shared Services Center breaks ground

    NASA Technical Reports Server (NTRS)

    2006-01-01

    NASA officials and elected leaders were on hand for the groundbreaking ceremony of the NASA Shared Services Center Feb. 24, 2006, on the grounds of Stennis Space Center. The NSSC provides agency centralized administrative processing, human resources, procurement and financial services. From left, Louisiana Economic Development Secretary Mike Olivier, Stennis Space Center Director Rick Gilbrech, Computer Sciences Corp. President Michael Laphen, NASA Deputy Administrator Shana Dale, Rep. Gene Taylor, Sen. Trent Lott, Mississippi Gov. Haley Barbour, NASA Administrator Mike Griffin and Shared Services Center Executive Director Arbuthnot use golden shovels to break ground at the site.

  15. Service vs. Revenue: Conflict or Convergence?

    ERIC Educational Resources Information Center

    DeBard, Robert; Overland, Wanda I.

    2003-01-01

    Discusses how administrators at Bowling Green State University, Ohio, worked to reconcile politics, economics, and today's consumer-oriented students as it renovated the student union, suggesting that a central issue for those responsible for determining services to be provided by student centers is what can best be outsourced and what can be kept…

  16. Diabetes and Adult Day Health Services

    ERIC Educational Resources Information Center

    Dabelko, Holly I.; DeCoster, Vaughn A.

    2007-01-01

    The purpose of this study is to provide a profile of individuals with diabetes who receive services in adult day centers. This exploratory study uses an administrative data set (N = 280) from five programs in central Ohio to examine four areas: demographics, health and mental health, financial and social resources, and disenrollment status. Older…

  17. The New Academic Library and Student Services

    ERIC Educational Resources Information Center

    Morris, Jim

    2007-01-01

    The academic library in the 21st Century must find innovative ways to remain central to the mission of the institution that it represents, and the people that it serves. Some of those ways involve what traditionally has been the province of student services. After hours events with music and art, poetry slams, and electronic gaming are a few of…

  18. Social determinants of workers' health in Central America.

    PubMed

    Aragón, Aurora; Partanen, Timo; Felknor, Sarah; Corriols, Marianela

    2011-01-01

    This communication summarizes the available data on work-related determinants of health in Central America. The Central American working population is young and moving from agriculture toward industry and services. Ethnicity, gender, migration, subemployment and precarious work, informality, rural conditions, low-level educational, poverty, ubiquitous worksite health hazards, insufficient occupational health services, low labor inspection density, and weak unions define the constellation of social determinants of workers' health in Central America. Data are, however, scanty both for hazards and work-related illnesses and injuries. Governments and industries have the responsibility of opening decent work opportunities, especially for those facing multiple inequalities in social determinants of health. A first step would be the ratification and implementation of the ILO Convention (187) on occupational safety and health by the seven national governments of the region. PMID:21905391

  19. A computerized aircraft battery servicing facility

    NASA Technical Reports Server (NTRS)

    Glover, Richard D.

    1992-01-01

    The latest upgrade to the Aerospace Energy Systems Laboratory (AESL) is described. The AESL is a distributed digital system consisting of a central system and battery servicing stations connected by a high-speed serial data bus. The entire system is located in two adjoining rooms; the bus length is approximately 100 ft. Each battery station contains a digital processor, data acquisition, floppy diskette data storage, and operator interfaces. The operator initiates a servicing task and thereafter the battery station monitors the progress of the task and terminates it at the appropriate time. The central system provides data archives, manages the data bus, and provides a timeshare interface for multiple users. The system also hosts software production tools for the battery stations and the central system.

  20. 77 FR 8758 - International Fisheries; Western and Central Pacific Fisheries for Highly Migratory Species; High...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-15

    ... National Oceanic and Atmospheric Administration 50 CFR Part 300 RIN 0648-BB64 International Fisheries; Western and Central Pacific Fisheries for Highly Migratory Species; High Seas Transshipment Prohibitions AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric Administration...

  1. 78 FR 1837 - Nominations for the Western and Central Pacific Fisheries Commission Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-09

    ... fisheries and international fishery agreements. NMFS, on behalf of the Secretary of Commerce, will provide... Pacific Fisheries Commission Advisory Committee AGENCY: National Marine Fisheries Service (NMFS), National... under the Western and Central Pacific Fisheries Convention Implementation Act (Act). The...

  2. Sucker rod centralizer

    SciTech Connect

    Rivas, O.; Newski, A.

    1989-10-03

    This patent describes a device for centralizing at least one sucker rod within a production pipe downhole in a well and for reducing frictional forces between the pipe and at least one sucker rod. It comprises an elongate, substantially cylindrical body member having a longitudinal axis, a plurality of slots within the member and a rotatable member mounted within each slot, each of the plurality of slots has its major dimension along a first axis parallel to the longitudinal axis of the body member and is oriented with respect to the other seats so as to form a helicoidal array for maximizing the total surface contact area between the rotatable members and the pipe and for decreasing the forces acting on each rotatable member.

  3. Flooding in Central China

    NASA Technical Reports Server (NTRS)

    2002-01-01

    During the summer of 2002, frequent, heavy rains gave rise to floods and landslides throughout China that have killed over 1,000 people and affected millions. This false-color image of the western Yangtze River and Dongting Lake in central China was acquired on August 21, 2002, by the Moderate-resolution Imaging Spectroradiometer (MODIS), flying aboard NASA's Terra spacecraft. (right) The latest flooding crisis in China centers on Dingtong Lake in the center of the image. Heavy rains have caused it to swell over its banks and swamp lakefront towns in the province of Hunan. As of August 23, 2002, more than 250,000 people have been evacuated, and over one million people have been brought in to fortify the dikes around the lake. Normally the lake would appear much smaller and more defined in the MODIS image. Credit: Image courtesy Jacques Descloitres, MODIS Land Rapid Response Team at NASA GSFC.

  4. Central solar energy receiver

    DOEpatents

    Drost, M. Kevin

    1983-01-01

    An improved tower-mounted central solar energy receiver for heating air drawn through the receiver by an induced draft fan. A number of vertically oriented, energy absorbing, fin-shaped slats are radially arranged in a number of concentric cylindrical arrays on top of the tower coaxially surrounding a pipe having air holes through which the fan draws air which is heated by the slats which receive the solar radiation from a heliostat field. A number of vertically oriented and wedge-shaped columns are radially arranged in a number of concentric cylindrical clusters surrounding the slat arrays. The columns have two mirror-reflecting sides to reflect radiation into the slat arrays and one energy absorbing side to reduce reradiation and reflection from the slat arrays.

  5. Central vestibular disorders.

    PubMed

    Dieterich, Marianne

    2007-05-01

    Dizziness or vertigo is an erroneous perception of selfmotion or object-motion as well as an unpleasant distortion of static gravitational orientation. It is caused by a mismatch between the vestibular, visual, and somatosensory systems. Thanks to their functional overlap, the three systems are able to compensate, in part, for each other's deficiencies. Thus, vertigo is not a well-defined disease entity, but rather a multisensory syndrome that results when there is a pathological dysfunction of any of the stabilizing sensory systems (e.g., central vestibular disorders, peripheral vestibular diseases with asymmetric input into the vestibular nuclei). This article provides an overview of the most important and frequent forms of central vestibular vertigo syndromes, including basilar/vestibular migraine, which are characterized by ocular motor, postural, and perceptual signs. In a simple clinical classification they can be separated according to the three major planes of action of the vestibulo-ocular reflex: yaw, roll, and pitch. A tonic imbalance in yaw is characterized by horizontal nystagmus, lateropulsion of the eyes, past-pointing, rotational and lateral body falls, and lateral deviation of the perceived straight-ahead. A tonic imbalance in roll is defined by torsional nystagmus, skew deviation, ocular torsion, tilts of head, body, and the perceived vertical. Finally, a tonic imbalance in pitch can be characterized by some forms of upbeat or downbeat nystagmus, fore-aft tilts and falls, and vertical deviation of the perceived straight ahead. The thus defined syndromes allow for a precise topographic diagnosis as regards their level and side.

  6. New applications for the EUTELTRACS service

    NASA Technical Reports Server (NTRS)

    Colcy, Jean-Noel; Vanderbrouck, Laurent

    1995-01-01

    The EUTELTRACS two-way Mobile Satellite Messaging and Automatic Satellite Position Reporting (ASPR) service is Europe's first commercially operated Mobile Satellite Service. It was introduced by the European Telecommunications Satellite Organization (EUTELSAT) for commercial service in 1991. The system is based on a centralized network architecture organized around a single hub station operated by EUTELSAT. Initially the system was designed with a close user group architecture enabling a mobile user to communicate exclusively with its own headquarters. This paper describes the new applications (design and tests prior to their introduction into service) especially developed for the European market and particularly the Double Hop Services opening the system to authorized external entities. In addition, the European Commission (EC) pilot demonstrations in which the EUTELTRACS system is involved are described.

  7. Thermal Performance Data Services (TPDS)

    NASA Technical Reports Server (NTRS)

    French, Richard T.; Wright, Michael J.

    2013-01-01

    Initiated as a NASA Engineering and Safety Center (NESC) assessment in 2009, the Thermal Performance Database (TPDB) was a response to the need for a centralized thermal performance data archive. The assessment was renamed Thermal Performance Data Services (TPDS) in 2012; the undertaking has had two fronts of activity: the development of a repository software application and the collection of historical thermal performance data sets from dispersed sources within the thermal performance community. This assessment has delivered a foundational tool on which additional features should be built to increase efficiency, expand the protection of critical Agency investments, and provide new discipline-advancing work opportunities. This report contains the information from the assessment.

  8. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  9. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  10. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  11. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 9 2010-01-01 2009-01-01 true Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  12. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  13. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... in 41 CFR chapter 1, 41 CFR chapter 101, subchapter H, and 48 CFR chapter 1. Information on... Resources Service. 105-53.144 Section 105-53.144 Public Contracts and Property Management Federal Property... FUNCTIONS Central Offices § 105-53.144 Federal Property Resources Service. (a) Creation and authority....

  14. Advancing the Women's Agenda within Bureaucracies: Services for Rape Victims.

    ERIC Educational Resources Information Center

    Boles, Janet K.

    Those studying the distribution of urban services have generally concluded that services are distributed according to bureaucratic decision rules based on professional and bureaucratic norms such as need, efficiency, economy, equity, and convenience. Interest groups and elected officials may play a central role in effecting changes in bureaucratic…

  15. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 9 2011-01-01 2011-01-01 false Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  16. The Progression of Early Intervention Disability Services in Ireland

    ERIC Educational Resources Information Center

    Carroll, Clare; Murphy, Geraldine; Sixsmith, Jane

    2013-01-01

    The Republic of Ireland is an island situated in north-west Europe inhabited by 4.6 million people, with 2.8% between 0 and 4 years of age with a disability (Central Statistics Office, 2012). The Irish Government funds the Irish health services, which, in turn, directly and indirectly funds disability services. Education and Disability legislation…

  17. Leadership for Service-Learning: The National Leadership Conference.

    ERIC Educational Resources Information Center

    Kielsmeier, James C.

    The central theme of the 10-day National Leadership Conference (NLC), sponsored by the American Youth Foundation at Camp Miniwanca (Michigan), is to train high school students in leadership for service; its goal is to sharpen service-learning leadership skills of young people and teachers and to encourage their application to transform and serve…

  18. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 9 2013-01-01 2013-01-01 false Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  19. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 9 2012-01-01 2012-01-01 false Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  20. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 9 2014-01-01 2013-01-01 true Deduction for marketing services. 1032.86 Section 1032.86 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING AGREEMENTS AND ORDERS; MILK), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL...

  1. Developing Material and Organizational Resources: The Resource and Referral Service.

    ERIC Educational Resources Information Center

    Hull, William L.

    The Resource and Referral Service (RRS), is a central services contractor to the Research and Development Exchange (RDx), which facilitates the flow of outputs from Research and Development (R&D) based organizations, specializing in fast responses to questions from states transmitted by the Regional Exchanges on R&D in education, testing, and…

  2. Service water assistance program

    SciTech Connect

    Munchausen, J.H.

    1995-09-01

    The Service Water Assistance Program was developed to provide utility service water system engineers with a mechanism to quickly and efficiently address service water issues. Since its inception, its ability to assist utilities has resulted in a reduction in the operations and maintenance costs associated with service water systems and has provided a medium for EPRI awareness of industry service water issues.

  3. 48 CFR 52.208-9 - Contractor Use of Mandatory Sources of Supply or Services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... supplies or services by the time required, or if the quality of supplies or services provided by the... central nonprofit agency has authorized purchase from other sources. (c) Price and delivery information... DLA/GSA/VA, price and delivery information is available from the appropriate central nonprofit...

  4. Service Learning: Service through Oral History Projects

    ERIC Educational Resources Information Center

    Spivey, Michael

    2005-01-01

    Service learning allows students to learn more about their classroom instruction through involvement with their local community. It is both a service given to the community, as well as a practical way for students to reflect on what they have been studying in class. The author of this article explains a service learning project which will be very…

  5. 77 FR 60461 - United States v. Standard Parking Corporation, KSPC Holdings, Inc. and Central Parking...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ... cash, about 6.1 million shares of Standard's common stock, and assumption of Central's debt. 2. The.... Off-street parking services provide many advantages over on-street parking. Off-street parking... to a 28% interest in Standard, and assumption by Standard of Central's debt. The proposed...

  6. 78 FR 63478 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  7. 77 FR 20037 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  8. 75 FR 36428 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  9. 76 FR 3912 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  10. 75 FR 12768 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  11. 78 FR 20328 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  12. 78 FR 63481 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  13. 75 FR 17417 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Peripheral and Central Nervous System Drugs Advisory...). The meeting will be open to the public. Name of Committee: Peripheral and Central Nervous System...

  14. 48 CFR 408.714 - Communications with the central nonprofit agencies and the Committee.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... central nonprofit agencies and the Committee. 408.714 Section 408.714 Federal Acquisition Regulations... SERVICES Acquisition From Nonprofit Agencies Employing People Who Are Blind or Severely Disabled 408.714 Communications with the central nonprofit agencies and the Committee. Any matter requiring referral to...

