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Sample records for central service prise

  1. 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.

  2. 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

  3. 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…

  4. 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.

  5. 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…

  6. 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...

  7. 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…

  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. 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.

  10. 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

  11. 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

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

    PubMed

    Teodosijevic, Nada; Rikanovic, Sasa

    2010-01-01

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

  13. 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

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

    ERIC Educational Resources Information Center

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

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

  15. 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....

  16. 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....

  17. 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....

  18. 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....

  19. 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....

  20. 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

  1. 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...

  2. 13 CFR 120.954 - Central Servicing Agent.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  3. 13 CFR 120.954 - Central Servicing Agent.

    Code of Federal Regulations, 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 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…

  9. 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)…

  10. 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…

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

    PubMed Central

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

    2016-01-01

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

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-14

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

  13. 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

    .... (DNC), Central Vermont Public Service Corporation (CVPS) and Massachusetts Municipal Wholesale Electric Company (MMWE) (collectively ``the licensees'' or ``DNC, Inc., et al.'') are the co-holders of the Renewed... Power Station, Unit 3 (MPS3). CVPS is a non-operating owner of a 1.7303% interest in MPS3. DNC is...

  14. 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

    ... COMMISSION Central Vermont Public Service Corporation, Millstone Power Station, Unit 3; Notice of.... NPF-49) for the Millstone Power Station, Unit 3 (MPS3) resulting from a subsequent restructuring in.... subsidiary Green Mountain Power Corporation (GMP). The Commission is also considering amending the...

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

    ERIC Educational Resources Information Center

    Barley, Zoe; Wegner, Sandra K.

    2007-01-01

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

  16. 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…

  17. 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…

  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. 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...

  20. 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

  1. 78 FR 41954 - TA-W-82,634, Prudential Global Business Technology Solutions Central Security Services Dresher...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

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

  2. 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.

  3. 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.

  4. 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.

  5. Cue Integration in Dynamic Decision Marking (Integration des indices dans la Prise de Decision Dynamique)

    DTIC Science & Technology

    2010-07-01

    environnements complexes et dynamiques. La nature complexe et dynamique de differents types d’operations (p. ex., les operations basees sur les...destinees a preparer les commandants et le personnel des etats- majors des Forces canadiennes (FC) a prendre des decisions dans des environnements ...Ia prise de decisions dans les environnements complexes et dynamiques est habituellement designee sous le nom de prise de decisions dynamique (POD

  6. 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.

  7. 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.

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. [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.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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)

  19. 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.

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. [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.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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.

  17. "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…

  18. 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.

  19. 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.

  20. 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…

  1. 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…

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  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. 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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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....

  14. [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.

  15. [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.

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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

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

    PubMed

    Hilde, Thomas; Paterson, Robert

    2014-12-15

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

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

    PubMed Central

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

    2015-01-01

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

  8. 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

  9. 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

  10. 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...

  11. 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 ...

  12. 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.

  13. [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.

  14. 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).

  15. 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

  16. 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

  17. 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…

  18. 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...

  19. 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.

  20. 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.

  1. 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

  2. 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)

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. [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 ».

  8. 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…

  9. 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

  10. 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

  11. 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 ...

  12. 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

  13. 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.

  14. 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

  15. 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

  16. 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…

  17. 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.

  18. 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

  19. 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:

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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

  9. 78 FR 21401 - Notice of Inventory Completion: Central Washington University, Ellensburg, WA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... National Park Service Notice of Inventory Completion: Central Washington University, Ellensburg, WA AGENCY: National Park Service, Interior. ACTION: Notice. ] SUMMARY: Central Washington University has completed an... remains should submit a written request to Central Washington University. If no additional requestors...

  10. 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

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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 ...

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

    PubMed Central

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

    2016-01-01

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

  17. 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

  18. 36 CFR 200.1 - Central organization.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 2 2011-07-01 2011-07-01 false Central organization. 200.1 Section 200.1 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE ORGANIZATION, FUNCTIONS, AND PROCEDURES Organization § 200.1 Central organization. (a) Central office. The national...

  19. 36 CFR 200.1 - Central organization.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 2 2014-07-01 2014-07-01 false Central organization. 200.1 Section 200.1 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE ORGANIZATION, FUNCTIONS, AND PROCEDURES Organization § 200.1 Central organization. (a) Central office. The national...

  20. 36 CFR 200.1 - Central organization.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 2 2013-07-01 2013-07-01 false Central organization. 200.1 Section 200.1 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE ORGANIZATION, FUNCTIONS, AND PROCEDURES Organization § 200.1 Central organization. (a) Central office. The national...

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

    PubMed Central

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

    2015-01-01

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

  2. 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.

  3. 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.…

  4. 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.

  5. 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.

  6. 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

  7. 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…

  8. 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)

  9. 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

  10. Medical Services: Ophthalmic Services

    DTIC Science & Technology

    2007-11-02

    optometrist may be employed according to Service regulations. Such examinations will include fitting and adjusting of spectacles. All prescriptions...below. a. An ophthalmologist or optometrist competent in contact lens fitting must be available. b. Adequate diagnostic, inspection, and modification...the prescribing officer. Enter name, grade, and title of the prescribing officer (oph- thalmologist or optometrist ). DD Form 577 (Signature Card) will

  11. 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... the Federal Advisory Committee Act. The purpose of the committee is to improve...

  12. 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

  13. 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...

  14. 22 CFR 94.3 - Functions of the Central Authority.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

  15. 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

  16. 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…

  17. 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.

  18. 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.…

  19. 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…

  20. 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

  1. 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

  2. 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.

  3. 77 FR 58094 - Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... Forest Service Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of... committee is to improve collaborative relationships and to provide advice and recommendations to the Forest Service concerning projects and funding consistent with the title II of the Act. The meeting is open...

  4. 78 FR 23741 - North Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-22

    ... Forest Service North Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION...) (Pub. L. 92-463). The purpose of the RAC is to improve collaborative relationships and to provide advice and recommendations to the Forest Service concerning projects and funding consistent with Title...

  5. 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... committee is to improve collaborative relationships and to provide advice and recommendations to the Forest Service concerning projects and funding consistent with the title II of the Act. The meeting is open...

  6. 77 FR 52310 - Central Idaho Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... Forest Service Central Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of... purpose of the committee is to improve collaborative relationships and to provide advice and recommendations to the Forest Service concerning projects and funding consistent with the title II of the Act....

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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...

  13. 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.

  14. 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...

  15. 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…

  16. 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

  17. 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

  18. 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,...

  19. 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

  20. 10 CFR 16.13 - Procedures for centralized administrative offset.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... collected. (f) Fees. Agencies that perform centralized salary offset computer matching services may charge a... made. The disbursing official may deduct the amount of the erroneous offset payment from future...

  1. 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.

  2. 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.

  3. 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...

  4. 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...

  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. 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...

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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...

  14. 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...

  15. 47 CFR 32.2230 - Central office-transmission.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  16. 47 CFR 32.2230 - 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...

  17. 47 CFR 32.6230 - Central office transmission expense.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

  18. The New START Treaty: Central Limits and Key Provisions

    DTIC Science & Technology

    2014-04-08

    The New START Treaty: Central Limits and Key Provisions Amy F. Woolf Specialist in Nuclear Weapons Policy April 8, 2014 Congressional...Treaty: Central Limits and Key Provisions 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...Rev. 8-98) Prescribed by ANSI Std Z39-18 The New START Treaty: Central Limits and Key Provisions Congressional Research Service Summary The

  19. The New START Treaty: Central Limits and Key Provisions

    DTIC Science & Technology

    2014-08-27

    The New START Treaty: Central Limits and Key Provisions Amy F. Woolf Specialist in Nuclear Weapons Policy August 27, 2014 Congressional...START Treaty: Central Limits and Key Provisions 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 The New START Treaty: Central Limits and Key Provisions Congressional Research Service Summary The

  20. 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.

  1. 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…

  2. 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…

  3. 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....

  4. 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...

  5. 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...

  6. 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…

  7. 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

  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. 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 California AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of document availability for review and comment. SUMMARY: We, U.S. Fish and Wildlife Service (Service), announce the availability of...

  10. 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…

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

    ERIC Educational Resources Information Center

    Jackson, Robert Jonathan

    2009-01-01

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

  12. 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 §...

  13. 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 §...

  14. 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 §...

  15. 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 §...

  16. 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 §...

  17. 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

  18. 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:…

  19. 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.

  20. 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.

  1. 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

  2. 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/ ...

  3. 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…

  4. 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.

  5. Medical Services: Veterinary Health Services

    DTIC Science & Technology

    2007-11-02

    Chapter 5 Government-Owned Animal Program, page 5 Duties of the veterinarian • 5–1, page 5 Death or euthanasia of Government-owned animals • 5–2, page 6...provision of veterinary services. b. The installation veterinarian will— (1) Coordinate the provision of veterinary services in support of all DOD component...c. Veterinarians supporting MWD procurement and training facil- ities will perform the duties listed in paragraph 5–1. 1AR 40–905/SECNAVINST 6401.1A

  6. 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…

  7. 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…

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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...

  13. 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…

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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...

  20. 40 CFR 3.20 - How will EPA provide notice of changes to the Central Data Exchange?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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...

  1. 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.

  2. 41 CFR 105-56.027 - Centralized salary offset computer match.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false Centralized salary... Services Administration 56-SALARY OFFSET FOR INDEBTEDNESS OF FEDERAL EMPLOYEES TO THE UNITED STATES Centralized Salary Offset (CSO) Procedures-GSA as Paying Agency § 105-56.027 Centralized salary...

  3. 41 CFR 105-56.017 - Centralized salary offset computer match.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false Centralized salary... Services Administration 56-SALARY OFFSET FOR INDEBTEDNESS OF FEDERAL EMPLOYEES TO THE UNITED STATES Centralized Salary Offset (CSO) Procedures-GSA as Creditor Agency § 105-56.017 Centralized salary...

  4. 41 CFR 105-56.017 - Centralized salary offset computer match.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false Centralized salary... Services Administration 56-SALARY OFFSET FOR INDEBTEDNESS OF FEDERAL EMPLOYEES TO THE UNITED STATES Centralized Salary Offset (CSO) Procedures-GSA as Creditor Agency § 105-56.017 Centralized salary...

  5. 41 CFR 105-56.027 - Centralized salary offset computer match.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false Centralized salary... Services Administration 56-SALARY OFFSET FOR INDEBTEDNESS OF FEDERAL EMPLOYEES TO THE UNITED STATES Centralized Salary Offset (CSO) Procedures-GSA as Paying Agency § 105-56.027 Centralized salary...

  6. 41 CFR 105-56.017 - Centralized salary offset computer match.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false Centralized salary... Services Administration 56-SALARY OFFSET FOR INDEBTEDNESS OF FEDERAL EMPLOYEES TO THE UNITED STATES Centralized Salary Offset (CSO) Procedures-GSA as Creditor Agency § 105-56.017 Centralized salary...

  7. 41 CFR 105-56.027 - Centralized salary offset computer match.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false Centralized salary... Services Administration 56-SALARY OFFSET FOR INDEBTEDNESS OF FEDERAL EMPLOYEES TO THE UNITED STATES Centralized Salary Offset (CSO) Procedures-GSA as Paying Agency § 105-56.027 Centralized salary...

  8. 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…

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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…

  1. Central venous line - infants

    MedlinePlus

    A central venous line (CVL) is a long, soft, plastic tube that is put into a large vein in the chest. WHY IS A CVL USED? A CVL is often put in when a baby cannot get a ... (MCC). A CVL can be used to give nutrients or medicines to a ...

  2. 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…

  3. 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.

  4. 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…

  5. 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.

  6. 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.

  7. 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

  8. [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.

  9. 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

  10. 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.

