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. Centralized administrative services management.

    PubMed

    Freed, D H

    1994-06-01

    Virtually every hospital has imposed guidelines or controls on one or more administrative service expenses. However, the actual deployment of such strategies is often voluntary, decentralized, disjointed and episodic. An alternative approach is to cluster administrative elements across hospital departments and make them the responsibility of a dedicated manager. This approach treats administrative services as an organizing principle with uniform, predictable standards of service and cost. Customer requirements for products and services are met without the need for them to physically manage that process. Materiel managers can demonstrate a leadership role by applying their professionalism and know-how to a set of products and services traditionally ignored or dealt with in an uncoordinated manner. While some initial resistance can be expected as traditional barriers are disassembled, the results should be very rewarding for the hospital and materiel manager alike.

  3. Prise en charge et résultats fonctionnels des cataractes traumatiques dans la région centrale du Togo

    PubMed Central

    Saa, Kassoula Batomaguela Nonon; Maneh, Nidain; Vonor, Kokou; Banla, Mèba; Sounouvou, Ignace; Alaglo, Kossi; Balo, Komi Patrice

    2016-01-01

    Introduction La cataracte traumatique est une affection grave, car pouvant être à l’origine de la baisse visuelle partielle ou totale. Le but de notre travail a été d'apprécier les résultats fonctionnels post opératoires des cataractes traumatiques opérées dans la région Centrale du Togo. Méthodes Il s’agissait d’une étude rétrospective basée sur l’analyse des dossiers des patients ayant bénéficié d’une prise en charge chirurgicale pour cataracte traumatique en stratégie avancée et en poste fixe entre le 1er janvier 2009 et le 30 juin 2011. Résultats Sur un total de 1086 cas de cataracte opérés au cours cette période, 131 (12,06%) étaient d’origine traumatique. La moyenne d’âge était de 30,01 ±16,61 ans avec des extrêmes de 5 et 70 ans 85% des patients ont bénéficié d’une implantation avec 66% de bons et moyens résultats après correction au premier jour postopératoire selon la classification de l’OMS. Après deux mois de suivi, 85% des patients revus présentaient une acuité visuelle supérieure à 3/10. Conclusion Malgré les progrès de la micro chirurgie oculaire, celle de la cataracte traumatique demeure d’accès difficile à la fois pour le patient que pour le praticien surtout dans les pays en développement. Pour ces raisons la priorité doit être donnée à la prévention des traumatismes oculaires. PMID:28292070

  4. PRISE Reporters 1978-79.

    ERIC Educational Resources Information Center

    PRISE Reporter, 1979

    1979-01-01

    Presented are six issues of the PRISE Reporter, a monthly newsletter providing information on special education in Pennsylvania. Key articles include the following titles and authors: "Human Sexuality and Mental Retardation" by B. Menhusen; "A Training Program for Teachers of Children with Behavior Disorders: An Interdisability…

  5. PRISE Reporter--1979-1980.

    ERIC Educational Resources Information Center

    n11 Sep, Nov 1979, 1980

    1980-01-01

    The document presents five issues of the PRISE Reporter, a newsletter of the Pennsylvania Resources and Information Center for Special Education devoted to issues and happenings in the field of special education. Separate issues treat the following disabilities: mental retardation, health impairments/learning disabilities, emotional disturbances,…

  6. Evolution in a centralized transfusion service.

    PubMed

    AuBuchon, James P; Linauts, Sandra; Vaughan, Mimi; Wagner, Jeffrey; Delaney, Meghan; Nester, Theresa

    2011-12-01

    The metropolitan Seattle area has utilized a centralized transfusion service model throughout the modern era of blood banking. This approach has used four laboratories to serve over 20 hospitals and clinics, providing greater capabilities for all at a lower consumption of resources than if each depended on its own laboratory and staff for these functions. In addition, this centralized model has facilitated wider use of the medical capabilities of the blood center's physicians, and a county-wide network of transfusion safety officers is now being developed to increase the impact of the blood center's transfusion expertise at the patient's bedside. Medical expectations and traffic have led the blood center to evolve the centralized model to include on-site laboratories at facilities with complex transfusion requirements (e.g., a children's hospital) and to implement in all the others a system of remote allocation. This new capability places a refrigerator stocked with uncrossmatched units in the hospital but retains control over the dispensing of these through the blood center's computer system; the correct unit can be electronically cross-matched and released on demand, obviating the need for transportation to the hospital and thus speeding transfusion. This centralized transfusion model has withstood the test of time and continues to evolve to meet new situations and ensure optimal patient care.

  7. Centralized Library Services for Audiovisual Media. AV in Action 4.

    ERIC Educational Resources Information Center

    Nederlands Bibliotheek en Lektuur Centrum, The Hague (Netherlands).

    Designed to provide assistance to countries in developing centralized services to their libraries for nonbook materials, this pamphlet contains examples from five countries that have succeeded in establishing such services. Those examples include: (1) "The Central Library Service for AV-Materials in Denmark" (Suzanne Hemmeth…

  8. 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…

  9. 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…

  10. 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…

  11. 13 CFR 120.1710 - Central servicing of the Program.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Central servicing of the Program. 120.1710 Section 120.1710 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS... its role as Central Servicing Agent for the Pool, at Pool formation, CSA issues a Seller Receipt...

  12. 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

  13. Diagnostic et prise en charge du psoriasis

    PubMed Central

    Kim, Whan B.; Jerome, Dana; Yeung, Jensen

    2017-01-01

    Résumé Objectif Présenter aux cliniciens en soins primaires un aperçu pratique et à jour du diagnostic et de la prise en charge du psoriasis. Sources des données Une recension a été effectuée dans les bases de données de PubMed, MEDLINE, EMBASE et Cochrane pour trouver des méta-analyses, des études randomisées contrôlées, des revues systématiques et des études observationnelles pertinentes portant sur le diagnostic et la prise en charge du psoriasis. Message principal Le psoriasis est une maladie inflammatoire chronique et multisystémique qui affecte principalement la peau et les articulations. En plus des dimensions physiques de la maladie, le psoriasis a des répercussions émotionnelles et psychosociales considérables sur les patients, et nuit au fonctionnement social et aux relations interpersonnelles. En tant que maladie inflammatoire systémique, le psoriasis est associé à de multiples comorbidités, dont les maladies cardiovasculaires et les cancers. Le diagnostic est principalement d’ordre clinique et une biopsie de la peau est rarement nécessaire. Selon la sévérité de la maladie, un traitement approprié peut être amorcé. Pour les cas de légers à modérés, le traitement de première intention comporte des thérapies topiques, dont les corticostéroïdes, les analogues de la vitamine D3 et des produits combinés. Ces traitements topiques sont efficaces et peuvent être initiés et prescrits en toute sécurité par des médecins de soins primaires. Les patients dont les symptômes sont plus graves et réfractaires pourraient devoir être envoyés en consultation auprès d’un dermatologue pour une évaluation plus approfondie et une thérapie systémique. Conclusion De nombreux patients atteints de psoriasis consultent leur médecin de soins primaires pour une évaluation initiale et pour recevoir un traitement. La reconnaissance du psoriasis, de même que des comorbidités médicales et psychiatriques qui lui sont associ

  14. 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

  15. Human resources for refraction services in Central Nepal.

    PubMed

    Kandel, Himal; Murthy, G V S; Bascaran, Covadonga

    2015-07-01

    Uncorrected refractive error is a public health problem globally and in Nepal. Planning of refraction services is hampered by a paucity of data. This study was conducted to determine availability and distribution of human resources for refraction, their efficiency, the type and extent of their training; the current service provision of refraction services and the unmet need in human resources for refraction in Central Nepal. This was a descriptive cross-sectional study. All refraction facilities in the Central Region were identified through an Internet search and interviews of key informants from the professional bodies and parent organisations of primary eye centres. A stratified simple random sampling technique was used to select 50 per cent of refraction facilities. The selected facilities were visited for primary data collection. Face-to-face interviews were conducted with the managers and the refractionists available in the facilities using a semi-structured questionnaire. Data was collected in 29 centres. All the managers (n=29; response rate 100 per cent) and 50 refractionists (Response rate 65.8 per cent) were interviewed. Optometrists and ophthalmic assistants were the main providers of refraction services (n=70, 92.11 per cent). They were unevenly distributed across the region, highly concentrated around urban areas. The median number of refractions per refractionist per year was 3,600 (IQR: 2,400 - 6,000). Interviewed refractionists stated that clients' knowledge, attitude and practice related factors such as lack of awareness of the need for refraction services and/or availability of existing services were the major barriers to the output of refraction services. The total number of refractions carried out in the Central Region per year was 653,176. An additional 170 refractionists would be needed to meet the unmet need of 1,323,234 refractions. The study findings demand a major effort to develop appropriately trained personnel when planning

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

    PubMed

    Church, D L; Hall, P

    1999-11-01

    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.

  17. 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

  18. 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).

  19. 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.

  20. 29 CFR 779.118 - Employees providing central services for multi-unit organizations.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Employees providing central services for multi-unit... 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 “in...

  1. Retrospective targeted HCV lookback using centralized contracted notification service.

    PubMed

    Saxena, Sunita; Shulman, Ira A; Pachciarz, Judith; Downey, Nancy; Figueroa, Priscilla I

    2003-06-01

    Mandated HCV 2.0 lookback significantly challenged the human and financial resources available to the six Los Angeles County Department of Health Services (DHS) hospital blood banks. To comply with FDA requirements, DHS developed a centralized process that utilized the services of a contract vendor for performing HCV lookback. A DHS public health nurse acted as HCV lookback coordinator and as liaison with the vendor. Cases were electronically forwarded to the vendor, who then reviewed the patient's chart to obtain information necessary for tracking the patient through commercial databases. The vendor was responsible for notifying the recipient for pretest counseling and for providing documentation of all efforts. In total, 411 recipients were identified, of which, 168 cases were completed by the hospitals, 243 were forwarded to the vendor, 50 percent were deceased, 21 percent were contacted, and 28 percent could not be contacted, and 1 percent could not be located on any databases. The vendor contacted 35 of 66 cases that the hospitals had unsuccessfully attempted to contact. Of the cases forwarded to the vendor, 82 percent were completed on time. Delays were attributable to the vendor in less than 2 percent of cases. The cost per case forwarded to the vendor was 322 US dollars. Utilizing a professional service to conduct HCV recipient notifications is an effective strategy for meeting FDA deadlines and for freeing transfusion service staff to perform critical functions. It remains to be seen whether such strategies offer a cost savings.

  2. BOWS (bioinformatics open web services) to centralize bioinformatics tools in web services.

    PubMed

    Velloso, Henrique; Vialle, Ricardo A; Ortega, J Miguel

    2015-06-02

    Bioinformaticians face a range of difficulties to get locally-installed tools running and producing results; they would greatly benefit from a system that could centralize most of the tools, using an easy interface for input and output. Web services, due to their universal nature and widely known interface, constitute a very good option to achieve this goal. Bioinformatics open web services (BOWS) is a system based on generic web services produced to allow programmatic access to applications running on high-performance computing (HPC) clusters. BOWS intermediates the access to registered tools by providing front-end and back-end web services. Programmers can install applications in HPC clusters in any programming language and use the back-end service to check for new jobs and their parameters, and then to send the results to BOWS. Programs running in simple computers consume the BOWS front-end service to submit new processes and read results. BOWS compiles Java clients, which encapsulate the front-end web service requisitions, and automatically creates a web page that disposes the registered applications and clients. Bioinformatics open web services registered applications can be accessed from virtually any programming language through web services, or using standard java clients. The back-end can run in HPC clusters, allowing bioinformaticians to remotely run high-processing demand applications directly from their machines.

  3. PRISE Reporter, No. 20, December 1988-May 1989.

    ERIC Educational Resources Information Center

    PRISE Reporter, 1989

    1989-01-01

    Each issue of "PRISE Reporter" focuses on some aspect of educating handicapped students and offers a feature article, other sources of information, and descriptions of research projects. The December 1988 issue contains an article titled "Now That the Door Is Open: Social Skills Instruction in the Classroom" (Sue Vernon et al.) which targets…

  4. 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…

  5. 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…

  6. 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

  7. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 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....

  8. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 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....

  9. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false 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....

  10. 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... County, Vermont. g. Filed Pursuant to: Federal Power Act, 16 U.S.C. 791(a)--825(r). h. Application...

  11. 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. ...

  12. 41 CFR 101-5.104 - Economic feasibility of centralized services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 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. ...

  13. 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

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 13 CFR 120.1710 - Central servicing of the Program.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Investor. (b) CSA fiscal transfer responsibilities. All Pool Loan Receivables on a Pool Loan received by... maintain a registry of Pool Investors and other information as SBA requires. CSA registers all Pool... Investors and other information as SBA requires. In fulfilling its obligation to keep the central...

  20. 13 CFR 120.1710 - Central servicing of the Program.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Investor. (b) CSA fiscal transfer responsibilities. All Pool Loan Receivables on a Pool Loan received by... maintain a registry of Pool Investors and other information as SBA requires. CSA registers all Pool... Investors and other information as SBA requires. In fulfilling its obligation to keep the central...

  1. Forest statistics for Central Florida, 1995. Forest Service resource bulletin

    SciTech Connect

    Brown, M.J.

    1995-12-31

    This report summarizes results from a 1995 inventory of the forest resources of Central Florida. Current estimates of forest area, related attributes, and timber volumes are presented and compared with earlier estimates. Timber volumes reported in previous bulletins have been adjusted for valid comparisons with current assessments. Average annual rates of growth, removals, and mortality since the previous inventory in 1988 are summarized.

  2. 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

    ... Central Security Services Iselin, New Jersey; TA-W-82,634B, Prudential Global Business Technology... Technology Solutions Central Security Services Roseland, New Jersey; TA-W-82,634E, Prudential Global Business... Business Technology Solutions Central Security Services New York, New York; Amended Certification Regarding...

  3. 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…

  4. 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)…

  5. 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)…

  6. 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…

  7. 78 FR 57922 - American Energy Production, Inc., Best Energy Services, Inc., Community Central Bank Corporation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-20

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION American Energy Production, Inc., Best Energy Services, Inc., Community Central Bank Corporation... accurate information concerning the securities of Best Energy Services, Inc. because it has not filed any...

  8. History of Forest Service Research in the Central and Southern Rocky Mountain Regions, 1908-1975

    Treesearch

    Raymond Price

    1976-01-01

    The first forest research area established by the Forest Service was in 1908­the Fort Valley Experimental Forest near Flagstaff, Arizona. In 1909, the Fremont Experiment Station near Colorado Springs was begun, as well as the Wagon Wheel Gap watershed experiment in the central Rockies. The Santa Rita Range Reserve, begun in 1903, was transferred to the Forest Service...

  9. Prise en charge du cancer du col utérin durant la grossesse: à propos de 05 cas

    PubMed Central

    El Mazghi, Abderrahman; Bouhafa, Touria; Loukili, Kaoutar; El Kacemi, Hanan; Lalya, Issam; Hassouni, Khalid

    2014-01-01

    L'association d'un cancer du col utérin avec une grossesse est une éventualité rare. Son incidence est assez mal évaluée, elle se situe selon les études entre 1 et 2/10 000. Lorsque la découverte en est faite, il faut conjuguer deux impératifs parfois totalement divergents: le traitement de la mère et la prise en charge du foetus. Cette association pose schématiquement quatre grands problèmes, qui sont: Celui du diagnostic, qui est loin d’être évident, compte tenu des remaniements cervicaux observés en début de gestation, le pronostic de l'affection, la date du traitement chirurgical et du délai entre le diagnostic et la prise en charge thérapeutique, enfin et de manière plus accessoire, le devenir de la grossesse et le mode d'accouchement. Nous rapportons une série de 5 cas de cancer du col utérin découverts au cours de la grossesse colligés dans notre service entre 2010 et 2013. La prise en charge thérapeutique est identique à celle des patientes en dehors de la grossesse même si quelques adaptations sont nécessaires du fait de l’état gravide, le pronostic du cancer ne semble pas être modifié par la grossesse. PMID:25852788

  10. PRISE (PRImer SElector): software for designing sequence-selective PCR primers.

    PubMed

    Fu, Qi; Ruegger, Paul; Bent, Elizabeth; Chrobak, Marek; Borneman, James

    2008-03-01

    This report presents PRImer Selector (PRISE), a new software package that implements several features that improve and streamline the design of sequence-selective PCR primers. The PRISE design process involves two main steps. In the first step, target and non-target DNA sequences are identified. In the second step, primers are designed to amplify target (but not non-target) sequences. One important feature of PRISE is that it automates the task of placing primer-template mismatches at the 3' end of the primers - a property that is crucial for sequence selectivity. Once a list of candidate primers has been produced, sorting tools in PRISE speed up the selection process by allowing a user to sort the primers by properties such as amplicon length, GC content and sequence selectivity. PRISE can be used to design primers with a range of specificities, targeting individual sequences as well as diverse assemblages of genes. PRISE also allows user-defined primers to be analyzed, enabling their properties to be examined in relation to target and non-target sequences. The utility of PRISE was demonstrated by using it to design sequence-selective PCR primers for an rRNA gene from the fungus Pochonia chlamydosporia.

  11. Survey of otolaryngology services in Central America: need for a comprehensive intervention.

    PubMed

    Wagner, Richard; Fagan, Johan

    2013-11-01

    In the developing world, there exists a scarcity of services and training in otolaryngology, audiology, and speech therapy, which is reflected by the gap between health care delivery in high-income countries and low-income countries. We surveyed, by questionnaire, the countries of Central America, except for Belize, because of the lack of otolaryngology services, on the following issues: availability of otolaryngology, audiology, and speech therapy services and equipment; otolaryngologist, audiologist, and speech therapist training; and availability of services in rural areas. Surveys were distributed via email and by hand at the 2011 Central American Congress of Otolaryngology, in San Salvador, El Salvador, to otolaryngologists, audiologists, and speech therapists. Not to our surprise, there is a shortfall in services and training in all three professions. The data collected and presented in this commentary will provide a basis by which change might take place.

  12. Production of infant scale evaluation (PRISE) in Italian normal hearing children: a validation study.

    PubMed

    Cuda, Domenico; Guerzoni, Letizia; Mariani, Valeria; Murri, Alessandra; Biasucci, Giacomo; Fabrizi, Enrico

    2013-12-01

    Parental questionnaires are important tools in the evaluation of auditory and language skills of very young children affected by sensorineural hearing loss. One of these instruments is the Production on Infant Scale Evaluation (PRISE). The purposes of this study were to adapt and validate the PRISE on Italian children with normal hearing; and to obtain normative data. A back translation technique was used to adapt the Italian version of PRISE. The PRISE was submitted to parents of 234 normal children aged between 3 and 18 months of life. All of them passed local universal newborn hearing screenings and they presented no audiological risk factors. The PRISE internal reliability (Cronbach's alpha) was 0.87. Split-half reliability indexes were λ(4) = 0.89 and λ(6) = 0.89. Corrected item-total correlation coefficients were significant for all items. The correlation of PRISE with a modified Infant Toddler Meaningful Auditory Integration Scale (IT-MAIS), collected for convergent validity measurement purposes, was good (r = 0.743). A positive correlation of PRISE scores with age was found, reflecting on the age-dependence of pre-verbal skills. These findings demonstrate high reliability and convergent validity of the Italian PRISE version. This questionnaire constitutes a robust tool for assessing early language development in infants and toddlers with normal hearing. It seems particularly sensitive to the normal language development in the first years of life, which can be very useful for early rehabilitation of hearing loss. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  13. 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

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

    PubMed

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

    2016-07-01

    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. 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. 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. 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. © The Author(s) 2016.

  15. 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

  16. 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...

  17. Marketing Children's Services at the Central Library of Sacramento Public Library.

    ERIC Educational Resources Information Center

    Hicks, Mary Frances

    Conducted prior to the building of a new central library, this study was designed to assess the need for children's library services in downtown Sacramento. The development of a profile of the community environment and general characteristics of the population through the use of secondary sources is described; the assessment of family needs and…

  18. "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…

  19. 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…

  20. 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

    ... 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 Power... relicensing. Applicant Contacts: For transferor: Todd Allard, Operations Engineer Omya, Inc., Vermont Marble...

  1. "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…

  2. 77 FR 42768 - Central Vermont Public Service Corporation, Millstone Power Station, Unit 3; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    .... subsidiary Green Mountain Power Corporation (GMP). The Commission is also considering amending the license... Central Vermont Public Service Corporation with Green Mountain Power Corporation, to reflect the proposed... . Participants may attempt to use other software not listed on the Web site, but should note that the NRC's E...

  3. 77 FR 59679 - Central Vermont Public Service Corporation (Millstone Power Station, Unit 3); Order Approving...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-28

    ... the change of name for the co-owner licensee on the MSP3 license from ``Central Vermont Public Service Corporation'' to ``Green Mountain Power Corporation.'' No physical changes to the MPS3 facility or operational changes are being proposed in the application. Notice of the request for approval and opportunity for a...

  4. 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…

  5. 77 FR 29625 - Central Vermont Public Service Corporation; Notice of Application Ready for Environmental...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ...] Central Vermont Public Service Corporation; Notice of Application Ready for Environmental Analysis... application has been accepted for filing and is now ready for environmental analysis. l. Project Description... with a storage capacity of 275 acre-feet at a normal maximum water surface elevation of 469.5...

  6. 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.

  7. PRISE2: software for designing sequence-selective PCR primers and probes.

    PubMed

    Huang, Yu-Ting; Yang, Jiue-in; Chrobak, Marek; Borneman, James

    2014-09-25

    PRISE2 is a new software tool for designing sequence-selective PCR primers and probes. To achieve high level of selectivity, PRISE2 allows the user to specify a collection of target sequences that the primers are supposed to amplify, as well as non-target sequences that should not be amplified. The program emphasizes primer selectivity on the 3' end, which is crucial for selective amplification of conserved sequences such as rRNA genes. In PRISE2, users can specify desired properties of primers, including length, GC content, and others. They can interactively manipulate the list of candidate primers, to choose primer pairs that are best suited for their needs. A similar process is used to add probes to selected primer pairs. More advanced features include, for example, the capability to define a custom mismatch penalty function. PRISE2 is equipped with a graphical, user-friendly interface, and it runs on Windows, Macintosh or Linux machines. PRISE2 has been tested on two very similar strains of the fungus Dactylella oviparasitica, and it was able to create highly selective primers and probes for each of them, demonstrating the ability to create useful sequence-selective assays. PRISE2 is a user-friendly, interactive software package that can be used to design high-quality selective primers for PCR experiments. In addition to choosing primers, users have an option to add a probe to any selected primer pair, enabling design of Taqman and other primer-probe based assays. PRISE2 can also be used to design probes for FISH and other hybridization-based assays.

  8. The effect of centralization of health care services on travel time and its equality.

    PubMed

    Kobayashi, Daisuke; Otsubo, Tetsuya; Imanaka, Yuichi

    2015-03-01

    To analyze the regional variations in travel time between patient residences and medical facilities for the treatment of ischemic heart disease and breast cancer, and to simulate the effects of health care services centralization on travel time and equality of access. We used medical insurance claims data for inpatients and outpatients for the two target diseases that had been filed between September 2008 and May 2009 in Kyoto Prefecture, Japan. Using a geographical information system, patient travel times were calculated based on the driving distance between patient residences and hospitals via highways and toll roads. Locations of residences and hospital locations were identified using postal codes. We then conducted a simulation analysis of centralization of health care services to designated regional core hospitals. The simulated changes in potential spatial access to care were examined. Inequalities in access to care were examined using Gini coefficients, which ranged from 0.4109 to 0.4574. Simulations of health care services centralization showed reduced travel time for most patients and overall improvements in equality of access, except in breast cancer outpatients. Our findings may contribute to the decision-making process in policies aimed at improving the potential spatial access to health care services. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Outsourcing the central plant: A value-added service that owners want

    SciTech Connect

    Robertson, W.K.

    1998-04-01

    The last regulated major industry in America, the electric utility industry, is facing deregulation in the very near future. Similar to events that occurred in the gas industry a few years ago, it will soon be possible for facilities managers across the nation to choose their suppliers of electricity. Facility managers and owners are making plans now to maximize their opportunities. Many are looking for lower rates and barebones service while others are interested in creative options like enhanced services, premium power and value-added services from their incumbent power supplier and from other players, even now, before deregulation comes. One creative options that offers win-win benefits for all parties is a value-added service to take over operation of an existing central heating and cooling plant, or develop a new one, for an owner.

  10. Mapping Ecosystem Services for Land Use Planning, the Case of Central Kalimantan

    NASA Astrophysics Data System (ADS)

    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.

  11. 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.

  12. 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

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

    PubMed

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

    2014-06-01

    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. 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. 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. 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. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association.

  14. 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

  15. 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.

  16. 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.

  17. Centralized automated cataloging of health science materials in the MLC/SUNY/OCLC shared cataloging service.

    PubMed Central

    Raper, J E

    1977-01-01

    Since February 1976, The Medical Library Center of New York, with the assistance of the SUNY/OCLC Network, has offered, on a subscription basis, a centralized automated cataloging service to health science libraries in the greater metropolitan New York area. By using workforms and prints of OCLC record (amended by the subscribing participants), technical services personnel at the center have fed cataloging data, via a CRT terminal, into the OCLC system, which provides (1) catalog cards, received in computer filing order; (2) book card, spine, and pocket labels; (3) accessions lists; and (4) data for eventual production of book catalogs and union catalogs. The experience of the center in the development, implementation, operation, and budgeting of its shared cataloging service is discussed. PMID:843650

  18. Centralized automated cataloging of health science materials in the MLC/SUNY/OCLC shared cataloging service.

    PubMed

    Raper, J E

    1977-04-01

    Since February 1976, The Medical Library Center of New York, with the assistance of the SUNY/OCLC Network, has offered, on a subscription basis, a centralized automated cataloging service to health science libraries in the greater metropolitan New York area. By using workforms and prints of OCLC record (amended by the subscribing participants), technical services personnel at the center have fed cataloging data, via a CRT terminal, into the OCLC system, which provides (1) catalog cards, received in computer filing order; (2) book card, spine, and pocket labels; (3) accessions lists; and (4) data for eventual production of book catalogs and union catalogs. The experience of the center in the development, implementation, operation, and budgeting of its shared cataloging service is discussed.

  19. 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

  20. 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.