  15. Evaluation of Service Activities Undertaken by the Educational Service Center for the Period July 1, 1967 to December, 1968.

    ERIC Educational Resources Information Center

    Legant, Jean

    According to this 1967-68 evaluation report, the Educational Service Center (ESC)--funded under Title III of the Elementary and Secondary Education Act--provided on-demand services to 29 northern, central, and western New Mexico school districts. In the document, 9 tables show the distribution and variety of ESC assistance in the areas of…

  16. [Central auditory prosthesis].

    PubMed

    Lenarz, T; Lim, H; Joseph, G; Reuter, G; Lenarz, M

    2009-06-01

    Deaf patients with severe sensory hearing loss can benefit from a cochlear implant (CI), which stimulates the auditory nerve fibers. However, patients who do not have an intact auditory nerve cannot benefit from a CI. The majority of these patients are neurofibromatosis type 2 (NF2) patients who developed neural deafness due to growth or surgical removal of a bilateral acoustic neuroma. The only current solution is the auditory brainstem implant (ABI), which stimulates the surface of the cochlear nucleus in the brainstem. Although the ABI provides improvement in environmental awareness and lip-reading capabilities, only a few NF2 patients have achieved some limited open set speech perception. In the search for alternative procedures our research group in collaboration with Cochlear Ltd. (Australia) developed a human prototype auditory midbrain implant (AMI), which is designed to electrically stimulate the inferior colliculus (IC). The IC has the potential as a new target for an auditory prosthesis as it provides access to neural projections necessary for speech perception as well as a systematic map of spectral information. In this paper the present status of research and development in the field of central auditory prostheses is presented with respect to technology, surgical technique and hearing results as well as the background concepts of ABI and AMI. PMID:19517084

  17. [MANAGEMENT OF CENTRAL HYPERSOMNIAS].

    PubMed

    Dauvilliers, Yves; Lopez, Régis

    2016-06-01

    Central hypersomnias include narcolepsy type 1, type 2 and idiopathic hypersomnia with daytime sleepiness excessive in the foreground of the clinical symptoms. Despite major advances in our understanding of the mechanisms of the narcolepsy type 1 with a low level of hypocretin-1 in cerebrospinal fluid, its current management is only symptomatic. The current management is also only symptomatic for type 2 narcolepsy and idiopathic hypersomnia with an unknown pathophysiology. Treatment options may vary from a single drug targeting several symptoms or several drugs treating a specific symptom. The treatment of daytime sleepiness is based on modafinil in first intention. Other psychostimulants such as methylphenidate, pitolisant and exceptionally dextro-amfetamine may be considered. In narcolepsy type 1, antidepressants such as inhibitors of the reuptake of serotonin and noradrenaline will be considered to improve cataplexy. Sodium oxybate is an effective treatment on sleepiness, cataplexy and bad night sleep in narcolepsy. The management for other symptoms or comorbidities should be considered it necessary such as hallucinations, sleep paralysis, the disturbed nighttime sleep, unpleasant dreams, parasomnias, depressive symptoms, overweight/obesity, cardiovascular disease and obstructive sleep apnea syndrome. Important therapeutic perspectives are to be expected concerning new psychostimulant and anticataplectiques, but mainly on immune-based therapies administered as early as possible after disease onset and on hypocretin replacement therapy for patients with severe symptoms. PMID:27538329

  18. Central Nervous System Lipoproteins

    PubMed Central

    Mahley, Robert W.

    2016-01-01

    ApoE on high-density lipoproteins is primarily responsible for lipid transport and cholesterol homeostasis in the central nervous system (CNS). Normally produced mostly by astrocytes, apoE is also produced under neuropathologic conditions by neurons. ApoE on high-density lipoproteins is critical in redistributing cholesterol and phospholipids for membrane repair and remodeling. The 3 main structural isoforms differ in their effectiveness. Unlike apoE2 and apoE3, apoE4 has markedly altered CNS metabolism, is associated with Alzheimer disease and other neurodegenerative disorders, and is expressed at lower levels in brain and cerebrospinal fluid. ApoE4-expressing cultured astrocytes and neurons have reduced cholesterol and phospholipid secretion, decreased lipid-binding capacity, and increased intracellular degradation. Two structural features are responsible for apoE4 dysfunction: domain interaction, in which arginine-61 interacts ionically with glutamic acid-255, and a less stable conformation than apoE3 and apoE2. Blocking domain interaction by gene targeting (replacing arginine-61 with threonine) or by small-molecule structure correctors increases CNS apoE4 levels and lipid-binding capacity and decreases intracellular degradation. Small molecules (drugs) that disrupt domain interaction, so-called structure correctors, could prevent the apoE4-associated neuropathology by blocking the formation of neurotoxic fragments. Understanding how to modulate CNS cholesterol transport and metabolism is providing important insights into CNS health and disease. PMID:27174096

  19. Central nervous system stimulants.

    PubMed

    George, A J

    2000-03-01

    Three major types of CNS stimulant are currently abused in sport: amphetamine, cocaine and caffeine. Each drug type has its own characteristic mechanism of action on CNS neurones and their associated receptors and nerve terminals. Amphetamine is widely abused in sports requiring intense anaerobic exercise where it prolongs the tolerance to anaerobic metabolism. It is addictive, and chronic abuse causes marked behavioural change and sometimes psychosis. Major sports abusing amphetamine are cycling, American football, ice-hockey and baseball. Cocaine increases tolerance to intense exercise, yet most of its chronic effects on energy metabolism are negative. Its greatest effects seem to be as a central stimulant and the enhancement of short-term anaerobic exercise. It is highly addictive and can cause cerebral and cardiovascular fatalities. Caffeine enhances fatty acid metabolism leading to glucose conservation, which appears to benefit long-distance endurance events such as skiing. Caffeine is also addictive, and chronic abuse can lead to cardiac damage. Social abuse of each of the three drugs is often difficult to distinguish from their abuse in sport.

  20. Marketing Youth Services.

    ERIC Educational Resources Information Center

    Dimick, Barbara

    1995-01-01

    Marketing techniques in youth services are useful for designing programs, collections, and services and for determining customer needs. The marketing mix--product, place, price, and practice--provides a framework for service analysis. (AEF)

  1. Cancer Genetics Services Directory

    MedlinePlus

    ... Services Directory Cancer Prevention Overview Research NCI Cancer Genetics Services Directory This directory lists professionals who provide services related to cancer genetics (cancer risk assessment, genetic counseling, genetic susceptibility testing, ...

  2. Theme: Service Learning.

    ERIC Educational Resources Information Center

    Agricultural Education Magazine, 2001

    2001-01-01

    Twelve theme articles discuss service learning and reflection in agricultural education, student perspective on service learning, Future Farmers of America, character education, intergenerational projects, agricultural communications, and service learning as advocacy. (SK)

  3. Central Line Maintenance Bundles and CLABSIs in Ambulatory Oncology Patients

    PubMed Central

    Bundy, David G.; Chen, Allen R.; Milstone, Aaron M.; Colantuoni, Elizabeth; Pehar, Miriana; Herpst, Cynthia; Fratino, Lisa; Miller, Marlene R.

    2013-01-01

    OBJECTIVE: Pediatric oncology patients are frequently managed with central lines as outpatients, and these lines confer significant morbidity in this immune-compromised population. We aimed to investigate whether a multidisciplinary, central line maintenance care bundle reduces central line–associated bloodstream infections (CLABSIs) and bacteremias in ambulatory pediatric oncology patients. METHODS: We conducted an interrupted time-series study of a maintenance bundle concerning all areas of central line care. Each of 3 target groups (clinic staff, homecare agency nurses, and patient families) (1) received training on the bundle and its importance, (2) had their practice audited, and (3) were shown CLABSI rates through graphs, in-service training, and bulletin boards. CLABSI and bacteremia person-time incidence rates were collected for 23 months before and 24 months after beginning the intervention and were compared by using a Poisson regression model. RESULTS: The mean CLABSI rate decreased by 48% from 0.63 CLABSIs per 1000 central line days at baseline to 0.32 CLABSIs per 1000 central line days during the intervention period (P = .005). The mean bacteremia rate decreased by 54% from 1.27 bacteremias per 1000 central line days at baseline to 0.59 bacteremias per 1000 central line days during the intervention period (P < .001). CONCLUSIONS: Implementation of a multidisciplinary, central line maintenance care bundle significantly reduced CLABSI and bacteremia person-time incidence rates in ambulatory pediatric oncology patients with central lines. Further research is needed to determine if maintenance care bundles reduce ambulatory CLABSIs and bacteremia in other adult and pediatric populations. PMID:24101764

  4. Youth services in Ethiopia.

    PubMed

    Meredith, P

    1990-12-01

    Departing from the usual family planning education format in teenage counseling, the IPPF is funding youth centers providing contraception as well as education in Ethiopia, Kenya, Togo, Tunisia, and Turkey. The development concern is for a cost efficient and effective center with minimal criticism. 2 experimental Mexican models were used in the Ethiopian youth centers. Both models utilize young adult coordinators who supervise young promoters, however each operates differently. Mexican staff trained their African counterparts and a detailed project manual will be available soon. The Ethiopian youth centers utilizing NGO's and the private sector have been permitted freedom from central control. Alarming statistics include: 20.8% of pregnancies are teenaged; 20.8% of hospital reported abortions are teenaged; the contraceptive prevalence rate is 2%; population increased by 3% per year with the average children per woman of 7.5. Addis Ababa's youth project provides services to mostly zone 5 school aged adolescents who are informed and eager to purchase condoms, although they are not able to purchase them commercially. Revolutionary Ethiopian Youth Association (REYA) with its 200,000 membership, is increasing its contribution to expanding the network of promoters. Promoters are used to register those receiving free condoms, but the recommendation to cease this practice of registration is in, and replace it with the sale of 50 US cents per condom.

  5. Cancer Genetics Services Directory

    MedlinePlus

    ... Overview–for health professionals Research NCI Cancer Genetics Services Directory This directory lists professionals who provide services related to cancer genetics (cancer risk assessment, genetic ...

  6. Central and southern Africa

    SciTech Connect

    McGrew, H.J.

    1981-10-01

    Exploration in central and southern Africa continued to expand during 1980. The greatest concentration of activity was in Nigeria. However, there was considerable increase in the level of exploratory work in Cameroon and Congo. Significant new finds have been made in Ivory Coast. Geological and geophysical activity was carried out in 18 of the countries, with those in the western part having the largest share. Seismic work involved 225 party months of operation. Most of this time was spent on land, but marine operations accounted for 73,389 km of new control. Gravity and magnetic data were recorded during the marine surveys, and several large aeromagnetic projects were undertaken to obtain a total of 164,498 line km of data. Exploratory and development drilling accounted for a total of 304 wells and 2,605,044 ft (794,212 m) of hole. The 92 exploratory wells that were drilled resulted in 47 oil and gas discoveries. In development drilling 89% of the 212 wells were successful. At the end of the year, 27 exploratory wells were underway, and 34 development wells were being drilled for a total of 61. Oil production from the countries that this review covers was 918,747,009 bbl in 1980, a drop of about 9% from the previous year. Countries showing a decline in production were Nigeria, Gabon, Cabinda, and Zaire. Increases were recorded in Cameroon, Congo, and Ghana. A new country was added to the list of producers when production from the Belier field in Ivory Coast came on stream. 33 figures, 15 tables.

  7. MyOcean Central Information System - Achievements and Perspectives

    NASA Astrophysics Data System (ADS)

    Claverie, Vincent; Loubrieu, Thomas; Jolibois, Tony; de Dianous, Rémi; Blower, Jon; Romero, Laia; Griffiths, Guy

    2013-04-01

    Since 2009, MyOcean (http://www.myocean.eu) is providing an operational service, for forecasts, analysis and expertise on ocean currents, temperature, salinity, sea level, primary ecosystems and ice coverage. The production of observation and forecasting data is done by 42 Production Units (PU). Product download and visualisation are hosted by 25 Dissemination Units (DU). All these products and associated services are gathered in a single catalogue hiding the intricate distributed organization of PUs and DUs. Besides applying INSPIRE directive and OGC recommendations, MyOcean overcomes technical choices and challenges. This presentation focuses on 3 specific issues met by MyOcean and relevant for many Spatial Data Infrastructures: user's transaction accounting, large volume download and stream line the catalogue maintenance. Transaction Accounting: Set up powerful means to get detailed knowledge of system usage in order to subsequently improve the products (ocean observations, analysis and forecast dataset) and services (view, download) offer. This subject drives the following ones: Central authentication management for the distributed web services implementations: add-on to THREDDS Data Server for WMS and NETCDF sub-setting service, specific FTP. Share user management with co-funding projects. In addition to MyOcean, alternate projects also need consolidated information about the use of the cofunded products. Provide a central facility for the user management. This central facility provides users' rights to geographically distributed services and gathers transaction accounting history from these distributed services. Propose a user-friendly web interface to download large volume of data (several GigaBytes) as robust as basic FTP but intuitive and file/directory independent. This should rely on a web service drafting the INSPIRE to-be specification and OGC recommendations for download taking into account that FTP server is not enough friendly (need to know

  8. 75 FR 842 - Notice of Central Idaho Resource Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-06

    ... agency #0;statements of organization and functions are examples of documents #0;appearing in this section...; ] DEPARTMENT OF AGRICULTURE Forest Service Notice of Central Idaho Resource Advisory Committee Meeting AGENCY: Forest Service, USDA. ACTION: Notice of Meeting. SUMMARY: Pursuant to the authorities in the...