  11. Gangs in Central America

    DTIC Science & Technology

    2007-08-02

    introduced – H.R. 1645 ( Gutierrez ), S. 330 (Isakson), and S. 1348 (Reid) – that includes provisions to increase cooperation among U.S., Mexican, and...America, Colombia, and Mexico, U.S. Attorney General Alberto Gonzales stated that “the United States stands with all of our neighbors in our joint fight...deportations on Central America. Legislation in the 110th Congress The 110th Congress has considered immigration legislation – H.R. 1645 ( Gutierrez ), S

  12. [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.

  13. 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.

  14. 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.

  15. [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.

  16. NASA Shared Services Center breaks ground

    NASA Technical Reports Server (NTRS)

    2006-01-01

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

  17. Service development of a nurse-led community-based PICC insertion service.

    PubMed

    Bedford, Eva; Waterhouse, Dee

    2017-01-26

    Patients receiving intravenous therapy require reliable venous access. Typically patients with poor peripheral access or requiring long-term treatment from an outpatient antibiotic therapy (OPAT) service need to receive secondary care input for safe central line placement, and radiological confirmation of the correct line tip placement where necessary, if treatment is to proceed as planned. Technological developments that enable accurate ultrasound-guided vein selection and electrocardiograph (ECG)-guided central line tip placement have eliminated the need for radiological or fluoroscopic confirmation of correct tip placement for peripherally placed central catheters (PICCs). This article outlines the development of an out-of-hospital nurse-led PICC insertion service using the Sherlock 3CG(®) Tip Confirmation System (C.R Bard) to meet the needs of patients requiring long-term intravenous treatment from an OPAT service, and its impact on reducing treatment delays and the need for secondary care intervention.

  18. Diabetes and Adult Day Health Services

    ERIC Educational Resources Information Center

    Dabelko, Holly I.; DeCoster, Vaughn A.

    2007-01-01

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

  19. The Agua Salud Project, Central Panama

    NASA Astrophysics Data System (ADS)

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

    2007-12-01

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

  20. Central effects of fingolimod.

    PubMed

    Cruz, Vítor T; Fonseca, Joaquim

    2014-08-01

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

  1. Meeting patient expectations: healthcare professionals and service re-engineering.

    PubMed

    Laing, Angus

    2002-08-01

    A central theme underpinning the reform of healthcare systems in western economies since the 1980s has been the emphasis on reorienting service provision around the patient. Healthcare organizations have been forced to re-appraise the design of the service delivery process, specifically the service encounter, to take account of these changing patient expectations. This reorientation of healthcare services around the patient has fundamental implications for healthcare professionals, specifically challenging the dominance of service professionals in the design and delivery of health services. Utilizing a qualitative methodological framework, this paper explores the responses of healthcare professionals to service redesign initiatives implemented in acute NHS hospitals in Scotland and considers the implications of such professional responses for the development of patient-focused service delivery. Within this, it specifically examines evolving professional perspectives on the place of a service user focus in a publicly funded healthcare system, professional attitudes towards private sector managerial practices, and the dynamics of changing professional behaviour.

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

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

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

  3. 47 CFR 32.2210 - Central office-switching.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  4. 22 CFR 94.2 - Designation of Central Authority.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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

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

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

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

  6. Measuring Customer Satisfaction. A Central Texas JTPA Study.

    ERIC Educational Resources Information Center

    Angel, P. Linda

    A study was conducted to determine the baseline by which to measure expected improvements in customer satisfaction for Central Texas Job Training Partnership (JTPA) programs. The survey was designed to facilitate assessment of the current level of customer satisfaction with service delivery and influences on customer satisfaction. Data were…

  7. New applications for the EUTELTRACS service

    NASA Technical Reports Server (NTRS)

    Colcy, Jean-Noel; Vanderbrouck, Laurent

    1995-01-01

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

  8. Central Asia After 2014

    DTIC Science & Technology

    2013-11-01

    Disputes With China,” Eurasia Daily Monitor, October 26, 2011. 9. Linda Jakobson et al., ”China’s Energy and Security relati- ons with Russia,” SIPRI...the_limits_of_regional_cooperati- on_in_south_asia. 65. Roman Muzalevski, ”India Seeks to Project Power In and Out of Central Asia,” Eurasia Daily...available from www.kom- mersant.ru/doc/1407757. 77. SIPRI Yearbook 2010, p. 291. 78. Kommersant, March 14, 2011. 79. Ibid. 80. Jakobson et al., ”China’s

  9. Flooding in Central Siberia

    NASA Technical Reports Server (NTRS)

    2002-01-01

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

  10. Central American resource studies

    SciTech Connect

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

    1989-01-01

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

  11. Floods in Central China

    NASA Technical Reports Server (NTRS)

    2002-01-01

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

  12. Fires in Central Africa

    NASA Technical Reports Server (NTRS)

    2002-01-01

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

  13. Service providers' views of community participation at six Australian primary healthcare services: scope for empowerment and challenges to implementation.

    PubMed

    Freeman, Toby; Baum, Frances E; Jolley, Gwyneth M; Lawless, Angela; Edwards, Tahnia; Javanparast, Sara; Ziersch, Anna

    2016-01-01

    Community participation is a key principle of comprehensive primary health care (PHC). There is little literature on how community participation is implemented at Australian PHC services. As part of a wider study conducted in partnership with five South Australian PHC services, and one Aboriginal community controlled health service in the Northern Territory, 68 staff, manager, regional health executives, and departmental funders were interviewed about community participation, perceived benefits, and factors that influenced implementation. Additional data were collected through analysis of policy documents, service reports on activity, and a web-based survey completed by 130 staff. A variety of community participation strategies was reported, ranging from consultation and participation as a means to improve service quality and acceptability, to substantive and structural participation strategies with an emphasis on empowerment. The Aboriginal community controlled health service in our study reported the most comprehensive community participation. Respondents from all services were positive about the benefits of participation but reported that efforts to involve service users had to compete with a centrally directed model of care emphasising individual treatment services, particularly at state-managed services. More empowering substantive and structural participation strategies were less common than consultation or participation used to achieve prescribed goals. The most commonly reported barriers to community participation were budget and lack of flexibility in service delivery. The current central control of the state-managed services needs to be replaced with more local management decision making if empowering community participation is to be strengthened and embedded more effectively in the culture of services.

  14. Central diabetes insipidus

    PubMed Central

    Arima, Hiroshi; Azuma, Yoshinori; Morishita, Yoshiaki; Hagiwara, Daisuke

    2016-01-01

    ABSTRACT Central diabetes insipidus (CDI), characterized by polyuria and polydipsia, is caused by deficiency of arginine vasopressin (AVP), an antidiuretic hormone which acts on V2 receptors in kidney to promote reabsorption of free water. CDI is classified into three subtypes; idiopathic, secondary and familial. A previous study suggests that infundibulo-neurohypophysitis might be an underlying cause of idiopathic CDI. Among secondary CDI, the tumors in the central nervous system such as craniopharyngioma and germ cell tumors are the most frequent causes. Familial CDI is inherited mostly in an autosomal dominant mode, and the number of causal mutations in the AVP gene locus reported so far exceeds 80. CDI is treated with desmopressin, an analogue of vasopressin, and the tablet is preferred to the nasal form because it is easier to administer. It is also shown that the oral disintegrating tablet formula increases QOL and decreases the incidence of hyponatremia in CDI patients. In some CDI patients, the osmoreceptors in the hypothalamus do not function and patients do not sense thirst. These adipsic CDI patients are treated with desmopressin and adjusting the amount of daily water intake based on body weight measurement; but controlling the water balance is extremely difficult, and morbidity and mortality are shown to be high in these patients. PMID:28008190

  15. Thermal Performance Data Services (TPDS)

    NASA Technical Reports Server (NTRS)

    French, Richard T.; Wright, Michael J.

    2013-01-01

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

  16. Essential Psychopharmacologic Information for Undergraduate Human Service Education Students.

    ERIC Educational Resources Information Center

    Taylor, Daniel

    2002-01-01

    In mental health settings, human service education students may participate in the administration, recording, and monitoring of prescribed psychoactive medications. This paper reviews three common groups of psychiatric medications, focusing on clinical applications, central effects, and how human service education students can assist in their safe…

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

    ERIC Educational Resources Information Center

    Boles, Janet K.

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

  18. Managing Copyright Clearance Services in Higher Education Libraries.

    ERIC Educational Resources Information Center

    Gadd, Elizabeth

    2001-01-01

    Investigated centralized copyright clearance services in higher education institutions based on the findings of a questionnaire survey and five case study interviews in United Kingdom libraries. Examines reasons why services were established, how they were funded and staffed, their overall remit, problems, and good practice guidelines. (Author/LRW)

  19. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  20. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

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

  1. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

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

  2. 7 CFR 1032.86 - Deduction for marketing services.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

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

  3. Presence Management and Merging Presence Information for NGN Services

    NASA Astrophysics Data System (ADS)

    Schumann, Sebastian; Mikoczy, Eugen; Podhradsky, Pavol; Muruchi, Feliciano; Maruschke, Michael

    This paper describes an approach for interworking scenarios between Session Initiation Protocol (SIP) based and non SIP based frameworks (e.g. web services) in case of the presence management service. The characteristics of the concept of a centralized presence management will be introduced.

  4. 41 CFR 105-53.143 - Information Resources Management Service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Information Resources... FUNCTIONS Central Offices § 105-53.143 Information Resources Management Service. (a) Creation and authority. The Information Resources Management Service (IRMS), headed by the Commissioner, Information...

  5. 41 CFR 105-53.143 - Information Resources Management Service.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false Information Resources... FUNCTIONS Central Offices § 105-53.143 Information Resources Management Service. (a) Creation and authority. The Information Resources Management Service (IRMS), headed by the Commissioner, Information...

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

    ERIC Educational Resources Information Center

    Kielsmeier, James C.

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

  7. The Uniframe .Net Web Service Discovery Service

    DTIC Science & Technology

    2003-06-27

    used: business; service; binding ; and specifications for the services. The UDDI businessEntity element represents Business information and 18 ...componentTable Mapping of the Web services directories and binding information necessary for clients to consume services. This object 35 also stores...SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT Same as Report (SAR) 18 . NUMBER OF PAGES 124 19a. NAME OF RESPONSIBLE PERSON a. REPORT

  8. 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

  9. Cable Television Service; Cable Television Relay Service.

    ERIC Educational Resources Information Center

    Federal Register, 1972

    1972-01-01

    The rules and regulations of the Federal Communications Commission (FCC) concerning cable television service and cable relay service are presented along with the comments of the National Cable Television Association, the National Association of Broadcasters, the Association of Maximum Service Telecasters, and a major group of program suppliers.…

  10. [Integration activities of a central municipal hospital].

    PubMed

    Shchepin, O P; Tregubov, Iu G; Rytvĭnskiĭ, S S; Parkhachev, V F

    2001-01-01

    Scientifically-based integration of therapeutic and prophylactic institutions is needed for better meeting the population requirement of medical care, and it is desirable to unite the financial resources and personnel; such is the objective reality for municipal therapeutic and prophylactic institutions of local public health systems. In order to make medical care available for the population and to ensure its high quality, structural changes in the public health of a region are needed. These changes include integration of medical services of these territories; creation of a network of therapeutic and prophylactic institutions corresponding to medical demographic structure of population, so that the scope of medical care be increased and specialized care made easier available for the population; and creation of the optimal managing system. Comparative studies of population health and its time course, public health organization at neighboring territories, where therapeutic and prophylactic institutions, such as Central Municipal Hospital and Central Regional Hospital have autonomous managing and financing, confirmed the need in integration of public health units functioning at a certain territory into a universal system, and in development of approaches to overcome the present-day miscellaneous network by integrating the activities of treatment-and-prophylaxis institutions. Identical economic, geographic, and macroeconomic living conditions of the population, similarity of medical demographic structure and similar changes in it, as well as similar morbidity structure, are sufficient grounds for integration of public health services.

  11. Centralized FITS Metadata Handling Framework at ESO

    NASA Astrophysics Data System (ADS)

    Vera, I.; Dobrzycki, A.; Vuong, M.-H.; Brion, A.