  1. The tradeoff between centralized and decentralized health services: evidence from rural areas in Mexico.

    PubMed

    Vargas Bustamante, Arturo

    2010-09-01

    This study investigates the effectiveness of centralized and decentralized health care providers in rural Mexico. It compares provider performance since both centralized and decentralized providers co-exist in rural areas of the country. The data are drawn from the 2003 household survey of Oportunidades, a comprehensive study of rural families from seven states in Mexico. The analyses compare out-of-pocket health care expenditures and utilization of preventive care among rural households with access to either centralized or decentralized health care providers. This study benefits from differences in timing of health care decentralization and from a quasi-random distribution of providers. Results show that overall centralized providers perform better. Households served by this organization report less regressive out-of-pocket health care expenditures (32% lower), and observe higher utilization of preventive services (3.6% more). Decentralized providers that were devolved to state governments in the early 1980s observe a slightly better performance than providers that were decentralized in the mid-1990s. These findings are robust to decentralization timing, heterogeneity in per capita government health expenditures, state and health infrastructure effects, and other confounders. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  2. Central and South West Services (CSWS) transmission system studies: (Rio Grande Valley FACTS studies). Final report

    SciTech Connect

    Arabi, S.; Hamadanizadeh, H.

    1998-12-01

    Stability limitations impose constraints on power imports into the Rio Grande Valley, the southern region of Central Power and Light`s (CPL) system. CPL`s parent company, Central and South West Services, sought to identify viable plans for eliminating these constraints to enable power transfers via two 345-kV transmission lines. This project conducted assessment studies of the CPL system, using applications from EPRI`s Power System Analysis Package, and identified two scenarios as the most likely remedial measures required. These consisted of the addition of generating units and the use of series compensation of the two transmission lines, in conjunction with shunt compensation. While Flexible AC Transmission System (FACTS) devices were not indicated in this study phase, the researchers indicated a Thyristor Controlled Series Compensation device could be considered to address a potential subsynchronous resonance issue.

  3. Effect of a centralized clinical pharmacy anticoagulation service on the outcomes of anticoagulation therapy.

    PubMed

    Witt, Daniel M; Sadler, Melanie A; Shanahan, Roberta L; Mazzoli, Georgann; Tillman, Donald J

    2005-05-01

    A growing body of reports has documented the ability of anticoagulation management services to help patients receiving warfarin therapy achieve better outcomes compared to the care provided by their personal physicians (ie, usual care). To compare clinical outcomes associated with anticoagulation therapy provided by a clinical pharmacy anticoagulation service (CPAS) to usual care. Retrospective, observational cohort study, 6 months in duration. Large nonprofit, group-model health maintenance organization. A total of 6,645 patients receiving warfarin therapy were included in the final analyses (intervention group, 3,323 patients; control group, 3,322 patients). Anticoagulation therapy for patients in the intervention group was managed by a centralized, telephonic CPAS. Therapy for patients in the control group was managed in the usual manner by their personal physicians. The primary outcome was the occurrence of anticoagulation therapy-related complications. A secondary outcome was the proportion of time spent in the target international normalized ratio (INR) range for each patient. Cox proportional hazards regression analyses were used to examine the risk of complications in relation to the study group. Patients in the CPAS were 39% less likely to experience an anticoagulation therapy-related complication than were patients in the control group (hazard ratio, 0.61; 95% confidence interval, 0.42 to 0.88). The number of patients needed to treat to prevent an anticoagulation therapy complication was 52. Additional analyses revealed that improved outcomes associated with CPAS were mediated largely through improved therapeutic INR control. Patients in the CPAS group spent 63.5% of study period days within their target INR range compared to 55.2% in the control group (p < 0.001). A centralized, telephonic, pharmacist-managed anticoagulation monitoring service reduced the risk of anticoagulation therapy-related complications compared to that with usual care. The

  4. [Surgical service at the Central Military Hospital of People's Commissariat of Defence shortly before the Great Patriotic War].

    PubMed

    Krainyukov, P E; Efimenko, N A; Abashin, V G

    2015-04-01

    Authors present the article historical data on the foundation and development of surgical service at the 1st Therapeutic Red Cross Hospital (Central Military Hospital of People's Commissariat. of Defense) since its organization. The structure of the hospital surgical service and organization of surgical activity during the pre-war years is presented. Provided information about outstanding surgeons who was working in the hospital.

  5. User experience of a centralized hyperacute stroke service: a prospective evaluation.

    PubMed

    Moynihan, Barry; Paul, Selina; Markus, Hugh S

    2013-10-01

    Centralizing hyperacute stroke unit (HASU) care services allows improved access to thrombolysis but could be associated with worse patient experience, particularly when early repatriation to a local stroke recovery unit occurs as this may result in discontinuity of care. A centralized model of care was introduced in London, United Kingdom, with 8 HASUs providing acute care for the whole 8.3 million population, with repatriation on day 3 to a local stroke recovery unit. The patient and carer experience of this model of care has not been previously reported. We undertook a prospective observational study of the new model of care in the South West London sector. Patient and carer experiences were evaluated using a modified Picker Questionnaire. Separate questionnaires were used for patients discharged directly home from the HASU, those repatriated to local stroke recovery units, and for carers of patients admitted to the HASU. Despite moving from a selected to nonselected admission pattern, thrombolysis rates increased from 6% to 9%. High satisfaction rates were reported among both patients and carers. Patients discharged directly home had higher satisfaction levels than those requiring repatriation to their local stroke unit, who were older and had more severe stroke. A total of 47% of carers expressed anxiety over the repatriation from the HASU back to the local stroke recovery unit, but few patients and carers reported an impact of this move on patient recovery. Centralized HASU care is associated with good levels of patient and carer satisfaction.

  6. 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.

  7. Development of community nursing: analysis of the central services and practice dilemmas.

    PubMed

    Timpka, T; Svensson, B; Molin, B

    1996-06-01

    As examples of nurse practitioners in primary care, Swedish district nurses have been shown, in several studies, to respond well to the general pressure to achieve higher productivity in health care. Yet they have less frequently been involved in studies of the detailed content of the service they provide. To maintain total service quality, change should not be brought about only for the sake of efficacy. This study is divided into an analysis of the basic service provided in district nursing by identifying a typical interaction with a patient; and an analysis of the daily dilemmas district nurses experience, their consequences, and possible measures for change. For the consultation study, data were collected from 40 videorecordings of office-hour consultations by a rural district nurse. Regarding the dilemma situations, a critical incident questionnaire was returned by 153 district nurses in a Swedish country. The analyses showed that the district nurse practises in an area between self-care on the one hand, and the intersection of the different specialties in health care, on the other. Both the consultation study and the study of dilemmas in practice showed that the district nurse has to approach the health care organisation from a viewpoint close to that of the patient, which implies that she can, and has to, maintain an overview of the patient's total interaction with social institutions. This focal localisation of the shared care and co-ordination aspects constitutes a critical target for change and development efforts. The conclusions are that, first, the role of the district nurse/nurse practitioner as co-ordinator and advocate in patient-centred care could be considered in central health services policies and planning. Second, the content of the district nurses' daily work could be taken into account in the implementation of quality programs. These measures together can lead to an integration between today's theoretical nursing models and the dynamically

  8. Urban Health Extension Services Utilization in Bishoftu Town, Oromia Regional State, Central Ethiopia.

    PubMed

    Gebreegziabher, Ewunetu Aberra; Astawesegn, Feleke Hailemichael; Anjulo, Antehun Alemayehu; Kerie, Mirkuzie Woldie

    2017-03-14

    Ethiopia has been deploying specially trained new cadres of community based health workers in urban areas of the country known as urban health extension professionals since 2009. At present, relatively little work has focused on understanding to what extent this new program is accepted and used by the community. Both qualitative and quantitative surveys were performed from March 10, 2012 to March 25, 2012 to explore the utilization of urban health extension services in Bishoftu Town, Oromia regional state, Central Ethiopia using a cross sectional study design. Qualitative data were collected using a total of 4 focus group discussions and 26 in-depth interviews. Quantitative data were collected from 418 randomly selected households using pre-tested, structured, interviewer-administered questionnaires. Data entry and analysis were done using SPSS version 16.0. Qualitative data were analyzed thematically. Of the 418 interviewed households, 72.8% of them had at least one service related contact with urban health extension professionals in the previous 6 month. The mean frequency of service related contact with Urban Health Extension Professionals was found to be 2.24 (±1) contacts per 6 months. The total number of households graduated as a model family in the study area was 3974 (14.3%). Though participants felt that urban health extension professionals faced community resistance at program implementation, its acceptability greatly improved in this study. Despite this, individual competencies of urban health extension professionals, availability of supply and logistic system, and the level of support from kebele officials were reported to influence the program acceptability and utilization. The introduction of urban health extension professionals positively changed the attitude of the majority of the households involved and improved the acceptability of the program. All stake holders, governmental and nongovernmental organizations, should have supportive systems to

  9. 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

  10. 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

  11. 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

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

    PubMed

    Arciero, Paul J; Miller, Vincent 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.

  13. Centralized intravenous additive services (CIVAS): the state of the art in 2010.

    PubMed

    Hecq, J-D

    2011-01-01

    In hospitals, the major part of the drugs is administered by intravenous way and the majority of the reconstitution of injectable drugs are carried out right before the administration to the patient by the nursing staff. The risks and errors related to the preparation and the administration of the injectable drugs are numerous. The standardization then the centralization of the preparations and reconstitution by the hospital pharmacy make it possible to reduce these various risks and errors. In addition to the preparation of the mixtures of parenteral nutrition as well as doses of anticancer chemotherapy, many other treatments can be taken in charge, such as antibiotics, antiemetics and pain treatments. Consequent equipment is necessary but the realization of these treatments proves non-overdrawn insofar as a certain quantity of production is reached. The reconstitution of the intravenous treatments by a centralized intravenous admixture service guarantees the chemical stability and the microbiological quality of the ready-to-use injectable drugs and contributes to the quality and the total management of the care of the patient. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  14. [Social determinants of exclusion from health services and medicines in three Central American countries].

    PubMed

    Acuña, Cecilia; Marina, Nelly; Mendoza, Adriana; Emmerick, Isabel Cristina Martins; Luiza, Vera Lucía; Azeredo, Thiago Botelho

    2014-02-01

    Examine the social determinants that affect population behavior with regard to the search for and acquisition of medicines, and their relationship to exclusion from health services based on aggregate data from three Central American countries: Guatemala, Honduras, and Nicaragua. A descriptive, observational cross-sectional study was conducted by administration of a household survey. The study sample was selected in accordance with the conglomerate method. Data was analyzed with the SPSS® V.17 program using descriptive statistics, bivariate, multivariate, and principal components analysis (PCA). Although the majority of the persons could access health care, health exclusion (odds ratio [OR] 4.10; 95% confidence interval [95% CI]) was the main determinant of lack of access to medicines. The characteristics of housing (OR 0.747, 95% CI), formal employment of head of the household (OR 0.707, 95% CI), and socioeconomic status of the household (OR 0.462, 95% CI) were also important determinants of lack of access to medicines. The phenomena of lack of access to health services and medicines are not independent from one another. It was corroborated that the health system, as an intermediate social determinant of health, is an important factor for improvement of access to medicines. Public policies that aim to achieve universal coverage should consider this relationship in order to be effective.

  15. 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

  16. 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.

  17. Central or local incident reporting? A comparative study in Dutch GP out-of-hours services

    PubMed Central

    Zwart, Dorien LM; Van Rensen, Elizabeth LJ; Kalkman, Cor J; Verheij, Theo JM

    2011-01-01

    Background Centralised incident reporting in a Dutch collaboration of nine out-of-hours services yielded very few incident reports. To improve incident reporting and the awareness of primary caregivers about patient safety issues, a local incident-reporting procedure was implemented. Aim To compare the number and nature of incident reports collected in a local incident-reporting procedure (intervention) versus the currently used centralised incident-reporting procedure. Design of study Quasi experiment. Setting Three GPs' out-of-hours services (OHSs) in the centre of the Netherlands participated over 2 years before and 2 years after the intervention. Method A local incident-reporting procedure was implemented in OHS1, in which participants were encouraged to report all occurring incidents. A local committee with peers analysed the reported incidents fortnightly in order to initiate improvements if necessary. In OHS2 and OHS3, the current centralised incident-reporting procedure was continued, where incidents were reported to an advisory committee of the board of directors of the OHSs collaboration and were assessed every 2 months. The main outcome measures were the number and nature of incidents reported. Results At baseline, participants reported fewer than 10 incidents per year each. In the follow-up period, the number of incidents reported in OHS1 increased 16-fold compared with the controls. The type of incidents reported did not alter. In the local incident-reporting procedure, improvements were implemented in a shorter time frame, but reports in the centralised incident-reporting procedure led to a more systematic addressing of general and recurring safety problems. Conclusion It is likely that a local incident-reporting procedure increases the willingness to report and facilitates faster implementation of improvements. In contrast, the central procedure, by collating reports from many settings, seems better at addressing generic and recurring safety issues

  18. Central or local incident reporting? A comparative study in Dutch GP out-of-hours services.

    PubMed

    Zwart, Dorien L M; Van Rensen, Elizabeth L J; Kalkman, Cor J; Verheij, Theo J M

    2011-03-01

    Centralised incident reporting in a Dutch collaboration of nine out-of-hours services yielded very few incident reports. To improve incident reporting and the awareness of primary caregivers about patient safety issues, a local incident-reporting procedure was implemented. To compare the number and nature of incident reports collected in a local incident-reporting procedure (intervention) versus the currently used centralised incident-reporting procedure. Quasi experiment. Three GPs' out-of-hours services (OHSs) in the centre of the Netherlands participated over 2 years before and 2 years after the intervention. A local incident-reporting procedure was implemented in OHS1, in which participants were encouraged to report all occurring incidents. A local committee with peers analysed the reported incidents fortnightly in order to initiate improvements if necessary. In OHS2 and OHS3, the current centralised incident-reporting procedure was continued, where incidents were reported to an advisory committee of the board of directors of the OHSs collaboration and were assessed every 2 months. The main outcome measures were the number and nature of incidents reported. At baseline, participants reported fewer than 10 incidents per year each. In the follow-up period, the number of incidents reported in OHS1 increased 16-fold compared with the controls. The type of incidents reported did not alter. In the local incident-reporting procedure, improvements were implemented in a shorter time frame, but reports in the centralised incident-reporting procedure led to a more systematic addressing of general and recurring safety problems. It is likely that a local incident-reporting procedure increases the willingness to report and facilitates faster implementation of improvements. In contrast, the central procedure, by collating reports from many settings, seems better at addressing generic and recurring safety issues. The advantages of both approaches should be combined.

  19. Nouvelle approche à la prise en charge des condylomes

    PubMed Central

    Lopaschuk, Catharine C.

    2013-01-01

    Résumé Objectif Faire le résumé des anciens et des nouveaux moyens de traitement des verrues génitales ou condylomes et déterminer comment les utiliser de manière appropriée. Sources des données Une recherche documentaire a été effectuée dans les bases de données suivantes: MEDLINE, PubMed, EMBASE, base de données des synthèses systématiques et registre central des études contrôlées de la Collaboration Cochrane (en anglais), ACP Journal Club et Trip. Les bibliographies des articles extraits ont aussi été examinées. Les études cliniques, les articles de révision qualitative, les rapports consensuels et les guides de pratique clinique ont été retenus. Message principal Les verrues symptomatiques sont présentes chez au moins 1 % des personnes âgées entre 15 et 49 ans et on estime que jusqu’à 50 % des gens sont infectés par le virus du papillome humain à un moment donné de leur vie. L’imiquimod et la podophyllotoxine sont 2 nouveaux traitements pour les verrues génitales externes qui sont moins douloureux et peuvent être appliqués par les patients à la maison. De plus, il a été démontré que le vaccin quadrivalent contre le virus du papillome humain est efficace pour prévenir les condylomes et le cancer du col. Les plus anciennes méthodes thérapeutiques ont aussi leur place dans certaines situations, comme les verrues intravaginales, urétrales, anales ou récalcitrantes ou encore pour les patientes enceintes. Conclusion Les nouveaux traitements des verrues génitales externes peuvent réduire la douleur causée par la thérapie et le nombre de visites au cabinet. Les autres méthodes thérapeutiques demeurent utiles dans certaines situations.

  20. 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

    ... POWER ACT AND NATURAL GAS ACT BOOKS AND RECORDS Accounting and Recordkeeping Under PUHCA 2005, the... and 366.4, every centralized service company (see § 367.2 of this chapter) in a holding company system..., or both, must file an annual report, FERC Form No. 60, as provided in § 369.1 of this chapter. Every...

  1. Finding the Answers: A Look at Central and Eastern Europe. [and] Setting Up Special Services: The Trade Union Approach.

    ERIC Educational Resources Information Center

    Poloni, Cesare; Flechsenhar, Ullrich H.

    1990-01-01

    Poloni reviews implications for unions of recent economic, social, technological, and political changes in Central and Eastern Europe. Flechsenhar states that unions play a role in the development and restructuring of developing countries by providing special services to meet the economic and social needs of their members. (SK)

  2. 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

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

    PubMed

    Gotsadze, George; Chikovani, Ivdity; Goguadze, Ketevan; Balabanova, Dina; McKee, Martin

    2010-07-27

    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. 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). 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. 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.

  4. 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.

  5. Ecosystem Services Mapping for Sustainable Agricultural Water Management in California's Central Valley.

    PubMed

    Matios, Edward; Burney, Jennifer

    2017-02-24

    Accurate information on agricultural water needs and withdrawals at appropriate spatial and temporal scales remains a key limitation to joint water and land management decision-making. We use InVEST ecosystem service mapping to estimate water yield and water consumption as functions of land use in Fresno County, a key farming region in California's Central Valley. Our calculations show that in recent years (2010-2015), the total annual water yield for the county has varied dramatically from ∼0.97 to 5.37 km(3) (all ±17%; 1 MAF ≈ 1.233 km(3)), while total annual water consumption has changed over a smaller range, from ∼3.37 to ∼3.98 km(3) (±20%). Almost all of the county's water consumption (∼96% of total use) takes place in Fresno's croplands, with discrepancy between local annual surface water yields and crop needs met by surface water allocations from outside the county and, to a much greater extent, private groundwater irrigation. Our estimates thus bound the amount of groundwater needed to supplement consumption each year (∼1.76 km(3) on average). These results, combined with trends away from field crops and toward orchards and vineyards, suggest that Fresno's land and water management have become increasingly disconnected in recent years, with the harvested area being less available as an adaptive margin to hydrological stress.

  6. Public health professionals’ perceptions of mental health services in Equatorial Guinea, Central-West Africa

    PubMed Central

    Reuter, Peter Robert; McGinnis, Shannon Marcail; Reuter, Kim Eleanor

    2016-01-01

    Introduction Mental health disorders constitute 13% of global disease burden, the impacts of which are disproportionality felt in sub-Saharan Africa. Equatorial Guinea, located in Central-West Africa, has the highest per-capita investment in healthcare on the African continent, but only two studies have discussed mental health issues in the country and none of have examined the perspective of professionals working in the field. The purpose of this study was to gain a preliminary understanding of Equatoguinean health care professionals' perspectives on the mental health care system. Methods Nine adult participants (directors or program managers) were interviewed in July 2013 in Malabo, Equatorial Guinea from government agencies, aid organizations, hospitals, and pharmacies. Interviews were designed to collect broad information about the mental healthcare system in Equatorial Guinea including the professionals' perspectives and access to resources. This research was reviewed and approved by an ethical oversight committee. Results All individuals interviewed indicated that the mental health system does not currently meet the needs of the community. Professionals cited infrastructural capacity, stigmatization, and a lack of other resources (training programs, knowledgeable staff, medications, data) as key factors that limit the effectiveness of mental healthcare. Conclusion This study provides a preliminary understanding of the existing mental health care needs in the country, highlighting opportunities for enhanced healthcare services. PMID:28293352

  7. 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.

  8. Public health professionals' perceptions of mental health services in Equatorial Guinea, Central-West Africa.

    PubMed

    Reuter, Peter Robert; McGinnis, Shannon Marcail; Reuter, Kim Eleanor

    2016-01-01

    Mental health disorders constitute 13% of global disease burden, the impacts of which are disproportionality felt in sub-Saharan Africa. Equatorial Guinea, located in Central-West Africa, has the highest per-capita investment in healthcare on the African continent, but only two studies have discussed mental health issues in the country and none of have examined the perspective of professionals working in the field. The purpose of this study was to gain a preliminary understanding of Equatoguinean health care professionals' perspectives on the mental health care system. Nine adult participants (directors or program managers) were interviewed in July 2013 in Malabo, Equatorial Guinea from government agencies, aid organizations, hospitals, and pharmacies. Interviews were designed to collect broad information about the mental healthcare system in Equatorial Guinea including the professionals' perspectives and access to resources. This research was reviewed and approved by an ethical oversight committee. All individuals interviewed indicated that the mental health system does not currently meet the needs of the community. Professionals cited infrastructural capacity, stigmatization, and a lack of other resources (training programs, knowledgeable staff, medications, data) as key factors that limit the effectiveness of mental healthcare. This study provides a preliminary understanding of the existing mental health care needs in the country, highlighting opportunities for enhanced healthcare services.

  9. Network Centrality and Geographical Concentration of Social and Service Venues that Serve Young Men Who Have Sex with Men.

    PubMed

    Fujimoto, Kayo; Turner, Rolf; Kuhns, Lisa M; Kim, Ju Yeong; Zhao, Jing; Schneider, John A

    2017-02-20

    This study examines network centrality of inter-venue networks formed by collaboration, competition, and sponsorship relationships among venues that serve young men who have sex with men (MSM) aged 16-29 years in relation to their geographical concentrations in Chicago, Illinois, and Houston, Texas. Our data on the physical venues comprised 116 venues in Chicago and 102 venues in Houston. We examined the relationship between the network centrality of different relations and the geographical intensity among these venues, and considered neighborhood-level socioeconomic determinants of health. The results indicate that young MSM-serving social and service venues found in close physical proximity to one another tend to have large centrality indegree values based on competition in both cities, and based on collaboration only in Chicago. No evidence, however, was found that occupying a central position in the sponsorship networks was related to geographic concentration. Combined, these results suggest that HIV prevention interventions should consider the organizing force for competition. Such a strategy could result in better services. However there may still be potential for overlap and redundancy in services at the expense of under-served regions where proven interventions could have the greatest impact.

  10. 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

  11. The effect of centralized hospital administration on financial control and hospital service delivery: the case of Hong Kong.

    PubMed

    Chu, D K

    1987-01-01

    Administration, financial control and service delivery are three mutually influential dimensions of a hospital system. The centralized hospital system of Hong Kong is a case-in-point that illustrates such influence. By spending only a small fraction of the Gross Domestic Product each year, the government has been able to provide limited modern health care services at nominal financial cost to the public. At the same time, hospitals are subject to a strict system of administrative and financial controls. Consequently, Hong Kong hospitals must utilize their limited facilities effectively to provide modern health services to the public. However, the trade-off between low-cost health services and limited facilities is the incurrence, by the public, of non-monetary costs in obtaining hospital admission.

  12. 17 CFR 256.01-4 - Construction or service contracts, and centralized procurement accounting.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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 physical property for associate or nonassociate companies. The difference in the nature of undertakings which will...

  13. 17 CFR 256.01-4 - Construction or service contracts, and centralized procurement accounting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 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 physical property for associate or nonassociate companies. The difference in the nature of undertakings which will...

  14. Evaluation of Central Services Professional Learning Teams as of Spring 2010. Eye on Evaluation. E&R Report No. 10.06

    ERIC Educational Resources Information Center

    Baenen, Nancy; Jackl, Andrew

    2010-01-01

    The Wake County Public School System (WCPSS) board policy states that central services staff are to support school implementation of Professional Learning Teams (PLTs) and to participate in PLTs at the central level. Central staff support school efforts in a variety of ways, and over 85% of principals at each level reported this support was…

  15. [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.

  16. Centralization but Decentralization of Computing Services: A Model for Schools of Teacher Education.

    ERIC Educational Resources Information Center

    Mocciola, Michael R.

    1979-01-01

    The advantages of centralized and decentralized computing facilities within institutions of higher learning are discussed; arguments for the decentralized but not random distribution of computing facilities for schools of teacher education are presented; and the organizational structure of one "centralized but decentralized" computing…

  17. Improving Emergency Medical Services (EMS) in the United States Through Improved and Centralized Federal Coordination

    DTIC Science & Technology

    2011-03-01

    other emergencies. 4 • Public Awareness of the EMS Discipline. The public at large is not aware of the EMS structure in its community or at a higher...regard for its imperative role in community service. For this reason, placing EMS under the USFA at the federal level would cause EMS to still be...service to include EMS is appropriate, and in some cases, it is not. Not all communities have a dedicated fire service, which can make EMS provision

  18. 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

  19. PRISE Reporter. Issues and Happenings in the Education of the Mentally Retarded. Volumes 13-15, November 1981-May 1984.

    ERIC Educational Resources Information Center

    PRISE Reporter, 1982

    1982-01-01

    The "PRISE Reporter" newsletter is issued six times a school year, generally from November through May. This collection of 18 issues examines the following special education topics: "Chronological Age in the Design of Educational Programs for Severely and Profoundly Impaired Students" (L. A. Larsen and L. B. Jackson); "Beyond Reading Skills:…

  20. 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

  1. 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

  2. Utilization Rates and Perceptions of (VCT) Services in Kisii Central District, Kenya

    PubMed Central

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

    2013-01-01

    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. PMID:23283034

  3. 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.

  4. Transmission of OFDM wired-wireless quintuple-play services along WDM LR-PONs using centralized broadband impairment compensation.

    PubMed

    Alves, Tiago M F; Morant, Maria; Cartaxo, Adolfo V T; Llorente, Roberto

    2012-06-18

    The simultaneous transmission of four orthogonal frequency-division multiplexing (OFDM)-based signals used to provide quintuple-play services along wavelength division multiplexing (WDM) long-reach passive optical networks (LR-PONs) is demonstrated experimentally. Particularly, the transmission performance of custom signal bearing Gigabit Ethernet data, Worldwide Interoperability for Microwave Access, Long Term Evolution and Ultra Wideband (sub-bands 2 and 3) signals is evaluated for different LR-PONs reaches, considering single-wavelength and WDM transmission, and using a centralized impairment compensation technique at the central office that is transparent to the services provided.It is shown that error vector magnitude-compliant levels are obtained for all the OFDM-based signals in WDM LR-PONs reaching 100 km and that negligible inter-channel crosstalk is obtained for a channel spacing of 100 GHz regardless the OFDM-based signal considered. The successful multi-format OFDM transmission along the 100 km-long WDM LR-PON is achieved in the absence of optical dispersion compensation or single sideband modulation, and it is enabled by the performance improvement provided by the centralized impairment compensation realized.

