Sample records for day reporting center

  1. Interactions Between Family and Day Care Systems. Final Technical Report.

    ERIC Educational Resources Information Center

    Romero, Det; And Others

    This research report studied the relationship between families and day care centers as systems. Three levels of subjects were investigated: 23 day care centers in Lansing, Michigan, day care staffs and families of children enrolled. Three questionnaires were developed to obtain data on demographic and attitudinal variables. A director's…

  2. Administration of the Radiation Control for Health and Safety Act of 1968, Public Law 90-602, (1987 annual report). Report for January-December 1987

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

    Not Available

    This document is an annual report submitted to the President for transmittal to the Congress. The Food and Drug Administration, through its Center for Devices and Radiological Health, is responsible for the day-to-day administration of the Radiation Control for Health and Safety Act of 1968. The report provides a summary of the operations of the Center in carrying out that responsibility for calendar year 1987. In reviewing the operations of the CDRH as reported in the document, it should be kept in mind that the day-to-day administration of the Act is only part of the Center's function. Other responsibilities includemore » the administration and enforcement of the 1976 Medical Device Amendments to the Federal Food, Drug, and Cosmetic Act (not covered in the report). Manufacturers of electronic products are required by 21 CFR 1002.20 to report accidental radiation occurrences to the CDRH. The Center no longer maintains a Radiation Incidents Registry, since accidental radiation occurrences are reported through the Device Experience Network (DEN) and through the requirements of the Medical Device Reporting (MDR) regulations.« less

  3. Evaluation of a day reporting center for repeat DWI offenders

    DOT National Transportation Integrated Search

    1999-08-01

    Describes and evaluates the effectiveness of a Day Reporting Center (DRC) in reducing the driving while intoxicated (DWI) recidivism of repeat DWI offenders. It also examines the effect of the DRC program in reducing the cost of post-conviction sanct...

  4. A Review of Experience: Establishing, Operating, Evaluating a Demonstration Nursery Center for the Daytime Care of Infants and Toddlers, 1967-1970. Final Report.

    ERIC Educational Resources Information Center

    Keister, Mary Elizabeth

    This document is the final report of Phase One (1967-1970) of the Group Care of Infants Demonstration (Center) Project. This report devotes major attention to the problems of establishing, operating, and evaluating a group day care center for infant and toddler care. The Center project describes what is required to provide housing, equipment,…

  5. Summary Report of the Demonstration and Evaluation for the City/University EPSDT Day Care Project.

    ERIC Educational Resources Information Center

    Hierta, Ebba L., Ed.; Axelrod, Pearl G., Ed.

    This summary report from a 3-year research and demonstration project describes the framework, methods and materials used by the University of Michigan-Ann Arbor Early Periodic Screening Diagnosis and Treatment (EPSDT) Day Care Project. The project served approximately 750 children and their families through day care centers and family day care…

  6. The concept of a composite perioperative quality index in kidney transplantation.

    PubMed

    Taber, David J; McGillicuddy, John W; Bratton, Charles F; Lin, Angello; Chavin, Kenneth D; Baliga, Prabhakar K

    2014-04-01

    Public reporting of patient and graft outcomes in a national registry and close Centers for Medicare and Medicaid Services oversight has resulted in transplantation being a highly regulated surgical discipline. Despite this, transplantation surgery lacks comprehensive tracking and reporting of perioperative quality measures. Therefore, the aim of this study was to determine the association between a kidney transplantation centers' perioperative quality benchmarking and graft and patient outcomes. This was an analysis of 2011 aggregate data compiled from 2 national datasets that track outcomes from member hospitals and transplantation centers. The transplantation centers included in this study were composed of accredited US kidney transplantation centers that report data through the national registry and are associate members of the University HealthSystem Consortium. A total of 16,811 kidney transplantations were performed at 236 centers in the United States in 2011, of which 10,241 (61%) from 93 centers were included in the analysis. Of the 6 perioperative quality indicators, 3 benchmarked metrics were significantly associated with a kidney transplantation center's underperformance: mean ICU length of stay (C-statistic 0.731; p = 0.002), 30-day readmissions (C-statistic 0.697; p = 0.012) and in-hospital complications (C-statistic 0.785; p = 0.001). The composite quality index strongly correlated with inadequate center performance (C-statistic 0.854; p < 0.001, R(2) = 0.349). The centers in the lowest quartile of the quality index performed 2,400 kidney transplantations in 2011, which led to 2,640 more hospital days, 4,560 more ICU days, 120 more postoperative complications, and 144 more patients with 30-day readmissions, when compared with centers in the 3 higher-quality quartiles. An objective index of a transplantation center's quality of perioperative care is significantly associated with patient and graft survival. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Evaluation of Street Projects for the Spanish Speaking. Findings, Conclusions, Recommendations. Volume II of a Two-Volume Report.

    ERIC Educational Resources Information Center

    Vasquez Associates Ltd., Milwaukee, WI.

    Nine Street Projects designed for the Spanish speaking and funded by Region V of the Department of Health, Education and Welfare (HEW) are examined here. They were: the El Hogar del Nino Day Care Center, Spanish-American Day Care Center, United Migrant Opportunity Services' Bilingual/Bicultural Early Childhood Center, Youth Services at El Centro…

  8. DAY-CARE REHABILITATION CENTER FOR EMOTIONALLY DISTURBED ADOLESCENTS. FINAL REPORT.

    ERIC Educational Resources Information Center

    CRAWFORD, HUGH A.; VAN DUYNE, WILLIAM V.

    IN THIS FIVE YEAR DEMONSTRATION PROJECT, EMOTIONALLY DISTURBED ADULTS AND ADOLESCENTS RECEIVED TREATMENT AT A DAY CARE REHABILITATION CENTER SPONSORED BY THE RHODE ISLAND DIVISION OF VOCATIONAL REHABILITATION (DVR) LOCATED IN A PRIVATE PSYCHIATRIC HOSPITAL (BUTLER HOSPITAL). THE MAJOR TREATMENT GOALS WERE PRESERVATION AND RESTORATION OF…

  9. Final Report of the Demonstration and Evaluation for the City/University EPSDT Day Care Project.

    ERIC Educational Resources Information Center

    Hierta, Ebba L., Ed.

    This report describes (1) the development of a comprehensive and interdisciplinary approach to early health assessment and follow-through for 750 children in day care centers and family day care homes, and (2) training and consultation provisions for day care staffs to aid children and their families. Objectives of the three year project were to…

  10. Evaluation of the HOPE Act: New State Services for Street Youth. Interim Report.

    ERIC Educational Resources Information Center

    McLain, Barbara

    This report reviews the effectiveness of Washington's HOPE Centers and Responsible Living Skills Programs (RLSPs) and reports findings and recommendations. In 1999, state legislators enacted the HOPE Act, which created these two services. HOPE Centers are temporary residential facilities where street youth can stay for 30 days while being…

  11. Financial Reporting and Cost Analysis Manual for Day Care Centers, Head Start, and Other Programs.

    ERIC Educational Resources Information Center

    Bedger, Jean E.; And Others

    This manual is designed to provide fundamental directions for systematic financial reporting and cost analysis for the administrators, accountants, bookkeepers, and staff of day care, Project Head Start, and other programs. The major aims of the manual are to induce day care directors to adopt uniform bookkeeping procedures and to analyze costs…

  12. Research Results of the National Day Care Study. Final Report of the National Day Care Study. Volume II.

    ERIC Educational Resources Information Center

    Travers, Jeffrey; And Others

    This final report of the National Day Care Study (NDCS), Volume II, provides researchers, social scientists and lay readers with information for judging the soundness of the evidence underlying NDCS conclusions about relationships between regulatable center characteristics and the outcome of care for the child. Thus, Volume II makes free use of…

  13. A one-day centralized work-up for kidney transplant recipient candidates: a quality improvement report.

    PubMed

    Formica, Richard N; Barrantes, Fidel; Asch, William S; Bia, Margaret J; Coca, Steven; Kalyesubula, Robert; McCloskey, Barbara; Leary, Tucker; Arvelakis, Antonios; Kulkarni, Sanjay

    2012-08-01

    Waiting time for a kidney transplant is calculated from the date the patient is placed on the UNOS (United Network for Organ Sharing) waitlist to the date the patient undergoes transplant. Time from transplant evaluation to listing represents unaccounted waiting time, potentially resulting in longer dialysis exposure for some patients with prolonged evaluation times. There are established disparities demonstrating that groups of patients take longer to be placed on the waitlist and thus have less access to kidney transplant. Quality improvement report. 905 patients from a university-based hospital were evaluated for kidney transplant candidacy, and analysis was performed from July 1, 2004, to January 31, 2010. A 1-day centralized work-up was implemented on July 1, 2007, whereby the transplant center coordinated the necessary tests needed to fulfill minimal listing criteria. Time from evaluation to UNOS listing was compared between the 2 cohorts. Multivariable Cox proportional hazards models were created to assess the relative hazards of waitlist placement comparing 1-day versus conventional work-up and were adjusted for age, sex, race, and education. Of 905 patients analyzed, 378 underwent conventional evaluation and 527 underwent a 1-day center-coordinated evaluation. Median time to listing in the 1-day center-coordinated evaluation compared with conventional was significantly less (46 vs 226 days, P < 0.001). On multivariable analysis controlling for age, sex, and education level, the 1-day in-center group was 3 times more likely to place patients on the wait list (adjusted HR, 3.08; 95% CI, 2.64-3.59). Listing time was significantly decreased across race, sex, education, and ethnicity. Single center, retrospective. Variables that may influence transplant practitioners, such as comorbid conditions or functional status, were not assessed. A 1-day center-coordinated pretransplant work-up model significantly decreased time to listing for kidney transplant. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  14. Ventilator-associated pneumonia rates at major trauma centers compared with a national benchmark: a multi-institutional study of the AAST.

    PubMed

    Michetti, Christopher P; Fakhry, Samir M; Ferguson, Pamela L; Cook, Alan; Moore, Forrest O; Gross, Ronald

    2012-05-01

    Ventilator-associated pneumonia (VAP) rates reported by the National Healthcare Safety Network (NHSN) are used as a benchmark and quality measure, yet different rates are reported from many trauma centers. This multi-institutional study was undertaken to elucidate VAP rates at major trauma centers. VAP rate/1,000 ventilator days, diagnostic methods, institutional, and aggregate patient data were collected retrospectively from a convenience sample of trauma centers for 2008 and 2009 and analyzed with descriptive statistics. At 47 participating Level I and II centers, the pooled mean VAP rate was 17.2 versus 8.1 for NHSN (2006-2008). Hospitals' rates were highly variable (range, 1.8-57.6), with 72.3% being above NHSN's mean. Rates differed based on who determined the rate (trauma service, 27.5; infection control or quality or epidemiology, 11.9; or collaborative effort, 19.9) and the frequency with which VAP was excluded based on aspiration or diagnosis before hospital day 5. In 2008 and 2009, blunt trauma patients had higher VAP rates (17.3 and 17.6, respectively) than penetrating patients (11.0 and 10.9, respectively). More centers used a clinical diagnostic strategy (57%) than a bacteriologic strategy (43%). Patients with VAP had a mean Injury Severity Score of 28.7, mean Intensive Care Unit length of stay of 20.8 days, and a 12.2% mortality rate. 50.5% of VAP patients had a traumatic brain injury. VAP rates at major trauma centers are markedly higher than those reported by NHSN and vary significantly among centers. Available data are insufficient to set benchmarks, because it is questionable whether any one data set is truly representative of most trauma centers. Application of a single benchmark to all centers may be inappropriate, and reliable diagnostic and reporting standards are needed. Prospective analysis of a larger data set is warranted, with attention to injury severity, risk factors specific to trauma patients, diagnostic method used, VAP definitions and exclusions, and reporting guidelines. III, prognostic study.

  15. Sacramento's Day-Treatment Center for Autistic Children

    PubMed Central

    Tribbey, John A.; Louargand, Edna M.; Allen, Adina; Olsen, Jerry

    1968-01-01

    A report of two years' operation of a day-treatment center for autistic children is given. A brief historical review and a capsule summary regarding current concepts on autism are presented. The educational and treatment programs at the center are described, and two case vignettes illustrate the progress of the children. Highlights from group counseling sessions with the mothers of autistic children reveal the conflicts with which parents of disturbed children must deal. The two-year experience indicates that the identification of autism at an early age is crucial and that a day-treatment facility has much to offer the psychotic child and his parents. PMID:5640191

  16. STS-73 Flight Day 15

    NASA Technical Reports Server (NTRS)

    1995-01-01

    On this fifteenth day of the STS-73 sixteen day mission, the crew Cmdr. Kenneth Bowersox, Pilot Kent Rominger, Payload Specialists Albert Sacco and Fred Leslie, and Mission Specialists Kathryn Thornton, Catherine 'Cady' Coleman, and Michael Lopez-Alegria are shown hosting an in-orbit interview with various newspaper reporters from Johnson Space Center, Kennedy Space Center, and Marshall Space Flight Center via satellite hookup. The astronauts were asked questions regarding the status of the United States Microgravity Lab-2 (USML-2) experiments, their personal goals regarding their involvement in the mission, their future in the space program, and general questions about living in space. Earth views included cloud cover and a tropical storm.

  17. STS-72 Flight Day 9

    NASA Technical Reports Server (NTRS)

    1996-01-01

    On this ninth day of the STS-72 mission, the flight crew, Cmdr. Brian Duffy, Pilot Brent W. Jett, and Mission Specialists Leroy Chiao, Daniel T. Barry, Winston E. Scott, and Koichi Wakata (NASDA), awakened to music from the movie Star Wars. The astronauts conducted a news conference via satellite and answered questions from both Japanese and U.S. reporters at the Kennedy Space Center and the Johnson Space Center. The preparation for the scheduled night landing continues from the previous day's activities.

  18. A Review of Federal and State Regulations for Day Care Programs and Facilities. Center for Human Services Development Report No. 10.

    ERIC Educational Resources Information Center

    Hollick, Rosemary; And Others

    This report provides a review of U.S. regulatory standards for day care programs and facilities and makes recommendations for the revision of day care regulations in Pennsylvania. Following a brief discussion of federal interagency requirements, a number of short descriptive analyses compare individual state standards in the areas of licensing,…

  19. The McDonald Observatory lunar laser ranging project

    NASA Technical Reports Server (NTRS)

    Silverberg, E. C.

    1978-01-01

    A summary of the activities of the McDonald lunar laser ranging station at Fort Davis for the FY 77-78 fiscal year is presented. The lunar laser experiment uses the observatory 2.7m reflecting telescope on a thrice-per-day, 21-day-per-lunation schedule. Data are recorded on magnetic tapes and sent to the University of Texas at Austin where the data is processed. After processing, the data is distributed to interested analysis centers and later to the National Space Science Data Center where it is available for routine distribution. Detailed reports are published on the McDonald operations after every fourth lunation or approximately once every 115 days. These reports contain a day-by-day documentation of the ranging activity, detailed discussions of the equipment development efforts, and an abundance of other information as is needed to document and archive this important data type.

  20. Child Care Insurance Crisis: Strategies for Survival.

    ERIC Educational Resources Information Center

    Koppelman, Jane

    Designed to help child care centers in their search for liability insurance, this report explores the controversy about insurance provision, and offers advice on how to combat high rates and locate policies offering the most protection. Chapter 1 reports on how insurers justify their treatment of day care centers as high risk enterprises.…

  1. Optimal Timing for Removal of the Double-J Stent After Kidney Transplantation.

    PubMed

    Yuksel, Y; Tekin, S; Yuksel, D; Duman, I; Sarier, M; Yucetin, L; Kiraz, K; Demirbas, M; Kaya Furkan, A; Aslan Sezer, M; Demirbas, A; Asuman, Y H

    2017-04-01

    Urologic complications (UC) have gradually decreased in recent years after advanced surgical experience. The incidence of urologic complications varies between 0.22% and 30% in different medical studies. There is no routine usage of double-J stenting (DJS) during renal transplantation (RT) in the literature. It is a necessity, and optimal timing for stent removal is an important question for many transplantation centers. This study includes 818 renal transplant patients whose ureteroneocystostomy anastomoses were completed by use of the Lich-Gregorie procedure during a 2-year period at a transplantation center. We performed 926 renal transplantations at Antalya Medical Park Hospital Renal Transplantation Center between January 2014 and January 2016. The patients were divided into four groups according to the timing of DJS removal. For group 1, removal time for DJS was between 5 and 7 days; group 2, Removal time for DJS was between 8 and 14 days; group 3, removal time for DJS was between 15 and 21 days; and group 4, removal time for DJS was later than 22 days. The patients were divided into two groups according to removal time of stent as 5 to 14 days and >15 days. DJS was performed again in the patients whose urine output was reduced during the first 5 days after removal of the DJS, whose creatine level increased, and whose graft ureter and collecting tubules were extended as an ultrasonographic finding. There is no declared optimal time for the removal of DJS. The removal time was reported between postoperative first week and 3 months in some of the reports of RT centers, according to their protocols. We emphasize that the optimal time for the removal of DJS is 14 to 21 days after RT, based on the findings of our large case report study. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Illinois Department of Children and Family Services Text of Adopted Rules. Subchapter e: Requirements for Licensure. Part 407: Licensing Standards for Day Care Centers.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Children and Family Services, Springfield.

    Reprinted in this document are day care center licensing standards adopted and codified, effective August 1983, by the Illinois Department of Children and Family Services and amended June 1984 and January 1985. Sections of the report concern purpose, definitions, effective date of standards, application for license and license renewal, provisions…

  3. 45 CFR 270.4 - On what measures will we base the bonus awards?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... child care centers and family day care homes responding to the State's market rate survey; and (ii) The... county or administrative region. (We will compare payments for children in center-based care to reported center care provider rates. We will compare payments for children in non-center-based care, i.e., family...

  4. National Response Center

    EPA Pesticide Factsheets

    The NRC is the federal government's national communications center, which is staffed 24 hours a day by U.S. Coast Guard officers and marine science technicians. Sole federal point of contact for reporting all hazardous substance releases and oil spills

  5. Summary Report: 2017 Annual Grantees Meeting of the NIH-EPA Centers of Excellence on Environmental Health Disparities Research

    EPA Science Inventory

    Approximately 100 researchers, trainees, students, and community partners attended the 2-day grantees meeting. In addition to research updates by the five EHD Centers, the meeting featured working group discussions around topics such as research translation, cross-center collabor...

  6. Report of the Child Care Training Needs Assessment.

    ERIC Educational Resources Information Center

    Poresky, Robert H.; Dirggers, Jo Ann M.

    The findings of a day care training needs assessment survey conducted in the State of Kansas by the Day Care Training Systems Project comprise the body of this report. Questionnaires were distributed to child care providers and agency personnel with child care responsibilities. Child care providers included both family and center providers, while…

  7. Assessment of an Innovative Voluntary Substance Abuse Treatment Program Designed to Replace Compulsory Drug Detention Centers in Malaysia.

    PubMed

    Khan, Farrah; Krishnan, Archana; Ghani, Mansur A; Wickersham, Jeffrey A; Fu, Jeannia J; Lim, Sin How; Dhaliwal, Sangeeth Kaur; Kamarulzaman, Adeeba; Altice, Frederick L

    2018-01-28

    As part of an ongoing initiative by the Malaysian government to implement alternative approaches to involuntary detention of people who use drugs, the National Anti-Drug Agency has created new voluntary drug treatment programs known as Cure and Care (C&C) Centers that provide free access to addiction treatment services, including methadone maintenance therapy, integrated with social and health services.   We evaluated early treatment outcomes and client satisfaction among patients accessing C&C treatment and ancillary services at Malaysia's second C&C Center located in Kota Bharu, Kelantan. In June-July 2012, a cross-sectional convenience survey of 96 C&C inpatients and outpatients who entered treatment >30 days previously was conducted to assess drug use, criminal justice experience, medical co-morbidities, motivation for seeking treatment, and attitudes towards the C&C. Drug use was compared for the 30-day-period before C&C entry and the 30-day-period before the interview. Self-reported drug use levels decreased significantly among both inpatient and outpatient clients after enrolling in C&C treatment. Higher levels of past drug use, lower levels of social support, and more severe mental health issues were reported by participants who were previously imprisoned. Self-reported satisfaction with C&C treatment services was high. Conclusions/Importance: Preliminary evidence of reduced drug use and high levels of client satisfaction among C&C clients provide support for Malaysia's ongoing transition from compulsory drug detention centers (CDDCs) to these voluntary drug treatment centers. If C&C centers are successful, Malaysia plans to gradually transition away from CDDCs entirely.

  8. Aspects of Quality in Greek Day Care Centres.

    ERIC Educational Resources Information Center

    Melhuish, Edward C.; Petrogiannis, Konstantinos

    1996-01-01

    Evaluates the quality of the caregiving environment for young infants in day care centers in Athens (Greece) using three global measures: ITERS, PROFILE, and CCFS. Reveals a great similarity among the three measures. Reports a generally low quality for day care, lower than for other countries with similar research. (DSK)

  9. Use of the Environment and Policy Evaluation and Observation as a Self-Report Instrument (EPAO-SR) to measure nutrition and physical activity environments in child care settings: validity and reliability evidence.

    PubMed

    Ward, Dianne S; Mazzucca, Stephanie; McWilliams, Christina; Hales, Derek

    2015-09-26

    Early care and education (ECE) centers are important settings influencing young children's diet and physical activity (PA) behaviors. To better understand their impact on diet and PA behaviors as well as to evaluate public health programs aimed at ECE settings, we developed and tested the Environment and Policy Assessment and Observation - Self-Report (EPAO-SR), a self-administered version of the previously validated, researcher-administered EPAO. Development of the EPAO-SR instrument included modification of items from the EPAO, community advisory group and expert review, and cognitive interviews with center directors and classroom teachers. Reliability and validity data were collected across 4 days in 3-5 year old classrooms in 50 ECE centers in North Carolina. Center teachers and directors completed relevant portions of the EPAO-SR on multiple days according to a standardized protocol, and trained data collectors completed the EPAO for 4 days in the centers. Reliability and validity statistics calculated included percent agreement, kappa, correlation coefficients, coefficients of variation, deviations, mean differences, and intraclass correlation coefficients (ICC), depending on the response option of the item. Data demonstrated a range of reliability and validity evidence for the EPAO-SR instrument. Reporting from directors and classroom teachers was consistent and similar to the observational data. Items that produced strongest reliability and validity estimates included beverages served, outside time, and physical activity equipment, while items such as whole grains served and amount of teacher-led PA had lower reliability (observation and self-report) and validity estimates. To overcome lower reliability and validity estimates, some items need administration on multiple days. This study demonstrated appropriate reliability and validity evidence for use of the EPAO-SR in the field. The self-administered EPAO-SR is an advancement of the measurement of ECE settings and can be used by researchers and practitioners to assess the nutrition and physical activity environments of ECE settings.

  10. Assessment of Atmospheric Winds Aloft during NASA Space Shuttle Program Day-of-Launch Operations

    NASA Technical Reports Server (NTRS)

    Decker, Ryan K.; Leach, Richard

    2005-01-01

    The Natural Environments Branch at the National Aeronautics and Space Administration s Marshall Space Flight Center monitors the winds aloft at Kennedy Space Center in support of the Space Shuttle Program day of launch operations. High resolution wind profiles are derived from radar tracked Jimsphere balloons, which are launched at predetermined times preceding the launch, for evaluation. The spatial (shear) and temporal (persistence) wind characteristics are assessed against a design wind database to ensure wind change does not violate wind change criteria. Evaluations of wind profies are reported to personnel at Johnson Space Center.

  11. 76 FR 61115 - Migrant and Seasonal Farmworkers (MSFWs) Monitoring Report and One-Stop Career Center Complaint...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ...: The calculations are based on a normal work week for most jobs are 8 hours a day for 5 days. There are 52 weeks in a year but most workers get a two week vacation. So, 8 x 5 x 50 = 2000 hours worked in a... keepers = 50 x reports = 4 = 200). Estimated hours per record-keeper: 1.16 (70 minutes per report). Total...

  12. Assessment of an Innovative Voluntary Substance Abuse Treatment Program Designed to Replace Compulsory Drug Detention Centers in Malaysia

    PubMed Central

    Khan, Farrah; Krishnan, Archana; Ghani, Mansur A.; Wickersham, Jeffrey A.; Fu, Jeannia J.; Lim, Sin How; Dhaliwal, Sangeeth Kaur; Kamarulzaman, Adeeba; Altice, Frederick L.

    2017-01-01

    Background As part of an ongoing initiative by the Malaysian government to implement alternative approaches to involuntary detention of people who use drugs, the National Anti-Drug Agency has created new voluntary drug treatment programs known as Cure and Care (C&C) Centers that provide free access to addiction treatment services, including methadone maintenance therapy, integrated with social and health services. Objectives We evaluated early treatment outcomes and client satisfaction among patients accessing C&C treatment and ancillary services at Malaysia’s second C&C Center located in Kota Bharu, Kelantan. Methods In June–July 2012, a cross-sectional convenience survey of 96 C&C inpatients and outpatients who entered treatment >30 days previously was conducted to assess drug use, criminal justice experience, medical co-morbidities, motivation for seeking treatment, and attitudes towards the C&C. Drug use was compared for the 30-day-period before C&C entry and the 30-day-period before the interview. Results Self-reported drug use levels decreased significantly among both inpatient and outpatient clients after enrolling in C&C treatment. Higher levels of past drug use, lower levels of social support, and more severe mental health issues were reported by participants who were previously imprisoned. Self-reported satisfaction with C&C treatment services was high. Conclusions/Importance Preliminary evidence of reduced drug use and high levels of client satisfaction among C&C clients provide support for Malaysia’s ongoing transition from compulsory drug detention centers (CDDCs) to these voluntary drug treatment centers. If C&C centers are successful, Malaysia plans to gradually transition away from CDDCs entirely. PMID:28635521

  13. The Development of a Prototype Infant, Preschool and Child Day Care Center in Metropolitan Toronto. Year I Progress Report: Program Development.

    ERIC Educational Resources Information Center

    Fowler, William; And Others

    The project reported on is designed to develop a model program of infant and child day care in a municipal setting. The development of the program is discussed under the following topics: (1) physical caregiving routines; (2) guided learning through play; (3) supervising children in free play; (4) staff guidance and communication: inservice…

  14. 77 FR 74483 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-14

    ... outcomes- oriented health promotion and disease prevention research on a broad range of topics using a... days of this notice. Proposed Project Prevention Research Centers Program National Evaluation Reporting... Description The Prevention Research Centers (PRC) Program was established by Congress through the Health...

  15. Human embryonic stem cells and good manufacturing practice: Report of a 1- day workshop held at Stem Cell Biology Research Center, Yazd, 27th April 2017.

    PubMed

    Akyash, Fatemeh; Sadeghian-Nodoushan, Fatemeh; Tahajjodi, Somayyeh Sadat; Nikukar, Habib; Farashahi Yazd, Ehsan; Azimzadeh, Mostafa; D Moore, Harry; Aflatoonian, Behrouz

    2017-05-01

    This report explains briefly the minutes of a 1-day workshop entitled; "human embryonic stem cells (hESCs) and good manufacturing practice (GMP)" held by Stem Cell Biology Research Center based in Yazd Reproductive Sciences Institute at Shahid Sadoughi University of Medical Sciences, Yazd, Iran on 27 th April 2017. In this workshop, in addition to the practical sessions, Prof. Harry D. Moore from Centre for Stem Cell Biology, University of Sheffield, UK presented the challenges and the importance of the biotechnology of clinical-grade human embryonic stem cells from first derivation to robust defined culture for therapeutic applications.

  16. Job demands and job performance: the mediating effect of psychological and physical strain and the moderating effect of role clarity.

    PubMed

    Lang, Jessica; Thomas, Jeffrey L; Bliese, Paul D; Adler, Amy B

    2007-04-01

    The aims of the present study were twofold: First, in differentiating between specific job characteristics, the authors examined the moderating influence of role clarity on the relationship between job demands and psychological and physical strain. Second, in providing a more comprehensive link between job demands and job performance, the authors examined strain as a mediator of that relationship. Participants were 1,418 Army cadets attending a 35-day assessment center. Survey data were collected on Day 26 of the assessment center and performance ratings were assessed throughout the assessment center period by expert evaluators. Role clarity was found to moderate the job demands-strain relationship. Specifically, cadets experiencing high demands reported less physical and psychological strain when they reported high role clarity. Moreover, psychological strain significantly mediated the demands-performance relationship. Implications are discussed from theoretical and applied perspectives. Copyright (c) 2007 APA, all rights reserved.

  17. Financial performance among adult day centers: results of a national demonstration program.

    PubMed

    Reifler, B V; Henry, R S; Rushing, J; Yates, M K; Cox, N J; Bradham, D D; McFarlane, M

    1997-02-01

    This paper describes the financial performance (defined as percent of total expenses covered by net operating revenue) of 16 adult day centers participating in a national demonstration program on day services for people with dementia, including examination of possible predictors of financial performance. Participating sites submitted quarterly financial and utilization reports to the National Program Office. Descriptive statistics summarize the factors believed to influence financial performance. Sites averaged meeting 35% of expenses from self-pay and 29% from government (mainly Medicaid) revenue, totaling 64% of all (cash plus in-kind) expenses met by operating revenue. Examination of center characteristics suggests that factors related to meeting consumer needs, such as being open a full day (i.e., 7:30 am to 6:00 pm) rather than shorter hours, and providing transportation, may be related to improved utilization and, thus, improved financial performance. Higher fees were not related to lower enrollment, census, or revenue. Adult day centers are able to achieve financial viability through a combination of operating (i.e., fee-for-service) and non-operating revenue. Operating revenue is enhanced by placing emphasis on consumer responsiveness, such as being open a full day. Because higher fees were not related to lower utilization, centers should set fees to reflect actual costs. The figure of 64% of expenses met by operating revenue is conservative inasmuch as sites included in-kind revenue as expenses in their budgeting calculations, and percent of cash expenses met by operating revenue would be higher (approximately 75% for this group of centers).

  18. Nutrition Education and Training Needs in Texas. Nutrition Education and Training Needs Assessment for Federal Fiscal Year 1995. Final Annual Report.

    ERIC Educational Resources Information Center

    Martin, Ruth E.; Ahmad, Mahassen

    A 3-year needs assessment study examined nutrition knowledge, attitudes, and food practices. Subjects were 135 preschool children ages 3-5 years, 610 parents, 118 day care teachers and providers, 35 food service personnel, and 76 administrators throughout Texas. Registered family day care homes, group day care homes, and day care centers from 11…

  19. 76 FR 71072 - Agency Information Collection Activities: Extension With Change of a Previously Approved...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-16

    ...: 30-Day notice. The United States Department of Justice (DOJ), National Drug Intelligence Center (NDIC..., including the validity of the methodology and assumptions used; --Enhance the quality, utility, and clarity... Assessment and other reports and assessments produced by the National Drug Intelligence Center. It provides...

  20. 77 FR 75166 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-19

    ... (OMB 0920-0650, exp. 6/30/2013). The web-based survey is designed to collect information on the PRCs... days of this notice. Proposed Project Prevention Research Centers Program National Evaluation Reporting... Description The Prevention Research Centers (PRC) Program was established by Congress through the Health...

  1. A Population-Based Study of Preschoolers' Food Neophobia and Its Associations with Food Preferences

    ERIC Educational Resources Information Center

    Russell, Catherine Georgina; Worsley, Anthony

    2008-01-01

    Objective: This cross-sectional study was designed to investigate the relationships between food preferences, food neophobia, and children's characteristics among a population-based sample of preschoolers. Design: A parent-report questionnaire. Setting: Child-care centers, kindergartens, playgroups, day nurseries, and swimming centers. Subjects:…

  2. EXERCISE AND STRESS MANAGEMENT TRAINING PRIOR TO HEMATOPOIETIC CELL TRANSPLANTATION: BLOOD AND MARROW TRANSPLANT CLINICAL TRIALS NETWORK (BMT CTN) 0902

    PubMed Central

    Jacobsen, Paul B.; Le-Rademacher, Jennifer; Jim, Heather; Syrjala, Karen; Wingard, John R.; Logan, Brent; Wu, Juan; Majhail, Navneet S.; Wood, William; Rizzo, J. Douglas; Geller, Nancy L.; Kitko, Carrie; Faber, Edward; Abidi, Muneer H.; Slater, Susan; Horowitz, Mary M.; Lee, Stephanie J.

    2014-01-01

    Studies show that engaging patients in exercise and/or stress management techniques during hematopoietic cell transplantation (HCT) improves quality of life. The Blood and Marrow Transplant Clinical Trials Network tested the efficacy of training patients to engage in self-directed exercise and stress management during their HCTs. The study randomized 711 patients at 21 centers to receive one of four training interventions before HCT: a self-directed exercise program, a self-administered stress management program, both or neither. Participants completed self-reported assessments at enrollment and up to 180 days after transplant. Randomization was stratified by center and transplant type. There were no differences in the primary endpoints of the physical (PCS) and mental (MCS) component scales of the SF36 at day 100 among the groups based on an intention-to-treat analysis. There were no differences observed in overall survival, hospital days through day 100 post-HCT, or in other patient-reported outcomes, including treatment-related distress, sleep quality, pain, and nausea. Patient randomized to training in stress management reported more use of those techniques; patients randomized to training in exercise did not report more physical activity. Although other studies have reported efficacy of more intensive interventions, brief training in an easy-to-disseminate format for either self-directed exercise or stress management was not effective in our trial. PMID:24910380

  3. Adult Day Care--Extended Family.

    ERIC Educational Resources Information Center

    Smith, Bert K.

    This booklet reports on a community project in Texas involving a day care center for senior citizens. It contains an analysis of successes and failures in attempting to satisfy the project's goals of: (l) keeping individuals out of institutions as long as possible; (2) providing social contact and enrichment experiences; (3) making the burden…

  4. Kansas Center for Research in Early Childhood Education. Annual Report (Part I) FY'73.

    ERIC Educational Resources Information Center

    Kansas Univ., Lawrence. Kansas Center for Research in Early Childhood Education.

    This report includes five documents, three on child care research, and two concerning individual differences and discriminative abilities in newborn and young infants. "The Organization of Infant Day Care Environments: Feedback-Produced Improvements in Staff Job Performance" reports on the effectiveness of monitoring procedures as…

  5. Lunar phases and crisis center telephone calls.

    PubMed

    Wilson, J E; Tobacyk, J J

    1990-02-01

    The lunar hypothesis, that is, the notion that lunar phases can directly affect human behavior, was tested by time-series analysis of 4,575 crisis center telephone calls (all calls recorded for a 6-month interval). As expected, the lunar hypothesis was not supported. The 28-day lunar cycle accounted for less than 1% of the variance of the frequency of crisis center calls. Also, as hypothesized from an attribution theory framework, crisis center workers reported significantly greater belief in lunar effects than a non-crisis-center-worker comparison group.

  6. The Door: A Model Youth Center. Treatment Program Monograph Series.

    ERIC Educational Resources Information Center

    National Inst. on Drug Abuse (DHHS/PHS), Rockville, MD.

    This report provides basic facts about The Door, a multifaceted youth center in New York City, which serves 300-400 young people each day. The origins, early stages, guiding philosophy, activities, and organizational structure are described. Recommendations for initiating and operating multiservice youth projects based on the experience of The…

  7. Patient-Reported Barriers to the Prekidney Transplant Evaluation in an At-Risk Population in the United States.

    PubMed

    Lockwood, Mark B; Saunders, Milda R; Nass, Rachel; McGivern, Claire L; Cunningham, Patrick N; Chon, W James; Josephson, Michelle A; Becker, Yolanda T; Lee, Christopher S

    2017-06-01

    Despite our knowledge of barriers to the early stages of the transplant process, we have limited insight into patient-reported barriers to the prekidney transplant medical evaluation in populations largely at-risk for evaluation failure. One-hundred consecutive adults were enrolled at an urban, Midwestern transplant center. Demographic, clinical, and quality of life data were collected prior to patients visit with a transplant surgeon/nephrologist (evaluation begins). Patient-reported barriers to evaluation completion were collected using the Subjective Barriers Questionnaire 90-days after the initial medical evaluation appointment (evaluation ends), our center targeted goal for transplant work-up completion. At 90 days, 40% of participants had not completed the transplant evaluation. Five barrier categories were created from the 85 responses to the Subjective Barriers Questionnaire. Patient-reported barriers included poor communication, physical health, socioeconomics, psychosocial influences, and access to care. In addition, determinants for successful evaluation completion included being of white race, higher income, free of dialysis, a lower comorbid burden, and reporting higher scores on the Kidney Disease Quality of Life subscale role-emotional. Poor communication between patients and providers, and among providers, was the most prominent patient-reported barrier identified. Barriers were more prominent in marginalized groups such as ethnic minorities and people with low income. Understanding the prevalence of patient-reported barriers may aid in the development of patient-centered interventions to improve completion rates.

  8. Attendance in adult day care centers of cognitively intact older persons: reasons for use and nonuse.

    PubMed

    Iecovich, Esther; Biderman, Aya

    2013-08-01

    The article aims to (a) examine the reasons for nonuse of ADCC, and (b) explore the reasons for use of adult day care centers (ADCCs) among users. The sample includes 819 respondents of whom 417 are users of 13 day care centers and 402 are nonusers, matched by age, gender, and family physician in the southern region of Israel. Data collection includes interviews that used a structured questionnaire. The most frequent reasons for nonuse of ADCCs are accessibility barriers, characteristics of participants and of the ADCCs, "no need for this service," and personal difficulties. Those who use this service report that it improved their well-being, met their needs, enabled them to establish social relationships, and alleviated their family caregivers' burden. ADCCs should be more responsive to the needs of various constituencies of frail older adults and be more accessible to those who do not use this type of service.