    2011-07-01

    The European Organization for Astronomical Research in the Southern Hemisphere (ESO) headquartered in Garching, Germany, operates three state-of-the-art observatories in Chile: at La Silla, Paranal and Chajnantor. The observatories produce huge amounts of data, which are transferred to the ESO headquarters and stored in the ESO Archive. The archive also stores the products generated by pipeline processing of raw data by the ESO Quality Control (QC) group. In addition, the Archive also stores science products delivered by the principal investigators. Historically, these three processes were independent from one another which resulted in different metadata handling frameworks for each kind of product. This architecture led to duplicate efforts for building metadata-based services as well as creating challenging scenarios for integrating metadata from different processes. We present the metadata handling framework recently implemented at the European Southern Observatory, in which all metadata from FITS compliant sources are stored in a centralized repository database. The framework allows building metadata-based services in a descriptive way, transparently propagating any modifications/updates performed in the central repository. In addition, through a set of common functions, the framework allows for enrichment of FITS-based metadata with derived values and/or with metadata from other ESO operational databases.

  12. 76 FR 4393 - Discover Financial Services Negotiated Service Agreement

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ... Discover Financial Services Negotiated Service Agreement AGENCY: Postal Regulatory Commission. ACTION... Financial Services negotiated service agreement to the market dominant product list. This notice addresses... 3020, et seq., to add a Discover Financial Services (DFS) negotiated service agreement to the...

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

    ERIC Educational Resources Information Center

    Legant, Jean

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

  14. The International Doris Service (IDS)

    NASA Astrophysics Data System (ADS)

    Tavernier, G.; Feissel-Vernier, M.; Lemoine, F.; Noll, C.; Ries, J.; Soudarin, L.; Willis, P.

    The DORIS system was developed for precise orbit determination and precise positioning on Earth. In continuation of the DORIS Pilot Experiment initiated in 1999, the International DORIS Service (IDS) officially started on July 1, 2003 as an IAG Service after the decision of the IAG Executive Committee at the IUGG General Assembly in Sapporo. Following this decision, the IERS Directing board accepted the DORIS Service as a new IERS external service. Six satellites fitted out with DORIS receivers are currently flying, permanently observed by 56 well distributed stations. Among them, three satellites equipped with new DORIS receivers (Jason-1, ENVISAT and SPOT5) have been successfully launched between Dec. 2001 and May 2002. All of them host a navigation function, called DIODE. Two new stations have been added to the permanent network in 2003: Crozet (French Southern Indian Ocean territories) and Jiufeng (China). In response to proposals submitted by candidate host agencies in the frame of IDS, the following stations were installed: Wettzell (Germany), Gavdos (radar altimeter calibration site in Crete), Lambert and Sorsdal (Glacier movement monitoring in Antarctica) in Winter 2001/2002, 2002/2003 and 2003/2004. The 2003 and early 2004 highlights include the renovation of a number of stations, reorganization of the Data Centers, and new developments in the coordination of analyses. While the Analysis Centers continue their support to IERS, the Analysis Coordinator and the Central Bureau are jointly developing comparison and combination activities that eventually aim at benefiting to the IERS Combination Pilot Project.

  15. Evaluating technology service options.

    PubMed

    Blumberg, D F

    1997-05-01

    Four service and support options are available to healthcare organizations for maintaining their growth arsenals of medical and information technology. These options include maintaining and servicing all equipment using a facility-based biomedical engineering and MIS service department; using a combination of facility-based service and subcontracted service; expanding facility-based biomedical and MIS service departments to provide service to other healthcare organizations to achieve economies of scale; and outsourcing all maintenance, repair, and technical support services. Independent service companies and original equipment manufacturers (OEMs) are offering healthcare organizations a wider array of service and support capabilities than ever before. However, some health systems have successfully developed their own independent service organizations to take care of their own--and other healthcare organizations'--service and support needs.

  16. Intelsat new services

    NASA Astrophysics Data System (ADS)

    Hinchman, W. R.; Perillan, L.

    Intelsat was created in 1964 with the prime objective to provide the space segment required for international telecommunication services. Now Intelsat is moving in the direction of meeting telecommunications demand with new services. In the early 1980's, surveys indicated the need for a global, flexible, digital service for the business community, and it was decided by Intelsat to provide such a service. Details regarding business services are discussed, taking into account a service description, satellites, the earth segment, an electronic mail service, the utilization of many inexpensive remote terminals, microterminals, and transmission techniques. Another new service, introduced in 1983/84, provides basic satellite communications facilities for rural and remote communities. Two other new services are related to TV services provided via satellite, and to domestic services. The domestic services will allow countries to have reliable and cost-effective domestic satellite networks using the Intelsat space segment.

  17. Cancer Genetics Services Directory

    MedlinePlus

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

  18. Marketing Youth Services.

    ERIC Educational Resources Information Center

    Dimick, Barbara

    1995-01-01

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

  19. Central pit craters on Ganymede

    NASA Astrophysics Data System (ADS)

    Alzate, Nathalia; Barlow, Nadine G.

    2011-02-01

    Central pit craters are common on Mars, Ganymede and Callisto, and thus are generally believed to require target volatiles in their formation. The purpose of this study is to identify the environmental conditions under which central pit craters form on Ganymede. We have conducted a study of 471 central pit craters with diameters between 5 and 150 km on Ganymede and compared the results to 1604 central pit craters on Mars (diameter range 5-160 km). Both floor and summit pits occur on Mars whereas floor pits dominate on Ganymede. Central peak craters are found in similar locations and diameter ranges as central pit craters on Mars and overlap in location and at diameters <60 km on Ganymede. Central pit craters show no regional variations on either Ganymede or Mars and are not concentrated on specific geologic units. Central pit craters show a range of preservation states, indicating that conditions favoring central pit formation have existed since crater-retaining surfaces have existed on Ganymede and Mars. Central pit craters on Ganymede are generally about three times larger than those on Mars, probably due to gravity scaling although target characteristics and resolution also may play a role. Central pits tend to be larger relative to their parent crater on Ganymede than on Mars, probably because of Ganymede's purer ice crust. A transition to different characteristics occurs in Ganymede's icy crust at depths of 4-7 km based on the larger pit-to-crater-diameter relationship for craters in the 70-130-km-diameter range and lack of central peaks in craters larger than 60-km-diameter. We use our results to constrain the proposed formation models for central pits on these two bodies. Our results are most consistent with the melt-drainage model for central pit formation.

  20. Flooding in Central China

    NASA Technical Reports Server (NTRS)

    2002-01-01

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

  1. Central solar energy receiver

    DOEpatents

    Drost, M. Kevin

    1983-01-01

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

  2. Future Flight Central

    NASA Technical Reports Server (NTRS)

    1999-01-01

    NASA 'Future Flight Central,' the world's first full-scale virtual airport control tower, opened December 13, 1999 at NASA Ames Research Center, Moffett Field, California. Constructed at a cost of $10 million, the two story facility was jointly funded by NASA and the Federal Aviation Administration (FAA). The facility is designed to test ways to solve potential air and ground traffic problems at commercial airports under realistic airport conditions and configurations. The facility provides an opportunity for airlines and airports to mitigate passenger delays by fine tuning airport hub operations, gate management, ramp movement procedures, and various other airport improvements. Twelve rear projection screens provide a seamless 360 degree high- resolution view of the airport or other screens being depicted. The imaging system, powered by supercomputers, provides a realistic view of weather conditions, enviromental and seasonal effects and the movement of up to 200 active aircraft and ground vehicles.

  3. Central America's shrinking forests.

    PubMed

    1992-01-01

    This news brief reports that 66% of deforestation in Central America has happened in the past 40 years, based on World Conservation Union (WCU) data. Deforestation is expected to continue. The population of Central America and Mexico grew by 28% between 1977 and 1987. Growth is decreasing but remains high at 2.5% in all countries of the region except Panama. 29 million was the regional population in 1990; the projection is for 63 million by 2025. Population is migrating to urban centers. Forests declined by 13% and croplands increased from 4% to 13% of total land area and pasture land from 2% to 37%. There was an increase in unproductive land from 145 to 24%, i.e., 50% of El Salvador's land had soil degradation as does 30% of Guatemala's. In addition to deforestation and soil degradation, there has been soil erosion leading to sedimentation buildup near dam sites and in rivers, which diminishes hydroelectric power capability. Silting also affects groundwater resources, which impact on a safe drinking water supply. Population growth results in increased demand for fuelwood, urban land, and agricultural land. New techniques practiced widely are needed in order to meet the region's needs or demands. Slowing population growth buys time for adjusting to the necessary changes needed for sustaining the region's population. WCU urges conservation organizations to raise awareness about the role population plays in environmental degradation, and to support efforts to reduce birth rates. Women's status needs to be improved through income-generating projects, for instance, and cooperation is needed between conservation groups and organizations involved with improving maternal and child health.

  4. Hospital and corporate information services: introducing a new column.

    PubMed

    Jajko, P

    1992-01-01

    Successful hospital and corporate libraries offer customized resources and services to meet the needs of their dynamic organizations. Concepts such as customer-driven, service-oriented and value-added are central to these libraries. Serving decision makers and integrating the library into the decision-making process of the organization is critical. Future articles in this new column will further explore the underlying philosophies and the specialized resources and services that characterize these libraries.

  5. Youth services in Ethiopia.

    PubMed

    Meredith, P

    1990-12-01

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

  6. Hospital service recovery.

    PubMed

    Gutbezahl, Cary; Haan, Perry

    2006-01-01

    An organization's ability to correct service errors is an important factor in achieving success in today's service economy. This paper examines service recovery in hospitals in the U.S. First is a general review of service recovery theories. Next is a discussion of specific service issues related to the hospital environment. The literature on service recovery is used to make specific recommendations to hospitals for ways to improve their ability to remedy service errors when they occur. Suggestions for future research in the field of service recovery are also made.

  7. Decision makers' allocation of home-care therapy services: a process map.

    PubMed

    Mohammed, Rakib; Poss, Jeff; Egan, Mary; Rappolt, Susan; Berg, Katherine

    2013-01-01

    Objectif : Explorer les mécanismes actuels de prise de décision en matière de répartition des services de physiothérapie et d'ergothérapie dans les soins à domicile pour les clients aux besoins complexes nécessitant des soins à domicile à long terme en Ontario. Méthode : Une étude exploratoire à l'aide d'entrevues auprès d'intervenants clés et de vignettes a été réalisée auprès des décideurs en matière de soins à domicile (gestionnaires de cas et personnel de direction) dans quatre régions de soins à domicile de l'Ontario. Les données des entrevues ont été analysées à l'aide d'une méthode dite de « l'analyse des structures ». Résultats : La prise de décision pour la répartition des services de thérapie comporte quatre étapes: admission, évaluation, acheminement vers le fournisseur de services et réévaluation. Certaines disparités dans les processus de gestion ont toutefois été observées à chacune des étapes. La principale variation se situait dans le processus visant à établir la quantité de services de thérapie dans les diverses régions, en raison principalement des contraintes financières touchant les programmes de soins à domicile. La méthode de financement du gouvernement et les modes de partage de l'information ont aussi des effets considérables sur la répartition des soins à domicile. Conclusion : Les contraintes financières des soins à domicile constituent le principal facteur contextuel affectant la répartition des services de thérapie dans les divers secteurs de soins à domicile. Compte tenu de l'inflation dans les coûts des soins de santé, de nouveaux modèles de financement et de prestation des services devront être créés afin de s'assurer que la bonne personne reçoit les bons soins avant que son état ne se détériore et qu'il ne nécessite des soins à long terme encore plus coûteux.