  5. Breast cancer screening services: trade-offs in quality, capacity, outreach, and centralization.

    PubMed

    Güneş, Evrim D; Chick, Stephen E; Akşin, O Zeynep

    2004-11-01

    This work combines and extends previous work on breast cancer screening models by explicitly incorporating, for the first time, aspects of the dynamics of health care states, program outreach, and the screening volume-quality relationship in a service system model to examine the effect of public health policy and service capacity decisions on public health outcomes. We consider the impact of increasing standards for minimum reading volume to improve quality, expanding outreach with or without decentralization of service facilities, and the potential of queueing due to stochastic effects and limited capacity. The results indicate a strong relation between screening quality and the cost of screening and treatment, and emphasize the importance of accounting for service dynamics when assessing the performance of health care interventions. For breast cancer screening, increasing outreach without improving quality and maintaining capacity results in less benefit than predicted by standard models.

  6. "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…

  7. Alternative Models of Service, Centralized Braille Operations. Phase II Report. Volume I.

    ERIC Educational Resources Information Center

    Technology Management Corp., Alexandria, VA.

    A study was conducted to determine if the centralization of braille operations for the national free library program would be feasible, economical, and desirable. This report presents the findings of the study in three sections. Section 1 provides background information, a summary of the first phase of operations, and the study objective for phase…

  8. 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.

  9. Management of health care services for flood victims: the case of the shelter at Nakhon Pathom Rajabhat University Central Thailand.

    PubMed

    Buajaroen, Hathaichanok

    2013-08-01

    In Central Thailand basic health care services were affected by a natural disaster in the form of a flood situation. Flood Relief Operations Centers were established from the crisis. Nakhon Pathom Rajabhat University and including the faculty of nursing volunteered to care for those affected and assist in re-establishing a functioning health care system. The aim of this study was to make explicit knowledge of concept, lesson learned, and the process of management for re-establishing a health care service system at a flood victims at Relief Operations Center, Nakhon Pathom Rajabhat University. We used a qualitative design with mixed methods. This involved in-depth interviews, focus group, observational participation and non-observational participation. Key informants included university administrators, instructors, leaders of flood victims and the flood victims. Data was collected during October-December, 2010. Data were analysed using content analysis and compared matrix. We found that the concept and principle of health care services management were community based and involved home care and field hospital services. We had prepared a management system that placed emphasise on a community based approach and holistic caring such as 24h Nursing Clinic Home, visits with family, a referral system, field hospital. The core of management was to achieve integrated instruction started from nursing students were practiced skills as Health promotion and nursing techniques practicum. Rules were established regarding the health care service system. The outcomes of Health Care Service at the Flood Relief Operations Center were direct and sincere help without conditions, administrations concerned and volunteer nursing students instructors, University Officer have sympathetic and charitable with flood victims and environment. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  10. 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…

  11. Trends in health surveillance and joint service delivery for pastoralists in West and Central Africa.

    PubMed

    Abakar, M F; Schelling, E; Béchir, M; Ngandolo, B N; Pfister, K; Alfaroukh, I O; Hassane, H M; Zinsstag, J

    2016-11-01

    In most sub-Saharan African countries, pastoralism represents an important economic resource and contributes significantly to national growth; however, challenges remain, particularly in providing social services to pastoralists (especially health and education) and in avoiding conflict with local sedentary communities and local authorities. All of this takes place while pastoralists try to maintain their mobile lifestyle within a rapidly changing ecosystem. Transdisciplinary approaches, such as 'One Health', which covers both human and animal health, have proven effective in delivering services and reaching mobile pastoralists in remote areas. The pastoralist way of life could be described as being linked to both their livestock and their environment, which makes social science an important element when researching the delivery and adaptation of social services to pastoralists. Early or pre-diagnostic detection of emerging and endemic infectious disease remains a vital aspect of health surveillance targeted at preventing further transmission and spread. Community-based syndromic surveillance, coupled with visual mobile phone technology, adapted to the high levels of illiteracy among nomads, could offer an alternative to existing health surveillance systems. Such an approach could contribute to accelerated reporting, which could in turn lead to targeted intervention among mobile pastoralists in sub-Saharan Africa. Although considerable efforts have been made towards integrating mobile pastoralists into social services, obstacles remain to the adoption of a clear, specific and sustainable policy on pastoralism in sub-Saharan Africa.

  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…

  13. Child Sexual Abuse: An Interdisciplinary Professional Reference Manual with Service Directory for Central Massachusetts.

    ERIC Educational Resources Information Center

    Worcester Area Child Sexual Abuse Task Force, MA.

    This manual represents a state-of-the-art summary of approaches in child sexual abuse interventions, emphasizing interdisciplinary cooperation between professionals in successful case management. Although prepared specifically for the use of professionals in Region II of the Massachusetts Department of Social Services and containing a service…

  14. 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…

  15. 2 CFR Appendix C to Part 225 - State/Local-Wide Central Service Cost Allocation Plans

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... brochure published by the Department of Health and Human Services entitled “A Guide for State and Local..., etc. 3. “Agency or operating agency” means an organizational unit or sub-division within a governmental unit that is responsible for the performance or administration of awards or activities of the...

  16. A long-reach WDM passive optical network enabling broadcasting service with centralized light source

    NASA Astrophysics Data System (ADS)

    Liu, D.; Tang, M.; Fu, S.; Liu, D.; Shum, P.

    2012-02-01

    We propose a long-reach wavelength-division-multiplexed (WDM) passive optical network (PON) to provide conventional point-to-point (P2P) data and downstream broadcasting service simultaneously by superimposing, for each WDM channel, the differential-phase-shift-keying (DPSK) broadcasting signal with the subcarrier multiplexing (SCM) modulated downstream P2P signal, at the optical line terminal (OLT). In the optical network units (ONUs), by re-modulating part of the downstream signal with a reflective semiconductor optical amplifier (RSOA), we realize color-less ONUs for upstream data transmission. The proposed scheme is numerically verified with a 5 Gb/s downstream P2P signal and broadcasting services, as well as 2.5 Gb/s upstream data through a 60 km bidirectional fiber link. In particular, the influence of the downstream lightwave's optical carrier-subcarrier ratio (OCSR) on the system performance is also investigated.

  17. Behind the Scenes: Patient Safety in the Operating Room and Central Materiel Service During Deployments

    DTIC Science & Technology

    2005-01-01

    TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Agency for Healthcare Research and Quality 540 Gaither Road...February 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/advances/ 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY... autoclave loads per month, (2,500 items per month), including service to “forward surgical teams,” medical detachments, area medical companies, and

  18. Leadership: a central tenet for postgraduate dementia services curricula development in Australia.

    PubMed

    Angus, Jocelyn

    2009-04-01

    In the next decades of the twenty-first century, the global aging of populations will challenge every nation's ability to provide leadership by qualified health professionals to reshape and improve health care delivery systems. The challenge for educators is to design and deliver courses that will give students the knowledge and skills they need to fill that leadership role confidently in dementia care services. This paper explores the ways in which a curriculum can develop graduates who are ready to become leaders in shaping their industry. The Master of Health Science-Aged Services (MHSAS) program at Victoria University, Melbourne, Australia is applied as a case study to describe the process by which the concept of leadership is applied as the key driver in curriculum development, teaching practices and learning outcomes. Evaluation instruments employed in a variety of purposes including teaching, curriculum planning and unit appraisal are discussed. Challenges for the future are proposed including the need for postgraduate programs in dementia to seek stronger national and international benchmarks and associations with other educational institutions to promote leadership and a vision of what is possible and desirable in dementia care provision. In the twenty-first century, effective service provision in the aged health care sector will require postgraduate curricula that equip students for dementia care leadership. The MHSAS program provides an established template for such curricula.

  19. La prise en charge du pneumothorax spontané: à propos de 138 cas

    PubMed Central

    Habibi, Bouchra; Achachi, Leila; Hayoun, Sohaib; Raoufi, Mohammed; Herrak, Laila; Ftouh, Mustapha El

    2017-01-01

    Le pneumothorax est définit par la présence d’air dans la cavité pleurale. L’objectif de notre étude rétrospective du pneumothorax spontanés au servie de pneumologie à l’hôpital Ibn Sina rabat (2009-2011) est de déterminer le profil épidémiologique, clinique, radiologique, thérapeutique et évolutif. Il s’agit de 138 patients: 128 hommes et 10 femmes (17 à 83 ans), un âge moyen de 44,5 +/- 17,4 ans; sexe ratio 12/8. Le tabagisme est noté chez 81,2%. La symptomatologie clinique est la douleur thoracique (92%), la dyspnée (60%). Et sur la radiographie thoracique: on trouve un PNO (pneumothorax) unilatéral total (110 cas); partiel (10 cas); localisé (6 cas); bilatéral (4 cas); à droite dans 51,4% et à gauche dans 45,7%. On a recensé 70% de pneumothorax spontanés primitifs et 30% de PNO secondaire à (BPCO 44%, et tuberculose pulmonaire 39%). La prise en charge initiale est l’hospitalisation de tous les patients : le drainage thoracique (95%), l’exsufflation à l’aiguille (1%). Le repos et l’O2 (4%). Le retour du poumon à la paroi a été obtenu avant 10 jours chez 63%. L’évolution est favorable chez 89%. Et les complications immédiates: l’emphysème sous cutané (5 cas); une infection (6 cas) et 3 décès (arrêt cardio-respiratoire); les complications à distance sont les récidives dans 11,6%; une 1ère récidive chez 13 cas (drainage thoracique chez 11 cas et oxygénothérapie chez 2 cas) et une 2ème récidive chez 3 cas (recours à la chirurgie). Ce travail montre l’intérêt du drainage thoracique et la surveillance dans la prise en charge du pneumothorax pour éviter les complications et surtout pour éviter les récidives avec un éventuel recours à la chirurgie. PMID:28533875

  20. 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.

  1. 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.

  2. Mutuelles de santé en Afrique : caractéristiques et relations contractuelles avec les prestataires de soins pour la prise en charge de la qualité des soins.

    PubMed

    Ndiaye, Pascal; Vanlerberghe, Veerle; Lefèvre, Pierre; Criel, Bart

    2015-01-16

    En Afrique, une part importante de la population est encore confrontée à plusieurs barrières pour accéder aux soins. Les mutuelles de santé (MS) sont mises en place pour réduire la barrière financière et assurer à leurs membres un accès à des soins de qualité. Les MS établissent des relations avec les prestataires de soins sous forme de contrat, dont certaines clauses peuvent contenir des notions de qualité des soins (QS). A travers une vue d'ensemble de la typologie de 180 MS de 14 pays (dans Afrique Ouest et Centrale), cet article vise à analyser dans quelle mesure les caractéristiques des MS influencent la mise en œuvre de mécanismes contractuels susceptibles de faciliter la discussion sur la QS. L'hypothèse de cette association a été étudiée avec trois types de caractéristiques (taille, utilisation des services et volume des soins achetés) et huit variables relatives à la contractualisation et la QS (existence d'un contrat, organisation de rencontres, fréquence de ces rencontres, présence de notions de QS dans le contrat, négociation du contrat, révision du contrat, révision des clauses spécifiques à la QS et organisation de rencontres pour discuter de QS). Les MS de type communautaire représentent 80% des mutuelles étudiées (60% d'entre elles sont localisées en zone rurale). Les MS professionnelles représentent 17% et se concentrent principalement au Mali et en Côte d'Ivoire. La quasi-totalité des MS disposent de contrats écrits et contenant des notions relatives à la QS. Bien que les MS de grande taille ayant des résultats financiers importants négocient plus les aspects liés à la qualité des soins lors de l'élaboration de la convention, les MS de taille et aux performances financières plus modestes mettent en œuvre des mécanismes plus réguliers de concertation avec les prestataires. Ces rencontres sont susceptibles de créer un espace de prise en charge de la QS.

  3. 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. Copyright © 2015

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

    PubMed Central

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

    2015-01-01

    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

  5. Effect of an Advanced Pharmacy Practice Experience on Medication Therapy Management Services in a Centralized Retail Pharmacy Program.

    PubMed

    Vande Griend, Joseph P; Rodgers, Melissa; Nuffer, Wesley

    2017-05-01

    Medication therapy management (MTM) delivery is increasingly important in managed care. Successful delivery positively affects patient health and improves Centers for Medicare & Medicaid Services star ratings, a measure of health plan quality. As MTM services continue to grow, there is an increased need for efficient and effective care models. The primary objectives of this project were to describe the delivery of MTM services by fourth-year Advanced Pharmacy Practice Experience (APPE) students in a centralized retail pharmacy system and to evaluate and quantify the clinical and financial contributions of the students. The secondary objective was to describe the engagement needed to complete comprehensive medication reviews (CMRs) and targeted interventions. From May 2015 to December 2015, thirty-five APPE students from the University of Colorado Skaggs School of Pharmacy provided MTM services at Albertsons Companies using the OutcomesMTM and Mirixa platforms. Students delivered patient care services by phone at the central office and provided face-to-face visits at pharmacies in the region. With implementation of the MTM APPE in 2015, the team consisted of 2 MTM pharmacists and pharmacy students, as compared with 1 MTM pharmacist in 2014. The number of CMRs and targeted interventions completed and the estimated additional revenue generated during the 2015 time period were compared with those completed from May through December 2014. The patient and provider engagement needed to complete the CMRs and targeted interventions was summarized. 125 CMRs and 1,918 targeted interventions were billed in 2015, compared with 13 CMRs and 767 targeted interventions in 2014. An estimated $16,575-$49,272 of additional revenue was generated in 2015. To complete the interventions in 2015, the team engaged in 1,714 CMR opportunities and 4,686 targeted intervention opportunities. In this MTM rotation, students provided real-life care to patients, resulting in financial and clinical

  6. [Profile of health services utilization during the XVII Central American and Caribbean Sport Games: Delegation of Puerto Rico, Ponce 1993].

    PubMed

    Aguirre, G; Frontera, W R; Colón, L R; Amy, E; Micheo, W; Correa, J J; Camuñas, J F

    1994-12-01

    During the XVII Central American and Caribbean Sports Games held in Ponce in 1993 the health services offered to the Puerto Rico Delegation included medical, dental and psychological assistance, physical therapy and services on the playing field. Information about the use of these services was obtained from the encounter sheets. The Puerto Rican delegation of 750 members had 1,800 encounters with the health team; 612 (34.0%) individual consults; 896 (54.8%) physical therapy sessions; 166 (9.2%) encounters in the sports venues; and 36 (20%) group therapies. The most common diagnoses were athletic injuries (304; 58.2%) and diseases of the respiratory system (76; 14.5%). The most frequent athletic injuries were first degree strains (75; 24.7%) and tendinitis (73, 24.0%). This pattern is similar to that observed in other sports games and delegations with mild conditions prevailing. An interdisciplinary work and biopsychosocial approach will be important for the better health and performance of our athletes.

  7. Effet paradoxal du type d’excision sur la prise et le délai de cicatrisation des greffes expansées pour le traitement des brûlures aiguës: a propos de 1129 cas

    PubMed Central

    Guibert, M.; Chaouat, M.; Boccara, D.; Marco, O.; Lavocat, R.; Alameri, O.; Deslandes, E.; Montlahuc, C.; Mimoun, M.

    2016-01-01

    Summary La greffe de peau mince expansée est très employée dans le traitement des brûlures aiguës. Nous avons étudié l’influence de la préparation du sous-sol sur le taux de prise et le délai de cicatrisation des greffes expansées. Nous avons analysé rétrospectivement les 1 129 greffes expansées réalisées dans notre service entre 1995 et 2005 pour le traitement des brûlures aiguës. Leur taux de prise a été significativement meilleur après une préparation du sous-sol par avulsion (82%) par rapport à une préparation du sous-sol par excision tangentielle (75%). Ce taux était meilleur lorsque l’avulsion était pratiquée dans les 7 jours suivant la brûlure (83% vs 73%). Pour une prise en charge entre 7 et 21 jours, ce taux a semblé être meilleur après excision tangentielle, mais de façon non significative. La durée d’évolution jusqu’à cicatrisation était significativement raccourcie pour une préparation du sous-sol par excision tangentielle par rapport à une préparation du sous-sol par avulsion. Ces résultats montrent, paradoxalement, qu’une préparation du sous-sol par avulsion favorise la prise des greffes expansées mais rallonge leur délai de cicatrisation au contraire de l’excision tangentielle. PMID:28149235

  8. 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.

  9. Epicormic branching on Central Appalachian hardwoods 10 years after deferment cutting. Forest Service research paper

    SciTech Connect

    Miller, G.W.

    1996-03-01

    Epicormic branching as monitored over a 10-year period following deferment cutting in four central Appalachian hardwood stands in West Virginia. Data from 545 codominant residual trees indicated that the average number of epicormic branches on the butt and second 16-food log sections increased significantly for the first 2 years after treatment. For upper log sections of basswood, northern red oak, and black cherry, significant increases continued from the second to the tenth year. The net effect on quality was that 11 percent of residual trees exhibited a reduction in butt-log grade due to epicormic branching. Of the few grade reductions observed, white oak, northern red oak, and black cherry were the most susceptible. Less than 1 percent of yellow-poplar trees had lower grades due to epicormic branching.

  10. Timber resource statistics for the central coast resource area of California. Forest Service resource bulletin

    SciTech Connect

    Waddell, K.L.; Bassett, P.M.

    1997-03-01

    This report is a summary of timber resource statistics for the Central Coast Resource Area of California, which includes Alameda, Contra Costa, Marin, Monterey, San Benito, San Francisco, San Luis Obispo, San Mateo, Santa Barbara, Santa Clara, Santa Cruz, Solano, and Ventura Counties. Data were collected as part of a state-wide multiresource inventory. The inventory sampled private and public lands except reserved areas and National Forests. The national Forest System provided data from regional inventories of the Los Padres National Forest. Area information for parks and other reserves was obtained directly from the organizations managing these areas. Statistical tables summarize all ownerships and provide estimates of land area, timber volume, growth, mortality, and harvest. Estimates of period change of timberland area and timber volume are presented for all ownerships outside National Forests.

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

    PubMed

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

    2016-06-07

    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. a retrospective and quantitative study with a sample of 188 patients transplanted records between 2007 and 2011. 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. 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. identificar o modelo, tempo médio de permanência e complicações de cateter venoso central em pacientes submetidos ao transplante de células-tronco hematopoiéticas e verificar a relação de correspondência entre as variáveis: idade, sexo, diagnóstico médico, tipo de transplante, cateter implantado e local de inserção. retrospectivo, quantitativo, com amostra de prontuários de 188 pacientes transplantados, entre 2007 e 2011. a maioria dos pacientes utilizou o cateter de Hickman com permanência média de 47,6 dias. A complicação febre/bacteremia foi significante em jovens do sexo masculino, com linfoma não Hodgkin, submetidos ao transplante autólogo, que permaneceram com o dispositivo por longo período, em veia subclávia. os enfermeiros devem planejar com a equipe o aguardo do tempo mínimo preconizado entre o implante do cateter e início do regime de condicionamento, assim como não estender o período de permanência e realizar

  12. 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

  13. [Centralization of health services in primary care in summer: Patients and professionals view during two consecutive years].

    PubMed

    Giménez, N; Martínez, J M; Clanchet, T

    2015-01-01

    The Spanish primary health care, gateway and pillar of the Health Care System has his resources increasingly constrained by current crisis. To know the opinion of users and professionals on two primary care centers which centralized in August 2011 and 2012 the attendance of seven primary care centers. Two questionnaires were designed: a telephone survey of a random sample of users and a self-completed questionnaire for health care professionals. The variables were scored on a scale of 1-10 (low to high). Cronbach's coefficient α>0,84. 1293 people responded (836 users and 357 professionals). Users rated, in 2011, the satisfaction with 6.7 points in August and 7.3 points the rest of the year (P<.001). And, in 2012, with 7.7 points in August and 8.1 points the rest of the year (P<.001). Health care professionals, rated their satisfaction with 6.8 points in 2011 and 7.3 points in 2012. The waiting time was the only variable best scores in August that the rest of the year. The perception of the solution given in consultation did not change. Satisfaction, marking, care and treatment were highest rated in the regular center than in the reference center (P<.001). The centralization of primary health care during periods of reduced demand could reduce costs while maintaining quality. The experience of centralizing primary care services during August was perceived as acceptable and improved over time. Users showed a slight, but significant, preference for their usual primary care center. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  14. 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.

  15. Caries experience and use of dental services in rural and urban adults and older adults from central Chile.

    PubMed

    Quinteros, Maria E; Cáceres, Dante D; Soto, Alex; Mariño, Rodrigo J; Giacaman, Rodrigo A

    2014-10-01

    To determine whether there is a relationship between the use of dental services and caries experience in adults and older adults from central Chile. A sample of 453 adults, 35-44 years of age, and 438 older adults, 65-74 years of age, was interviewed and examined using World Health Organisation (WHO) methods. Sociodemographic variables were also registered. Caries experience was assessed using the Decayed, Missing and Filled teeth (DMFT) index. Multiple linear regression models were used to determine whether there was an association between the independent variables and caries experience. Caries prevalence was 99.6% for adults [DMFT score = 14.89 (±6.16)] and 99.8% for older adults [DMFT score = 25.68 (±6.49)]. Less than half of the population - 41.7% of adults and 31.5% of older adults - received dental care. Regardless of the age group, there were no differences in the DMFT score between those who received and those who did not receive attention (P > 0.05). When the DMFT findings were analysed in greater detail, people who received dental care and urban participants had more fillings (P < 0.05) than did those who were not provided with attention or lived in rural areas, who, in turn, had more missing teeth (P < 0.05). A higher educational level was associated with a decrease of 1.15 DMFT points (P = 0.003) in the group of older adults. Adults and older adults from the Maule Region showed severe dental damage from caries. Although rurality and use of services do not seem to affect caries experience, they are associated with differences in fillings and missing teeth. © 2014 FDI World Dental Federation.

  16. 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

  17. 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

    ... Central Service Cost Allocation Plans V Appendix V to Part 200 Grants and Agreements Office of Management and Budget Guidance for Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET GUIDANCE Reserved... contained in the governmental unit's accounting system; a revenue/expenses statement, with revenues broken...

  18. 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

    ... 48 Federal Acquisition Regulations System 3 2013-10-01 2013-10-01 false Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in... South Asian (SC/CASA) state in support of operations in Afghanistan. ...

  19. 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

    ... 48 Federal Acquisition Regulations System 3 2011-10-01 2011-10-01 false Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in... and South Asian (SC/CASA) state in support of operations in Afghanistan. ...

  20. 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

    ... 48 Federal Acquisition Regulations System 3 2014-10-01 2014-10-01 false Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in... South Asian (SC/CASA) state in support of operations in Afghanistan. ...

  1. 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

    ... 48 Federal Acquisition Regulations System 3 2012-10-01 2012-10-01 false Acquisitions of products and services from South Caucasus/Central and South Asian (SC/CASA) state in support of operations in... and South Asian (SC/CASA) state in support of operations in Afghanistan. ...

  2. Burnout and Associated Factors among Administrators/Mid-Managers of the Cooperative Extension Service in the North Central Region. Summary of Research 46.

    ERIC Educational Resources Information Center

    Clark, Richard Warner; Smith, Keith L.

    A study was conducted to (1) determine the level of burnout, job satisfaction, personal strain, occupational stress, and personal coping resources of associate directors, assistant directors, and district supervisors of the Cooperative Extension Service in the North Central Region; (2) determine the extent of association between burnout and…

  3. Utilization of institutional delivery service at Wukro and Butajera districts in the Northern and South Central Ethiopia

    PubMed Central

    2014-01-01

    Background Ethiopia has one of the highest maternal mortality in the world. Institutional delivery is the key intervention in reducing maternal mortality and complications. However, the uptake of the service has remained low and the factors which contribute to this low uptake appear to vary widely. Our study aims to determine the magnitude and identify factors affecting delivery at health institution in two districts in Ethiopia. Methods A community based cross sectional household survey was conducted from January to February 2012 in 12 randomly selected villages of Wukro and Butajera districts in the northern and south central parts of Ethiopia, respectively. Data were collected using a pretested questionnaire from 4949 women who delivered in the two years preceding the survey. Results One in four women delivered the index child at a health facility. Among women who delivered at health facility, 16.1% deliveries were in government hospitals and 7.8% were in health centers. The factors that significantly affected institutional delivery in this study were district in which the women lived (AOR: 2.21, 95% CI: 1.28, 3.82), women age at interview (AOR: 1.96, 95% CI: 1.05, 3.62), women’s education (AOR: 3.53, 95% CI: 1.22, 10.20), wealth status (AOR: 16.82, 95% CI: 7.96, 35.54), women’s occupation (AOR: 1.50, 95% CI: 1.01, 2.24), antenatal care (4+) use (AOR: 1.77, 95% CI: 1.42, 2.20), and number of pregnancies (AOR: 0.25, 95% CI: 0.18,0.35). We found that women who were autonomous in decision making about place of delivery were less likely to deliver in health facility (AOR: 0.38, 95% CI: 0.23,0.63). Conclusions Institutional delivery is still low in the Ethiopia. The most important factors that determine use of institutional delivery appear to be women education and household economic status. Women’s autonomy in decision making on place of delivery did not improve health facility delivery in our study population. Actions targeting the disadvantaged, improving

  4. 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

  5. [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.

  6. [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.

  7. Real-time Data Streams from ``e-RemoteCtrl'' to Central VLBI Network Status Monitoring Services Like IVS Live

    NASA Astrophysics Data System (ADS)

    Neidhardt, Alexander; Collioud, Arnaud

    2014-12-01

    A central VLBI network status monitoring can be realized by using online status information about current VLBI sessions, real-time, and status data directly from each radio telescope. Such monitoring helps to organize sessions or to get immediate feedback from the active telescopes. Therefore the remote control software for VLBI radio telescopes ``e-RemoteCtrl'' (http://www.econtrol-software.de), which enables remote access as extension to the NASA Field System, realizes real-time data streams to dedicated data centers. The software has direct access to the status information about the current observation (e.g., schedule, scan, source) and the telescope (e.g., current state, temperature, pressure) in real-time. This information are directly sent to ``IVS Live''. ``IVS Live'' (http://ivslive.obs.u-bordeaux1.fr/) is a Web tool that can be used to follow the observing sessions, organized by the International VLBI Service for Geodesy and Astrometry (IVS), navigate through past or upcoming sessions, or search and display specific information about sessions, sources (like VLBI images), and stations, by using an Internet browser.