  9. Who Pays Student Workers Higher Wages, Central IT or Distributed IT?

    ERIC Educational Resources Information Center

    Stack, David

    2009-01-01

    In a time of scarce resources, it is counterproductive for an institution to artificially inflate student wages via internecine struggles between central IT services and similar, distributed services in university departments. The pressure to inflate student wages might be exacerbated by similar but opposite viewpoints on the part of supervisors,…

  10. Central American Grandparents Raising Grandchildren

    ERIC Educational Resources Information Center

    Fuller-Thomson, Esme; Minkler, Meredith

    2007-01-01

    This study documents the prevalence and profile of Central American grandparents raising grandchildren in the United States of America. Using nationally representative data from the Census 2000 Supplementary Survey, Central American grandparent caregivers are compared with their noncare-giving peers. Results indicate that nationally an estimated…

  11. Central control of body temperature.

    PubMed

    Morrison, Shaun F

    2016-01-01

    Central neural circuits orchestrate the behavioral and autonomic repertoire that maintains body temperature during environmental temperature challenges and alters body temperature during the inflammatory response and behavioral states and in response to declining energy homeostasis. This review summarizes the central nervous system circuit mechanisms controlling the principal thermoeffectors for body temperature regulation: cutaneous vasoconstriction regulating heat loss and shivering and brown adipose tissue for thermogenesis. The activation of these thermoeffectors is regulated by parallel but distinct efferent pathways within the central nervous system that share a common peripheral thermal sensory input. The model for the neural circuit mechanism underlying central thermoregulatory control provides a useful platform for further understanding of the functional organization of central thermoregulation, for elucidating the hypothalamic circuitry and neurotransmitters involved in body temperature regulation, and for the discovery of novel therapeutic approaches to modulating body temperature and energy homeostasis. PMID:27239289

  12. Central control of body temperature

    PubMed Central

    Morrison, Shaun F.

    2016-01-01

    Central neural circuits orchestrate the behavioral and autonomic repertoire that maintains body temperature during environmental temperature challenges and alters body temperature during the inflammatory response and behavioral states and in response to declining energy homeostasis. This review summarizes the central nervous system circuit mechanisms controlling the principal thermoeffectors for body temperature regulation: cutaneous vasoconstriction regulating heat loss and shivering and brown adipose tissue for thermogenesis. The activation of these thermoeffectors is regulated by parallel but distinct efferent pathways within the central nervous system that share a common peripheral thermal sensory input. The model for the neural circuit mechanism underlying central thermoregulatory control provides a useful platform for further understanding of the functional organization of central thermoregulation, for elucidating the hypothalamic circuitry and neurotransmitters involved in body temperature regulation, and for the discovery of novel therapeutic approaches to modulating body temperature and energy homeostasis. PMID:27239289

  13. Central control of body temperature.

    PubMed

    Morrison, Shaun F

    2016-01-01

    Central neural circuits orchestrate the behavioral and autonomic repertoire that maintains body temperature during environmental temperature challenges and alters body temperature during the inflammatory response and behavioral states and in response to declining energy homeostasis. This review summarizes the central nervous system circuit mechanisms controlling the principal thermoeffectors for body temperature regulation: cutaneous vasoconstriction regulating heat loss and shivering and brown adipose tissue for thermogenesis. The activation of these thermoeffectors is regulated by parallel but distinct efferent pathways within the central nervous system that share a common peripheral thermal sensory input. The model for the neural circuit mechanism underlying central thermoregulatory control provides a useful platform for further understanding of the functional organization of central thermoregulation, for elucidating the hypothalamic circuitry and neurotransmitters involved in body temperature regulation, and for the discovery of novel therapeutic approaches to modulating body temperature and energy homeostasis.

  14. North Central Thailand

    NASA Technical Reports Server (NTRS)

    1998-01-01

    This radar image shows the dramatic landscape in the Phang Hoei Range of north central Thailand, about 40 kilometers (25 miles) northeast of the city of Lom Sak. The plateau, shown in green to the left of center, is the area of Phu Kradung National Park. This plateau is a remnant of a once larger plateau, another portion of which is seen along the right side of the image. The plateaus have been dissected by water erosion over thousands of years. Forest areas appear green on the image; agricultural areas and settlements appear as red and blue. North is toward the lower right. The area shown is 38 by 50 kilometers (24 by 31 miles) and is centered at 16.96 degrees north latitude, 101.67 degrees east longitude. Colors are assigned to different radar frequencies and polarizations as follows: red is L-band horizontally transmitted and horizontally received; green is L-band horizontally transmitted and vertically received; blue is C-band horizontally transmitted and vertically received. The image was acquired by the Spaceborne Imaging Radar-C/X-band Synthetic Aperture (SIR-C/X-SAR) imaging radar on October 3, 1994, when it flew aboard the space shuttle Endeavour. SIR-C/X-SAR is a joint mission of the U.S./German and Italian space agencies.

    Spaceborne Imaging Radar-C and X-Band Synthetic Aperture Radar (SIR-C/X-SAR) is part of NASA's Mission to Planet Earth. The radars illuminate Earth with microwaves allowing detailed observations at any time, regardless of weather or sunlight conditions. SIR-C/X-SAR uses three microwave wavelengths: L-band (24 cm), C-band (6 cm) and X-band (3 cm). The multi-frequency data will be used by the international scientific community to better understand the global environment and how it is changing. The SIR-C/X-SAR data, complemented by aircraft and ground studies, will give scientists clearer insights into those environmental changes which are caused by nature and those changes which are induced by human activity. SIR-C was developed by

  15. Reference and Information Services in Special Libraries.

    ERIC Educational Resources Information Center

    Larson, Signe E.

    1983-01-01

    Describes reference and information services which special libraries may provide in serving clientele, including information services, bibliographic services, online search services, document delivery services, indexing services, abstracting services, publishing and alerting services, translation services, newspaper clipping services, and records…

  16. Estimating Health Services Requirements

    NASA Technical Reports Server (NTRS)

    Alexander, H. M.

    1985-01-01

    In computer program NOROCA populations statistics from National Center for Health Statistics used with computational procedure to estimate health service utilization rates, physician demands (by specialty) and hospital bed demands (by type of service). Computational procedure applicable to health service area of any size and even used to estimate statewide demands for health services.

  17. Service Opportunities for Youths.

    ERIC Educational Resources Information Center

    Heffernan, David; Tarlov, Suzanne

    The emerging youth service movement has reinforced and built on the foundation of service in traditional organizations and focuses on tapping youth talent and energy. Youth service is a concept that has roots in pre-20th century American society. Service programs today increasingly include training, education, prevention, and employment…

  18. Reference Service Policy Statement.

    ERIC Educational Resources Information Center

    Young, William F.

    This reference service policy manual provides general guidelines to encourage reference service of the highest possible quality and to insure uniform practice. The policy refers only to reference service in the University Libraries and is intended for use in conjunction with other policies and procedures issued by the Reference Services Division.…

  19. SHARING EDUCATIONAL SERVICES.

    ERIC Educational Resources Information Center

    Catskill Area Project in Small School Design, Oneonta, NY.

    SHARED SERVICES, A COOPERATIVE SCHOOL RESOURCE PROGRAM, IS DEFINED IN DETAIL. INCLUDED IS A DISCUSSION OF THEIR NEED, ADVANTAGES, GROWTH, DESIGN, AND OPERATION. SPECIFIC PROCEDURES FOR OBTAINING STATE AID IN SHARED SERVICES, EFFECTS OF SHARED SERVICES ON THE SCHOOL, AND HINTS CONCERNING SHARED SERVICES ARE DESCRIBED. CHARACTERISTICS OF THE SMALL…

  20. Implementing Service Learning.

    ERIC Educational Resources Information Center

    Degelman, Charles, Ed.

    1999-01-01

    This theme issue of "Service-Learning Network" explores some challenges and rewards of integrating service learning into school and community culture. The lead article, "Integrating Community Service Learning with School Culture" (Sheldon Berman), surveys the integration of community service learning in the culture of school reform. "Program…

  1. Unbundling services in a competitive electricity market

    SciTech Connect

    Spiller, P.T.

    1996-03-01

    The purpose of this presentation is to provide an in-depth discussion of the possible evolution of unbundling of services in a competitive environment. The author discusses unbundling from both a technical/engineering and an economic perspective. The main thrust of the talk is threefold: (a) that in the long run the potential for unbundling of services is extremely large from an engineering perspective; (b) that the form of the initial industry structure will have an important impact on the extent of service unbundling; and (c) that unbundling of wholesale related services is where most of the initial demand will be. (A) Engineering Perspectives on Unbundling: A large proportion of ancillary services can be provided in a competitive framework with current technologies. The author discusses those that current technologies may not facilitate such a decentralized approach. (B) The relation between unbundling and industry structure: Not all industry structures provide the same incentives for the independent service operator (ISO) to unbundle its services. Direct access provides incentives to suppliers to provide ancillary services to its own customers. Such incentive is limited by more centralized organizational modes. (C) Different Demand for Wholesale and Retail Unbundling: Lessons from other sectors: The experience with unbundling in telecommunications is illuminating. Wholesale unbundling, when allowed, has turned out to be a key component of competition. Retail unbundling is limited by customer sophistication. Indeed, retail unbundling will evolve in waves: initially retail customers will demand bundled services, as complexity of services may overwhelm customer sophistication. As customer sophistication increases and technology improves, the demand for partial unbundling increases providing opportunities for speicialized firms to provide partially unbundled services.

  2. Geospatial database for regional environmental assessment of central Colorado.

    USGS Publications Warehouse

    Church, Stanley E.; San Juan, Carma A.; Fey, David L.; Schmidt, Travis S.; Klein, Terry L.; DeWitt, Ed H.; Wanty, Richard B.; Verplanck, Philip L.; Mitchell, Katharine A.; Adams, Monique G.; Choate, LaDonna M.; Todorov, Todor I.; Rockwell, Barnaby W.; McEachron, Luke; Anthony, Michael W.

    2012-01-01

    In conjunction with the future planning needs of the U.S. Department of Agriculture, Forest Service, the U.S. Geological Survey conducted a detailed environmental assessment of the effects of historical mining on Forest Service lands in central Colorado. Stream sediment, macroinvertebrate, and various filtered and unfiltered water quality samples were collected during low-flow over a four-year period from 2004–2007. This report summarizes the sampling strategy, data collection, and analyses performed on these samples. The data are presented in Geographic Information System, Microsoft Excel, and comma-delimited formats. Reports on data interpretation are being prepared separately.

  3. Centralized versus Decentralized Information Systems

    NASA Astrophysics Data System (ADS)

    Hugoson, Mats-Åke

    This paper brings into question whether information systems should be centralized or decentralized in order to provide greater support for different business processes. During the last century companies and organizations have used different approaches for centralization and decentralization; a simple answer to the question does not exist. This paper provides a survey of the evolution of centralized and decentralized approaches, mainly in a Nordic perspective. Based on critical reflections on the situation in the end of the century we can discuss what we can learn from history to achieve alignment between centralized and decentralized systems and the business structure. The conclusion is that theories, management and practice for decisions on centralization or decentralization of information systems must be improved. A conscious management and control of centralization /decentralization of IT support is a vital question in the company or the organization, and this is not a task that can be handled only by IT-specialists. There is a need for business oriented IT management of centralization/decentralization.

  4. Central chemoreceptors: locations and functions.

    PubMed

    Nattie, Eugene; Li, Aihua

    2012-01-01

    Central chemoreception traditionally refers to a change in ventilation attributable to changes in CO2/H(+) detected within the brain. Interest in central chemoreception has grown substantially since the previous Handbook of Physiology published in 1986. Initially, central chemoreception was localized to areas on the ventral medullary surface, a hypothesis complemented by the recent identification of neurons with specific phenotypes near one of these areas as putative chemoreceptor cells. However, there is substantial evidence that many sites participate in central chemoreception some located at a distance from the ventral medulla. Functionally, central chemoreception, via the sensing of brain interstitial fluid H(+), serves to detect and integrate information on (i) alveolar ventilation (arterial PCO2), (ii) brain blood flow and metabolism, and (iii) acid-base balance, and, in response, can affect breathing, airway resistance, blood pressure (sympathetic tone), and arousal. In addition, central chemoreception provides a tonic "drive" (source of excitation) at the normal, baseline PCO2 level that maintains a degree of functional connectivity among brainstem respiratory neurons necessary to produce eupneic breathing. Central chemoreception responds to small variations in PCO2 to regulate normal gas exchange and to large changes in PCO2 to minimize acid-base changes. Central chemoreceptor sites vary in function with sex and with development. From an evolutionary perspective, central chemoreception grew out of the demands posed by air versus water breathing, homeothermy, sleep, optimization of the work of breathing with the "ideal" arterial PCO2, and the maintenance of the appropriate pH at 37°C for optimal protein structure and function.

  5. Central Chemoreceptors: Locations and Functions

    PubMed Central

    Nattie, Eugene; Li, Aihua

    2016-01-01

    Central chemoreception traditionally refers to a change in ventilation attributable to changes in CO2/H+ detected within the brain. Interest in central chemoreception has grown substantially since the previous Handbook of Physiology published in 1986. Initially, central chemoreception was localized to areas on the ventral medullary surface, a hypothesis complemented by the recent identification of neurons with specific phenotypes near one of these areas as putative chemoreceptor cells. However, there is substantial evidence that many sites participate in central chemoreception some located at a distance from the ventral medulla. Functionally, central chemoreception, via the sensing of brain interstitial fluid H+, serves to detect and integrate information on 1) alveolar ventilation (arterial PCO2), 2) brain blood flow and metabolism and 3) acid-base balance, and, in response, can affect breathing, airway resistance, blood pressure (sympathetic tone) and arousal. In addition, central chemoreception provides a tonic ‘drive’ (source of excitation) at the normal, baseline PCO2 level that maintains a degree of functional connectivity among brainstem respiratory neurons necessary to produce eupneic breathing. Central chemoreception responds to small variations in PCO2 to regulate normal gas exchange and to large changes in PCO2 to minimize acid-base changes. Central chemoreceptor sites vary in function with sex and with development. From an evolutionary perspective, central chemoreception grew out of the demands posed by air vs. water breathing, homeothermy, sleep, optimization of the work of breathing with the ‘ideal’ arterial PCO2, and the maintenance of the appropriate pH at 37°C for optimal protein structure and function. PMID:23728974

  6. Centralized digital control of accelerators

    SciTech Connect

    Melen, R.E.

    1983-09-01

    In contrasting the title of this paper with a second paper to be presented at this conference entitled Distributed Digital Control of Accelerators, a potential reader might be led to believe that this paper will focus on systems whose computing intelligence is centered in one or more computers in a centralized location. Instead, this paper will describe the architectural evolution of SLAC's computer based accelerator control systems with respect to the distribution of their intelligence. However, the use of the word centralized in the title is appropriate because these systems are based on the use of centralized large and computationally powerful processors that are typically supported by networks of smaller distributed processors.