  8. 78 FR 63481 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

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

  9. 77 FR 20037 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-03

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

  10. 75 FR 17417 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-06

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

  11. 75 FR 36428 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-25

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

  12. 78 FR 63478 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-24

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

  13. 78 FR 20328 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-04

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

  14. 76 FR 3912 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-21

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

  15. 75 FR 12768 - Peripheral and Central Nervous System Drugs Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-17

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

  16. Combined Control of Special Operations Forces in the Central Region of Allied Command Europe

    DTIC Science & Technology

    1989-05-01

    Armed Services Committee, 25 Mal-ch 1987, p. 11. 50 2. Chalupa , Gen. Leopold, Commander Allied Forces Central Europe, "the Defence of Central Europe...34Fury form the Sea: Marines in Grenada," U.S. Naval Institute Proceedings, U.S. Naval Institute, Annapolis, ML, 1984. Chalupa , Gen. Leopold

  17. 75 FR 45658 - Notice of Inventory Completion: Museum of Cultural and Natural History, Central Michigan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... National Park Service Notice of Inventory Completion: Museum of Cultural and Natural History, Central... funerary objects in the possession of the Museum of Cultural and Natural History, Central Michigan... detailed assessment of the human remains was made by the Museum of Cultural and Natural...

  18. Towards viable drinking water services.

    PubMed

    Hukka, J J; Katko, T S

    1997-01-01

    This article offers a framework for developing viable drinking water services and institutional development in developing countries. The framework evolved from the authors' research and field experience in transition and developing economies. Viability is related to operative technology, appropriate organizations, and adequate cost recovery within the context of water resources, human and economic resources, sociocultural conditions, and other constraints. The ability of institutions to solve the problems of coordination and production depends upon player motivation, the complexity of the environment, and the ability of the players to control the environment. Third party enforcement of agreements are essential to reduce gains from opportunism, cheating, and shirking. Empirical research finds that per capita water production costs are 4 times higher in centralized systems and lowest in decentralized systems with coordination from a central party. Three-tiered systems of governments, regulators, and service providers are recommended. Management options must be consumer driven. The worst case scenario is consumer's reliance on vending and reselling with no alternative source of supply. Policies should have a strong focus on institutional reforms in the water sector, the development of a consumer driven water sector, facilitation of appropriate private-public partnerships, sound management of existing capital assets, a system for building viability into national strategies for the water sector, and financially self-sufficient and consumer responsible water supply organizations.

  19. Mexico and Central America.

    PubMed

    Bronfman, M

    1998-01-01

    This article reviews the literature on migration and HIV/AIDS in Mexico and Central America, including Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama. Most migrants travel to the US through Mexico. US-Mexico trade agreements created opportunities for increased risk of HIV transmission. The research literature focuses on Mexico. Most countries, with the exception of Belize and Costa Rica, are sending countries. Human rights of migrants are violated in transit and at destination. Migration policies determine migration processes. The Mexican-born population in the US is about 3% of US population and 8% of Mexico's population. About 22% arrived during 1992-97, and about 500,000 are naturalized US citizens. An additional 11 million have a Mexican ethnic background. Mexican migrants are usually economically active men who had jobs before leaving and were urban people who settled in California, Texas, Illinois, and Arizona. Most Mexican migrants enter illegally. Many return to Mexico. The main paths of HIV transmission are homosexual, heterosexual, and IV-drug-injecting persons. Latino migrants frequently use prostitutes, adopt new sexual practices including anal penetration among men, greater diversity of sexual partners, and use of injectable drugs.

  20. Central Disorders of Hypersomnolence

    PubMed Central

    Khan, Zeeshan

    2015-01-01

    The central disorders of hypersomnolence are characterized by severe daytime sleepiness, which is present despite normal quality and timing of nocturnal sleep. Recent reclassification distinguishes three main subtypes: narcolepsy type 1, narcolepsy type 2, and idiopathic hypersomnia (IH), which are the focus of this review. Narcolepsy type 1 results from loss of hypothalamic hypocretin neurons, while the pathophysiology underlying narcolepsy type 2 and IH remains to be fully elucidated. Treatment of all three disorders focuses on the management of sleepiness, with additional treatment of cataplexy in those patients with narcolepsy type 1. Sleepiness can be treated with modafinil/armodafinil or sympathomimetic CNS stimulants, which have been shown to be beneficial in randomized controlled trials of narcolepsy and, quite recently, IH. In those patients with narcolepsy type 1, sodium oxybate is effective for the treatment of both sleepiness and cataplexy. Despite these treatments, there remains a subset of hypersomnolent patients with persistent sleepiness, in whom alternate therapies are needed. Emerging treatments for sleepiness include histamine H3 antagonists (eg, pitolisant) and possibly negative allosteric modulators of the gamma-aminobutyric acid-A receptor (eg, clarithromycin and flumazenil). PMID:26149554

  1. [MANAGEMENT OF CENTRAL HYPERSOMNIAS].

    PubMed

    Dauvilliers, Yves; Lopez, Régis

    2016-06-01

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

  2. Service Opportunities for Youths.

    ERIC Educational Resources Information Center

    Heffernan, David; Tarlov, Suzanne

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

  3. SHARING EDUCATIONAL SERVICES.

    ERIC Educational Resources Information Center

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

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

  4. Reinventing Information Services.

    ERIC Educational Resources Information Center

    Farkas-Conn, Irene; And Others

    1996-01-01

    This special section includes seven articles that discuss reinventing information services. Highlights include linking information services to business strategies; meeting client initiatives; information services at the Ottawa laboratory of Bell-Northern Research (BNR); product service strategies; information management and transition economies;…

  5. Reference Service Policy Statement.

    ERIC Educational Resources Information Center

    Young, William F.

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

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

    ERIC Educational Resources Information Center

    Stack, David

    2009-01-01

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

  7. 3 CFR - Eligibility of the Economic Community of Central African States To Receive Defense Articles and...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... of State Pursuant to the authority vested in me by the Constitution and the laws of the United States... services to the Economic Community of Central African States will strengthen the security of the United... African States To Receive Defense Articles and Defense Services Under the Foreign Assistance Act of...

  8. MyOcean Central Information System - Achievements and Perspectives

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  9. Improving Internal Customer Service

    DTIC Science & Technology

    1990-09-01

    sector to find a morse comprehensive model. , , /, v-/ii viii IMPROVING INTERNAL CUSTOMER SERVICE I. Introduction Backgro’rnd More and more American...service, but this research is mostly limited to the general issue of customer service and external customers in regard to the civilian sector of business...the focus is on what quality customer service is, both internal and external, and why customer service is so important today. Second, the dimensions of

  10. Central and southern Africa

    SciTech Connect

    McGrew, H.J.

    1981-10-01

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

  11. Designing web services in health information systems: from process to application level.

    PubMed

    Mykkänen, Juha; Riekkinen, Annamari; Sormunen, Marko; Karhunen, Harri; Laitinen, Pertti

    2007-01-01

    Service-oriented architectures (SOAs) and web service technologies have been proposed to respond to some central interoperability challenges of heterogeneous health information systems (HIS). We propose a model which we are using to define services and solutions for healthcare applications from the requirements in the healthcare processes. Focusing on the transition from the process level of the model to the application level, we also present some central design considerations, which can be used to guide the design of service-based interoperability. We illustrate these aspects with examples from our current work from the service-enabled HIS.

  12. Designing web services in health information systems: from process to application level.

    PubMed

    Mykkänen, Juha; Riekkinen, Annamari; Laitinen, Pertti; Karhunen, Harri; Sormunen, Marko

    2005-01-01

    Service-oriented architectures (SOA) and web service technologies have been proposed to respond to some central interoperability challenges of heterogeneous health information systems (HIS). We propose a model, which we are using to define services and solutions for healthcare applications from the requirements in the healthcare processes. Focusing on the transition from the process level of the model to the application level, we also present some central design considerations, which can be used to guide the design of service-based interoperability and illustrate these aspects with examples from our current work in service-enabled HIS.

  13. OCULUS Sea Track Fusion Service

    NASA Astrophysics Data System (ADS)

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

    2015-06-01

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

  14. Difficulties in Field-Based Observation among Pre-Service Teachers: Implications to Practice Teaching

    ERIC Educational Resources Information Center

    Abas, Maripaz C.

    2016-01-01

    Field-based observation has long been a central part of pre-service teacher education in many countries and is crucial for implementing effective practicum of pre-service teachers. This paper focused on the perspectives of graduating pre-service teachers regarding their difficulties related to administrative support, cooperating teachers, student…

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

    ERIC Educational Resources Information Center

    Petri, Alexis Nicolle

    2012-01-01

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

  16. Examining Primary Pre-Service Teachers' Perspectives on Teaching Practice Courses

    ERIC Educational Resources Information Center

    Basturk, Savas

    2016-01-01

    The courses "school experience" and "teaching practice" are undoubtedly among the central courses to be received by pre-service teachers who will be future teachers. Through them, pre-service teachers obtain the realistic information about their profession. Therefore, the aim of this study was to examine pre-service teachers'…

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

    ERIC Educational Resources Information Center

    Olsen, Timothy John

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2003-01-01

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

  19. MyOcean Central Information System - Achievements and Perspectives

    NASA Astrophysics Data System (ADS)

    de Dianous, Rémi; Jolibois, Tony; Besnard, Sophie

    2015-04-01

    MyOcean (http://www.myocean.eu) is providing a pre-operational service, for forecasts, analysis and expertise on ocean currents, temperature, salinity, sea level, primary ecosystems and ice coverage. Since 2009, three successive projects (MyOcean-I, MyOcean-II and MyOcean-Follow-on) have been designed to prepare and to lead the demonstration phases of the future Copernicus Marine Environment Monitoring Service. The main goal of these projects was to build a system of systems offering the users a unique access point to European oceanographic data. Reaching this goal at European level with 59 partners from 28 different countries was a real challenge: initially, each local system had its own human processes and methodology, its own interfaces for production and dissemination. At the end of MyOcean Follow-on, any user can connect to one web portal, browse an interactive catalogue of products and services, use one login to access all data disseminated through harmonized interfaces in a common format and contact a unique centralized service desk. In this organization the central information system plays a key role. The production of observation and forecasting data is done by 48 Production Units (PU). Product download and visualisation are hosted by 26 Dissemination Units (DU). All these products and associated services are gathered in a single system hiding the intricate distributed organization of PUs and DUs. This central system will be presented in detail, including notably the technical choices in architecture and technologies which have been made and why, and the lessons learned during these years of real life of the system, taking into account internal and external feedbacks. Then, perspectives will be presented to sketch the future of such system in the next Marine Copernicus Service which is meant to be fully operational from 2015 onwards.

  20. A framework for implementing data services in multi-service mobile satellite systems

    NASA Technical Reports Server (NTRS)

    Ali, Mohammed O.; Leung, Victor C. M.; Spolsky, Andrew I.

    1988-01-01

    Mobile satellite systems being planned for introduction in the early 1990s are expected to be invariably of the multi-service type. Mobile Telephone Service (MTS), Mobile Radio Service (MRS), and Mobile Data Service (MDS) are the major classifications used to categorize the many user applications to be supported. The MTS and MRS services encompass circuit-switched voice communication applications, and may be efficiently implemented using a centralized Demand-Assigned Multiple Access (DAMA) scheme. Applications under the MDS category are, on the other hand, message-oriented and expected to vary widely in characteristics; from simplex mode short messaging applications to long duration, full-duplex interactive data communication and large file transfer applications. For some applications under this service category, the conventional circuit-based DAMA scheme may prove highly inefficient due to the long time required to set up and establish communication links relative to the actual message transmission time. It is proposed that by defining a set of basic bearer services to be supported in MDS and optimizing their transmission and access schemes independent of the MTS and MRS services, the MDS applications can be more efficiently integrated into the multi-service design of mobile satellite systems.

  1. Central control of body temperature

    PubMed Central

    Morrison, Shaun F.

    2016-01-01

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

  2. Controlling centrality in complex networks

    PubMed Central

    Nicosia, V.; Criado, R.; Romance, M.; Russo, G.; Latora, V.