  8. Factors associated with four or more antenatal care services among pregnant women: a cross-sectional survey in eight South Central Coast provinces of Vietnam.

    PubMed

    Ha, Bui Tt; Tac, Pham V; Duc, Duong M; Duong, Doan Tt; Thi, Le M

    2015-01-01

    In Vietnam, four or more antenatal care (ANC4+) visits/services among pregnant women have not been officially reported in the health system. Moreover, the factors associated with the use of ANC4+ services have not been studied in previous studies. In this study, we conducted an exploratory analysis to identify the rate of utilization of ANC4+ services and factors associated with use of ANC4+ services among pregnant women in rural areas of Vietnam. The study was conducted in eight provinces in the South Central Coast region of Vietnam between August 2013 and May 2014. A total of 907 women, who delivered in the past 1 year, participated in the study. Multivariate logistic regression model was used to examine the association between all potential factors and utilization of ANC4+ services. The rate of utilization of ANC4+ services by women in eight South Central Coast provinces was 53.9%. Factors negatively associated with using ANC4+ services were belonging to ethnic minority groups having lower education, doing informal works, having lower income, having lower knowledge on ANC4+ services, and receiving no financial support from the husband. In particular, financial support from the husband was considered important in improving the use of ANC4+ services by women in rural areas. The study asserted an inadequacy for ANC4+ utilization and can contribute to missed opportunities to achieve better maternal outcomes for women in rural areas of Vietnam. The necessity of introducing ANC4+ services in the national guidelines on maternal health care should be disseminated to health policy-makers. Strategies to increase ANC4+ utilization should focus on knowledge improvement and on poor, low-income, and ethnic minority women.

  9. 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

  10. Difficulté de la prise en charge de la Leucémie aiguë au cours de la grossesse au Maroc

    PubMed Central

    Tissir, Rajaa; Lamchahab, Mouna; Benhassou, Mustapha; Quachouh, Meryeme; Rachid, Mohammed; Benchakroun, Said; Quessar, Asmaa

    2012-01-01

    L'association de la leucémie aiguë (LA) et grossesse est rare. Son incidence est estimée à 1/100 000 grossesses. Dans les 2/3 des cas ce sont des leucémies aiguës myéloblastiques. Le diagnostic est généralement fait pendant le 2ème et le 3ème trimestre. Elle pose un problème éthique et thérapeutique car La chimiothérapie au cours de la grossesse expose le fœtus aux complications. Tout retard ou changement de traitement pour sauvetage fœtal risque d'aggraver le pronostic maternel. L'objectif de ce travail est de décrire les particularités de la prise en charge de la leucémie aiguë chez la femme enceinte. Etude prospective descriptive des femmes enceintes atteintes de leucémie aiguë colligées au service d'hématologie et d'oncologie pédiatrique à l'hôpital 20 Août du CHU IBN ROCHD de Casablanca depuis janvier 2009 à Août 2011. Le diagnostic de LA est fait selon les critères de l'OMS. Le traitement était instauré après consentement des patientes selon le type de LA. Huit cas de leucémies aiguës au cours de la grossesse sont colligés au service d'hématologie et d'oncologie pédiatrique à l'hôpital 20 Août du CHU IBN ROCHD de Casablanca. Sept leucémies aiguës myéloblastiques et une leucémie aiguë lymphoblastique. Quatre cas ont été diagnostiqués durant le 1er trimestre de la grossesse, Un cas pendant le 2ème trimestre et 3 cas pendant le 3ème trimestre. L'accouchement est par césarienne programmée dans 2 cas et par voie basse dans 3 cas dont un est prématuré, 2 fausses couches et une mort fœtal après décès maternel. Trois patientes ont reçue la chimiothérapie durant la grossesse après consentement éclairé et les 5 autres après l'accouchement. Les 5 nouveau-nés sont bien portants avec un bilan malformatif négatif. L'association de la leucémie aiguë et grossesse est un évènement rare. Elle nécessite une prise en charge multidisciplinaire tenant compte des impératifs de la maladie et de son traitement

  11. 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

  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. Linking hydropedology and ecosystem services: differential controls of surface field saturated hydraulic conductivity in a volcanic setting in central Mexico

    NASA Astrophysics Data System (ADS)

    Gómez-Tagle, A.

    2009-03-01

    In this study the variation of field saturated soil hydraulic conductivity (Kfs) as key control variable and descriptor of infiltration was examined by means of a constant head single ring infiltrometer. The study took place in five coverage types and land uses in a volcanic setting in central Mexico. The tested hypothesis was that there exist a positive relationship between plant cover and surface Kfs for the study area. The examined coverage types included; Second growth pine-oak forest, pasture land, fallow land, gully and Cupresus afforestation. Results indicate that Kfs did not depend exclusively of plant cover; it was related to surface horizontal expression of the unburied soil horizons and linked to land use history. Therefore the Kfs measured at a certain location did not depend exclusively of the actual land use, it was also influenced by soil bioturbation linked to plant succession patterns and land use management practices history. The hypothesis accounts partially the variation between sites. Kfs under dense plant cover at the Cupresus afforestation was statistically equal to that measured at the fallow land or the gully sites, while second growth pine-oak forest Kfs figures were over an order of magnitude higher than the rest of the coverage types. The results suggest the relevance of unburied soil horizons in the soil hydrologic response when present at the surface. Under these conditions loosing surface soil horizons due to erosion, not only fertility is lost, but environmental services generation potential. A conceptual model within the hydropedological approach is proposed. It explains the possible controls of Kfs, for this volcanic setting. Land use history driven erosion plays a decisive role in subsurface horizon presence at the surface and soil matrix characteristic determination, while plant succession patterns seem to be strongly linked to soil bioturbation and preferential flow channel formation.

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. 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. Copyright © 2014 the American Physiological Society.

  1. 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.

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

    PubMed

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

    2015-01-01

    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. 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. 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. 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 entitlements and that the duty bearers were not

  3. 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

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

    PubMed

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

    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 entitlements

  5. N° 341-Diagnostic et prise en charge de la torsion annexielle chez les filles, les adolescentes et les femmes adultes.

    PubMed

    Kives, Sari; Gascon, Suzy; Dubuc, Élise; Van Eyk, Nancy

    2017-02-01

    Passer en revue les connaissances scientifiques actuelles et formuler des recommandations relatives au diagnostic et à la prise en charge de la torsion annexielle chez les filles, les adolescentes et les femmes adultes. L'étude porte sur les facteurs de risque, la précision diagnostique, les options de prise en charge et les issues de la torsion annexielle. RéSULTATS: Nous avons examiné les études publiées en faisant des recherches dans MEDLINE, Embase, CINAHL et la Bibliothèque Cochrane à l'aide d'une terminologie contrôlée et de mots-clés appropriés (« adnexal torsion », « ovarian torsion »). Nous avons limité les résultats aux revues systématiques, aux essais contrôlés aléatoires, aux essais cliniques contrôlés et aux études d'observation. Nous avons refait les recherches de façon régulière et intégré de nouvelles données à la directive jusqu'en décembre 2014. Nous avons également étudié la littérature grise (non publiée) trouvée sur les sites Web d'organismes d'évaluation des technologies de la santé et d'autres organismes connexes, dans des collections de directives cliniques et dans des registres d'essais cliniques, et obtenue auprès d'associations nationales et internationales de médecins spécialistes. Les résultats ont été examinés et évalués par le comité CANPAGO de la Société des obstétriciens et gynécologues du Canada (SOGC), sous la direction des auteures principales. Les recommandations ont été classées selon les critères établis par le Groupe d'étude canadien sur les soins de santé préventifs. AVANTAGES, DéSAVANTAGES ET COûTS: L'application de la directive devrait aider les praticiens à adopter une approche de diagnostic et de prise en charge optimale en matière de torsion annexielle, à réduire au minimum les effets néfastes et à améliorer l'issue qui attend les patientes. La présente directive a été évaluée et approuvée par le Comité de pratique - gynécologie de la SOGC

  6. 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.

  7. Place de la chirurgie dans la prise en charge des cancers du sein chez la femme au Centre Hospitalier Universitaire Yalgado Ouedraogo: à propos de 81 cas

    PubMed Central

    Zongo, Nayi; Millogo-Traore, Timonga Françoise Danielle; Bagre, Sidpawalmdé Carine; Bagué, Abdoul-Halim; Ouangre, Edgar; Zida, Maurice; Bambara, Aboubacar; Bambara, Tozoula Augustin; Traoré, Si Simon

    2015-01-01

    Etudier la place de la chirurgie dans la prise en charge des cancers du sein au centre hospitalier universitaire Yalgado Ouédraogo. Nous avons réalisé une étude prospective et descriptive sur dix (10) mois portant sur la place de la chirurgie dans le cancer du sein. Elle a eu pour cadre les services de gynécologie-obstétrique et de chirurgie viscérale et digestive du centre hospitalier universitaire Yalgado Ouédraogo. Ont été pris en compte les indications, les gestes et les résultats de la chirurgie. Nous avons colligé 81 cancers mammaires. Le délai moyen de consultation a été de 14,26 mois. Les tumeurs T3 à T4 représentaient 82,71% des cas. Trente-huit patientes (46,91%) ont été opérées. La chimiothérapie néo adjuvante a été réalisée dans 29,63% des cas. Trente-quatre patientes (41,97%) étaient opérables d'emblée. Il s'agissait de mastectomie selon Madden dans 94,74% des cas et de chirurgie de propreté dans 2 cas (5,26% des cas). Une chimiothérapie adjuvante a été réalisée chez 52,63% des patientes opérées. Des complications à type de lymphocèle ont été notées dans 23,68% des cas. Leur traitement a consisté en des ponctions évacuatrices. Les indications de la chirurgie sont limitées par le retard diagnostique corollaire de stades avancés des cancers du sein. L'absence de la radiothérapie rend délicate la pratique de la chirurgie conservatrice et la mastectomie occupe toujours une place importante. Un diagnostic précoce permettrait d'augmenter les indications chirurgicales. PMID:26848364

  8. Les fractures luxations du cotyle: prise en charge et pronostic à long terme; étude rétrospective portant sur 40 cas

    PubMed Central

    Chagou, Aniss; Hmouri, Ismail; Rhanim, Abdelkarim; Lahlou, Abdou; Berrada, Mohammed Saleh; Yaacoubi, Moradh

    2014-01-01

    Les fractures luxations du cotyle sont le plus souvent dues à des traumatismes de haute énergie. Elles constituent une urgence thérapeutique, l'association de la luxation à une fracture du cotyle fait apparaître la question du choix thérapeutique entre traitement orthopédique et traitement médical. L'objectif de l’étude est de mettre le point sur l'aspect thérapeutique dans ces lésions mais aussi leurs pronostics à long terme. Nous rapportons une étude rétrospective portant sur 40 cas colligés au service d'orthopédie du centre hospitalier universitaire de Rabat. Nous avons évalué les résultats de notre prise en charge mais aussi le pronostic à court et à long terme. Dans notre série, vingt cinq patients ont bénéficié d'un traitement orthopédique alors que les quinze restants ont été opérés, la voie d'abord la plus utilisée est la voie postérieure. Les résultats fonctionnels ont été évalués, après un recul de 3 à 8 ans, selon la cotation de Merle d'Aubigné. Nous avons obtenu 90% de résultats satisfaisants. La comparaison de nos résultats à ceux de la littérature montre que le résultat des traitements orthopédiques et chirurgicaux dépend essentiellement du type de fracture. Le pronostic à long terme reste imprévisible. La survenue des complications tardives telle que la nécrose céphalique et de l'arthrose reste toujours imprévisible, ce qui impose un suivi régulier et prolongé des patients. PMID:25722763

  9. Research publications of the pringle falls experimental forest, central Oregon cascade range, 1930 to 1993. Forest Service general technical report

    SciTech Connect

    Youngblood, A.

    1995-05-01

    An annotated bibliography of publications resulting from research at the Pringle Falls Experimental Forest, Deschutes National Forest, in central Oregon from 1930 to 1993 is presented. Over 100 publications are listed, including papers, theses, and reports. An index is provided that cross-references the listings under appropriate keywords.

  10. National Bibliographies and the International Conference on National Bibliographic Services Recommendations: Europe; North, Central and South America; and Oceania.

    ERIC Educational Resources Information Center

    Langballe, Anne M. Hasund

    This paper discusses the findings of a survey that examined the national bibliographies of 81 countries in Europe, North America, Central America, South America, and Oceania. Results are presented in the following areas: (1) the connection between legal deposit laws and national bibliographies; (2) coverage and scripts of the national…

  11. 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...

  12. 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 ...

  13. 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...

  14. 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 ...

  15. [Effects of Three Gorges Reservoir impoundment on the wetland ecosystem service value of Dongting Lake, South-central China].

    PubMed

    Li, Jing-Bao; Dai, Yong; Yin, Ri-Xin; Yang, Yan; Li, Yu-dan; Wang, Ke-ying

    2013-03-01

    Based on the field investigation and measurement, and by using the monetary method, this paper estimated the wetland ecosystem service value of Dongting Lake before and after the impoundment of Three Gorges Reservoir (in 1996 and 2010, respectively). After the impoundment, the total ecosystem service value increased from 156.69x10(8) yuan in 1996 to 177.11x10(8) yuan in 2010. The main services value in 1996 was in the order of flood storage and regulation > water storage and supply > air regulation > scientific research and education, while that in 2010 was leisure tourism > shipping transportation > air regulation > water storage and supply. In the total service value of the wetland ecosystem, the direct value associated with water decreased from 110. 85x10(8) in 1996 to 27.47x10(8) in 2010, with a decrement of 75.2%. Though the proportion of the direct value in the production and supply of material products had somewhat increase, the indirect value in ecological environment regulation and maintenance and in culture and society still maintained at about 80% of the total value. In addition to climate factors, the impoundment of Three Gorges Reservoir and the reduction of water and sediment from Yangtze River to the Lake were the crucial reasons leading to the changes of the wetland ecosystem service value of Dongting Lake.

  16. 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

  17. 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

  18. 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).

  19. Optimizing PMTCT Service Delivery in Rural North Central Nigeria: Protocol and Design for a Cluster Randomized Study

    PubMed Central

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

    2013-01-01

    More HIV-infected women in need of services for the prevention of mother-to-child transmission of HIV (PMTCT) give birth in Nigeria than in 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 services for PMTCT. A systematic reassignment 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 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 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 live long, healthy lives (Trial registration: NCT01805752). PMID:23816493

  20. The use of a policy dialogue to facilitate evidence-informed policy development for improved access to care: the case of the Winnipeg Central Intake Service (WCIS).

    PubMed

    Damani, Zaheed; MacKean, Gail; Bohm, Eric; DeMone, Brie; Wright, Brock; Noseworthy, Tom; Holroyd-Leduc, Jayna; Marshall, Deborah A

    2016-10-18

    Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba. Using guiding principles of public participation processes, we hosted a policy roundtable meeting to engage stakeholders and use their input to refine the policy directions. Here, we report on the use and input of a policy roundtable meeting and its role in contributing to the development of evidence-informed policy. Our evidence-informed policy directions focused on formal measurement/monitoring of quality, central intake as a preferred model for service delivery, provincial scope, transparent processes/performance indicators, and patient choice of provider. We held a policy roundtable meeting and used outcomes of facilitated discussions to refine these directions. Individuals from our team and six stakeholder groups across Manitoba participated (n = 44), including patients, family physicians, orthopaedic surgeons, surgical office assistants, Winnipeg Central Intake team, and administrators/managers. We developed evaluation forms to assess the meeting process, and collected decision-maker partners' perspectives on the value of the policy roundtable meeting and use of policy directions to improve access to scheduled clinical services after the meeting, and again 15 months later. We analyzed roundtable and evaluation data using thematic analysis to identify key themes. Four key findings emerged. First, participants supported all policy directions, with revisions and key implementation considerations identified. Second, participants felt the policy roundtable

  1. 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

    ... functions. 366.23 Section 366.23 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE PUBLIC UTILITY HOLDING COMPANY ACT OF 2005, FEDERAL... or narrative description. (b) Transition period. Service companies in holding company...

  2. 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…

  3. 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.

  4. Effects of Centralizing Acute Stroke Services on Stroke Care Provision in Two Large Metropolitan Areas in England

    PubMed Central

    Morris, Stephen; Hoffman, Alex; Hunter, Rachael M.; Boaden, Ruth; McKevitt, Christopher; Perry, Catherine; Pursani, Nanik; Rudd, Anthony G.; Turner, Simon J.; Tyrrell, Pippa J.; Wolfe, Charles D.A.; Fulop, Naomi J.

    2015-01-01

    Background and Purpose— In 2010, Greater Manchester and London centralized acute stroke care into hyperacute units (Greater Manchester=3, London=8), with additional units providing ongoing specialist stroke care nearer patients’ homes. Greater Manchester patients presenting within 4 hours of symptom onset were eligible for hyperacute unit admission; all London patients were eligible. Research indicates that postcentralization, only London’s stroke mortality fell significantly more than elsewhere in England. This article attempts to explain this difference by analyzing how centralization affects provision of evidence-based clinical interventions. Methods— Controlled before and after analysis was conducted, using national audit data covering Greater Manchester, London, and a noncentralized urban comparator (38 623 adult stroke patients, April 2008 to December 2012). Likelihood of receiving all interventions measured reliably in pre- and postcentralization audits (brain scan; stroke unit admission; receiving antiplatelet; physiotherapist, nutrition, and swallow assessments) was calculated, adjusting for age, sex, stroke-type, consciousness, and whether stroke occurred in-hospital. Results— Postcentralization, likelihood of receiving interventions increased in all areas. London patients were overall significantly more likely to receive interventions, for example, brain scan within 3 hours: Greater Manchester=65.2% (95% confidence interval=64.3–66.2); London=72.1% (71.4–72.8); comparator=55.5% (54.8–56.3). Hyperacute units were significantly more likely to provide interventions, but fewer Greater Manchester patients were admitted to these (Greater Manchester=39%; London=93%). Differences resulted from contrasting hyperacute unit referral criteria and how reliably they were followed. Conclusions— Centralized systems admitting all stroke patients to hyperacute units, as in London, are significantly more likely to provide evidence-based clinical

  5. 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.

  6. 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)

  7. 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

  8. Perception des médecins résidents de la prise en charge et de la valorisation de la médecine familiale

    PubMed Central

    B-Lajoie, Marie-Renée; Carrier, Johanne

    2012-01-01

    Résumé Objectif Cette recherche visait à documenter la perception de la prise en charge chez les médecins résidents en médecine familiale. Type d’étude Un questionnaire électronique quantitatif bilingue de 10 questions. Contexte Québec. Participants Tous les résidents en médecine familiale au Québec, soit 747 résidents. Principaux paramètres de l’étude Le questionnaire visait à préciser les intentions des médecins résidents quant à leur perception de la prise en charge et son inclusion dans leur pratique, et les moyens qu’ils privilégieraient pour valoriser cet aspect de la pratique. Résultats Au total, 289 médecins résidents ont rempli le questionnaire (38,7 %). De ce nombre, 201 répondants ont indiqué qu’ils anticipaient faire de la prise en charge dans leurs 5 premières années de pratique. Les facteurs inhibitifs les plus soulignés dans la section commentaires sont la difficulté à quitter la pratique, la complexité des cas et les responsabilités face au suivi du patient. Les plans régionaux d’effectifs médicaux et les activités médicales particulières ne sont pas ressortis de manière significative comme facteurs inhibitifs. Selon les répondants, la valorisation de la médecine familiale devrait passer par la promotion auprès des étudiants en médecine, par une modification de la culture institutionnelle et par une augmentation de la visibilité des médecins résidents et des patrons en médecine familiale au sein des équipes dans les milieux de formation. Conclusion Cette étude permet de conclure que les médecins résidents québécois prévoient inclure la prise en charge dans leur pratique. Toutefois, des solutions tangibles doivent être établies pour mitiger le poids de la pratique en cabinet et continuer à promouvoir la prise en charge auprès des jeunes médecins de famille.

  9. 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.

  10. The impact of the increasing burden of trauma in Malawi on orthopedic trauma service priorities at Kamuzu Central Hospital

    PubMed Central

    Young, Sven; Banza, Leonard; Munthali, Boston S; Manda, Kumbukani G; Gallaher, Jared; Charles, Anthony

    2016-01-01

    Background and purpose — The burden of road traffic injuries globally is rising rapidly, and has a huge effect on health systems and development in low- and middle-income countries. Malawi is a small low-income country in southeastern Africa with a population of 16.7 million and a gross national income per capita of only 250 USD. The impact of the rising burden of trauma is very apparent to healthcare workers on the ground, but there are very few data showing this development. Patients and methods — The annual number of femoral fracture patients admitted to Kamuzu Central Hospital (KCH) in the Capital of Malawi, Lilongwe, from 2009 to 2014 was retrieved from the KCH trauma database. Linear regression curve estimation was used to project the growth in the burden of femoral fractures and the number of operations performed for femoral fractures over the same time period. Results — 992 patients with femoral fractures (26% of all admissions for fractures) presented at KCH from 2009 through 2014. In this period, there was a 132% increase in the annual number of femoral fractures admitted to KCH. In the same time period, the total number of operations more than doubled, but there was no increase in the number of operations performed for femoral fractures. Overall, there was a 7% mortality rate for patients with femoral fractures. Interpretation — The burden of femoral fractures in Malawi is rising rapidly, and the surgical resources available cannot keep up with this development. Limited funds for orthopedic trauma care in Malawi should be invested in central training hospitals, to develop a sustainable number of orthopedic surgeons and improve current infrastructure and equipment. The centralization of orthopedic surgical care delivery at the central training hospitals will lead to better access to surgical care and early return of patients to local district hospitals for rehabilitation, thus increasing surgical throughput and efficiency in a more cost

  11. 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.

  12. 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.

  13. An overview of cancer survival in Africa, Asia, the Caribbean and Central America: the case for investment in cancer health services.

    PubMed

    Sankaranarayanan, R; Swaminathan, R; Jayant, K; Brenner, H

    2011-01-01

    Population-based cancer survival data, a key indicator for monitoring progress against cancer, are reported from 27 population-based cancer registries in 14 countries in Africa, Asia, the Caribbean and Central America. In China, Singapore, the Republic of Korea, and Turkey, the 5-year age-standardized relative survival ranged from 76-82% for breast, 63-79% for cervical, 71-78% for bladder, and 44-60% for large-bowel cancer. Survival did not exceed 22% for any cancer site in The Gambia, or 13% for any cancer site except breast (46%) in Uganda. For localized cancers of the breast, large bowel, larynx, ovary, urinary bladder and for regional diseases at all sites, higher survival rates were observed in countries with more rather than less developed health services. Inter- and intra-country variations in survival imply that the levels of development of health services and their efficiency to provide early diagnosis, treatment and clinical follow-up care have a profound impact on survival from cancer. These are reliable baseline summary estimates to evaluate improvements in cancer control and emphasise the need for urgent investment to improve awareness, population-based cancer registration, early detection programmes, health-services infrastructure, and human resources in these countries in the future.

  14. KENNEDY SPACE CENTER, FLA. - NASA Administrator Sean O’Keefe (center) is welcomed to the Central Florida Research Park, near Orlando. Central Florida leaders are proposing the research park as the site for the new NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - NASA Administrator Sean O’Keefe (center) is welcomed to the Central Florida Research Park, near Orlando. Central Florida leaders are proposing the research park as the site for the new NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

  15. Assessment of health services for people who use drugs in Central Asia: findings of a quantitative survey in Kazakhstan and Kyrgyzstan.

    PubMed

    Rosenkranz, Moritz; Kerimi, Nina; Takenova, Madina; Impinen, Antti; Mamyrov, Mirlan; Degkwitz, Peter; Zurhold, Heike; Martens, Marcus-Sebastian

    2016-01-27

    In Central Asia, there is a need to update information about the situation of people who use (opioid) drugs (PWUD), especially regarding their access to and utilization of health care services. The aim of the study was to gather information about two different groups of drug users in Kazakhstan and Kyrgyzstan. In 2013, two groups of PWUD were recruited in Kazakhstan and in Kyrgyzstan in order to gather quantitative data via interviewer-administered questionnaires. PWUD registered with the Narcological Register were allocated to group A while non-registered PWUD were allocated to group B. Interviews were conducted in the office of the Narcological Register as well as in low-threshold facilities. Participants reported about their drug use patterns, health status, and utilization of health services as well as barriers to utilization. The sample consisted of N = 600 PWUD (301 registered and 299 non-registered PWUD) from Kazakhstan and N = 900 PWUD (450 registered and 450 non-registered PWUD) from Kyrgyzstan. Both groups-registered (group A) and non-registered (group B)-consisted of mainly male long-term intravenous opioid users. We found high rates of current (last 30 days) opioid use (group A up to 70%; group B up to 84%). Most PWUD were burdened with poor physical and mental health. The prevalence of infectious diseases added up to 19% (group A) or 13% (group B) regarding HIV, 56% (group A) or 30% (group B) regarding HCV, and 24% (group A) or 20% (group B) regarding tuberculosis. Registered and non-registered PWUD reported high rates (95 or 82%) of lifetime use of health services for PWUD. Drug-related services were utilized less often, especially among the non-registered PWUD (13%). The most important barriers preventing PWUD from accessing services were the belief not to need treatment, doubts about the effectiveness of treatment, mistrust of treatment regime/staff, and fear of being registered with the Narcological Register (mainly group B). Results show

  16. Self-efficacy in providing smoking-cessation services among psychiatric nurses in central and southern Taiwan: an exploratory study.