  7. IUE observations of central stars

    NASA Technical Reports Server (NTRS)

    Heap, S. R.

    1983-01-01

    IUE satellite data on sixty galactic planetary nebulae (PN) and three PNs in the Magellanic clouds are examined to establish a mass distribution among the central star types. An evolutionary lineage was determined for the observed central stars, based on UV magnitudes, demonstrating that central stars in optically thin nebulae have a narrow distribution around 0.58 solar mass, whereas stars in optically thick nebulae exhibited the highest masses of the sample, implying that highest mass stars in PN are the most difficult to detect. No definitive correlation was found between the mass of an object and its spectral type.

  8. Apport de l’écho-doppler artériel des membres inférieurs dans la prise en charge du pied diabétique à l'hôpital Saint-Jean de Dieu de Thiès (Sénégal)

    PubMed Central

    Dia, Aliou Amadou; Affangla, Désiré Alain; Dione, Jean-Michel; Akpo, Géraud; Mbengue, Marie; Ka, Mamadou Mourtalla; Diop, Bernard Marcel

    2015-01-01

    Introduction Le pied diabétique se définit comme l'ensemble des manifestations trophiques du pied survenant chez le diabétique par atteinte nerveuse, artérielle et ou infectieuse. Le pied diabétique est un problème majeur de santé publique à l’échelle mondiale avec un taux d'amputation de membres inférieurs très élevé. L’écho-doppler artériel des membres inférieurs est de nos jours incontournable dans la prise en charge du pied diabétique. Le but de cette étude est de montrer la place prépondérante qu'occupe l’écho-doppler artériel dans le bilan lésionnel du pied diabétique. Méthodes Nous avons mené une étude rétrospective monocentrique incluant 46 patients sur une période de 24 mois, de mars 2012 à mars 2014 à l'hôpital Saint-Jean de Dieu, un des deux hôpitaux de référence de la région de Thiès, doté depuis juillet 2011 d'un centre moderne de traitement du diabète et des maladies cardio-métaboliques (Diabcarmet). Dans les critères d'inclusion, nous avons sélectionné tous les patients diabétiques adressés pour un écho-doppler artériel des membres inférieurs dans le cadre d'une prise en charge du pied diabétique. Etaient exclus de l’étude, les patients artéritiques non-diabétiques et les patients diabétiques asymptomatiques référés pour un bilan écho-doppler de routine. Résultats Le sex-ratio était de 1.42 (27 hommes pour 19 femmes). L’âge moyen des patients était de 62,86 ans avec des extrêmes de 23 et 88 ans. 60% des patients (n=28) étaient âgés entre 50 et 70 ans. Le diabète de type 2 était retrouvé chez 95% des patients (n=44) alors que le diabète de type 1 représentait 5% (n=2). La moyenne d’évolution du diabète était estimée à 8 ans, avec des extrêmes de 2 et 20 ans. On notait une atteinte du pied droit chez 24 patients, une atteinte du pied gauche chez 18 patients et une atteinte bilatérale chez 4 patients. La plupart du temps, les lésions du pied diabétique survenaient

  9. Stratégie de prise en charge de l'hypertension artérielle en hémodialyse chronique: un modèle appliqué d’éducation thérapeutique des patients (ETP)

    PubMed Central

    El Harraqui, Ryme; Naima, Abda; Yassamine, Bentata; Haddiya, Intissar

    2014-01-01

    Même après l'entrée en dialyse, la prévalence de l'hypertension artérielle (HTA) reste élevée. Elle est souvent greffée d'une forte morbi-mortalité, et altère la qualité de vie des patients hémodialysés chroniques. La « méthode du poids sec (PS) », établie par Scribner, présente un intérêt indéniable dans la gestion de l'HTA chez le patient hémodialysé. Le but de notre travail était de déterminer la prévalence et les facteurs de risque (FDR) de l'HTA chez nos hémodialysés chroniques et d'en tenter une réduction en nous basant sur une stratégie d’éducation thérapeutique basée sur les recommandations de Scribner. Nous avons mené une étude prospective interventionnelle en trois mois et en trois phases, auprès des 93 hémodialysés chroniques de l'Hôpital Al Farabi d'Oujda. En phase 1, nous avons déterminé la prévalence de l'HTA par la surveillance horaire de la tension artérielle (TA) durant la séance de dialyse pendant deux semaines, soit sur un total de 442 séances. Les patients ont également mesuré leur pression artérielle (PA) hors-centre de façon biquotidienne les jours de non-dialyse, soit un total de 1720 mesures hors-centre. L'HTA a été définie par une Pression Artérielle Systolique (PAS) supérieure ou égale à 140mmHg et/ou une Pression Artérielle Diastolique (PAD) supérieure ou égale à 90mmHg sur au moins 2 mesures. En phase 2, les patients hypertendus ont bénéficié d'une prise en charge basée sur les recommandations de Scribner et une éducation thérapeutique (ETP). En phase 3, nous évalué les retombées de notre prise en charge. Une HTA a été notée sur 231 séances chez 57 patients, soit une prévalence de 61,3%. La PAS moyenne était de 172,75±17,69 (145-220) mmHg. Les FDR retenus sont: l’âge, la PPID importante, le non respect des règles hygiéno-diététiques (RHD) et le rythme de 2 séances de dialyse/semaine. Au départ, 13 patients (22,8%) étaient dialysés trois fois par

  10. Demographic tensions in Central America.

    PubMed

    1986-08-01

    This discussion of Central America focuses on the rapid growth of its population, its stagnating economy, and those countries that are socioeconomically advanced. Between 1950-85 the population of Central America tripled, from 9.1 million to 26. 4 million, due to marked mortality declines and the absence of off-setting fertility declines. The distribution of Central Americas's growing populations sets its population growth apart from that of other developing regions. Currently, almost half of all Central Americans live in cities. Although the average growth rate for Central American countries has fallen and is expected to drop further, the decline does not counterbalance the effect of the absolute rise in population numbers. The average annual growth rate of more than 3% annually in the 1960s fell to about 2.6% in recent years, but this decline is due primarily to socioeconomically advanced Costa Rica and Panama. Central America's age structure further complicates the population crisis. About 43% of Central Americans are under the age of 15. When the increasingly larger young population group enters it reproductive years, the potential for future growth (albeit the falling rate of population increase) is unparalleled. UN population projections show the region's population at 40 million by the year 2000. The 1973 oil crisis began a downward spiral for the buoyant post World War II Central American economy. Between 1950-79, real per capita income growth in Central America doubled, with Central American economies growing an average of 5.3% annually. By the early 1980s, overseas markets of the trade-dependent countries of Central America had dried up due to protectionism abroad and slumping basic commodity prices. These and other factors plunged Central America into its current economic malaise of falling real per capita income, rising unemployment, curtailed export led economic growth, and a rising cost of living. In general, economic growth in Central America

  11. OCULUS Sea Track Fusion Service

    NASA Astrophysics Data System (ADS)

    Panagiotou, Stylianos C.; Rizogiannis, Constantinos; Katsoulis, Stavros; Lampropoulos, Vassilis; Kanellopoulos, Sotirios; Thomopoulos, Stelios C. A.

    2015-06-01

    Oculus Sea is a complete solution regarding maritime surveillance and communications at Local as well as Central Command and Control level. It includes a robust and independent track fusion service whose main functions include: 1) Interaction with the User to suggest the fusion of two or more tracks, confirm Track ID and Vessel Metadata creation for the fused track, and suggest de-association of two tracks 2) Fusion of same vessel tracks arriving simultaneously from multiple radar sensors featuring track Association, track Fusion of associated tracks to produce a more accurate track, and Multiple tracking filters and fusion algorithms 3) Unique Track ID Generator for each fused track 4) Track Dissemination Service. Oculus Sea Track Fusion Service adopts a system architecture where each sensor is associated with a Kalman estimator/tracker that obtains an estimate of the state vector and its respective error covariance matrix. Finally, at the fusion center, association and track state estimation fusion are carried out. The expected benefits of this system include multi-sensor information fusion, enhanced spatial resolution, and improved target detection.

  12. Eye casualty services in London

    PubMed Central

    Smith, H B; Daniel, C S; Verma, S

    2013-01-01

    The combined pressures of the European Working Time Directive, 4 h waiting time target, and growing rates of unplanned hospital attendances have forced a major consolidation of eye casualty departments across the country, with the remaining units seeing a rapid increase in demand. We examine the effect of these changes on the provision of emergency eye care in Central London, and see what wider lessons can be learned. We surveyed the managers responsible for each of London's 8 out-of-hours eye casualty services, analysed data on attendance numbers, and conducted detailed interviews with lead clinicians. At London's two largest units, Moorfields Eye Hospital and the Western Eye Hospital, annual attendance numbers have been rising at 7.9% per year (to 76 034 patients in 2010/11) and 9.6% per year (to 31 128 patients in 2010/11), respectively. Using Moorfields as a case study, we discuss methods to increase capacity and efficiency in response to this demand, and also examine some of the unintended consequences of service consolidation including patients travelling long distances to geographically inappropriate units, and confusion over responsibility for out-of-hours inpatient cover. We describe a novel ‘referral pathway' developed to minimise unnecessary travelling and delay for patients, and propose a forum for the strategic planning of London's eye casualty services in the future. PMID:23370420

  13. Reciprocal Exchange: Understanding the Community Partner Perspective in Higher Education Service-Learning

    ERIC Educational Resources Information Center

    Petri, Alexis Nicolle

    2012-01-01

    This study investigates service-learning from the community partners' perspective, especially in terms of reciprocity. As a central construct in the theory of service-learning, reciprocity for community partners is virtually unknown. Little scholarship exists that explains or explores the benefits and opportunity costs of service-learning.…

  14. Student & Family Assistance Programs and Services To Address Barriers to Learning. A Center Training Tutorial.

    ERIC Educational Resources Information Center

    California Univ., Los Angeles. Center for Mental Health in Schools.

    Most school districts employ student support or "pupil services professionals," such as school psychologists, counselors, and social workers. These personnel perform services connected with mental health and psychosocial problems. The format usually is a combination of centrally based and school-based services. Amelioration of the full continuum…

  15. Theory and Practical Application of Information Research Services at Lakeland Community College.

    ERIC Educational Resources Information Center

    Valvoda, Mary Alice

    The focus of this report is an in-depth analysis of the Research Services Office (RSO) at Lakeland Community College, including specialized information services and procedures of the RSO. Research services at Lakeland include but are not limited to: (1) acquisition, centralization, and coordination of internal reports; (2) collection of…

  16. 76 FR 60112 - Consent Based Social Security Number Verification (CBSV) Service

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-28

    ... Service. SUMMARY: We provide limited fee-based Social Security number (SSN) verification service to...) and our regulation at 20 CFR 401.100, establish the legal authority for us to provide SSN... addition to the benefit of providing high volume, centralized SSN verification services to the...

  17. The Four Furies: Primary Tensions between Service-Learners and Host Agencies

    ERIC Educational Resources Information Center

    Mills, Steven D.

    2012-01-01

    This paper explores four potent tensions between service-learning students and their community agency hosts. These tensions result from naturally opposing perspectives and are reflected in the service-learning literature focused on criticism and complaint. Given the centrality of the alliance between service-learners and their community host…

  18. Realizing Shared Services--A Punctuated Process Analysis of a Public IT Department

    ERIC Educational Resources Information Center

    Olsen, Timothy John

    2012-01-01

    IT services are increasingly being offered via a shared service model. This model promises the benefits of centralization and consolidation, as well as an increased customer satisfaction. Adopting shared services is not easy as it necessitates a major organizational change, with few documented exemplars to guide managers. This research explores a…

  19. Pathways into and through Mental Health Services for Children and Adolescents.

    ERIC Educational Resources Information Center

    Farmer, Elizabeth M. Z.; Burns, Barbara J.; Phillips, Susan D.; Angold, Adrian; Costello, E. Jane

    2003-01-01

    Examined points of entry into mental health service system for children and adolescents and patterns of movement through five service sectors (specialty mental health services, education, general medicine, juvenile justice, child welfare). Education sector plays central role as point of entry. Interagency collaboration among education, specialty…

  20. "Unruly Pupils" in Pre-Service English Language Teachers' Teaching Practicum Experiences

    ERIC Educational Resources Information Center

    Gao, Xuesong; Benson, Phil

    2012-01-01

    The teaching practicum is a pivotal event for pre-service teachers to experience the transition from being students to being teachers. This paper examines the emergence of "unruly pupils" as a central concern for pre-service English language teachers in their teaching practicum. The inquiry relates the pre-service teachers' perceived challenge of…

  1. Elimination of Rhodnius prolixus in Central America

    PubMed Central

    2012-01-01

    Rhodnius prolixus is one of the main vectors of Trypanosoma cruzi, causative agent of Chagas disease. In Central America, it was first discovered in 1915 in El Salvador, from where it spread northwest to Guatemala and Mexico, and southeast to Nicaragua and Costa Rica, arriving also in Honduras in the late 1950s. Indoor residual spraying (IRS) by the antimalaria services of Costa Rica prevented its spread southwards, and similar IRS programmes appear to have eliminated it from El Salvador by the late 1970s. In 1997, by resolution of the Ministers of Health of the seven Central American countries, a multinational initiative against Chagas disease (IPCA) was launched with one of the specific objectives being the elimination of R. prolixus from the region. As a result, more and more infested areas were encountered, and progressively sprayed using an IRS strategy already deployed against Triatoma infestans in the southern cone countries of South America. In 2008, Guatemala became the first of these countries to be formally certified as free of Chagas disease transmission due to R. prolixus. The other infested countries have since been similarly certified, and none of these has reported the presence of R. prolixus since June 2010. Further surveillance is required, but current evidence suggests that R. prolixus may now been eliminated from throughout the mesoamerican region, with a corresponding decline in the incidence of T. cruzi infections. PMID:22357219

  2. [AIDS and tuberculosis in central Tunisia].