    2012-01-01

    Spectral centrality measures allow to identify influential individuals in social groups, to rank Web pages by popularity, and even to determine the impact of scientific researches. The centrality score of a node within a network crucially depends on the entire pattern of connections, so that the usual approach is to compute node centralities once the network structure is assigned. We face here with the inverse problem, that is, we study how to modify the centrality scores of the nodes by acting on the structure of a given network. We show that there exist particular subsets of nodes, called controlling sets, which can assign any prescribed set of centrality values to all the nodes of a graph, by cooperatively tuning the weights of their out-going links. We found that many large networks from the real world have surprisingly small controlling sets, containing even less than 5 – 10% of the nodes. PMID:22355732

  3. North Central Thailand

    NASA Technical Reports Server (NTRS)

    1998-01-01

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

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

  4. Mental health services in the Solomon Islands.

    PubMed

    Orotaloa, Paul; Blignault, Ilse

    2012-06-01

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

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

    USGS Publications Warehouse

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

    2012-01-01

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

  6. Quantification des besoins en intrants antipaludiques: contribution à l'actualisation des hypothèses pour la quantification des intrants de prise en charge des cas de paludisme grave en République Démocratique du Congo

    PubMed Central

    Likwela, Joris Losimba; Otokoye, John Otshudiema

    2015-01-01

    Les formes graves de paludisme à Plasmodium falciparum sont une cause majeure de décès des enfants de moins de 5 ans en Afrique Sub-saharienne. Un traitement rapide dépend de la disponibilité de médicaments appropriés au niveau des points de prestation de service. La fréquence des ruptures de stock des commodités antipaludiques, en particuliers celles utilisées pour le paludisme grave, avait nécessité une mise à jour des hypothèses de quantification. Les données issues de la collecte de routine du PNLP de 2007 à 2012 ont été comparées à celles rapportés par d'autres pays africains et utilisées pour orienter les discussions au cours d'un atelier organisé par le PNLP et ses partenaires techniques et financiers afin de dégager un consensus national. La proportion des cas de paludisme rapportés comme grave en RDC est resté autour d'une médiane de 7% avec un domaine de variation de 6 à 9%. Hormis la proportion rapportée au Kenya (2%), les pays africains ont rapporté une proportion de cas grave variant entre 5 et 7%. Il apparaît que la proportion de 1% précédemment utilisée pour la quantification en RDC a été sous-estimée dans le contexte de la gestion des cas graves sur terrain. Un consensus s'est dégagé autour de la proportion de 5% étant entendu que des efforts de renforcement des capacités seraient déployés afin d'améliorer le diagnostic au niveau des points de prestation des services. PMID:26213595

  7. Central Chemoreceptors: Locations and Functions

    PubMed Central

    Nattie, Eugene; Li, Aihua

    2016-01-01

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

  8. The CDF Central Outer Tracker

    SciTech Connect

    Pitts, K.T.; CDF Collaboration

    1997-01-01

    We describe the CDF Central Outer Tracker (COT), an open-cell drift chamber currently being constructed for the CDF detector to run at the upgraded Fermilab Tevatron collider. This detector will provide central tracking with excellent momentum resolution in the high- density environment of a hadron collider. It will be able to resolve 132 ns beam crossings and provide tracking trigger information to the Level 1 trigger. The design is based upon the existing and successful CDF Central Tracking Chamber. The preliminary mechanical and electrical designs are presented. 5 refs., 5 figs., 1 tab.

  9. Centralized digital control of accelerators

    SciTech Connect

    Melen, R.E.

    1983-09-01

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

  10. Elimination of Rhodnius prolixus in Central America

    PubMed Central

    2012-01-01

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

  11. Specialized Investment Services

    ERIC Educational Resources Information Center

    Burgess, Robert S.

    1970-01-01

    The informational needs of the investing public should be met by the public library. Suggestions for specialized investment information services with broad appeal, technical charts, and advisory services which public libraries might consider purchasing. (JS)

  12. Venture Class Launch Services

    NASA Technical Reports Server (NTRS)

    Wiese, Mark

    2016-01-01

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

  13. Rehabilitation Services Administration

    MedlinePlus

    ... Contacts OSEP Reports & Resources RSA Welcome to RSA Rehabilitation Services Administration RSA Spotlight News Commissioner's Quarterly Newsletter ... The Office of Special Education and Rehabilitative Services’ Rehabilitation Services Administration is proud to announce the publication ...

  14. Managing customer service.

    PubMed

    Paget, Zoe

    2015-02-28

    Zoe Paget is the customer services manager at YourVets. Her role includes managing the company's call centre, social media marketing, working with the marketing department to develop customer care initiatives and reporting service levels to the company's directors.

  15. The Customer Service Experience.

    ERIC Educational Resources Information Center

    Bell, Chip R.

    2001-01-01

    Discusses ways to embed customer service learning and customer loyalty including making customers think, examining every aspect of customers' service encounters with staff, providing follow-up, making learning fun, and involving customers in your business. (JOW)

  16. Community Services Brief.

    ERIC Educational Resources Information Center

    ERIC Clearinghouse for Junior Colleges, Los Angeles, CA.

    This Brief reviews a variety of materials about two-year college community services programs. Specific topics include: their philosophy and definition, organization and administration, descriptions of noteworthy programs, and models for new community service programs. (Author/CK)

  17. FRS REST Services

    EPA Pesticide Factsheets

    FRS exposes several REST services that allows developers to utilize a live feed of data from the FRS database. This web page is intended for a technical audience and describes the content and purpose of each service available.

  18. Denying or Delivering Services?

    ERIC Educational Resources Information Center

    Kirk, Stuart A.; Greenley, James R.

    1974-01-01

    Many who apply to agencies for service do not receive it. To make service more accessible, changing the behavior patterns of organizations may be as important as changing organizational structure. (Author)

  19. Emergency Medical Services

    MedlinePlus

    ... need help right away, you should use emergency medical services. These services use specially trained people and ... emergencies, you need help where you are. Emergency medical technicians, or EMTs, do specific rescue jobs. They ...

  20. Demographic tensions in Central America.

    PubMed

    1986-08-01

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

  1. Local Data Integration in East Central Florida

    NASA Technical Reports Server (NTRS)

    Case, Jonathan L.; Manobianco, John T.

    1999-01-01

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

  2. Communications and media services

    NASA Technical Reports Server (NTRS)

    Mcculla, James W.; Kukowski, James F.

    1990-01-01

    NASA's internal and external communication methods are reviewed. NASA information services for the media, for the public, and for employees are discussed. Consideration is given to electron information distribution, the NASA TV-audio system, the NASA broadcast news service, astronaut appearances, technology and information exhibits, speaker services, and NASA news reports for internal communications. Also, the NASA worldwide electronic mail network is described and trends for future NASA communications and media services are outlined.

  3. Introduction to the LaRC central scientific computing complex

    NASA Technical Reports Server (NTRS)

    Shoosmith, John N.

    1993-01-01

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

  4. Shopping for Funeral Services

    MedlinePlus

    ... homes to give you written price lists for products and services. Resist pressure to buy goods and services you ... a Cemetery Site Choosing a Funeral Provider Comparing Products Online Extended Warranties and Service Contracts Finding a Locksmith Funeral Costs and Pricing ...

  5. Secondary Services in Physics.

    ERIC Educational Resources Information Center

    Cooper, Marianne; Terry, Edward

    The basic characteristics of sixty-nine secondary services in physics were analyzed in terms of sponsorship and distribution by: (1) country of origin, (2) language, (3) age, (4) frequency of publication, (5) subject and geographical coverage and (6) size. The eight major services, in terms of size, are identified. The use of the services by the…

  6. Talking about Customer Service.

    ERIC Educational Resources Information Center

    Talley, Mary; Axelroth, Joan

    2001-01-01

    Discusses customer service in information centers and how to define it. Topics include the effects of competition, that give customers more choices; defining customers, and defining services; communications; physical environment; change, in customers and in technology; measuring customer service; and evaluating policies and procedures. (LRW)

  7. Holding Services to Account

    ERIC Educational Resources Information Center

    Clegg, J.

    2008-01-01

    Background: Recently, the frequency of audit inspections of health services for people with intellectual disability (ID) in the UK has increased, from occasional inquiries to a systematic audit of all services. From 2008, a process of continuous audit "surveillance" of specialist health services is to be introduced. Similar regimes of…

  8. Space based OTV servicing

    NASA Technical Reports Server (NTRS)

    Mcallister, J. G.

    1984-01-01

    Space based servicing of an orbit transfer vehicle (OTV) was previously outlined in sufficient detail to arrive at OTV and support system servicing requirements. Needed space station facilities and their functional requirements were identified. The impact of logistics and space serviceable design on the OTV design is detailed herein. RL10 derivative rocket engine inspection task times are enumerated.

  9. Simple Lookup Service

    SciTech Connect

    2013-05-01

    Simple Lookup Service (sLS) is a REST/JSON based lookup service that allows users to publish information in the form of key-value pairs and search for the published information. The lookup service supports both pull and push model. This software can be used to create a distributed architecture/cloud.

  10. 75 FR 2580 - Pioneer Industrial Railway Co.-Discontinuance of Service Exemption-Line in Peoria County, IL...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-15

    ... Surface Transportation Board Pioneer Industrial Railway Co.--Discontinuance of Service Exemption--Line in Peoria County, IL; Central Illinois Railroad Company--Discontinuance of Service Exemption--Line in Peoria County, IL On December 29, 2009, Pioneer Industrial Railway Co. (PIRY) and Central Illinois...

  11. Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times.

    PubMed

    Murcott, W J

    2014-09-01

    A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services.

  12. Percutaneously inserted central catheter - infants

    MedlinePlus

    PICC - infants; PQC - infants; Pic line - infants; Per-Q cath - infants ... A percutaneously inserted central catheter (PICC) is a long, very thin, soft plastic tube that is put into a small blood vessel. This article addresses PICCs in ...

  13. The Centrality of Media Economics.

    ERIC Educational Resources Information Center

    Gomery, Douglas

    1993-01-01

    Argues that the study of media economics should stand at the core of the field of communication. Describes central concerns to be addressed, such as economic influence and effect, economic structure and conduct, and analysis of performance. (SR)

  14. Central Fan Integrated Ventilation Systems

    SciTech Connect

    2009-05-12

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

  15. Central-Office Real Estate.

    ERIC Educational Resources Information Center

    Pardini, Priscilla

    2003-01-01

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

  16. Peripherally inserted central catheter - insertion

    MedlinePlus

    ... nontunneled central venous catheters. In: Mauro MA, Murphy KPJ, Thomson KR, et al., eds. Image-Guided Interventions . ... by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is ...

  17. CENTRAL PLATEAU REMEDIATION OPTIMIZATION STUDY

    SciTech Connect

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

    2012-09-19

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

  18. CopperCore Service Integration

    ERIC Educational Resources Information Center

    Vogten, Hubert; Martens, Harrie; Nadolski, Rob; Tattersall, Colin; van Rosmalen, Peter; Koper, Rob

    2007-01-01

    In an e-learning environment there is a need to integrate various e-learning services like assessment services, collaboration services, learning design services and communication services. In this article we present the design and implementation of a generic integrative service framework, called CopperCore Service Integration (CCSI). We will…

  19. Defining a service tech

    SciTech Connect

    Keeler, J.A.

    1996-01-01

    The job title for a service technician in the fuel oil industry is discussed. A service technician in any of the many diversified service fields, has three basic task to perform: The service technician is a professional, a consultant, and a logical thinking individual who appears to be the Einstein of service knowledge in the eyes of the customer; the technician must be able to take the necessary action to complete the call and to make the system operable as well as start, check and tune the system; and the technician must complete the paperwork. The rule is that all paperwork must be completed before leaving the job site.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  2. Unifying access to services: ESO's user portal

    NASA Astrophysics Data System (ADS)

    Chavan, A. M.; Tacconi-Garman, L. E.; Peron, M.; Sogni, F.; Canavan, T.; Nass, P.