    PubMed

    Guo, Su-Er; Wang, Ai-Ling; Shu, Bih-Ching

    2015-04-01

    Smoking by psychiatric patients remains prevalent. The purpose of this cross-sectional study was to understand the influence of self-efficacy and its correlates among psychiatric nurses when providing smoking-cessation services (SCS). A convenience sample of 193 nurses from psychiatric institutions was obtained. Surveys were conducted using self-report measures regarding SCS provided by psychiatric nurses. The survey questions focused on self-efficacy, attitude, practical experience, and smoke-free policies, and their implementation in the workplace. The participants reported low self-efficacy for providing SCS in their self-assessment, as demonstrated by their scores of 55.3 ± 20.4, on a scale of 0 (low confidence) to 100 (high confidence). Using multiple linear regressions, statistically-significant, relevant factors included perceived provider-related barriers in providing SCS, environmental tobacco smoke exposure, the nurse's attitude towards a patient smoking, and the nurse's frequency and practical experience in providing SCS. The correlates of this self-efficacy can serve as a reference for in-service curriculum planning of SCS by psychiatric nurses. In addition, policies to limit exposure to second-hand tobacco smoke should be explored. © 2015 Australian College of Mental Health Nurses Inc.

  17. Demand for long acting and permanent contraceptive methods and associated factors among family planning service users, Batu town, Central Ethiopia.

    PubMed

    Haile, Anley; Fantahun, Mesganaw

    2012-01-01

    Evidence suggests a high unsatisfied demand for long acting and permanent contraceptive methods in sub-Saharan Africa. However, there is limited knowledge on demand for long acting and permanent contraceptive methods and associated factors in Ethiopia. The objective of this study was to assess demand for long acting and permanent contraceptive methods and associated factors among women of age group 18-49 years in Batu town, East Shoa Zone, Ethiopia. A facility based cross-sectional survey was conducted in six service delivery points from March to April 2009 on 398 women of age 18-49 years old. Thirteen (3%) were using long acting and permanent contraceptive methods and 89 (22.4%) wanted no more child in the future making the total demand of long acting and permanent contraceptive methods 24.4%. Older age group, multiparty, that the provider asked about reproductive intention, and the provider explained side effects of method selected were significantly associated with using LA and MPs (P < 0.05). There is high total demand and several socio demographic and family planning service quality related factors were associated with demand for long acting and permanent contraceptive methods indicating that multi-dimensional measures are needed to improve the use of long acting and permanent contraceptive methods.

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. Effect of an innovative community based health program on maternal health service utilization in north and south central Ethiopia: a community based cross sectional study

    PubMed Central

    2014-01-01

    Background Among Millennium Development Goals, achieving the fifth goal (MDG-5) of reducing maternal mortality poses the greatest challenge in Sub-Saharan Africa. Ethiopia has one of the highest maternal mortality ratios in the world with unacceptably low maternal health service utilization. The Government of Ethiopia introduced an innovative community-based intervention as a national strategy under the Health Sector Development Program. This new approach, known as the Health Extension Program, aims to improve access to and equity in essential health services through community based Health Extension Workers. Objective The objective of the study is to assess the role of Health Extension Workers in improving women’s utilization of antenatal care, delivery at health facility and postnatal care services. Methods A cross sectional household survey was conducted in early 2012 in two districts of northern and south central parts of Ethiopia. Data were collected from 4949 women who had delivered in the two years preceding the survey. Logistic regression analysis was performed to determine the association between visit by Health Extension Workers during pregnancy and use of maternal health services, controlling for the effect of other confounding factors. Results The non–adjusted analysis showed that antenatal care attendance at least four times during pregnancy was significantly associated with visit by Health Extension Workers [Odds Ratio 3.46(95% CI 3.07,3.91)], whereas health facility delivery (skilled attendance at birth) was not significantly associated with visit by Health Extension Workers during pregnancy [Odds Ratio 0.87(95% CI 0.25,2.96)]. When adjusted for other factors the association of HEWs visit during pregnancy was weaker for antenatal care attendance [Adjusted Odds Ratio: 1.35(95% CI: 1.05, 1.72)] but positively and significantly associated with health facility delivery [Adjusted Odds Ratio 1.96(1.25,3.06)]. Conclusion In general HEWs visit during

  4. Profil épidémiologique et prise en charge de l’éclampsie au Sénégal: à propos de 62 cas

    PubMed Central

    Diouf, Abdoul Aziz; Diallo, Moussa; Mbaye, Magatte; Sarr, Sokhna Diarra; Faye-Diémé, Marie Edouard; Moreau, Jean Charles; Diouf, Alassane

    2013-01-01

    Introduction L'objectif de cette étude etait d'apprécier les caractéristiques épidémiologiques et cliniques de l’éclampsie et d’évaluer la prise en charge et le pronostic maternel et périnatal. Méthodes Étude descriptive rétrospective sur 3 années (2007-2010) dans un service de Gynécologie Obstétrique de Dakar (Sénégal). Le critère d'inclusion était toute crise convulsive en période gravido-puerpérale dans un contexte de prééclampsie. Résultats Sur un total de 4587 accouchements, 62 cas d’éclampsie étaient enregistrés représentant une incidence de 1,35%. Le profil retrouvé était celui d'une jeune femme (24 ans), primipare (58.1%), habitant la banlieue dakaroise (83.8%), porteuse d'une grossesse à terme (56.5%), mal suivie (82.3%) et référée par un poste de santé environnant (82.3%). La crise était survenue en antépartum et en post-partum dans 72.5 et 27,5% respectivement. Toutes les patientes présentaient une HTA ; l’‘dème et la protéinurie étaient retrouvés dans 72.5 et 84% respectivement. La majorité des patientes (88%) avait présenté plus de deux crises et l’état de mal éclamptique concernait 14.5% des cas. Le sulfate de magnésium était utilisé chez toutes les patientes. La césarienne était le mode d'accouchement largement adopté (75.5%) pour les patientes reçues en antépartum. Le pronostic maternel était marqué par un cas de décès. La mortalité périnatale était de 130%. Conclusion L’éclampsie est un problème de santé publique dans les pays en développement. Les principaux facteurs de risque sont la primiparité et l’âge jeûne. L'administration du sulfate de magnésium et la césarienne permettent d'améliorer le pronostic maternel et foetal. La prévention passe nécessairement par un suivi prénatal de qualité. PMID:24711873

  5. 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

  6. La place de la double arthrodèse dans la prise en charge du pied bot varus équin invétéré

    PubMed Central

    Atarraf, Karima; Arroud, Mounir; Chater, Lamiae; Afifi, My Abderrahmane

    2014-01-01

    La prise en charge du pied bot varus équin invétéré ( PBVEI) pose d’énormes problèmes thérapeutiques. La double arthrodèse sous-talienne et médio-tarsienne longtemps considérée comme la solution de sécurité pour ces déformations est encore couramment utilisée. Nous rapportons une série de 13 enfants opérés pour un pied bot varus équin invétérés (16 pieds) par Arthrodèse sous-talienne et médio tarsienne réalisée au service d'orthopédie pédiatrique du CHU Hassan II; de Fès au Maroc sur une période de 4 ans; étalée de janvier 2009 à décembre 2012. L’âge moyen de nos patients était de 12,6 ans avec prédominance féminine. L'origine congénitale était retrouvée chez 10 patients. L'atteinte était gauche chez 8 patients avec une localisation bilatérale chez 3 patients. La radiographie standard du pied de face et de profil a révélée une divergence talo-calcanéenne qui variait entre 5 et 20°, l'angle talus-1er métatarsien entre 20 et 40° (avec une moyenne de 28°) et l'angle calcanéus-5ème métatarsien entre 15° et 45° (avec une moyenne de 30°). Tous les patients ont bénéficiés d'une arthrodèse sous-talienne et médio tarsienne. Les résultats étaient satisfaisants dans 98% des cas. Le pied était plantigrade dans 9 cas, le varus de l'arrière pied persistait dans 4 pieds alors que l’équin et le varus de l'avant pied étaient notés chez 2 cas. La double arthrodèse est l'intervention idéale pour stabiliser et corriger les déformations rencontrées dans le PBVE invétéré, elle assure totalement le verrouillage du couple de torsion. Elle permet outre une correction des diverses déformations et une ré-axation de l'arrière-pied dans les 3 plans de l'espace. PMID:25829977

  7. 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

  8. KENNEDY SPACE CENTER, FLA. - KSC Director Jim Kennedy (center) makes a presentation to NASA and other officials about the benefits of locating NASA’s new Shared Services Center in the Central Florida Research Park, near Orlando. Central Florida leaders are proposing the research park as the site for the NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - KSC Director Jim Kennedy (center) makes a presentation to NASA and other officials about the benefits of locating NASA’s new Shared Services Center in the Central Florida Research Park, near Orlando. Central Florida leaders are proposing the research park as the site for the NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

  9. [L'effet et l'influence de l'espoir et de la surmédiatisation sur la prise de décision en matière de technologies de la santé].

    PubMed

    Simpson, Christy

    2015-09-01

    La prise de décision en matière de technologies de la santé est complexe. L'effet potentiel de l'espoir et de la surmédiatisation est peu exploré. Le présent article traite de la commercialisation de l'espoir et de l'influence de sa surmédiatisation sur la prise de décision. Puisque les leaders en santé jouent un rôle essentiel dans la prise de ce type de décisions, l'auteure traite également des possibilités et des suggestions liées à la structure des processus de décision afin de jeter un regard critique sur la « surmédiatisation de l'espoir ».

  10. 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

  11. Prise maternelle d’anti-inflammatoires non stéroïdiens et fermeture du canal artériel

    PubMed Central

    Ndour, Daouda Diamane

    2016-01-01

    Nous rapportons un cas de fermeture prématurée in utero du canal artériel diagnostiqué chez un fœtus en état d’anasarque avec insuffisance cardiaque majeure après prise d’anti-inflammatoire non stéroïdiens (AINS) par la mère. Une échographie obstétricale au deuxième trimestre a permis la découverte d’une asymétrie des cavités cardiaques. L’indication de césarienne a été posée à 30 semaines d’aménorrhées devant un fœtus en état d’anasarque avec insuffisance cardiaque majeure sur une fermeture anténatale du canal artériel. A partir de ce cas nous nous proposons de réaliser une revue de la littérature pour illustrer les complications fœtales et néonatales potentielles résultant de la fermeture précoce du canal artériel secondaire à la prise d’AINS pendant la grossesse. PMID:28293367

  12. 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

  13. 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

  14. 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…

  15. Hymenoptera of Afghanistan and the central command area of operations: assessing the threat to deployed U.S. service members with insect venom hypersensitivity.

    PubMed

    Turbyville, Joseph C; Dunford, James C; Nelson, Michael R

    2013-01-01

    Insect venom hypersensitivity can pose a threat to personnel deployed to a combat zone but the exposure risk in Afghanistan is currently unknown. This study was designed to assess the threat of Hymenoptera stings and associated allergic reactions in Afghanistan. Hymenoptera species were collected during a deployment to southern Afghanistan from June 2010 through January 2011. The literature was also reviewed to determine species of medically important Hymenoptera recorded in the region. The U.S. Army theater electronic medical data system was mined for ICD-9 codes associated with insect stings to determine the number of theater medical clinic encounters addressing insect sting reactions. Three species of flying hymenoptera were commonly encountered during the study period: Vespa orientalis L., Polistes wattii Cameron, and Vespula germanica (F.). A literature review also confirms the presence of honeybees (Apidae), numerous velvet ant (Mutillidae) species, and various ant (Formicidae) species all capable of stinging. No evidence was identified to suggest that fire ants (Solenopsis ssp.) are a threat in the region. Based on electronic medical records from the U.S. Central Command area of operations over a 2-year period, roughly 1 in 500 clinic visits involved a patient with a diagnosis of insect bite or sting. Cross-reactive members of all five flying Hymenoptera species commonly assessed for in Hymenoptera allergy evaluations are present in Afghanistan. The review of in-theater medical records confirms that insect stings pose an environmental threat to deployed service members.

  16. Factors influencing specialist outreach and support services to rural populations in the Eden and Central Karoo districts of the Western Cape.

    PubMed

    Schoevers, Johan; Jenkins, Louis

    2015-04-21

    Access to health care often depends on where one lives. Rural populations have significantly poorer health outcomes than their urban counterparts. Specialist outreach to rural communities is one way of improving access to care. A multifaceted style of outreach improves access and health outcomes, whilst a shifted outpatients style only improves access. In principle, stakeholders agree that specialist outreach and support (O&S) to rural populations is necessary. In practice, however, factors influence whether or not O&S reaches its goals, affecting sustainability.Aim and setting: Our aim was to better understand factors associated with the success or failure of specialist O&S to rural populations in the Eden and Central Karoo districts in the Western Cape. An anonymous parallel three-stage Delphi process was followed to obtain consensus in a specialist and district hospital panel. Twenty eight specialist and 31 district hospital experts were invited, with response rates of 60.7%-71.4% and 58.1%-74.2% respectively across the three rounds. Relationships, communication and planning were found to be factors feeding into a service delivery versus capacity building tension, which affects the efficiency of O&S. The success of the O&S programme is dependent on a site-specific model that is acceptable to both the outreaching specialists and the hosting district hospital. Good communication, constructive feedback and improved planning may improve relationships and efficiency, which might lead to a more sustainable and mutually beneficial O&S system.

  17. Central Campus

    NASA Image and Video Library

    2017-05-17

    A long exposure photograph of the new headquarters building, part of the Central Campus in the industrial area at NASA’s Kennedy Space Center in Florida. The nearly-complete seven-story, 200,000-square-foot facility will house about 500 NASA civil service and contractor employees. The building will be more energy efficient than the current Headquarters building and will feature the latest in office and administrative building technology to fulfill Kennedy's role as the premiere spaceport for NASA and, increasingly, commercial entities.

  18. Problématique de la prise en charge des cancers du sein au Sénégal: une approche transversale

    PubMed Central

    Gueye, Serigne Modou Kane; Gueye, Mamour; Coulbary, Sophie Aminata; Diouf, Alassane; Moreau, Jean Charles

    2016-01-01

    L’heure où les thérapeutiques innovantes se multiplient dans le cancer du sein, des pays moins nantis comme le Sénégal accusent encore un retard considérable dans la prise en charge globale de ce type de cancer. Au Sénégal, même si la prise en charge des cancers du sein avancés est actuellement bien codifiée, les résultats en terme de survie et de morbidités sont encore médiocres vu les retards diagnostiques et les traitements mutilants, parfois onéreux et mal tolérés, devenus nécessaires. Pour ces cancers avancés, les défis qui restent à relever résident dans l’érection de centres de soins palliatifs et le développement de la pluridisciplinarité pour améliorer la qualité de vie et l’accompagnement des malades. En revanche, pour les cancers infracliniques ou potentiellement guérissables, les défis restent immenses car il s’agira de les dépister, de bien les localiser et les diagnostiquer aussitôt (biopsie écho guidée ou stéréotaxique) mais également de les opérer de façon précise et entière (repérage – exérèse in sano et radiographie de pièce opératoire) tout en limitant les complications comme celles du curage classique (biopsie du ganglion sentinelle). Il s’agit là autant d’objectifs auxquels nos structures de santé ne sont pas toujours préparées. Cette mise au point est une analyse situationnelle sur les écueils contextuels qui grèvent encore la prise en charge globale des cancers du sein au Sénégal. PMID:28154696

  19. Central nervous system toxicity of mefenamic acid overdose compared with other NSAIDs: an analysis of cases reported to the United Kingdom National Poisons Information Service.

    PubMed

    Kamour, Ashraf; Crichton, Siobhan; Cooper, Gill; Lupton, David J; Eddleston, Michael; Vale, J Allister; Thompson, John P; Thomas, Simon H L

    2017-04-01

    Case reports and small case series suggest increased central nervous system (CNS) toxicity, especially convulsions, after overdose of mefenamic acid, compared with other nonsteroidal anti-inflammatory drugs (NSAIDs), although comparative epidemiological studies have not been conducted. The current study compared rates of CNS toxicity after overdose between mefenamic acid, ibuprofen, diclofenac and naproxen, as reported in telephone enquiries to the UK National Poisons Information Service (NPIS). NPIS telephone enquiries related to the four NSAIDs, received between January 2007 and December 2013, were analysed, comparing the frequency of reported CNS toxicity (convulsions, altered conscious level, agitation or aggression, confusion or disorientation) using multivariable logistic regression. Of 22 937 patient-specific telephone enquiries, 10 398 did not involve co-ingestion of other substances (mefenamic acid 461, ibuprofen 8090, diclofenac 1300, naproxen 547). Patients taking mefenamic acid were younger and more commonly female than those using other NSAIDs. Those ingesting mefenamic acid were more likely to experience CNS toxicity than those ingesting the other NSAIDs combined [adjusted odds ratio (OR) 7.77, 95% confidence interval (CI) 5.68, 10.62], especially convulsions (adjusted OR 81.5, 95% CI 27.8, 238.8). Predictors of CNS toxicity included reported dose and age, but not gender. Mefenamic acid overdose is associated with a much larger and dose-related risk of CNS toxicity, especially convulsions, compared with overdose of other NSAIDs. The benefit-risk profile of mefenamic acid should now be re-evaluated in light of effective and less toxic alternatives. © 2016 The British Pharmacological Society.

  20. Place de l'hémodialyse dans la prise en charge de l'intoxication aiguë au lithium

    PubMed Central

    Maghraoui, Jaouad El; Kabbali, Nadia; Arrayhani, Mohamed; Houssaini, Tarik Sqalli

    2016-01-01

    Nous rapportons le cas d'un patient âgé de 47 ans, suivi depuis vingt ans pour une psychose maniaco-dépressive sous lithium admis dans un tableau de trouble de conscience après une tentative de suicide au lithium (30 comprimés de Téralithe® LP 400, forme galénique retard correspondant à 12 g de carbonate de lithium), bien amélioré cliniquement après trois séances d'hémodialyse. Cette observation illustre l'intérêt thérapeutique de l'hémodialyse au cours des intoxications volontaires au lithium sous sa forme retard même après une semaine de la prise et l'insuffisance thérapeutique d'une seule séance d'hémodialyse. PMID:27583091

  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. Report of a Study to Determine the Feasibility of Establishing a Central Foreign Credential Evaluation Service Under Non-Governmental Auspices.

    ERIC Educational Resources Information Center

    Frey, James F.

    The study was conducted to determine whether a non-governmental Foreign Credential Evaluation Service (FCES) should be established and if so, what services it would provide, what the demand for these services would be, and what financial resources it would require. A survey of admissions officers at 223 educational institutions and representatives…

  3. Délais de prise en charge des syndromes coronariens aigus avec sus-décalage du segment ST à Ouagadougou et facteurs associés à un allongement de ces délais: étude transversale à propos de 43 cas colligés au CHU-Yalgado Ouédraogo

    PubMed Central

    Yameogo, Nobila Valentin; Samadoulougou, André; Millogo, Georges; Kologo, Koudougou Jonas; Kombassere, Karim; Toguyeni, Boubacar Jean Yves; Zabsonre, Patrice

    2012-01-01

    La prise en charge de l'infarctus du myocarde est une course contre la montre et les trois premières heures constituent les « golden hours ». Les objectifs de ce travail étaient de déterminer le délai de prise en charge des infarctus du myocarde du myocarde au Burkina Faso, les facteurs liés à un allongement du délai et le pronostic des patients. Il s'agit d'une étude transversale descriptive menée de Septembre 2010 à Août 2011. Le critère d'inclusion était l'infarctus du myocarde dont le diagnostic était basé sur des critères clinique (douleur angineuse), électrocardiographique (sus-décalage persistant du segment ST dans au moins deux dérivations contiguës du même territoire coronaire, onde Q de nécrose) et biologique (élévation de la troponine). Les informations relatives au délai de prise en charge ont été recueillies: début du premier symptôme, contact avec le premier agent de santé et le cardiologue, nombre de centre de santé consulté avant le transfert en cardiologie, situation géographique des patients, moyen de transport utilisé. Les données ont été analysées grâce au logiciel SPSS version 17. Durant la période d’étude, 43 patients d’âge moyen de 56,51 ± 12,91 ans ont été admis pour infarctus du myocarde. Plus de la moitié des patients (72,0%) habitait Ouagadougou et sa banlieue. Le délai moyen entre le début de la douleur et la consultation dans la première structure sanitaire était de 48 ± 20,8 heures; celui entre le début de la douleur et la réalisation du premier ECG était en moyenne de 8,6 ±4,5 jours. Le délai entre la réalisation de l'ECG et l'admission dans le service de cardiologie était de 4,35 ±4,0 jours [00 heure et 13 jours]. Le délai entre l'admission dans le service de cardiologie et la thrombolyse était de 34 minutes. Enfin le délai entre le début de la douleur et le contact avec le cardiologue était de 9,6±3,5 jours. Il n'y avait pas de différence statiquement

  4. 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

  5. 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.

  6. Rehabilitation and Prosthetic Services

    MedlinePlus

    ... Guide and Service Dogs Contact VA Central Office Prosthetic & Sensory Aids Service If you have a general question regarding artificial limbs/orthotics, automobile adaptive equipment, clothing allowance, durable medical ...

  7. 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

  8. Formation et stabilité de l'ettringite responsable de la durée le prise du ciment Portland

    NASA Astrophysics Data System (ADS)

    Jauberthie, R.; Fejean, J.; Lanos, Ch.

    2002-07-01

    The time of set of concrete containing hydraulic binders depends on the temperature parameter. It is regulated by the calcium sulfate contained in cement which also influences the mechanical strength development at short terms. During the hydration process first instants, an aluminium and calcium sulfate, called ettringite, is generated. This inorganic phase is unstable and its synthesis domain is limited by temperature. Ettringite converts into mono sulfate near 60^{circ}C or carbonate after a long stay in standard temperature and pressure conditions. The crystal aspect is studied through X-ray diffraction. The study of the associated mechanical résistances is based on SEM observations of the crystal shapes and tangles. The long ettringite needles very interlace induce high hardness. The mono aluminium and calcium sulfate created by a temperature increase is badly crystallised. It constitutes shorter needles and slats. Le paramètre température influence fortement les temps de prise des bétons à base de liants hydrauliques. Le sulfate de calcium présent dans le ciment régule ce temps de prise et conditionne l'acquisition de résistances mécaniques induites à court terme. Celui ci forme, dès les premiers instants de l'hydratation, un sulfate de calcium et d'aluminium hydraté appelé ettringite, minéral qui se révèle instable et dont le domaine de synthèse est limité en température. L'ettringite se transforme en mono sulfate vers 60^{circ}C ou se carbonate par contact prolongé avec l'air ambiant. L'évolution de la cristallinité de cette phase est suivie par diffraction X. Les observations au MEB de la forme de ces cristaux et de leur enchevêtrement permettent d'expliquer l'évolution des résistances mécaniques associées. Les longues aiguilles d'ettringite fortement entrelacées entraînent des duretés élevées. Le mono sulfate de calcium et d'aluminium, obtenu à température plus élevée, est mal cristallisé et formé d'aiguilles ou de

  9. Stratégie de traitement : Rôle de l’enfuvirtide dans la prise en charge des effets secondaires limitant le traitement

    PubMed Central

    Tsoukas, Christos

    2007-01-01

    Les effets secondaires peuvent limiter les options s’offrant aux médecins dans le traitement de l’infection par le VIH. La prise en charge de ces effets secondaires est essentielle afin d’éviter l’arrêt du traitement. L’enfuvirtide, un inhibiteur de la fusion du VIH, peut être utile en tant qu’un des trois agents actifs du traitement antirétroviral. Ce peut être une façon de réduire les effets secondaires limitant le traitement et d’avoir un agent efficace pour le contrôle viral. Dans le cas présent, le patient avait des antécédents de traitements longs et problématiques, avec de nombreuses affections concomitantes. Son dernier schéma thérapeutique en date, qui comprend un agent d’une nouvelle classe thérapeutique, l’enfuvirtide, a maintenu la suppression du VIH tout en minimisant la toxicité.

  10. 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…

  11. Goals for Business Operations and Family Life. The Service Provider's Tool Kit and Instructor's Guide. North Central Regional Extension Publications #287 and #288.

    ERIC Educational Resources Information Center

    Gessaman, Paul H.

    This packet contains student materials and an instructor's guide for use in a series of workshops on the "GOALS Process" for persons in service-producing businesses (often family-owned). The materials provide a framework for individual or family use in self-assessment and a means of identifying business and family life goals, setting priorities,…

  12. 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.

  13. 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:

  14. 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

    Senate - 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:

  15. 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:

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. Prise de suppléments multivitaminiques pour la prévention primaire des anomalies congénitalies

    PubMed Central

    Morin, Pascale; Demers, Karine; Giguère, Christine; Tribble, Denise St-Cyr; Lane, Julie

    2007-01-01

    RÉSUMÉ OBJECTIF Déterminer si les recommandations véhiculées par les professionnels de la santé sur l’importance de l’acide folique encouragent les femmes susceptibles de procréer de prendre les suppléments d’acide folique. CONCEPTION Enquête. CONTEXTE Centre de santé et de services sociaux, Institut universitaire de gériatrie de Sherbrooke, à Sherbrooke, Qué. PARTICIPANTS 323 femmes francophones âgées entre 18 et 45 ans. PRINCIPALES MESURES DES RÉSULTATS La consommation de suppléments de vitamines et de minéraux au cours de la dernière année. Des analyses statistiques descriptives et bivariées et une modélisation par régression logistique ont été effectuées pour déterminer si l’association observée entre la recommandation d’un professionnel de la santé et la consommation de vitamines et de minéraux persistait après avoir tenu compte de l’effet des variables de contrôle (consultation de documentation, connaissances, sources d’information, perception, âge, scolarité, revenu, état matrimonial, intention de devenir enceinte). RÉSULTATS Environ 41% des femmes rapportent que leur médecin leur avait recommandé de consommer un supplément de vitamines et de minéraux. Après avoir ajusté toutes les variables dans le modèle, il est apparu que le fait de se faire recommander par un professionnel de la santé de prendre un supplément de vitamines et de minéraux était significativement associé à la consommation de vitamines et de minéraux par les femmes susceptibles de devenir enceintes. CONCLUSION Les professionnels peuvent améliorer la santé de la population par une pratique clinique préventive. Nous soulignons l’importance de soutenir ces derniers dans leurs efforts d’intégrer puis d’appliquer des connaissances scientifiques dans leur pratique. PMID:18077754

  1. Prise en charge des complications des fistules artério-veineuses pour hémodialyse chronique

    PubMed Central

    Jiber, Hamid; Zrihni, Youssef; Zaghloul, Rachid; Hajji, Rita; Zizi, Othman; Bouarhroum, Abdellatif

    2015-01-01

    La fistule artério-veineuse native est l'accès vasculaire de choix pour l'hémodialyse chronique en raison de sa longévité, son taux faible de complication et de mortalité par rapport aux pontages artério-veineux et aux cathéters. Cependant, il arrive assez souvent que l'on assiste à des complications qui sont dominées par la sténose et la thrombose. C'est une étude rétrospective des complications ayants survenues pour 31 fistules artério-veineuses pour hémodialyse chronique des 200 fistules réalisées chez 200 patients au sein du service de chirurgie vasculaire du CHU Hassan II de Fès sur une période de trois ans, étendue de Janvier 2007 à Décembre 2009. Ces complications ont été présentés par les thromboses dans 14 cas soit 45,15% de l'ensemble des complications, les sténoses dans 4 cas (12,90%,) les anévrismes dans 4 cas (12,90%), les complications ischémiques dans 3 cas (9,67%), l'infection dans 3 cas (9,67%), l'hémorragie dans 2 cas (6,45%) et l’ hyperdébit dans un seul cas soit 3,22%. On a pu conserver 22 fistules soit 70,96% par traitement chirurgical ou endovasculaire, on a confectionné une nouvelle fistule dans 8 cas soit 25,80%, et on a adressé une patiente (3,22%) pour pose d'un cathéter veineux tunnelisé permanent. Les complications des fistules artério-veineuses pour l'hémodialyse chronique sont la principale cause de morbidité chez les patients hémodialysés, il est donc important de s'impliquer lors de leur création, et de donner un maximum d'attention quand ils sont manipulés. Ceci suggère la mise en place d'un programme de surveillance de ces fistules en raison de l'impact des complications sur la morbi-mortalité du patient hémodialysé et sur le plan financier. PMID:26113933

  2. 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

  3. 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

  4. 77 FR 45575 - Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-01

    ... Forest Service Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Central Idaho Resource Advisory Committee will meet in Salmon, Idaho. The committee...