    PubMed

    Jemni, L; Bahri, S; Saadi, M; Letaif, A; Dhidah, M; Lahdhiri, H; Bouchoucha, S

    1991-05-01

    7 men and 2 women seropositive for HIV were carefully screened for tuberculosis in the internal medicine service of a hospital in Sousse, central Tunisia, and all tuberculosis patients aged 20-50 years registered at the tuberculosis treatment center in Sousse between May 1987-December 1988 were screened for HIV infections using the ELISA test. The HIV seropositive patients ranged in age from 21-42 years and averaged 28 at the time of diagnosis. Marriage to an HIV-positive man was the only risk factor for the 2 seropositive women. 1 of the men had hemophilia and the rest had travelled abroad and used drugs or had homosexual or heterosexual relations while outside Tunisia. 4 of the 9 HIV positive patients were diagnoses with tuberculosis, 2 with isolated pulmonary tuberculosis, 1 with pulmonary and hepatoslenic tuberculosis, and 1 with a cervical ganglionary tuberculosis. 3 of the 4 with tuberculosis had apparently normal thoracic X-rays. The 4 were treated with the normal course of antitubercular drugs for a year or more. Screening for HIV in the 104 tuberculosis patients aged 20-50 years revealed no cases of HIV infection. Tuberculosis appears to be 1 of the most frequent opportunistic infections among patients seropositive for HIV, but it is not an indicator or predictor of HIV infection in central Tunisia as it reportedly is in some African countries.

  3. Local Data Integration in East Central Florida

    NASA Technical Reports Server (NTRS)

    Case, Jonathan L.; Manobianco, John T.

    1999-01-01

    The Applied Meteorology Unit has configured a Local Data Integration System (LDIS) for east central Florida which assimilates in-situ and remotely-sensed observational data into a series of high-resolution gridded analyses. The ultimate goal for running LDIS is to generate products that may enhance weather nowcasts and short-range (less than 6 h) forecasts issued in support of the 45th Weather Squadron (45 WS), Spaceflight Meteorology Group (SMG), and the Melbourne National Weather Service (NWS MLB) operational requirements. LDIS has the potential to provide added value for nowcasts and short-ten-n forecasts for two reasons. First, it incorporates all data operationally available in east central Florida. Second, it is run at finer spatial and temporal resolutions than current national-scale operational models such as the Rapid Update Cycle and Eta models. LDIS combines all available data to produce grid analyses of primary variables (wind, temperature, etc.) at specified temporal and spatial resolutions. These analyses of primary variables can be used to compute diagnostic quantities such as vorticity and divergence. This paper demonstrates the utility of LDIS over east central Florida for a warm season case study. The evolution of a significant thunderstorm outflow boundary is depicted through horizontal and vertical cross section plots of wind speed, divergence, and circulation. In combination with a suitable visualization too], LDIS may provide users with a more complete and comprehensive understanding of evolving mesoscale weather than could be developed by individually examining the disparate data sets over the same area and time.

  4. Cytoclasmosis in central lymph production.

    PubMed

    Shields, J W

    1979-06-01

    Electron microscopic observations and ancillary data are reviewed to show that lymphatic organs produce quantities of central lymph by releasing cytoplasm-depleted cells into colloidal hydrosols produced by cell fragmentation (cytoclasmosis).

  5. Central Fan Integrated Ventilation Systems

    SciTech Connect

    2009-05-12

    This information sheet describes one example of a ventilation system design, a central fan integrated supply (CFIS) system, a mechanical ventilation and pollutant source control to ensure that there is reasonable indoor air quality inside the house.

  6. Central cementifying fibroma of maxilla.

    PubMed

    Sheikhi, Mahnaz; Mosavat, Farzaneh; Jalalian, Faranak; Rashidipoor, Roghayeh

    2013-01-01

    Central cementifying fibroma is a bony tumor, which is believed to be derived from the cells of the periodontal ligament. Central cemento-ossifying fibroma behaves like, a benign bone neoplasm. This bone tumor consists of highly cellular, fibrous tissue that contains varying amounts of calcified tissue resembling bone, cementum, or both. Central cemento-ossifying fibromas of the mandible are common; however, they are rare in the maxilla region. This tumor is most frequent between 35 and 40 years of ages. In this report we have described a 37-year-old male with cemento-ossifying fibroma of the maxilla region with the mass that had been appeared 2-3 months prior to his first referral. Radiologic imaging such as intra-oral, panoramic, and Cone Beam CT had been performed. Histological analysis was done and finally diagnosis of central cementifying fibroma was made. The postoperative follow up at 12 months revealed no recurrence. PMID:23878576

  7. Central-Office Real Estate.

    ERIC Educational Resources Information Center

    Pardini, Priscilla

    2003-01-01

    Describes how to upgrade a school district's central-office facilities without incurring taxpayer enmity. Includes case studies from Harford County, Maryland; Orange and Broward Counties, Florida; South Milwaukee, Wisconsin; Mt. Baker, Washington; Chicago, Illinois; and Rochester, New Hampshire. (PKP)

  8. Minerals Management Service perspective of platform reassessment

    SciTech Connect

    Dyhrkopp, F.G.

    1995-10-01

    As a result of the destruction caused by the Loma Prieta Earthquake, which occurred in the San Francisco Bay Area in 1989, and the passage of Hurricane Andrew through the Central Gulf of Mexico (GOM) oil and gas fields in August 1002, the Minerals Management Service (MMS) has been actively developing a policy over the past few years that will comprehensively address the reassessment of existing Outer Continental Shelf (OCS) oil and gas structures. Central to the development of such policy has been the need to develop a procedure by which reassessment can be carried out. This paper discusses the history of MMS involvement in the area of reassessment, their concerns, and how they view the reassessment procedures found in the Draft Section 17, Assessment of Existing Platforms, proposed for inclusion in future API RP 2A Editions. Minerals Management Service procedures for review and approval of proposals to remove and reuse existing structures in OCS waters are also discussed.

  9. Mental health services in the Solomon Islands.

    PubMed

    Orotaloa, Paul; Blignault, Ilse

    2012-06-01

    The Solomon Islands comprise an archipelago of nearly 1,000 islands and coral atolls and have an estimated population of 549,574 people. Formal mental health services date back to 1950 when an asylum was established. Since then the process of mental health service development has been largely one of incremental change, with a major boost to community services in the last two decades. During the 1990s a mental health outpatient clinic was established in Honiara, together with attempts to recruit nursing staff as psychiatric coordinators in the provinces. In 1996, the Ministry commenced sending registered nurses for psychiatric training in Papua New Guinea. By 2010, there were 13 psychiatric nurses and one psychiatrist, with a second psychiatrist in training. A National Mental Health Policy was drafted in 2009 but is yet to be endorsed by Cabinet. A significant portion of the population still turns to traditional healers or church leaders for purposes of healing, seeking help from Western medicine only after all other alternatives in the community have been exhausted. There is still a long way to go before mental health services are available, affordable and accessible to the whole population, including people living in geographically remote areas. Realization of this vision requires increased resourcing for mental health services; improved communication and collaboration between the centrally-based, national mental health services and the provincial health services; and closer, ongoing relationships between all stakeholders and partners, both locally and internationally. PMID:26767360

  10. Mental health services in the Solomon Islands.

    PubMed

    Orotaloa, Paul; Blignault, Ilse

    2012-06-01

    The Solomon Islands comprise an archipelago of nearly 1,000 islands and coral atolls and have an estimated population of 549,574 people. Formal mental health services date back to 1950 when an asylum was established. Since then the process of mental health service development has been largely one of incremental change, with a major boost to community services in the last two decades. During the 1990s a mental health outpatient clinic was established in Honiara, together with attempts to recruit nursing staff as psychiatric coordinators in the provinces. In 1996, the Ministry commenced sending registered nurses for psychiatric training in Papua New Guinea. By 2010, there were 13 psychiatric nurses and one psychiatrist, with a second psychiatrist in training. A National Mental Health Policy was drafted in 2009 but is yet to be endorsed by Cabinet. A significant portion of the population still turns to traditional healers or church leaders for purposes of healing, seeking help from Western medicine only after all other alternatives in the community have been exhausted. There is still a long way to go before mental health services are available, affordable and accessible to the whole population, including people living in geographically remote areas. Realization of this vision requires increased resourcing for mental health services; improved communication and collaboration between the centrally-based, national mental health services and the provincial health services; and closer, ongoing relationships between all stakeholders and partners, both locally and internationally.

  11. CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY

    SciTech Connect

    BERGMAN, T. B.; STEFANSKI, L. D.; SEELEY, P. N.; ZINSLI, L. C.; CUSACK, L. J.

    2012-09-19

    THE CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY WAS CONDUCTED TO DEVELOP AN OPTIMAL SEQUENCE OF REMEDIATION ACTIVITIES IMPLEMENTING THE CERCLA DECISION ON THE CENTRAL PLATEAU. THE STUDY DEFINES A SEQUENCE OF ACTIVITIES THAT RESULT IN AN EFFECTIVE USE OF RESOURCES FROM A STRATEGIC PERSPECTIVE WHEN CONSIDERING EQUIPMENT PROCUREMENT AND STAGING, WORKFORCE MOBILIZATION/DEMOBILIZATION, WORKFORCE LEVELING, WORKFORCE SKILL-MIX, AND OTHER REMEDIATION/DISPOSITION PROJECT EXECUTION PARAMETERS.

  12. Introduction to the LaRC central scientific computing complex

    NASA Technical Reports Server (NTRS)

    Shoosmith, John N.

    1993-01-01

    The computers and associated equipment that make up the Central Scientific Computing Complex of the Langley Research Center are briefly described. The electronic networks that provide access to the various components of the complex and a number of areas that can be used by Langley and contractors staff for special applications (scientific visualization, image processing, software engineering, and grid generation) are also described. Flight simulation facilities that use the central computers are described. Management of the complex, procedures for its use, and available services and resources are discussed. This document is intended for new users of the complex, for current users who wish to keep appraised of changes, and for visitors who need to understand the role of central scientific computers at Langley.

  13. Venture Class Launch Services

    NASA Technical Reports Server (NTRS)

    Wiese, Mark

    2016-01-01

    Provide an introduction to the Launch Services Program, and specifically the strategic initiative that drove the Venture Class Launch Services contracts. Provide information from the VCLS request for proposals, as well as the Agency's CubeSat Launch Initiative.

  14. Emergency Medical Services

    MedlinePlus

    ... and need help right away, you should use emergency medical services. These services use specially trained people ... facilities. You may need care in the hospital emergency room (ER). Doctors and nurses there treat emergencies, ...

  15. Invoices for Online Services.

    ERIC Educational Resources Information Center

    Forrest, Vicki

    1988-01-01

    Review of current billing practices for online services in Great Britain discusses determinants of successful numeric data display; invoice structure; display format; invoice content; display characteristics; and invoice regularity. Sample invoices from several services are included. (three references) (MES)

  16. Managing customer service.

    PubMed

    Paget, Zoe

    2015-02-28

    Zoe Paget is the customer services manager at YourVets. Her role includes managing the company's call centre, social media marketing, working with the marketing department to develop customer care initiatives and reporting service levels to the company's directors.

  17. The Customer Service Experience.

    ERIC Educational Resources Information Center

    Bell, Chip R.

    2001-01-01

    Discusses ways to embed customer service learning and customer loyalty including making customers think, examining every aspect of customers' service encounters with staff, providing follow-up, making learning fun, and involving customers in your business. (JOW)

  18. Communications and media services

    NASA Technical Reports Server (NTRS)

    Mcculla, James W.; Kukowski, James F.

    1990-01-01

    NASA's internal and external communication methods are reviewed. NASA information services for the media, for the public, and for employees are discussed. Consideration is given to electron information distribution, the NASA TV-audio system, the NASA broadcast news service, astronaut appearances, technology and information exhibits, speaker services, and NASA news reports for internal communications. Also, the NASA worldwide electronic mail network is described and trends for future NASA communications and media services are outlined.

  19. Leadership in Children's Services

    ERIC Educational Resources Information Center

    Booker, Roger

    2012-01-01

    This paper examines the different contexts for leadership in children's services with a particular focus on integrated working. It reviews contemporary theories that appear to offer relevant frameworks for thinking about children's service leadership. It is argued that children's services require leadership at all levels to enable a dynamic,…

  20. Space based OTV servicing

    NASA Technical Reports Server (NTRS)

    Mcallister, J. G.

    1984-01-01

    Space based servicing of an orbit transfer vehicle (OTV) was previously outlined in sufficient detail to arrive at OTV and support system servicing requirements. Needed space station facilities and their functional requirements were identified. The impact of logistics and space serviceable design on the OTV design is detailed herein. RL10 derivative rocket engine inspection task times are enumerated.

  1. Simple Lookup Service

    SciTech Connect

    2013-05-01

    Simple Lookup Service (sLS) is a REST/JSON based lookup service that allows users to publish information in the form of key-value pairs and search for the published information. The lookup service supports both pull and push model. This software can be used to create a distributed architecture/cloud.

  2. Licensing of Children's Services.

    ERIC Educational Resources Information Center

    Terpstra, Jake

    The purpose of licensing is to provide protection in circumstances in which people are vulnerable and to mandate that positive services will be provided. The common denominator of human vulnerability in licensed children's services is the fact that the children are in the care of someone other than their families. Licensed services include family…

  3. Contracting for Services.

    ERIC Educational Resources Information Center

    Jenkins, Robin E.; Nord, Roy

    1982-01-01

    The major steps a college should undertake in contracting for services, including the initial determination as to whether or not contracting is the best way to provide a particular service, are described. Three general activities that apply to decisions about contracting in most circumstances are: investigating service characteristics; identifying…

  4. Holding Services to Account

    ERIC Educational Resources Information Center

    Clegg, J.

    2008-01-01

    Background: Recently, the frequency of audit inspections of health services for people with intellectual disability (ID) in the UK has increased, from occasional inquiries to a systematic audit of all services. From 2008, a process of continuous audit "surveillance" of specialist health services is to be introduced. Similar regimes of inspection…

  5. Learning through Community Service.

    ERIC Educational Resources Information Center

    Powell, Gwynn M.

    2001-01-01

    In implementing community service programs, camps need to develop safe, specific projects. Key planning points for service projects are presented. Risk management considerations specific to community service projects include developing guidelines for camper interaction with the public; discussing first-aid and emergency precautions, including…

  6. Audiology Services Manual.

    ERIC Educational Resources Information Center

    Gallaudet Coll., Washington, DC. Pre-College Programs.