  9. Malaysia's First Day Care Center for Children with Disabilities: Future Needs in Research in Early Intervention.

    ERIC Educational Resources Information Center

    Bhagwanji, Yash

    This paper describes the development and implementation of the first private nonprofit day care program serving children with disabilities in Malaysia. Preliminary information describes Malaysia's economic, ethnic, and cultural situation. The naturalistic inquiry approach used to prepare this report, involving interviews and observations, is then…

  10. Environmental Assessment of the Proposed Denver Security Operations Center (DSOC) Center of Excellence at Buckley Air Force Base, Colorado

    DTIC Science & Technology

    2004-07-01

    COLORADO 460 CES/CEV 660 South Aspen Street, Stop 86 Buckley AFB, CO 80011-9551 JULY 2004 Report...and local agencies, and the public for a 30-day review period, 3 June - 3 July 2004. Comments were received from the Colorado Department of 2...3-29 Buckley AFB, CO UNCLASSIFIED/FOR OFFICIAL USE ONLY July 2004 i EA for DSOC Center of Excellence

  11. NHRC (Naval Health Research Center) Report for 1979

    DTIC Science & Technology

    1979-01-01

    of cross- validation analyses on an independent sample (n = 336) were also reported and were generally consistent with the foregoing analyses. 79-3...antigens in sputum. Initial sputum samples from patients with pneumococcal p,; Lmonia (᝼ hr antibiotic therapy) were positive for antigen in 37 of 44...the decline was gree’ar for CIE (only 29% of samples positive at three days of therapy) than with coagglutination (61% positive at three days) (pɘ.05

  12. Evaluation of employees in public day care centers knowledge about breastfeeding and complementary feeding.

    PubMed

    Souza, Joelânia Pires de O; Prudente, Amanda Moura; Silva, Dyene Aparecida; Pereira, Leandro Alves; Rinaldi, Ana Elisa M

    2013-12-01

    To evaluate the knowledge of public day care centers employees about breastfeeding and complementary feeding. A cross-sectional study was conducted in 15 public day care centers randomly selected in the city of Uberlandia, Southeast Brazil. A questionnaire applied to school principals, teachers, educators and general services assistants (GSA) included demographic and socioeconomic variables and questions about knowledge on breastfeeding, complementary feeding besides employees' perceptions about these subjects. Kruskal-Wallis with multiple comparison and chi-square tests were used to compare variables by professional category. 304 employees participated in the study. The highest percentages of correct answers were noted for questions about exclusive breastfeeding: definition - 97% (n=296) and duration - 65% (n=199). Regarding complementary feeding, 61% (n=187) correctly answered about the appropriate age to introduce it, with a lower percentage for meat (56%; n=170) and sugar (16%; n=50). Concerning employees' perceptions, 9% (n=29) believed that there is weak breast milk, 79% (n=241) and 51% (n=157) reported the negative influence of bottle feeding and pacifier use on breastfeeding. Among the interviewed subjects, 77% (n=234) answered that they had a positive influence on the quality of the food given to the children. There were no differences in the answers according to professional category, except for the negative influence of pacifiers on breastfeeding. Employees of public day care centers knew more about breastfeeding than about complementary feeding. Educational activities about breastfeeding and complementary feeding are necessary for day care centers employees.

  13. HAZARD ASSESSMENT FOR NANOPARTICLES: REPORT FROM AN INTERDISCIPLINARY WORKSHOP

    EPA Science Inventory

    Abstract This report presents the findings from a nanotoxicology workshop held on April 6-7, 2006 at the Woodrow Wilson International Center for Scholars in Washington, D.C. Over two days, 26 scientists from government, academia, industry, and non-profit organizations ad...

  14. Try Caring...For a Living. Wisconsin Child Care Improvement Project Child Care Administration Series.

    ERIC Educational Resources Information Center

    Wisconsin Early Childhood Association, Madison.

    A collection of 26 fact sheets on child care administration produced by the Wisconsin Child Care Improvement Project from 1986 through 1989 is presented. Individual fact sheets concern: national trends, center start-up, family day care start-up, site and facility acquisition, public funding, effective center operation, reporting of child abuse and…

  15. Capital Needed: Financing New Space for Day Care Centers.

    ERIC Educational Resources Information Center

    Ward, Antony; And Others

    The issue of how to finance creation of new space or expansion of current space for day care in New York City (NYC) is the subject of this report. In NYC, there are close to 105,000 children under 6 years of age for whom there is no space in day care programs. Even if there were sufficient subsidies to help parents obtain child care, there would…

  16. Behavior problems among young children in low-income urban day care centers.

    PubMed

    Gross, D; Sambrook, A; Fogg, L

    1999-02-01

    The purposes of this study were to describe: (a) the frequency and correlates of behavior problems among a sample of 2- and 3-year-old children from low-income families as seen by their parents and day care teachers, (b) the degree to which parents and teachers agree about the children's behavior problems in their respective contexts, and (c) family characteristics that distinguish toddlers with behavior problems both at home and at day care from the rest of the sample. Parents of 133 toddlers from 10 Chicago day care centers completed measures of child behavior problems, child behavioral intensity, parenting self-efficacy, discipline strategies, and stress. Children's day care teachers also completed a measure of child behavior problems. Parent-reported behavior problems were associated with higher child behavioral intensity, greater parent stress, lower self-efficacy, and discipline strategies characterized by irritability, coercion, and inconsistency. Parent and teacher ratings on child behavior were correlated for boys' behavior problems only. Parents reported more child behavior problems than teachers. Approximately 8% of the children were rated as having behavior problems at home and at day care. Although most of the children are functioning well, many of these parents and toddlers are engaged in highly stressful and coercive relationships.

  17. Improving Reports Turnaround Time: An Essential Healthcare Quality Dimension.

    PubMed

    Khan, Mustafa; Khalid, Parwaiz; Al-Said, Youssef; Cupler, Edward; Almorsy, Lamia; Khalifa, Mohamed

    2016-01-01

    Turnaround time is one of the most important healthcare performance indicators. King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia worked on reducing the reports turnaround time of the neurophysiology lab from more than two weeks to only five working days for 90% of cases. The main quality improvement methodology used was the FOCUS PDCA. Using root cause analysis, Pareto analysis and qualitative survey methods, the main factors contributing to the delay of turnaround time and the suggested improvement strategies were identified and implemented, through restructuring transcriptionists daily tasks, rescheduling physicians time and alerting for new reports, engaging consultants, consistent coordination and prioritizing critical reports. After implementation; 92% of reports are verified within 5 days compared to only 6% before implementation. 7% of reports were verified in 5 days to 2 weeks and only 1% of reports needed more than 2 weeks compared to 76% before implementation.

  18. The Burden of Gastroesophageal Reflux Disease on Patients' Daily Lives: A Cross-Sectional Study Conducted in a Primary Care Setting in Serbia.

    PubMed

    Bjelović, Miloš; Babić, Tamara; Dragicević, Igor; Corac, Aleksandar; Goran Trajković

    2015-01-01

    Recent data from the studies conducted in the Western countries have proved that patients with gastroesophageal reflux disease have significantly impaired health-related quality of life compared to general population. The study is aimed at evaluating the burden of reflux symptoms on patients'health-related quality of life. The study involved 1,593 patients with diagnosed gastroesophageal reflux disease.The Serbian version of a generic self-administered Centers for Disease Control and Prevention questionnaire was used. Statistical analyses included descriptive statistics, Pearson chi-square test and a multiple regression model. Among all participants, 43.9% reported fair or poor health. Mean value of unhealthy days during the past 30 days was 10.4 days, physically unhealthy days 6.4 days, mentally unhealthy days 5.3 days and activity limitation days 4.3 days. Furthermore, 24.8% participants reported having ≥ 14 unhealthy days, 14.9% had 14 physically unhealthy days, 11.8% reported 14 mentally unhealthy days, and 9.4% had ≥ 14 activity limitation days. This study addressed complex relationships between reflux symptoms and patients'impaired everyday lives.

  19. Hennepin County Grant Purchase of Child Day Care through a Voucher System: An Evaluation and Use of Technology (Transfer and Technical Assistance to Enhance Service Delivery (with Exeuctive Summary). Final Report.

    ERIC Educational Resources Information Center

    Scoll, Barbara; Engstrom, Roger

    In January of 1982, the Hennepin County Community Services Department began implementing a day care voucher system which allowed day care clients to place their children in any licensed day care home or center that was willing to contract with Hennepin County. In October of the same year, Hennepin County was awarded a grant by the Department of…

  20. The effect of social desirability trait on self-reported dietary measures among multi-ethnic female health center employees.

    PubMed

    Hébert, J R; Peterson, K E; Hurley, T G; Stoddard, A M; Cohen, N; Field, A E; Sorensen, G

    2001-08-01

    To evaluate the effect of social desirability trait, the tendency to respond in a manner consistent with societal expectations, on self-reported fruit, vegetable, and macronutrient intake. A 61-item food frequency questionnaire (FFQ), 7-item fruit and vegetable screener, and a single question on combined fruit and vegetable intake were completed by 132 female employees at five health centers in eastern Massachusetts. Intake of fruit and vegetables derived from all three methods and macronutrients from the FFQ were fit as dependent variables in multiple linear regression models (overall and by race/ethnicity and education); independent variables included 3-day mean intakes derived from 24-hour recalls (24HR) and score on the 33-point Marlowe-Crowne Social Desirability scale (the regression coefficient for which reflects its effect on estimates of dietary intake based on the comparison method relative to 24HR). Results are based on the 93 women with complete data and FFQ-derived caloric intake between 450 and 4500 kcal/day. In women with college education, FFQ-derived estimates of total caloric were associated with under-reporting by social desirability trait (e.g., the regression coefficient for total caloric intake was -23.6 kcal/day/point in that group versus 36.1 kcal/day/point in women with education less than college) (difference = 59.7 kcal/day/point, 95% confidence interval (CI) = 13.2, 106.2). Except for the single question on which women with college education tended to under-report (difference =.103 servings/day/point, 95% CI = 0.003, 0.203), there was no association of social desirability trait with self-reported fruit and vegetable intake. The effect of social desirability trait on FFQ reports of macronutrient intake appeared to differ by education, but not by ethnicity or race. The results of this study may have important implications for epidemiologic studies of diet and health in women.

  1. Technical Report Series on Global Modeling and Data Assimilation. Volume 7: Proceedings of the Workshop on the GEOS-1 Five-year Assimilation

    NASA Technical Reports Server (NTRS)

    Suarez, Max J. (Editor); Schubert, Siegfried; Rood, Richard

    1995-01-01

    The primary objective of the three-day workshop on results from the Data Assimilation Office (DAO) five-year assimilation was to provide timely feedback from the data users concerning the strengths and weaknesses of version 1 of the Goddard Earth Observing System (GEOS-1) assimilated products. A second objective was to assess user satisfaction with the current methods of data access and retrieval. There were a total of 49 presentations, with about half (23) of the presentations from scientists from outside of Goddard. The first two days were devoted to applications of data: studies of the energy diagnostics, precipitation and diabatic heating, hydrological modeling and moisture transport, cloud forcing and validation, various aspects of intraseasonal, seasonal, and interannual variability, ocean wind stress applications, and validation of surface fluxes. The last day included talks from the National Meteorological Center (NMC), the National Center for Atmospheric Research (NCAR), the Center for Ocean-Land-Atmosphere Studies (COLA), the United States Navy, and the European Center for Medium Range Weather Forecasts (ECMWF).

  2. Cost-effectiveness of an Evidence-Based Childhood Asthma Intervention in Real-World Primary Care Settings.

    PubMed

    Dor, Avi; Luo, Qian; Gerstein, Maya Tuchman; Malveaux, Floyd; Mitchell, Herman; Markus, Anne Rossier

    We present an incremental cost-effectiveness analysis of an evidence-based childhood asthma intervention (Community Healthcare for Asthma Management and Prevention of Symptoms [CHAMPS]) to usual management of childhood asthma in community health centers. Data used in the analysis include household surveys, Medicaid insurance claims, and community health center expenditure reports. We combined our incremental cost-effectiveness analysis with a difference-in-differences multivariate regression framework. We found that CHAMPS reduced symptom days by 29.75 days per child-year and was cost-effective (incremental cost-effectiveness ratio: $28.76 per symptom-free days). Most of the benefits were due to reductions in direct medical costs. Indirect benefits from increased household productivity were relatively small.

  3. Child and Family Resource Program (Modesto, California). Program Description.

    ERIC Educational Resources Information Center

    Development Associates, Inc., Washington, DC.

    Migrant farm workers were the primary target of the Child and Family Resource Program (CFRP) in Modesto, California, one of 11 sites in this Head Start affiliated program. The CFRP focused on an infant day care center operation providing day care service to families working in the agricultural fields. This report describes and evaluates: (1) the…

  4. Operation Borderstar Field Evaluation of the Ration, Lightweight, 30-Day

    DTIC Science & Technology

    1985-05-01

    Lightweight, 30-Day (RLW-30) was conducted at Ft. Bliss, TX as part of work unit # AH99BF034 "Sensory and Behavioral Engineering of Low-Volume Rations...corresponding hedonic ratings obtained from the final questionnaire. B. Amounts of Ration Comsumed Daily self-reports of the amounts of each ration...Lightweight, 30-Day Food Packet Assault 23 LIGHT WEIGHT RATION QUESTIONNAIRE Behavioral Sciences Division U.S. Army Natick Research & Development Center

  5. Caring for a Living: A Study on Wages and Working Conditions in Canadian Child Care. Final Report.

    ERIC Educational Resources Information Center

    Canadian Child Care Federation, Ottawa (Ontario).

    Between November 1990 and August 1992, a study examined wages and working conditions of child care staff in both licensed group centers and family day care homes in Canada. Three instruments were developed for the study, a short telephone interview for center directors, a follow-up director's questionnaire, and a staff questionnaire. The study…

  6. Evaluation of employees in public day care centers knowledge about breastfeeding and complementary feeding

    PubMed Central

    Souza, Joelânia Pires de O.; Prudente, Amanda Moura; Silva, Dyene Aparecida; Pereira, Leandro Alves; Rinaldi, Ana Elisa M.

    2013-01-01

    OBJECTIVE: To evaluate the knowledge of public day care centers employees about breastfeeding and complementary feeding. METHODS: A cross-sectional study was conducted in 15 public day care centers randomly selected in the city of Uberlandia, Southeast Brazil. A questionnaire applied to school principals, teachers, educators and general services assistants (GSA) included demographic and socioeconomic variables and questions about knowledge on breastfeeding, complementary feeding besides employees' perceptions about these subjects. Kruskal-Wallis with multiple comparison and chi-square tests were used to compare variables by professional category. RESULTS: 304 employees participated in the study. The highest percentages of correct answers were noted for questions about exclusive breastfeeding: definition - 97% (n=296) and duration - 65% (n=199). Regarding complementary feeding, 61% (n=187) correctly answered about the appropriate age to introduce it, with a lower percentage for meat (56%; n=170) and sugar (16%; n=50). Concerning employees' perceptions, 9% (n=29) believed that there is weak breast milk, 79% (n=241) and 51% (n=157) reported the negative influence of bottle feeding and pacifier use on breastfeeding. Among the interviewed subjects, 77% (n=234) answered that they had a positive influence on the quality of the food given to the children. There were no differences in the answers according to professional category, except for the negative influence of pacifiers on breastfeeding. CONCLUSIONS: Employees of public day care centers knew more about breastfeeding than about complementary feeding. Educational activities about breastfeeding and complementary feeding are necessary for day care centers employees. PMID:24473953

  7. 19 CFR 103.31 - Information on vessel manifests and summary statistical reports.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... members of the press. Accredited representatives of the press, including newspapers, commercial magazines... mailed from the CBP Technology Support Center, first class, on the next business day after compilation...

  8. Novel Modes Workshop Summary Report

    DOT National Transportation Integrated Search

    2015-12-01

    On December 2-3, 2014, the Federal Highway Administration's (FHWA's) Exploratory Advanced Research Program, with support from the John A. Volpe National Transportation Systems Center, convened the 2-day workshop "Novel Modes." It was held concurrentl...

  9. KSC-03pd0833

    NASA Image and Video Library

    2003-03-25

    KENNEDY SPACE CENTER, FLA. - At the third public hearing of the Columbia Accident Investigation Board, held in Cape Canaveral, Fla., reporters listen intently to Center Director Roy Bridges (background, right). Board members are in the background, left. Over the course of two days, the Board's chairman, retired Navy Admiral Harold W. "Hal" Gehman Jr., and other board members would hear from experts discussing the role of the Kennedy Space Center in the Shuttle Program, Shuttle Safety and Debris Collection, Layout and Analysis and Forensic Metallurgy.

  10. KSC-03PD-0833

    NASA Technical Reports Server (NTRS)

    2003-01-01

    KENNEDY SPACE CENTER, FLA. - At the third public hearing of the Columbia Accident Investigation Board, held in Cape Canaveral, Fla., reporters listen intently to Center Director Roy Bridges (background, right). Board members are in the background, left. Over the course of two days, the Board's chairman, retired Navy Admiral Harold W. 'Hal' Gehman Jr., and other board members would hear from experts discussing the role of the Kennedy Space Center in the Shuttle Program, Shuttle Safety and Debris Collection, Layout and Analysis and Forensic Metallurgy.

  11. Delinquent Medical Service Accounts at Landstuhl Regional Medical Center Need Additional Management Oversight

    DTIC Science & Technology

    2016-04-28

    L 2 8 , 2 0 1 6 Report No. DODIG-2016-079 Delinquent Medical Service Accounts at Landstuhl Regional Medical Center Need Additional Management...Department of Defense F r a u d , W a s t e & A b u s e DODIG-2016-079 (Project No. D2015-D000CL-0214.000) │ i Results in Brief Delinquent Medical...objective was to determine whether Landstuhl Regional Medical Center (LRMC) effectively managed accounts delinquent over 120 days by properly

  12. Understanding Mothers' Experiences of Infant Daycare: A New Approach Using Computer-Assisted Analysis of Qualitative Data.

    ERIC Educational Resources Information Center

    Rolfe, Sharne; And Others

    This paper reports on a small-scale introductory study of Australian mothers' experiences of infant day care. Ten employed, middle- and lower-socioeconomic status women with an infant in center-based day care were interviewed. Brief narrative examples from the mothers' accounts are presented. Discussion then concentrates on a new approach to…

  13. Parent Run Day Care Centres: The Growth of a French Community Initiative. Studies and Evaluation Papers No. 8.

    ERIC Educational Resources Information Center

    Combes, Josette

    This report examines how parent involvement in running day care centers in France has increased in recent years, and investigates the role that the Association des Collectifs Enfants Parents Professionnels (ACEPP) has played in making this form of child care more acceptable. After a discussion of the historical development and current choices of…

  14. Students Celebrate Space Days with NASA and the Traveling Space Museum (Reporter Package)

    NASA Image and Video Library

    2012-06-04

    NASA Ames Research Center partnered with the Traveling Space Museum to bring NASA Space Days to schools in California. Students visited 14 interactive stations that demonstrated concepts such as living in space, physics, aeronautics and Earth Science. During the Space Days at the Ronald McNair Academy in East Palo Alto, Calif., Cheryl McNair, the widow of the fallen astronaut, was a guest of honor who spoke to inspire the students.

  15. Zero to Sixty Plus in 108 Days: Launching a Central Elearning Unit and Its First Faculty Development Program

    ERIC Educational Resources Information Center

    Orozco, Monica; Fowlkes, James; Jerzak, Page; Musgrove, Ann

    2012-01-01

    The Center for eLearning was established at Florida Atlantic University (FAU) as a result of a university-wide task force. A brief overview of the center's start-up activity is followed by a thorough report of the first faculty development program created and implemented. The structure of the program is described, and data are provided showing…

  16. Television in Higher Education; Psychology; A Special Report from the National Center for School and College Television. NSCT News Supplement, Number 9.

    ERIC Educational Resources Information Center

    Sanford, Fillmore H.

    At a two-day meeting sponsored by the National Center for School and College Television and by the American Psychological Association, 15 specialists viewed and reacted to recorded television materials currently used in psychology instruction. Most of the television programs were designed to be courses in Introductory Psychology, and most of the…

  17. Special land use trip generation in Virginia.

    DOT National Transportation Integrated Search

    1981-01-01

    Vehicle trip rates at shopping centers, apartment complexes, and subdivisions throughout Virginia were determined from seven-day volume counts. These rates were then compared with rates reported in four recognized sources of trip rate statistics and ...

  18. Who Cares for Kids? A Report on Child Care Providers.

    ERIC Educational Resources Information Center

    Benson, Carolyn

    This study offers a profile of child care workers in family day care homes and child care centers, reporting general statistics and examining their wages, benefits, training, working conditions, and turnover rates. In addition, it looks at government regulation and licensing, employer-sponsored programs, child abuse, insurance rates, and federal…

  19. Protein and calorie prescription for children and young adults receiving continuous renal replacement therapy: a report from the Prospective Pediatric Continuous Renal Replacement Therapy Registry Group.

    PubMed

    Zappitelli, Michael; Goldstein, Stuart L; Symons, Jordan M; Somers, Michael J G; Baum, Michelle A; Brophy, Patrick D; Blowey, Douglas; Fortenberry, James D; Chua, Annabelle N; Flores, Francisco X; Benfield, Mark R; Alexander, Steven R; Askenazi, David; Hackbarth, Richard; Bunchman, Timothy E

    2008-12-01

    Few published reports describe nutrition provision for critically ill children and young adults with acute kidney injury receiving continuous renal replacement therapy. The goals of this study were to describe feeding practices in pediatric continuous renal replacement therapy and to evaluate factors associated with over- and under-prescription of protein and calories. Retrospective database study. Multicenter study in pediatric critical care units. Patients with acute kidney injury (estimated glomerular filtration rate < 75 mL/min/1.73 m at continuous renal replacement therapy initiation) enrolled in the Prospective Pediatric Continuous Renal Replacement Therapy Registry. None. Nutrition variables: initial and maximal protein (g/kg/day) and caloric (kcal/kg/day) prescription and predicted resting energy expenditure (kcal/kg/day). We determined factors predicting initial and maximal protein and caloric prescription by multivariate analysis. One hundred ninety-five patients (median [interquartile range] age = 8.1 [12.8] yrs, 56.9% men) were studied. Mean protein and caloric prescriptions at continuous renal replacement therapy initiation were 1.3 +/- 1.5 g/kg/day (median, 1.0; range, 0-10) and 37 +/- 27 kcal/kg/day (median, 32; range, 0-107). Mean maximal protein and caloric prescriptions during continuous renal replacement therapy were 2.0 +/- 1.5 g/kg/day (median, 1.7; range, 0-12) and 48 +/- 32 kcal/kg/day (median, 43; range, 0-117). Thirty-four percent of patients were initially prescribed < 1 g/kg/day protein; 23% never attained > 1 g/kg/day protein prescription. By continuous renal replacement therapy day 5, median protein prescribed was > 2 g/kg/day. Protein prescription practices differed substantially between medical centers with 5 of 10 centers achieving maximal protein prescription of > 2 g/kg/day in > or = 40% of patients. Caloric prescription exceeded predicted resting energy expenditure by 30%-100%. Factors independently associated with maximal protein and caloric prescription while on continuous renal replacement therapy were younger age, initial protein and caloric prescription and number of continuous renal replacement therapy treatment days (p < 0.05). Protein prescription in pediatric continuous renal replacement therapy may be inadequate. Inter-center variation exists with respect to nutrition prescription. Feeding practice standardization and research in pediatric acute kidney injury nutrition are essential to begin providing evidence-based feeding recommendations.

  20. JPRS Report. West Europe, Turkish Expatriates’ Religious Developments, Home Connections

    DTIC Science & Technology

    1987-08-05

    shall be the official day of rest of the week. There shall be a 2-day holiday for Ramadan and a 3-day holiday for the Festival of Sacrifice [’Id al...press and tourism coordinator of the Turkish embassy in Bonn and a former parliamentary deputy; Ali Riza Ozguc, the educational counselor at the...the Federation of Islamic Cultural Centers sponsored a fast-breaking dinner which was attended by Press and Tourism Coordinator Mehmet Ali Arsan and

  1. 75 FR 5328 - Agency Information Collection Request; 60-Day Public Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-02

    ... center (REC) will be provided with a customer relationship management (CRM) software tool, which they... selecting a CRM vendor. Once this is completed it will submit the specific reports for clearance. [[Page...

  2. Transcript of proceedings: National Aeronautics and Space Administration, Goddard Space Flight Center, 1972 GSFC Battery Workshop, first day

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The proceedings of the 1972 NASA/Goddard Battery Workshop are reported. Topics discussed include: separators, materials and processing, test and storage experience, and improved energy density systems.

  3. 100 Days of Learning in Place: How a Small School Utilized "Place-Based" Learning To Master State Academic Standards.

    ERIC Educational Resources Information Center

    Lewicki, James

    This report describes the development and implementation of a place-based curriculum for a small charter high school of 25 students in Wisconsin. The curriculum involved 100 days of field studies in local places such as historical archives, a restored wetland, a river valley, and a senior citizen community center. The students worked with 60…

  4. Creating Learning Environments in the Early Grades That Support Teacher and Student Success: Profiles of Effective Practices in Three Expanded Learning Time Schools

    ERIC Educational Resources Information Center

    Farbman, David A.; Novoryta, Ami

    2016-01-01

    In "Creating Learning Environments in the Early Grades that Support Teacher and Student Success," the National Center on Time & Learning (NCTL) profiles three expanded-time elementary schools that leverage a longer school day to better serve young students. In particular, the report describes how a longer day opens up opportunities…

  5. Corporations and Child Care: Profit-Making Day Care, Workplace Day Care, and a Look at the Alternatives.

    ERIC Educational Resources Information Center

    Avrin, Cookie; And Others

    This report presents a critical look at the ways profit-making child care centers treat the problems of racism and sexism, handle parent and community involvement, and provide care for children. Quantifiable factors in child care which have been found to bear a relationship to quality, warmth and flexibility are evaluated (staff/child ratios,…

  6. Service use and financial performance in a replication program on adult day centers.

    PubMed

    Reifler, B V; Cox, N J; Jones, B N; Rushing, J; Yates, K

    1999-01-01

    The authors describe results from Partners in Caregiving: The Dementia Services Program, and present information on service utilization and financial performance among a group of 48 adult day centers across the United States from 1992 to 1996. Centers, with nonrandom assignment, received either grant support (average value: $93,000) or intensive technical assistance (average value: $39,000). Sites reported baseline data and submitted utilization information (enrollment and census) and financial data (revenue and expenses) quarterly. Overall, there were significant increases in enrollment, census, and financial performance (percent of cash expenses met through operating revenue) over the 4-year period. The grant-supported and technical-assistance sites had similar rates of improvement. Results provide data on service utilization and financial performance and demonstrate gains that can be achieved in these areas through improved marketing and financial management.

  7. A Short Term Evaluation of the Direct Operating Grants. Final Report.

    ERIC Educational Resources Information Center

    Levy-Coughlin Partnership.

    Findings of a survey of a sample of center-based child care (CBCC) programs and private home day care (PHDC) agencies listed in Ontario's Direct Operating Grant Calculation Data Base are reported. During 1988, licensed child care programs in Ontario received approximately 46.5 million dollars in Direct Operating Grants (DOGs). Grants were…

  8. CAFES 2009 New Student Survey Report. Survey Research Center Report 2010/3

    ERIC Educational Resources Information Center

    Speerstra, Mandy; Trechter, David

    2010-01-01

    During Academic Day, September 1, 2009, incoming freshmen and transfer students in the College of Agriculture, Food and Environmental Sciences (CAFES) were asked to complete a one-page questionnaire designed to find out: (1) how they learned about UW-River Falls as an option for their tertiary education; (2) what factors most influenced their…

  9. Monitoring of Childcare Fees: Prices Surveillance Authority Monitoring Report No. 13.

    ERIC Educational Resources Information Center

    Prices Surveillance Authority, Melbourne (Australia).

    This report documents a survey conducted to determine if Australian parents have benefited from an increase in child care assistance subsidies authorized in April 1993. A total of 281 day care centers across Australia responded to surveys mailed in July 1992, February 1993, and May 1993. Data was also collected about profit margins, quality of…

  10. Trauma center finances and length of stay: identifying a profitability inflection point.

    PubMed

    Fakhry, Samir M; Couillard, Debbie; Liddy, Casey T; Adams, David; Norcross, E Douglass

    2010-05-01

    Trauma centers frequently report unfavorable financial results for the care of injured patients. Many variables contribute to these results. The objective of this study was to determine the relationship of adult trauma patient hospital length of stay (LOS) to trauma center profitability. The trauma registry of a Level I trauma center was queried for patients older than 18 years for the period July 1, 2003 to June 30, 2008. Hospital financial records were matched to patient trauma registry data. There were 7,990 patients who met selection criteria: 71% were men, mean age was 40 years, mean Injury Severity Score was 12 +/-10, 84.2% of injuries were blunt, and mean LOS was 6.23 days. In the 5 years of the study, total charges were $329,315,191, total costs were $137,680,039, and overall profit was $7,644,894. Total costs rose each year and percent collections fell. The bulk of the profit was realized from patients with LOS < 11 days, with progressively escalating cost per case, lower collections, and resultant lower profitability as LOS increased. A notable "inflection point" at 11 days defined the cohort of profitable patients. Trauma patient LOS correlates closely with profitability. In this center, the vast majority of profit was realized from patients with LOS < 11 days and was eroded by most patient cohorts with longer LOS. Identification of an institution's "inflection point" may help direct efforts at increasing profitability and reflects the current reimbursement environment, which rewards shorter LOS over severity and quality. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  11. The impact of a large-scale power outage on hemodialysis center operations.

    PubMed

    Abir, Mahshid; Jan, Sophia; Jubelt, Lindsay; Merchant, Raina M; Lurie, Nicole

    2013-12-01

    On June 29, 2012, mid-Atlantic storms resulted in a large-scale power outage affecting up to three million people across multiple (US) states. Hemodialysis centers are dependent on electricity to provide dialysis care to end-stage renal disease patients. The objective of this study was to determine how the power outage impacted operations in a sample of hemodialysis centers in the impacted regions. The sample consisted of all hemodialysis centers located in the District of Columbia and a total of five counties with the largest power losses in West Virginia, Virginia, and Maryland. A semi-structured interview guide was developed, and the charge nurse or supervisor in each facility was interviewed. The survey questions addressed whether their centers lost power, if so, for how long, where their patients received dialysis, whether their centers had backup generators, and if so, whether they had any problems operating them, and whether their center received patients from other centers if they had power. Calls were placed to 90 dialysis centers in the sampled areas and a 90% response rate was achieved. Overall, hemodialysis operations at approximately 30% (n = 24) of the centers queried were impacted by the power outage. Of the 36 centers that lost power, 31% (n = 11) referred their patients to other dialysis centers, 22% (n = 8) accommodated their patients during a later shift or on a different day; the rest of the centers either experienced brief power outages that did not affect operations or experienced a power outage on days that the center is usually closed. Some centers in the study cohort reported receiving patients from other centers for dialysis 33% (n = 27). Thirty-two percent (n = 26) of the centers queried had backup generators on site. Eleven percent (n = 4) of the centers experiencing power outages reported that backup generators were brought in by their parent companies. Comprehensive emergency planning for dialysis centers should include provisions for having backup generators on site, having plans in place for the timely delivery of a generator during a power outage, or having predesignated backup dialysis centers for patients to receive dialysis during emergencies. Most dialysis centers surveyed in this study were able to sustain continuity of care by implementing such pre-existing emergency plans.

  12. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 4 2013-01-01 2013-01-01 false Adult day care center provisions. 226.19a Section 226..., DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program...

  13. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 4 2012-01-01 2012-01-01 false Adult day care center provisions. 226.19a Section 226..., DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program...

  14. 7 CFR 226.19a - Adult day care center provisions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 4 2014-01-01 2014-01-01 false Adult day care center provisions. 226.19a Section 226..., DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM Operational Provisions § 226.19a Adult day care center provisions. (a) Adult day care centers may participate in the Program...

  15. Child Care in Federal Buildings: Twenty-First Report by the Committee on Government Operations. House of Representatives, 100th Congress, 1st Session.

    ERIC Educational Resources Information Center

    Congress of the U. S., Washington, DC. House Committee on Government Operations.

    The employment of over half the women in the United States with children under age 6 creates a need for quality day care that the General Services Administration (GSA) has tried to meet by encouraging the establishment of child care centers in federal buildings. Although free or reduced rent has been available, only ten such centers currently…

  16. Assessment of indoor environment in Paris child day care centers.

    PubMed

    Roda, Célina; Barral, Sophie; Ravelomanantsoa, Hanitriniala; Dusséaux, Murielle; Tribout, Martin; Le Moullec, Yvon; Momas, Isabelle

    2011-11-01

    Children are sensitive to indoor environmental pollution. Up until now there has been a lack of data on air quality in child day care centers. The aim of this study is to document the indoor environment quality of Paris child day care centers by repeated measurements, and to compare pollutant levels in child day care centers with levels in Paris dwellings. We selected 28 child day care centers frequented by a random sample of babies who participated in the PARIS birth cohort environmental investigation, and visited the child day care centers for one week twice in one year. Biological contaminants assessed were fungi, endotoxin, dust mite allergens, and chemical pollutants: aldehydes, volatile organic compounds and nitrogen dioxide (NO2). Relative humidity, temperature, and carbon dioxide levels were measured simultaneously. A standardized questionnaire was used to gather information about the buildings and their inhabitants. Airborne endotoxin levels in child day care centers were higher than those found in Paris dwellings. Dust mite allergens in child day care centers were below the threshold level for sensitization in the majority of samples, and in common with dwelling samples. Penicillium and Cladosporium were the most commonly identified genera fungi. The child day care center indoor/outdoor ratio for most chemical pollutants was above unity except for NO2, the levels for NO2 being significantly higher than those measured in homes. Chemical and biological contamination in child day care centers appears to be low, apart from endotoxin and NO2. Failure to take child exposure in child day care centers into account could result in an overestimation of children's exposure to other pollutants. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. What Caused the August 2002 Catastrophic Floods in Central Europe?

    NASA Technical Reports Server (NTRS)

    Otterman, J.; Atlas, R.; Jusem, J. C.; Van Engelen, A.; Terry, J.

    2002-01-01

    The catastrophic August 2002 floods in central Europe followed very intense rains over a span of several days, reported over a large region. On Aug. 12 meteorological stations over an elongated swath, from the vicinity of Saltzburg (Austria) in the south to the vicinity of Berlin in the north, reported precipitation exceeding 100 mm/day. Synoptic analysis points to a jet streak in the mid-Atlantic. moving eastward, which reached Spain on about 9th of August. An understanding of the mechanism that ultimately produced the unprecedented rains was derived conveniently from the GEOS 3 Model developed at NASA Goddard Space Flight Center. Examining the scenarios of omega, we observe on Aug. 10, OOZ, a center of ascending vertical motions, stronger than 0.6 Pa/s at the 700 hPa level over the western Mediterranean. Advecting moist and warm air to higher levels from the near-ocean level, the center moved eastward, reaching the northern Adriatic on Aug. 11, OOZ, then continuing northeast to the regions where most intense precipitation was reported on Aug. 12. The omega at 850 hPa shows a closely similar pattern but especially interesting is the 850 omega pattern on Aug. 12, 12Z, which shows descending motions stronger than 0.4 Pa/s over the eastern Po Valley (northern Italy), and an elongated region of ascending motions stronger than 1.0 Pa/s coinciding in extent with the extreme-precipitation region on that day. At that time, the cyclone which formed over the Po Valley, was centered on eastern Czech Republic, producing on its western side these strong ascending motions over the precipitation region. The pattern of the surface-pressure lows provides further insight into the processes, and specifically, the Aug. 12,06Z map, shows a 996 mb low over the western Czech Republic. The flooding following the extreme rains was acerbated by the fact that river-channels were made narrower over the recent decades by the urbanization of river banks.

  18. Orbital Analysis of Two Triple Systems in the Open Cluster NGC 2516

    NASA Astrophysics Data System (ADS)

    Veramendi, M. E.; González, J. F.

    2010-12-01

    We report the discovery of two hierarchical triple systems in the open cluster NGC 2516. Both systems are double-lined spectroscopic binaries whose center-of-mass velocity varies in a time scale of a few years. The system BDA 19 consists of an eccentric spectroscopic binary with a period of 8.7 days and a third body orbiting with a period of about 3300 days. The close pair in the triple BDA 2 has an orbital period of 11.2 days and contains a HgMn star.

  19. Effects of the 2017 Solar Eclipse on HF Radio Propagation and the D-Region Ionosphere: Citizen Science Investigation

    NASA Technical Reports Server (NTRS)

    Fry, C. D.; Rawlins, L.; Krause, L. H.; Suggs, R. M.; McTernan, J. K.; Adams, M. L.; Gallagher, D. L.; Anderson, Scott; Allsbrooks, Robert IV

    2017-01-01

    August 21, 2017 provided a unique opportunity to investigate the effects of the total solar eclipse on high frequency (HF) radio propagation and ionospheric variability. In Marshall Space Flight Center's partnership with the US Space and Rocket Center (USSRC) and Austin Peay State University (APSU), we engaged students and citizen scientists in an investigation of the eclipse effects on the mid-latitude ionosphere. Activities included implementing and configuring software, monitoring the HF Amateur Radio frequency bands and collecting radio transmission data on days before, the day of, and days after the eclipse to build a continuous record of changing propagation conditions as the moon's shadow marched across the United States. Post-eclipse radio propagation analysis provided insights into ionospheric variability due to the eclipse. We report on results, interpretation, and conclusions of these investigations.

  20. Pakistan-U.S. Relations

    DTIC Science & Technology

    2009-02-06

    Peshawar. Days later, an Iranian diplomat in Peshawar was kidnaped by suspected Sunni militants, and a Japanese journalist and his Afghan colleague were...center, a café frequented by foreigners, a cinema house, and two hospitals. Six American citizens were among the 26 foreigners reported dead. Indian

  1. Analysis of the Effect of Race, Socioeconomic Status, and Center Size on Unrelated National Marrow Donor Program Donor Outcomes: Donor Toxicities Are More Common at Low-Volume Bone Marrow Collection Centers.