    2006-06-01

    The European Southern Observatory (ESO) is in the process of creating a central access point for all services offered to its user community via the Web. That gateway, called the User Portal, will provide registered users with a personalized set of service access points, the actual set depending on each user's privileges. Correspondence between users and ESO will take place by way of "profiles", that is, contact information. Each user may have several active profiles, so that an investigator may choose, for instance, whether their data should be delivered to their own address or to a collaborator. To application developers, the portal will offer authentication and authorization services, either via database queries or an LDAP server. The User Portal is being developed as a Web application using Java-based technology, including servlets and JSPs.

  3. EPA Facility Registry Service (FRS): RADINFO

    EPA Pesticide Factsheets

    This web feature service contains location and facility identification information from EPA's Facility Registry Service (FRS) for the subset of facilities that link to the Radiation Information Database (RADINFO). RADINFO contains information about facilities that are regulated by EPA for radiation and radioactivity. FRS identifies and geospatially locates facilities, sites or places subject to environmental regulations or of environmental interest. 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 data set contains the subset of FRS integrated facilities that link to RADINFO facilities once the RADINFO data has been integrated into the FRS database. Additional information on FRS is available at the EPA website https://www.epa.gov/enviro/facility-registry-service-frs

  4. 78 FR 33891 - North Central Railway Association, Inc.-Abandonment Exemption-in Franklin and Hardin Counties, Iowa

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-05

    ... Counties, Iowa North Central Railway Association, Inc. (NCRA), has filed a verified notice of exemption..., Iowa. The line traverses United States Postal Service Zip Codes 50633 and 50601. NCRA has...

  5. Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight

    DTIC Science & Technology

    2015-03-04

    and Surgery CAC Common Access Card CRS Centralized Receivables Service DoD FMR DoD Financial Management Regulation MSA Medical Service Account MTF...H 4 , 2 0 1 5 Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight Report No. DODIG-2015...04 MAR 2015 2. REPORT TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Delinquent Medical Service Accounts at Naval

  6. Coproduction of healthcare service

    PubMed Central

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-01-01

    Efforts to ensure effective participation of patients in healthcare are called by many names—patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always ‘coproduced’. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services. PMID:26376674

  7. Coproduction of healthcare service.

    PubMed

    Batalden, Maren; Batalden, Paul; Margolis, Peter; Seid, Michael; Armstrong, Gail; Opipari-Arrigan, Lisa; Hartung, Hans

    2016-07-01

    Efforts to ensure effective participation of patients in healthcare are called by many names-patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always 'coproduced'. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services.

  8. Satellite Services Workshop, Volume 1

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Key issues associated with the orbital servicing of satellites are examined including servicing spacecraft and equipment, servicing operations, economics, satellite design, docking and berthing, and fluid management.

  9. 12 CFR 704.12 - Permissible services.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... These services may include loan reviews, investment portfolio reviews and investment advisory services. (3) Electronic financial services. Electronic financial services are any services, products... aggregation services, and internet access services to perform or deliver products or services to members....

  10. Involvement of users and relatives in mental health service evaluation.

    PubMed

    Barbato, Angelo; D'Avanzo, Barbara; D'Anza, Vito; Montorfano, Emanuele; Savio, Monica; Corbascio, Caterina G

    2014-06-01

    Although Italian mental health (MH) services are community based, user and relative participation in service evaluation lagged behind until lately. We here review three recent studies involving stakeholder participation in service evaluation: two were quantitative studies, one on 204 users in an MH service in Pistoia (Central Italy) and the other on 2259 relatives, conducted with the National Union of Associations for Mental Health. The third (supported by The Centro per il Controllo delle Malattie, the ministerial Center for Disease Control) was a qualitative study in seven MH services, involving users, relatives, and professionals together, which collected interviews from 136 users, 119 relatives, and 79 professionals. In the quantitative studies, positive evaluations outnumbered negative ones. The qualitative study explored negative aspects in greater depth. Common findings were insufficient information, underinvolvement of users-relatives in planning, no choice of clinician, psychiatrist domination, and limited helpfulness of interventions. With stakeholder participation in service evaluation, the present medical framework will need reshaping.

  11. [Selection of government instruments in schistosomiasis control services].

    PubMed

    Yi, Ping; Li, Sheng-Ming; Franziska, Bieri; Yuan, Li-Ping; Zhao, Zheng-Yuan; He, Yong-Kang; Liu, Zong-Chuan; Zhou, Jie; He, Hong-Bin

    2011-06-01

    From the perspective of public administration and epidemiology, on the combination of the governance cases in the central and local government of China, the author explores ten modes of the provision of public goods and services in schistosomiasis control services, discusses seven main government instruments, and points out its pluralism, complexity and the slight changes of government' s preference. This paper also explores the approach to help the relevant government make schistosomiasis control work more practicable in field.

  12. Against customer service.

    PubMed

    Trotter, G

    1998-01-01

    This essay examines the nature of service in medicine and the relationship between service and profit. "Customer service medicine" is identified with the interrelated views that 1) profit is or ought to be healthcare's fundamental concern and 2) the quality of medical service corresponds to the degree to which it produces a feeling of approval in patients. This position is contrasted with the more traditional "beneficence model," which holds that 1) service ought to be healthcare's fundamental concern and 2) the proper criterion of quality medical service is the alleviation, mitigation, or prevention of the human suffering that occasions illness. Five shortcomings in the customer service model are identified: 1) customer service advocates often appeal to an unsound "efficiency argument"; 2) the prioritization of profit over service will vitiate patients' legitimate trust in healthcare; 3) the prioritization of profit converts medicine from a "practice" into an "instrumental activity"; 4) the prioritization of profit countervails the values of continuity and thoroughness; and 5) the notion of service as customer satisfaction derives more from the exigencies of turning a profit than from an analysis of sick persons' needs.

  13. Focusing on customer service.

    PubMed

    1996-01-01

    This booklet is devoted to a consideration of how good customer service in family planning programs can generate demand for products and services, bring customers back, and reduce costs. Customer service is defined as increasing client satisfaction through continuous concern for client preferences, staff accountability to clients, and respect for the rights of clients. Issues discussed include the introduction of a customer service approach and gaining staff commitment. The experience of PROSALUD in Bolivia in recruiting appropriate staff, supervising staff, soliciting client feedback, and marketing services is offered as an example of a successful customer service approach. The key customer service functions are described as 1) establishing a welcoming atmosphere, 2) streamlining client flow, 3) personalizing client services, and 4) organizing and providing clear information to clients. The role of the manager in developing procedures is explored, and the COPE (Client-Oriented Provider-Efficient) process is presented as a good way to begin to make improvements. Techniques in staff training in customer service include brainstorming, role playing, using case studies (examples of which are provided), and engaging in practice sessions. Training also leads to the development of effective customer service attitudes, and the differences between these and organizational/staff-focused attitudes are illustrated in a chart. The use of communication skills (asking open-ended questions, helping clients express their concerns, engaging in active listening, and handling difficult situations) is considered. Good recovery skills are important when things go wrong. Gathering and using client feedback is the next topic considered. This involves identifying, recording, and discussing customer service issues as well as taking action on these issues and evaluating the results. The booklet ends by providing a sample of customer service indicators, considering the maintenance of a

  14. JBI instrumentation services

    NASA Astrophysics Data System (ADS)

    Muccio, M.; Lopez, E.; McKeel, R.

    2005-05-01

    The Joint Battlespace Infosphere (JBI) is an information management infrastructure that provides a basic set of flexible core services: publish, subscribe, and query. Managed Information Objects (MIOs) are published by JBI clients and are subsequently managed and disseminated to other subscribing JBI Clients by the JBI Core Services. MIOs can also be archived into a repository managed by the JBI Core Services upon publication and can later be queried for by JBI Clients. A reference implementation (RI) of the JBI Core Services using Java 2 Enterprise Edition (J2EE) technology is currently being developed at the Air Force Research Laboratory Information Directorate (AFRL/IF) in Rome, NY. JBI Instrumentation Services will allow users to gain insight into what activity is occurring inside the JBI Core Services. The phase 1 Instrumentation Services implementation has been developed as a standalone system that interacts with the JBI Core Services through a set of interfaces that provide a low impact, multi-implementation compatible connection. The Instrumentation Services Architecture makes use of the Instrumentation Entity Model to create entities that describe the real elements of the JBI Core Services: platforms, connections, users, nodes, and sequences. These entities populate the Instrumentation Space and are accessed by clients through the Instrumentation Client API (ICAPI). A web-based client that makes use of this ICAPI has been developed to visualize instrumentation information and demonstrate the capabilities of the Instrumentation Services. This client utilizes numerical rate graphs and dynamic graph trees to visualize JBI activity. This paper describes the phase 1 Instrumentation Services Architecture and development efforts involved in creating the JBI Instrumentation Services and prototype instrumentation client.

  15. Coverage centralities for temporal networks*

    NASA Astrophysics Data System (ADS)

    Takaguchi, Taro; Yano, Yosuke; Yoshida, Yuichi

    2016-02-01

    Structure of real networked systems, such as social relationship, can be modeled as temporal networks in which each edge appears only at the prescribed time. Understanding the structure of temporal networks requires quantifying the importance of a temporal vertex, which is a pair of vertex index and time. In this paper, we define two centrality measures of a temporal vertex based on the fastest temporal paths which use the temporal vertex. The definition is free from parameters and robust against the change in time scale on which we focus. In addition, we can efficiently compute these centrality values for all temporal vertices. Using the two centrality measures, we reveal that distributions of these centrality values of real-world temporal networks are heterogeneous. For various datasets, we also demonstrate that a majority of the highly central temporal vertices are located within a narrow time window around a particular time. In other words, there is a bottleneck time at which most information sent in the temporal network passes through a small number of temporal vertices, which suggests an important role of these temporal vertices in spreading phenomena. Contribution to the Topical Issue "Temporal Network Theory and Applications", edited by Petter Holme.Supplementary material in the form of one pdf file available from the Journal web page at http://dx.doi.org/10.1140/epjb/e2016-60498-7

  16. Upper Mantle Discontinuities Underneath Central and Southern Mexico

    NASA Astrophysics Data System (ADS)

    Perez-Campos, X.; Clayton, R. W.

    2011-12-01

    Central and southern Mexico are affected by the subduction of Cocos plate beneath North American plate. The MesoAmerican Subduction Experiment (MASE) and the Veracruz-Oaxaca (VEOX) project have mapped the geometry of the Cocos slab. It is characterized in central Mexico by a shallow horizontal geometry up to ~300 km from the trench, then it dives steeply (70°) into the mantle, to its apparent end at 500 km depth. In contrast, some 400 km to the south, the slab subducts smoothly, with a dip angle of ~26° to a depth of 150 km. We use receiver functions from teleseismic events, recorded at stations from MASE, VEOX, and the Servicio Sismológico Nacional (SSN, Mexican National Seismological Service) to map the upper mantle discontinuities and properties of the transition zone in central and southern Mexico. We also use data from the Mapping the Rivera Subduction Zone (MARS) Experiment to get a complete picture of the subduction regime in central Mexico and compare the mantle transition zone in a slab tear regime. The 410 discontinuity shows significant variation in topography in central Mexico, particularly where the slab is expected to reach such depth. The 660 discontinuity shows a smoother topography, indicating that the slab does not penetrate this far down. The results will be compared with a ridge regime in the Gulf of California.

  17. Service employees give as they get: internal service as a moderator of the service climate-service outcomes link.

    PubMed

    Ehrhart, Karen Holcombe; Witt, L A; Schneider, Benjamin; Perry, Sara Jansen

    2011-03-01

    We lend theoretical insight to the service climate literature by exploring the joint effects of branch service climate and the internal service provided to the branch (the service received from corporate units to support external service delivery) on customer-rated service quality. We hypothesized that service climate is related to service quality most strongly when the internal service quality received is high, providing front-line employees with the capability to deliver what the service climate motivates them to do. We studied 619 employees and 1,973 customers in 36 retail branches of a bank. We aggregated employee perceptions of the internal service quality received from corporate units and the local service climate and external customer perceptions of service quality to the branch level of analysis. Findings were consistent with the hypothesis that high-quality internal service is necessary for branch service climate to yield superior external customer service quality.