    The manual describes audiology services offered at the Model Secondary School for the Deaf (MSSD). Components are listed for diagnostic services, instructional services, program development, training, and publications. Testing and reporting procedures for MSSD students are outlined. Testing includes pure-tone air conduction testing, tympanometry,…

  7. Linking Service Learning & Standards.

    ERIC Educational Resources Information Center

    Degelman, Charles, Ed.

    2000-01-01

    This theme issue explores the connection between service learning and standards-based education. In the lead article, "Service Learning and Standards: Are They Compatible?" (Brian Loney), an educator applies his extensive experience with Active Citizenship Today, a successful social studies service-learning program, to a representative set of…

  8. Secondary Services in Physics.

    ERIC Educational Resources Information Center

    Cooper, Marianne; Terry, Edward

    The basic characteristics of sixty-nine secondary services in physics were analyzed in terms of sponsorship and distribution by: (1) country of origin, (2) language, (3) age, (4) frequency of publication, (5) subject and geographical coverage and (6) size. The eight major services, in terms of size, are identified. The use of the services by the…

  9. Outreach Library Services.

    ERIC Educational Resources Information Center

    The Bookmark, 1985

    1985-01-01

    Focusing on the theme, Outreach Library Services, the articles in this publication provide a panoramic view of outreach services in eight of the public library systems in New York State. The compilation also contains four papers on special topics. Articles included are: (1) "Not So Trivial: In Pursuit of Outreach Services" (Joan F. Cooke, Finger…

  10. Talking about Customer Service.

    ERIC Educational Resources Information Center

    Talley, Mary; Axelroth, Joan

    2001-01-01

    Discusses customer service in information centers and how to define it. Topics include the effects of competition, that give customers more choices; defining customers, and defining services; communications; physical environment; change, in customers and in technology; measuring customer service; and evaluating policies and procedures. (LRW)

  11. Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times.

    PubMed

    Murcott, W J

    2014-09-01

    A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services.

  12. Coverage centralities for temporal networks*

    NASA Astrophysics Data System (ADS)

    Takaguchi, Taro; Yano, Yosuke; Yoshida, Yuichi

    2016-02-01

    Structure of real networked systems, such as social relationship, can be modeled as temporal networks in which each edge appears only at the prescribed time. Understanding the structure of temporal networks requires quantifying the importance of a temporal vertex, which is a pair of vertex index and time. In this paper, we define two centrality measures of a temporal vertex based on the fastest temporal paths which use the temporal vertex. The definition is free from parameters and robust against the change in time scale on which we focus. In addition, we can efficiently compute these centrality values for all temporal vertices. Using the two centrality measures, we reveal that distributions of these centrality values of real-world temporal networks are heterogeneous. For various datasets, we also demonstrate that a majority of the highly central temporal vertices are located within a narrow time window around a particular time. In other words, there is a bottleneck time at which most information sent in the temporal network passes through a small number of temporal vertices, which suggests an important role of these temporal vertices in spreading phenomena. Contribution to the Topical Issue "Temporal Network Theory and Applications", edited by Petter Holme.Supplementary material in the form of one pdf file available from the Journal web page at http://dx.doi.org/10.1140/epjb/e2016-60498-7

  13. CopperCore Service Integration

    ERIC Educational Resources Information Center

    Vogten, Hubert; Martens, Harrie; Nadolski, Rob; Tattersall, Colin; van Rosmalen, Peter; Koper, Rob

    2007-01-01

    In an e-learning environment there is a need to integrate various e-learning services like assessment services, collaboration services, learning design services and communication services. In this article we present the design and implementation of a generic integrative service framework, called CopperCore Service Integration (CCSI). We will…

  14. Service quality measurement.

    PubMed

    McAlexander, J H; Kaldenberg, D O; Koenig, H F

    1994-01-01

    Extending the research on service quality in health care, the authors examine the efficacy of four models for measuring service quality and conclude that SERVPERF methods are superior to SERVQUAL methods. Their study found that dental patients' assessments of overall service quality were strongly influenced by assessments of provider performance. Furthermore, an examination into the causal order between perceptions of overall service quality and patient satisfaction reveals such strong reciprocal influences that it's impossible to conclude that one empirically precedes the other. Finally, the authors found that purchase intentions are influenced by both patient satisfaction and patient assessments of overall service quality. PMID:10138734

  15. Spatial services grid

    NASA Astrophysics Data System (ADS)

    Cao, Jian; Li, Qi; Cheng, Jicheng

    2005-10-01

    This paper discusses the concept, key technologies and main application of Spatial Services Grid. The technologies of Grid computing and Webservice is playing a revolutionary role in studying the spatial information services. The concept of the SSG (Spatial Services Grid) is put forward based on the SIG (Spatial Information Grid) and OGSA (open grid service architecture). Firstly, the grid computing is reviewed and the key technologies of SIG and their main applications are reviewed. Secondly, the grid computing and three kinds of SIG (in broad sense)--SDG (spatial data grid), SIG (spatial information grid) and SSG (spatial services grid) and their relationships are proposed. Thirdly, the key technologies of the SSG (spatial services grid) is put forward. Finally, three representative applications of SSG (spatial services grid) are discussed. The first application is urban location based services gird, which is a typical spatial services grid and can be constructed on OGSA (Open Grid Services Architecture) and digital city platform. The second application is region sustainable development grid which is the key to the urban development. The third application is Region disaster and emergency management services grid.

  16. MRDIS Standalone Central Alarm Station

    SciTech Connect

    2012-09-12

    The MRDIS Standalone Central Alarm Station(MRDIS-CAS} is a software system for receiving, storing, and reviewing radiation data collected by the Mobile Radiation Detection and Identification System (MRDIS}, a mobile radiation scanning system developed for use in foreign ports for the DOE Megaports Initiative. It is designed to run on one of the on board computers in the MRDIS cab. It will collect, store, and display data from the MRDIS without the need for wireless communications or centralized server technology. It is intended to be a lightweight replacement for a distributed Megaports communication system in ports where the necessary communications infrastructure does not exist for a full Megaports communications system.

  17. Organization of rehabilitation services.

    PubMed

    Graham, Laura A

    2013-01-01

    In the past 20 years there have been many changes in the way that neurological rehabilitation is delivered worldwide. This is in part a reflection of improved acute medical therapies and intensive care and also related to the development of a more holistic approach to recovery, embracing the principles of the WHO International Classification of Functioning as a model for rehabilitation. Traditionally, rehabilitation services have tended to develop piecemeal according to local resources and need. By definition such services should be driven by a patient-centered approach and thus there is wide variety in service provision nationally and internationally. This chapter describes the background to current service set-ups and provision, exploring models of rehabilitation delivery and common presentations in neurological rehabilitation. Relevant legislation and guidance documents are reviewed. The text provides an overview of different aspects of rehabilitation services including acute and inpatient provision, outpatient services, community-based rehabilitation, residential facilities, and vocational services.

  18. Coproduction of healthcare service.

    PubMed

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-07-01

    Efforts to ensure effective participation of patients in healthcare are called by many names-patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. PMID:26376674

  19. Coproduction of healthcare service

    PubMed Central

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-01-01

    Efforts to ensure effective participation of patients in healthcare are called by many names—patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always ‘coproduced’. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. PMID:26376674

  20. Satellite Services Workshop, Volume 1

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Key issues associated with the orbital servicing of satellites are examined including servicing spacecraft and equipment, servicing operations, economics, satellite design, docking and berthing, and fluid management.

  1. 76 FR 24472 - UGI Central Penn Gas, Inc.; Notice of Petition for Rate Approval Take notice that on April 8...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-02

    ... Energy Regulatory Commission UGI Central Penn Gas, Inc.; Notice of Petition for Rate Approval Take notice that on April 8, 2011, UGI Central Penn Gas, Inc. (CPG) filed a petition pursuant to section 284.123(b)(1)(ii) of the Commission's regulations a rate election for interruptible transportation service....

  2. 75 FR 56548 - Joint Meeting of the Peripheral and Central Nervous System Drugs Advisory Committee and the Drug...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Joint Meeting of the Peripheral and Central Nervous System... the public. Name of Committees: Peripheral and Central Nervous System Drugs Advisory Committee and...

  3. Involvement of users and relatives in mental health service evaluation.

    PubMed

    Barbato, Angelo; D'Avanzo, Barbara; D'Anza, Vito; Montorfano, Emanuele; Savio, Monica; Corbascio, Caterina G

    2014-06-01

    Although Italian mental health (MH) services are community based, user and relative participation in service evaluation lagged behind until lately. We here review three recent studies involving stakeholder participation in service evaluation: two were quantitative studies, one on 204 users in an MH service in Pistoia (Central Italy) and the other on 2259 relatives, conducted with the National Union of Associations for Mental Health. The third (supported by The Centro per il Controllo delle Malattie, the ministerial Center for Disease Control) was a qualitative study in seven MH services, involving users, relatives, and professionals together, which collected interviews from 136 users, 119 relatives, and 79 professionals. In the quantitative studies, positive evaluations outnumbered negative ones. The qualitative study explored negative aspects in greater depth. Common findings were insufficient information, underinvolvement of users-relatives in planning, no choice of clinician, psychiatrist domination, and limited helpfulness of interventions. With stakeholder participation in service evaluation, the present medical framework will need reshaping.

  4. Georgiaites: Tektites in Central Georgia.

    ERIC Educational Resources Information Center

    Albin, Edward F.

    1991-01-01

    Information is provided about the origin, the features, and the availability of tektites which are odd and very rare types of transparent glass theorized to be from a common, yet unknown, origin. The basis for this article is the Howard collection of tektites found in a small region of central Georgia. (seven references) (JJK)

  5. Percutaneously inserted central catheter - infants

    MedlinePlus

    ... the PICC through the needle into a larger (central) vein, putting its tip near (but not in) the heart. Take an x-ray to place the needle. Remove the needle after the catheter is placed. WHAT ARE THE RISKS OF HAVING ...

  6. Central Auditory Function in Stutterers

    ERIC Educational Resources Information Center

    Hall, James W.; Jerger, James

    1978-01-01

    Central auditory function was assessed in 10 stutterers and 10 nonstutterers between the ages of 10 and 35 years, and the performance of the two groups compared for seven audiometric procedures, including acoustic reflex threshold and acoustic reflex amplitude function. (Author)

  7. ACT: Acting Out Central Theme.

    ERIC Educational Resources Information Center

    Kise, Joan Duff

    1982-01-01

    The author describes ACT (Acting Out Central Theme), a method for dealing with psychomotor, cognitive, and affective domains in slow readers. The ACT approach involves three sessions which focus on discussion of a theme such as friendship, presentaton of the theme as a skit, and assignment of topics to individual students. (SW)

  8. Investing in the Central Office

    ERIC Educational Resources Information Center

    Shields, Regis Anne

    2010-01-01

    Benchmarking against similar districts, ideally higher-performing ones, can be a valuable tool for determining the appropriate level of central-office investment. Unfortunately, reliable benchmarks on district spending in teaching and learning support are not readily available. This should not preclude districts from using this valuable method to…

  9. Readability of Central Florida Newspapers.

    ERIC Educational Resources Information Center

    Olmstead, Phyllis M.

    A study analyzed the readability of seven central Florida newspapers (one of which is a college newspaper) and "USA Today.""Rightwriter," a grammar checker and readability computer program, was used to evaluate front page articles for each of the eight newspapers. The readability formulas invoked in the readability program included the…

  10. Central New York's New Workforce

    ERIC Educational Resources Information Center

    Center for an Urban Future, 2009

    2009-01-01

    Conducted in late 2008 in partnership with the Greater Syracuse Chamber of Commerce and the Mohawk Valley Chamber of Commerce, this is the largest survey ever taken of Central New York businesses regarding the English language skills of the area workforce. The online survey was emailed to several hundred local businesses; 126 responses were…

  11. Central Libraries in Uncertain Times.

    ERIC Educational Resources Information Center

    Kenney, Brian J.

    2001-01-01

    Discusses security and safety issues for public libraries, especially high-profile central facilities, in light of the September 11 terrorist attacks. Highlights include inspecting bags as patrons enter as well as exit; the need for security guidelines for any type of disaster or emergency; building design; and the importance of communication.…

  12. Central California Action Associates, Inc.

    ERIC Educational Resources Information Center

    Sortor, Maia, Comp.

    The overall goal of the Central California Action Associates Inc. (CCAA) program is to provide basic education and pre-vocational training so that migrant and seasonal adult farm workers will be able to upgrade their economic and social lives. Without increased educational attainment, the San Joaquin Valley farm workers face a grim future because…

  13. Despair at the Central Office.

    ERIC Educational Resources Information Center

    Tewel, Kenneth J.

    1995-01-01

    The psychological fallout of school restructuring can paralyze central office staff. Superintendents need effective incentives to keep people engaged in organization-building. They must create a trusting, risk-taking environment, develop a shared mission, empower staff to make decisions, provide learning opportunities, afford professional…

  14. The CMS central hadron calorimeter

    SciTech Connect

    Freeman, J.; E892 Collaboration

    1996-12-31

    The CMS central hadron calorimeter is a copper absorber/ scintillator sampling structure. We describe design choices that led us to this concept, details of the mechanical and optical structure, and test beam results. We discuss calibration techniques, and finally the anticipated construction schedule.