    PubMed

    Shaw, Bronwen E; Logan, Brent R; Kiefer, Deidre M; Chitphakdithai, Pintip; Pedersen, Tanya L; Abdel-Azim, Hisham; Abidi, Muneer H; Akpek, Gorgun; Diaz, Miguel A; Artz, Andrew S; Dandoy, Christopher; Gajewski, James L; Hematti, Peiman; Kamble, Rammurti T; Kasow, Kimberley A; Lazarus, Hillard M; Liesveld, Jane L; Majhail, Navneet S; O'Donnell, Paul V; Olsson, Richard F; Savani, Bipin N; Schears, Raquel M; Stroncek, David F; Switzer, Galen E; Williams, Eric P; Wingard, John R; Wirk, Baldeep M; Confer, Dennis L; Pulsipher, Michael A

    2015-10-01

    Previous studies have shown that risks of collection-related pain and symptoms are associated with sex, body mass index, and age in unrelated donors undergoing collection at National Marrow Donor Program centers. We hypothesized that other important factors (race, socioeconomic status [SES], and number of procedures at the collection center) might affect symptoms in donors. We assessed outcomes in 2726 bone marrow (BM) and 6768 peripheral blood stem cell (PBSC) donors collected between 2004 and 2009. Pain/symptoms are reported as maximum levels over mobilization and collection (PBSC) or within 2 days of collection (BM) and at 1 week after collection. For PBSC donors, race and center volumes were not associated with differences in pain/symptoms at any time. PBSC donors with high SES levels reported higher maximum symptom levels 1 week after donation (P = .017). For BM donors, black males reported significantly higher levels of pain (OR, 1.90; CI, 1.14 to 3.19; P = .015). No differences were noted by SES group. BM donors from low-volume centers reported more toxicity (OR, 2.09; CI, 1.26 to 3.46; P = .006). In conclusion, race and SES have a minimal effect on donation-associated symptoms. However, donors from centers performing ≤ 1 BM collection every 2 months have more symptoms after BM donation. Approaches should be developed by registries and low-volume centers to address this issue. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  2. An Analysis of the Effect of Race, Socioeconomic Status and Center Size on Unrelated NMDP Donor Outcomes: Donor Toxicities are More Common at Low Volume Bone Marrow Collection Centers

    PubMed Central

    Shaw, Bronwen E.; Logan, Brent R.; Kiefer, Deidre M.; Chitphakdithai, Pintip; Pedersen, Tanya L.; Abdel-Azim, Hisham; Abidi, Muneer H.; Akpek, Gorgun; Diaz, Miguel A.; Artz, Andrew S.; Dandoy, Christopher; Gajewski, James L.; Hematti, Peiman; Kamble, Rammurti T.; Kasow, Kimberley A.; Lazarus, Hillard M.; Liesveld, Jane L.; Majhail, Navneet S.; O’Donnell, Paul V.; Olsson, Richard F.; Savani, Bipin N.; Schears, Raquel M.; Stroncek, David F.; Switzer, Galen E.; Williams, Eric P.; Wingard, John R.; Wirk, Baldeep M.; Confer, Dennis L.; Pulsipher, Michael A.

    2015-01-01

    Previous studies have shown that risks of collection-related pain and symptoms are associated with sex, body mass index (BMI), and age in unrelated donors undergoing collection at National Marrow Donor Program (NMDP) centers. We hypothesized that other important factors (race, socioeconomic status (SES), and number of procedures at the collection center) might affect symptoms in donors. We assessed outcomes in 2,726 bone marrow (BM) and 6,768 peripheral blood stem cell (PBSC) donors collected between 2004 and 2009. Pain/symptoms are reported as maximum levels over mobilization and collection (PBSC) or within 2 days of collection (BM) and at 1 week after collection. For PBSC donors, race and center volumes were not associated with differences in pain/symptoms at any time. PBSC donors with high SES levels reported higher maximum symptom levels 1 week post donation (p=0.017). For BM donors, black males reported significantly higher levels of pain (OR=1.90, CI=1.14-3.19, p=0.015). No differences were noted by SES groups. BM donors from low volume centers reported more toxicity (OR=2.09, CI=1.26-3.46, p=0.006). In conclusion, race and SES have a minimal effect on donation associated symptoms. However, donors from centers performing ≤1 BM collection every 2 months have more symptoms following BM donation. Approaches should be developed by registries and low volume centers to address this issue. PMID:26116089

  3. Studies of Day Care Center Climate and Its Effect on Children's Social and Emotional Behavior.

    ERIC Educational Resources Information Center

    Ekholm, Bodil; Hedin, Anna

    School climates at 12 day care centers in Sweden were compared to investigate effects of center climates on children's social and emotional behavior. Observations and interviews conducted at the day care centers revealed differences in center climates related to child-rearing patterns, patterns of interaction, the distribution of power, and in…

  4. Pneumococcal vaccination reduces the risk of community-acquired pneumonia in children.

    PubMed

    Hasegawa, Junko; Mori, Mitsuru; Ohnishi, Hirofumi; Tsugawa, Takeshi; Hori, Tsukasa; Yoto, Yuko; Tsutsumi, Hiroyuki

    2017-03-01

    The seven-valent pneumococcal conjugate vaccine (PCV7) was introduced to Japan in 2009, after which there was a rapid decline in invasive pneumococcal disease. There are few data, however, on the effectiveness of PCV7 against community-acquired pneumonia (CAP). We conducted an ambispective cohort study among children aged 0-6 years old who attended day-care centers. A total of 624 children at 10 day-care centers in Sapporo, Japan participated in the study. The parents reported whether their child had received PCV7 one or more times, as well as the exact dates of vaccination from records in maternal and child health handbooks marked by pediatricians. Each CAP event was reported by parents according to doctor diagnosis. A Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and 95%CI of CAP incidence reduced by PCV7 inoculation. During the observational period, 94 subjects contracted CAP. After adjusting for potentially confounding variables, inoculation with PCV7 was significantly associated with a reduced risk of CAP (HR, 0.22; 95%CI: 0.13-0.34). On stratified analysis by age, PCV7 was significantly associated with a reduced risk of CAP in both children aged <3 years (HR, 0.31; 95%CI: 0.14-0.71), and those ≥3 years (HR, 0.20; 95%CI: 0.09-0.43). PCV7 is highly effective in reducing the risk of CAP in children attending day-care centers. © 2016 Japan Pediatric Society.

  5. Residential Neighborhood Amenities and Physical Activity Among U.S. Children with Special Health Care Needs.

    PubMed

    An, Ruopeng; Yang, Yan; Li, Kaigang

    2017-05-01

    Objectives Children with special health care needs (SHCN) have or are at elevated risk for chronic physical, developmental, behavioral or emotional conditions and therefore require specialized health care services. This study examines the relationship between residential neighborhood amenities and physical activity among U.S. children with SHCN. Methods A nationally representative sample of 113,767 children aged 6-17 years was taken from National Survey of Children's Health (NSCH) 2007-2008 and 2011-2012. Residential neighborhood amenities were defined by parent-reported presence or absence of sidewalks, parks/playgrounds, and recreation center. Physical activity was measured by parent-reported number of physically active days (0-7), defined as 20 min or longer during the past week. Negative binomial regressions were performed to estimate the associations between residential neighborhood amenities and physical activity among U.S. children with and without SHCN, adjusting for various neighborhood (detracting condition and safety) and individual characteristics and NSCH sampling design. Results Approximately 23% of young children aged 6-11 years and adolescents aged 12-17 years had SHCN. Number of weekly physically active days was both 4.8 among young children with and without SHCN, and 3.7 and 4.1 among adolescents with and without SHCN, respectively. Among young children with SHCN, neighborhood availability of a recreation center was associated with increased weekly physically active days by 0.23; whereas among young children without SHCN, number of weekly physically active days was not associated with the availability of any amenity. Among adolescents with SHCN, neighborhood availability of parks/playgrounds was associated with increased weekly physically active days by 0.33, whereas neighborhood availability of sidewalks was associated with reduced weekly physically active days by 0.21. Conversely, among adolescents without SHCN, neighborhood availability of a recreation center was associated with increased weekly physically active days by 0.22. Conclusions for Practice Vulnerable health status and high dependence on health care may prevent children with SHCN from being physically active. Provision of adequate amenities in residential neighborhoods could be essential in promoting physical activity and preventing obesity among children/adolescents with SHCN.

  6. Using the Milieu: Treatment-Environment Consistency.

    ERIC Educational Resources Information Center

    Szekais, Barbara

    1985-01-01

    Describes trial use of milieu and activity-based therapy in two adult day centers to increase client involvement in physical and social environments of treatment settings. Reports results from empirical observations and recommends further investigation of this treatment modality in settings for the elderly. (Author/NRB)

  7. The Phoenix: Vocational Education and Training in Singapore. International Comparative Study of Leading Vocational Education Systems

    ERIC Educational Resources Information Center

    Tucker, Marc S.

    2012-01-01

    This is the first in a series of reports from the Center on International Education Benchmarking (CIEB) exploring the leading vocational and technical education systems from around the world to draw out what makes these systems great and what other countries can learn from them. This first report was based on a visit of several days to Singapore…

  8. Effect of employment status on length of hospital stay, 30-day readmission and patient reported outcomes after spine surgery.

    PubMed

    Adogwa, Owoicho; Elsamadicy, Aladine A; Fialkoff, Jared; Mehta, Ankit I; Vasquez, Raul A; Cheng, Joseph; Karikari, Isaac O; Bagley, Carlos A

    2017-03-01

    Growing scrutiny has placed hospitals at the center of readmission prevention. The relationship between pre-operative employment status, length of hospital stays (LOS) and 30-day readmission rates after elective spine surgery remains unclear. The medical records of 360 patients (employed: n=174, unemployed: n=70, retired: n=40, disabled: n=76) undergoing elective spine surgery at a major academic medical center were reviewed. Patient demographics, comorbidities, and post-operative complication rates were recorded. All patients had comprehensive 1-year patient reported outcomes (PROs) measures. We hypothesized that employment status is associated with decreased LOS and decreased risk of 30-day readmission after elective spine surgery. All-cause readmissions within 30 days of discharge was the primary outcome variable. Baseline characteristics were similar in all cohorts. There was no difference in operative time, estimated blood loss (EBL), or number of fusion levels between all patient cohorts. There were no significant differences in peri-operative complication rates between patient cohorts. On average, the LOS was shorter for the employed compared to non-employed patients (4.89 vs. 5.26 days). The rate of 30-day readmission was 2-fold greater unemployed compared to employed patients (5.17% vs. 10%). At 1-year after surgery, employed patients were more likely to express functional improvement (change in ODI score) compared to unemployed patients (ODI: employed: 33.80 vs. unemployed: 41.93). Our study suggests that employment status may be associated with shorter duration of hospital stay, lower 30-day readmission rates and greater functional improvement. Future interventions to reduce unplanned hospital readmissions should consider pre-operative employment status.

  9. Risk factors for hospital morbidity and mortality after the Norwood procedure: A report from the Pediatric Heart Network Single Ventricle Reconstruction trial.

    PubMed

    Tabbutt, Sarah; Ghanayem, Nancy; Ravishankar, Chitra; Sleeper, Lynn A; Cooper, David S; Frank, Deborah U; Lu, Minmin; Pizarro, Christian; Frommelt, Peter; Goldberg, Caren S; Graham, Eric M; Krawczeski, Catherine Dent; Lai, Wyman W; Lewis, Alan; Kirsh, Joel A; Mahony, Lynn; Ohye, Richard G; Simsic, Janet; Lodge, Andrew J; Spurrier, Ellen; Stylianou, Mario; Laussen, Peter

    2012-10-01

    We sought to identify risk factors for mortality and morbidity during the Norwood hospitalization in newborn infants with hypoplastic left heart syndrome and other single right ventricle anomalies enrolled in the Single Ventricle Reconstruction trial. Potential predictors for outcome included patient- and procedure-related variables and center volume and surgeon volume. Outcome variables occurring during the Norwood procedure and before hospital discharge or stage II procedure included mortality, end-organ complications, length of ventilation, and hospital length of stay. Univariate and multivariable Cox regression analyses were performed with bootstrapping to estimate reliability for mortality. Analysis included 549 subjects prospectively enrolled from 15 centers; 30-day and hospital mortality were 11.5% (63/549) and 16.0% (88/549), respectively. Independent risk factors for both 30-day and hospital mortality included lower birth weight, genetic abnormality, extracorporeal membrane oxygenation (ECMO) and open sternum on the day of the Norwood procedure. In addition, longer duration of deep hypothermic circulatory arrest was a risk factor for 30-day mortality. Shunt type at the end of the Norwood procedure was not a significant risk factor for 30-day or hospital mortality. Independent risk factors for postoperative renal failure (n = 46), sepsis (n = 93), increased length of ventilation, and hospital length of stay among survivors included genetic abnormality, lower center/surgeon volume, open sternum, and post-Norwood operations. Innate patient factors, ECMO, open sternum, and lower center/surgeon volume are important risk factors for postoperative mortality and/or morbidity during the Norwood hospitalization. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  10. Coping, productive time use, and negative mood among adults with severe mental illness: a daily diary study.

    PubMed

    Yanos, Philip T; West, Michelle L; Smith, Stephen M

    2010-12-01

    Most studies on coping among persons with severe mental illness have relied on retrospective self-report methods; a limitation of this methodology is susceptibility to recall bias. The purpose of the present investigation was to expand the current understanding of the impact of coping among persons with severe mental illness by examining coping strategies, mood, and social functioning (operationalized as productive time use) using a daily process design. Twenty-seven adults diagnosed with severe mental illness completed baseline clinical interviews and up to 20 days of nightly telephone interviews addressing coping and daily life. A total of 198 coping efforts were reported for 387 days. Mixed-effects regression analyses examined the association between type of daily coping strategy (problem-centered, neutral, or avoidant) and both daily proportion of time participants spent in productive activity and daily negative mood, controlling for demographic and clinical variables. The results indicated that productive time use was significantly lower on days when avoidant strategies were used, in contrast with days when problem-centered strategies and neutral strategies were used. There was no significant main effect of coping on negative mood, although there was a trend in the expected direction. Findings support the hypothesis that the types of coping strategies adults with severe mental illness use are related to better social functioning on a daily level. Copyright © 2010 Elsevier B.V. All rights reserved.

  11. The Good-Bye Window: A Year in the Life of a Day-Care Center.

    ERIC Educational Resources Information Center

    Brown, Harriet N.

    Started 25 years ago by a group of parents in Madison, Wisconsin, the Red Caboose is one of the oldest independent day-care centers in the United States. This book recounts observations of the activities at the center for 1 year, exploring what makes a good day care center successful and what obstacles a center is up against. Interspersed among…

  12. Report to the Commission to Assess United States National Security Space Management and Organization

    DTIC Science & Technology

    2001-01-11

    including the Vice Chairman, Joint Chiefs of Staff, the Chief of Staff of the Air Force and, in a three-day session in Colorado Springs, Colorado , the...Naval Space Command serves as the Alternate Space Command Center to U.S. Space Command’s primary center located at Cheyenne Mountain, Colorado . It is...Fogleman, United States Air Force (Retired) General Fogleman is president and chief operating officer of the B Bar J Cattle and Consulting Company, Durango

  13. jsc2012e238680

    NASA Image and Video Library

    2012-11-28

    The next trio of residents that will launch to the International Space Station clasp hands for reporters and photojournalists at the Gagarin Cosmonaut Training Center in Star City, Russia Nov. 28, 2012 during the second of two days of flight qualification exams. Expedition 34/35 Flight Engineer Chris Hadfield of the Canadian Space Agency (left), Soyuz Commander Roman Romanenko (center) and NASA Flight Engineer Tom Marshburn (right) are scheduled to launch Dec. 19 from the Baikonur Cosmodrome in Kazakhstan on the Soyuz TMA-07M spacecraft. NASA/Stephanie Stoll

  14. jsc2012e238679

    NASA Image and Video Library

    2012-11-28

    The next trio of residents that will launch to the International Space Station fielded questions from reporters at the Gagarin Cosmonaut Training Center in Star City, Russia Nov. 28, 2012 during the second of two days of flight qualification exams. Expedition 34/35 Flight Engineer Chris Hadfield of the Canadian Space Agency (left), Soyuz Commander Roman Romanenko (center) and NASA Flight Engineer Tom Marshburn (right) are scheduled to launch Dec. 19 from the Baikonur Cosmodrome in Kazakhstan on the Soyuz TMA-07M spacecraft. NASA/Stephanie Stoll

  15. jsc2012e238677

    NASA Image and Video Library

    2012-11-28

    The next trio of residents that will launch to the International Space Station fielded questions from reporters at the Gagarin Cosmonaut Training Center in Star City, Russia Nov. 28, 2012 during the second of two days of flight qualification exams. Expedition 34/35 Flight Engineer Chris Hadfield of the Canadian Space Agency (left), Soyuz Commander Roman Romanenko (center) and NASA Flight Engineer Tom Marshburn (right) are scheduled to launch Dec. 19 from the Baikonur Cosmodrome in Kazakhstan on the Soyuz TMA-07M spacecraft. NASA/Stephanie Stoll

  16. 78 FR 14764 - Agency Information Collection Activities; Proposed Collection; Comment Request: Report of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-07

    ... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Agency Information Collection Activities... Disqualified Responsible Principal/Individual or Day Care Home Provider (FNS-844) AGENCY: Food and Nutrition..., Food and Nutrition Service, U.S. Department of Agriculture, 3101 Park Center Drive, Room 640...

  17. CTEPP-OH DATA COLLECTED ON FORM 05: CHILD DAY CARE CENTER PRE-MONITORING QUESTIONNAIRE

    EPA Science Inventory

    This data set contains data for CTEPP-OH concerning the potential sources of pollutants at the day care center including the chemicals that have been applied in the past at the day care center by staff members or by commercial contractors. The day care teacher was asked questions...

  18. CTEPP NC DATA COLLECTED ON FORM 05: CHILD DAY CARE CENTER PRE-MONITORING QUESTIONNAIRE

    EPA Science Inventory

    This data set contains data concerning the potential sources of pollutants at the day care center including the chemicals that have been applied in the past at the day care center by staff members or by commercial contractors. The day care teacher was asked questions related to t...

  19. Storefront Day Care Centers: The Radical Berlin Experiment.

    ERIC Educational Resources Information Center

    1973

    Tired of being excluded from political activities because of lack of day care facilities, women's liberation members of the German Student Federation of Social Democrats (SDS) organized Storefront Day Care Centers early in 1968 in West Berlin. In "Storefront Day Care Centers," an authors' collective recounts the events that marked the growth of…

  20. Interagency technical consultation on improving mortality reporting in Sierra Leone: meeting report

    PubMed Central

    Asfaw, Yonas; Boateng, Isaac; Calderon, Mauricio; Caleo, Grazia; Conteh, Allan; Conteh, Salifu; Dafae, Foday; Dey, Achintya; Duffy, Nadia; Davies, Daffney; Fatoma, Patrick; Fleming, John; Gogra, Boima; Gorina, Yelena; Grigoryan, Anna; Hersey, Sara; Hoare, Sam; Jabbi, Sonnia-Magba Bu-Buakei; Jambai, Amara; Jasperse, Joseph; Kaiser, Reinhard; Kallon, Gandi; Kamara, Ansumana; Kamara, Fatmata Zara; Kamara, Isata Pamela; Kamara, Wogba; Kandeh, Joseph; Kanu, Mustapha; Kargbo, Mabinty; Kargbo, Samuel; Konie, Richard; Kuyembeh, Simeon; Lansana, Patrick; Mclysaght, Fiona; McCann, Sheena; Nallo, Alhaji Samuka; Ngai, Stephanie; Nichols, Erin; Njuguna, Charles; O-Tipo, Shikanga; Parker, Sulaiman; Rafique, Nuzhat; Redd, John; Samba, Thomas; Souza, Kerry; Tran, Alex; Younge, Chief Mathew Gibao

    2017-01-01

    By the end of the Ebola epidemic, death reporting in Sierra Leone (SL) became more acceptable amongst local populations, with nearly all deaths being reported to the Ebola hot line alert centers. To continue the positive momentum generated by the epidemic, the Sierra Leone Ministry of Health and Sanitation (MoHS) and the US Centers for Disease Control and Prevention (CDC) organized and conducted the two-day Inter-agency Consultations on Improving Mortality Reporting in Sierra Leone (Consultations). In conjunction with the Consultations, participants were also offered a one-day, in-person training on the major components, characteristics, and uses of a national Civil Registration and Vital Statistics (CRVS) system. To understand processes used by governmental and non-governmental organizations in collection of death data before and during the Ebola epidemic, and to develop recommendations on improving death reporting and CRVS in Sierra Leone. The Inter-agency Consultations were conducted in person over two days in October, 2015. Real-time notes were kept by CDC staff for later abstraction and summarizing. Presenters agreed to share their materials (usually PowerPoint presentations) and approved the summaries. Challenges to implementation and suggestions for improving death reporting were drawn from the presentations and from anonymous suggestions collected at the end of each of three days of the Consultations. The Consultations attracted more than 80 participants from 28 Sierra Leone governmental, business, and other non-governmental organizations. Over the course of 18 presentations, participants presented and discussed the ways deaths were reported before and during the Ebola epidemic and ways in which the CRVS in Sierra Leone might be improved. The presentations made clear the need to improve death reporting in order to improve the health status of Sierra Leone. Many presenters and participants discussed the challenges to improvements, including lack of infrastructure and country diversity. In addition, participants generally agreed upon the need for improving the government’s understanding of the benefits of death reporting at multiple levels: from local chiefdom authorities and councils to the community and individual families. Despite the many challenges identified, all participants stressed the need for modernizing and improving death registration in Sierra Leone. The recommendations from the presentations and notes collected at the end of each day can be categorized within the following five domains: capacity building (organizational, staffing, infrastructure, policies, guidelines and tools), awareness and sensitization (including strategies to use best practices and emerging technologies), political will (governmental support and prioritization), funding (providing resources to achieve sustainability), and monitoring and evaluation (developing charts of existing death reporting pathways and identifying challenges).

  1. Homelessness: Recent Statistics, Targeted Federal Programs, and Recent Legislation

    DTIC Science & Technology

    2005-05-31

    submit semiannual financial and program reports, as well as a final report 90 days after the end of the project period. Transitional Living Program. (42...costs. To prevent homelessness, financial assistance may be given to families who have received eviction or termination of utility service notices if...assistance. Centers must also be equipped to provide job training, counseling and placement services (including job readiness and literacy and skills

  2. 78 FR 27974 - Proposed Collection; 60-Day Comment Request: National Cancer Institute (NCI) Alliance for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-13

    ... Comment Request: National Cancer Institute (NCI) Alliance for Nanotechnology in Cancer Platform... Nanotechnology Research, National Cancer Institute, 31 Center Drive, Bldg. 31 A, Rm. 10A52, Bethesda, MD 20892 or... Institute (NCI) Alliance for Nanotechnology in Cancer Platform Partnership Scientific Progress Reports, 0925...

  3. 10 CFR 110.50 - Terms.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...; or (ii) The licensee has given at least 40 days advance notice of the intended shipment in writing to... cooperation with the United States; and (B) Communicated this in writing to the licensee. (c) Advanced... or call (301) 816-5100. Difficulties notifying the NRC Operations Center must be promptly reported to...

  4. 10 CFR 110.50 - Terms.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...; or (ii) The licensee has given at least 40 days advance notice of the intended shipment in writing to... cooperation with the United States; and (B) Communicated this in writing to the licensee. (c) Advanced... or call (301) 816-5100. Difficulties notifying the NRC Operations Center must be promptly reported to...

  5. 10 CFR 110.50 - Terms.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...; or (ii) The licensee has given at least 40 days advance notice of the intended shipment in writing to... cooperation with the United States; and (B) Communicated this in writing to the licensee. (c) Advanced... or call (301) 816-5100. Difficulties notifying the NRC Operations Center must be promptly reported to...

  6. Report of a Health Screening Project in Pre-School Programs.

    ERIC Educational Resources Information Center

    Grever, Elizabeth

    This paper describes a preschool health screening service in which nurses, contracted through the Visiting Nurse Association, are assigned to day care centers receiving Title XX funds. The program focuses on health, safety and nutrition education. Screening includes history and physical assessment, developmental assessment, assessment or updating…

  7. Argument for a Joint Safety Reporting System

    DTIC Science & Technology

    2015-02-13

    Process Manager for the HQ AF Safety Center (AFSEC) at Kirtland AFB, New Mexico . His primary duties included leadership and oversight of the day-to...Military Mishaps Functional Lead and Navy-Marine Corps Subject Matter Expert ( SME ) for the SIMWG, the DOD Force Risk Reduction system rolls up the service

  8. Choosing a College: Student Voices

    ERIC Educational Resources Information Center

    Mooney, Carolyn

    2007-01-01

    Young adults applying to college these days are bombarded with information--from the institutions themselves, from well-meaning relatives and friends, from high-school counselors, from directories and news-media reports, and from a cottage industry that has spawned consultants, test-prep centers, and special Web sites. At the same time, they need…

  9. Organisation of Prevention in Primary Health Care.

    ERIC Educational Resources Information Center

    Council of Europe, Strasbourg (France).

    This report examines the possiblities of increasing the amount of preventive work being carried out by primary care workers in European communities. Before making practical recommendations about promoting prevention, an analysis is presented of the main present day problems. These center on the environment (not only physical but also social and…

  10. NANOTECHNOLOGY AND LIFE CYCLE ASSESSMENT: A SYSTEMS APPROACH TO NANOTECHNOLOGY AND THE ENVIRONMENT

    EPA Science Inventory

    This report summarizes the results of a two-day workshop jointly convened by the Woodrow Wilson Center Project on Emerging Nanotechnologies; the US Environmental Protection Agency¿s Office of Research and Development; and the European Commission. Held in October 2006, the worksh...

  11. 76 FR 10369 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-24

    ... technology. Written comments should be received within 60 days of this notice. Proposed Project Coal Workers... and work histories, and participating physicians report radiographic findings. The Centers for Disease... history and spirometry tests have been recommended by NIOSH for both surface and underground coal miners...

  12. QuickStats: Percentage of Adult Day Services Center Participants, by Selected Diagnoses

    MedlinePlus

    ... MMWR ) MMWR Share Compartir QuickStats: Percentage of Adult Day Services Center Participants,* by Selected Diagnoses † — National Study ... which is the estimated number of enrolled adult day services center participants in the United States on ...

  13. Alzheimer's: Glossary

    MedlinePlus

    ... as a nursing home. Learn more: Residential Care Working with Care Providers Adult day centers Adult day centers offer people with Alzheimer's and other dementias the opportunity to be social and to participate in activities in a safe environment. Learn more: Adult Day Centers Advance directive An ...

  14. Constellation X-Ray Mission and Support

    NASA Technical Reports Server (NTRS)

    Tananbaum, H.; Grady, Jean (Technical Monitor)

    2002-01-01

    This report is a supplement to the Third Annual Report summarizing work performed by the Smithsonian Astrophysical Observatory (SAO) for NASA Goddard Space Flight Center (GSFC) under Cooperative Agreement NCC5-3681. The Agreement is entitled 'Constellation X-ray Mission Study and Support.' This supplementary report covers the period from October 1, 2001 through January 10, 2002. The report has been prepared and submitted to ensure that the Constellation-X Project Office at GSFC has current performance information needed to evaluate a proposed modified budget for FY02. That proposed budget is being submitted separately. SAO continues to perform work under the overall direction of Dr. Harvey Tananbaum, the SAO Principal Investigator for the program. Mr. Robert Rasche is the SAO Program Manager and is responsible for day-to-day program management at SAO and coordination with GSFC. The report summarizes the main areas of SAO activity. Most of the work has been done jointly with personnel from GSFC and Marshall Space Flight Center (MSFC). We describe SAO participation in these efforts. Under the Agreement, SAO performed work in seven major areas of activity. These areas related to: (1) Constellation X-ray Mission Facility Definition Team and Study Management; (2) Science Support; (3) Spectroscopy X-ray Telescope (SXT); (4) Systems Engineering; (5) Travel in Support of the Work Effort; and (6) In-house Management and Coordination.

  15. Depressive symptoms and health-related quality of life among participants in the Pasos Adelante chronic disease prevention and control program, Arizona, 2005-2008.

    PubMed

    Cutshaw, Christina A; Staten, Lisa K; Reinschmidt, Kerstin M; Davidson, Christopher; Roe, Denise J

    2012-01-01

    Chronic diseases are the leading causes of death in the United States and have been associated with depressive symptoms and poor health-related quality of life (HRQOL). This study examined whether depressive symptoms and HRQOL indicators changed among participants in Pasos Adelante, a chronic disease prevention and control program implemented in a US-Mexico border community. Pasos Adelante was a 12-week promotora-led program that included educational sessions and walking groups. We used the Centers for Epidemiologic Studies Depression Scale (CES-D) and the Center for Disease Control's "Healthy Days" measures to measure depressive symptoms and HRQOL. We used linear mixed-effects models and general estimating equations to analyze changes in CES-D scores and HRQOL indicators from baseline to postprogram and from postprogram to 3-month follow-up. At baseline, participants had a mean of 7.1 physically unhealthy days, 7.4 mentally unhealthy days, and 3.9 days of activity limitation. The mean number of physically and mentally unhealthy days declined significantly from baseline to postprogram, but the mean number of activity limitation days did not. At baseline, 42.6% of participants reported their health as fair/poor; 20.8% of participants reported frequent mental distress, and 31.8% had a CES-D score of 16 or more. All 3 proportions declined from baseline to postprogram. No significant changes occurred between postprogram and follow-up. Participants in Pasos Adelante showed improvement in depressive symptoms and several HRQOL indicators. Future studies should use an experimental design with a comparison group to determine whether these findings can be replicated and to examine potential mediators and moderators of program effects.

  16. Climate Prediction Center - Outlooks Index

    Science.gov Websites

    Temperature and Precipitation Outlooks 3-7 Day Excessive Heat Outlooks (Weather Prediction Center) 6-10 Day Excessive Heat Outlook 8-14 Day Excessive Heat Outlook 6-10 Day Wind Chill Index Outlooks 8-14 Day Wind

  17. Development and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research.

    PubMed

    Lee, Jong Woo; LaRoche, Suzette; Choi, Hyunmi; Rodriguez Ruiz, Andres A; Fertig, Evan; Politsky, Jeffrey M; Herman, Susan T; Loddenkemper, Tobias; Sansevere, Arnold J; Korb, Pearce J; Abend, Nicholas S; Goldstein, Joshua L; Sinha, Saurabh R; Dombrowski, Keith E; Ritzl, Eva K; Westover, Michael B; Gavvala, Jay R; Gerard, Elizabeth E; Schmitt, Sarah E; Szaflarski, Jerzy P; Ding, Kan; Haas, Kevin F; Buchsbaum, Richard; Hirsch, Lawrence J; Wusthoff, Courtney J; Hopp, Jennifer L; Hahn, Cecil D

    2016-04-01

    The rapid expansion of the use of continuous critical care electroencephalogram (cEEG) monitoring and resulting multicenter research studies through the Critical Care EEG Monitoring Research Consortium has created the need for a collaborative data sharing mechanism and repository. The authors describe the development of a research database incorporating the American Clinical Neurophysiology Society standardized terminology for critical care EEG monitoring. The database includes flexible report generation tools that allow for daily clinical use. Key clinical and research variables were incorporated into a Microsoft Access database. To assess its utility for multicenter research data collection, the authors performed a 21-center feasibility study in which each center entered data from 12 consecutive intensive care unit monitoring patients. To assess its utility as a clinical report generating tool, three large volume centers used it to generate daily clinical critical care EEG reports. A total of 280 subjects were enrolled in the multicenter feasibility study. The duration of recording (median, 25.5 hours) varied significantly between the centers. The incidence of seizure (17.6%), periodic/rhythmic discharges (35.7%), and interictal epileptiform discharges (11.8%) was similar to previous studies. The database was used as a clinical reporting tool by 3 centers that entered a total of 3,144 unique patients covering 6,665 recording days. The Critical Care EEG Monitoring Research Consortium database has been successfully developed and implemented with a dual role as a collaborative research platform and a clinical reporting tool. It is now available for public download to be used as a clinical data repository and report generating tool.

  18. Pediatric Extracorporeal Life Support Organization Registry International Report 2016.

    PubMed

    Barbaro, Ryan P; Paden, Matthew L; Guner, Yigit S; Raman, Lakshmi; Ryerson, Lindsay M; Alexander, Peta; Nasr, Viviane G; Bembea, Melania M; Rycus, Peter T; Thiagarajan, Ravi R

    The purpose of this report is to describe the international growth, outcomes, complications, and technology used in pediatric extracorporeal life support (ECLS) from 2009 to 2015 as reported by participating centers in the Extracorporeal Life Support Organization (ELSO). To date, there are 59,969 children who have received ECLS in the ELSO Registry; among those, 21,907 received ECLS since 2009 with an overall survival to hospital discharge rate of 61%. In 2009, 2,409 ECLS cases were performed at 157 centers. By 2015, that number grew to 2,992 cases in 227 centers, reflecting a 24% increase in patients and 55% growth in centers. ECLS delivered to neonates (0-28 days) for respiratory support was the largest subcategory of ECLS among children <18-years old. Overall, 48% of ECLS was delivered for respiratory support and 52% was for cardiac support or extracorporeal life support to support cardiopulmonary resuscitation (ECPR). During the study period, over half of children were supported on ECLS with centrifugal pumps (51%) and polymethylpentene oxygenators (52%). Adverse events including neurologic events were common during ECLS, a fact that underscores the opportunity and need to promote quality improvement work.

  19. Routine bacterial screening of apheresis platelets on Day 4 using a rapid test: a 4-year single-center experience.

    PubMed

    Dunbar, Nancy M; Kreuter, Justin D; Marx-Wood, Cynthia R; Dumont, Larry J; Szczepiorkowski, Zbigniew M

    2013-10-01

    The platelet (PLT) Pan Genera Detection test (PGD) is a rapid bacterial detection system used to screen PLTs for bacterial contamination. We report a single center 46-month experience with secondary screening of apheresis PLTs by PGD testing. Existing testing records of apheresis PLTs screened by PGD from July 2008 to April 2012 were reviewed. All PLT units were initially screened by routine postcollection culture methods. Secondary screening using PGD was performed for indated PLTs on PLT storage Day 4 and for outdated PLTs on Day 8. A total of 8535 apheresis PLTs were available in inventory during the study period. Of these, 5030 (58.9%) were dispensed and transfused before PGD testing and 3505 (41.1%) underwent PGD testing on Day 4. Twenty-five units tested on Day 4 were PGD initial reactive (0.71%). All were confirmed to be false positive by repeat PGD testing in triplicate (n=20) or by confirmatory culture (n=5). An additional 364 units that were PGD nonreactive on Day 4 were approved for transfusion on Day 6 or Day 7 due to urgent clinical need. A total of 371 outdated units underwent repeat PGD testing before discard on Day 8; all were nonreactive. Secondary PGD testing of culture-screened apheresis PLTs results in low yield in a medium-sized transfusion service. Use of PGD testing on Day 4 may allow for extension of the apheresis PLT shelf life to Day 7 for hospitals that face supply constraints. © 2013 American Association of Blood Banks.

  20. Adjuvant Docetaxel and Cyclophosphamide (DC) with Prophylactic Granulocyte Colony-Stimulating Factor (G-CSF) on Days 8 &12 in Breast Cancer Patients: A Retrospective Analysis

    PubMed Central

    Yerushalmi, Rinat; Goldvaser, Hadar; Sulkes, Aaron; Ben-Aharon, Irit; Hendler, Daniel; Neiman, Victoria; Ciuraru, Noa Beatrice; Bonilla, Luisa; Amit, Limor; Zer, Alona; Granot, Tal; Rizel, Shulamith; Stemmer, Salomon M.

    2014-01-01

    Purpose Four cycles of docetaxel/cyclophosphamide (DC) resulted in superior survival than doxorubicin/cyclophosphamide in the treatment of early breast cancer. The original study reported a 5% incidence of febrile neutropenia (FN) recommending prophylactic antibiotics with no granulocyte colony-stimulating factor (G-CSF) support. The worldwide adoption of this protocol yielded several reports on substantially higher rates of FN events. We explored the use of growth factor (GF) support on days 8 and 12 of the cycle with the original DC protocol. Methods Our study included all consecutive patients with stages I–II breast cancer who were treated with the DC protocol at the Institute of Oncology, Davidoff Center (Rabin Medical Center, Petah Tikva, Israel) from April, 2007 to March, 2012. Patient, tumor characteristics, and toxicity were reported. Results: In total, 123 patients received the DC regimen. Median age was 60 years, (range, 25–81 years). Thirty-three patients (26.8%) were aged 65 years and older. Most of the women (87%) adhered to the planned G-CSF protocol (days 8 &12). 96% of the patients completed the 4 planned cycles of chemotherapy. Six patients (5%) had dose reductions, 6 (5%) had treatment delays due to non-medical reasons. Thirteen patients (10.6%) experienced at least one event of FN (3 patients had 2 events), all requiring hospitalization. Eight patients (6.5%) required additional support with G-CSF after the first chemotherapy cycle, 7 because of FN and one due to neutropenia and diarrhea. In Conclusion Primary prophylactic G-CSF support on days 8 and 12 of the cycle provides a tolerable option to deliver the DC protocol. Our results are in line with other retrospective protocols using longer schedules of GF support. PMID:25330205

  1. Adjuvant Docetaxel and Cyclophosphamide (DC) with prophylactic granulocyte colony-stimulating factor (G-CSF) on days 8 &12 in breast cancer patients: a retrospective analysis.