  5. 76 FR 17817 - North Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ...; ] DEPARTMENT OF AGRICULTURE Forest Service North Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The North Central Idaho RAC will meet in Grangeville...

  6. KENNEDY SPACE CENTER, FLA. - NASA Administrator Sean O’Keefe (right) greets Florida Congressman Tom Feeney during a tour of the Central Florida Research Park, near Orlando. Central Florida leaders are proposing the research park as the site for the new NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - NASA Administrator Sean O’Keefe (right) greets Florida Congressman Tom Feeney during a tour of the Central Florida Research Park, near Orlando. Central Florida leaders are proposing the research park as the site for the new NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

  7. KENNEDY SPACE CENTER, FLA. - NASA Administrator Sean O’Keefe (center) listens to Congressman Tom Feeney (second from left) during a tour of the Central Florida Research Park, near Orlando. At right is U.S. Congressman Dave Weldon. Central Florida leaders are proposing the research park as the site for the new NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - NASA Administrator Sean O’Keefe (center) listens to Congressman Tom Feeney (second from left) during a tour of the Central Florida Research Park, near Orlando. At right is U.S. Congressman Dave Weldon. Central Florida leaders are proposing the research park as the site for the new NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

  8. KENNEDY SPACE CENTER, FLA. - - U.S. Representative Ric Keller (left) listens intently to a presentation proposing the use of the Central Florida Research Park, near Orlando, as the site of NASA’s new Shared Services Center. NASA and Florida officials toured the research park as well. Central Florida leaders are proposing the research park as the site for the center, which would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - - U.S. Representative Ric Keller (left) listens intently to a presentation proposing the use of the Central Florida Research Park, near Orlando, as the site of NASA’s new Shared Services Center. NASA and Florida officials toured the research park as well. Central Florida leaders are proposing the research park as the site for the center, which would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

  9. KENNEDY SPACE CENTER, FLA. - NASA Administrator Sean O’Keefe (left) greets U.S. Representative Ric Keller during a tour of the Central Florida Research Park, near Orlando. Central Florida leaders are proposing the research park as the site for the new NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - NASA Administrator Sean O’Keefe (left) greets U.S. Representative Ric Keller during a tour of the Central Florida Research Park, near Orlando. Central Florida leaders are proposing the research park as the site for the new NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

  10. Les barrières à une bonne prise en charge des diabétiques dans les structures de première ligne de la province de Khouribga (MAROC)

    PubMed Central

    Hassoune, Samira; Badri, Soufiane; Nani, Samira; Belhadi, Leila; Maaroufi, Abderrahmane

    2012-01-01

    Introduction Le diabète constitue un important enjeu de santé publique au Maroc et représente un défi auquel les médecins généralistes sont confrontés dans leur pratique quotidienne. Le but de ce travail était de décrire les barrières entravant une bonne prise en charge des patients diabétiques dans les structures de 1ère ligne de la province de khouribga. Méthodes Il s'agit d'une étude transversale menée de décembre 2010 à mars 2011, chez les 54 médecins généralistes (MG) exerçants dans les centres de santé de la province. La collecte des données a été réalisée à l'aide d'un questionnaire prétesté et auto administré et la saisie et l'analyse effectuées sur le logiciel SPSS 16. Résultats Huit pourcent des MG disposaient de registre informatisé pour le suivi des diabétiques. Les principales barrières à une prise en charge correcte des patients étaient le statut socio-économique faible des patients (94%), leur niveau scolaire bas (86%), le manque de moyens de traitement et de suivi (80%), le nombre insuffisant de diabétologues (80%), le manque de coordination avec les structures de 2ème ligne (74%) et l'insuffisance des séminaires de formation continue (58%). Conclusion Les médecins généralistes sont confrontés à de nombreux obstacles concernant la prise en charge des patients diabétiques. L’équipement des centres de santé en moyens diagnostiques et thérapeutiques suffisants, l'amélioration de l'accessibilité des diabétiques aux soins et la formation continue des médecins pourraient être des solutions pour améliorer cette prise en charge surtout devant la pénurie de spécialistes dans notre pays. PMID:23330033

  11. 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

  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. The impact of recent Central and Eastern European migration on the Scottish health service: A study of newspaper coverage 2004-2008.

    PubMed

    Catto, Alastair; Gorman, Dermot; Higgins, Martin

    2010-09-01

    This paper examines newspaper coverage of the impact on NHS Scotland of recent Central and Eastern European immigration. It follows rising public interest in the impacts of 'record' and 'unexpected' levels of migration after the 2004 and 2007 European Union (EU) enlargements. We reviewed reporting in six Scottish newspapers during 2004-2008 to track underlying themes within their coverage of EU migration. The framework of Social Representations Theory (SRT) was used to analyse how migration's impact was conceptualised and explained. This research shows that portrayal of migrants posing a threat to the NHS (e.g. European staff with inadequate qualifications), has increased in frequency but changed in nature over the past 4 years. Meanwhile, reports have also portrayed themes of reassurance (e.g. NHS management control) to allay societies' fears. The overall pattern is of representations of threat in the Scottish press being closely followed by those of reassurances. The most important reassurances relate to Scottish socioeconomic conditions, which raises questions might be seen in other UK newspapers as well as what will happen in Scotland if A8 migration decreases.

  14. Central venous access.

    PubMed

    Ganeshan, Arul; Warakaulle, Dinuke R; Uberoi, Raman

    2007-01-01

    Central venous access plays an important role in the management of an ever-increasing population of patients ranging from those that are critically ill to patients with difficult clinical access. Interventional radiologists are key in delivering this service and should be familiar with the wide range of techniques and catheters now available to them. A comprehensive description of these catheters with regard to indications, technical aspects of catheterization, success rates, and associated early and late complications, as well as a review of various published guidelines on central venous catheter insertion are given in this article.

  15. 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.

  16. Effects of land use and climate change on ecosystem services in Central Asia's arid regions: A case study in Altay Prefecture, China.

    PubMed

    Fu, Qi; Li, Bo; Hou, Ying; Bi, Xu; Zhang, Xinshi

    2017-12-31

    The sustainable use of ecosystem services (ES) can contribute to enhancing human well-being. Understanding the effects of land use and climate change on ES can provide scientific and targeted guidance for the sustainable use of ES. The objective of this study was to reveal the way in which land use and climate change influence the spatial and temporal variations of ES in the mountain-oasis-desert system (MODS). In this study, we assessed water yield, soil conservation, crop production, and sand fixation in 1990, 2000, and 2010 in Altay Prefecture, which is representative of the MODS, based on widely used biophysical models. Moreover, we analyzed the effects of different land use and climate change conditions on ES. The results show that the area of forest and bare land decreased in Altay Prefecture. In contrast, the area of grassland with low coverage and cropland increased. The climate of this area presented an overall warming-wetting trend, with warming-drying and cooling-wetting phenomena in some areas. Soil conservation in the mountain zone, water yield in the oasis zone, and sand fixation in the desert zone all decreased under the influence of land use change alone. The warming-drying trend led to decreased water yield in the oasis zone and increased wind erosion in the desert zone. Based on the results, we recommend that local governments achieve sustainable use of ES by planting grasslands with high coverage in the oasis zone, increasing investment in agricultural science and technology, and establishing protected areas in the mountain and desert zones. The methodology in our study can also be applied to other regions with a MODS structure. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. 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

  18. 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 ...

  19. [Centralization versus decentralization. Hematology].

    PubMed

    Borregaard, Niels

    2006-04-10

    Clinical haematology is the result of teamwork among dedicated specialists in pathology, molecular diagnostics, imaging, radiotherapy and the haematologist, who in turn can focus on only a limited fraction of the various and highly complex diseases that together constitute clinical haematology. The treatment of patients should be centralized in departments large enough to permit internal subspecialization and to provide expert service focused on haematology. No more than three such hematology centers are needed in Denmark.

  20. Vulvovaginite : Dépistage et prise en charge de la trichomonase, de la candidose vulvovaginale et de la vaginose bactérienne.

    PubMed

    van Schalkwyk, Julie; Yudin, Mark H

    2016-12-01

    Analyser les données probantes et formuler des recommandations quant au dépistage et à la prise en charge de la candidose vulvovaginale, de la trichomonase et de la vaginose bactérienne. Parmi les issues évaluées, on trouve l'efficacité de l'antibiothérapie, les taux de guérison en ce qui concerne les infections simples et compliquées, et les implications de ces pathologies pendant la grossesse. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans MEDLINE, EMBASE, CINAHL et The Cochrane Library en juin 2013 au moyen d'un vocabulaire contrôlé (p. ex. « vaginitis », « trichomoniasis », « vaginal candidiasis ») et de mots clés (p. ex. « bacterial vaginosis », « yeast », « candidiasis », « trichomonas vaginalis », « trichomoniasis », « vaginitis », « treatment ») appropriés. Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n'a été appliquée en matière de date, mais les résultats ont été limités aux documents rédigés en anglais ou en français. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu'en mai 2014. La littérature grise (non publiée) a été identifiée par l'intermédiaire de recherches menées dans les sites Web d'organismes s'intéressant à l'évaluation des technologies dans le domaine de la santé et d'organismes connexes, dans des collections de directives cliniques et auprès de sociétés de spécialité médicale nationales et internationales. La qualité des résultats est évaluée au moyen des critères décrits par le Groupe d'étude canadien sur les soins de santé préventifs (Tableau 1). DéCLARATIONS SOMMAIRES: RECOMMANDATIONS. Copyright © 2016. Published by Elsevier Inc.

  1. Providing low-cost sexually transmitted diseases services in two semi-urban health centers in Central African Republic (CAR): characteristics of patients and patterns of health care-seeking behavior.

    PubMed

    Parker, K A; Koumans, E H; Hawkins, R V; Massanga, M; Somse, P; Barker, K; Moran, J

    1999-10-01

    This study examines the feasibility of providing comprehensive, low-cost sexually transmitted disease (STD) services through the existing primary care infrastructure in two semi-urban health centers in the Central African Republic. The results showed that out of the 9552 visits made by index patients and partners over a 28-month period, 60% were made by women. Among these women, 90% were symptomatic, 77% had vaginal discharge, 70% had lower abdominal pain, and 7% had genital ulcer. In addition, 44% of men, as compared to 18% of women, had looked for treatment elsewhere prior to the clinic visit. The average cost per STD treated with the recommended drugs was $3.90. Furthermore, condom use was low in both areas and etiologic data suggest that a large proportion of patients was infected with an STD. The findings suggest that a comprehensive and affordable model for STD control can be implemented in primary care systems to prevent the spread of STDs in Africa.

  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. KENNEDY SPACE CENTER, FLA. - KSC Director Jim Kennedy makes a presentation to NASA and other officials about the benefits of locating NASA’s new Shared Services Center in the Central Florida Research Park, near Orlando. At the far left is Pamella J. Dana, Ph.D., director, Office of Tourism, Trade, and Economic Development in Florida. Central Florida leaders are proposing the research park as the site for the NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - KSC Director Jim Kennedy makes a presentation to NASA and other officials about the benefits of locating NASA’s new Shared Services Center in the Central Florida Research Park, near Orlando. At the far left is Pamella J. Dana, Ph.D., director, Office of Tourism, Trade, and Economic Development in Florida. Central Florida leaders are proposing the research park as the site for the NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

  5. 76 FR 37773 - Central Montana Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ... Forest Service Central Montana Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Central Montana Resource Advisory Committee will meet in Stanford, MT. The... the public. This will be the second official meeting of the Central Montana Resource Advisory...

  6. 76 FR 30094 - Central Montana Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-24

    ... Forest Service Central Montana Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Central Montana Resource Advisory Committee will meet in Stanford, MT. The... the public. This will be the second official meeting of the Central Montana Resource Advisory...

  7. 76 FR 20624 - Central Montana Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... Forest Service Central Montana Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Central Montana Resource Advisory Committee will meet in Stanford, Montana... 109 Central Avenue, Stanford, MT. Written comments should be sent to Ron Wiseman, Lewis and Clark...

  8. 76 FR 49433 - Central Montana Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... Forest Service Central Montana Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Central Montana Resource Advisory Committee will meet in Stanford, Montana... 109 Central Avenue, Stanford, MT. Written comments should be sent to Ron Wiseman, Lewis and Clark...

  9. 77 FR 54556 - Central Montana Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-05

    ...-54557] [FR Doc No: 2012-21809] DEPARTMENT OF AGRICULTURE Forest Service Central Montana Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Central Montana..., 109 Central Ave., Stanford, MT. VTC/Telephone will be available. Written comments may be submitted as...

  10. Integrated prevention of mother-to-child HIV transmission services, antiretroviral therapy initiation, and maternal and infant retention in care in rural north-central Nigeria: a cluster-randomised controlled trial.

    PubMed

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

    2016-05-01

    Antiretroviral therapy (ART) and retention in care are essential for the prevention of mother-to-child HIV transmission (PMTCT). We aimed to assess the effect of a family-focused, integrated PMTCT care package. In this parallel, cluster-randomised controlled trial, we pair-matched 12 primary and secondary level health-care facilities located in rural north-central Nigeria. Clinic pairs were randomly assigned to intervention or standard of care (control) by computer-generated sequence. HIV-infected women (and their infants) presenting for antenatal care or delivery were included if they had unknown HIV status at presentation (there was no age limit for the study, but the youngest participant was 16 years old); history of antiretroviral prophylaxis or treatment, but not receiving these at presentation; or known HIV status but had never received treatment. Standard of care included health information, opt-out HIV testing, infant feeding counselling, referral for CD4 cell counts and treatment, home-based services, antiretroviral prophylaxis, and early infant diagnosis. The intervention package added task shifting, point-of-care CD4 testing, integrated mother and infant service provision, and male partner and community engagement. The primary outcomes were the proportion of eligible women who initiated ART and the proportion of women and their infants retained in care at 6 weeks and 12 weeks post partum (assessed by generalised linear mixed effects model with random effects for matched clinic pairs). The trial is registered with ClinicalTrials.gov, number NCT01805752. Between April 1, 2013, and March 31, 2014, we enrolled 369 eligible women (172 intervention, 197 control), similar across groups for marital status, duration of HIV diagnosis, and distance to facility. Median CD4 count was 424 cells per μL (IQR 268-606) in the intervention group and 314 cells per μL (245-406) in the control group (p<0·0001). Of the 369 women included in the study, 363 (98%) had WHO

  11. Central Italy

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Clouds and haze cover most of the Italian peninsula in this view of central Italy (41.5N, 14.0E) but the Bay of Naples region with Mt. Vesuvius and the island of Capri are clear. The Adriatic Sea in the background separates Italy from the cloud covered Balkans of eastern Europe and the Tyrrhenian Sea in the foreground lies between the Italian mainland and the off scene islands of Corsica and Sardinia. Several aircraft contrails can also be seen.

  12. Central Campus Construction Progress

    NASA Image and Video Library

    2016-10-18

    A large crane towers overhead as the new, seven-story headquarters building takes shape in the industrial area at NASA’s Kennedy Space Center in Florida. The 200,000-square-foot facility will anchor the spaceport’s Central Campus and house about 500 NASA civil service and contractor employees. The building will be more energy efficient than the current Headquarters building and will feature the latest in office and administrative building technology to fulfill Kennedy's role as the premiere multi-user spaceport for NASA and, increasingly, commercial entities.

  13. Central Campus Construction Progress

    NASA Image and Video Library

    2016-10-18

    The new headquarters building’s seven floors are clearly visible as construction continues in the industrial area at NASA’s Kennedy Space Center in Florida. The 200,000-square-foot facility will anchor the spaceport’s Central Campus and house about 500 NASA civil service and contractor employees. The building will be more energy efficient than the current Headquarters building and will feature the latest in office and administrative building technology to fulfill Kennedy's role as the premiere multi-user spaceport for NASA and, increasingly, commercial entities.

  14. Central Campus

    NASA Image and Video Library

    2017-05-17

    A panoramic view of the Industrial Area at NASA's Kennedy Space Center in Florida, shows the nearly-complete new headquarters building at right. The new seven-story, 200,000-square-foot facility will house about 500 NASA civil service and contractor employees. The building will be more energy efficient than the current Headquarters building and will feature the latest in office and administrative building technology to fulfill Kennedy's role as the premiere spaceport for NASA and, increasingly, commercial entities.

  15. Central pain.

    PubMed

    Singh, Supreet

    2014-12-01

    Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is central pain, a neuropathic pain syndrome caused by a lesion in the brain or spinal cord that sensitizes one's perception of pain. It is a debilitating condition caused by various diseases such as multiple sclerosis, strokes, spinal cord injuries, or brain tumors. Varied symptoms and the use of pharmacological medicines and nonpharmacological therapies will be addressed.

  16. Prise en charge des hypertendus dans la ville de Cotonou (Bénin) en 2011: connaissances attitudes et pratiques des médecins généralistes

    PubMed Central

    Houenassi, Martin Dèdonougbo; David, Dokoui; Codjo, Léopold Houétondji; Attinsounon, Angelo Cossi; Alassani, Adebayo; Ahoui, Séraphin; Dovonou, Albert Comlan; Adoukonou, Thierry Armel; Dohou, Serge Hugues Mahougnon; Wanvoegbe, Armand; Agbodande, Anthelme

    2016-01-01

    Summary But: Ce travail vise à évaluer les connaissances, attitudes et pratiques des médecins généralistes sur la prise en charge de l’hypertension artérielle à Cotonou. Méthodes: L’étude était transversale et descriptive basée sur une enquête multicentrique du 1er Mai 2011 au 31 Juillet 2011. Un recrutement de tous les médecins généralistes, volontaires exerçant dans les centres de santé privés, publics et confessionnels de la ville de Cotonou, ayant autorisé l’étude, a été fait. Le 7ème rapport de Joint National Committee (JNC7) a été utilisé comme référentiel pour l’évaluation de la prise en charge des hypertendus. Un auto-questionnaire adressé aux généralistes, testé et validé, a été utilisé pour recueillir ces données. Résultats: Au total, 41 médecins généralistes dans huit établissements sanitaires ont été inclus. Près de la moitié des généralistes (48.8%) ne connaissaient pas la définition de l’HTA. Seulement 25 généralistes (61.0%) pouvaient décrire les conditions de mesure de la pression artérielle. Dix généralistes (24.4%) étaient incapables de lister la moitié des examens du bilan minimum de l’hypertension artérielle (HTA). La majorité (92.7%) ne connaissait pas la notion de risque cardiovasculaire global. L’objectif tensionnel (TA ≤ 140/90 mmHg) n’était connu que par 18 (43.9%) médecins. Les mesures hygiéno-diététiques seules (82.9%) et la monothérapie seule (70.7%) étaient les modalités thérapeutiques les plus prescrites. Les classes pharmacologiques antihypertensives prescrites étaient surtout les inhibiteurs calciques (82.9%), les inhibiteurs de l’enzyme de conversion (53.7%) et les diurétiques (36.6%). Les généralistes référaient les hypertendus aux cardiologues principalement pour non-maitrise du chiffres tensionnels (63,4%) et l’apparition de complications aigues (56.1%). Conclusion: Les connaissances des généralistes sur la prise en charge de l

  17. Centralized scheduling an unanticipated revenue cycle opportunity.

    PubMed

    O'Neill, Daniel P; Kenniff, Peter B

    2007-09-01

    Centralized outpatient scheduling can provide acute care hospitals with accessibility and service levels equal to freestanding facilities, enabling hospitals to recapture lost market share. Two implementation strategies are critical to the success of centralized scheduling: Correctly developing the schedule. Managing the incoming call volume.

  18. Forest statistics of central and northern Indiana

    Treesearch

    The Forest Survey Organization. Central States Forest Experiment Station

    1952-01-01

    The Forest Survey is conducted in the various regions by the forest experiment stations of the Forest Service. In Indiana the project is directed by the Central States Forest Experiment Station with headquarters in Columbus, Ohio. This Survey Release presents the more significant preliminary statistics on the forest area and timber volume for Central and Northern...

  19. South-central Alaska forests: inventory highlights.

    Treesearch

    Sally Campbell; Willem W.S. van Hees; Bert. Mead

    2005-01-01

    This publication presents highlights of a recent south-central Alaska inventory conducted by the Pacific Northwest Research Station Forest Inventory and Analysis Program (USDA Forest Service). South-central Alaska has about 18.5 million acres, of which one-fifth (4 million acres) is forested. Species diversity is greatest in closed and open Sitka spruce forests, spruce...

  20. 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

  1. The Preparation of Human Service Professionals.

    ERIC Educational Resources Information Center

    Gartner, Alan

    New forms of preparing workers in the human services have the potential of changing and improving those services. A central feature of the new forms of preparation is that they must both be preparatory for the services and be characteristic of them (for example, if the services are participatory in nature, the training should also be so). There is…

  2. The Preparation of Human Service Professionals.

    ERIC Educational Resources Information Center

    Gartner, Alan

    New forms of preparing workers in the human services have the potential of changing and improving those services. A central feature of the new forms of preparation is that they must both be preparatory for the services and be characteristic of them (for example, if the services are participatory in nature, the training should also be so). There is…

  3. 77 FR 71825 - Notice of Continuation of Visitor Services

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-04

    .... NACC001-89 Golf Course National Capital Specialists, Inc. Park--Central. NACC003-86 Guest Services, Inc. National Capital Park--Central. GATE003-98 Marinas of the Gateway National Future, Inc. Recreation Area... National Park Service Notice of Continuation of Visitor Services AGENCY: National Park Service, Interior...

  4. Centralized Purchasing in a Decentralized Environment.

    ERIC Educational Resources Information Center

    Barclay, Brian C.

    1995-01-01

    Purchasing in the Edmonton, Alberta, Public Schools focuses on delivering service that is driven by and sensitive to the customers. Purchasing Services respond to site-based decision making, and the Distribution Centre--a central stores operation--ensures the district the best value for dollars expended. (MLF)

  5. 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

  6. Les critères diagnostiques et les particularités de prise en charge de l’angiomyolipome rénal: à propos de 8 cas

    PubMed Central

    El Majdoub, Aziz; Khallouk, Abdelhak; Farih, Moulay Hassan

    2016-01-01

    L'angiomyolipome rénal est une tumeur rénale bénigne ayant une composante graisseuse. À travers une série de 8 cas nous montrons les critères diagnostiques et les particularités de prise en charges de l angiomyolipome rénal. Notre étude porte sur 8 cas d'angiomyolipomes rénaux durant une période de 4 ans, explorés par une échographie et une tomodensitométrie abdominales. le diagnostic a été retenu sur les données de l'imagerie dans tous les cas. Deux patients suivis pour une sclérose tubéreuse de Bourneville depuis l'enfance. L'âge moyenest de 42 ans. L'échographie aretrouvé un aspect hyperéchogène hétérogène dans tous les cas. La tomodensitométrie a permis la détection de la composante graisseuse. Le diagnostic radiologique de l'angiomyolipome rénal repose essentiellement sur la détection de la composante graisseuse. L'association à une sclérose tubéreuse de Bourneville est un argument diagnostique supplémentaire. PMID:28292144

  7. The EMBRACE web service collection.

    PubMed

    Pettifer, Steve; Ison, Jon; Kalas, Matús; Thorne, Dave; McDermott, Philip; Jonassen, Inge; Liaquat, Ali; Fernández, José M; Rodriguez, Jose M; 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

    2010-07-01

    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.

  8. 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

  9. 76 FR 1594 - North Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service North Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meetings. SUMMARY: The North Central Idaho RAC will meet in Grangeville, Idaho. The committee...

  10. 77 FR 48950 - South Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service South Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The South Central Idaho Resource Advisory Committee will meet in Jerome...

  11. 76 FR 22364 - Central Montana Resource Advisory Committee; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service Central Montana Resource Advisory Committee; Correction AGENCY: Forest Service, USDA... Register of April 13, 2011, concerning a notice of meeting for the Central Montana Resource Advisory...

  12. 77 FR 51967 - North Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service North Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The North Central Idaho RAC will be meeting via a conference call. The...

  13. 76 FR 12933 - North Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service North Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meetings. SUMMARY: The North Central Idaho RAC will meet in Grangeville, Idaho. The committee...

  14. 77 FR 43236 - North Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service North Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The North Central Idaho RAC will meet in Grangeville, Idaho. The committee is...

  15. 75 FR 4523 - North Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service North Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The North Central Idaho RAC will meet in Grangeville, Idaho. The committee is...

  16. 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...