  18. Inferring Centrality from Network Snapshots

    NASA Astrophysics Data System (ADS)

    Shao, Haibin; Mesbahi, Mehran; Li, Dewei; Xi, Yugeng

    2017-01-01

    The topology and dynamics of a complex network shape its functionality. However, the topologies of many large-scale networks are either unavailable or incomplete. Without the explicit knowledge of network topology, we show how the data generated from the network dynamics can be utilised to infer the tempo centrality, which is proposed to quantify the influence of nodes in a consensus network. We show that the tempo centrality can be used to construct an accurate estimate of both the propagation rate of influence exerted on consensus networks and the Kirchhoff index of the underlying graph. Moreover, the tempo centrality also encodes the disturbance rejection of nodes in a consensus network. Our findings provide an approach to infer the performance of a consensus network from its temporal data.

  19. Inferring Centrality from Network Snapshots

    PubMed Central

    Shao, Haibin; Mesbahi, Mehran; Li, Dewei; Xi, Yugeng

    2017-01-01

    The topology and dynamics of a complex network shape its functionality. However, the topologies of many large-scale networks are either unavailable or incomplete. Without the explicit knowledge of network topology, we show how the data generated from the network dynamics can be utilised to infer the tempo centrality, which is proposed to quantify the influence of nodes in a consensus network. We show that the tempo centrality can be used to construct an accurate estimate of both the propagation rate of influence exerted on consensus networks and the Kirchhoff index of the underlying graph. Moreover, the tempo centrality also encodes the disturbance rejection of nodes in a consensus network. Our findings provide an approach to infer the performance of a consensus network from its temporal data. PMID:28098166

  20. Central Hyperthermia Treated with Bromocriptine

    PubMed Central

    Natteru, P.; George, P.; Bell, R.; Nattanmai, P.

    2017-01-01

    Introduction. Central hyperthermia is common in patients with brain injury. It typically has a rapid onset with high temperatures and marked fluctuations and responds poorly to antibiotics and antipyretics. It is also associated with worse outcomes in the brain injured patient. Recognizing this, it is important to aggressively manage it. Case Report. We report a 34-year-old male with a right thalamic hemorrhage extending to the midbrain and into the ventricles. During his admission, he developed intractable fevers with core temperatures as high as 39.3°C. Infectious workup was unremarkable. The fever persisted despite empiric antibiotics, antipyretics, and cooling wraps. Bromocriptine was started resulting in control of the central hyperthermia. The fever spikes were reduced to minor fluctuations that significantly worsened with any attempt to wean off the bromocriptine. Conclusion. Diagnosing and managing central hyperthermia can be challenging. The use of bromocriptine can be beneficial as we have reported. PMID:28348904

  1. Flight telerobotic servicer

    NASA Technical Reports Server (NTRS)

    Haley, Dennis

    1990-01-01

    Viewgraphs on the Space Station Flight Telerobotic Servicer (SSFTS) are presented. Topics covered include: SSFTS design; SSFTS elements; FTS mission requirements; FTS general requirements; flight telerobotic servicer - telerobot; FTS manipulator; force-torque transducer; end effector changeout mechanism; flight telerobotic servicer - end-of-arm tooling; user interfaces; FTS data management and processing; control subsystem; FTS vision subsystem and camera positioning assembly; FTS workstation display assembly panel; mini-master hand controller; and FTS NASREM system architecture.

  2. Radio determination satellite service

    NASA Astrophysics Data System (ADS)

    Briskman, Robert D.

    1990-07-01

    The capabilities and measured performance of a geosynchronous satellite-based service called the radio determination satellite service (RDSS), which operates at radio frequencies allocated by the International Telecommunications Union (ITU) and is licensed in the United States by the Federal Communications Commission (FCC), are discussed. Plans for both improvement in capability and expansion to nearly global coverage are described. Since RDSS can also provide radio navigation, some comparisons of this service with the Global Positioning System (GPS) are made.

  3. MSAT broadcast voice services

    NASA Technical Reports Server (NTRS)

    Jones, John W.

    1995-01-01

    Later this year the MSAT satellite network will be delivering mobile and remote communications throughout North America. Its services include a family of Broadcast Voice Services, the first of which will be MSAT Dispatch Radio, which will extend the features and functionality of terrestrial Specialized Mobile Radio (SMR) to the entire continent. This paper describes the MSAT Broadcast Voice Services in general, and MSAT Dispatch Radio in particular, and provides examples of commercial and government applications.

  4. MRDIS Standalone Central Alarm Station

    SciTech Connect

    2012-09-12

    The MRDIS Standalone Central Alarm Station(MRDIS-CAS} is a software system for receiving, storing, and reviewing radiation data collected by the Mobile Radiation Detection and Identification System (MRDIS}, a mobile radiation scanning system developed for use in foreign ports for the DOE Megaports Initiative. It is designed to run on one of the on board computers in the MRDIS cab. It will collect, store, and display data from the MRDIS without the need for wireless communications or centralized server technology. It is intended to be a lightweight replacement for a distributed Megaports communication system in ports where the necessary communications infrastructure does not exist for a full Megaports communications system.

  5. Comparative Human Health Risk Analysis of Coastal Community Water and Waste Service Options

    EPA Science Inventory

    As a pilot approach to describe adverse human health effects from alternative decentralized community water systems compared to conventional centralized services (business-as-usual [BAU]), selected chemical and microbial hazards were assessed using disability adjusted life years ...

  6. Providing Database Services in a Nationwide Research Organisation--Coexistence of Traditional Information Services and a Modern CD-ROM/Online Hybrid Solution.

    ERIC Educational Resources Information Center

    Bowman, Benjamin F.

    For the past two decades the central Information Retrieval Services of the Max Planck Society has been providing database searches for scientists in Max Planck Institutes and Research Groups throughout Germany. As a supplement to traditional search services offered by professional intermediaries, they have recently fostered the introduction of a…

  7. Trade in health services.

    PubMed

    Chanda, Rupa

    2002-01-01

    In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services.

  8. Trade in health services.

    PubMed Central

    Chanda, Rupa

    2002-01-01

    In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795

  9. Guide to Federal Consumer Services.

    ERIC Educational Resources Information Center

    Office of Consumer Affairs, Washington, DC.

    This publication lists the consumer services of every Federal agency or bureau that is either directly of indirectly concerned with consumer issues. Services covered include agricultural research service, consumer and marketing service, extension service, food and nutrition service, rural development and conservation, farm credit, environmental…

  10. Technology, Proximity, Gender, and Ethnicity as Factors Affecting Kins' Services to the Aged: An Elaboration of the Modified Extended Family Model of Kin Structure.

    ERIC Educational Resources Information Center

    Litwak, Eugene; And Others

    Two central issues relevant to services delivered to older adults by family members (including extended family) were analyzed: the method used in delivering the services and the geographic proximity required to deliver the service. The analysis involved a study of 1,400 people aged 65 and over and 800 of their helpers. Delivery of services was…

  11. Medical Services: The Disputed Related Service.

    ERIC Educational Resources Information Center

    Bartlett, Larry

    2000-01-01

    This article analyzes the 1999 Supreme Court decision, Cedar Rapids Community School District v. Garret F., which affirmed the school district's responsibility to provide medical services to a student with disabilities. It traces the legal history of the issue, examines lines of case law underlying the decision, and discusses the likely…

  12. America's Service Academies, Your Service Academies

    ERIC Educational Resources Information Center

    Born, Dana H.; Phillips, Andrew T.; Trainor, Timothy E.

    2012-01-01

    The United States Air Force Academy, United States Naval Academy, and United States Military Academy are America's three largest service academies. They are "the" primary undergraduate institutions and commissioning sources that educate and develop the officers who are expected to lead this nation's armed forces. They are special places that have…

  13. Scholarly Service and the Scholarship of Service

    ERIC Educational Resources Information Center

    Lee, E. Suzanne

    2009-01-01

    The scholarship of teaching has received a considerable amount of attention in recent years, with new recognition that faculty members' research does not necessarily exclude their pedagogy. But research and teaching are not the only parts of their lives as faculty members. Much of what they do on their campuses comes under the heading of service.…

  14. Services supporting collaborative alignment of engineering networks

    NASA Astrophysics Data System (ADS)

    Jansson, Kim; Uoti, Mikko; Karvonen, Iris

    2015-08-01

    Large-scale facilities such as power plants, process factories, ships and communication infrastructures are often engineered and delivered through geographically distributed operations. The competencies required are usually distributed across several contributing organisations. In these complicated projects, it is of key importance that all partners work coherently towards a common goal. VTT and a number of industrial organisations in the marine sector have participated in a national collaborative research programme addressing these needs. The main output of this programme was development of the Innovation and Engineering Maturity Model for Marine-Industry Networks. The recently completed European Union Framework Programme 7 project COIN developed innovative solutions and software services for enterprise collaboration and enterprise interoperability. One area of focus in that work was services for collaborative project management. This article first addresses a number of central underlying research themes and previous research results that have influenced the development work mentioned above. This article presents two approaches for the development of services that support distributed engineering work. Experience from use of the services is analysed, and potential for development is identified. This article concludes with a proposal for consolidation of the two above-mentioned methodologies. This article outlines the characteristics and requirements of future services supporting collaborative alignment of engineering networks.

  15. Analysis of United States Air Forces Central Government Purchase Card Reachback Viability

    DTIC Science & Technology

    2011-12-01

    Analysis of United States Air Forces Central Government Purchase Card Reachback Viability 1 December 2011 by Capt. Jason R. Ackiss, USAF...United States Air Forces Central Government Purchase Card Reachback Viability 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...USAFCENT) government purchase card (GPC) purchases by utilizing reachback services. The study analyzed FY 2011 data to include the number of

  16. Central New York's New Workforce

    ERIC Educational Resources Information Center

    Center for an Urban Future, 2009

    2009-01-01

    Conducted in late 2008 in partnership with the Greater Syracuse Chamber of Commerce and the Mohawk Valley Chamber of Commerce, this is the largest survey ever taken of Central New York businesses regarding the English language skills of the area workforce. The online survey was emailed to several hundred local businesses; 126 responses were…

  17. Central Corneal Thickness in Children

    PubMed Central

    2011-01-01

    Objective To report the central corneal thickness (CCT) in healthy white, African-American, and Hispanic children from birth to 17 years of age. Design Prospective observational multicenter study. Central corneal thickness was measured with a hand-held contact pachymeter. Results Two thousand seventy-nine children were included in the study, with ages ranging from day of birth to 17 years. Included were 807 white, 494 Hispanic, and 474 African-American individuals, in addition to Asian, unknown and mixed race individuals. African-American children had thinner corneas on average than that of both white (p< .001) and Hispanic children (p< .001) by approximately 20 micrometers. Thicker median CCT was observed with each successive year of age from age 1 to 11 years, with year-to-year differences steadily decreasing and reaching a plateau after age 11 at 573 micrometers in white and Hispanic children and 551 micrometers in African-American children. For every 100 micrometers of thicker CCT measured, the intraocular pressure was 1.5 mmHg higher on average (p< 0.001). For every diopter of increased myopic refractive error (p< 0.001) CCT was 1 micrometer thinner on average. Conclusions Median CCT increases with age from 1 to 11 years with the greatest increase present in the youngest age groups. African-American children on average have thinner central corneas than white and Hispanic children, while white and Hispanic children demonstrate similar central corneal thickness. PMID:21911662

  18. The Centrality of Ethical Leadership

    ERIC Educational Resources Information Center

    Ehrich, Lisa C.; Harris, Jessica; Klenowski, Val; Smeed, Judy; Spina, Nerida

    2015-01-01

    Purpose: The central argument in this paper is that ethical school leadership is imperative in a context of increasing performance-driven accountability. The purpose of this paper is to focus on school principals' perceptions of how they understand ethical leadership and how they lead the ethical use of data. Design/Methodology/Approach: This…

  19. Illustrating the Central Limit Theorem

    ERIC Educational Resources Information Center

    Corcoran, Mimi

    2016-01-01

    Statistics is enjoying some well-deserved limelight across mathematics curricula of late. Some statistical concepts, however, are not especially intuitive, and students struggle to comprehend and apply them. As an AP Statistics teacher, the author appreciates the central limit theorem as a foundational concept that plays a crucial role in…

  20. Investing in the Central Office

    ERIC Educational Resources Information Center

    Shields, Regis Anne

    2010-01-01

    Benchmarking against similar districts, ideally higher-performing ones, can be a valuable tool for determining the appropriate level of central-office investment. Unfortunately, reliable benchmarks on district spending in teaching and learning support are not readily available. This should not preclude districts from using this valuable method to…

  1. Readability of Central Florida Newspapers.

    ERIC Educational Resources Information Center

    Olmstead, Phyllis M.