    PubMed

    Yerushalmi, Rinat; Goldvaser, Hadar; Sulkes, Aaron; Ben-Aharon, Irit; Hendler, Daniel; Neiman, Victoria; Ciuraru, Noa Beatrice; Bonilla, Luisa; Amit, Limor; Zer, Alona; Granot, Tal; Rizel, Shulamith; Stemmer, Salomon M

    2014-01-01

    Four cycles of docetaxel/cyclophosphamide (DC) resulted in superior survival than doxorubicin/cyclophosphamide in the treatment of early breast cancer. The original study reported a 5% incidence of febrile neutropenia (FN) recommending prophylactic antibiotics with no granulocyte colony-stimulating factor (G-CSF) support. The worldwide adoption of this protocol yielded several reports on substantially higher rates of FN events. We explored the use of growth factor (GF) support on days 8 and 12 of the cycle with the original DC protocol. Our study included all consecutive patients with stages I-II breast cancer who were treated with the DC protocol at the Institute of Oncology, Davidoff Center (Rabin Medical Center, Petah Tikva, Israel) from April, 2007 to March, 2012. Patient, tumor characteristics, and toxicity were reported. In total, 123 patients received the DC regimen. Median age was 60 years, (range, 25-81 years). Thirty-three patients (26.8%) were aged 65 years and older. Most of the women (87%) adhered to the planned G-CSF protocol (days 8 &12). 96% of the patients completed the 4 planned cycles of chemotherapy. Six patients (5%) had dose reductions, 6 (5%) had treatment delays due to non-medical reasons. Thirteen patients (10.6%) experienced at least one event of FN (3 patients had 2 events), all requiring hospitalization. Eight patients (6.5%) required additional support with G-CSF after the first chemotherapy cycle, 7 because of FN and one due to neutropenia and diarrhea. Primary prophylactic G-CSF support on days 8 and 12 of the cycle provides a tolerable option to deliver the DC protocol. Our results are in line with other retrospective protocols using longer schedules of GF support.

  2. Child Care: The Emerging Insurance Crisis. Hearings before the Select Committee on Children, Youth, and Families. House of Representatives, Ninety-Ninth Congress, First Session (Washington, DC, July 18 and July 30, 1985).

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

    The Select Committee on Children, Youth, and Families examined recent reports about dramatically reduced availability of liability insurance for providers of child care services. Child care centers, family day care homes, Head Start programs, and resource and referral agencies have reported that their liability policies are not being renewed, that…

  3. Stressors Among Latino Day Laborers A Pilot Study Examining Allostatic Load

    PubMed Central

    de Castro, A. B.; Voss, Joachim G.; Ruppin, Ayelet; Dominguez, Carlos F.; Seixas, Noah S.

    2010-01-01

    This pilot study evaluated the feasibility of conducting a research project focused on stressors and allostatic load (AL) among day laborers. A total of 30 Latino men were recruited from CASA Latina. a worker center in Seattle. Participants completed an interview and researchers measured six indicators of AL (body mass index, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, C-reactive protein, and cortisol). Percentages and mean scores were calculated for several self-reported stressors in work, economic, and social contexts and were compared between low and high AL groups. Overall, participants with high AL reported experiencing more stressors than those with low AL. Additionally, those with high AL generally reported being less healthy both physically and mentally. Findings suggest that Latino day laborers experience stressors that place them at risk for high AL. Also, a study of this nature is possible, but must be conducted with trust and collaboration between researchers and community partners. PMID:20507008

  4. Increased Fruit and Vegetable Intake among Older Adults Participating in Kentucky's Congregate Meal Site Program

    PubMed Central

    Brewer, Dawn; Dickens, Emily; Humphrey, Alyson; Stephenson, Tammy

    2016-01-01

    The purpose of this study was to determine if the amount and variety of fruits and vegetables consumed increased among community-dwelling older adults participating in Kentucky's congregate meal site program following a series of five nutrition education lessons. A convenience sample of older adults attending senior centers (n=35), two intervention (n=19) and two control (n=16) centers, participated in this quasi-experimental pilot study. Following the intervention there was a significant increase in actual fruit and vegetable intake in the intervention group (p<0.05) as assessed by plate waste measurements of the congregate lunch meal. In addition, from pre- to post-intervention, a trend towards increased self-reported intake in the variety of fruit and vegetables was observed among the intervention group. As well, a significant increase in the number of days intervention participants self-reported consuming at least 4.5 cups of fruits and vegetables in the last seven days (2.44±2.09 days to 4.28±1.99 days (p=0.004)) was observed; and knowledge pertaining to phytochemicals increased (p<0.05). The phytochemical index (PI) score of the lunch meal, taking into account that the older adults consumption of meal components, including phytochemical-rich foods, was 26.9. Overall, study results indicated that a short theory-based nutrition education program offered to community-dwelling older adults was linked to an increase in fruit and vegetable consumption and phytochemical knowledge. PMID:28642630

  5. Garde a l'enfance: Etude sur la remuneration et les conditions de travail dans le domaine de la garde a l'enfance au Canada. Rapport final (Caring for a Living: A Study on Wages and Working Conditions in Canadian Child Care. Final Report).

    ERIC Educational Resources Information Center

    Canadian Child Care Federation, Ottawa (Ontario).

    Between November 1990 and August 1992, a study examined wages and working conditions of child care staff in both licensed group centers and family day care homes in Canada. Three instruments were developed for the study, a short telephone interview for center directors, a follow-up director's questionnaire, and a staff questionnaire. The study…

  6. Educating nurse leaders in ethics and end-of-life care.

    PubMed

    Simpson, M

    1999-01-01

    The Midwest Bioethics Center's Nursing Leadership Institute 1999 focused on leadership in ethics and end-of-life care. Twenty-four nurses attended the four-day retreat, during which national speakers, community experts, and Center staff facilitated the continuing education of nurse leaders dedicated to improving end-of-life care in their communities. All participants in the Institute agreed to design and implement a community project for their constituency. Project reports will be made prior to the next nursing leadership institute. This article examines the role of nurses in providing end-of-life care.

  7. 10 CFR 15.21 - Written demands for payment.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... that is delinquent for 180 days or more will be transferred to the Treasury for collection. Credit bureau reporting for transferred debts will be handled by Treasury or a Treasury-designated center. (iii... does not prevent the NRC from proceeding with respect to that matter. (e) When the NRC learns that a...

  8. 10 CFR 15.21 - Written demands for payment.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... that is delinquent for 180 days or more will be transferred to the Treasury for collection. Credit bureau reporting for transferred debts will be handled by Treasury or a Treasury-designated center. (iii... does not prevent the NRC from proceeding with respect to that matter. (e) When the NRC learns that a...

  9. 10 CFR 15.21 - Written demands for payment.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... that is delinquent for 180 days or more will be transferred to the Treasury for collection. Credit bureau reporting for transferred debts will be handled by Treasury or a Treasury-designated center. (iii... does not prevent the NRC from proceeding with respect to that matter. (e) When the NRC learns that a...

  10. 10 CFR 15.21 - Written demands for payment.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... that is delinquent for 180 days or more will be transferred to the Treasury for collection. Credit bureau reporting for transferred debts will be handled by Treasury or a Treasury-designated center. (iii... does not prevent the NRC from proceeding with respect to that matter. (e) When the NRC learns that a...

  11. 78 FR 46994 - Proposed Collection; 60-Day Comment Request: National Institute of Mental Health Recruitment and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-02

    ... Project Clearance Liaison, Science Policy and Evaluation Branch, OSPPC, NIMH, NIH, Neuroscience Center... NIMH-sponsored clinical research studies that plan to enroll 150 or more human subjects in a single study. Clinical studies can have difficulty recruiting, and accurate and timely reporting is the best...

  12. FYI: Services to Poor Families; Controlling Infectious Diseases; Parent Groups.

    ERIC Educational Resources Information Center

    Children Today, 1987

    1987-01-01

    Discusses services and resources available for families, parents, and child care providers. Describes a National Resource Center for Children in Poverty; a guide for controlling infectious diseases among young children in day care; a directory of parent support groups; and reports of a link between household pesticides and childhood leukemia. (BB)

  13. Child Day Care Center Licensing Study, 1996.

    ERIC Educational Resources Information Center

    Children's Foundation, Washington, DC.

    The information contained in this report was compiled by The Children's Foundation in fall 1995 and reflects data provided by the regulatory offices in the 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands. The study is organized in alphabetical order of the states and territories. The requirements, regulations, and policies…

  14. Piloting social engagement on a federal agency-administered Facebook page.

    PubMed

    Chiu, Kimberly; Wagner, Lindsay; Choe, Lena; Chew, Catherine; Kremzner, Mary

    2016-01-01

    To evaluate the impact of a Federal drug information center initiating engagement with stakeholders on a Facebook Page administered by a Federal Agency. The U.S. Food and Drug Administration (FDA) Facebook page from July 21, 2014, to October 18, 2014. FDA's Division of Drug Information (DDI) in the Center for Drug Evaluation and Research (CDER) Office of Communications serves as a federal drug information center providing timely, accurate, and useful information on CDER initiatives and CDER-regulated products. We report a 90-day (July 21 to October 18, 2014) pilot during which DDI pharmacists monitored and moderated comments received on FDA's Facebook page to identify those warranting a reply. Once identified, DDI pharmacists replied within 2 business days. Impact was measured by comparing the average number of Likes, Shares, and Reach for Facebook posts before and after the pilot. Additional metrics collected include the number of DDI replies provided to stakeholders' comments and the number of DDI replies provided on time (within 2 business days). During the pilot, DDI contributed 14 posts. On average, each post reached 23,582 more individuals (an increase of 187% compared with pre-pilot posts). On average, each post also received 463 more Likes (450% increase) and 130 more Shares (271% increase). DDI pharmacists replied to 3% (121/3994) and hid 0.58% (23/3994) of Facebook comments received during the 90-day period. All actions were taken within 2 business days. Initiating social engagement had a positive impact on FDA's Facebook page. Published by Elsevier Inc.

  15. Prospective study of cost of care at multidisciplinary ALS centers adhering to American Academy of Neurology (AAN) ALS practice parameters.

    PubMed

    Boylan, Kevin; Levine, Todd; Lomen-Hoerth, Catherine; Lyon, Mary; Maginnis, Kimberly; Callas, Peter; Gaspari, Celeste; Tandan, Rup

    2015-01-01

    Multidisciplinary care in ALS is associated with longer survival, improved quality of life, and reduced hospital admissions, but there are no published data on institutional costs associated with multidisciplinary ALS care at U.S. centers. We prospectively examined institutional costs, adherence to AAN Practice Parameters and patient satisfaction in multidisciplinary ALS clinics at 18 U.S. ALS centers. Centers reported patient volumes; direct costs for staff salary/benefits, supplies and equipment; and institutional non-salary and overhead costs over a three-month period. In 1117 patients seen during this period, mean age was 61.5 years (range 25-91 years), 56% were male, and mean ALSFRS-R score was 29. Mean total salary/benefit cost per clinic day for all providers was $2964 (range $1692-$5236 across centers). Mean salary/benefit cost per patient per clinic was $507 (range $258-$806 across centers). Differences among centers in reporting non-salary costs prevented meaningful analysis. Practice parameter adherence and patient satisfaction were high. This prospective collaborative study demonstrates the direct financial burden of evidence-based multidisciplinary ALS care in the U.S.; more refined non-salary and overhead cost data are needed to evaluate the full cost impact of care. These data may be useful in supporting evidence-based models of patient centered care for ALS.

  16. Prevalence of Unmet Health Care needs and description of health care-seeking behavior among displaced people after the 2007 California wildfires.

    PubMed

    Jenkins, J Lee; Hsu, Edbert B; Sauer, Lauren M; Hsieh, Yu-Hsiang; Kirsch, Thomas D

    2009-06-01

    The southern California wildfires in autumn 2007 resulted in widespread disruption and one of the largest evacuations in the state's history. This study aims to identify unmet medical needs and health care-seeking patterns as well as prevalence of acute and chronic disease among displaced people following the southern California wildfires. These data can be used to increase the accuracy, and therefore capacity, of the medical response. A team of emergency physicians, nurses, and epidemiologists conducted surveys of heads of households at shelters and local assistance centers in San Diego and Riverside counties for 3 days beginning 10 days postdisaster. All households present in shelters on the day of the survey were interviewed, and at the local assistance centers, a 2-stage sampling method was used that included selecting a sample size proportionate to the number of registered visits to that site compared with all sites followed by a convenience sampling of people who were not actively being aided by local assistance center personnel. The survey covered demographics; needs following the wildfires (shelter, food, water, and health care); acute health symptoms; chronic health conditions; access to health care; and access to prescription medications. Among the 175 households eligible, 161 (92.0%) households participated. Within the 47 households that reported a health care need since evacuation, 13 (27.7%) did not receive care that met their perceived need. Need for prescription medication was reported by 47 (29.2%) households, and 20 (42.6%) of those households did not feel that their need for prescription medication had been met. Mental health needs were reported by 14 (8.7%) households with 7 of these (50.0%) reporting unmet needs. At least 1 family member per household left prescription medication behind during evacuation in 46 households (28.6%), and 1 family member in 48 households (29.8%) saw a health care provider since their evacuation. Most people sought care at a clinic (24, 50.0%) or private doctor (11, 22.9%) as opposed to an emergency department (6, 12.5%). A significant portion of the households reported unmet health care needs during the evacuations of the southern California wildfires. The provision of prescription medication and mental health services were the most common unmet need. In addition, postdisaster disease surveillance should include outpatient and community clinics, given that these were the most common treatment centers for the displaced population.

  17. Translating research into action: An evaluation of the World Trade Center Health Registry's Treatment Referral Program.

    PubMed

    Welch, Alice E; Debchoudhury, Indira; Jordan, Hannah T; Petrsoric, Lysa J; Farfel, Mark R; Cone, James E

    2014-01-01

    This manuscript describes the design, implementation and evaluation of the World Trade Center (WTC) Health Registry's Treatment Referral Program (TRP), created to respond to enrollees' self-reported 9/11-related physical and mental health needs and promote the use of WTC-specific health care. In 2009-2011, the TRP conducted personalized outreach, including an individualized educational mailing and telephone follow-up to 7,518 selected enrollees who resided in New York City, did not participate in rescue/recovery work, and reported symptoms of 9/11-related physical conditions or posttraumatic stress disorder (PTSD) on their most recently completed Registry survey. TRP staff spoke with enrollees to address barriers to care and schedule appointments at the WTC Environmental Health Center for those eligible. We assessed three nested outcomes: TRP participation (e.g., contact with TRP staff), scheduling appointments, and keeping scheduled appointments. A total of 1,232 (16.4%) eligible enrollees participated in the TRP; 32% of them scheduled a first-time appointment. We reached 84% of participants who scheduled appointments; 79.4% reported having kept the appointment. Scheduling an appointment, but not keeping it, was associated with self-reported unmet health care need, PTSD, and poor functioning (≥14 days of poor physical or mental health in the past 30 days) ( P < 0.05). Neither scheduling nor keeping an appointment was associated with demographic characteristics. Successful outreach to disaster-exposed populations may require a sustained effort that employs a variety of methods in order to encourage and facilitate use of post-disaster services. Findings from this evaluation can inform outreach to the population exposed to 9/11 being conducted by other organizations.

  18. Productivity Measures Associated With a Patient Access Initiative

    PubMed Central

    Gable, William H.; Pappas, Theodore N.; Jacobs, Danny O.; Cutler, Desmond A.; Kuo, Paul C.

    2006-01-01

    Objective: To assess financial performance associated with a patient 7-day access initiative. Background Data: Patient access to clinical services is frequently an obstacle at academic medical centers. Conflicting surgeon priorities among academic, clinical, educational, and leadership duties often create difficulties for patient entry into the “system.” Methods: The scope and objectives were identified to be: design of a standard, simple new patient appointment process, design of a standard process in cases where an appointment is not available in 7 days, use subspecialty team search capabilities, minimize/eliminate prescheduling requirements, centralize appointment scheduling, and creation and reporting of 7-day access metrics. Following maturation of the process, the 7-day access metrics from the period July 2004 to December 2004 and January 2005 to June 2005 were compared with corresponding time periods from calendar years 2001, 2002, and 2003. Results: Payor mix was unaltered. The median waiting time for a new patient appointment decreased from 21 days to 10 days. When compared with calendar years 2001, 2002, and 2003, respectively, the 2 periods of the 7-day access initiative in calendar years 2004 and 2005 were associated with significantly increased visits, new patients, operative procedures, hospital charges, and physician charges. Conclusions: Implementation of a 7-day access initiative can significantly increase financial productivity of general surgery groups in academic medical centers. We conclude that simplifying access to services can benefit academic surgical practices. Sustaining this level of productivity will continue to prove challenging. PMID:16632994

  19. Quality of post arrest care does not differ by time of day at a specialized resuscitation center.

    PubMed

    Uray, Thomas; Sterz, Fritz; Weiser, Christoph; Schreiber, Wolfgang; Spiel, Alexander; Schober, Andreas; Stratil, Peter; Mayr, Florian B

    2015-04-01

    Previous studies suggest worse outcomes after out-of-hospital cardiac arrest (OHCA) at night. We analyzed whether patients admitted after nontraumatic OHCA to a resuscitation center received the same quality post arrest care at day and night and whether quality of care affected clinical outcomes. We analyzed data of OHCA patients with return of spontaneous circulation admitted to the Vienna general hospital emergency department between January 2006 and May 2013. Data reported include admission time (day defined from 8 AM to 4 PM based on staffing), time to initiation of hypothermia, and door-to-balloon time in patients with ST-elevation myocardial infarction. Survival and cognitive performance at 12 months were assessed. In this retrospective observational study, 1059 patients (74% males, n = 784) with a mean age of 58 ± 16 years were analyzed. The vast majority was treated with induced hypothermia (77% of day vs. 79% of night admissions, P = 0.32) within 1 hour of admission (median time admission to cooling 27 (confidence interval [CI]: 10-60) vs. 23 (CI: 11-59) minutes day vs. night, P = 0.99). In 298 patients with ST-elevation myocardial infarction, median door-to-balloon time did not differ between day and night admissions (82 minutes, CI: 60 to 142 for day vs. 86 minutes, CI: 50 to 135 for night, P = 0.36). At 12 months, survival was recorded in 238 of 490 day and 275 of 569 night admissions (49% vs. 48%, P = 0.94%), and a good neurologic outcome was recorded in 210 of 490 day and 231 of 569 night admissions (43% vs. 41%, P = 0.46). Patients admitted to our department after OHCA were equally likely to receive timely high-quality postresuscitation care irrespective of time of day. Survival and good neurologic outcome at 12 months did not differ between day and night admissions. Our results may support the concept of specialized post arrest care centers.

  20. Challenges in the management of nutritional disorders and communicable diseases in child day care centers: a quantitative and qualitative approach.

    PubMed

    Konstantyner, Tulio; Konstantyner, Thais Cláudia Roma de Oliveira; Toloni, Maysa Helena Aguiar; Longo-Silva, Giovana; Taddei, José Augusto de Aguiar Carrazedo

    2017-03-01

    In Brazil, although many children from low income families attend day care centers with appropriate hygiene practices and food programs, they have nutritional disorders and communicable diseases. This quantitative and qualitative cross-sectional study identified staff challenges in child day care centers and suggested alternative activity management to prevent nutritional disorders and communicable diseases. The study included 71 nursery teachers and 270 children from public and philanthropic day care centers (teacher to child ratios of 1:2.57 and 1:6.40, respectively). Interviews and focus groups were conducted with teachers and parents, and anthropometry and blood samples were drawn from the children by digital puncture. Children in philanthropic child day care centers were more likely to be hospitalized due to communicable diseases. Teachers from philanthropic child day care centers had lower age, income and education and higher work responsibilities based on the number of children and working time. The focus groups characterized institutions with organized routines, standard food practices, difficulties with caretaking, and lack of training to provide healthcare to children. Strategies to improve children's health in day care settings should focus on training of teachers about healthcare and nutrition.

  1. Intake of protein, calcium and sodium in public child day care centers

    PubMed Central

    Longo-Silva, Giovana; Toloni, Maysa Helena de A.; de Menezes, Risia Cristina E.; Temteo, Tatiane Leocádio; Oliveira, Maria Alice A.; Asakura, Leiko; Costa, Emília Chagas; Taddei, José Augusto de A. C.

    2014-01-01

    OBJECTIVE: To assess calcium, protein and sodium intake, of children that attend public day-care centers and to compare it with the recommended one. METHODS: Cross-sectional descriptive study in seven public day care centers of São Paulo city, Southeast Brazil, which enrolled 366 children between 12 and 36 months of age. The data collection occurred between September and December 2010. Each day care center was evaluated for three non-consecutive days, totaling 42 days and 210 meals. Dietary intake was assessed by a direct food weighing method. For the nutritional calculation, DietWin(r) Profissional 2.0 was used, and the adequacy was calculated according to the recommendations of the National School Feeding Program for energy, protein, calcium and sodium. The calcium/protein relation was also calculated, as well as calcium density (mg/1,000kcal). RESULTS: The energy (406.4kcal), protein (18.2g) and calcium (207.6mg) consumption did not reach the recommended values ​​in all the evaluated day care centers. Sodium intake exceeded up to three times the recommendation. The calcium/protein ratio of 11.7mg/g was less than the adequate one (20mg/g). CONCLUSIONS: There was inadequacy of calcium, protein and sodium dietary intake, in children attending public day-care centers. PMID:25119750

  2. A systematic review of evidence for older adults' sedentary behavior and physical activity after hip fracture.

    PubMed

    Zusman, Enav Z; Dawes, Martin G; Edwards, Nicola; Ashe, Maureen C

    2018-05-01

    To synthesize evidence on older adults' sedentary behavior and physical activity during rehabilitation and recovery for hip fracture (1) across the care continuum and (2) from clinical interventions. We conducted a systematic review of peer-reviewed publications using CINAHL, Embase, Ovid MEDLINE, PsycINFO, and SportDiscus (last search: 17 October 2017). We included studies that measured sedentary behavior and physical activity of older adults with hip fracture using activity monitors (e.g. accelerometers). We identified literature at Level 1 (title and abstract) and Level 2 (full text), and conducted forward and backward searches. We assessed observational studies' adherence to reporting guidelines and intervention studies' risk of bias. We included 14 studies (882 participants). Four studies reported sedentary behavior data, while all studies reported information on physical activity. Settings included hospital, rehabilitation centers, and the community. Nine studies were observational; five were experimental design. Older adults had excessive sedentary time (>10 hours/day) and low physical activity. Participants' average upright time differed across settings. During hospital stay, it ranged 16-52 minutes/day, while in the community, it ranged 51-261 minutes/day. Data from five interventions reported on physical activity change: two studies increased between 14 and 27 minutes/day. Another study reported participants accumulated 6994 steps/day at the end of the intervention, but for two other interventions, activity was below 5000 steps/day. Based on available evidence, older adults with hip fracture engage in prolonged sedentary behavior and have low levels of physical activity during rehabilitation and recovery.

  3. Employer-Supported Child Care in Ontario.

    ERIC Educational Resources Information Center

    Ontario Ministry of Community and Social Services, Toronto.

    Six case studies describing current employer-supported child care services in Ontario are presented. The studies describe the PLADEC Day Care Center of the Kingston Psychiatric Hospital, the day care center at the Chedoke-McMaster Hospitals in Hamilton, the Early Learning Centre at Durham College in Oshawa, the Hydrokids day care center at the…

  4. 39 CFR 121.4 - Package Services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Center Facility (SCF) turnaround Package Services mail accepted at the origin SCF before the day-zero...) Package Services mail accepted at origin before the day-zero Critical Entry Time is 3 days, for each... Center (NDC) Package Services mail accepted at origin before the day-zero Critical Entry Time is 4 days...

  5. HIV/AIDS related commodities supply chain management in public health facilities of Addis Ababa, Ethiopia: a cross-sectional survey.

    PubMed

    Berhanemeskel, Eyerusalem; Beedemariam, Gebremedhin; Fenta, Teferi Gedif

    2016-01-01

    A wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia. A descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach. The study revealed that 16 health centers and one hospital had recorded and reported patient medication record. Six months prior to the study, 14 health centers and 2 hospitals had stopped VCT services for one time or more. Three hospitals and 18 health centers claimed to have been able to submit the requisition and report concerning ARV medicines to Pharmaceutical Fund and Supply Agency according to the specific reporting period. More than three-fourth of the health centers had one or more emergency order of ARV medicines on the day of visit, while all of hospitals had emergency order more than 3 times within 6 months prior to the study. All of the hospitals and nearly half of the health centers had an emergency order of test kits more than 3 times in the past 6 months. Overall, nearly 3/4th of the health facilities faced stock-out of one or more ARV medicines and test kits on the day of visit. There was no adequate data on patient medication record and stock status of HIV/AIDS related commodities. Moreover there were frequent stock-outs of ARV medicines and HIV test kits, which was an indicator of the weak supply chain management. Hospitals and health centers, therefore, should devise a system to capture and make use of patient medication record and stock status information so as to ensure continuous supply of the commodities.

  6. STS-96 FD Highlights and Crew Activities Report: Flight Day 06

    NASA Technical Reports Server (NTRS)

    1999-01-01

    On this sixth day of the STS-96 Discovery mission, the flight crew, Commander Kent V. Rominger, Pilot Rick D. Husband, and Mission Specialists Ellen Ochoa, Tamara E. Jernigan, Daniel T. Barry, Julie Payette, and Valery Ivanovich Tokarev are seen performing logistics transfer activities within the Discovery/International Space Station orbiting complex. Ochoa, Jernigan, Husband and Barry devote a significant part of their day to the transfer of bags of different sizes and shapes from the SPACEHAB module in Discovery's cargo bay to resting places inside the International Space Station. Payette and Tokarev complete the maintenance on the storage batteries. Barry and Tokarev complete installation of the remaining sound mufflers over the fans in Zarya. Barry then measures the sound levels at different positions inside the module. Rominger and Tokarev conduct a news conference with Russian reporters from the Mission Control Center in Moscow.

  7. Examining the Relationship Between Perceived Quality of Care and Actual Quality of Care as Measured by 30-Day Readmission Rates.

    PubMed

    Salinas, Stanley R

    To test the relationship between patient experience, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and actual quality of care, as measured by 30-day readmission rates. Both HCAHPS data and outcome data reported to the Centers of Medicare & Medicaid Services (CMS). This secondary, nationwide (N = 4060), hospital-level study focused only on acute care hospitals. HCAHPS question 22 "Would you recommend this hospital to your friends and family?" was used to determine level of overall satisfaction, and 30-day readmission rates, as reported to the CMS, was used as a proxy for actual quality of care. A statistically significant relationship was found between patient experience and actual quality outcomes. The results of this study reinforce the inclusion of patient experience in Medicare's Value Based Purchasing program as a matter of good public policy.

  8. Patient goal setting as a method for program improvement/development in partial hospitalization programs.

    PubMed

    Gates, A

    1991-12-01

    Data were collected from a study of 49 patients in 1990 and 106 patients in 1991 admitted into Country View Treatment Center and Green Country Counseling Center. Country View is a 30-bed chemical dependency residential center operating under St. John Medical Center in Tulsa, Oklahoma. Green Country is an evening partial hospital chemical dependency program operating under St. John Medical Center in Tulsa, Oklahoma, The tools used in this study were the Country View Patient Self-Reporting Questionnaire, the global Rating Scale, and the Model of Recovering Alcoholics Behavior Stages and Goal Setting (Wing, 1990). These assessments were specifically designed to measure the patient's perceptions of goal setting and the patient's perspective on treatment outcome. The study outcome resulted in program improvement (Green Country evening partial hospital program) and the development of the Country View Substance Abuse Intermediate Link (SAIL) Program (day partial hospital).

  9. Chemical Compatibility of High-Tc Superconductors with Other Materials

    DTIC Science & Technology

    1988-07-22

    OFFICE OF NAVAL RESEARCH oil fit Research Contract N00014-87-K-0014 R&T Code 413E26---01 0 Technical Report No. 12 0)" CHEMICAL COMPATIBILITY OF...Center University of California, Los Angeles, CA 90024-1569 In Press ’, in Z- "Physical Chemistry of High -Temperature Superc ,nductorx" D.L. Nelson and...1 flTERTALS4 12 PERSONAL AUTHOR(S .. (ilasai~ 113a TYPE Of REPORT I13b TIME COVERED 14 DATE OF REPORT (Year,PMonth, Day) S PAGE COUNT _Tehia Prpit__AI

  10. Case report: cranioplasty infection due to Roseomonas gilardii at a university hospital in turkey

    PubMed Central

    Ece, Gulfem; Ruksen, Mete; Akay, Ali

    2013-01-01

    Roseomonas is a pink-pigmented, nonfermentative, oxidative, Gram-negative coccobacilli that has clinical importance as opportunistic pathogen which can lead to infections especially in immunosuppressed individuals. It is relatively less reported in many centers. These microorganisms are detected after several days growth in culture environment, and typical pink, mucoid colonies are detected. We are reported a case of cranioplasty infection that took place in a patient with with cranial abscess formation due to Roseomonas gilardii at Izmir University School of Medicine Medicalpark Hospital. PMID:23819004

  11. Case report: cranioplasty infection due to Roseomonas gilardii at a university hospital in Turkey.

    PubMed

    Ece, Gulfem; Ruksen, Mete; Akay, Ali

    2013-01-01

    Roseomonas is a pink-pigmented, nonfermentative, oxidative, Gram-negative coccobacilli that has clinical importance as opportunistic pathogen which can lead to infections especially in immunosuppressed individuals. It is relatively less reported in many centers. These microorganisms are detected after several days growth in culture environment, and typical pink, mucoid colonies are detected. We are reported a case of cranioplasty infection that took place in a patient with with cranial abscess formation due to Roseomonas gilardii at Izmir University School of Medicine Medicalpark Hospital.

  12. White centered retinal hemorrhages in vitamin b(12) deficiency anemia.

    PubMed

    Zehetner, Claus; Bechrakis, Nikolaos E

    2011-05-01

    To report a case of severe vitamin B(12) deficiency anemia presenting with white centered retinal hemorrhages. Interventional case report. A 40-year-old man, general practitioner himself, presented with a 1-day history of diminished left visual acuity and a drop-shaped central scotoma. The corrected visual acuities were 20/20, OD and 20/100, OS. Ophthalmic examination revealed bilaterally pale tarsal conjunctiva, discretely icteric bulbar conjunctiva and disseminated white centered intraretinal hemorrhages with foveal involvement. OCT imaging through these lesions revealed a retinal thickening caused by a sub-ILM accumulation of hyperreflective and inhomogeneous deposits within the nerve fiber layer. Immediate laboratory work-up showed severe megaloblastic anemia caused by vitamin B(12) deficiency requiring erythrocyte transfusions. Most reports of white centered retinal hemorrhages have been described in patients with leukemic retinopathy and bacterial endocarditis. It is interesting that this case of vitamin B(12) deficiency anemia retinopathy has a clinically indistinguishable fundus appearance. This is probably due to the common pathology of capillary disruption and subsequent hemostatic fibrin plug formation. In megaloblastic anemia, direct anoxia results in endothelial dysfunction. The loss of impermeability allows extrusion of whole blood and subsequent diffusion from the disrupted site throughout and above the nerve fiber layer. Therefore the biomicroscopic pattern of white centered hemorrhages observed in anemic retinopathy is most likely due to the clot formation as the reparative sequence after capillary rupture.

  13. Description of a Method to Obtain Complete One-Year Follow-Up in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.

    PubMed

    Wooley, Jordan; Neatherlin, Holly; Mahoney, Cecile; Squiers, John J; Tabachnick, Deborah; Suresh, Mitta; Huff, Eleanor; Basra, Sukhdeep S; DiMaio, J Michael; Brown, David L; Mack, Michael J; Holper, Elizabeth M

    2018-03-15

    The Centers for Medicare and Medicaid Services National Coverage Determination requires centers performing transcatheter aortic valve implantation (TAVI) to report clinical outcomes up to 1 year. Many sites encounter challenges in obtaining complete 1-year follow-up. We report our process to address this challenge. A multidisciplinary process involving clinical personnel, data and quality managers, and research coordinators was initiated to collect TAVI data at baseline, 30 days, and 1 year. This process included (1) planned clinical follow-up of all patients at 30 days and 1 year; (2) query of health-care system-wide integrated data warehouse (IDW) to ascertain last date of clinical contact within the system for all patients; (3) online obituary search, cross-referencing for unique patient identifiers to determine if mortality occurred in remaining unknown patients; and (4) phone calls to remaining unknown patients or patients' families. Between January 2012 and December 2016, 744 patients underwent TAVI. All 744 patients were eligible for 30-day follow-up and 546 were eligible for 1-year follow-up. At routine clinical follow-up of 22 of 744 (3%) patients at 30 days and 180 of 546 (33%) patients at 1 year had unknown survival status. The integrated data warehouse query confirmed status-alive for an additional 1 of 22 patients at 30 days (55%) and 91 of 180 patients at 1 year (51%). Obituaries were identified for 23 of 180 additional patients at 1 year (13%). Phone contact identified the remaining unknown patients at 30 days and 1 year, resulting in 100% known survival status for patients at 30 days (744 of 744) and at 1 year (546 of 546). In conclusion, using a comprehensive approach, we were able to determine survival status in 100% of patients who underwent TAVI. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Measuring patient-centered medical home access and continuity in clinics with part-time clinicians.

    PubMed

    Rosland, Ann-Marie; Krein, Sarah L; Kim, Hyunglin Myra; Greenstone, Clinton L; Tremblay, Adam; Ratz, David; Saffar, Darcy; Kerr, Eve A

    2015-05-01

    Common patient-centered medical home (PCMH) performance measures value access to a single primary care provider (PCP), which may have unintended consequences for clinics that rely on part-time PCPs and team-based care. Retrospective analysis of 110,454 primary care visits from 2 Veterans Health Administration clinics from 2010 to 2012. Multi-level models examined associations between PCP availability in clinic, and performance on access and continuity measures. Patient experiences with access and continuity were compared using 2012 patient survey data (N = 2881). Patients of PCPs with fewer half-day clinic sessions per week were significantly less likely to get a requested same-day appointment with their usual PCP (predicted probability 17% for PCPs with 2 sessions/week, 20% for 5 sessions/week, and 26% for 10 sessions/week). Among requests that did not result in a same-day appointment with the usual PCP, there were no significant differences in same-day access to a different PCP, or access within 2 to 7 days with patients' usual PCP. Overall, patients had >92% continuity with their usual PCP at the hospital-based site regardless of PCP sessions/week. Patients of full-time PCPs reported timely appointments for urgent needs more often than patients of part-time PCPs (82% vs 71%; P < .01), but reported similar experiences with routine access and continuity. Part-time PCP performance appeared worse when using measures focused on same-day access to patients' usual PCP. However, clinic-level same-day access, same-week access to the usual PCP, and overall continuity were similar for patients of part-time and full-time PCPs. Measures of in-person access to a usual PCP do not capture alternate access approaches encouraged by PCMH, and often used by part-time providers, such as team-based or non-face-to-face care.

  15. Epidemic activity after natural disasters without high mortality in developing settings

    PubMed Central

    Loayza-Alarico, Manuel J; Lescano, Andres G; Suarez-Ognio, Luis A; Ramirez-Prada, Gladys M; Blazes, David L

    2013-01-01

    Natural disasters with minimal human mortality rarely capture headlines but occur frequently and result in significant morbidity and economic loss. We compared the epidemic activity observed after a flood, an earthquake, and volcanic activity in Peru. Following post-disaster guidelines, healthcare facilities and evacuation centers surveyed 10–12 significant health conditions for ~45 days and compared disease frequency with Poisson regression. The disasters affected 20,709 individuals and 15% were placed in evacuation centers. Seven deaths and 6,056 health conditions were reported (mean: 0.29 per person). Health facilities reported fewer events than evacuation centers (0.06–0.24 vs. 0.65–2.02, P < 0.001) and disease notification increased 1.6 times after the disasters (95% CI: 1.5–1.6). Acute respiratory infections were the most frequent event (41–57%) and psychological distress was second/third (7.6% to 14.3%). Morbidity increased after disasters without substantial casualties, particularly at evacuation centers, with frequent respiratory infections and psychological distress. Post-disaster surveillance is valuable even after low-mortality events. PMID:28228992

  16. Embedding care management in the medical home: a case study.

    PubMed

    Daaleman, Timothy P; Hay, Sherry; Prentice, Amy; Gwynne, Mark D

    2014-04-01

    Care managers are playing increasingly significant roles in the redesign of primary care and in the evolution of patient-centered medical homes (PCMHs), yet their adoption within day-to-day practice remains uneven and approaches for implementation have been minimally reported. We introduce a strategy for incorporating care management into the operations of a PCMH and assess the preliminary effectiveness of this approach. A case study of the University of North Carolina at Chapel Hill Family Medicine Center used an organizational model of innovation implementation to guide the parameters of implementation and evaluation. Two sources were used to determine the effectiveness of the implementation strategy: data elements from the care management informatics system in the health record and electronic survey data from the Family Medicine Center providers and care staff. A majority of physicians (75%) and support staff (82%) reported interactions with the care manager, primarily via face-to-face, telephone, or electronic means, primarily for facilitating referrals for behavioral health services and assistance with financial and social and community-based resources. Trend line suggests an absolute decrease of 8 emergency department visits per month for recipients of care management services and an absolute decrease of 7.5 inpatient admissions per month during the initial 2-year implementation period. An organizational model of innovation implementation is a potentially effective approach to guide the process of incorporating care management services into the structure and workflows of PCMHs.

  17. A Survey of Management Tasks Performed by Day Care Center Directors.

    ERIC Educational Resources Information Center

    Dent, Barbara

    The general problem addressed in this survey is the identification of the management training needs of day care center directors. A questionnaire was developed and mailed to 102 directors of full time, pre-school day care centers in Baltimore City. The directors' answers were tabulated and simple percentages were computed. Directors were asked to…

  18. PENNSYLVANIA MIGRANT DAY CARE PROGRAM AND PARTICIPATING AGENCIES.

    ERIC Educational Resources Information Center

    NAYLOR, NAOMI L.

    A DESCRIPTION OF A MIGRANT DAY CARE PROGRAM WAS GIVEN. A TOTAL OF 180 PRESCHOOL AND SCHOOL AGE CHILDREN WERE ENROLLED IN SIX DAY CARE CENTERS. SOME FINANCIAL AID, EQUIPMENT, MATERIALS, AND ADVISORY HELP WERE GIVEN TO TWO OTHER CENTERS ENROLLING 40 MORE CHILDREN. FUNDS FOR THE OPERATION OF THE CENTERS WERE FEDERAL FUNDS, ALLOCATED TO PROVIDE…

  19. From Teacher to Day Care Center Director!

    ERIC Educational Resources Information Center

    De Viteri, Jorge Saenz

    This paper addresses the roles and responsibilities of a day care center director, based on the author's personal experience as an interim director during his junior year at college and a survey of other directors. The paper aims to provide insight into the reality of being a day care center director, particularly the acquisition of knowledge,…

  20. Starting a Day Care Center: The Day Care Center Handbook.

    ERIC Educational Resources Information Center

    Checkett, Donald

    Designed to be of help to individuals and groups seeking to establish a day care center in the metropolitan St. Louis area, this manual calls attention to important and basic information which must be taken into account if planning is to produce tangible results. Following a brief section defining commonly used terms referring to organized…

  1. Stroke outcomes measures must be appropriately risk adjusted to ensure quality care of patients: a presidential advisory from the American Heart Association/American Stroke Association.