  17. KENNEDY SPACE CENTER, FLA. - NASA and government officials are gathered to hear about the assets of the Central Florida Research Park, near Orlando, as the site of NASA’s new Shared Services Center. Seated at right are Lisa Malone, director of KSC External Affairs, and Joel Wells, with the Government Relations Office. Fourth from right is Jim Jennings, NASA deputy associate administrator for institutions and asset management. Six sites around the U.S. are under consideration for the center, which would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - NASA and government officials are gathered to hear about the assets of the Central Florida Research Park, near Orlando, as the site of NASA’s new Shared Services Center. Seated at right are Lisa Malone, director of KSC External Affairs, and Joel Wells, with the Government Relations Office. Fourth from right is Jim Jennings, NASA deputy associate administrator for institutions and asset management. Six sites around the U.S. are under consideration for the center, which would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus.

  18. KENNEDY SPACE CENTER, FLA. - Pamella J. Dana, Ph.D., director, Office of Tourism, Trade, and Economic Development in Florida, takes part in the proposal for locating NASA’s new Shared Services Center in the Central Florida Research Park, near Orlando. The presentation was given to NASA Administrator Sean O’Keefe and other officials. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - Pamella J. Dana, Ph.D., director, Office of Tourism, Trade, and Economic Development in Florida, takes part in the proposal for locating NASA’s new Shared Services Center in the Central Florida Research Park, near Orlando. The presentation was given to NASA Administrator Sean O’Keefe and other officials. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

  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. Reference Services.

    ERIC Educational Resources Information Center

    Bunge, Charles A.

    1999-01-01

    Discusses library reference services. Topics include the historical development of reference services; instruction in library use, particularly in college and university libraries; guidance; information and referral services and how they differ from traditional question-answering service; and future concerns, including user fees and the planning…

  1. Reference Services.

    ERIC Educational Resources Information Center

    Bunge, Charles A.

    1999-01-01

    Discusses library reference services. Topics include the historical development of reference services; instruction in library use, particularly in college and university libraries; guidance; information and referral services and how they differ from traditional question-answering service; and future concerns, including user fees and the planning…

  2. 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.

  3. Ecosystem services

    Treesearch

    Trista Patterson

    2014-01-01

    Since its inception, the ecosystem service approach has stimulated interest from numerous planning, management, and partnership perspectives. To date, however, research that quantifies ecosystem services in the study area (in the form of explicit ecosystem service studies) has been limited. This chapter reviews and synthesizes the concept of ecosystem services,...

  4. 26 CFR 49.4252-7 - Wire and equipment service.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... services, burglar alarm or fire alarm service, and all other similar services (whether or not oral... following are examples of wire and equipment service: (1) Burglar, fire, or other alarm service where the..., or a police or fire station, or a central station, and over which a signal is transmitted in the case...

  5. 26 CFR 49.4252-7 - Wire and equipment service.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... services, burglar alarm or fire alarm service, and all other similar services (whether or not oral... following are examples of wire and equipment service: (1) Burglar, fire, or other alarm service where the..., or a police or fire station, or a central station, and over which a signal is transmitted in the case...

  6. 26 CFR 49.4252-7 - Wire and equipment service.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... services, burglar alarm or fire alarm service, and all other similar services (whether or not oral... following are examples of wire and equipment service: (1) Burglar, fire, or other alarm service where the..., or a police or fire station, or a central station, and over which a signal is transmitted in the case...

  7. 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

  8. 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…

  9. Virtual Reference Services: Directions and Agendas.

    ERIC Educational Resources Information Center

    Gray, Suzanne M.

    2000-01-01

    Analyzes Web sites of ten large research libraries in order to establish a basic understanding of how some major libraries are currently providing virtual reference services. Discusses centralization; email reference guidelines; creating a service economy; expanding hours of service; virtual users' needs; and real-time virtual reference.…

  10. 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…

  11. Collection development at the NOAA Central Library

    NASA Technical Reports Server (NTRS)

    Quillen, Steve R.

    1994-01-01

    The National Oceanic and Atmospheric Administration (NOAA) Central Library collection, approximately one million volumes, incorporates the holdings of its predecessor agencies. Within the library, the collections are filed separately, based on their source and/or classification schemes. The NOAA Central Library provides a variety of services to users, ranging from quick reference and interlibrary loan to in-depth research and online data bases.

  12. 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

  13. 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.

  14. 78 FR 34428 - Missouri Central Railroad Company-Abandonment Exemption-in Cass, Henry, Johnson, and Pettis...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-07

    ..., Johnson, and Pettis Counties, MO; Central Midland Railway Company--Discontinuance of Service Exemption--in Cass, Henry, Johnson, and Pettis Counties, MO Missouri Central Railroad Company (MCRR) and Central...

  15. 41 CFR 101-5.105 - Operation of the centralized facility.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... justification in terms of economy and efficiency. Centralized services provided pursuant to the regulation may... centralized facility. 101-5.105 Section 101-5.105 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN...

  16. Ecosystem Services

    EPA Pesticide Factsheets

    Ecosystem goods and services are the many life-sustaining benefits we receive from nature and contribute to environmental and human health and well-being. Ecosystem-focused research will develop methods to measure ecosystem goods and services.

  17. Service Inequality.

    ERIC Educational Resources Information Center

    Lang, Kurt

    1981-01-01

    Criticizes Michael Useem's argument that compulsory military service in the U.S. should not be reinstated because of the social inequities it fosters. Discusses social and economic pros and cons of the draft and voluntary military service. (GC)

  18. Central Bureau Status and Perspective

    NASA Technical Reports Server (NTRS)

    Neilan, Ruth

    2004-01-01

    The Central Bureau continues to promote the IGS organization, data and data products as setting the world standard for GPS/GNSS geodetic applications as outlined in the IGS Strategic Plan. The Central Bureau was responsible for the organization of the strategic planning process, preparation of all documents, and the editing and publication of the plan. This was a major activity and the Board s consensus on the plan is a significant milestone in the evolution of the IGS. The Central Bureau is responsible for the day-to-day management of the Service. With 200 organizations in over 80 countries and a ground network of approx. 350 stations, this requires daily interfaces on many different levels globally. The separate summary of the IGS Network Coordinator is included in this annual report and demonstrates the vital technical tasks of the Central Bureau. The CB is also responsible to arrange and organize all Board activities and is involved in the supporting the planning and logistics of all IGS workshops and meetings.

  19. IGP Services

    NASA Technical Reports Server (NTRS)

    Smith, Warren

    2003-01-01

    The goal is location-independent computing. Implementing a set of services to satisfy this goal, build upon the GLOBUS toolkit services, and implementing with OGSA. Current status includes: Event service, Job manager, Resource selector and Broker, Next versions in development.Development includes: Monitoring and testing, Portability manager, Performance prediction, Dynamic accounting, and MDS evaluation.

  20. 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

  1. Central Neuropathic Pain Syndromes.

    PubMed

    Watson, James C; Sandroni, Paola

    2016-03-01

    Chronic pain is common in patients with neurologic complications of a central nervous system insult such as stroke. The pain is most commonly musculoskeletal or related to obligatory overuse of neurologically unaffected limbs. However, neuropathic pain can result directly from the central nervous system injury. Impaired sensory discrimination can make it challenging to differentiate central neuropathic pain from other pain types or spasticity. Central neuropathic pain may also begin months to years after the injury, further obscuring recognition of its association with a past neurologic injury. This review focuses on unique clinical features that help distinguish central neuropathic pain. The most common clinical central pain syndromes-central poststroke pain, multiple sclerosis-related pain, and spinal cord injury-related pain-are reviewed in detail. Recent progress in understanding of the pathogenesis of central neuropathic pain is reviewed, and pharmacological, surgical, and neuromodulatory treatments of this notoriously difficult to treat pain syndrome are discussed.

  2. Central and peripheral demyelination

    PubMed Central

    Mehndiratta, Man Mohan; Gulati, Natasha Singh

    2014-01-01

    Several conditions cause damage to the inherently normal myelin of central nervous system, perepheral nervous system or both central and perepheral nervous system and hence termed as central demyelinating diseases, perepheral demyelinating diseases and combined central and perepheral demyelinating diseases respectively. Here we analysed and foccused on the etiology, prevalance, incidence and age of these demyelinating disorders. Clinical attention and various diagnostic tests are needed to adequately assess all these possibilities. PMID:24741263

  3. 20 CFR 346.1 - Central register.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Central register. 346.1 Section 346.1 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT... employees with at least one year of service who have declared their current availability for rail...

  4. Recovery of central Appalachian forested watershed

    Treesearch

    Mary Beth Adams; James N. Kochendenfer [sic

    2014-01-01

    The Fernow Experimental Forest (FEF) was established to conduct research in forest and watershed management in the central Appalachians. The 1868-ha FEF, located south of Parsons, West Virginia, is administered by the Northern Research Station of the USDA Forest Service and provides a valuable point of comparison with the Coweeta Hydrologic Laboratory (CHL), located in...

  5. 13th Central Hardwoods Forest Conference

    Treesearch

    J.W. Van Sambeek; Jeffrey O. Dawson; Felix Jr Ponder; Edward F. Loewenstein; James S. Fralish

    2003-01-01

    This conference was the 13th in a series of biennial meetings that have been hosted by numerous universities and research stations of the USDA Forest Service in the Central Hardwood forest region in the eastern United States. The purpose of the Conference has remained the same since it's inception -- that is to provide a forum for the formal and informal exchange...

  6. 34 CFR 303.301 - Central directory.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Central directory. 303.301 Section 303.301 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND TODDLERS WITH...

  7. Central Police Dispatch: An Exemplary Project.

    ERIC Educational Resources Information Center

    McDonnell, John J.

    The document presents a description of the Central Police Dispatch (PCD) system of Muskegon County, Michigan. The CPD, a civilian-staffed organization, is concerned with the regionalization of police services and improved police communications. The development of the CPD is traced from the Muskegon Interlocal Public Agency (1969-72) to the present…

  8. 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.

  9. 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...

  10. 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...

  11. 41 CFR 101-5.105 - Operation of the centralized facility.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.105 Operation of the centralized facility. (a) GSA...

  12. 41 CFR 101-5.105 - Operation of the centralized facility.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.105 Operation of the centralized facility. (a) GSA...

  13. 41 CFR 101-5.105 - Operation of the centralized facility.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.105 Operation of the centralized facility. (a) GSA...

  14. 41 CFR 101-5.105 - Operation of the centralized facility.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN FEDERAL BUILDINGS AND COMPLEXES 5.1-General § 101-5.105 Operation of the centralized facility. (a) GSA...

  15. 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, is...

  16. 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, is...

  17. 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, is...

  18. 32 CFR 242.6 - Central point of contact.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) 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, is...

  19. KENNEDY SPACE CENTER, FLA. - NASA officials and government representatives are gathered to learn about the assets of the Central Florida Research Park, near Orlando. At the far end of the table is NASA Administrator Sean O’Keefe. He is flanked, on the left, by Florida Congressman Tom Feeney and U.S. Senator Bill Nelson; and on the right by U.S. Congressman Dave Weldon. Central Florida leaders are proposing the research park as the site for the NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

    NASA Image and Video Library

    2004-02-19

    KENNEDY SPACE CENTER, FLA. - NASA officials and government representatives are gathered to learn about the assets of the Central Florida Research Park, near Orlando. At the far end of the table is NASA Administrator Sean O’Keefe. He is flanked, on the left, by Florida Congressman Tom Feeney and U.S. Senator Bill Nelson; and on the right by U.S. Congressman Dave Weldon. Central Florida leaders are proposing the research park as the site for the NASA Shared Services Center. The center would centralize NASA’s payroll, accounting, human resources, facilities and procurement offices that are now handled at each field center. The consolidation is part of the One NASA focus. Six sites around the U.S. are under consideration by NASA.

  20. 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.

  1. 41 CFR 105-53.147 - Public Buildings Service.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Public Buildings Service... Central Offices § 105-53.147 Public Buildings Service. (a) Creation and authority. The Public Buildings Service (PBS), headed by the Commissioner, Public Buildings Service, was established on December 11,...

  2. Current Trends in Reference Service in Public Libraries.

    ERIC Educational Resources Information Center

    King, Geraldine B.

    1983-01-01

    Current trends in public library reference service include use of online systems; budget constraints in public sector; increased service; use, training, and supervision of paraprofessionals; centralized organization of reference service; participation in management of reference services; and more realistic attempts at measurement and evaluation of…

  3. 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,…

  4. 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…

  5. Martian Central Pit Craters

    NASA Technical Reports Server (NTRS)

    Hillman, E.; Barlow, N. G.

    2005-01-01

    Impact craters containing central pits are rare on the terrestrial planets but common on icy bodies. Mars is the exception among the terrestrial planets, where central pits are seen on crater floors ( floor pits ) as well as on top of central peaks ( summit pits ). Wood et al. [1] proposed that degassing of subsurface volatiles during crater formation produced central pits. Croft [2] argued instead that central pits might form during the impact of volatile-rich comets. Although central pits are seen in impact craters on icy moons such as Ganymede, they do show some significant differences from their martian counterparts: (a) only floor pits are seen on Ganymede, and (b) central pits begin to occur at crater diameters where the peak ring interior morphology begins to appear in terrestrial planet craters [3]. A study of craters containing central pits was conducted by Barlow and Bradley [4] using Viking imagery. They found that 28% of craters displaying an interior morphology on Mars contain central pits. Diameters of craters containing central pits ranged from 16 to 64 km. Barlow and Bradley noted that summit pit craters tended to be smaller than craters containing floor pits. They also noted a correlation of central pit craters with the proposed rings of large impact basins. They argued that basin ring formation fractured the martian crust and allowed subsurface volatiles to concentrate in these locations. They favored the model that degassing of the substrate during crater formation was responsible for central pit formation due to the preferential location of central pit craters along these basin rings.

  6. Service Modeling for Service Engineering

    NASA Astrophysics Data System (ADS)

    Shimomura, Yoshiki; Tomiyama, Tetsuo

    Intensification of service and knowledge contents within product life cycles is considered crucial for dematerialization, in particular, to design optimal product-service systems from the viewpoint of environmentally conscious design and manufacturing in advanced post industrial societies. In addition to the environmental limitations, we are facing social limitations which include limitations of markets to accept increasing numbers of mass-produced artifacts and such environmental and social limitations are restraining economic growth. To attack and remove these problems, we need to reconsider the current mass production paradigm and to make products have more added values largely from knowledge and service contents to compensate volume reduction under the concept of dematerialization. Namely, dematerialization of products needs to enrich service contents. However, service was mainly discussed within marketing and has been mostly neglected within traditional engineering. Therefore, we need new engineering methods to look at services, rather than just functions, called "Service Engineering." To establish service engineering, this paper proposes a modeling technique of service.

  7. Aspects épidémiologiques, cliniques et prise en charge de sténose urétrale chez l’adulte dans un Hôpital de District de Ngaoundéré, Cameroun

    PubMed Central

    Ngaroua; Eloundou, Ngah Joseph; Djibrilla, Yaouba; Asmaou, Ousmane; Mbo, Amvene Jérémie

    2017-01-01

    Introduction L'objectif était de déterminer les aspects épidémiologiques, cliniques et prise en charge de la sténose de l’urètre à l’Hôpital Protestant de Ngaoundéré (HPN). Méthodes Une étude rétrospective a été conduite, basée sur la revue des dossiers des patients hospitalisés pour sténose urétrale dans l’unité urologique de l’HPN, d’une période d’un an (janvier 2013 à janvier 2014). Seuls les dossiers complets étaient inclus. Résultats 57 patients ont été retenus sur les 69 dossiers enregistrés dont tous était de sexe masculin. L’âge moyen était 52,6 ans (19 ans à 85 ans). La tranche d’âge la plus représentée était celle de 41 à 60 ans. La sténose urétrale représentait 0,6% des consultations externes, 11,36 % des hospitalisations en chirurgie, et 6,96% des interventions chirurgicales dans cette structure sanitaire. La dysurie (70, 17%) était le principal motif de consultation. Les étiologies étaient d’origines infectieuses (52,63%), traumatiques (26,32%) et iatrogènes (21,05%). L’ECBU réalisé sur tous les patients a permis d’isoler les gonocoques(14,03%) et Escherichia coli (21,05%), le reste de culture était stérile (64,91%). L’Uretro-Cystographie Rétrograde (UCR) a été réalisée sur 28 patients (49,12%), dont 26 cas était des rétrécissements antérieurs (92,85%). L’Urétrotomie Interne Endoscopique (UTI) était le geste chirurgical le plus réalisé (58%). La sténose était le plus souvent localisée au niveau des régions bulbaires et péno-bulbaires. Le taux de guérison était de 87,73% contre 12,27% de récidives. Conclusion La sténose urétrale est fréquente en Urologie de l’HPN mais les patients consultent souvent en stade compliqué. L’urétrotomie interne endoscopique a montré des résultats plausibles. PMID:28674586

  8. 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 Regulating...

  9. 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 Regulating...

  10. 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...

  11. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 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...

  12. 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... Central office—transmission. This account shall be used by Class B companies to record the original...

  13. 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... Central office—transmission. This account shall be used by Class B companies to record the original...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. Habitat associations of bats in south-central West Virginia

    Treesearch

    Michael R. Schirmacher; Steven B. Castleberry; W. Mark Ford; Karl V. Miller

    2007-01-01

    We conducted acoustic surveys at National Park Service and state park properties in south-central West Virginia to create bat habitat association models across a large, topographically complex and relatively intact Appalachian Hardwood landscape representative of the Allegheny Plateau portion of the central Appalachians. We developed generalized and species-specific...

  1. 25 CFR 273.26 - Submitting application to Central Office.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Submitting application to Central Office. 273.26 Section 273.26 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR INDIAN SELF-DETERMINATION AND... Submitting application to Central Office. When services under the proposed contract will be provided to...

  2. 47 CFR 32.6210 - Central office switching expenses.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Central office switching expenses. 32.6210 Section 32.6210 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... Central office switching expenses. Class B telephone companies shall use this account for expenses of the...

  3. 76 FR 50452 - South Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE South Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The South Central Idaho Resource Advisory Committee will meet in Jerome, Idaho. The committee is...

  4. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 9 2013-01-01 2013-01-01 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...

  5. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 9 2012-01-01 2012-01-01 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...

  6. 7 CFR 1032.2 - Central marketing area.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 9 2014-01-01 2013-01-01 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...

  7. 41 CFR 101-25.203 - Centralized purchases by GSA.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Centralized purchases by...-Interagency Purchase Assignments § 101-25.203 Centralized purchases by GSA. GSA will exclusively, or with specified limited exceptions, make purchases and contracts on a continuing basis for articles and services...

  8. 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

  9. Central Pit Crater

    NASA Image and Video Library

    2015-11-13

    Crater floors can have a range of features, from flat to a central peak or a central pit. This image from NASA 2001 Mars Odyssey spacecraft shows an unnamed crater in Terra Sabaea has a central pit. This unnamed crater in Terra Sabaea has a central pit. The different floor features develop do due several factors, including the size of the impactor, the geology of the surface material and the geology of the materials at depth. Orbit Number: 60737 Latitude: 22.3358 Longitude: 61.2019 Instrument: VIS Captured: 2015-08-23 20:13 http://photojournal.jpl.nasa.gov/catalog/PIA20092

  10. 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

  11. 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.

  12. 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…

  13. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 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 §...

  14. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 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 §...

  15. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 25 Indians 1 2013-04-01 2013-04-01 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 §...

  16. 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 §...

  17. 25 CFR 23.35 - Deadline for Central Office action.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 25 Indians 1 2012-04-01 2011-04-01 true 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 §...

  18. 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…

  19. Central Arizona College Master Plan for 1980-1985.

    ERIC Educational Resources Information Center

    Central Arizona Coll., Coolidge.

    College-wide and departmental goals are outlined for 1980 through 1985 in this master plan for Central Arizona College (CAC). The plan first presents CAC's institutional philosophy and then outlines 40 college-wide goals in terms of service objectives and desired outcomes. Population projections through 1985 for CAC's service district are followed…

  20. Central Arizona College Master Plan for 1980-1985.

    ERIC Educational Resources Information Center

    Central Arizona Coll., Coolidge.

    College-wide and departmental goals are outlined for 1980 through 1985 in this master plan for Central Arizona College (CAC). The plan first presents CAC's institutional philosophy and then outlines 40 college-wide goals in terms of service objectives and desired outcomes. Population projections through 1985 for CAC's service district are followed…

  1. 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…

  2. 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 the...

  3. 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 the...

  4. Support Services--Stability or Erosion?

    ERIC Educational Resources Information Center

    Bangs, John

    1993-01-01

    A survey of 40 local education authorities (LEAs) in England found that the number of LEAs cutting special education support services provision has increased, funding for low incidence support services is being delegated despite policy recommendations that they be held centrally, and increasing numbers of LEAs are reducing provision in services…

  5. 7 CFR 1776.16 - Loan servicing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... HWWS loan payments will be received by and processed at the Centralized Servicing Center. The grant.... Servicing will include preparing loan agreements, processing loan payments, reviewing financial statements and debt reserves balances, and other responsibilities such as enforcement of loan terms....

  6. 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…

  7. 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…

  8. Vocational Rehabilitation Services for Handicapped Individuals.

    ERIC Educational Resources Information Center

    Goodwill Industries of North Central Pennsylvania, Inc., DuBois.

    The manual describes the vocational rehabilitation program and services for handicapped individuals that are provided by Goodwill Industries of North Central Pennsylvania, Inc., which services an eight-county outreach area. An introductory section provides general background information regarding program objectives, philosophy, and organizational…

  9. [The need for national transfusion services].

    PubMed

    Contreras, M; de los Angeles Rodríguez, M

    1992-07-01

    Continuing advances in medical and surgical treatment have resulted in increasing demands for blood and blood derivatives. In most developed countries and in many developing ones, the blood transfusion services are organised centrally either as National Blood Transfusion Services or under the auspices of organisations such as the League of Red Cross or Red Crescent Societies. Centrally organised services have been shown clearly to be superior to hospital based transfusion services. Although hospital based services may be a convenient alternative under certain circumstances, in most cases there is inefficient use of resources and difficulties in setting, achieving and enforcing quality standards. This is so particularly in developing countries. The need to change from a remunerated or replacement donor system is emphasised, with the ultimate goal being national self-sufficiency in blood and blood derivatives. Attention is also drawn to the importance of education and motivation of staff working in the blood transfusion services if these objectives are to be met.

  10. Flash Flooding Events in South Central Texas.

    DTIC Science & Technology

    1982-08-01

    I AD-ALI 977 AIR FORCE INST OF TECH WRIGHT-PATTERSON AFa OH F/G 4/2 FLASH FLOODING EVENTS IN SOUTH CENTRAL TEXAS. CU) N AU 82 T W UTLEY UNCLASSIFIED...COVERED Flash Flooding Events in South Central Texas THESIS/ESeAMAN S. PERFORMING ORG. REPORI NUMBER 7. AUTHOR(*) S. CONTRACT OR GRANT NUMBER(s) Tom...and to flash flooding events which occurred in 1981 they proved to be excellent predi’ctors. When compared to the 1981 National Weather Service

  11. Idiopathic central diabetes Insipidus.

    PubMed

    Grace, Mary; Balachandran, Venu; Menon, Sooraj

    2011-10-01

    Idiopathic central diabetes insipidus (CDI) is a rare disorder characterized clinically by polyuria and polydipsia, and an abnormal urinary concentration without any identified etiology. We report a case of central diabetes insipidus in a 60-year-old lady in the absence of secondary causes like trauma, infection, and infiltrative disorders of brain.

  12. Central College Data Book.

    ERIC Educational Resources Information Center

    Central Coll., McPherson, KS.

    Tabulated data relevant to several aspects of Central College, a private two-year church-related institution, are compiled in this data book. Content includes statistical data and information on: (1) the purposes, objectives, history, and accreditation and memberships of Central College; (2) full- and part-time faculty, faculty utilization,…

  13. Central diffraction at ALICE

    NASA Astrophysics Data System (ADS)

    Lämsä, J. W.; Orava, R.

    2011-02-01

    The ALICE experiment is shown to be well suited for studies of exclusive final states from central diffractive reactions. The gluon-rich environment of the central system allows detailed QCD studies and searches for exotic meson states, such as glueballs, hybrids and new charmonium-like states. It would also provide a good testing ground for detailed studies of heavy quarkonia. Due to its central barrel performance, ALICE can accurately measure the low-mass central systems with good purity. The efficiency of the Forward Multiplicity Detector (FMD) and the Forward Shower Counter (FSC) system for detecting rapidity gaps is shown to be adequate for the proposed studies. With this detector arrangement, valuable new data can be obtained by tagging central diffractive processes.

  14. 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:…

  15. 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:…

  16. Department of Defense Food Service Program

    DTIC Science & Technology

    1991-06-05

    information . 3. Centralized and consolidated food service facilities. 4. A viable research, development, testing, and engineerii’g program to provide...aZ Department of Defense - INSTRUCTION June 5, I~qq AD-A270 334 NUMBER 1338.1o ASD(P&L) SUBJECT: Department of Defense Food Service Program...34Manual for the Department of Defense Food Service Program," November 1978, authorized by this Directive (e) through (hi), see enclosure 1I~% A

  17. 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.

  18. 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.

  19. 75 FR 70200 - Notice of Central Idaho Resource Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service Notice of Central Idaho Resource Advisory Committee Meeting AGENCY: Forest Service, USDA.... L. 110-343), the Salmon-Challis National Forest's Central Idaho Resource Advisory Committee will...

  20. 75 FR 5036 - Notice of Central Idaho Resource Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-01

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF AGRICULTURE Forest Service Notice of Central Idaho Resource Advisory Committee Meeting AGENCY: Forest Service, USDA.... L. 110-343), the Salmon-Challis National Forest's Central Idaho Resource Advisory Committee will...

  1. 75 FR 58347 - Notice of Central Idaho Resource Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service Notice of Central Idaho Resource Advisory Committee Meeting AGENCY: Forest Service, USDA.... L. 110-343), the Salmon-Challis National Forest's Central Idaho Resource Advisory Committee will...

  2. 75 FR 17375 - Notice of Central Idaho Resource Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service Notice of Central Idaho Resource Advisory Committee Meeting AGENCY: Forest Service, USDA.... L. 110-343), the Salmon-Challis National Forest's Central Idaho Resource Advisory Committee will...

  3. 76 FR 48801 - Notice of Central Idaho Resource Advisory Committee Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-09

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Forest Service Notice of Central Idaho Resource Advisory Committee Meeting AGENCY: Forest Service, USDA.... L. 110-343), the Salmon-Challis National Forest's Central Idaho Resource Advisory Committee will...

  4. 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.