    A study analyzed the readability of seven central Florida newspapers (one of which is a college newspaper) and "USA Today.""Rightwriter," a grammar checker and readability computer program, was used to evaluate front page articles for each of the eight newspapers. The readability formulas invoked in the readability program…

  2. Central venous catheter - dressing change

    MedlinePlus

    ... flushing Peripherally inserted central catheter - flushing Sterile technique Surgical wound care - open Review Date 9/17/2016 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, ...

  3. Despair at the Central Office.

    ERIC Educational Resources Information Center

    Tewel, Kenneth J.

    1995-01-01

    The psychological fallout of school restructuring can paralyze central office staff. Superintendents need effective incentives to keep people engaged in organization-building. They must create a trusting, risk-taking environment, develop a shared mission, empower staff to make decisions, provide learning opportunities, afford professional…

  4. Central Asian Drug Trafficking Dilemma

    DTIC Science & Technology

    2003-12-01

    DRUG ADDICTION AND HIV/AIDS ........................................................18 G. UNITED STATES AND RUSSIA...throughout the area since the breakup. Heroin , opium, hashish, cocaine, and many other large-scale drugs have spread throughout the region in epidemic...The wider Central Asia region was experiencing a sharp rise in drug addiction . Tajikistan is not a major producer of narcotics, but is a major

  5. Central Statistical Libraries in Europe.

    ERIC Educational Resources Information Center

    Kaiser, Lisa

    The paper tries to clarify the position special governmental libraries hold in the system of libraries of today by investigating only one specific type of library mainly from a formal and historical point of view. Central statistical libraries in Europe were first regarded as administrative and archival libraries. Their early holdings of foreign…

  6. Putting Central Registers to Work

    ERIC Educational Resources Information Center

    Besharov, Douglas J.

    1977-01-01

    Cites shortcomings of existing centralized state systems for processing child protection case records. Diagnostic, monitoring and statistical functions of these registers are described as severely limited by inaccurate and incomplete reporting. Confidentiality of records, subjects' access to records and problems of verification are discussed. (BF)

  7. Central America: A Regional Study.

    ERIC Educational Resources Information Center

    Mowry, George; Lacy, Ann

    This lesson is a series of activities and multi-media presentations designed to enable students to understand the historic and geographic roots of some of the problems that Central American nations have faced. Geography, history, writing, and storytelling are used as ways of understanding a multicultural world. Creative thinking and participation…

  8. Today's central receiver power plant

    NASA Astrophysics Data System (ADS)

    Alpert, D. J.; Kolb, G. J.; Chavez, J. M.

    1991-04-01

    For 15 years, the United States Department of Energy has worked with industry, both utilities and manufacturers, to develop the technology of solar central receiver power plants. In this type of plant, sunlight is concentrated by a field of sun-tracking mirrors, called heliostats, onto a centrally located receiver. The solar energy is collected in the form of a heated fluid, which is used to generate steam to power a conventional turbine generator. For a number of reasons, molten nitrate salt is now the preferred heat transfer fluid. Commercial plants will be sized between 100 and 200 MW. The impetus for developing central receivers comes from their unique advantages: (1) they produce clean, reliable, low-cost electricity; (2) they have practical energy storage that provides a high degree of dispatchability (annually up to 60 percent) - without fossil fuels; and (3) they are environmentally benign. Development efforts around the world have brought the technology to the brink of commercialization: The technical feasibility has been proven, and cost, performance, and reliability can be confidently predicted. Plans are currently being developed for the final steps toward commercial central receiver power plants.

  9. Central American geologic map project

    SciTech Connect

    Dengo, G.

    1986-07-01

    During the Northeast Quadrant Panel meeting of the Circum-Pacific Map Project held in Mexico City, February 1985, Central American panel members proposed and adopted plans for compiling a geologic map of Central America, probably at a scale of 1:500,000. A local group with participants from each country was organized and coordinated by Rolando Castillo, director, Central American School of Geology, University of Costa Rica, for the geologic aspects, and Fernando Rudin, director, Geographic Institute of Costa Rica, for the topographic base. In 1956, the US Geological Survey published a geologic map of the region at a scale of 1:1 million. Subsequent topographic and geologic mapping projects have provided a large amount of new data. The entire area is now covered by topographic maps at a scale of 1:50,000, and these maps have been used in several countries as a base for geologic mapping. Another regional map, the Metallogenic Map of Central America (scale = 1:2 million), was published in 1969 by the Central American Research Institute for Industry (ICAITI) with a generalized but updated geologic base map. Between 1969 and 1980, maps for each country were published by local institutions: Guatemala-Belize at 1:500,000, Honduras at 1:500,000, El Salvador at 1:100,000, Nicaragua at 1:1 million, Costa Rica at 1:200,000, and Panama at 1:1 million. This information, in addition to that of newly mapped areas, served as the base for the Central American part of the Geologic-Tectonic Map of the Caribbean Region (scale = 1:2.5 million), published by the US Geological Survey in 1980, and also fro the Northeast Quadrant Maps of the Circum-Pacific Region. The new project also involves bathymetric and geologic mapping of the Pacific and Caribbean margins of the Central American Isthmus. A substantial amount of new information of the Middle America Trench has been acquired through DSDP Legs 67 and 84.

  10. International GPS (Global Positioning System) Service for Geodynamics

    NASA Technical Reports Server (NTRS)

    Zumberge, J. F. (Editor); Liu, R. (Editor); Neilan, R. E. (Editor)

    1995-01-01

    The International GPS (Global Positioning System) Service for Geodynamics (IGS) began formal operation on January 1, 1994. This first annual report is divided into sections, which mirror different aspects of the service. Section (1) contains general information, including the history of the IGS, its organization, and the global network of GPS tracking sites; (2) contains information on the Central Bureau Information System; (3) describes the International Earth Rotation Service (IERS); (4) details collecting and distributing IGS data in Data Center reports; (6) describes how the IGS Analysis Centers generate their products; (7) contains miscellaneous contributions from other organizations that share common interests with the IGS.

  11. Positive Effects of Peer-Led Reflection on Undergraduates' Concept Integration and Synthesis during Service Learning

    ERIC Educational Resources Information Center

    Hudsonm Monika; Hunter, Keith O.

    2014-01-01

    Service learning that features mutually constructed community-based service can enhance the understanding of a range of concepts (Butin, 2006). However, such service is often seen as "charity" as opposed to a dually constructed experience that is central to real learning (Howard, 2000; Tellis, 2011). This project was designed to…

  12. A Cross-Sectional Cohort Study of a Large, Statewide Medicaid Home and Community-Based Services Autism Waiver Program

    ERIC Educational Resources Information Center

    Eskow, Karen Goldrich; Chasson, Gregory S.; Summers, Jean Ann

    2015-01-01

    State-specific 1915(c) Medicaid Home and Community-Based Services waiver programs have become central in the provision of services specifically tailored to children with autism spectrum disorders (ASD). Using propensity score matching, 130 families receiving waiver services for a child with ASD were matched with and compared to 130 families…

  13. Network Centrality of Metro Systems

    PubMed Central

    Derrible, Sybil

    2012-01-01

    Whilst being hailed as the remedy to the world’s ills, cities will need to adapt in the 21st century. In particular, the role of public transport is likely to increase significantly, and new methods and technics to better plan transit systems are in dire need. This paper examines one fundamental aspect of transit: network centrality. By applying the notion of betweenness centrality to 28 worldwide metro systems, the main goal of this paper is to study the emergence of global trends in the evolution of centrality with network size and examine several individual systems in more detail. Betweenness was notably found to consistently become more evenly distributed with size (i.e. no “winner takes all”) unlike other complex network properties. Two distinct regimes were also observed that are representative of their structure. Moreover, the share of betweenness was found to decrease in a power law with size (with exponent 1 for the average node), but the share of most central nodes decreases much slower than least central nodes (0.87 vs. 2.48). Finally the betweenness of individual stations in several systems were examined, which can be useful to locate stations where passengers can be redistributed to relieve pressure from overcrowded stations. Overall, this study offers significant insights that can help planners in their task to design the systems of tomorrow, and similar undertakings can easily be imagined to other urban infrastructure systems (e.g., electricity grid, water/wastewater system, etc.) to develop more sustainable cities. PMID:22792373

  14. Child Care Services Handbook.

    ERIC Educational Resources Information Center

    Duval County School Board, Jacksonville, FL.

    A companion document to the curriculum guide for a secondary level child care services curriculum, this handbook contains a variety of administrative and program resources for the teacher: The vocational curriculum outline for child care services; a calendar of suggested public relations activities; procedures for building child care services…

  15. Guidelines for Guidance Services.

    ERIC Educational Resources Information Center

    Manitoba Dept. of Education and Training, Winnipeg.

    The purpose of this booklet is to provide direction and assistance to school divisions as they develop responsive, effective, and accountable guidance services and programs at the school level. The guidelines presented provide a broad conceptual framework of definitions and goals and outline expectations for service standards. Models and…

  16. Virtual Libraries: Service Realities.

    ERIC Educational Resources Information Center

    Novak, Jan

    2002-01-01

    Discussion of changes in society that have resulted from information and communication technologies focuses on changes in libraries and a new market for library services with new styles of clients. Highlights client service issues to be considered when transitioning to a virtual library situation. (Author/LRW)

  17. Food Service Fundamentals.

    ERIC Educational Resources Information Center

    Marine Corps Inst., Washington, DC.

    Developed as part of the Marine Corps Institute (MCI) correspondence training program, this course on food service fundamentals is designed to provide a general background in the basic aspects of the food service program in the Marine Corps; it is adaptable for nonmilitary instruction. Introductory materials include specific information for MCI…

  18. Celebrating Service and Learning

    ERIC Educational Resources Information Center

    Emeagwali, Susan; Berkey, Lisa; Guempel, Martha

    2010-01-01

    This month's "Techniques" magazine celebrates service-learning and the contributions that it makes to students' learning by fostering civic engagement while students learn in hands-on, real-world contexts. For close to half a century, service-learning has spread throughout schools in the United States as students engage in activities as diverse as…

  19. Adult Day Services

    MedlinePlus

    A Smart Choice Adult Day Services Comparison At-a-Glance 1 Adult Day Services Assisted Living Home Care Nursing Homes Live at home with family ... supervision Nursing care available as needed during the day Flexibility to receive care only on days when ...

  20. Food Service Management

    NASA Technical Reports Server (NTRS)

    Rappole, C. L.; Louvier, S. A.

    1985-01-01

    A study to design a food service system using current technology to serve a small scale Space Station was conducted. The psychological, sociological and nutritional factors affecting feeding in microgravity conditions was investigated. The logistics of the food service system was defined.