    PubMed

    Fonarow, Gregg C; Alberts, Mark J; Broderick, Joseph P; Jauch, Edward C; Kleindorfer, Dawn O; Saver, Jeffrey L; Solis, Penelope; Suter, Robert; Schwamm, Lee H

    2014-05-01

    Because stroke is among the leading causes of death, disability, hospitalizations, and healthcare expenditures in the United States, there is interest in reporting outcomes for patients hospitalized with acute ischemic stroke. The American Heart Association/American Stroke Association, as part of its commitment to promote high-quality, evidence-based care for cardiovascular and stroke patients, fully supports the development of properly risk-adjusted outcome measures for stroke. To accurately assess and report hospital-level outcomes, adequate risk adjustment for case mix is essential. During the development of the Centers for Medicare & Medicaid Services 30-day stroke mortality and 30-day stroke readmission measures, concerns were expressed that these measures were not adequately designed because they do not include a valid initial stroke severity measure, such as the National Institutes of Health Stroke Scale. These outcome measures, as currently constructed, may be prone to mischaracterizing the quality of stroke care being delivered by hospitals and may ultimately harm acute ischemic stroke patients. This article details (1) why the Centers for Medicare & Medicaid Services acute ischemic stroke outcome measures in their present form may not provide adequate risk adjustment, (2) why the measures as currently designed may lead to inaccurate representation of hospital performance and have the potential for serious unintended consequences, (3) what activities the American Heart Association/American Stroke Association has engaged in to highlight these concerns to the Centers for Medicare & Medicaid Services and other interested parties, and (4) alternative approaches and opportunities that should be considered for more accurately risk-adjusting 30-day outcomes measures in patients with ischemic stroke.

  2. Effects of the 2017 Solar Eclipse on HF Radio Propagation and the D-Region Ionosphere: Citizen Science Investigation

    NASA Astrophysics Data System (ADS)

    Fry, C. D.; Adams, M.; Gallagher, D. L.; Habash Krause, L.; Rawlins, L.; Suggs, R. M.; Anderson, S. C.

    2017-12-01

    August 21, 2017 provided a unique opportunity to investigate the effects of the total solar eclipse on high frequency (HF) radio propagation and ionospheric variability. In Marshall Space Flight Center's partnership with the US Space and Rocket Center (USSRC) and Austin Peay State University (APSU), we engaged students and citizen scientists in an investigation of the eclipse effects on the mid-latitude ionosphere. The Amateur Radio community has developed several automated receiving and reporting networks that draw from widely-distributed, automated and manual radio stations to build a near-real time, global picture of changing radio propagation conditions. We used these networks and employed HF radio propagation modeling in our investigation. A Ham Radio Science Citizen Investigation (HamSCI) collaboration with the American Radio Relay League (ARRL) ensured that many thousands of amateur radio operators would be "on the air" communicating on eclipse day, promising an extremely large quantity of data would be collected. Activities included implementing and configuring software, monitoring the HF Amateur Radio frequency bands and collecting radio transmission data on days before, the day of, and days after the eclipse to build a continuous record of changing propagation conditions as the moon's shadow marched across the United States. Our expectations were the D-Region ionosphere would be most impacted by the eclipse, enabling over-the-horizon radio propagation on lower HF frequencies (3.5 and 7 MHz) that are typically closed during the middle of the day. Post-eclipse radio propagation analysis provided insights into ionospheric variability due to the eclipse. We report on results, interpretation, and conclusions of these investigations.

  3. Decreasing the dispatch time of medical reports sent from hospital to primary care with Lean Six Sigma.

    PubMed

    Basta, Yara L; Zwetsloot, Inez M; Klinkenbijl, Jean H G; Rohof, Thomas; Monster, Mathijs M C; Fockens, Paul; Tytgat, Kristien M A J

    2016-10-01

    Timely communication is important to ensure high-quality health care. To facilitate this, the Gastro Intestinal Oncology Center Amsterdam (GIOCA) stipulated to dispatch medical reports on the day of the patient's visit. However, with the increasing number of patients, administrative processes at GIOCA were under pressure, and this standard was not met for the majority of patients. The aim and objective of this study was to dispatch 90% of medical reports on the day of the patient's visit by improving the logistic process. To assess the main causes for a prolonged dispatch time and to design improvements actions, the roadmap offered by Lean Six Sigma (LSS) was used, consisting of five phases: Define, Measure, Analyze, Improve and Control (DMAIC roadmap). Initially, 12.3% of the reports were dispatched on the day of the patient's visit. Three causes for a prolonged dispatch time were identified: (1) determining which doctors involved with treatment would compose the report; (2) the reports composed by a senior resident had to be reviewed by a medical specialist; and (3) a medical specialist had to authorize the administration to dispatch the reports. To circumvent these causes, a digital form was implemented in the electronic medical record that could be completed during the multidisciplinary team meeting. After implementation, 90.6% of the reports were dispatched on the day of the visit. The dispatch time of reports sent from hospital to primary care can be significantly reduced using Lean Six Sigma, improving the communication between hospital and primary care. © 2016 John Wiley & Sons, Ltd.

  4. Polygonal tundra geomorphological change in response to warming alters future CO2 and CH4 flux on the Barrow Peninsula.

    PubMed

    Lara, Mark J; McGuire, A David; Euskirchen, Eugenie S; Tweedie, Craig E; Hinkel, Kenneth M; Skurikhin, Alexei N; Romanovsky, Vladimir E; Grosse, Guido; Bolton, W Robert; Genet, Helene

    2015-04-01

    The landscape of the Barrow Peninsula in northern Alaska is thought to have formed over centuries to millennia, and is now dominated by ice-wedge polygonal tundra that spans drained thaw-lake basins and interstitial tundra. In nearby tundra regions, studies have identified a rapid increase in thermokarst formation (i.e., pits) over recent decades in response to climate warming, facilitating changes in polygonal tundra geomorphology. We assessed the future impact of 100 years of tundra geomorphic change on peak growing season carbon exchange in response to: (i) landscape succession associated with the thaw-lake cycle; and (ii) low, moderate, and extreme scenarios of thermokarst pit formation (10%, 30%, and 50%) reported for Alaskan arctic tundra sites. We developed a 30 × 30 m resolution tundra geomorphology map (overall accuracy:75%; Kappa:0.69) for our ~1800 km² study area composed of ten classes; drained slope, high center polygon, flat-center polygon, low center polygon, coalescent low center polygon, polygon trough, meadow, ponds, rivers, and lakes, to determine their spatial distribution across the Barrow Peninsula. Land-atmosphere CO2 and CH4 flux data were collected for the summers of 2006-2010 at eighty-two sites near Barrow, across the mapped classes. The developed geomorphic map was used for the regional assessment of carbon flux. Results indicate (i) at present during peak growing season on the Barrow Peninsula, CO2 uptake occurs at -902.3 10(6) gC-CO2 day(-1) (uncertainty using 95% CI is between -438.3 and -1366 10(6) gC-CO2 day(-1)) and CH4 flux at 28.9 10(6) gC-CH4 day(-1) (uncertainty using 95% CI is between 12.9 and 44.9 10(6) gC-CH4 day(-1)), (ii) one century of future landscape change associated with the thaw-lake cycle only slightly alter CO2 and CH4 exchange, while (iii) moderate increases in thermokarst pits would strengthen both CO2 uptake (-166.9 10(6) gC-CO2 day(-1)) and CH4 flux (2.8 10(6) gC-CH4 day(-1)) with geomorphic change from low to high center polygons, cumulatively resulting in an estimated negative feedback to warming during peak growing season. © 2014 John Wiley & Sons Ltd.

  5. Ten Most Searched Databases by a Business Generalist--Part 1 or A Day in the Life of....

    ERIC Educational Resources Information Center

    Meredith, Meri

    1986-01-01

    Describes databases frequently used in Business Information Center, Cummins Engine Company (Columbus, Indiana): Dun and Bradstreet Business Information Report System, Newsearch, Dun and Bradstreet Market Identifiers, Trade and Industry Index, PTS PROMT, Bureau of Labor Statistics files, ABI/INFORM, Magazine Index, NEXIS, Dow Jones News/Retrieval.…

  6. An Analysis of New Jersey's Day Reporting Center and Halfway Back Programs: Embracing the Rehabilitative Ideal through Evidence Based Practices

    ERIC Educational Resources Information Center

    Ostermann, Michael

    2009-01-01

    Over the past several years practitioners in the field of Criminal Justice have begun to reaffirm, recognize, and implement the tenets of the rehabilitative ideal within their daily operations. However, despite scholarly research showing that offender rehabilitation can have marked positive affects upon recidivism, many practitioners remain…

  7. TRAINING FOR INDEPENDENT LIVING, A COMMUNITY PROGRAM FOR SEVERELY RETARDED ADULTS. A THREE YEAR REPORT.

    ERIC Educational Resources Information Center

    TOBIAS, JACK

    AN OCCUPATIONAL DAY CENTER FOR MENTALLY RETARDED ADULTS WAS ESTABLISHED TO PROVIDE COMMUNITY SERVICES FOR RETARDED PERSONS WHO LIVE AT HOME AND, ALTHOUGH BEYOND SCHOOL AGE, ARE UNABLE TO PARTICIPATE IN SHELTERED WORKSHOP ACTIVITIES. THE STAFF INCLUDES A DIRECTOR, A SOCIAL WORKER, FIVE INSTRUCTORS, A TRAINING SUPERVISOR, AN OFFICE WORKER, AND A…

  8. 78 FR 62635 - Advisory Committee to the Director (ACD), Centers for Disease Control and Prevention-Health...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-22

    ... Disparities Subcommittee members will discuss some of the current health equity activities at CDC, as well as... dictate. Web links: Connection-1: http://wm.onlinevideoservice.com/CDC1 . Mac/Flash Connection-3: http... Media link Connection-1. Viewer's report is given the next day. Number for Technical Support: (404) 639...

  9. Supporting Collaboration between K-12 and Higher Education: Year One, Interim Report One

    ERIC Educational Resources Information Center

    College Board Advocacy & Policy Center, 2012

    2012-01-01

    In April 2012, more than 100 educators and administrators from across the nation came together in Reston, Virginia, for a full day of meetings and discussions to launch the College Board Advocacy & Policy Center Affinity Network. The Affinity Network's mission is to facilitate students' successful transition from high school to college by: (1)…

  10. Expanding Horizons: Pacesetters in Adult Education for Work

    ERIC Educational Resources Information Center

    Chisman, Forrest P.

    2009-01-01

    The publication is based on the "Adult Readiness Roundtable" Project co-sponsored by CAAL and the National Center on Education and the Economy on April 6-7, 2009. It is not a transcript of the Roundtable discussion; instead it reports on a two-day discussion meeting among a group of exemplary adult-education-for-work programs from around the…

  11. Military Training Time and Cost Should Be Reduced Through Improved Management.

    ERIC Educational Resources Information Center

    General Accounting Office, Washington, DC.

    The report on the management of recruit and initial skill training identifies delays in training cycles, their causes, and resultant costs. In visits to four recruit training centers, eight initial skill training schools, and various headquarters offices, the General Accounting Office (GAO) identified 1,979,000 man-days per year that new members…

  12. A Comprehensive, Coordinated Child Care System. Final Report.

    ERIC Educational Resources Information Center

    Colorado Univ., Denver. Medical Center.

    The establishment and subsequent modification of a child care system for employees, faculty, and students of the University of Colorado Medical Center are discussed in detail. The project was partially funded by the Office of Child Development. Components of the project included three direct service programs: (1) day care for children ages 2 1/2…

  13. 3 CFR 13630 - Executive Order 13630 of December 6, 2012. Establishment of an Interagency Task Force on...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...) Department of Defense; (iv) Department of Agriculture; (v) Department of Health and Human Services; (vi... progress report to the Export Promotion Cabinet every 180 days, which should include, but not be limited to... Advocacy Center at the Department of Commerce, is focused on ensuring that the Federal Government's...

  14. Space Solar Power Exploratory Research and Technology (SERT) Technical Interchange Meeting 2 (SERT TIM 2)

    NASA Technical Reports Server (NTRS)

    Howell, Joe; Sanders, Clark W.

    2000-01-01

    The University of Alabama in Huntsville's (UAH) Propulsion Research Center hosted the Space Solar Power Exploratory Research & Technology (SERT) Technical Interchange Meeting TIM) 2 in Huntsville, Alabama December 7-10. 1999 with 126 people in attendance. The SERT program includes both competitively procured activities. which are being implemented through a portfolio of focused R&D investments--with the maximum leveraging of existing resources inside and outside NASA. and guided by these system studies. Axel Roth. Director of the Flight Projects Directorate NASA MSFC, welcomed the SERT TIM 2 participants and challenged them to develop the necessary technologies and demonstrations that will lead to Space Solar Power (SSP) International implementation. Joe Howell, NASA MSFC, reiterated the SERT TIM 2 objectives: 1) Refining and modeling systems approaches for the utilization of SSP concepts and technologies, ranging, from the near-term e.g. for space science, exploration and commercial space applications to the far-term (e. g. SSP for terrestrial markets), including systems concepts, technology, infrastructure (i.g., transportation), and economics. 2) Conducting technology research, development and demonstration activities to produce "proof- of-concept" validation of critical SSP elements for both the nearer and farther-term applications. 3) Initiating partnerships Nationality and Internationally that could be expanded, as appropriate, to pursue later SSP technology and applications (e.g., space science. colonization, etc.). Day one began with the NASA Centers presenting their SERT activities summary since SERT TIM 1 and wound up with a presentation by Masahiro Mori, NASDA titled "NASDA In-house Study for SSP". Demonstration for the Near-Term. Day two began with the SERT Systems Studies and Analysis reports resulting from NRA 8-23 followed by presentations of SERT Technology Demonstrations reports resulting from NRA 8-23. Day two closed with John Mankins presentation on "Technology Roadmapping" and the delivery of the charge to the Work Breakout Sessions. Day three began with the eleven Work Breakout Session which was the major function of this TIM 2 and day three ended with reports by the Chairs of the eleven Work Breakdown Sessions. Day four began with the six Integrated Product Team OPT) meetings and ended with closing plenary panel sessions.

  15. Physical Activity Opportunities Within the Schedule of Early Care and Education Centers.

    PubMed

    Mazzucca, Stephanie; Hales, Derek; Evenson, Kelly R; Ammerman, Alice; Tate, Deborah F; Berry, Diane C; Ward, Dianne S

    2018-02-01

    Physical activity has many benefits for young children's health and overall development, but few studies have investigated how early care and education centers allot time for physical activity, along with measured individual physical activity levels for indoor/outdoor activities during a typical day. Fifty early care and education centers in central North Carolina participated in 4 full-day observations, and 559 children aged 3-5 years within centers wore accelerometers assessing physical activity during observation days. Observation and physical activity data were linked and analyzed for associations between child activity and type of classroom activity. Children averaged 51 (13) minutes per day of moderate to vigorous physical activity and 99 (18) minutes per day of light physical activity while in child care. Children averaged 6 (10) and 10 (13) minutes per day of observed outdoor and indoor daily teacher-led physical activity, respectively. Outdoor time averaged 67 (49) minutes per day, and physical activity levels were higher during outdoor time than during common indoor activities (center time, circle time, and TV time). Physical activity levels varied between indoor and outdoor class activities. Policy and program-related efforts to increase physical activity in preschoolers should consider these patterns to leverage opportunities to optimize physical activity within early care and education centers.

  16. [Nutrition in childhood--demands and reality. Outcomes of the nutrition and catering situation in Saxon day-care centers].

    PubMed

    Wolfram, N; Hillger, C; Jüttler, G; Müller, C; Benterbusch, R; Kirch, W

    2007-10-01

    The aim of this research project was to compile a significant database and information about the nutritional and catering situation concerning children aged between 4 and 6 years in Saxony. The project focused on the range of foods available in day-care centers. The actual food consumption was not assessed. Standardized interviews of the management of day-care centers were undertaken. Furthermore standardized questionnaires, which included a three-day-recall of the contents of the children's lunch boxes, were used to interview parents (n = 4082, response rate 49 %). In order to evaluate the lunch catering, the menus were analysed for 4 weeks. Hot lunches were delivered to the day-care centers. For the most part caterers and day-care center management did not translate the recommendations of an optimized mixed diet. Meat dishes were too often part of the menus. Salt-water fish was offered irregularly and the preparation did not fulfill the recommendations. Potatoes, fresh fruits, uncooked vegetarian food or salads were seldom offered on the menus. Regardless of the monthly household budget most children have lunch in day-care centers. The meal offerings, not only lunches, showed potential for improvement concerning a balanced energy and nutrient provision. Therefore all persons involved in providing children's meals should take on full responsibility.

  17. Information Infrastructure Technology and Applications (IITA) Program: Annual K-12 Workshop

    NASA Technical Reports Server (NTRS)

    Hunter, Paul; Likens, William; Leon, Mark

    1995-01-01

    The purpose of the K-12 workshop is to stimulate a cross pollination of inter-center activity and introduce the regional centers to curing edge K-1 activities. The format of the workshop consists of project presentations, working groups, and working group reports, all contained in a three day period. The agenda is aggressive and demanding. The K-12 Education Project is a multi-center activity managed by the Information Infrastructure Technology and Applications (IITA)/K-12 Project Office at the NASA Ames Research Center (ARC). this workshop is conducted in support of executing the K-12 Education element of the IITA Project The IITA/K-12 Project funds activities that use the National Information Infrastructure (NII) (e.g., the Internet) to foster reform and restructuring in mathematics, science, computing, engineering, and technical education.

  18. Public School Center vs. Family Home Day Care: Single Parents' Reasons for Selection.

    ERIC Educational Resources Information Center

    Rothschild, Maria Stupp

    This study investigates the reasons single parents in San Diego had for choosing either a public day care center or a licensed day care home for their children. A sample of 30 single parents with children in school district administered children's centers was drawn and matched by a similarly geographically distributed sample of 23 parents with…

  19. Gendering of day center occupations as perceived by people with psychiatric disabilities in Sweden.

    PubMed

    Widerberg, Stefan; Eklund, Mona

    2018-05-01

    The aim was to explore the experiences and views of people attending day centers for people with psychiatric disabilities concerning the occurrence and nature of gendering of the occupations performed there. Twenty-five day center attendees were interviewed regarding occupational choices at the day centers, whether they would describe day center occupations as gendered, and if so what the consequences were of the gendering of occupations. The transcribed texts were analyzed by thematic analysis. Three main themes were identified: Thinking and doing gender; Understandings of gendering of day center occupations; and Consequences of gendered occupation. The participants were more open-minded in their reasoning than in what they were doing. They understood gendering to be a result of traditions, role models from childhood, ideas about typically male and female innate capacities, lack of knowledge and low self-confidence. Doing seemed to reproduce gender, but being in a group of the same sex could shape unity and a relaxed atmosphere. The findings could be understood as a set of gender frames, which might prevent either of the sexes from developing their full potentials and transgress into e.g. the employment market. Gendering should be highlighted and debated in psychosocial rehabilitation.

  20. Determining the hospital trauma financial impact in a statewide trauma system.

    PubMed

    Mabry, Charles D; Kalkwarf, Kyle J; Betzold, Richard D; Spencer, Horace J; Robertson, Ronald D; Sutherland, Michael J; Maxson, Robert T

    2015-04-01

    There have been no comprehensive studies across an organized statewide trauma system using a standardized method to determine cost. Trauma financial impact includes the following costs: verification, response, and patient care cost (PCC). We conducted a survey of participating trauma centers (TCs) for federal fiscal year 2012, including separate accounting for verification and response costs. Patient care cost was merged with their trauma registry data. Seventy-five percent of the 2012 state trauma registry had data submitted. Each TC's reasonable cost from the Medicare Cost Report was adjusted to remove embedded costs for response and verification. Cost-to-charge ratios were used to give uniform PCC across the state. Median (mean ± SD) costs per patient for TC response and verification for Level I and II centers were $1,689 ($1,492 ± $647) and $450 ($636 ± $431) for Level III and IV centers. Patient care cost-median (mean ± SD) costs for patients with a length of stay >2 days rose with increasing Injury Severity Score (ISS): ISS <9: $6,787 ($8,827 ± $8,165), ISS 9 to 15: $10,390 ($14,340 ± $18,395); ISS 16 to 25: $15,698 ($23,615 ± $21,883); and ISS 25+: $29,792 ($41,407 ± $41,621), and with higher level of TC: Level I: $13,712 ($23,241 ± $29,164); Level II: $8,555 ($13,515 ± $15,296); and Levels III and IV: $8,115 ($10,719 ± $11,827). Patient care cost rose with increasing ISS, length of stay, ICU days, and ventilator days for patients with length of stay >2 days and ISS 9+. Level I centers had the highest mean ISS, length of stay, ICU days, and ventilator days, along with the highest PCC. Lesser trauma accounted for lower charges, payments, and PCC for Level II, III, and IV TCs, and the margin was variable. Verification and response costs per patient were highest for Level I and II TCs. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Family Day Care: Some Observations.

    ERIC Educational Resources Information Center

    Saunders, Minta M.; Keister, Mary Elizabeth

    A study comparing family and group day care was conducted. Data were collected over a two-year period on 12 children in a Greensboro, N. C., family day care program and 10 children in the UNC-G Demonstration Center for Infant-Toddler Care, a group day care center. Results, which disproved many assumptions cited as advantages of family day care,…

  2. Triaxial fiber optic magnetic field sensor for MRI applications

    NASA Astrophysics Data System (ADS)

    Filograno, Massimo L.; Pisco, Marco; Catalano, Angelo; Forte, Ernesto; Aiello, Marco; Soricelli, Andrea; Davino, Daniele; Visone, Ciro; Cutolo, Antonello; Cusano, Andrea

    2016-05-01

    In this paper, we report a fiber-optic triaxial magnetic field sensor, based on Fiber Bragg Gratings (FBGs) integrated with giant magnetostrictive material, the Terfenol-D. The realized sensor has been designed and engineered for Magnetic Resonance Imaging (MRI) applications. A full magneto-optical characterization of the triaxial sensing probe has been carried out, providing the complex relationship among the FBGs wavelength shift and the applied magnetostatic field vector. Finally, the developed fiber optic sensors have been arranged in a sensor network composed of 20 triaxial sensors for mapping the magnetic field distribution in a MRI-room at a diagnostic center in Naples (SDN), equipped with Positron emission tomography/magnetic resonance (PET/MR) instrumentation. Experimental results reveal that the proposed sensor network can be efficiently used in MRI centers for performing quality assurance tests, paving the way for novel integrated tools to measure the magnetic dose accumulated day by day by MRI operators.

  3. Zika Virus and Chikungunya Virus CoInfections: A Series of Three Cases from a Single Center in Ecuador

    PubMed Central

    Zambrano, Hector; Waggoner, Jesse J.; Almeida, Cristina; Rivera, Lisette; Benjamin, Juan Quintana; Pinsky, Benjamin A.

    2016-01-01

    Zika virus (ZIKV) and chikungunya virus (CHIKV) cocirculate throughout much of the tropical Western Hemisphere; however, few cases of coinfection with these two pathogens have been reported. Herein, we describe three cases of ZIKV–CHIKV coinfection detected at a single center in Ecuador: a patient who developed symptoms on postoperative day 5 from an orthopedic procedure, a woman who had traveled to Ecuador for fertility treatment, and a woman who was admitted for Guillain–Barré syndrome and had ZIKV and CHIKV detected in serum and cerebrospinal fluid. All cases were diagnosed using a multiplex real-time reverse transcription polymerase chain reaction, and ZIKV viremia was detected as late as 16 days after symptom onset. These cases demonstrate the varied clinical presentation of ZIKV–CHIKV coinfections as well as the importance of multiplexed arboviral testing for these pathogens. PMID:27402518

  4. Zika Virus and Chikungunya Virus CoInfections: A Series of Three Cases from a Single Center in Ecuador.

    PubMed

    Zambrano, Hector; Waggoner, Jesse J; Almeida, Cristina; Rivera, Lisette; Benjamin, Juan Quintana; Pinsky, Benjamin A

    2016-10-05

    Zika virus (ZIKV) and chikungunya virus (CHIKV) cocirculate throughout much of the tropical Western Hemisphere; however, few cases of coinfection with these two pathogens have been reported. Herein, we describe three cases of ZIKV-CHIKV coinfection detected at a single center in Ecuador: a patient who developed symptoms on postoperative day 5 from an orthopedic procedure, a woman who had traveled to Ecuador for fertility treatment, and a woman who was admitted for Guillain-Barré syndrome and had ZIKV and CHIKV detected in serum and cerebrospinal fluid. All cases were diagnosed using a multiplex real-time reverse transcription polymerase chain reaction, and ZIKV viremia was detected as late as 16 days after symptom onset. These cases demonstrate the varied clinical presentation of ZIKV-CHIKV coinfections as well as the importance of multiplexed arboviral testing for these pathogens. © The American Society of Tropical Medicine and Hygiene.

  5. Report of the American Heart Association (AHA) Scientific Sessions 2016, New Orleans.

    PubMed

    Amaki, Makoto; Konagai, Nao; Fujino, Masashi; Kawakami, Shouji; Nakao, Kazuhiro; Hasegawa, Takuya; Sugano, Yasuo; Tahara, Yoshio; Yasuda, Satoshi

    2016-12-22

    The American Heart Association (AHA) Scientific Sessions 2016 were held on November 12-16 at the Ernest N. Morial Convention Center, New Orleans, LA. This 5-day event featured cardiovascular clinical practice covering all aspects of basic, clinical, population, and translational content. One of the hot topics at AHA 2016 was precision medicine. The key presentations and highlights from the AHA Scientific Sessions 2016, including "precision medicine" as one of the hot topics, are herein reported.

  6. NASA Report to Education, Volume 9

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This is an edition of 'NASA Report to Education' covering NASA's Educational Workshop, Lewis Research Center's T-34 and the Space Exploration Initiative. The first segment shows NASA Education Workshop program (NEWEST - NASA Educational Workshops for Elementary School Teachers). Highlights of the 14 days of intense training, lectures, fieldtrips and simple projects that the educators went through to teach the program are included. Participants are shown working on various projects such as the electromagnetic spectrum, living in Space Station Freedom, experience in T-34, tour of tower at the Federal Aviation Administrative Facilities, conducting an egg survival system and an interactive video conference with astronaut Story Musgrave. Participants share impressions of the workshop. The second segment tells how Lewis Research Center's T-34 aircraft is used to promote aerospace education in several Cleveland schools and excite students.

  7. Worldwide Experience with the Syncardia Total Artificial Heart in the Pediatric Population.

    PubMed

    Morales, David L S; Lorts, Angela; Rizwan, Raheel; Zafar, Farhan; Arabia, Francisco A; Villa, Chet R

    Individual centers have documented the use of the Syncardia Total Artificial Heart (TAH) in adolescents with heart failure; however, the number of patients at any given center is small. Herein, we describe the worldwide experience for all patients ≤21 years old supported with the TAH between May 2005 and May 2015 (n = 43). The number of patients experiencing a positive outcome at 60, 90, and 120 days were 30 (70%), 27 (63%), and 25 (58%), respectively. Successful bridge to transplantation varied by diagnosis, but outcomes reported are similar to adults supported with the TAH or biventricular assist devices.

  8. 39 CFR 121.4 - Package Services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Center Facility (SCF) turnaround Package Services mail accepted at the origin SCF before the day zero... origin before the day-zero Critical Entry Time is 3 days, for each remaining (non-intra-SCF) 3-digit ZIP... intra-Network Distribution Center (NDC) Package Services mail accepted at origin before the day-zero...

  9. 39 CFR 121.4 - Package Services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Center Facility (SCF) turnaround Package Services mail accepted at the origin SCF before the day zero... origin before the day-zero Critical Entry Time is 3 days, for each remaining (non-intra-SCF) 3-digit ZIP... intra-Network Distribution Center (NDC) Package Services mail accepted at origin before the day-zero...

  10. A Learning Center Approach to Infant Education.

    ERIC Educational Resources Information Center

    Adams, Polly K.; Taylor, Michaell K.

    Following a prefatory description of infant development and high-quality infant day care centers, this paper focuses on the construction of learning centers for infants and toddlers in day care. Issues for consideration are specified, and 18 different care/learning centers and 6 work sstations for parents/staff are briefly described. In addition…

  11. 1997 News Releases | NREL

    Science.gov Websites

    Continues Day 8 - St. Francis, Kan. to Limon, Color. - (6/26/97) Sunrayce 97 Continues Day 7 - Smith Center to St. Francis - (6/25/97) Sunrayce 97 Continues Day 6 - Manhattan to Smith Center - (6/24/97

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

    Poenkae, A.

    The weekly changes in ambient sulfur dioxide, nitrogen dioxide, and temperature were compared with the figures for respiratory infection in children and adults and for absenteeism from day-care centers (DCC), schools, and workplaces during a 1-year period in Helsinki. The annual average level of sulfur dioxide was 21 micrograms/m3 and of nitrogen dioxide 47 micrograms/m3; the average temperature was +3.1 degrees C. The levels of these pollutants and the temperature were significantly correlated with the number of upper respiratory infections reported from health centers. Low temperature also correlated with increased frequency of acute tonsillitis, of lower respiratory tract infection amongmore » DCC children, and of absenteeism from day-care centers, schools and workplaces. Furthermore, a significant association was found between levels of sulfur dioxide and absenteeism. After statistical standardization for temperature, no other correlations were observed apart from that between high levels of sulfur dioxide and numbers of upper respiratory tract infections diagnosed at health centers (P = 0.04). When the concentrations of sulfur dioxide were above the mean, the frequency of the upper respiratory tract infections was 15% higher than that during the periods of low concentration. The relative importance of the effects of low-level air pollution and low temperature on health is difficult to assess.« less

  13. Enhancing Disaster Management: Development of a Spatial Database of Day Care Centers in the USA

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

    Singh, Nagendra; Tuttle, Mark A.; Bhaduri, Budhendra L.

    Children under the age of five constitute around 7% of the total U.S. population and represent a segment of the population, which is totally dependent on others for day-to-day activities. A significant proportion of this population spends time in some form of day care arrangement while their parents are away from home. Accounting for those children during emergencies is of high priority, which requires a broad understanding of the locations of such day care centers. As concentrations of at risk population, the spatial location of day care centers is critical for any type of emergency preparedness and response (EPR). However,more » until recently, the U.S. emergency preparedness and response community did not have access to a comprehensive spatial database of day care centers at the national scale. This paper describes an approach for the development of the first comprehensive spatial database of day care center locations throughout the USA utilizing a variety of data harvesting techniques to integrate information from widely disparate data sources followed by geolocating for spatial precision. In the context of disaster management, such spatially refined demographic databases hold tremendous potential for improving high resolution population distribution and dynamics models and databases.« less

  14. Enhancing Disaster Management: Development of a Spatial Database of Day Care Centers in the USA

    DOE PAGES

    Singh, Nagendra; Tuttle, Mark A.; Bhaduri, Budhendra L.

    2015-07-30

    Children under the age of five constitute around 7% of the total U.S. population and represent a segment of the population, which is totally dependent on others for day-to-day activities. A significant proportion of this population spends time in some form of day care arrangement while their parents are away from home. Accounting for those children during emergencies is of high priority, which requires a broad understanding of the locations of such day care centers. As concentrations of at risk population, the spatial location of day care centers is critical for any type of emergency preparedness and response (EPR). However,more » until recently, the U.S. emergency preparedness and response community did not have access to a comprehensive spatial database of day care centers at the national scale. This paper describes an approach for the development of the first comprehensive spatial database of day care center locations throughout the USA utilizing a variety of data harvesting techniques to integrate information from widely disparate data sources followed by geolocating for spatial precision. In the context of disaster management, such spatially refined demographic databases hold tremendous potential for improving high resolution population distribution and dynamics models and databases.« less

  15. Storm Prediction Center May 28, 2018 0100 UTC Day 1 Convective Outlook

    Science.gov Websites

    services. Day 2 Outlook > May 28, 2018 0100 UTC Day 1 Convective Outlook Updated: Mon May 28 01:01:01 UTC 2018 (Print Version | 20180528 0100Z Day 1 shapefile | 20180528 0100Z Day 1 KML ) Probabilistic to . Forecast Discussion SPC AC 280101 Day 1 Convective Outlook NWS Storm Prediction Center Norman OK 0801 PM

  16. Resection of a cholangiocarcinoma via laparoscopic hepatopancreato- duodenectomy: A case report

    PubMed Central

    Zhang, Miao-Zun; Xu, Xiao-Wu; Mou, Yi-Ping; Yan, Jia-Fei; Zhu, Yi-Ping; Zhang, Ren-Chao; Zhou, Yu-Cheng; Chen, Ke; Jin, Wei-Wei; Matro, Erik; Ajoodhea, Harsha

    2014-01-01

    Some laterally advanced cholangiocarcinomas behave as ductal spread or local invasion, and hepatopancreatoduodenectomy (HPD) may be performed for R0 resection. To date, there have been no reports of laparoscopic HPD (LHPD) in the English literature. We report the first case of LHPD for the resection of a Bismuth IIIa cholangiocarcinoma invading the duodenum. The patient underwent laparoscopic pancreaticoduodenectomy and right hemihepatectomy. Child’s approach was used for the reconstruction. The patient recovered well with bile leakage from the 2nd postoperative day and was discharged on the 16th postoperative day with a drainage tube in place which was removed 2 wk after discharge. Postoperative pathology revealed a well-differentiated cholangiocarcinoma and the margin of liver parenchyma, pancreas and stomach was negative for metastases. The results suggest that LHPD is a feasible and safe procedure when performed in highly specialized centers and in suitable patients with cholangiocarcinoma. PMID:25493044

  17. The KIzSS network, a sentinel surveillance system for infectious diseases in day care centers: study protocol.

    PubMed

    Enserink, Remko; Noel, Harold; Friesema, Ingrid H M; de Jager, Carolien M; Kooistra-Smid, Anna M D; Kortbeek, Laetitia M; Duizer, Erwin; van der Sande, Marianne A B; Smit, Henriette A; Pelt, Wilfrid van

    2012-10-15

    Day care-associated infectious diseases are widely recognized as a public health problem but rarely studied. Insights into their dynamics and their association with the day care setting are important for effective decision making in management of infectious disease control. This paper describes the purpose, design and potential of our national multi-center, day care-based sentinel surveillance network for infectious diseases (the KIzSS network). The aim of the KIzSS network is to acquire a long-term insight into the syndromic and microbiological aspects of day care-related infectious diseases and associated disease burden and to model these aspects with day care setting characteristics. The KIzSS network applies a prospective cohort design, following day care centers rather than individual children or staff members over time. Data on infectious disease symptoms and related morbidity (children and staff), medical consumption, absenteeism and circulating enteric pathogens (children) are collected on a daily, weekly or monthly basis. Every two years, a survey is performed to assess the characteristics of participating day care centers. The KIzSS network offers a unique potential to study infectious disease dynamics in the day care setting over a sustained period of time. The created (bio)databases will help us to assess day care-related disease burden of infectious diseases among attending children and staff and their relation with the day care setting. This will support the much needed development of evidence-based and pragmatic guidelines for infectious disease control in day care centers.

  18. The KIzSS network, a sentinel surveillance system for infectious diseases in day care centers: study protocol

    PubMed Central

    2012-01-01

    Background Day care-associated infectious diseases are widely recognized as a public health problem but rarely studied. Insights into their dynamics and their association with the day care setting are important for effective decision making in management of infectious disease control. This paper describes the purpose, design and potential of our national multi-center, day care-based sentinel surveillance network for infectious diseases (the KIzSS network). The aim of the KIzSS network is to acquire a long-term insight into the syndromic and microbiological aspects of day care-related infectious diseases and associated disease burden and to model these aspects with day care setting characteristics. Methods/design The KIzSS network applies a prospective cohort design, following day care centers rather than individual children or staff members over time. Data on infectious disease symptoms and related morbidity (children and staff), medical consumption, absenteeism and circulating enteric pathogens (children) are collected on a daily, weekly or monthly basis. Every two years, a survey is performed to assess the characteristics of participating day care centers. Discussion The KIzSS network offers a unique potential to study infectious disease dynamics in the day care setting over a sustained period of time. The created (bio)databases will help us to assess day care-related disease burden of infectious diseases among attending children and staff and their relation with the day care setting. This will support the much needed development of evidence-based and pragmatic guidelines for infectious disease control in day care centers. PMID:23066727

  19. Genomic Comparisons and Shiga Toxin Production among Escherichia coli O157:H7 Isolates from a Day Care Center Outbreak and Sporadic Cases in Southeastern Wisconsin

    PubMed Central

    Gouveia, S.; Proctor, M. E.; Lee, M.-S.; Luchansky, J. B.; Kaspar, C. W.