  15. Illustrating the Central Limit Theorem

    ERIC Educational Resources Information Center

    Corcoran, Mimi

    2016-01-01

    Statistics is enjoying some well-deserved limelight across mathematics curricula of late. Some statistical concepts, however, are not especially intuitive, and students struggle to comprehend and apply them. As an AP Statistics teacher, the author appreciates the central limit theorem as a foundational concept that plays a crucial role in…

  16. The Centrality of Ethical Leadership

    ERIC Educational Resources Information Center

    Ehrich, Lisa C.; Harris, Jessica; Klenowski, Val; Smeed, Judy; Spina, Nerida

    2015-01-01

    Purpose: The central argument in this paper is that ethical school leadership is imperative in a context of increasing performance-driven accountability. The purpose of this paper is to focus on school principals' perceptions of how they understand ethical leadership and how they lead the ethical use of data. Design/Methodology/Approach: This…

  17. Focusing on customer service.

    PubMed

    1996-01-01

    This booklet is devoted to a consideration of how good customer service in family planning programs can generate demand for products and services, bring customers back, and reduce costs. Customer service is defined as increasing client satisfaction through continuous concern for client preferences, staff accountability to clients, and respect for the rights of clients. Issues discussed include the introduction of a customer service approach and gaining staff commitment. The experience of PROSALUD in Bolivia in recruiting appropriate staff, supervising staff, soliciting client feedback, and marketing services is offered as an example of a successful customer service approach. The key customer service functions are described as 1) establishing a welcoming atmosphere, 2) streamlining client flow, 3) personalizing client services, and 4) organizing and providing clear information to clients. The role of the manager in developing procedures is explored, and the COPE (Client-Oriented Provider-Efficient) process is presented as a good way to begin to make improvements. Techniques in staff training in customer service include brainstorming, role playing, using case studies (examples of which are provided), and engaging in practice sessions. Training also leads to the development of effective customer service attitudes, and the differences between these and organizational/staff-focused attitudes are illustrated in a chart. The use of communication skills (asking open-ended questions, helping clients express their concerns, engaging in active listening, and handling difficult situations) is considered. Good recovery skills are important when things go wrong. Gathering and using client feedback is the next topic considered. This involves identifying, recording, and discussing customer service issues as well as taking action on these issues and evaluating the results. The booklet ends by providing a sample of customer service indicators, considering the maintenance of a

  18. Network Centrality of Metro Systems

    PubMed Central

    Derrible, Sybil

    2012-01-01

    Whilst being hailed as the remedy to the world’s ills, cities will need to adapt in the 21st century. In particular, the role of public transport is likely to increase significantly, and new methods and technics to better plan transit systems are in dire need. This paper examines one fundamental aspect of transit: network centrality. By applying the notion of betweenness centrality to 28 worldwide metro systems, the main goal of this paper is to study the emergence of global trends in the evolution of centrality with network size and examine several individual systems in more detail. Betweenness was notably found to consistently become more evenly distributed with size (i.e. no “winner takes all”) unlike other complex network properties. Two distinct regimes were also observed that are representative of their structure. Moreover, the share of betweenness was found to decrease in a power law with size (with exponent 1 for the average node), but the share of most central nodes decreases much slower than least central nodes (0.87 vs. 2.48). Finally the betweenness of individual stations in several systems were examined, which can be useful to locate stations where passengers can be redistributed to relieve pressure from overcrowded stations. Overall, this study offers significant insights that can help planners in their task to design the systems of tomorrow, and similar undertakings can easily be imagined to other urban infrastructure systems (e.g., electricity grid, water/wastewater system, etc.) to develop more sustainable cities. PMID:22792373

  19. 7 CFR 800.76 - Prohibited services; restricted services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Prohibited services; restricted services. 800.76..., PACKERS AND STOCKYARD ADMINISTRATION (FEDERAL GRAIN INSPECTION SERVICE), DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS Kinds of Official Services § 800.76 Prohibited services; restricted services. (a)...

  20. 76 FR 4393 - Discover Financial Services Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ... Financial Services negotiated service agreement to the market dominant product list. This notice addresses... 3020, et seq., to add a Discover Financial Services (DFS) negotiated service agreement to the market... Data and Request to Add Discover Financial Services Negotiated Service Agreement to the...

  1. Service employees give as they get: internal service as a moderator of the service climate-service outcomes link.

    PubMed

    Ehrhart, Karen Holcombe; Witt, L A; Schneider, Benjamin; Perry, Sara Jansen

    2011-03-01

    We lend theoretical insight to the service climate literature by exploring the joint effects of branch service climate and the internal service provided to the branch (the service received from corporate units to support external service delivery) on customer-rated service quality. We hypothesized that service climate is related to service quality most strongly when the internal service quality received is high, providing front-line employees with the capability to deliver what the service climate motivates them to do. We studied 619 employees and 1,973 customers in 36 retail branches of a bank. We aggregated employee perceptions of the internal service quality received from corporate units and the local service climate and external customer perceptions of service quality to the branch level of analysis. Findings were consistent with the hypothesis that high-quality internal service is necessary for branch service climate to yield superior external customer service quality. PMID:21142340

  2. 75 FR 22689 - Fiscal Service

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-29

    ... Management Service, Financial Accounting and Services Division, Surety Bond Branch, 3700 East-West Highway..., Financial Accounting and Services Division. BILLING CODE 4810-35-M ... Fiscal Service Surety Companies Acceptable on Federal Bonds: Western Bonding Company AGENCY:...

  3. Public water supplies in central and north-central Texas

    USGS Publications Warehouse

    Sundstrom, Raymond W.; Broadhurst, W.L.; Dwyer, B.C.

    1949-01-01

    This report gives a summarized description of the public water supplies in 35 counties of central and north-central Texas, extending from the southern boundaries of Travis, Blanco, Gillespie, and Kerr Counties northward to the TexasOklahoma State line. It gives the available data as follows for each of the 145 communities: Population of the community; name of the official from whom the information was obtained; ownership of water works, whether private or municipal source of supply, whether ground water or surface water; the amount of water consumed; the facilities for storage; the number of customers served; the character of the chemical and sanitary treatment, if any; and chemical analyses of the water. Where ground water is used, the following is also given: Records of wells, including drillers' logs; character of the pumping equipment; yields of the wells, and records of water levels, if available.

  4. Service-oriented science.

    PubMed

    Foster, Ian

    2005-05-01

    New information architectures enable new approaches to publishing and accessing valuable data and programs. So-called service-oriented architectures define standard interfaces and protocols that allow developers to encapsulate information tools as services that clients can access without knowledge of, or control over, their internal workings. Thus, tools formerly accessible only to the specialist can be made available to all; previously manual data-processing and analysis tasks can be automated by having services access services. Such service-oriented approaches to science are already being applied successfully, in some cases at substantial scales, but much more effort is required before these approaches are applied routinely across many disciplines. Grid technologies can accelerate the development and adoption of service-oriented science by enabling a separation of concerns between discipline-specific content and domain-independent software and hardware infrastructure.

  5. Comparative Human Health Risk Analysis of Coastal Community Water and Waste Service Options

    EPA Science Inventory

    As a pilot approach to describe adverse human health effects from alternative decentralized community water systems compared to conventional centralized services (business-as-usual [BAU]), selected chemical and microbial hazards were assessed using disability adjusted life years ...

  6. Satellite services system overview

    NASA Technical Reports Server (NTRS)

    Rysavy, G.

    1982-01-01

    The benefits of a satellite services system and the basic needs of the Space Transportation System to have improved satellite service capability are identified. Specific required servicing equipment are discussed in terms of their technology development status and their operative functions. Concepts include maneuverable television systems, extravehicular maneuvering unit, orbiter exterior lighting, satellite holding and positioning aid, fluid transfer equipment, end effectors for the remote manipulator system, teleoperator maneuvering system, and hand and power tools.

  7. MSAT broadcast voice services

    NASA Technical Reports Server (NTRS)

    Jones, John W.

    1995-01-01

    Later this year the MSAT satellite network will be delivering mobile and remote communications throughout North America. Its services include a family of Broadcast Voice Services, the first of which will be MSAT Dispatch Radio, which will extend the features and functionality of terrestrial Specialized Mobile Radio (SMR) to the entire continent. This paper describes the MSAT Broadcast Voice Services in general, and MSAT Dispatch Radio in particular, and provides examples of commercial and government applications.

  8. Providing Database Services in a Nationwide Research Organisation--Coexistence of Traditional Information Services and a Modern CD-ROM/Online Hybrid Solution.

    ERIC Educational Resources Information Center

    Bowman, Benjamin F.

    For the past two decades the central Information Retrieval Services of the Max Planck Society has been providing database searches for scientists in Max Planck Institutes and Research Groups throughout Germany. As a supplement to traditional search services offered by professional intermediaries, they have recently fostered the introduction of a…

  9. Trade in health services.

    PubMed

    Chanda, Rupa

    2002-01-01

    In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services.

  10. Trade in health services.

    PubMed Central

    Chanda, Rupa

    2002-01-01

    In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795

  11. Presence Service in IMS

    PubMed Central

    Petras, David

    2013-01-01

    This paper describes the presence service, which is located in the IP multimedia subsystem. This service allows making many applications for different groups of people. The paper describes differences between a network without the service and with the service. The biggest change is an increased number of transmitted messages. The presence uses some part of the IP multimedia subsystem control layer, which is shown in communication between the user and the server. The paper deals with the number of generated messages depending on the behaviour of the users. This is described by a mathematical model using discrete Markov chains. PMID:23970836

  12. Holding services to account

    PubMed Central

    Clegg, J

    2008-01-01

    Background Recently, the frequency of audit inspections of health services for people with intellectual disability (ID) in the UK has increased, from occasional inquiries to a systematic audit of all services. From 2008, a process of continuous audit ‘surveillance’ of specialist health services is to be introduced. Similar regimes of inspection are in place for social care services. Aim To explore the conceptual positions which inform audit, through detailed examination of the investigation into the learning disability service at Sutton and Merton. Findings Audit is distinct from evaluation because it neither provides opportunities for service staff to give an account of their work nor represents a search for knowledge. Audit investigates adherence to government policy. In ID, audits measure aspirations derived from normalisation, despite research showing that some of these aspirations have not been achieved by any service. As audit consumes significant public resource, it is questionable whether the dominant finding of the Healthcare Commission's investigation into Sutton and Merton, that the ID service was chronically under-funded, represents value for money. Discussion and conclusions While basic checks on minimum standards will always be necessary, service excellence requires not audit but research-driven evaluation. Audits inhibit rather than open-up debate about improving support to people with ID. They impose an ideology, squander resource, and demoralise carers and staff. Evaluations challenge the implicit management-versus-professional binary enacted by audit, and can inform new care systems which make effective use of all those engaged with people with ID. PMID:18498335

  13. [Mechanization of the work of the personnel of the sterilization service of therapeutic-preventive institutions].

    PubMed

    Rabin'kiĭ, B Ia

    1978-01-01

    The presently functioning service of central sterilization departments at medical institutions has presented itself in a good light. The home industry already puts out the necessary basic facilities and is putting into production the ancillary ones to equip them. Further development of the sterilization service centralization follows the way of setting up sterilization centres organized on the principle of highly mechanized and automated industrial enterprises.

  14. America's Service Academies, Your Service Academies

    ERIC Educational Resources Information Center

    Born, Dana H.; Phillips, Andrew T.; Trainor, Timothy E.

    2012-01-01

    The United States Air Force Academy, United States Naval Academy, and United States Military Academy are America's three largest service academies. They are "the" primary undergraduate institutions and commissioning sources that educate and develop the officers who are expected to lead this nation's armed forces. They are special places that have…

  15. A library-based bioinformatics services program*

    PubMed Central

    Yarfitz, Stuart; Ketchell, Debra S.

    2000-01-01

    Support for molecular biology researchers has been limited to traditional library resources and services in most academic health sciences libraries. The University of Washington Health Sciences Libraries have been providing specialized services to this user community since 1995. The library recruited a Ph.D. biologist to assess the molecular biological information needs of researchers and design strategies to enhance library resources and services. A survey of laboratory research groups identified areas of greatest need and led to the development of a three-pronged program: consultation, education, and resource development. Outcomes of this program include bioinformatics consultation services, library-based and graduate level courses, networking of sequence analysis tools, and a biological research Web site. Bioinformatics clients are drawn from diverse departments and include clinical researchers in need of tools that are not readily available outside of basic sciences laboratories. Evaluation and usage statistics indicate that researchers, regardless of departmental affiliation or position, require support to access molecular biology and genetics resources. Centralizing such services in the library is a natural synergy of interests and enhances the provision of traditional library resources. Successful implementation of a library-based bioinformatics program requires both subject-specific and library and information technology expertise. PMID:10658962

  16. Services supporting collaborative alignment of engineering networks

    NASA Astrophysics Data System (ADS)

    Jansson, Kim; Uoti, Mikko; Karvonen, Iris

    2015-08-01

    Large-scale facilities such as power plants, process factories, ships and communication infrastructures are often engineered and delivered through geographically distributed operations. The competencies required are usually distributed across several contributing organisations. In these complicated projects, it is of key importance that all partners work coherently towards a common goal. VTT and a number of industrial organisations in the marine sector have participated in a national collaborative research programme addressing these needs. The main output of this programme was development of the Innovation and Engineering Maturity Model for Marine-Industry Networks. The recently completed European Union Framework Programme 7 project COIN developed innovative solutions and software services for enterprise collaboration and enterprise interoperability. One area of focus in that work was services for collaborative project management. This article first addresses a number of central underlying research themes and previous research results that have influenced the development work mentioned above. This article presents two approaches for the development of services that support distributed engineering work. Experience from use of the services is analysed, and potential for development is identified. This article concludes with a proposal for consolidation of the two above-mentioned methodologies. This article outlines the characteristics and requirements of future services supporting collaborative alignment of engineering networks.

  17. Service delivery for e-Health applications.

    PubMed

    Staemmler, Martin

    2011-01-01

    E-Health applications have to take the business perspective into account. This is achieved by adding a fourth layer reflecting organizational and business processes to an existing three layer model for IT-system functionality and management. This approach is used for designing a state-wide e-Health service delivery allowing for distributed responsibilities: clinical organizations act on the fourth layer and have established mutual cooperation in this state-wide approach based on collectively outsourced IT-system services. As a result, no clinical organization can take a dominant role based on operating the IT-system infrastructure. The implementation relies on a central infrastructure with extended means to guarantee service delivery: (i) established redundancy within the system architecture, (ii) actively controlled network and application availability, (iii) automated routine performance tests fulfilling regulatory requirements and (iv) hub-to-spoke and end-to-end authentication. As a result, about half of the hospitals and some practices of the state have signed-up to the services and guarantee long-term sustainability by sharing the infrastructural costs. Collaboration takes place for more than 1000 patients per month based on second opinion, online consultation and proxy services for weekend and night shifts.

  18. A centralized audio presentation manager

    SciTech Connect

    Papp, A.L. III; Blattner, M.M.