  5. Central sleep apnea

    MedlinePlus

    ... Ramar K, et al. The treatment of central sleep apnea syndromes in adults: practice parameters with an evidence-based literature review and meta-analyses. SLEEP . 2012;35:17-40. Clodagh MR, Bradley TD. ...

  6. 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.

  7. Pigmented central neurocytoma.

    PubMed

    Kiehl, Tim-Rasmus; Kalkanis, Steven N; Louis, David N

    2004-06-01

    Central neurocytoma is a low-grade neuronal neoplasm that occurs most often within the lateral ventricles. We report the case of a 60-year-old woman who presented with gait problems, headache and memory loss. Preoperative evaluation demonstrated a heterogeneous, hypervascular and partially cystic mass in the left lateral ventricle. Histopathological examination revealed characteristic features of central neurocytoma, including immunoreactivity for synaptophysin, as well as the unusual feature of abundant pigment in the cytoplasm of tumor cells. Special stains revealed iron, consistent with hemosiderin, but found no evidence of melanin or melanosomes. Previous reports of pigmented central neurocytoma have described the presence of lipofuscin or neuromelanin. To our knowledge, the present case represents the first example of pigmented central neurocytoma secondary to hemosiderin deposition.

  8. Central Peak Crater

    NASA Image and Video Library

    2010-10-07

    As crater size increases, craters become more complex. This moderate size crater contains a central peak, created by rebound of molten material just following the impact. This image was captured by NASA Mars Odyssey on Sept. 8, 2010.

  9. 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

  10. TACS Central Control Facility.

    DTIC Science & Technology

    1981-02-12

    Central Control Facility 6 3. System Management Data Flow 7 B. Hardware Operating Environment 9 1. Computer 9 2. TACS Interfaces 9 3. Other Central...TERMINATION TIMING 131 Appendix C SYSTEM MANAGEMENT DATA FORMATS 135 Appendix D FIVE- AND NINE-SLOT SYSTEM IMPLEMENTATION DIFFERENCES 147 Appendix E...control burst management ) 26 2-7 Call Progress Messages 29 2-8 Flowchart of Assignment/Blockage Decision Process for All-Member Net Requests 30 2-9

  11. Central Diffraction in ALICE

    SciTech Connect

    Schicker, R.

    2011-07-15

    The ALICE experiment consists of a central barrel in the pseudorapidity range -0.9<{eta}<0.9 and of additional detectors covering about 3 units of pseudorapidity on either side of the central barrel. Such a geometry allows the tagging of single and double gap events. The status of the analysis of such diffractive events in proton-proton collisions at {radical}(s) = 7 TeV is presented.

  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.

  13. Orthopedic services

    MedlinePlus

    ... MedlinePlus GO GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español You Are Here: Home → Medical Encyclopedia → Orthopedic services URL of this page: //medlineplus.gov/ency/article/ ...

  14. Food Service.

    ERIC Educational Resources Information Center

    Furneisen, Barbara K.

    Written to teach deaf students skills in food services, this guide and the two related documents (see note) present practical skills needed to work in a school dining room setting serving approximately two hundred students and faculty. Eleven units are included, with each unit containing from three to eleven lessons. Each lesson includes an…

  15. 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.

  16. 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…

  17. 40 CFR 3.20 - How will EPA provide notice of changes to the Central Data Exchange?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... section, whenever EPA plans to change Central Data Exchange hardware or software in ways that would affect... the equipment, software, or services needed to transmit electronic documents to the Central...

  18. Accessibility benchmarks: interpretive programs and services in north central California

    Treesearch

    Laura J. McLachlin; Emilyn A. Sheffield; Donald A. Penland; Charles W. Nelson

    1995-01-01

    The Heritage Corridors Project was a unique partnership between the California Department of Parks and Recreation, the California State University, and the Across California Conservancy. The purpose of the project was to develop a map of selected northern California outdoor recreation and heritage sites. Data about facility accessibility improvements (restrooms, clear...

  19. 75 FR 6696 - Draft Recovery Plan for Tidal Marsh Ecosystems of Northern and Central California

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-10

    ... Fish and Wildlife Service Draft Recovery Plan for Tidal Marsh Ecosystems of Northern and Central... draft recovery plan for Tidal Marsh Ecosystems of Northern and Central California for public review and... Marsh Ecosystems of Northern and Central California features five endangered species. The biology of...

  20. USEPA Facility Registry Service Datasets

    EPA Pesticide Factsheets

    This collection contains datasets relating to location and facility identification information from EPA's Facility Registry Service (FRS). Using vigorous verification and data management procedures, FRS integrates facility data from EPA's national program systems, other federal agencies, and State and tribal master facility records and provides EPA with a centrally managed, single source of comprehensive and authoritative information on facilities. This collection provides access to a variety of live data services, APIs and downloadable FRS data, many of which are also enumerated here: https://www.epa.gov/enviro/frs-data-resources .

  1. The Cure for Ailing Self-Service Business Intelligence

    DOE PAGES

    Burke, Marsha; Simpson, Wayne; Staples, Shad

    2016-09-14

    There are many reasons that self-service models fail. Furthermore, these reasons are directly applicable in the management of self-service business inteligence modeling. Our article expands upon the reasons for failure and suggests how self-service models can be made successful through implementation of a centralized approach to development, testing, implementation and support for the delivery of decision making information.

  2. 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…

  3. 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…

  4. Student Services Transformed: Helping Students to Help Themselves

    ERIC Educational Resources Information Center

    Denogean, Anne; Schwalbach, Paul

    2010-01-01

    Pima Community College (PCC) successfully centralized operations to ensure consistent, reliable delivery of student services. A new emphasis on self-efficacy lets students learn to do for themselves what was once done for them by staff. Renovated Student Service Centers at each campus place a diverse set of services in one location.

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. 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... SERVICE (Marketing Agreements and Orders; Milk), DEPARTMENT OF AGRICULTURE MILK IN THE CENTRAL MARKETING AREA Order Regulating Handling Administrative Assessment and Marketing Service Deduction § 1032.86...

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

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 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. The Federal Property Resources Service (FPRS), headed by the Commissioner, Federal Property Resources...

  11. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 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. The Federal Property Resources Service (FPRS), headed by the Commissioner, Federal Property Resources...

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

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 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. The Federal Property Resources Service (FPRS), headed by the Commissioner, Federal Property Resources...

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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. The Federal Property Resources Service (FPRS), headed by the Commissioner, Federal Property Resources...

  14. 41 CFR 105-53.144 - Federal Property Resources Service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 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. The Federal Property Resources Service (FPRS), headed by the Commissioner, Federal Property Resources...

  15. Service-Learning and Student Volunteerism: Reflections on Institutional Commitment.

    ERIC Educational Resources Information Center

    Ward, Kelly

    1996-01-01

    A study examined how five colleges and universities with stated commitments to public service incorporate volunteerism and service-learning into organizational structures. Results suggest that institutions that make centralized decisions and share governance are more apt to institutionalize service-learning than are more loosely coupled systems.…

  16. 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…

  17. 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.

  18. 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.

  19. 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…

  20. CENTRAL PLATEAU REMEDIATION

    SciTech Connect

    ROMINE, L.D.

    2006-02-01

    A systematic approach to closure planning is being implemented at the Hanford Site's Central Plateau to help achieve the goal of closure by the year 2035. The overall objective of Central Plateau remediation is to protect human health and the environment from the significant quantity of contaminated material that resulted from decades of plutonium production in support of the nation's defense. This goal will be achieved either by removing contaminants or placing the residual contaminated materials in a secure configuration that minimizes further migration to the groundwater and reduces the potential for inadvertent intrusion into contaminated sites. The approach to Central Plateau cleanup used three key concepts--closure zones, closure elements, and closure process steps--to create an organized picture of actions required to complete remediation. These actions were merged with logic ties, constraints, and required resources to produce an integrated time-phased schedule and cost profile for Central Plateau closure. Programmatic risks associated with implementation of Central Plateau closure were identified and analyzed. Actions to mitigate the most significant risks are underway while high priority remediation projects continue to make progress.

  1. Computing Services

    DTIC Science & Technology

    2008-08-08

    Speed in delivering capacity to the datacenter floor – Managed services partnerships • ITIL -based processes 4 Virtualization & Application Stacking...House” Communications 129 450 1140 482 232 117 MAINFRAME ROUTERS SWITCHES SECURITY MANAGEMENT STORAGE Communication Devices by Function Terminal...to protect and enforce security boundaries • Managing content as an extension of the glass house (e.g., GCDS) Communication Provider(s) Value Added

  2. USDA Forest Service wetlands research

    SciTech Connect

    Bartuska, A.M. )

    1993-05-01

    Wetland and riparian systems play a major role in flood control, water quality, and food chain support. Timber production, fisheries, and recreation vie economically as primary uses of forested wetlands. This article reviews current Forest Service research in the Intermountain Region, North Central Region, Northeast Region, Pacific Northwest Region, Rocky Mountain Region, and Southern Region. Future research areas are discussed: ecosystem processes, restoration and rehabilitation, management of the wetland resource, socioeconomic values, and landscape-scale links. 8 refs.

  3. Central auditory imperception.

    PubMed

    Snow, J B; Rintelmann, W F; Miller, J M; Konkle, D F

    1977-09-01

    The development of clinically applicable techniques for the evaluation of hearing impairment caused by lesions of the central auditory pathways has increased clinical interest in the anatomy and physiology of these pathways. A conceptualization of present understanding of the anatomy and physiology of the central auditory pathways is presented. Clinical tests based on reduction of redundancy of the speech message, degradation of speech and binaural interations are presented. Specifically performance-intensity functions, filtered speech tests, competing message tests and time-compressed speech tests are presented with the emphasis on our experience with time-compressed speech tests. With proper use of these tests not only can central auditory impairments by detected, but brain stem lesions can be distinguished from cortical lesions.

  4. Hale Central Peak

    NASA Technical Reports Server (NTRS)

    2004-01-01

    19 September 2004 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows some of the mountains that make up the central peak region of Hale Crater, located near 35.8oS, 36.5oW. Dark, smooth-surfaced sand dunes are seen to be climbing up the mountainous slopes. The central peak of a crater consists of rock brought up during the impact from below the crater floor. This autumn image is illuminated from the upper left and covers an area approximately 3 km (1.9 mi) across.

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

    PubMed

    Singer, Judy; Adams, Jon

    2014-05-22

    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. 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. 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 of treating the whole person

  6. 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

  7. What We Can Learn from Service Design in Order to Design Services

    NASA Astrophysics Data System (ADS)

    Giusti, Leonardo; Zancanaro, Massimo

    Service Design emerged as distinct discipline in the late '80s to specifically address the peculiar challenges of a post-industrial society in moving toward a more pervasive offer of services with respect to products. The central tenet of this discipline is that services are radically different from products and a different mindset is necessary for designing them. Its aim was to develop theoretical basis as well as practical methods to design the intermix of processes, artifacts exchanges and user experience which are going on in delivering services. We believe that several of the concepts investigated in the past 20 years of research in Service Design might be fruitfully applied to design the user experience with Service-Oriented Applications for Future Internet. In this paper, we briefly introduce Service Design and we link the key concepts to the challenges posed by Service-Oriented Computing. We will then exemplify some concepts within a simple scenario.

  8. CENTRALIZATION AND HIGHER EDUCATION.

    ERIC Educational Resources Information Center

    MCKEAN, ROLAND N.

    SUGGESTED COSTS AND BENEFITS OF CENTRALIZED AUTHORITY IN HIGHER EDUCATION AS THEY AFFECT THE BEHAVIOR OF LEGISLATORS, ADMINISTRATORS, VOTERS, TEACHERS, AND STUDENTS, WERE EXAMINED BY COMPARING POLICIES OF DIFFERENT INSTITUTIONS (TWO MULTIVERSITIES OR COORDINATED STATE COLLEGE SYSTEMS, TWO RELATIVELY INDEPENDENT PUBLIC UNIVERSITIES IN ONE STATE,…

  9. CENTRALIZATION OF CAMPUS CONTROLS.

    ERIC Educational Resources Information Center

    1967

    A COLLEGE CAMPUS HAVING A LARGE NUMBER OF SEPARATE BUILDINGS WITH ONE BASIC HEATING AND COOLING SYSTEM IS AN IDEAL SITUATION FOR REALIZING GREAT BENEFITS FROM CENTRALIZED BUILDING CONTROL SYSTEMS. TYPICAL REQUIREMENTS AND ADVANTAGES OF SUCH SYSTEMS ARE DISCUSSED BRIEFLY AND DESCRIPTIONS OF THE SYSTEM AT FOUR MAJOR UNIVERSITIES ARE GIVEN. THIS…

  10. Ghrelin in central neurons.

    PubMed

    Ferrini, F; Salio, C; Lossi, L; Merighi, A

    2009-03-01

    Ghrelin, an orexigenic peptide synthesized by endocrine cells of the gastric mucosa, is released in the bloodstream in response to a negative energetic status. Since discovery, the hypothalamus was identified as the main source of ghrelin in the CNS, and effects of the peptide have been mainly observed in this area of the brain. In recent years, an increasing number of studies have reported ghrelin synthesis and effects in specific populations of neurons also outside the hypothalamus. Thus, ghrelin activity has been described in midbrain, hindbrain, hippocampus, and spinal cord. The spectrum of functions and biological effects produced by the peptide on central neurons is remarkably wide and complex. It ranges from modulation of membrane excitability, to control of neurotransmitter release, neuronal gene expression, and neuronal survival and proliferation. There is not at present a general consensus concerning the source of ghrelin acting on central neurons. Whereas it is widely accepted that the hypothalamus represents the most important endogenous source of the hormone in CNS, the existence of extra-hypothalamic ghrelin-synthesizing neurons is still controversial. In addition, circulating ghrelin can theoretically be another natural ligand for central ghrelin receptors. This paper gives an overview on the distribution of ghrelin and its receptor across the CNS and critically analyses the data available so far as regarding the effects of ghrelin on central neurotransmission.

  11. Multicultural Central Asia.

    ERIC Educational Resources Information Center

    Boyle, Eric D.

    This article addresses the multicultural aspect of Central Asia in response to the discussion on diversity in U.S. classrooms. Many areas of the world are more diverse than the U.S., and these areas experience successes and failures with many of the same issues the U.S. is currently struggling with. Comparing the U.S. diversity debate with similar…

  12. Education in Central America.

    ERIC Educational Resources Information Center

    Waggoner, George R.; Waggoner, Barbara Ashton

    The first chapter of this book describes the physical and cultural environment of Central America and includes analytical comments showing the complexity of the problems confronting the region. Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, and Panama are then treated in separate chapters including: 1) political, economic, social and…

  13. The central hardwood forest

    Treesearch

    F. Bryan Clark

    1989-01-01

    The central hardwood forest covers a vast area of the United States where the dominant native vegetation is hardwood trees. It is one of the largest forest areas in the country and contains about 100 million acres. The forests include more than 70 hardwood tree species, several conifers, many shrubs and herbaceous plants, and a large number of animal species.

  14. Central hardwood notes

    Treesearch

    F. Bryan Clark; Jay G. Hutchinson

    1989-01-01

    The central hardwood forest covers a vast area of the United States where the dominant native vegetation is hardwood trees. It is one of the largest forest areas in the country and contains about 100 million acres. The forests include more than 70 hardwood tree species, several conifers, many shrubs and herbaceaous plants, and a large number of animal species. This...

  15. Central College Perspectives.

    ERIC Educational Resources Information Center

    Knapp, Wesley L.; Hawkins, Calvin H.

    Institutional data are presented which reflect five-year trends in the characteristics of Central College, a two-year institution established by members of the Free Methodist Church of North America in 1884. Data tables present a profile of the faculty with figures for 1972 through 1977 for the following: number and characteristics of full- and…

  16. 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.

  17. Ghrelin in Central Neurons

    PubMed Central

    Ferrini, F; Salio, C; Lossi, L; Merighi, A

    2009-01-01

    Ghrelin, an orexigenic peptide synthesized by endocrine cells of the gastric mucosa, is released in the bloodstream in response to a negative energetic status. Since discovery, the hypothalamus was identified as the main source of ghrelin in the CNS, and effects of the peptide have been mainly observed in this area of the brain. In recent years, an increasing number of studies have reported ghrelin synthesis and effects in specific populations of neurons also outside the hypothalamus. Thus, ghrelin activity has been described in midbrain, hindbrain, hippocampus, and spinal cord. The spectrum of functions and biological effects produced by the peptide on central neurons is remarkably wide and complex. It ranges from modulation of membrane excitability, to control of neurotransmitter release, neuronal gene expression, and neuronal survival and proliferation. There is not at present a general consensus concerning the source of ghrelin acting on central neurons. Whereas it is widely accepted that the hypothalamus represents the most important endogenous source of the hormone in CNS, the existence of extra-hypothalamic ghrelin-synthesizing neurons is still controversial. In addition, circulating ghrelin can theoretically be another natural ligand for central ghrelin receptors. This paper gives an overview on the distribution of ghrelin and its receptor across the CNS and critically analyses the data available so far as regarding the effects of ghrelin on central neurotransmission. PMID:19721816

  18. Public service satellites

    NASA Technical Reports Server (NTRS)

    Fletcher, J. C.

    1977-01-01

    The development of the communications satellite system is discussed, taking into account a suggestion by Clarke in 1945 concerning the significance of geosynchronous satellites, the establishment of Intelsat, reductions in the cost of transatlantic telephone calls as a result of satellite communications service, questions of satellite cost, and the need for larger satellites. It is pointed out that the use of the Space Shuttle will reduce the cost of placing a satellite in orbit from more than half to less than a quarter of the total cost of design, construction, and launch. Attention is given to studies of a personal communications system which involves direct broadcast from a 'wrist watch radio' to a high-capacity, multibeam satellite for retransmission to ground communications centrals.

  19. 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.

  20. 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

  1. Developing a central sterile surgical instrument technician program.

    PubMed

    Garner, Marie; Collins, Angela; Dunphy, Sallie; Bullock, Patricia; Wright, Deborah

    2004-08-01

    Many hospitals report high vacancy rates in their central sterile processing departments related to the lack of a workforce that is knowledgeable about instrument processing and medical terminology. Creating an education course that focused on the knowledge and skills necessary for success in this vocation provided a solution to this problem for one facility. Outcomes included a dramatic decrease in the number of vacancies in the central sterile processing department and an increase in community awareness of employment options available in perioperative services.

  2. 41 CFR 101-5.304 - Type of occupational health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN FEDERAL BUILDINGS AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.304 Type of occupational...

  3. 41 CFR 101-5.304 - Type of occupational health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS GENERAL 5-CENTRALIZED SERVICES IN FEDERAL BUILDINGS AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.304 Type of occupational...

  4. Full Service

    NASA Technical Reports Server (NTRS)

    Morring, Frank, Jr.

    2004-01-01

    NASA is moving ahead with the sole-source procurement of a Canadian robot to service the Hubble Space Telescope, gaining confidence the International Space Station (ISS) technology can perform all of the tasks shuttle-launched astronauts were scheduled to do before the Columbia accident changed everything. The U.S. agency is negotiating with MD Robotics, a MacDonald Dettwiler unit located in Brampton, Ontario, for a version of the Special Purpose Dexterous Manipulator (SPDM) the company developed for the ISS. The SPDM would be the business end of a throwaway module designed to replace batteries and gyroscopes, pull old instruments and install new ones before plunging to a targeted reentry over the Pacific.

  5. [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.

  6. 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.

  7. Fires in Central America

    NASA Technical Reports Server (NTRS)

    2002-01-01

    As can be seen in this true-color scene acquired on April 2, 2002, many fires dot the landscape across portions of Central America. This image spans from Mexico's Yucatan Peninsula across Guatemala and into El Salvador and Honduras. This image was acquired by the Moderate-resolution Imaging Spectroradiometer (MODIS), flying aboard NASA's Terra satellite. The red boxes indicate where active fires were burning.

  8. Central nervous system toxicity.

    PubMed

    Ruha, Anne-Michelle; Levine, Michael

    2014-02-01

    Central nervous system toxicity caused by xenobiotic exposure is a common reason for presentation to the emergency department. Sources of exposure may be medicinal, recreational, environmental, or occupational; the means of exposure may be intentional or unintended. Toxicity may manifest as altered thought content resulting in psychosis or confusion; may affect arousal, resulting in lethargy, stupor, or coma; or may affect both elements of consciousness. Seizures may also occur. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. [Central neurocytoma: case report].

    PubMed

    Bouaziz, M; Mansour, A; Feknous, S; Yassi, F; Smati, S; Belhouchet, S; Lankar, A

    2009-12-01

    In this study, we report one case of central neurocytoma treated in our department. It is a benign tumor of the lateral ventricles of the brain with neuronal differentiation. The clinical symptoms mainly consisted in intracranial hypertension syndrome. Immunohistochemical studies are necessary for the histopathological diagnosis. The treatment of choice is surgical. To guarantee good progression, complete ablation is necessary. The clinical progression, radiological aspects, treatment, histopathology, and postoperative progression will be discussed.

  10. Centrality based Document Ranking

    DTIC Science & Technology

    2014-11-01

    approach. We model the documents to be ranked as nodes in a graph and place edges between documents based on their similarity. Given a query, we compute...similarity of the query with respect to every document in the graph . Based on these similarity values, documents are ranked for a given query...clinical documents using centrality based approach. We model the documents to be ranked as nodes in a graph and place edges between documents based on their

  11. [The central pattern generators].

    PubMed

    Balaban, P M; Vorontsov, D D; Dyakonova, V E; Dyakonova, T L; Zakharov, I S; Korshunova, T A; Orlov, O Yu; Pavlova, G A; Panchin, Yi V; Sakharov, D A; Falikman, M V

    2013-01-01

    The central pattern generator (CPG) is defined as a set of neurons involved in joint production of patterned motor output. The roundtable discussion on the CPG was a part of the 5th All-Russian Conference on Animal Behavior (Moscow, Nov. 21, 2012). The discussion centred on three core themes: 1) the mechanisms of the organization and reconfiguration of pattern generating neuronal ensembles, 2) extrapolations that extend the CPG concept beyond the motor systems, and 3) evolutionary and developmental aspects of CPG.

  12. Central corneal abscess.

    PubMed

    van Bijsterveld, O P

    1976-05-01

    Central corneal abscess developed in the experimental animal after inoculation of biologically active staphylococcal strains in a paracentral epithelial lesion of the cornea. These abscesses did not ulcerate, developed only with high inocula, occurred more frequently in immunized rabbits. A serpiginous type of ulceration did not develop at the site of the initial epithelial lesion nor at any other place in the cornea. Histologically, the lesions consisted of densely packed polymorphonuclear leukocytes between the corneal lamellae.

  13. Gangs in Central America

    DTIC Science & Technology

    2007-08-02

    564 ( Engel ) recognizing that violence poses an increasingly serious threat to peace and stability in Central America and supporting expanded...2005; UNODC, May 2007. 10 For example, see Federico Brevé, former Minister of Defense of Honduras, “The Maras: A Menace to the Americas,” Military...police training and judicial reform. On July 31, 2007, the House Committee on Foreign Affairs approved H.Res. 564 ( Engel ) recognizing that violence

  14. Gangs in Central America

    DTIC Science & Technology

    2008-10-17

    activity and in the handling of deported gang members. However, none of those bills were enacted. On October 2, 2007, the House passed H.Res. 564 ( Engel ...UNODC, May 2007. 12 For example, see Federico Brevé, former Minister of Defense of Honduras, “The Maras: A Menace to the Americas,” Military Review...passed H.Res. 564 ( Engel ) supporting expanded cooperation between the United States and Central America to combat crime and violence. Mérida

  15. Gangs in Central America

    DTIC Science & Technology

    2008-03-27

    handling of deported gang members, but none of those bills were enacted. On October 2, 2007, the House passed H.Res. 564 ( Engel ) supporting expanded...crimes committed CRS-4 12 For example, see Federico Brevé, former Minister of Defense of Honduras, “The Maras: A Menace to the Americas,” Military...examined the effects of U.S. deportations on Central America. On October 2, 2007, the House passed H.Res. 564 ( Engel ) supporting expanded

  16. [Central precocious puberty].

    PubMed

    Krysiak, Robert; Marek, Bogdan; Okopień, Bogusław

    2008-01-01

    Central precocious puberty, defined as the onset of puberty before the age 8 years in girls and 9 years in boys, results from a premature activation of gonadotropin-releasing hormone neurons in the hypothalamus. This condition is characterised by early pubertal changes, acceleration of growth velocity, and rapid bone maturation that often result in reduced adult height. It may be either idiopathic or associated with hypothalamic hamartoma, brain neoplasms, numerous non-cancerous disorders of the central nervous system and treatment of peripheral precocious puberty. The goal of the initial assessment of children is to exclude the presence of all these organic disorders. The diagnosis should include detailed anamnesis and clinical examination, measurement of pituitary and sex hormones, assessment of bone age, and imaging of the hypothalamus, pituitary gland, abdomen, pelvis and gonads. The treatment of choice are gonadotropin-releasing hormone agonists. In this paper, we review the current views on the etiopathogenesis, clinical presentation, diagnosis and management of central precocious puberty.

  17. 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.

  18. 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

  19. Developing a rural community-based disability service: (I) service framework and implementation strategy.

    PubMed

    Kuipers, P; Kendall, E; Hancock, T

    2001-02-01

    In response to widely recognised dilemmas associated with rehabilitation and disability service provision in remote and rural areas of Australia, a community-based, participatory approach to service development was adapted for a disability service project in central Queensland. The service framework, known as Community Based Rehabilitation (CBR), fosters the involvement of community members in disability service provision. Although this framework has been described previously, few guidelines exist regarding appropriate implementation of such an approach. Consequently, the implementation strategy known as Participatory Rural Appraisal (PRA) was adopted. Participatory Rural Appraisal has been reported to foster the participation and decision-making of community members in community projects. The present article describes the application of this implementation strategy to disability service provision in a relatively under-resourced rural shire. The rationale, framework and process of the pilot are described. A subsequent publication will document the service component, detail evaluation findings and describe the long-term outcomes of this research.

  20. Southern Nevadas Club Ride Commuter Service Wins EPA Honor

    EPA Pesticide Factsheets

    · Clean Air Partners Program - CLEAN AIR Force of Central Texas · Club Ride Commuter Services - Regional Transportation Commission of Southern Nevada · Air Quality Partnership of the Delaware Valley - Delaware Valley Regional Planning