    1998-01-01

    Contour-clamped homogeneous electric field pulsed-field gel electrophoresis (CHEF-PFGE) was used to compare Wisconsin isolates of Escherichia coli O157:H7, including 39 isolates from a 1994 day care center outbreak, 28 isolates from 18 individuals from the surrounding geographic area with sporadic cases occurring during the 3 months before the outbreak, and 3 isolates, collected in 1995, from patients with hemolytic-uremic syndrome (HUS) who were from eastern Wisconsin counties other than those inhabited by the day care center and sporadic-case individuals. The technique of CHEF-PFGE using XbaI identified seven highly related restriction endonuclease digestion profiles (REDPs) (93 to 98% similarity) among the 39 day care center isolates and nine XbaI REDPs (63 to 93% similarity) among the 28 isolates from sporadic-case individuals, including REDP 33, which was exhibited by both day care and sporadic-case isolates. PFGE analyses of sequential E. coli O157:H7 isolates from symptomatic day care center attendees revealed that the REDPs of 25 isolates from eight patients were indistinguishable whereas the REDPs of 2 of 6 isolates from two patients differed slightly (93 to 95% similarity). The REDPs of the three isolates from 1995 HUS patients were 78 to 83% similar, with REDP 26 being exhibited by one HUS-associated isolate and an isolate from one day care attendee who did not develop HUS. The genes for both Shiga toxins I and II (stx1 and stx2, respectively) were detected in all but one isolate (sporadic case), and Shiga toxin production by the day care center isolates was not significantly different from that of the other isolates, including the three HUS-associated isolates. Analyses of E. coli O157:H7 isolates from both the day care center outbreak and sporadic cases by CHEF-PFGE permitted us to define the REDP variability of an outbreak and geographic region and demonstrated that the day care center outbreak and a HUS case in 1995 were caused by E. coli O157:H7 strains endemic to eastern Wisconsin. PMID:9508303

  20. Day-to-day consistency of lower extremity kinematics during stair ambulation in 24-45 years old athletes.

    PubMed

    Husa-Russell, Johanna; Ukelo, Thomas; List, Renate; Lorenzetti, Silvio; Wolf, Peter

    2011-04-01

    Before making interpretations on the effects of interventions or on the features of pathological gait patterns during stair ambulation, the day-to-day consistency of the investigated variables must be established. In this article, the day-to-day consistency was determined for kinematic variables during barefoot stair ambulation. Ten healthy athletes performed two gait analysis sessions, at least one week apart, utilizing a marker set of 47 skin markers, and a functional joint center/axes determination. Being found on limits of agreement and mean differences between the repeated stair ambulation sessions, totally 43 ranges of motions were examined at the hip, knee, ankle, and midfoot joints. The day-to-day consistency was generally in the magnitude of three degrees, irrespective of test condition, investigated joint, or regarded cardinal body plane. The reported values of the day-to-day consistency provide guidelines to distinguish between pathological and healthy gait patterns, and thresholds to determine minimal effects of interventions during stair ambulation. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Childhood Acute Lymphoblastic Leukemia and Indicators of Early Immune Stimulation: A Childhood Leukemia International Consortium Study

    PubMed Central

    Rudant, Jérémie; Lightfoot, Tracy; Urayama, Kevin Y.; Petridou, Eleni; Dockerty, John D.; Magnani, Corrado; Milne, Elizabeth; Spector, Logan G.; Ashton, Lesley J.; Dessypris, Nikolaos; Kang, Alice Y.; Miller, Margaret; Rondelli, Roberto; Simpson, Jill; Stiakaki, Eftichia; Orsi, Laurent; Roman, Eve; Metayer, Catherine; Infante-Rivard, Claire; Clavel, Jacqueline

    2015-01-01

    The associations between childhood acute lymphoblastic leukemia (ALL) and several proxies of early stimulation of the immune system, that is, day-care center attendance, birth order, maternally reported common infections in infancy, and breastfeeding, were investigated by using data from 11 case-control studies participating in the Childhood Leukemia International Consortium (enrollment period: 1980–2010). The sample included 7,399 ALL cases and 11,181 controls aged 2–14 years. The data were collected by questionnaires administered to the parents. Pooled odds ratios and 95% confidence intervals were estimated by unconditional logistic regression adjusted for age, sex, study, maternal education, and maternal age. Day-care center attendance in the first year of life was associated with a reduced risk of ALL (odds ratio = 0.77, 95% confidence interval: 0.71, 0.84), with a marked inverse trend with earlier age at start (P < 0.0001). An inverse association was also observed with breastfeeding duration of 6 months or more (odds ratio = 0.86, 95% confidence interval: 0.79, 0.94). No significant relationship with a history of common infections in infancy was observed even though the odds ratio was less than 1 for more than 3 infections. The findings of this large pooled analysis reinforce the hypothesis that day-care center attendance in infancy and prolonged breastfeeding are associated with a decreased risk of ALL. PMID:25731888

  2. A National Coordinating Center for Trauma Research

    DTIC Science & Technology

    2016-10-01

    of ketamine during the first three days following injury has a sustained effect on reducing the incidence or severity of Post -Traumatic Stress... design , medical modeling, physical modeling, engineering and system integration. Progress Reported: The subcontract was fully executed on 05...were posted on the NTI website (www.nationaltraumainstitute.org). The goal is to comprehensively disseminate published works to the wider trauma

  3. Improving Motor Skill Development for Toddlers and Preschoolers through Planning and Teacher Involvement.

    ERIC Educational Resources Information Center

    Treme, Cindy Gehron

    This practicum report describes an intervention designed to increase opportunities for children in a day care center and preschool to practice gross motor skills, and to help teachers gain confidence in their ability to foster children's maturation. It was expected that as a result of the intervention, 50 of 70 children would participate in gross…

  4. SOFIA Aircraft Visits NASA Ames, Reporter Package for TWAN/Web

    NASA Image and Video Library

    2011-10-19

    Taking a break from its science mission flights, the Stratospheric Observatory For Infrared Astronomy or SOFIA came to NASA Ames Research Center to offer tours to employees and VIP's alike. For two days, the aircraft was opened up so that dignitaries, members of the media, NASA employees and the general public could take self-guided tours of the aircraft.

  5. Storm Prediction Center Product & Report Archives

    Science.gov Websites

    Current Watches Meso. Discussions Conv. Outlooks Tstm. Outlooks Fire Wx Outlooks XML logo RSS Feeds E-Mail Archived Fire Weather Outlooks To view fire weather outlooks for a previous day, type in the date you wish to retrieve (e.g. 140503 for May 3, 2014). Data available since June 4, 2002. 150101 Retrieve Fire

  6. A Survey of Self-Advocacy Groups for People with Learning Disabilities in an English Region: Part II.

    ERIC Educational Resources Information Center

    McNally, Steve

    2003-01-01

    The second article on a survey of self-advocacy groups for people with learning disabilities in England reports key findings that included the consistency of the issues identified as important and the willingness to engage in research. Key themes were self-advocacy, rights, day service center issues, staffing, personal relationships, complaints,…

  7. A Day at the Shopping Mall: Educational Computing in Action. Techniques.

    ERIC Educational Resources Information Center

    Gray, Robert A.; Gray, Dianne E.

    1988-01-01

    This report relates the experiences of a teacher who conducted a graduate computer education class at a shopping center in Dallas, Texas. The activity asked each member of the class to spend up to 5,000 mythical dollars on a hardware system and appropriate software to facilitate his/her current job performance. Students could "shop" in three…

  8. Employment and Post-Secondary Educational Activities for Young Adults with Autism Spectrum Disorders during the Transition to Adulthood

    ERIC Educational Resources Information Center

    Taylor, Julie Lounds; Seltzer, Marsha Mailick

    2011-01-01

    This report describes the post-high school educational and occupational activities for 66 young adults with autism spectrum disorders who had recently exited the secondary school system. Analyses indicated low rates of employment in the community, with the majority of young adults (56%) spending time in sheltered workshops or day activity centers.…

  9. Michigan Day Care Provider Training Project, Year One: An Evaluation.

    ERIC Educational Resources Information Center

    Kaplan, Melissa G.; And Others

    A Title XX funded statewide training program offering 20 hours of instruction for 1,662 licensed center and home child care providers who served Title XX eligible children in Michigan was evaluated at the end of its first year of operation. The first three chapters of this evaluation report discuss (1) the history, philosophy, and goals of the…

  10. Association of hospice utilization and publicly reported outcomes following hospitalization for pneumonia or heart failure: a retrospective cohort study.

    PubMed

    Lah, Soowhan; Wilson, Emily L; Beesley, Sarah; Sagy, Iftach; Orme, James; Novack, Victor; Brown, Samuel M

    2018-01-09

    The Center for Medicare and Medicaid Services (CMS) and the Hospital Quality Alliance began collecting and reporting United States hospital performance in the treatment of pneumonia and heart failure in 2008. Whether the utilization of hospice might affect CMS-reported mortality and readmission rates is not known. Hospice utilization (mean days on hospice per decedent) for 2012 from the Dartmouth Atlas (a project of the Dartmouth Institute that reports a variety of public health and policy-related statistics) was merged with hospital-level 30-day mortality and readmission rates for pneumonia and heart failure from CMS. The association between hospice use and outcomes was analyzed with multivariate quantile regression controlling for quality of care metrics, acute care bed availability, regional variability and other measures. 2196 hospitals reported data to both CMS and the Dartmouth Atlas in 2012. Higher rates of hospice utilization were associated with lower rates of 30-day mortality and readmission for pneumonia but not for heart failure. Higher quality of care was associated with lower rates of mortality for both pneumonia and heart failure. Greater acute care bed availability was associated with increased readmission rates for both conditions (p < 0.05 for all). Higher rates of hospice utilization were associated with lower rates of 30-day mortality and readmission for pneumonia as reported by CMS. While causality is not established, it is possible that hospice referrals might directly affect CMS outcome metrics. Further clarification of the relationship between hospice referral patterns and publicly reported CMS outcomes appears warranted.

  11. Single Incision Laparoscopic Pancreas Resection for Pancreatic Metastasis of Renal Cell Carcinoma

    PubMed Central

    Sümer, Aziz; Demirel, Tugrul; Karakullukçu, Nazlι; Batman, Burçin; İçscan, Yalιn; Sarιçam, Gülay; Serin, Kürçsat; Loh, Wei-Liang; Dinççağ, Ahmet; Mercan, Selçuk

    2010-01-01

    Background: Transumbilical single incision laparoscopic surgery (SILS) offers excellent cosmetic results and may be associated with decreased postoperative pain, reduced need for analgesia, and thus accelerated recovery. Herein, we report the first transumbilical single incision laparoscopic pancreatectomy case in a patient who had renal cell cancer metastasis on her pancreatic corpus and tail. Methods: A 59-year-old female who had metastatic lesions on her pancreas underwent laparoscopic subtotal pancreatectomy through a 2-cm umbilical incision. Results: Single incision pancreatectomy was performed with a special port (SILS port) and articulated equipment. The procedure lasted 330 minutes. Estimated blood loss was 100mL. No perioperative complications occurred. The patient was discharged on the seventh postoperative day with a low-volume (20mL/day) pancreatic fistula that ceased spontaneously. Pathology result of the specimen was renal cell cancer metastases. Conclusion: This is the first reported SILS pancreatectomy case, demonstrating that even advanced surgical procedures can be performed using the SILS technique in well-experienced centers. Transumbilical single incision laparoscopic pancreatectomy is feasible and can be performed safely in experienced centers. SILS may improve cosmetic results and allow accelerated recovery for patients even with malignancy requiring advanced laparoscopic interventions. PMID:21605524

  12. Single incision laparoscopic pancreas resection for pancreatic metastasis of renal cell carcinoma.

    PubMed

    Barbaros, Umut; Sümer, Aziz; Demirel, Tugrul; Karakullukçu, Nazlı; Batman, Burçin; Içscan, Yalın; Sarıçam, Gülay; Serin, Kürçsat; Loh, Wei-Liang; Dinççağ, Ahmet; Mercan, Selçuk

    2010-01-01

    Transumbilical single incision laparoscopic surgery (SILS) offers excellent cosmetic results and may be associated with decreased postoperative pain, reduced need for analgesia, and thus accelerated recovery. Herein, we report the first transumbilical single incision laparoscopic pancreatectomy case in a patient who had renal cell cancer metastasis on her pancreatic corpus and tail. A 59-year-old female who had metastatic lesions on her pancreas underwent laparoscopic subtotal pancreatectomy through a 2-cm umbilical incision. Single incision pancreatectomy was performed with a special port (SILS port) and articulated equipment. The procedure lasted 330 minutes. Estimated blood loss was 100mL. No perioperative complications occurred. The patient was discharged on the seventh postoperative day with a low-volume (20mL/day) pancreatic fistula that ceased spontaneously. Pathology result of the specimen was renal cell cancer metastases. This is the first reported SILS pancreatectomy case, demonstrating that even advanced surgical procedures can be performed using the SILS technique in well-experienced centers. Transumbilical single incision laparoscopic pancreatectomy is feasible and can be performed safely in experienced centers. SILS may improve cosmetic results and allow accelerated recovery for patients even with malignancy requiring advanced laparoscopic interventions.

  13. Comparing tiltmeters for crustal deformation measurement--a preliminary report.

    PubMed

    Wyatt, F; Bilham, R; Beavan, J; Sylvester, A G; Owen, T; Harvey, A; Macdonald, C; Jackson, D D; Agnew, D C

    1984-10-01

    A collection of high-precision tiltmeters is being operated at Pinon Flat Observatory, southern California, both to compare instruments and to measure tectonic deformation. We report on 1.2 years of data from four of these: two Michelson-Gale long fluid tiltmeters, one long center-pressure tiltmeter, and a shallow borehole tiltmeter. The three long-base instruments are all located on the same baseline, with a precise leveling line running between their end-monuments. At nontidal frequencies, only the two Michelson-Gale instruments show some coherence (gamma 2 = .3 for periods of 2 to 4 days), while the center-pressure instrument is correlated with air temperature at periods from a few days to a few weeks. The most stable tilt record shows a secular rate of 0.28 mu rad/a, which may be real. Over much longer times, leveling to specially stabilized bench-marks should confirm this. Comparing instruments has identified more and less successful measurement techniques; it appears that low-noise data will most probably be produced only by relatively complex and expensive instruments, though even for these, the operating costs over any reasonable lifetime will exceed the capital cost. Even the best existing sensors must be improved to measure continuous tectonic motions.

  14. Efficacy of the Chicago Parent Program with Low-Income African American and Latino Parents of Young Children

    PubMed Central

    Gross, Deborah; Garvey, Christine; Julion, Wrenetha; Fogg, Louis; Tucker, Sharon; Mokros, Hartmut

    2009-01-01

    This study tested the efficacy of a 12-session parent training program, the Chicago Parent Program (CPP), which was developed in collaboration with African American and Latino parents. Using growth curve modeling, data were analyzed from 253 parents (58.9% African American, 32.8% Latino) of 2–4 year old children enrolled in 7 day care centers serving low-income families. Day care centers were matched and randomly assigned to intervention and waiting-list control conditions. At 1-year follow-up, intervention group parents used less corporal punishment and issued fewer commands with their children. Intervention children exhibited fewer behavior problems during observed play and clean-up sessions than controls. Additional group differences were observed when dose was included in the analytic model. Parents who participated in at least 50% of CPP sessions also reported greater improvements in parenting self-efficacy, more consistent discipline, greater warmth, and a decline in child behavior problems when compared to reports from controls. The implications of these results for preventive parent training with low-income African American and Latino parents and the role of intervention dose on parent-child outcomes are discussed. PMID:19067166

  15. CTEPP DATA COLLECTION FORM 05: CHILD DAY CARE CENTER PRE-MONITORING QUESTIONNAIRE

    EPA Science Inventory

    This data collection form is used to identify the potential sources of pollutants at the day care center. The day care teacher is asked questions related to the age of their day care building; age and frequency of cleaning carpets or rugs; types of heating and air conditioning de...

  16. KENNEDY SPACE CENTER, FLA. - Astronaut Barry E. Wilmore (left) and Center Director Jim Kennedy pose for a photo after Wilmore presented Kennedy with a special award for Spaceport Super Safety and Health Day.

    NASA Image and Video Library

    2003-10-15

    KENNEDY SPACE CENTER, FLA. - Astronaut Barry E. Wilmore (left) and Center Director Jim Kennedy pose for a photo after Wilmore presented Kennedy with a special award for Spaceport Super Safety and Health Day.

  17. Creditable Foods Guide for Child Care Centers on the Child Care Food Program.

    ERIC Educational Resources Information Center

    Colorado State Dept. of Health, Denver.

    This manual provides information on creditable and noncreditable foods in child care centers, before-and-after-school centers, family day care homes, and adult day care centers. Creditable foods are foods that may be counted toward meeting the requirements for a reimbursable meal. Foods are determined to be creditable according to guidelines…

  18. Rounding Behavior in the Reporting of Headache Frequency Complicates Headache Chronification Research

    PubMed Central

    Houle, Timothy T.; Turner, Dana P.; Houle, Thomas A.; Smitherman, Todd A.; Martin, Vincent; Penzien, Donald B.; Lipton, Richard B.

    2013-01-01

    Objectives To characterize the extent of measurement error arising from rounding in headache frequency reporting (days per month) in a population sample of headache sufferers. Background When reporting numerical health information, individuals tend to round their estimates. The tendency to round to the nearest 5 days when reporting headache frequency can distort distributions and engender unreliability in frequency estimates in both clinical and research contexts. Methods This secondary analysis of the 2005 American Migraine Prevalence and Prevention study (AMPP) survey characterized the population distribution of 30-day headache frequency among community headache sufferers and determined the extent of numerical rounding (“heaping”) in self-reported data. Headache frequency distributions (days per month) were examined using a simplified version of Wang and Heitjan’s (2008) approach to heaping to estimate the probability that headache sufferers round to a multiple of 5 when providing frequency reports. Multiple imputation was used to estimate a theoretical “true” headache frequency. Results Of the 24,000 surveys, headache frequency data were available for 15,976 respondents diagnosed with migraine (68.6%), probable migraine (8.3%), or episodic tension-type headache (10.0%); the remainder had other headache types. The mean number of headaches days/month was 3.7 (SD = 5.6). Examination of the distribution of headache frequency reports revealed a disproportionate number of responses centered on multiples of 5 days. The odds that headache frequency was rounded to 5 increased by 24% with each one-day increase in headache frequency (OR: 1.24, 95% CI: 1.23 to 1.25), indicating that heaping occurs most commonly at higher headache frequencies. Women were more likely to round than men, and rounding decreased with increasing age and increased with symptoms of depression. Conclusions Because of the coarsening induced by rounding, caution should be used when distinguishing between episodic and chronic headache sufferers using self-reported estimates of headache frequency. Unreliability in frequency estimates is of particular concern among individuals with high-frequency (chronic) headache. Employing shorter recall intervals when assessing headache frequency, preferably using daily diaries, may improve accuracy and allow more precise estimation of chronic migraine onset and remission. PMID:23721238

  19. A Study in Child Care (Case Study from Volume II-A): "Children as 'Kids'." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    O'Farrell, Brigid

    The Georgetown Day Care Center, in Washington, D.C., is dually sponsored by a large hospital and a private non-profit organization and offers day care services to a small number of the children of parents who work at the hospital. The center also functions as a halfway house for children in a diagnostic center which identifies preschool children…

  20. VVV Survey Microlensing Events in the Galactic Center Region

    NASA Astrophysics Data System (ADS)

    Navarro, María Gabriela; Minniti, Dante; Contreras Ramos, Rodrigo

    2017-12-01

    We search for microlensing events in the highly reddened areas surrounding the Galactic center using the near-IR observations with the VISTA Variables in the Vía Láctea Survey (VVV). We report the discovery of 182 new microlensing events, based on observations acquired between 2010 and 2015. We present the color-magnitude diagrams of the microlensing sources for the VVV tiles b332, b333, and b334, which were independently analyzed, and show good qualitative agreement among themselves. We detect an excess of microlensing events in the central tile b333 in comparison with the other two tiles, suggesting that the microlensing optical depth keeps rising all the way to the Galactic center. We derive the Einstein radius crossing time for all of the observed events. The observed event timescales range from t E = 5 to 200 days. The resulting timescale distribution shows a mean timescale of < {t}{{E}}> =30.91 days for the complete sample (N = 182 events), and < {t}{{E}}> =29.93 days if restricted only for the red clump (RC) giant sources (N = 96 RC events). There are 20 long timescale events ({t}{{E}}≥slant 100 days) that suggest the presence of massive lenses (black holes) or disk-disk event. This work demonstrates that the VVV Survey is a powerful tool to detect intermediate/long timescale microlensing events in highly reddened areas, and it enables a number of future applications, from analyzing individual events to computing the statistics for the inner Galactic mass and kinematic distributions, in aid of future ground- and space-based experiments.

  1. Geography and the burden of care in pediatric cancers.

    PubMed

    Fluchel, Mark N; Kirchhoff, Anne C; Bodson, Julia; Sweeney, Carol; Edwards, Sandra L; Ding, Qian; Stoddard, Gregory J; Kinney, Anita Y

    2014-11-01

    Childhood cancers typically require rigorous treatment at specialized centers in urban areas, which can create substantial challenges for families residing in remote communities. We evaluated the impact of residence and travel time on the burden of care for families of childhood cancer patients. We conducted a cross-sectional, self-administered survey of 354 caregivers of pediatric cancer patients at a children's hospital serving a seven state area. Measures included the impact of cancer treatment on relocation, employment, schooling, and finances. We evaluated these domains by rural/urban residence and travel time (>1 hour and >2 hours) to the hospital in multivariable regression models. Of the 29% of caregivers who reported moving residences as their child was diagnosed, 33% reported that the move was due to their child's cancer. Rural and remote (e.g., >1 hour travel time) caregivers missed more days of work during the first month after diagnosis than did urban and local caregivers, however, these differences did not persist over the first 6 months of therapy. One-third of caregivers reported quitting or changing jobs as a direct result of their child being diagnosed with cancer. Rural respondents had greater out-of-pocket travel expenses and reported a significantly greater perceived financial burden. Rural patients missed more school days and were at an increased risk of having to repeat a grade. Childhood cancer has an appreciable impact on the lives of patients and caregivers. The burden is greater for those living far from a treatment center. © 2014 Wiley Periodicals, Inc.

  2. Electronic-cigarette use by individuals in treatment for substance abuse: A survey of 24 treatment centers in the United States.

    PubMed

    Gubner, Noah R; Andrews, K Blakely; Mohammad-Zadeh, Ana; Lisha, Nadra E; Guydish, Joseph

    2016-12-01

    Prevalence and reasons for using electronic cigarettes (e-cigarettes) was examined among patients enrolled in 24 substance abuse treatment centers in the United States (N=1113). Prevalence of e-cigarette use was assessed for the full sample. Bivariate analyses and multivariate logistic regression were used to identify characteristics associated with e-cigarette use among current cigarette smokers (the majority of e-cigarette users). Overall 55.5% of the sample reported lifetime use of e-cigarettes, and 30.5% reported using e-cigarettes in the past 30days (current users). The main reasons for using e-cigarettes were (a) at times/places when smoking was prohibited (53.5%), and (b) as a way to quit/reduce cigarette smoking (50.3%). Daily vs non-daily e-cigarette users were more likely to use e-cigarettes both as a way to reduce health risks, and as a way to quit/reduce cigarette smoking. A majority of e-cigarette users (87.1%) reported dual use of e-cigarettes and tobacco cigarettes during the past month. Among current cigarette smokers, those that also used e-cigarettes smoked more cigarettes per day, were more likely to have made a past year cigarette quit attempt, and to have tried nicotine replacement therapy compared to cigarette only smokers. There was a high rate of dual e-cigarette and cigarette use by persons enrolled in addiction treatment. E-cigarette users may be heavier cigarette smokers trying to quit or reduce their cigarette smoking. However, e-cigarettes were also used at times when individuals could not smoke cigarettes. Substance abuse treatment centers developing tobacco policies need to consider these potentially conflicting reasons for using e-cigarettes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Under-reporting and Poor Adherence to Monitoring Guidelines for Severe Cases of Isoniazid Hepatotoxicity.

    PubMed

    Hayashi, Paul H; Fontana, Robert J; Chalasani, Naga P; Stolz, Andrew A; Talwalkar, Jay A; Navarro, Victor J; Lee, William M; Davern, Timothy J; Kleiner, David E; Gu, Jiezhun; Hoofnagle, Jay H

    2015-09-01

    Isoniazid is a leading cause of liver injury but it is not clear how many cases are reported or how many clinicians and patients adhere to American Thoracic Society (ATS) guidelines. We collected data on cases of isoniazid hepatotoxicity and assessed adherence to ATS guidelines and reports to the Centers for Disease Control's (CDC) isoniazid severe adverse events program. We analyzed Drug-Induced Liver Injury Network (DILIN) cases considered definite, highly likely, or probable for isoniazid injury from 2004 through 2013. We assessed the delays in isoniazid discontinuance according to ATS criteria and hepatotoxicity severity by Severity Index Score. We checked reporting to the CDC by matching cases based on age, latency, indication, reporting period, and comorbidities. Isoniazid was the second most commonly reported agent in the DILIN, with 69 cases; 60 of these met inclusion criteria. The median age of cases was 49 years (range, 4-68 y), 70% were female, 97% had latent tuberculosis, and 62% were hospitalized. Patients took a median of 9 days to stop taking isoniazid (range, 0-99 days). Thirty-three cases (55%) continued taking isoniazid for more than 7 days after the ATS criteria for stopping were met. Twenty-four cases (40%) continued isoniazid for more than 14 days after meeting criteria for stopping. A delay in stopping was associated with more severe injury (P < .05). Of 13 patients who died or underwent liver transplantation, 9 (70%) continued taking isoniazid for more than 7 days after meeting criteria for stopping. Only 1 of 25 cases of isoniazid hepatotoxicity eligible for reporting to the CDC was reported. Poor adherence to ATS guidelines is common in cases of hepatotoxicity and is associated with more severe outcomes including hospitalization, death, and liver transplantation. Isoniazid continues to be a leading cause of DILI in the United States, and its hepatotoxicity is under-reported significantly. Copyright © 2015 AGA Institute. Published by Elsevier Inc. All rights reserved.

  4. Business continuity after catastrophic medical events: the Joplin medical business continuity report.

    PubMed

    Carlton, Paul K; Bringle, Dottie

    2012-01-01

    On May 22, 2011, The St Johns Mercy Medical Center in Joplin, MO, was destroyed by an F-5 tornado. There were 183 patients in the building at that time in this 367-bed Medical Center. The preparation and response were superbly done and resulted in many lives saved. This report is focused on the reconstitution phase of this disaster response, which includes how to restore business continuity. As 95 percent of our medical capacity resides in the private sector in the United States, we must have a proper plan for how to restore business continuity or face the reality of the medical business failing and not providing critical medical services to the community. A tornado in 2007 destroyed a medical center in Sumter County, GA, and it took more than 365 days to restore business continuity at a cost of $18M. The plan executed by the Mercy Medical System after the disaster in Joplin restored business continuity in 88 days and cost a total of $6.6M, with all assets being reusable. The recommendation from these lessons learned is that every county, state, and Federal Emergency Management Agency region has a plan on the shelf to restore business continuity and the means to be able to do so. The hard work that the State of Missouri and the Mercy Medical System did after this disaster can serve as a model for the nation in how to quickly recover from any loss of medical capability.

  5. Effectiveness of Japanese SHARE model in improving Taiwanese healthcare personnel's preference for cancer truth telling.

    PubMed

    Tang, Woung-Ru; Chen, Kuan-Yu; Hsu, Sheng-Hui; Juang, Yeong-Yuh; Chiu, Shin-Che; Hsiao, Shu-Chun; Fujimori, Maiko; Fang, Chun-Kai

    2014-03-01

    Communication skills training (CST) based on the Japanese SHARE model of family-centered truth telling in Asian countries has been adopted in Taiwan. However, its effectiveness in Taiwan has only been preliminarily verified. This study aimed to test the effect of SHARE model-centered CST on Taiwanese healthcare providers' truth-telling preference, to determine the effect size, and to compare the effect of 1-day and 2-day CST programs on participants' truth-telling preference. For this one-group, pretest-posttest study, 10 CST programs were conducted from August 2010 to November 2011 under certified facilitators and with standard patients. Participants (257 healthcare personnel from northern, central, southern, and eastern Taiwan) chose the 1-day (n = 94) or 2-day (n = 163) CST program as convenient. Participants' self-reported truth-telling preference was measured before and immediately after CST programs, with CST program assessment afterward. The CST programs significantly improved healthcare personnel's truth-telling preference (mean pretest and posttest scores ± standard deviation (SD): 263.8 ± 27.0 vs. 281.8 ± 22.9, p < 0.001). The CST programs effected a significant, large (d = 0.91) improvement in overall truth-telling preference and significantly improved method of disclosure, emotional support, and additional information (p < 0.001). Participation in 1-day or 2-day CST programs did not significantly affect participants' truth-telling preference (p > 0.05) except for the setting subscale. Most participants were satisfied with the CST programs (93.8%) and were willing to recommend them to colleagues (98.5%). The SHARE model-centered CST programs significantly improved Taiwanese healthcare personnel's truth-telling preference. Future studies should objectively assess participants' truth-telling preference, for example, by cancer patients, their families, and other medical team personnel and at longer times after CST programs. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Hospital-based, acute care after ambulatory surgery center discharge.

    PubMed

    Fox, Justin P; Vashi, Anita A; Ross, Joseph S; Gross, Cary P

    2014-05-01

    As a measure of quality, ambulatory surgery centers have begun reporting rates of hospital transfer at discharge. This process, however, may underestimate the acute care needs of patients after care. We conducted this study to determine rates and evaluate variation in hospital transfer and hospital-based, acute care within 7 days among patients discharged from ambulatory surgery centers. Using data from the Healthcare Cost and Utilization Project, we identified adult patients who underwent a medical or operative procedure between July 2008 and September 2009 at ambulatory surgery centers in California, Florida, and Nebraska. The primary outcomes were hospital transfer at the time of discharge and hospital-based, acute care (emergency department visits or hospital admissions) within 7-days expressed as the rate per 1,000 discharges. At the ambulatory surgery center level, rates were adjusted for age, sex, and procedure-mix. We studied 3,821,670 patients treated at 1,295 ambulatory surgery centers. At discharge, the hospital transfer rate was 1.1 per 1,000 discharges (95% confidence interval 1.1-1.1). Among patients discharged home, the hospital-based, acute care rate was 31.8 per 1,000 discharges (95% confidence interval 31.6-32.0). Across ambulatory surgery centers, there was little variation in adjusted hospital transfer rates (median = 1.0/1,000 discharges [25th-75th percentile = 1.0-2.0]), whereas substantial variation existed in adjusted, hospital-based, acute care rates (28.0/1,000 [21.0-39.0]). Among adult patients undergoing ambulatory care at surgery centers, hospital transfer at time of discharge from the ambulatory care center is a rare event. In contrast, the rate of need for hospital-based, acute care in the first week afterwards is nearly 30-fold greater, varies across centers, and may be a more meaningful measure for discriminating quality. Published by Mosby, Inc.

  7. Can group-based reassuring information alter low back pain behavior? A cluster-randomized controlled trial

    PubMed Central

    Indahl, Aage; Andersen, Lars L.; Burton, Kim; Hertzum-Larsen, Rasmus

    2017-01-01

    Background Low back pain (LBP) is common in the population and multifactorial in nature, often involving negative consequences. Reassuring information to improve coping is recommended for reducing the negative consequences of LBP. Adding a simple non-threatening explanation for the pain (temporary muscular dysfunction) has been successful at altering beliefs and behavior when delivered with other intervention elements. This study investigates the isolated effect of this specific information on future occupational behavior outcomes when delivered to the workforce. Design A cluster-randomized controlled trial. Methods Publically employed workers (n = 505) from 11 Danish municipality centers were randomized at center-level (cluster) to either intervention (two 1-hour group-based talks at the workplace) or control. The talks provided reassuring information together with a simple non-threatening explanation for LBP—the ‘functional-disturbance’-model. Data collections took place monthly over a 1-year period using text message tracking (SMS). Primary outcomes were self-reported days of cutting down usual activities and work participation. Secondary outcomes were self-reported back beliefs, work ability, number of healthcare visits, bothersomeness, restricted activity, use of pain medication, and sadness/depression. Results There was no between-group difference in the development of LBP during follow-up. Cumulative logistic regression analyses showed no between-group difference on days of cutting down activities, but increased odds for more days of work participation in the intervention group (OR = 1.83 95% CI: 1.08–3.12). Furthermore, the intervention group was more likely to report: higher work ability, reduced visits to healthcare professionals, lower bothersomeness, lower levels of sadness/depression, and positive back beliefs. Conclusion Reassuring information involving a simple non-threatening explanation for LBP significantly increased the odds for days of work participation and higher work ability among workers who went on to experience LBP during the 12-month follow-up. Our results confirm the potential for public-health education for LBP, and add to the discussion of simple versus multidisciplinary interventions. PMID:28346472

  8. Voice Changes in Real Speaking Situations During a Day, With and Without Vocal Loading: Assessing Call Center Operators.

    PubMed

    Ben-David, Boaz M; Icht, Michal

    2016-03-01

    Occupational-related vocal load is an increasing global problem with adverse personal and economic implications. We examined voice changes in real speaking situations during a single day, with and without vocal loading, aiming to identify an objective acoustic index for vocal load over a day. Call center operators (CCOs, n = 27) and age- and gender-matched students (n = 25) were recorded at the beginning and at the end of a day, with (CCOs) and without (students) vocal load. Speaking and reading voice samples were analyzed for fundamental frequency (F0), sound pressure level (SPL), and their variance (F0 coefficient of variation [F0 CV], SPL CV). The impact of lifestyle habits on voice changes was also estimated. The main findings revealed an interaction, with F0 rise at the end of the day for the students but not for the CCOs. We suggest that F0 rise is a typical phenomenon of a day of normal vocal use, whereas vocal loading interferes with this mechanism. In addition, different lifestyle profiles of CCOs and controls were observed, as the CCOs reported higher incidence of dehydrating behaviors (eg, smoking, caffeine). Yet, this profile was not linked with voice changes. In sum, we suggest that F0 rise over a day can potentially serve as an index for typical voice use. Its lack thereof can hint on consequent voice symptoms and complaints. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  9. A Sounding-based Severe Weather Tool to Support Daily Operations at Kennedy Space Center and Cape Canaveral Air Force Station

    NASA Technical Reports Server (NTRS)

    Bauman, William H.; Roeder, William P.

    2014-01-01

    People and property at Kennedy Space Center (KSC) and Cape Canaveral Air Force Station (CCAFS) are at risk when severe weather occurs. Strong winds, hail and tornadoes can injure individuals and cause costly damage to structures if not properly protected. NASA's Launch Services Program and Ground Systems Development and Operations Program and other KSC programs use the daily and weekly severe weather forecasts issued by the 45th Weather Squadron (45 WS) to determine if they need to limit an activity such as working on gantries, or protect property such as a vehicle on a pad. The 45 WS requested the Applied Meteorology Unit (AMU) develop a warm season (May-September) severe weather tool for use in the Meteorological Interactive Data Display System (MIDDS) based on the late morning, 1500 UTC (1100 local time), CCAFS (XMR) sounding. The 45 WS frequently makes decisions to issue a severe weather watch and other severe weather warning support products to NASA and the 45th Space Wing in the late morning, after the 1500 UTC sounding. The results of this work indicate that certain stability indices based on the late morning XMR soundings can depict differences between days with reported severe weather and days with no reported severe weather. The AMU determined a frequency of reported severe weather for the stability indices and implemented an operational tool in MIDDS.

  10. Exposure and Human Health Evaluation of Airborne Pollution ...

    EPA Pesticide Factsheets

    Following the collapse of the World Trade Center towers on September 11, 2001, New York State and Federal agencies initiated numerous air monitoring activities to better understand the ongoing impact of emissions from the disaster. This report focuses on these air measurement data, evaluating them in terms of what is typical for New York City or general urban background and interpreting it with regard to the potential for human health consequences. The report does not evaluate exposures possibly faced by rescue or clean-up workers and briefly discusses past and current indoor monitoring efforts. The analysis in this report supports three general findings: 1) Persons exposed to the extremely high levels of ambient particulate matter and its components during the collapse of the World Trade Center towers and for several hours afterwards were likely to be at risk for immediate acute (and possibly chronic) respiratory and other types (e.g., cardiovascular) of symptoms. 2) The first measurements of some of the contaminants were on September 14, while other contaminants were not measured until September 23. Available data suggest that the concentrations within and near Ground Zero were likely to be highest in the few days following September 11. Because there are only limited data on these critical few days, exposures and potential health impacts cannot be evaluated with certainty for this time period. 3) Except for exposures on September 11 and possibly d

  11. Best Practices and Barriers to Obesity Prevention in Head Start: Differences Between Director and Teacher Perceptions.

    PubMed

    Byrd-Williams, Courtney; Dooley, Erin E; Sharma, Shreela V; Chuang, Ru-Jye; Butte, Nancy; Hoelscher, Deanna M

    2017-12-21

    Practices and barriers to promoting healthy eating and physical activity at Head Start centers may influence children's energy balance behaviors. We examined differences between directors' and teachers' perspectives on best practices and barriers to promoting healthy eating and physical activity in Head Start centers. We conducted a cross-sectional study of directors (n = 23) and teachers (n = 113) at 23 Head Start centers participating in the baseline assessment of the Texas Childhood Obesity Research Demonstration study. Participants completed surveys about practices and barriers to promoting healthy eating and physical activity. Multilevel regression models examined differences between director and teacher responses. More than half of directors and teachers reported meeting most best practices related to nutrition and physical activity; few directors or teachers (<25%) reported conducting physical activity for more than 60 minutes a day, and less than 40% of teachers helped children attend to satiety cues. Significantly more directors than teachers reported meeting 2 nutrition-related best practices: "Teachers rarely eat less healthy foods (especially sweets, salty snacks, and sugary drinks) in front of children" and "Teachers talk to children about trying/enjoying new foods" (P < .05). No barrier to healthy eating or physical activity was reported by more than 25% of directors or teachers. Significantly more teachers than directors reported barriers to healthy eating, citing lack of food service staff support, limited time, and insufficient funds (P < .05). More barriers to healthy eating were reported than were barriers to physical activity indicating that more support may be needed for healthy eating. Differences between responses of directors and teachers may have implications for future assessments of implementation of best practices and barriers to implementation related to nutrition and physical activity in early care and education centers.

  12. 2010 Stennis Day of Service

    NASA Image and Video Library

    2010-01-12

    Employees at NASA's John C. Stennis Space Center visit exhibits of volunteer organizations during their observance of Martin Luther King Jr. Day with a Day of Service on Jan. 12. During the day, Mississippi and Louisiana organizations visited the center to encourage employees to register and serve as volunteers for various community activities. The day's focus was emphasized again and again - great things can happen when individuals work together toward a common goal.