    1994-05-16

    The centralized audio presentation manager addresses the problems which occur when multiple programs running simultaneously attempt to use the audio output of a computer system. Time dependence of sound means that certain auditory messages must be scheduled simultaneously, which can lead to perceptual problems due to psychoacoustic phenomena. Furthermore, the combination of speech and nonspeech audio is examined; each presents its own problems of perceptibility in an acoustic environment composed of multiple auditory streams. The centralized audio presentation manager receives abstract parameterized message requests from the currently running programs, and attempts to create and present a sonic representation in the most perceptible manner through the use of a theoretically and empirically designed rule set.

  19. Bedrock topography of central Iowa

    USGS Publications Warehouse

    Hansen, R.E.

    1985-01-01

    The bedrock in Iowa (Hershey, 1969) generally is ovelain by deposits of glacial drift and alluvium. The drift, comprised of glacial till and glacial outwash, varies in thickness from less than 1 foot to more than 400 feet; the alluvium in central Iowa varies in thickness from less than 1 foot to about 60 feet. The configuration of the bedrock suface is the result of a complex system of ancient drainage courses which were developed during a long period of preglacial erosion and during shorter, but more intense, periods of interglacial erosion. This map, for a 10 county area in central Iowa, is the seventh of a series of 9 reports that will provide statewide coverage of the bedrock surface of Iowa. 

  20. Central exclusive production at RHIC

    NASA Astrophysics Data System (ADS)

    Adamczyk, Leszek; Guryn, Włodek; Turnau, Jacek

    2014-11-01

    The present status and future plans of the physics program of Central Exclusive Production (CEP) at RHIC are described. The measurements are based on the detection of the forward protons from the Double Pomeron Exchange (DPE) process in the Roman Pot system and of the recoil system of charged particles from the DPE process measured in the STAR experiment's Time Projection Chamber (TPC). The data described here were taken using polarized proton-proton collisions at √ {s} = 200 GeV. The preliminary spectra of two-pion mass reconstructed by STAR TPC in central region of pseudorapidity |η| < 1, are presented. Near future plans to take data with the current system at center-of-mass energy √ {s} = 200 GeV and plans to upgrade the forward proton tagging system are presented. Also a possible addition of the RPs to the sPHENIX detector is discussed.

  1. Central exclusive production at RHIC

    SciTech Connect

    Adamczyk, Leszek; Guryn, Włodek; Turnau, Jacek

    2014-11-10

    The present status and future plans of the physics program of Central Exclusive Production (CEP) at RHIC are described. The measurements are based on the detection of the forward protons from the Double Pomeron Exchange (DPE) process in the Roman Pot system and of the recoil system of charged particles from the DPE process measured in the STAR experiment’s Time Projection Chamber (TPC). The data described here were taken using polarized proton-proton collisions at ps = 200 GeV. The preliminary spectra of two pion and four pion invariant mass reconstructed by STAR TPC in central region of pseudo-rapidity | | < 1, are presented. Near future plans to take data with the current system at center-of-mass energy ps = 200 GeV and plans to upgrade the forward proton tagging sys- tem are presented. Also a possible addition of the Roman Pots to the sPHENIX detector is discussed.

  2. MRDIS Standalone Central Alarm Station

    2012-09-12

    The MRDIS Standalone Central Alarm Station(MRDIS-CAS} is a software system for receiving, storing, and reviewing radiation data collected by the Mobile Radiation Detection and Identification System (MRDIS}, a mobile radiation scanning system developed for use in foreign ports for the DOE Megaports Initiative. It is designed to run on one of the on board computers in the MRDIS cab. It will collect, store, and display data from the MRDIS without the need for wireless communicationsmore » or centralized server technology. It is intended to be a lightweight replacement for a distributed Megaports communication system in ports where the necessary communications infrastructure does not exist for a full Megaports communications system.« less

  3. Central odontogenic fibroma: Retrospective study of 8 clinical cases

    PubMed Central

    Hrichi, Radia; Gargallo-Albiol, Jordi; Berini-Aytés, Leonardo

    2012-01-01

    Introduction and Objectives: The central odontogenic fibroma (COF) is a benign odontogenic tumour derived from the dental mesenchymal tissues. It is a rare tumour and only 70 cases of it have been published. Bearing in mind the rareness of the tumour, 8 new cases of central odontogenic fibroma have been found by analyzing the clinical, radiological and histopathological characteristics of COF. Patients and Method: A retrospective study was carried out on 3011 biopsies in the Service of Oral and Maxillofacial Surgery of the Dental Clinic of Barcelona University between January 1995 and March 2008. 85 odontogenic tumours were diagnosed of which 8 were central odontogenic fibroma. The radiological study was based on orthopantomographs, periapical and occlusal radiographies and computerised tomographics. The variables collected were: sex, age, clinical characteristics of the lesion, treatment received and possible reappearances of the tumour. Results: The central odontogenic fibroma represents 9.4% of all odontogenic tumours. Of the 8 cases, 5 were diagnosed in men and 3 in women. The average age was 19.9 years with an age range of 11 to 38 years. The most common location of the tumour was in the mandible. All cases were associated with unerupted teeth. Of the 8 tumours, 3 provoked rhizolysis of the adjacent teeth and 4 cases caused cortical bone expansion. 50% of the patients complained of pain associated to the lesion. No case of recurrence was recorded up to 2 years after the treatment. Conclusions: Central odontogenic fibromas usually evolve asymptomatically although they can manifest very aggressively provoking dental displacement and rhizolysis. Radiologically, COF manifest as a uni or multilocular radiotransparent image although they can be indistinguishable from other radiotransparent lesions making diagnosis more difficult. COF treatment involves conservative surgery as well as follow-up patient checks. Key words: Odontogenic tumour, central odontogenic

  4. Central collisions of heavy ions

    SciTech Connect

    Fung, Sun-yiu.

    1992-10-01

    This report describes the activities of the Heavy Ion Physics Group at the University of California, Riverside from October 1, 1991 to September 30, 1992. During this period, the program focused on particle production at AGS energies, and correlation studies at the Bevalac in nucleus-nucleus central collisions. As part of the PHENIX collaboration, contributions were made to the Preliminary Conceptual Design Report (pCDR), and work on a RHIC silicon microstrip detector R D project was performed.

  5. The CDF Central Analysis Farm

    SciTech Connect

    Kim, T.H.; Neubauer, M.; Sfiligoi, I.; Weems, L.; Wurthwein, F.; /UC, San Diego

    2004-01-01

    With Run II of the Fermilab Tevatron well underway, many computing challenges inherent to analyzing large volumes of data produced in particle physics research need to be met. We present the computing model within CDF designed to address the physics needs of the collaboration. Particular emphasis is placed on current development of a large O(1000) processor PC cluster at Fermilab serving as the Central Analysis Farm for CDF. Future plans leading toward distributed computing and GRID within CDF are also discussed.

  6. Tectonics of the central Andes

    NASA Technical Reports Server (NTRS)

    Bloom, Arthur L.; Isacks, Bryan L.; Fielding, Eric J.; Fox, Andrew N.; Gubbels, Timothy L.

    1989-01-01

    Acquisition of nearly complete coverage of Thematic Mapper data for the central Andes between about 15 to 34 degrees S has stimulated a comprehensive and unprecedented study of the interaction of tectonics and climate in a young and actively developing major continental mountain belt. The current state of the synoptic mapping of key physiographic, tectonic, and climatic indicators of the dynamics of the mountain/climate system are briefly reviewed.

  7. Geochronology Database for Central Colorado

    USGS Publications Warehouse

    Klein, T.L.; Evans, K.V.; deWitt, E.H.

    2010-01-01

    This database is a compilation of published and some unpublished isotopic and fission track age determinations in central Colorado. The compiled area extends from the southern Wyoming border to the northern New Mexico border and from approximately the longitude of Denver on the east to Gunnison on the west. Data for the tephrochronology of Pleistocene volcanic ash, carbon-14, Pb-alpha, common-lead, and U-Pb determinations on uranium ore minerals have been excluded.

  8. Celtic Sites of Central Iberia

    NASA Astrophysics Data System (ADS)

    Pérez Gutiérrez, Manuel

    This chapter concerns the astronomy practiced by Celtic peoples in some parts of central Iberia, specifically the Vetton and Celtiberian peoples, inhabitants of the so-called Late Iron Age. The construction of some elements of religion or worship was perfectly determined by geometry, topography, and especially astronomy, because their spatial orientation occurs in locations of great interest for maintaining the local calendar. The maintenance of this calendar was probably the primary objective of some of the elements studied.

  9. Central Asia Active Fault Database

    NASA Astrophysics Data System (ADS)

    Mohadjer, Solmaz; Ehlers, Todd A.; Kakar, Najibullah

    2014-05-01

    The ongoing collision of the Indian subcontinent with Asia controls active tectonics and seismicity in Central Asia. This motion is accommodated by faults that have historically caused devastating earthquakes and continue to pose serious threats to the population at risk. Despite international and regional efforts to assess seismic hazards in Central Asia, little attention has been given to development of a comprehensive database for active faults in the region. To address this issue and to better understand the distribution and level of seismic hazard in Central Asia, we are developing a publically available database for active faults of Central Asia (including but not limited to Afghanistan, Tajikistan, Kyrgyzstan, northern Pakistan and western China) using ArcGIS. The database is designed to allow users to store, map and query important fault parameters such as fault location, displacement history, rate of movement, and other data relevant to seismic hazard studies including fault trench locations, geochronology constraints, and seismic studies. Data sources integrated into the database include previously published maps and scientific investigations as well as strain rate measurements and historic and recent seismicity. In addition, high resolution Quickbird, Spot, and Aster imagery are used for selected features to locate and measure offset of landforms associated with Quaternary faulting. These features are individually digitized and linked to attribute tables that provide a description for each feature. Preliminary observations include inconsistent and sometimes inaccurate information for faults documented in different studies. For example, the Darvaz-Karakul fault which roughly defines the western margin of the Pamir, has been mapped with differences in location of up to 12 kilometers. The sense of motion for this fault ranges from unknown to thrust and strike-slip in three different studies despite documented left-lateral displacements of Holocene and late

  10. Centrally managed tapes at DESY

    SciTech Connect

    Hell, O.

    1994-12-31

    Tapes at DESY are managed by the computer center and thus offer virtually unlimited storage space to the DESY computer center users. This paper describes the most recent version of the DESY tape management system, its predecessors having been in service for many years.

  11. International GPS (Global Positioning System) Service for Geodynamics

    NASA Technical Reports Server (NTRS)

    Zumberge, J. F. (Editor); Liu, R. (Editor); Neilan, R. E. (Editor)

    1995-01-01

    The International GPS (Global Positioning System) Service for Geodynamics (IGS) began formal operation on January 1, 1994. This first annual report is divided into sections, which mirror different aspects of the service. Section (1) contains general information, including the history of the IGS, its organization, and the global network of GPS tracking sites; (2) contains information on the Central Bureau Information System; (3) describes the International Earth Rotation Service (IERS); (4) details collecting and distributing IGS data in Data Center reports; (6) describes how the IGS Analysis Centers generate their products; (7) contains miscellaneous contributions from other organizations that share common interests with the IGS.

  12. A Cross-Sectional Cohort Study of a Large, Statewide Medicaid Home and Community-Based Services Autism Waiver Program

    ERIC Educational Resources Information Center

    Eskow, Karen Goldrich; Chasson, Gregory S.; Summers, Jean Ann

    2015-01-01

    State-specific 1915(c) Medicaid Home and Community-Based Services waiver programs have become central in the provision of services specifically tailored to children with autism spectrum disorders (ASD). Using propensity score matching, 130 families receiving waiver services for a child with ASD were matched with and compared to 130 families…

  13. Positive Effects of Peer-Led Reflection on Undergraduates' Concept Integration and Synthesis during Service Learning

    ERIC Educational Resources Information Center

    Hudsonm Monika; Hunter, Keith O.

    2014-01-01

    Service learning that features mutually constructed community-based service can enhance the understanding of a range of concepts (Butin, 2006). However, such service is often seen as "charity" as opposed to a dually constructed experience that is central to real learning (Howard, 2000; Tellis, 2011). This project was designed to…

  14. Serial Services 1992.

    ERIC Educational Resources Information Center

    Shroyer, Andrew; Nanna, Laura

    1992-01-01

    This 1992 price index for serial services presents data on the number of titles, average price, percent of price change, and price indexed to 1977 for the following areas: business; general and humanities; law; science and technology; social sciences; U.S. documents; and H.W. Wilson services. (MES)

  15. Computerized Drug Information Services

    ERIC Educational Resources Information Center

    And Others; Smith, Daniel R.

    1972-01-01

    To compare computerized services in chemistry, pharmacology, toxicology, and clinical medicine of pharmaceutical interest, equivalent profiles were run on magnetic tape files of CA-Condensates," CBAC," Excerpta Medica," MEDLARS" and Ringdoc." The results are tabulated for overlap of services, relative speed of citing references, and unique…

  16. Summer Service, 1963.

    ERIC Educational Resources Information Center

    Brown, Michael J.

    1993-01-01

    The author's experiences in community service at a Quaker summer work camp 30 years ago taught him more about himself than about the community in which he helped. National service needs to include an organizing orientation that allows the strengths of both participants and community members to flourish. (SLD)

  17. Academic Library Reference Services.

    ERIC Educational Resources Information Center

    Batt, Fred

    This examination of the philosophy and objectives of academic library reference services provides an overview of the major reference approaches to fulfilling the following primary objectives of reference services: (1) providing accurate answers to patrons' questions and/or helping patrons find sources to pursue their research needs; (2) building…

  18. Hospitality Services Reference Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

  19. Recreation Service Handicapped Inc.

    ERIC Educational Resources Information Center

    Iowa Univ., Iowa City. Recreation Education Program.

    Presented are duplications of the responses given by Recreation Service Handicapped (Memphis, Tennessee) as part of a project to collect, share, and compile information about, and techniques in the operation of 18 community action models for recreation services to the disabled. Model programs are categorized as consumer, client competency,…

  20. The Call to Service

    ERIC Educational Resources Information Center

    Gray, B. Allison

    2009-01-01

    On January 19, 2009, the day before his historic inauguration, President Obama and his wife, Michelle, commemorated Martin Luther King Day by volunteering for various community service projects around the Washington, DC, area. A record number of Americans also participated in the King Day of Service, joining in over 13,000 projects, more than…