  13. 2010 Stennis Day of Service

    NASA Technical Reports Server (NTRS)

    2010-01-01

    Employees at NASA's John C. Stennis Space Center visit exhibits of volunteer organizations during their observance of Martin Luther King Jr. Day with a Day of Service on Jan. 12. During the day, Mississippi and Louisiana organizations visited the center to encourage employees to register and serve as volunteers for various community activities. The day's focus was emphasized again and again - great things can happen when individuals work together toward a common goal.

  14. 2017 A Day of Remembrance

    NASA Image and Video Library

    2017-01-26

    Following Kennedy Space Center's Day of Remembrance ceremony in the Center for Space Education at the Kennedy visitor complex, guests including astronauts Tom Stafford, left, and Buzz Aldrin, center, gathered to place flowers at the Space Mirror Memorial. Many of those in attendance were family members of the fallen astronauts.

  15. Penny Pettigrew in the Payload Operations Integration Center

    NASA Image and Video Library

    2017-11-09

    Penny Pettigrew chats in real time with a space station crew member conducting an experiment in microgravity some 250 miles overhead. The Payload Operations Integration Center cadre monitor science communications on station 24 hours a day, seven days a week, 365 days per year.

  16. Administrative Services Staff with New Teleticketing Machine

    NASA Image and Video Library

    1968-02-21

    Peggy Heintz, left, receives an airline ticket from supervisor Judy Kuebeler in the Administrative Services Building at the National Aeronautics and Space Administration (NASA) Lewis Research Center. The center had recently purchased a teleticket machine that automatically printed airline tickets as directed by the airline’s computer system. The Administrative Services Branch had 55 staff members performing a variety of roles. They served as telephone operators and set up communications with other centers. They operated the motor pool, handled all travel arrangements, prepared forms and work instructions, and planned offices. The staff was also responsible for records management and storage. It was reported that the staff processed 65 bags of incoming mail per day, which was said to be on par with a city of 15,000 to 20,000 people.

  17. Brazilian daycares: weighing the risks and benefits.

    PubMed

    Marchand, D

    1994-10-01

    The number of day care centers in Brazil has doubled over the last few years; with this increase has come a rise in the numbers of cases of communicable disease, particularly pneumonia (the main cause of child mortality in Brazil). A study by Dr. Walter V.C. da Fonseca states that a day care child is 5 times more likely to contact pneumonia. However, since the income earned by women in Brazil today is necessary to meet basic needs, children must be left at home with relatives or sent to day care. Most of the centers taking in children under 6 years of age are urban; they care for, on average, 125-200 children. These children are usually from low income families who live on the outskirts of cities; free day care is only provided to working mothers. There are 3 social factors involved: the greater number of single-parent families, more households supported solely by the mother, and an economic crisis that has hit the poor particularly hard. Financial and administrative responsibility for these centers varies. The centers provide meals, baths, rest, education (including some special education services), and health care (doctors, dentists, and nurses). Some accept abandoned children, who are cared for until they are adopted. However, new studies indicate that the centers represent the primary risk factor for respiratory illnesses and were, until recently, the principal causes of diarrhea and child mortality. An ongoing comparative study by da Fonseca is analyzing the incidence rates of respiratory and infectious diseases among 400 children attending a nursery in Fortaleza in comparison to those for 400 cared for at home by family. Doctor Aluiso Barros, in another study, is observing 1000 children in 40 nurseries in Campinas. For 8 weeks, data was collected on the health, socioeconomic situation, medical history, and family medical history of each child. The nurseries were examined and information was collected regarding the number of diseases reported each month, their causes, possible associations with services provided, and possibilities of transmission. Dr. Barros' research is supported by IDRC; Dr. da Fonseca's is supported by the British Overseas Development Agency.

  18. Emetogenicity-risk procedures in same day surgery center of an academic university hospital in United States: a retrospective cost-audit of postoperative nausea vomiting management.

    PubMed

    Gupta, Deepak; Haber, Halim

    2014-06-01

    Despite the variable results of published studies, it is imperative for ambulatory surgery centers to self-audit local cost-implications for post-operative nausea and vomiting (PONV) management. Our retrospective cost-audit assessed if there were comparative peri-anesthesia care cost-trends among patients who had undergone Low-Emetogenicity-Risk Procedures (LERP), Moderate-Emetogenicity-Risk Procedures (MERP) and Severe-Emetogenicity-Risk Procedures (SERP). This study was a review of Same Day Surgery Center practices in an academic university hospital setting during a three-year period (2010-2012). The patient lists were accessed from CIS and CITRIX App Bar for time audit and OR (operating room) schedule reports. Subsequently, OR pharmacy department ran a search for peri-operative anti-emetics and opioids that were billed for the patients at Same Day Surgery Center for the review period. The primary outcomes were the comparative costs/charges of these medications and comparative durations/ charges for these patients' stay in the post-anesthesia care unit (PACU). Secondary outcomes analyzed in the study included peri-anesthesia durations. A total of 8,657 patient records were analyzed. Almost all analyzed variables revealed statistically significant inter-variable positive correlations. The patients' age was significantly (P < 0.001) different among LERP/MERP/SERP patients (LERP: 48.8 +/- 14.7 years; MERP: 61.8 +/- 14.6 years; SERP: 51.3 +/- 14.5 years). In regards to primary and secondary outcomes, the statistical significant differences among LERP/MERP/SERP patients (after correcting for both patients' age as well as patients' sex) were only achieved for preoperative times (P = 0.002; Power = 0.9), operating room recovery times (P = 0.003; Power = 0.9), PACU stay times (P < 0.001; Power = 1.0), and PACU charges (P < 0.001; Power = 1.0). PACU stay times and PACU charges were significantly higher in patients who had undergone SERP as compared to patients who had undergone LERP or MERP at our Same Day Surgery Center.

  19. Online reporting of adverse drug reactions: a study from a French regional pharmacovigilance center.

    PubMed

    Abadie, Delphine; Chebane, Leyla; Bert, Max; Durrieu, Geneviève; Montastruc, Jean-Louis

    2014-01-01

    In France, online reporting via a website is a new method for notifying adverse drug reactions (ADRs). The French Midi-Pyrénées Regional Pharmacovigilance Center (RPVC) set up in July, 2010 a Web-based ADR reporting tool in order to improve ADR reporting rate. To assess feasibility, use and performances of this new ADR reporting system. To evaluate the main characteristics of these online reports. In a retrospective study, we evaluated characteristics (numbers, ADR reporting and file processing times, type of reporters, suspected drugs, "seriousness" and nature of ADRs) of online notifications reported to the RPVC between July 7(th), 2010 (first online notification) and December 31(th), 2011. We performed comparisons to a random sample of "conventional" notifications, i.e. spontaneously reported to the RPVC via traditional tools (post, fax, e-mail or telephone) during the same period. The total number of online reports was 312 over the 18-month period. There was a 45% increase in numbers of reports from ambulatory healthcare professionals after the implementation of the new reporting tool. Online reports were transmitted to the French Medicine Agency on average almost one month (26 days) earlier than "conventional" ones. This difference was mainly due to a faster ADR notification process via the online form (on average, the reporting period was decreased by 19 days with the new tool). In comparison to "conventional" notifications, online reports came more often from ambulatory healthcare professionals, and involved more frequently neuropsychiatric drugs and neuropsychiatric ADRs. None difference was observed for "seriousness" of ADRs. It is feasible to deploy an online ADR reporting system used by health professionals in current practice. We underline the efficiency of this new online reporting tool for increasing ADRs reporting. Moreover, this is the first published study demonstrating that an online reporting tool can help to save time on the ADR reporting period and file processing, which is essential to generate early safety signals. © 2014 Société Française de Pharmacologie et de Thérapeutique.

  20. Leptin increases growth of primary ossification centers in fetal mice

    PubMed Central

    Bertoni, Laura; Ferretti, Marzia; Cavani, Francesco; Zavatti, Manuela; Resca, Elisa; Benelli, Augusta; Palumbo, Carla

    2009-01-01

    The effect of peripheral leptin on fetal primary ossification centers during the early phases of bone histogenesis was investigated by administration of leptin to pregnant mice. Fourteen pregnant mice were divided into two groups. The treated pregnant group was subcutaneously injected in the intrascapular region with supraphysiologic doses (2 mg kg−1) of leptin (Vinci Biochem, Firenze, Italy) in a volume of 0.1 mL per 10 g body weight, at the 7th, 9th and 11th day of gestation. The control group was treated with physiological solution in the same manner and same times as the treated group. The new-born mice were killed 1 day after birth and the primary ossification centers were stained with Alizarin Red S after diaphanizing the soft tissues in 1% potassium hydroxide. The development of both endochondral and intramembranous ossification centers was morphometrically analysed in long bones. The results showed that the ossification centers of mice born by mothers treated with leptin grow more rapidly in both length and cross-sectional area compared with mice born by the untreated mothers. As the development of long bones depends on endochondral ossification occurring at proximal and distal epiphyseal plates as well as on intramembranous ossification along the periosteal surface, it appears that leptin activates the differentiation and proliferation of both chondrocytes and osteoblasts. The role of leptin as a growth factor of cartilage and bone is discussed in the light of the data reported in the literature. PMID:19682137

  1. Improving the Implementation of Evidence-Based Clinical Practices in Adolescent Reproductive Health Care Services

    PubMed Central

    Romero, Lisa M.; Middleton, Dawn; Mueller, Trisha; Avellino, Lia; Hallum-Montes, Rachel

    2015-01-01

    Purpose The purposes of the study were to describe baseline data in the implementation of evidence-based clinical practices among health center partners as part of a community-wide teen pregnancy prevention initiative and to identify opportunities for health center improvement. Methods Health center partner baseline data were collected in the first year (2011) and before program implementation of a 5-year community-wide teen pregnancy prevention initiative. A needs assessment on health center capacity and implementation of evidence-based clinical practices was administered with 51 health centers partners in 10 communities in the United States with high rates of teen pregnancy. Results Health centers reported inconsistent implementation of evidence-based clinical practices in providing reproductive health services to adolescents. Approximately 94.1% offered same-day appointments, 91.1% had infrastructure to reduce cost barriers, 90.2% offered after-school appointments, and 80.4% prescribed hormonal contraception without prerequisite examinations or testing. Approximately three quarters provided visual and audio privacy in examination rooms (76.5%) and counseling areas (74.5%). Fewer offered a wide range of contraceptive methods (67.8%) and took a sexual health history at every visit (54.9%). Only 45.1% reported Quick Start initiation of hormonal contraception, emergency contraception (43.1%), or intrauterine devices (12.5%) were “always” available to adolescents. Conclusions The assessment highlighted opportunities for health center improvement. Strategies to build capacity of health center partners to implement evidence-based clinical practices may lead to accessibility and quality of reproductive health services for adolescents in the funded communities. PMID:26381918

  2. Analysis of Macular and Retinal Nerve Fiber Layer Thickness in Children with Refractory Amblyopia after Femtosecond Laser-assisted Laser In situ Keratomileusis: A Retrospective Study.

    PubMed

    Zhao, Peng-Fei; Zhou, Yue-Hua; Zhang, Jing; Wei, Wen-Bin

    2017-09-20

    Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK). In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0-6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis. One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups. No significant difference was found 3 days or 1 week after surgery (P > 0.05). In all three groups, no significant difference was found in the macular inner retinal or peripapillary RNFL thickness 1 day, 3 days, or 1 week after surgery (P > 0.05). The foveal center retinal edema after FS-LASIK is mild and reversible in children, that mostly occurred in the high myopic group with no effect on the visual acuity, and is always relieved within 1 week.

  3. 2017 A Day of Remembrance

    NASA Image and Video Library

    2017-01-26

    Apollo launch team member John Tribe addresses guests at Kennedy Space Center's Day of Remembrance ceremony. Held this year in the Center for Space Education at the Kennedy Space Center Visitor Complex in Florida, the annual event honors the contributions of all astronauts who lost their lives in the quest for space exploration.

  4. Positive Education Program's Day Treatment Centers

    ERIC Educational Resources Information Center

    Fecser, Frank A.

    2003-01-01

    The Positive Education Program in Cleveland, Ohio, is grounded in the Re-EDucation philosophy and serves more than 700 students with emotional and behavioral disorders in eight day treatment centers. The centers blend special education with mental health in a school environment in which students and families are both supported and challenged as…

  5. Student-Centered Coaching: The Moves

    ERIC Educational Resources Information Center

    Sweeney, Diane; Harris, Leanna S.

    2017-01-01

    Student-centered coaching is a highly-effective, evidence-based coaching model that shifts the focus from "fixing" teachers to collaborating with them to design instruction that targets student outcomes. But what does this look like in practice? "Student-Centered Coaching: The Moves" shows you the day-to-day coaching moves that…

  6. The first clinical liver transplantation of Brazil revisited.

    PubMed

    Bacchella, T; Machado, M C C

    2004-05-01

    The first clinical orthotopic liver transplantation in Brazil was performed on August 5, 1968. The patient was awake after surgery and died on the seventh postoperative day due to subdural hematoma, bronchopneumonia, renal failure, and graft rejection. The report of this case is important to understand the evolution of clinical liver transplantation in Brazil, where this procedure is now routinely carried out in many medical centers.

  7. Perforated Solitary Diverticulitis of the Ascending Colon

    DTIC Science & Technology

    2005-06-01

    postoperative day 6. DISCUSSION Diverticuli of the right colon exist in approximately 1% to 5% of patients with diverticular disease .1-3 They are...ORIGINAL REPORTS Perforated Solitary Diverticulitis of the Ascending Colon CPT David S. Kauvar, MC, USA, MAJ, Jayson Aydelotte, MC, USA, and MAJ...Michael Harnisch, MC, USA Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas KEY WORDS: solitary colon diverticulum

  8. [NASA Johnson Space Center Co-Op Student Experience Report

    NASA Technical Reports Server (NTRS)

    Judge, David

    2011-01-01

    My primary task on my first tour at JSC was to assist my mentor, Sheikh Ahsan, with a research study he is conducting on aluminum wire. While assisting my mentor with the aluminum wire study, I've also had an opportunity to complete work for other projects including the In-Situ Resource Utilization (ISRU) Project and an Electrolysis Project for Innovation Day at JSC.

  9. CTEPP NC DATA CHILD DAY CARE CENTER WEEKLY MENUS

    EPA Science Inventory

    This data set contains information on the weekly day care menus. The day care centers provided menus up to three months prior to field sampling.

    The Children’s Total Exposure to Persistent Pesticides and Other Persistent Pollutant (CTEPP) study was one of the largest aggregate...

  10. Implications of the Trauma Quality Improvement Project inclusion of nonsurvivable injuries in performance benchmarking.

    PubMed

    Heaney, Jiselle Bock; Schroll, Rebecca; Turney, Jennifer; Stuke, Lance; Marr, Alan B; Greiffenstein, Patrick; Robledo, Rosemarie; Theriot, Amanda; Duchesne, Juan; Hunt, John

    2017-10-01

    The Trauma Quality Improvement Project (TQIP) uses an injury prediction model for performance benchmarking. We hypothesize that at a Level I high-volume penetrating trauma center, performance outcomes will be biased due to inclusion of patients with nonsurvivable injuries. Retrospective chart review was conducted for all patients included in the institutional TQIP analysis from 2013 to 2014 with length of stay (LOS) less than 1 day to determine survivability of the injuries. Observed (O)/expected (E) mortality ratios were calculated before and after exclusion of these patients. Completeness of data reported to TQIP was examined. Eight hundred twenty-six patients were reported to TQIP including 119 deaths. Nonsurvivable injuries accounted 90.9% of the deaths in patients with an LOS of 1 day or less. The O/E mortality ratio for all patients was 1.061, and the O/E ratio after excluding all patients with LOS less than 1 day found to have nonsurvivable injuries was 0.895. Data for key variables were missing in 63.3% of patients who died in the emergency department, 50% of those taken to the operating room and 0% of those admitted to the intensive care unit. Charts for patients who died with LOS less than 1 day were significantly more likely than those who lived to be missing crucial. This study shows TQIP inclusion of patients with nonsurvivable injuries biases outcomes at an urban trauma center. Missing data results in imputation of values, increasing inaccuracy. Further investigation is needed to determine if these findings exist at other institutions, and whether the current TQIP model needs revision to accurately identify and exclude patients with nonsurvivable injuries. Prognostic and epidemiological, level III.

  11. Elder self-neglect is associated with an increased rate of 30-day hospital readmission: findings from the Chicago Health and Aging Project.

    PubMed

    Dong, XinQi; Simon, Melissa A

    2015-01-01

    Elder self-neglect is associated with increased morbidity and mortality. The objective of this study is to examine the prospective relationship between reported elder self-neglect and the rate of 30-day hospital readmission in a community population. We conducted a prospective population-based study of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 7,219 participants in the Chicago Health and Aging Project, a subset of 1,228 participants was reported to the social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to the social services agency. The outcome of interest was the annual rate of 30-day hospital readmission calculated from the Center for Medicare and Medicaid System hospitalization data from 1993 to 2009. Poisson regression models were used to assess these relationships. The average annual rate of 30-day hospital readmission for those without elder self-neglect was 0.2 (SD 0.7) and for those with reported elder self-neglect 0.9 (SD 2.8). After adjusting for sociodemographic and socioeconomic characteristics, medical comorbidities, cognitive function, physical function, and psychosocial well-being, elders who self-neglect had a significantly higher rate of 30-day hospital readmission (rate ratio 2.50, 95% confidence interval 2.02-3.10). Greater self-neglect severity [mild: parameter estimate (PE) 1.09, standard error (SE) 0.19, p < 0.001; moderate: PE 0.84, SE 0.13, p < 0.001; severe: PE 1.24, SE 0.40, p = 0.002] was associated with increased annual rates of 30-day hospital readmission after considering the same confounders. Interaction term analyses suggest that the significant relationship between self-neglect and 30-day hospital readmission was not moderated by medical conditions, cognitive impairment, physical disability, or psychosocial well-being. Reported elder self-neglect was associated with increased rates of 30-day hospital readmission in this community population. Greater self-neglect severity was associated with a greater increase in the rate of 30-day hospital readmission. © 2014 S. Karger AG, Basel.

  12. Pre- to Post-operative Changes in Physical Activity: Report from the Longitudinal Assessment of Bariatric Surgery-2

    PubMed Central

    King, Wendy C; Hsu, Jesse Y; Belle, Steven H; Courcoulas, Anita P; Eid, George M; Flum, David R; Mitchell, James E; Pender, John R; Smith, Mark D; Steffen, Kristine J; Wolfe, Bruce M

    2011-01-01

    Background Numerous studies report that bariatric surgery patients report more physical activity (PA) after surgery than before, but the quality of PA assessment has been questionable. Methods The Longitudinal Assessment of Bariatric Surgery-2 is a 10-center longitudinal study of adults undergoing bariatric surgery. Of 2458 participants, 455 were given an activity monitor, which records steps/minute, and an exercise diary before and 1 year after surgery. Mean step/day, active minutes/day, and high-cadence minutes/week were calculated for 310 participants who wore the monitor at least 10 hours/day for at least 3 days at both time points. Pre- and post-surgery PA were compared for differences using the Wilcoxon signed-rank test. Generalized Estimating Equations identified independent pre-operative predictors of post-operative PA. Results PA increased significantly (p<.0001) pre- to post-operative for all PA measures. Median values pre- and post-operative were: 7563 and 8788 steps/day; 309 and 340 active minutes/day; and 72 and 112 high-cadence minutes/week, respectively. However, depending on the PA measure, 24–29% of participants were at least 5% less active post-operative than pre-operative. Controlling for surgical procedure, sex, age and BMI, higher PA preoperative independently predicted higher PA post-operative (p<.0001, all PA measures). Less pain, not having asthma and self-report of increasing PA as a weight loss strategy pre-operative also independently predicted more high-cadence minutes/week post-operative (p<.05). Conclusion The majority of adults increase their PA level following bariatric surgery. However, most remain insufficiently active and some become less active. Increasing PA, addressing pain and treating asthma prior to surgery may have a positive impact on post-operative PA. PMID:21944951

  13. Planetary Protection Knowledge Gaps for Human Extraterrestrial Missions: Workshop Report

    NASA Technical Reports Server (NTRS)

    Race, Margaret S. (Editor); Johnson, James E. (Editor); Spry, James A. (Editor); Siegel, Bette; Conley, Catharine A.

    2015-01-01

    This report on Planetary Protection Knowledge Gaps for Human Extraterrestrial Missions summarizes the presentations, deliberations and findings of a workshop at NASA Ames Research Center, March 24-26, 2015, which was attended by more than 100 participants representing a diverse mix of science, engineering, technology, and policy areas. The main objective of the three-day workshop was to identify specific knowledge gaps that need to be addressed to make incremental progress towards the development of NASA Procedural Requirements (NPRs) for Planetary Protection during human missions to Mars.

  14. KENNEDY SPACE CENTER, FLA. - Center Director Jim Kennedy (center) shares the kudos for Spaceport Super Safety and Health Day with members of the coordinating committee. Astronaut Barry E. Wilmore (at right) presented the award to Kennedy. Next to Wilmore at right is Dr. Woodrow Whitlow, KSC’s deputy director.

    NASA Image and Video Library

    2003-10-15

    KENNEDY SPACE CENTER, FLA. - Center Director Jim Kennedy (center) shares the kudos for Spaceport Super Safety and Health Day with members of the coordinating committee. Astronaut Barry E. Wilmore (at right) presented the award to Kennedy. Next to Wilmore at right is Dr. Woodrow Whitlow, KSC’s deputy director.

  15. Molluscum Contagiosum

    MedlinePlus

    ... pit in the center. Molluscum Contagiosum in Special Environments Swimming Pools Day Care Centers and Schools At ... Risk Factors Treatment Prevention Long-Term Effects Special Environments Swimming Pools Swimming Pool Safety Recommendations Day Care ...

  16. CTEPP-OH DATA CHILD DAY CARE CENTER WEEKLY MENUS

    EPA Science Inventory

    This data set contains information on the weekly day care menus for CTEPP-OH. The day care centers provided menus up to three months prior to field sampling.

    The Children’s Total Exposure to Persistent Pesticides and Other Persistent Pollutant (CTEPP) study was one of the larg...

  17. Results From the Bipartisan Policy Center's CEO Council Physical Activity Challenge to American Business

    PubMed Central

    Berko, Jeff; Goetzel, Ron Z.; Roemer, Enid Chung; Kent, Karen; Marchibroda, Janet

    2016-01-01

    Objective: The aim of this study was to describe findings from a survey of employees at 10 businesses participating in the “Building Better Health: Physical Activity Challenge,” an effort led by the Bipartisan Policy Center's CEO Council on Health and Innovation. Methods: Employers provided employees with pedometers as part of an 8-week Physical Activity Challenge (Challenge). Employees were then asked to complete a survey about their awareness of, participation in, and satisfaction with the Challenge. Results: One hundred three thousand three hundred eighty-three employees participated in the Challenge, averaging 6886 steps per day per participant. Of the 3820 respondents to an employee survey sent to all workers, 62% reported enrolling in the program, and of those, the majority reported positive impacts on health (76%), fitness (73%), and lifestyle (70%). Conclusion: A brief, workplace-based physical activity challenge can achieve positive self-reported health impacts when supported by senior management of the company. PMID:27930485

  18. Return to work following robot-assisted laparoscopic and open retropubic radical prostatectomy: A single-center cohort study to compare duration of sick leave.

    PubMed

    von Mechow, Stefanie; Graefen, Markus; Haese, Alexander; Tennstedt, Pierre; Pehrke, Dirk; Friedersdorff, Frank; Beyer, Burkhard

    2018-06-01

    To compare the duration of sick leave in patients with localized prostate cancer after robot-assisted radical prostatectomy (RARP) and open retropubic RP (ORP) at a German high-volume prostate cancer center. The data of 1,415 patients treated with RP at Martini Klinik, Prostate Cancer Center between 2012 and 2016 were, retrospectively, analyzed. Information on employment status, monthly revenues and days of work missed due to sickness were assessed via online questionnaire. Additional data were retrieved from our institutional database. Medians and interquartile ranges (IQR) were reported for continuous data. Cox proportional hazard analysis was performed to compare both surgical techniques for return to work time after RP. Median time elapsed between surgery and return to work comprised 42 days in patients undergoing RARP (IQR: 21-70) and ORP (IQR: 28-84, P = 0.05). In Cox regression analysis, surgical approach showed no impact on return to work time (RARP vs. ORP hazard ratio = 1, 95% CI: 0.91-1.16, P = 0.69). Return to work time was significantly associated with employment status, physical workload and monthly income (all P<0.001). Limitation of this study is the nonrandomized design in a single-center. As the surgical approach did not show any influence on the number of days missed from work in patients undergoing RP, no superiority of either RARP or ORP could be identified for return to work time in a German cohort. Both surgical approaches are safe options usually allowing the patients to resume normal activities including work after an appropriate convalescence period. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Prevalence and Impact of Work-Related Musculoskeletal Disorders on Job Performance of Call Center Operators in Nigeria.

    PubMed

    Odebiyi, D O; Akanle, O T; Akinbo, S Ra; Balogun, S A

    2016-04-01

    Work-related musculoskeletal disorders (WMSDs) have been documented among various occupational groups in Nigeria. However, there is limited data on the prevalence of WMSDs among call center operators (CCOs). To determine the prevalence of WMSDs among CCOs in Nigeria and to explore the extent to which these discomforts impact the daily work activities of the respondents. 374 respondents who were randomly selected from 4 telecommunication companies in Lagos State, Nigeria, participated in this study. They were asked to complete a pre-tested questionnaire designed to capture the prevalence, impact and associated risk factors of WMSDs among CCOs. 42% and 65.2% of respondents experienced at least one WMSDs in the past 7 days, and 12 months, respectively. Women and CCOs who received calls with hand-held phones rather than headsets reported more discomforts during both 7 days and 12 months periods. Neck, shoulder, upper back, and lower back were the most affected areas during past 7 days and 12 months. Discomforts in the neck, low back, and knees prevented most of the respondents from performing their daily work. WMSDs have a serious impact on the daily job activities of the CCOs in Nigeria.

  20. Accuracy of self-reported length of coma and posttraumatic amnesia in persons with medically verified traumatic brain injury.

    PubMed

    Sherer, Mark; Sander, Angelle M; Maestas, Kacey Little; Pastorek, Nicholas J; Nick, Todd G; Li, Jingyun

    2015-04-01

    To determine the accuracy of self-reported length of coma and posttraumatic amnesia (PTA) in persons with medically verified traumatic brain injury (TBI) and to investigate factors that affect self-report of length of coma and PTA duration. Prospective cohort study. Specialized rehabilitation center with inpatient and outpatient programs. Persons (N=242) with medically verified TBI who were identified from a registry of persons who had previously participated in TBI-related research. Not applicable. Self-reported length of coma and self-reported PTA duration. Review of medical records revealed that the mean medically documented length of coma and PTA duration was 6.9±12 and 19.2±22 days, respectively, and the mean self-reported length of coma and PTA duration was 16.7±22 and 106±194 days, respectively. The average discrepancy between self-report and medical record for length of coma and PTA duration was 8.2±21 and 64±176 days, respectively. Multivariable regression models revealed that time since injury, performance on cognitive tests, and medical record values were associated with self-reported values for both length of coma and PTA duration. In this investigation, persons with medically verified TBI showed poor accuracy in their self-report of length of coma and PTA duration. Discrepancies were large enough to affect injury severity classification. Caution should be exercised when considering self-report of length of coma and PTA duration. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. The Detection of a Striking Increase in the Microwave Emission from Jupiter's Radiation Belts in June and July 2003.

    NASA Astrophysics Data System (ADS)

    Klein, M. J.; Bolton, S. J.; Levin, S. M.; Mac Laren, D.

    2004-12-01

    Synchrotron emission from energetic electrons in Jupiter's radiation belts has been routinely measured by ground-based radio telescopes for three decades. The NASA-JPL Jupiter Patrol, using NASA's Deep Space Network (DSN) antennas at Goldstone, CA., has reported significant (5 %-to-30 %) variations in Jupiter's flux density near 13-cm wavelength with timescales from a few days to several months. In this paper we report observations of an unusually sudden increase in flux density from 3.8 to 4.3 Jy that occurred between 20 June and 15 July 2003. The rate of increase (approximately 0.6 percent per day) is the steepest increase that we have detected with the exception of the increase in 1994 following the impacts of fragments from comet Shoemaker-Levy 9. More than half of the reported observations were conducted by middle- and high school students from classrooms across the nation. The students and their teachers are participants in the Goldstone-Apple Valley Radio Telescope (GAVRT) science education project, which is a partnership involving NASA, the Jet Propulsion Laboratory and the Lewis Center for Educational Research (LCER) in Apple Valley, CA. Working with the Lewis Center over the Internet, GAVRT students conduct remotely controlled radio astronomy observations using 34-m antennas at Goldstone. We also report preliminary results from a special GAVRT observing campaign conducted in the fall of 2003 before, during and after the controlled impact of the Galileo spacecraft into the Jovian atmosphere. Simultaneous observations were made at 3.5 and 13 cm wavelengths three-to-four days per week. These data are being incorporated into synchrotron emission studies of the state of the radiation belts during the last weeks of the Galileo mission. The JPL contribution to this paper was performed at the Jet Propulsion Laboratory, California Institute of Technology, under contract with the National Aeronautics and Space Administration.

  2. Child voice and noise: a pilot study of noise in day cares and the effects on 10 children's voice quality according to perceptual evaluation.

    PubMed

    McAllister, Anita M; Granqvist, Svante; Sjölander, Peta; Sundberg, Johan

    2009-09-01

    The purpose of this investigation was to study children's exposure to background noise at the ears during a normal day at the day care center and also to relate this to a perceptual evaluation of voice quality. Ten children, from three day care centers, with no history of hearing and speech problems or frequent infections were selected as subjects. A binaural recording technique was used with two microphones placed on both sides of the subject's head, at equal distance from the mouth. A portable digital audio tape (DAT) recorder (Sony TCD-D 100, Stockholm, Sweden) was attached to the subject's waist. Three recordings were made for each child during the day. Each recording was calibrated and started with three repetitions of three sentences containing only sonorants. The recording technique allowed separate analyses of the background noise level and of the sound pressure level (SPL) of each subjects' own voice. Results showed a mean background noise level for the three day care centers at 82.6dBA Leq, ranging from 81.5 to 83.6dBA Leq. Day care center no. 2 had the highest mean value and also the highest value at any separate recording session with a mean background noise level of 85.4dBA Leq during the noontime recordings. Perceptual evaluation showed that the children attending this day care center also received higher values on the following voice characteristics: hoarseness, breathiness, and hyperfunction. Girls increased their loudness level during the day, whereas for boys no such change could be observed.

  3. 2010 Stennis Day of Service

    NASA Image and Video Library

    2010-01-12

    Rich Delgado, commanding officer of the Fleet Survey Team located at NASA's John C. Stennis Space Center, visits with Kertrina Watson Lewis, executive director of the HandsOn volunteer organization in New Orleans, during Day of Service activities Jan. 12. The Day of Service was part of the annual Martin Luther King Jr. Day observance at Stennis. During the day, Mississippi and Louisiana organizations visited the center to encourage employees to register and serve as volunteers for various community activities.

  4. 2010 Stennis Day of Service

    NASA Technical Reports Server (NTRS)

    2010-01-01

    Rich Delgado, commanding officer of the Fleet Survey Team located at NASA's John C. Stennis Space Center, visits with Kertrina Watson Lewis, executive director of the HandsOn volunteer organization in New Orleans, during Day of Service activities Jan. 12. The Day of Service was part of the annual Martin Luther King Jr. Day observance at Stennis. During the day, Mississippi and Louisiana organizations visited the center to encourage employees to register and serve as volunteers for various community activities.

  5. Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial.

    PubMed

    Bakitas, Marie A; Tosteson, Tor D; Li, Zhigang; Lyons, Kathleen D; Hull, Jay G; Li, Zhongze; Dionne-Odom, J Nicholas; Frost, Jennifer; Dragnev, Konstantin H; Hegel, Mark T; Azuero, Andres; Ahles, Tim A

    2015-05-01

    Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use. Between October 2010 and March 2013, 207 patients with advanced cancer at a National Cancer Institute cancer center, a Veterans Affairs Medical Center, and community outreach clinics were randomly assigned to receive an in-person PC consultation, structured PC telehealth nurse coaching sessions (once per week for six sessions), and monthly follow-up either early after enrollment or 3 months later. Outcomes were QOL, symptom impact, mood, 1-year survival, and resource use (hospital/intensive care unit days, emergency room visits, chemotherapy in last 14 days, and death location). Overall patient-reported outcomes were not statistically significant after enrollment (QOL, P = .34; symptom impact, P = .09; mood, P = .33) or before death (QOL, P = .73; symptom impact, P = .30; mood, P = .82). Kaplan-Meier 1-year survival rates were 63% in the early group and 48% in the delayed group (difference, 15%; P = .038). Relative rates of early to delayed decedents' resource use were similar for hospital days (0.73; 95% CI, 0.41 to 1.27; P = .26), intensive care unit days (0.68; 95% CI, 0.23 to 2.02; P = .49), emergency room visits (0.73; 95% CI, 0.45 to 1.19; P = .21), chemotherapy in last 14 days (1.57; 95% CI, 0.37 to 6.7; P = .27), and home death (27 [54%] v 28 [47%]; P = .60). Early-entry participants' patient-reported outcomes and resource use were not statistically different; however, their survival 1-year after enrollment was improved compared with those who began 3 months later. Understanding the complex mechanisms whereby PC may improve survival remains an important research priority. © 2015 by American Society of Clinical Oncology.

  6. Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial

    PubMed Central

    Bakitas, Marie A.; Tosteson, Tor D.; Li, Zhigang; Lyons, Kathleen D.; Hull, Jay G.; Li, Zhongze; Dionne-Odom, J. Nicholas; Frost, Jennifer; Dragnev, Konstantin H.; Hegel, Mark T.; Azuero, Andres; Ahles, Tim A.

    2015-01-01

    Purpose Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use. Patients and Methods Between October 2010 and March 2013, 207 patients with advanced cancer at a National Cancer Institute cancer center, a Veterans Affairs Medical Center, and community outreach clinics were randomly assigned to receive an in-person PC consultation, structured PC telehealth nurse coaching sessions (once per week for six sessions), and monthly follow-up either early after enrollment or 3 months later. Outcomes were QOL, symptom impact, mood, 1-year survival, and resource use (hospital/intensive care unit days, emergency room visits, chemotherapy in last 14 days, and death location). Results Overall patient-reported outcomes were not statistically significant after enrollment (QOL, P = .34; symptom impact, P = .09; mood, P = .33) or before death (QOL, P = .73; symptom impact, P = .30; mood, P = .82). Kaplan-Meier 1-year survival rates were 63% in the early group and 48% in the delayed group (difference, 15%; P = .038). Relative rates of early to delayed decedents' resource use were similar for hospital days (0.73; 95% CI, 0.41 to 1.27; P = .26), intensive care unit days (0.68; 95% CI, 0.23 to 2.02; P = .49), emergency room visits (0.73; 95% CI, 0.45 to 1.19; P = .21), chemotherapy in last 14 days (1.57; 95% CI, 0.37 to 6.7; P = .27), and home death (27 [54%] v 28 [47%]; P = .60). Conclusion Early-entry participants' patient-reported outcomes and resource use were not statistically different; however, their survival 1-year after enrollment was improved compared with those who began 3 months later. Understanding the complex mechanisms whereby PC may improve survival remains an important research priority. PMID:25800768

  7. Immunogenicity and safety of the inactivated Japanese encephalitis vaccine IXIARO® in elderly subjects: Open-label, uncontrolled, multi-center, phase 4 study.

    PubMed

    Cramer, Jakob P; Dubischar, Katrin; Eder, Susanne; Burchard, Gerd D; Jelinek, Tomas; Jilma, Bernd; Kollaritsch, Herwig; Reisinger, Emil; Westritschnig, Kerstin

    2016-08-31

    IXIARO® is a Vero cell-derived, inactivated Japanese encephalitis (JE) vaccine licensed mainly in western countries for children and adults traveling to JE endemic areas. Limited immunogenicity and safety data in elderly travelers have been available. To evaluate safety and immunogenicity of IXIARO in elderly subjects. Open-label, single arm, multi-centered study. Two-hundred subjects with good general health, including adequately controlled chronic conditions, received two doses of IXIARO®, 28days apart. Protective levels of antibodies were tested 42days after the second dose. Systemic and local adverse events (AEs) were solicited for 7days after each dose, unsolicited AEs were collected up to day 70 and in a phone call at month 7. Subjects were aged 64-83years (median 69.0years). Nineteen percent of subjects had serious or medically attended AEs up to Day 70 (primary endpoint), none of them causally linked to IXIARO. Solicited local AEs were reported by 33.5% (most common: local tenderness) and solicited systemic AEs by 27% (most common: headache) of subjects. The seroprotection rate was 65% with a geometric mean titre (GMT) of 37. Subjects with tick borne encephalitis (TBE) vaccinations in the past 5years (N=29) had a SCR of 90% and GMT of 65. IXIARO is generally well tolerated in the elderly, and the safety profile is largely comparable with younger adults. SCR and GMT are lower compared to younger adults, but SCR is in the range reported in elderly for other vaccines e.g. against TBE, hepatitis-A virus (HAV)/hepatitis-B virus (HBV), influenza. The differences in SCR and GMT from younger to elderly adults were in the range of other vaccines. Duration of protection is uncertain in older persons, therefore a booster dose (third dose) should be considered before any further exposure to JE virus. Copyright © 2016. Published by Elsevier Ltd.

  8. Ventriculostomy-associated infection: a new, standardized reporting definition and institutional experience.

    PubMed

    Gozal, Yair M; Farley, Chad W; Hanseman, Dennis J; Harwell, Daniel; Magner, Mark; Andaluz, Norberto; Shutter, Lori

    2014-08-01

    Shortcomings created by the lack of both a uniform definition of ventriculostomy-associated infection (VAI) and reporting standards have led to widely ranging infections rates (2-24%) whose significance is uncertain. We propose a standardized definition of VAI and a consistent reporting format compliant with Centers for Disease Control and Prevention (CDC) for device-related infections. Using those parameters to establish an infection-control surveillance program, we report our 4-year institutional VAI rates. In this prospective study covering ventriculostomy utilization (October 2006-December 2010), 498 patients had a total of 4,673 ventriculostomy days. By review of the literature and our institutional analysis, we defined VAI as a positive CSF culture in a patient with ventriculostomy catheter, plus one or more of the following (1) fever recorded >101.5 °F or (2) cerebrospinal fluid (CSF) glucose level, either <50 mg/dL or <50% of a serum glucose level drawn within 24 h of the CSF glucose. In a report format that is CDC compliant, rates of VAI are reported. Among our patients, the CDC-compliant infection rate was 2.14 per 1,000 ventriculostomy days. Of the 10 VAIs occurring in 498 patients during 4,673 ventriculostomy days, this 2.0% infection rate was lower than the previously reported 8.8% composite rates of VAI. Average duration of ventriculostomy was 9.4 days. Neither antibiotic-impregnated catheters nor periprocedural or prophylactic antibiotics were used. Our standardized VAI definition and CDC format seems promising toward facilitating future study and guideline development. Given our strict protocol of sterile catheter placement and care, and our institution's low 2.0% infection rates, we propose an infection-rate target of ≤5 per 1,000 device days. Our results suggest that the use of antibiotics or antibiotic-impregnated catheters is unwarranted--a positive given concerns of evolving anti-microbial resistance.

  9. Effectiveness of an influenza vaccine used in Poland in the 1998-1999 influenza season.

    PubMed

    Banzhoff, A; Kaniok, W; Muszer, A

    2001-05-01

    The aim of this study was to evaluate the effectiveness of the influenza vaccine used at the Proelmed Medical Center, Poland during the influenza season 1998-1999. The study randomised patients attending the Proelmed Medical Center, Poland to receive influenza vaccination or not. Volunteers were monitored for the following 6 months by interviews at which systemic and local symptoms were recorded. 193 volunteers were randomised to receive influenza vaccine and 206 to the control group. In the vaccinated group, 7 cases (3.7%) of influenza were recorded, compared to 59 cases (28.6%) in the unvaccinated group. Respiratory disease other than influenza occurred in 29.5% of the vaccinated group and 34.5% of the unvaccinated group. Vaccinated patients had a total of 62 days off sick due to influenza, compared to 467 days for the unvaccinated patients. No unexpected adverse events were reported. The influenza vaccine used is highly efficacious in protecting against influenza infection leading to absenteeism from work, and has a good safety profile.

  10. Birth after 12 hours of oocyte refrigeration.

    PubMed

    Coban, Onder; Hacifazlioglu, Oguzhan; Ciray, H Nadir; Ulug, Ulun; Tekin, H Ibrahim; Bahceci, Mustafa

    2010-12-01

    To assess cycle outcome after oocyte refrigeration. Case report. Private IVF center. One couple in a donor oocyte program. Intracytoplasmic sperm injection and blastocyst culture after refrigeration of oocytes for 12 hours. Birth. Fourteen two-pronuclei zygotes from 17 metaphase II refrigerated oocytes resulted in transfer of two blastocysts at day 5 and cryopreservation of six excess embryos at day 6. The patient delivered one healthy male baby after 38 weeks' gestation. The successful outcome of oocyte refrigeration indicates that this protocol could be useful in circumstances in which a delay in obtaining spermatozoa arises. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Fire eater's lung: retrospective analysis of 123 cases reported to a National Poison Center.

    PubMed

    Franzen, Daniel; Kohler, Malcolm; Degrandi, Colette; Kullak-Ublick, Gerd A; Ceschi, Alessandro

    2014-01-01

    Fire eater's lung (FEL) is a distinct form of acute chemical toxic pneumonitis, which is caused by aspiration of flammable petrochemical derivatives used by street performers for 'fire eating'. The optimal management of this condition has not yet been determined. The aim of this study was to investigate patient characteristics, clinical features, treatment, and outcome of FEL. A single-center retrospective review of consecutive cases of FEL in children and adults reported to a national poison center (the Swiss Toxicological Information Center) between 1995 and 2012. 123 cases (83.7% males, mean age 21.9 years) were included. The most frequently reported symptom was cough (50.4%), followed by chest pain (45.5%), and fever (35.8%). Dyspnea was reported by 23.6%. Cough (p = 0.002) and chest pain (p = 0.02) were significantly more prevalent in subjects reporting to have aspirated the fuel compared to those who have swallowed it or who did not perceive poison exposure. A pulmonary infiltrate was detected in 83% of the cases in whom chest X-ray was performed. Overall, 22% were treated with an antibiotic agent for a mean duration of 10.4 days. Corticosteroids were administered in 4.9%. All showed complete recovery irrespective of the therapeutic management. The combination of intense pleuritic chest pain, cough, dyspnea, and fever, or any of these symptoms after 'fire eating' or erroneous swallowing of a petroleum distillate should alert the clinician to the diagnosis of FEL. Early antibiotic treatment of severe cases seems justified, considering that clinical, laboratory, and radiologic findings of FEL are overlapping with bacterial superinfection. Copyright © 2013 S. Karger AG, Basel.

  12. Improved short-term variability in the thermosphere-ionosphere-mesosphere-electrodynamics general circulation model

    NASA Astrophysics Data System (ADS)

    Häusler, K.; Hagan, M. E.; Baumgaertner, A. J. G.; Maute, A.; Lu, G.; Doornbos, E.; Bruinsma, S.; Forbes, J. M.; Gasperini, F.

    2014-08-01

    We report on a new source of tidal variability in the National Center for Atmospheric Research thermosphere-ionosphere-mesosphere-electrodynamics general circulation model (TIME-GCM). Lower boundary forcing of the TIME-GCM for a simulation of November-December 2009 based on 3-hourly Modern-Era Retrospective Analysis for Research and Application (MERRA) reanalysis data includes day-to-day variations in both diurnal and semidiurnal tides of tropospheric origin. Comparison with TIME-GCM results from a heretofore standard simulation that includes climatological tropospheric tides from the global-scale wave model reveal evidence of the impacts of MERRA forcing throughout the model domain, including measurable tidal variability in the TIME-GCM upper thermosphere. Additional comparisons with measurements made by the Gravity field and steady-state Ocean Circulation Explorer satellite show improved TIME-GCM capability to capture day-to-day variations in thermospheric density for the November-December 2009 period with the new MERRA lower boundary forcing.

  13. Earth Day 2018 Activities

    NASA Image and Video Library

    2018-04-17

    During the annual Earth Day celebration at the Kennedy Space Center Visitor Complex, Shari Blissett-Clark of the Florida Bat Conservancy displays one of the mammals. The event took place during the annual Earth Day celebration at the Kennedy Space Center Visitor Complex, guests have an opportunity to learn more about energy awareness, the environment and sustainability.

  14. The Stride Rite Intergenerational Day Care Center: Background.

    ERIC Educational Resources Information Center

    Stride Rite Corp., Cambridge, MA.

    The Stride Rite Intergenerational Day Care Center is located in the Stride Rite Corporation's headquarters in Cambridge, Massachusetts. The facility is designed to provide day care to both children and elders, using two separate wings to afford privacy to each group and a large central area for informal interaction between children and elders. The…

  15. Day Care Centers: Profit Making Businesses?

    ERIC Educational Resources Information Center

    MacEwan, Phyllis

    1970-01-01

    Deplores promotion of day care for profit, and urges opposition to this trend. Suggests strong political demand for free centers controlled by parents and financed by public funds and perhaps taxation on large corporations. (CJ)

  16. Traumeel S in preventing and treating mucositis in young patients undergoing SCT: a report of the Children’s Oncology Group

    PubMed Central

    Sencer, SF; Zhou, T; Freedman, LS; Ives, JA; Chen, Z; Wall, D; Nieder, ML; Grupp, SA; Yu, LC; Sahdev, I; Jonas, WB; Wallace, JD; Oberbaum, M

    2012-01-01

    Mucositis can be a serious complication of hematopoietic SCT (HSCT). A previous phase II trial in 32 children undergoing HSCT reported a beneficial effect of the homeopathic remedy Traumeel S. The Children’s Oncology Group sought to replicate the results in a multi-institutional trial. The study was an international multi-center, double-blind, randomized trial comparing Traumeel with placebo in patients aged 3–25 years undergoing myeloablative HSCT. Traumeel/placebo was started on Day −1 as a five-time daily mouth rinse. Efficacy of the treatment was assessed using the modified Walsh scale for mucositis, scored daily from Day −1 to 20 days after HCST. The main outcome was the sum of Walsh scale scores (area-under-the-curve (AUC)) over this period. Other outcomes included narcotic use, days of total parenteral feeding, days of nasogastric feeding and adverse events. In 181 evaluable patients, there was no statistical difference in mucositis (AUC) in the Traumeel group (76.7) compared with placebo (67.3) (P = 0.13). There was a trend towards less narcotic usage in the Traumeel patients. No statistically beneficial effect from Traumeel was demonstrated for mucositis. We could not confirm that Traumeel is an effective treatment for mucositis in children undergoing HSCT. PMID:22504933

  17. Advancing TVET for Youth Employability and Sustainable Development. Promising Practices in TVET and Entrepreneurship Education in the Arab States (Beirut, Lebanon, November 19-21, 2013). Meeting Report

    ERIC Educational Resources Information Center

    Sulieman, Sulieman, Comp.; Freiburg, Lisa, Comp.; Newashi, Qasem, Comp.

    2013-01-01

    UNESCO-UNEVOC and UNESCO Regional Bureau, Beirut, in cooperation with the Ministry of Education and Higher Education, Lebanon (General Directorate for Vocational and Technical Education, GDVTE, and Center for Educational Research and Development, CERD), organized a three-day Regional Expert Meeting (Beirut, 19-21 November 2013) as a platform for…

  18. NASA Ames Celebrates Curiosity Rover's Landing on Mars (Reporter Package)

    NASA Image and Video Library

    2012-08-08

    Nearly 7,000 people came to NASA Ames Research Center, Moffett Field, Calif., to watch the Mars Science Laboratory rover Curiosity land on Mars. A full day's worth of activities and discussions with local Mars experts informed attendees about the contributions NASA Ames made to the mission. The highlight of the event was the live NASA TV broadcast of MSL's entry, descent and landing on the Martian surface.

  19. ENVIRONMENTAL TECHNOLOGY VERIFICATION REPORT - PHYSICAL REMOVAL OF MICROBIOLOGICAL & PARTICULATE CONTAMINANTS IN DRINKING WATER: US FILTER 3M10C MICROFILTRATION MEMBRANE SYSTEM AT CHULA VISTA, CALIFORNIA

    EPA Science Inventory

    Verification testing of the US Filter 3M10C membrane system was conducted over a 44-day test period at the Aqua 2000 Research Center in Chula Vista, California. The test period extended from July 24, 2002 to September 5, 2002. The source water was a blend of Colorado River and ...

  20. Verification and Enhancement of VIIRS Day-Night Band (DNB) Power Outage Detection Product

    NASA Technical Reports Server (NTRS)

    Burke, Angela; Schultz, Lori A.; Omitaomu, Olufemi; Molthan, Andrew L.; Cole, Tony; Griffin, Robert

    2017-01-01

    This case study of Hurricane Matthew (October 2016) uses the NASA Short-Term Prediction Research and Transition (SPoRT) Center DNB power outage product (using GSFC VIIRS DNB preliminary Black Marble product, Roman et al.. 2017) and 2013 LandScan Global population data to look for correlations between the post-event %-of-normal radiance and the utility company-reported outage numbers (obtained from EAGLE-1).

  1. Zika Phase I Clinical Trial Material—From Research to Release in 90 Days | Poster

    Cancer.gov

    Over the past 12 months, we’ve grown accustomed to seeing Zika in the news. The virus has been linked to thousands of cases of microcephaly in Brazilian babies. Numerous countries, including the United States, have reported Zika-related deaths. And there is no vaccine available at this time. In the face of what has become a global health crisis, the Vaccine Research Center

  2. Commercial Practices as Applied to Total Asset Visibility

    DTIC Science & Technology

    2003-12-01

    Defense Technical Information Center 8725 John J. Kingman Road, Suite 0944 Ft. Belvoir, VA 22060-6218 DISCLAIMER This Technical Report is published...visibility," says John Coburn, retired four-star commanding general of the United States Army, materiel command, an operation that supports the Army...would still take an additional three days for maintenance personnel to get their hands on it). This outsourcing phenomenon is common at most Air Force

  3. Copolymer-1 vaccination regimens for neuroprotection in laser-induced retinal injuries

    NASA Astrophysics Data System (ADS)

    Belokopytov, Mark; Dubinsky, Galina; Belkin, Michael; Epstein, Yoram; Rosner, Mordechai

    2005-04-01

    The neuroprotective effect of immunization by glatiramer acetate (Copolymer-1, Cop-1, Copaxone) in adjuvant against laser-induced retinal damage was previously reported. The present study quantitatively compares various regimens of this vaccination for reducing the spread of laser-induced retinal damage and investigates the cellular mechanism of Cop-1 activity. Standard argon laser lesions were created in 78 DA pigmented rats divided into five groups: three Cop-1 single treatment groups (treated 7 days before, immediately after, or 24 hours after the injury), one group treated twice (7 days before and 20 days after injury), and a control group treated with adjuvant 7 days before the injury. The retinal lesions were evaluated 3, 20, and 60 days after the injury. Immunostaining of the retinas of the pretreated and control group animals 3 days after the laser injury was performed for T-cell detection. Cop-1 pre-immunization reduced photoreceptor loss at all time points as measured over the central zone of the lesion and 3 and 20 days after lasing as measured over the whole damaged area. Lesion diameter was reduced only 60 days after laser injury in pre-treated animals. Cop-1 given immediately after injury reduced cell loss as measured 20 and 60 days later in the whole lesion and 20 days after the laser irradiation, when measured in the center of lesion. It had no effect on lesion diameter. Late treatment reduced only the lesion diameter at all time points. Repeated treatment enhanced the neuroprotective effect, decreasing the cell loss in the center of lesion and reducing the diameter of lesion. T-cells were detected in the retinal lesions of pre-immunized animals and not in non-treated group, demonstrating the cellular immune mechanism of Cop-1. Immunization with Cop-1 is neuroprotective against laser-induced retinal injuries, and repeating the treatment enhances this effect. Cellular immune action of Cop-1 of was detected.

  4. Work Productivity in Scleroderma – Analysis from the UCLA Scleroderma Quality of Life Study

    PubMed Central

    Singh, Manjit K.; Clements, Philip J.; Furst, Daniel E.; Maranian, Paul; Khanna, Dinesh

    2011-01-01

    Objective To examine the productivity of patients with scleroderma (SSc) both outside and within the home in a large observational cohort. Methods 162 patients completed the Work Productivity Survey. Patients indicated whether or not they were employed outside of the home, how many days/month they missed work (employment or household work) due to SSc and how many days/month productivity was decreased ≥ 50%. Patients also completed other patient-reported outcome measures. We developed binomial regression models to assess the predictors of days missed from work (paid employment or household activities). The covariates included: type of SSc, education, physician and patient global assessments, HAQ-DI, FACIT-Fatigue, and Center of Epidemiologic Studies Depression Scale – Short Form (CESD). Results The average age of patients was 51.8 years and 51% had limited SSc. Of 37% patients employed outside of the home, patients reported missing 2.6 days/month of work and had 2.5 days per month productivity reduced by half. Of the 102 patients who were not employed, 39.4% were unable to work due to their SSc. When we assessed patients for household activities (N = 162), patients missed an average of 8 days of housework/month and had productivity reduced by average of 6 days/month. In the regression models, patients with lower education and poor assessment of overall health by physician were more likely to miss work outside the home. Patients with limited SSc and high HAQ-DI were more likely to miss work at home. Conclusion SSc has a major impact on productivity at home and at work. Nearly 40% of patients reported disability due to their SSc. PMID:22012885

  5. Transition Components of the Frost Center, a Model Program Background: The Frost Center and Its Students.

    ERIC Educational Resources Information Center

    Mosso, Janet L.

    The Frost Center (Rockville, Maryland) is a private, nonprofit school and therapeutic day program that serves adolescents with emotional, learning, and behavioral disabilities and their families. Approximately two-thirds of each student's day is spent in academic classes, acquiring the skills and behavior necessary for a return to a less…

  6. Quality of Care: A National Sample.

    ERIC Educational Resources Information Center

    Ferrari, Monica

    This survey of 25 day care centers in 5 regions of Italy was designed to determine the characteristics of competent centers and the effects of differing local regulations on the quality of care provided. The Infant and Toddler Environment Rating Scale (ITERS) and a questionnaire were utilized to assess the quality of the day care centers in the…

  7. A Study Identifying the Components of a Quality Child Care Center.

    ERIC Educational Resources Information Center

    Panetta, Sandra J.

    Specific characteristics of a quality day care center are identified through a survey of parents, teachers, and directors utilizing or working in day care centers. The introduction to this descriptive research study offers background information on the history of the child care movement in America and a review of related research projects. A…

  8. The comparative effectiveness of clinic, work-site, phone, and Web-based tobacco treatment programs.

    PubMed

    An, Lawrence C; Betzner, Anne; Schillo, Barbara; Luxenberg, Michael G; Christenson, Matthew; Wendling, Ann; Saul, Jessie E; Kavanaugh, Annette

    2010-10-01

    Tobacco treatment programs may be offered in clinical settings, at work-sites, via telephone helplines, or over the Internet. Little comparative data exist regarding the real-world effectiveness of these programs. This paper compares the reach, effectiveness, and costs of these different modes of cessation assistance. This is an observational study of cohorts of participants in Minnesota's QUITPLAN programs in 2004. Cessation assistance was provided in person at 9 treatment centers, using group counseling at 68 work-sites, via a telephone helpline, or via the Internet. The main outcomes of the study are enrollment by current smokers, self-reported 30-day abstinence, and cost per quit. Reach was calculated statewide for the helpline and Web site, regionally for the treatment centers, and for the employee population for work-site programs. Enrollment was greatest for the Web site (n = 4,698), followed by the helpline (n = 2,351), treatment centers (n = 616), and work-sites (n = 479). The Web site attracted younger smokers. Smokers at treatment centers had higher levels of nicotine dependence. The helpline reached more socially disadvantaged smokers. Responder 30-day abstinence rates were higher for the helpline (29.3%), treatment centers (25.8%), and work-sites (19.6%) compared with the online program (12.5%). These differences persisted after controlling for baseline differences in participant characteristics and use of pharmacological therapy. The cost per quit was lowest for the Web site program ($291 per quit, 95% CI = $229-$372). Treatment center, work-site, helpline, and Web site programs differ in their reach, effectiveness, and estimated cost per quit. Each program plays a part in assisting populations of tobacco users in quitting.

  9. Avianca flight No. 052 accident: a plastic surgical perspective.

    PubMed

    Greenberg, B M; Brewer, B W

    1991-09-01

    The crash of Avianca Airlines flight no. 052 en route to JFK Airport on January 25, 1990, in Cove Neck, New York, resulted in the death of 72 passengers. Eighty-nine victims were admitted to 13 regional hospitals. Despite difficult access to the wooded crash site, early warning and prompt response by 37 volunteer fire and rescue units resulted in organized EMS triage and rapid hospital transport. This report reviews the specific injuries incurred, highlights the team management approach to a major aviation accident in a suburban area, and studies the likelihood of accidents of this magnitude. Thirty-eight patients triaged to two level I trauma centers, North Shore University Hospital-Cornell University Medical Center and Nassau County Medical Center, form the basis of this report. Seventeen patients were male; 21 were female. The average patient age was 33 years. Eight patients were children. The average length of stay was 30.9 days (range 2 to greater than 90 days). Twenty-six patients (including nonsurvivors) (68 percent) sustained significant multiple orthopedic injuries. The majority of fractures were open grade II to III tibia-fibula fractures. Bilaterality was commonly seen. Soft-tissue coverage of open long bone fractures was required in 10 patients (11 extremities) and included 3 microvascular muscle transfers, 7 muscle transposition flaps, and 3 skin grafts. Seven patients required open reduction and fixation of complex facial fractures (two of Le Fort II to III type, four of complex naso-orbital-ethmoid type). Plastic surgical repair of complex lacerations was common. Peripheral nerve exploration was required in three patients.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Universal immunization in urban areas: Calcutta's success story.

    PubMed

    Chaudhuri, E R

    1990-01-01

    The Central Government of Calcutta, India aimed to immunize 85% (85,262) of the city's 12 month old infants against polio, diphtheria, measles, tuberculosis, pertussis and tetanus. The Universal Immunization Program (UIP) achieved this target 3 months earlier than intended. In fact, at the end of December 1990, it achieved 110.6% for DPT3, 142.16% for OPV3, 151.96% for BCG, and 97% for measles. UIP was able to surpass its targets by emphasizing team work. Government, the private sector, UNICEF, and the voluntary sector made up the Apex Coordination Committee on Immunization headed up by the mayor. The committee drafted an action plan which included routine immunization sessions on a fixed day and intensive immunization drives. Further the involved organizations pooled together cold chain equipment. In addition, the District Family Welfare Bureau was the distribution center for vaccines, syringes, immunization cards, report formats, vaccine carriers, and ice packs. Health workers administered immunizations from about 300 centers generally on Wednesday, National Immunization Day. Intensive immunization drives focused on measles immunizations. UIP leaders encouraged all center to routinely record coverage and submit monthly progress reports to the District Family Welfare Bureau. The Calcutta Municipal Corporation coordinated promotion activities and social mobilization efforts. Promotion included radio and TV announcements, newspaper advertisements, cinema slides, billboards, and posters. The original UIP plan to use professional communicators to mobilize communities was ineffective, so nongovernmental organizations entered the slums to encourage people to encourage their neighbors to immunize their children. Further Islamic, Protestant, and Catholic leaders encouraged the faithful to immunize their children. A UNICEF officer noted that this success must be sustained, however.

  11. Moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a day care center.

    PubMed

    Bocchi, Silvia Cristina Mangini; Cano, Karen Cristina Urtado; Baltieri, Lilian; Godoy, Daniele Cristina; Spiri, Wilza Carla; Juliani, Carmen Maria Casquel Monti

    2010-09-01

    This study aimed at understanding the interactional experience between family caregivers and disabled elderly persons supported in a Day Care Center according to the caregiver's perspective. It also aimed at developing a representative theoretical model for the events experienced by such caregiver. The Grounded Theory was used as methodological framework whereas Interactional Symbolism served as the theoretical framework. Observation and interviews were used for data collection. The following phenomenon arose from the results: feeling of support by the Day Care Center, by the strength of the bond with the elderly and by spirituality in order to continue playing the challenging role of a family caregiver for a disabled elderly person. The study made possible to understand that, among these three supporting cornerstones for coping with the burden generated by the family caregiver role, the care model promoted by the Day Care Center was the intervenient variable in the process of improving the quality of life of the family caregiver-disabled elderly person binomial. This allowed the identification of the main category--moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a Day Care Center.

  12. [Patients' satisfaction and waiting time in oncology day care centers in Champagne-Ardenne].

    PubMed

    Debreuve-Theresette, A; Jovenin, N; Stona, A C; Kraïem-Leleu, M; Burde, F; Parent, D; Hettler, D; Rey, J B

    2015-12-01

    Quality of life of patients suffering from cancer may be influenced by the way healthcare is organized and by patient experiences. Nowadays, chemotherapy is often provided in day care centers. This study aimed to assess patient waiting time and satisfaction in oncology day care centers in Champagne-Ardenne, France. This cross-sectional survey involved all patients receiving ambulatory chemotherapy during a one-week period in day care centers of Champagne-Ardenne public and private healthcare institutions participating in the study. Sociodemographic, medical and outpatient data were collected. Patient satisfaction was measured using the Out-Patsat35 questionnaire. Eleven (out of 16) oncology day care centers and 441 patients participated in the study. Most of the patients were women (n=252, 57.1%) and the mean age was 61±12 years. The mean satisfaction score was 82±14 (out of 100) and the mean waiting time between the assigned appointment time and administration of chemotherapy was 97±60 min. This study has shown that waiting times are important. However, patients are satisfied with the healthcare organization, especially regarding nursing support. Early preparation of chemotherapy could improve these parameters. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. Transperitoneal laparoscopic adrenalectomy. Our experience.

    PubMed

    Antonino, Antonio; Rosato, Andrea; Zenone, Pasquale; Ranieri, Raffaele; Maglio, Mauro; Lupone, Gennaro; Gragnano, Eugenio; Sangiuliano, Nicola; Docimo, Giovanni; De Palma, Maurizio

    2013-01-01

    Laparoscopic adrenalectomy is considered the standard technique for the surgical removal of the adrenal gland. This report is about a 4-year single experience in our Endocrine and General Surgery Unit with laparoscopic adrenalectomy. A total of 24 lateral transperitoneal laparoscopic adrenalectomies were performed. The indications for laparoscopic surgery were: aldosteronoma in 3 patients, pheochromocytoma in 6 patients, nonfunctioning adenoma in 6 patients, adenoma causing Cushing's syndrome in 3 patients, 1 lymphangioma-like adenomatoid tumor, 1 myelolipoma, 1 complicated adrenal cyst, 2 adrenocortical carcinomas, 1 lung metastasis. All except two had successful laparoscopic adrenalectomy. Complication occurred in one patient. 3 patients underwent other associated laparoscopic procedures. Operative time ranged from 100 to 240 minutes for laparoscopic adrenalectomy, from 180 to 210 minutes in the cases with two associated laparoscopic procedures, 5 hours for bilateral adrenalectomy; the postoperative hospital stay for laparoscopic adrenalectomy ranged from 4 to 8 days (6,79 days) and from 7 to 13 days (9,12 days) for patients undergoing the open or converted procedure. Laparoscopic adrenalectomy is technically feasible and reproducible. We evaluate the effectiveness of laparoscopic adrenalectomy for a variety of endocrine disorders except in the case of invasive carcinoma or large masses. Antonio Cardarelli Endocrine and General Surgery Unit in Naples is known as a specialized center for thyroid and parathyroid surgery; in future, we could also become a high-volume laparoscopic referral center for adrenal gland pathologies.

  14. NASA Space Day in Mississippi - House of Representatives

    NASA Technical Reports Server (NTRS)

    2008-01-01

    Astronaut Michael Foale (center) and Stennis Space Center officials met with Mississippi House of Representatives Gulf Coast delegation, including Speaker William 'Billy' McCoy (far right), during NASA Space Day in Mississippi on January 30.

  15. Community-Based Care

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Community-Based Care Basic Facts & Information A variety of healthcare options ... day care centers are either in churches or community centers. Adult day care is commonly used to care for people who ...

  16. Comparisons Between TIME-GCM/MERRA Simulations and LEO Satellite Observations

    NASA Astrophysics Data System (ADS)

    Hagan, M. E.; Haeusler, K.; Forbes, J. M.; Zhang, X.; Doornbos, E.; Bruinsma, S.; Lu, G.

    2014-12-01

    We report on yearlong National Center for Atmospheric Research (NCAR) thermosphere-ionosphere-mesosphere-electrodynamics general circulation model (TIME-GCM) simulations where we utilize the recently developed lower boundary condition based on 3-hourly MERRA (Modern-Era Retrospective Analysis for Research and Application) reanalysis data to account for tropospheric waves and tides propagating upward into the model domain. The solar and geomagnetic forcing is based on prevailing geophysical conditions. The simulations show a strong day-to-day variability in the upper thermospheric neutral temperature tidal fields, which is smoothed out quickly when averaging is applied over several days, e.g. up to 50% DE3 amplitude reduction for a 10-day average. This is an important result with respect to tidal diagnostics from satellite observations where averaging over multiple days is inevitable. In order to assess TIME-GCM performance we compare the simulations with measurements from the Gravity field and steady-state Ocean Circulation Explorer (GOCE), Challenging Minisatellite Payload (CHAMP) and Gravity Recovery and Climate Experiment (GRACE) satellites.

  17. "DI Days:" Differentiating Instruction through Student Choice. Classroom Tips

    ERIC Educational Resources Information Center

    Hammond, Donald J.

    2011-01-01

    To better meet the needs of the author's high school students, who have a variety of abilities, interests and engagement levels, he often differentiates instruction through the use of "DI Days." On these days, students use a choice board to select from a wide range of activities offered in learning centers. Each center offers content-focused…

  18. Status Report on the Development of Micro-Scheduling Software for the Advanced Outage Control Center Project

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

    Germain, Shawn St.; Thomas, Kenneth; Farris, Ronald

    2014-09-01

    The long-term viability of existing nuclear power plants (NPPs) in the United States (U.S.) is dependent upon a number of factors, including maintaining high capacity factors, maintaining nuclear safety, and reducing operating costs, particularly those associated with refueling outages. Refueling outages typically take 20-30 days, and for existing light water NPPs in the U.S., the reactor cannot be in operation during the outage. Furthermore, given that many NPPs generate between $1-1.5 million/day in revenue when in operation, there is considerable interest in shortening the length of refueling outages. Yet, refueling outages are highly complex operations, involving multiple concurrent and dependentmore » activities that are difficult to coordinate. Finding ways to improve refueling outage performance while maintaining nuclear safety has proven to be difficult. The Advanced Outage Control Center project is a research and development (R&D) demonstration activity under the Light Water Reactor Sustainability (LWRS) Program. LWRS is a R&D program which works with industry R&D programs to establish technical foundations for the licensing and managing of long-term, safe, and economical operation of current NPPs. The Advanced Outage Control Center project has the goal of improving the management of commercial NPP refueling outages. To accomplish this goal, this INL R&D project is developing an advanced outage control center (OCC) that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. This report describes specific recent efforts to develop a capability called outage Micro-Scheduling. Micro-Scheduling is the ability to allocate and schedule outage support task resources on a sub-hour basis. Micro-Scheduling is the real-time fine-tuning of the outage schedule to react to the actual progress of the primary outage activities to ensure that support task resources are optimally deployed with the least amount of delay and unproductive use of resources. The remaining sections of this report describe in more detail the scheduling challenges that occur during outages, how a Micro-Scheduling capability helps address those challenges, and provides a status update on work accomplished to date and the path forward.« less

  19. The Role of Day-to-Day Emotions, Sleep, and Social Interactions in Pediatric Anxiety Treatment

    PubMed Central

    Wallace, Meredith L.; McMakin, Dana L.; Tan, Patricia Z.; Rosen, Dana; Forbes, Erika E.; Ladouceur, Cecile D.; Ryan, Neal D.; Siegle, Greg J.; Dahl, Ronald E.; Kendall, Philip C.; Mannarino, Anthony; Silk, Jennifer S.

    2016-01-01

    Do day-to-day emotions, social interactions, and sleep play a role in determining which anxious youth respond to supportive child-centered therapy (CCT) versus cognitive behavioral therapy (CBT)? We explored whether measures of day-to-day functioning (captured through ecological momentary assessment, sleep diary, and actigraphy), along with clinical and demographic measures, were predictors or moderators of treatment outcome in 114 anxious youth randomized to CCT or CBT. We statistically combined individual moderators into a single, optimal composite moderator to characterize subgroups for which CCT or CBT may be preferable. The strongest predictors of better outcome included: (a) experiencing higher positive affect when with one’s mother and (b) fewer self-reported problems with sleep duration. The composite moderator indicated that youth for whom CBT was indicated had: (a) more day-to-day sleep problems related to sleep quality, efficiency, and waking, (b) day-to-day negative events related to interpersonal concerns, (c) more DSM-IV anxiety diagnoses, and (d) college-educated parents. These findings illustrate the value of both day-to-day functioning characteristics and more traditional sociodemographic and clinical characteristics in identifying optimal anxiety treatment assignment. Future studies will need to enhance the practicality of real-time measures for use in clinical decision making and evaluate additional anxiety treatments. PMID:28013054

  20. "Gender aware therapy" for professional men in a day treatment center.

    PubMed

    Robertson, John M; Williams, Betsy White

    2010-09-01

    High accountability men in the medical, legal, corporate, and mental health professions sometimes engage in behavior that violates their fiduciary responsibilities. These highly skilled men may engage in disruptive or explosive behavior, cross sexual boundaries with clients or patients, abuse substances, or have other psychiatric problems that compromise their workplace performance. When this occurs, licensing boards, professional societies, or supervising executives often require the dysregulated man to seek assistance. This article reports on ways the Professional Renewal Center incorporates recommendations from "Gender Aware Therapy" in developing a male-friendly approach to conducting comprehensive multidisciplinary psychological assessments, and to providing intensive, multimodal, weeks-long treatment services. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  1. The day that the START triage system came to a STOP: observations from the World Trade Center disaster.

    PubMed

    Asaeda, Glenn

    2002-03-01

    The Fire Department of the City of New York--Emergency Medical Services (EMS) Operations is one of the largest EMS systems in the country. On a daily basis, this system responds to approximately 3,000 to 3,500 calls for ambulance requests. This equates to 1.2 to 1.5 million calls annually. As part of its response, EMS deals on a daily basis with multiple casualty and disaster-type situations. The magnitude of the attacks on the World Trade Center, however, was on a scale not previously seen by any system. This article is a case report of the September 11, 2001, incident.

  2. How To Cover NASA's Chandra X-ray Observatory

    NASA Astrophysics Data System (ADS)

    1999-07-01

    NASA's newest space telescope, the Chandra X-ray Observatory, is scheduled for launch not earlier than July 20, 1999, aboard Space Shuttle mission STS-93. The world's most powerful X-ray observatory, Chandra will join the Hubble Space Telescope and NASA's other great observatories in an unprecedented study of our universe. With its capability to "see" an otherwise invisible but violent, vibrant and ever-changing universe, Chandra will provide insights into the universe's structure and evolution. The following information is designed to assist news media representatives cover launch and activation of the Chandra X-ray Observatory. Covering from the Chandra Control Center NASA will establish a news center at the Chandra X-ray Observatory Operations Control Center in Cambridge, Mass., during the critical period of launch and early activation. The news center will be open from approximately two days prior to launch until the observatory is established in its operating orbit approximately 11 days after launch. The telephone numbers for the news center are: (617) 496-4454 (617) 496-4462 (617) 496-4484 The news center will be staffed around the clock during the Shuttle mission by media relations officers knowledgeable about the Chandra mission and its status. Media covering from the news center will be provided work space and have opportunities for face-to-face interviews with Chandra management, control team members and Chandra scientists. They will be able to participate in daily Chandra status briefings and have access to a special control room viewing area. Additionally, media covering from Cambridge will receive periodic status reports on Chandra and the STS-93 mission, and will be able to participate in interactive televised briefings on the STS-93 mission originating from other NASA centers. While advance accreditation is not required, media interested in covering Chandra from the Operations Control Center should contact Dave Drachlis by telephone at (256) 544-0031 in advance of the mission to make arrangements for special support, such as telephone service, and uplink or remote truck parking. Covering from the Kennedy Space Center The Kennedy Space Center, Fla., news center is primarily responsible for disseminating information about the Shuttle countdown and launch. However, media relations officers knowledgeable about Chandra will be present at the Kennedy news center through launch. Additionally, some members of the Chandra management and science team will be at the Kennedy Space Center and available for interviews through launch. Media interested in covering the Chandra launch from the Kennedy Space Center should contact its Public Affairs Office at (407) 867-2468. Prior accreditation is required. Covering from the Johnson Space Center The Johnson Space Center, Houston, Texas, news center has responsibility for disseminating information about STS-93 flight operations. Media interested in covering the mission from the Johnson Space Center should contact its Public Affairs Office at (281) 483-5111. Prior accreditation is required. Status Reports During the STS-93 Space Shuttle mission to launch Chandra, NASA will issue twice-daily status reports from the Chandra Operations Control Center in Cambridge, Mass. Following the Shuttle mission, through Chandra's on-orbit checkout period, reports will be issued weekly. These reports are available via the Internet at: http://chandra.msfc.nasa.gov Press Briefings During the Space Shuttle mission to launch the observatory, NASA will conduct daily press briefings on the status of the observatory. These briefings will be conducted at the Chandra Operations Control Center in Cambridge, Mass. Media briefings will be broadcast on NASA Television (see below). Media without access to NASA Television may monitor the briefings by calling (256) 544-5300 and asking to be connected to the NASA Television audio feed. A briefing schedule will be released before launch and updated as appropriate during the mission. NASA Television The launch and early activation of the Chandra X-ray Observatory will be carried live on NASA Television, available through the GE2 satellite system, which is located on Transponder 9C, at 85 degrees west longitude, frequency 3880.0 MHz, audio 6.8 MHz. Around-the-clock, up-to-the minute commentary, television and daily briefings on Chandra's status will originate from the Chandra Operations Control Center in Cambridge, Mass., during Shuttle Mission STS-93. Internet Information Up-to-date, comprehensive information on the Chandra X-ray Observatory is available to news media on the Internet at: http://chandra.harvard.edu The latest status reports, news releases, photos, fact sheets and background archives, as well as links to other Chandra-related sites, are available at this address. Live Shots - Television Back-hauls Television station news departments may conduct live, or live-to-tape interviews via the NASA satellite with Chandra program managers, scientists and control team members prior to, during, and following the launch of Chandra. For additional information or to arrange interviews, broadcasters may contact Dave Drachlis at (256) 544-0031. Interviews Members of the Chandra development, operations, and science teams are available to the news media for interviews upon request. NASA TV on the web

  3. Powerful Tropical Cyclone Ita Making Landfall in Queensland, Australia

    NASA Image and Video Library

    2014-04-11

    NASA's Aqua satellite passed over Tropical Cyclone Ita as it began making landfall on the Eastern Cape York Peninsula of Queensland, Australia, today, April 11, 2014. Ita officially made landfall at Cape Flattery about 9:00 p.m. local AEST time as a Category 4 storm according to reports from the Australian Broadcasting Corporation (ABC). The Moderate Resolution Imaging Spectroradiometer that flies aboard Aqua captured an image of the Category 4 storm on April 11 at 12:00 a.m. EDT (4 a.m. UTC). Satellite imagery indicates the eye is 9.2 miles wide (8 nautical miles, or 14.8 km). Warnings and watches remain in effect as the center of Ita is expected to remain at hurricane strength as it moves in a southerly direction, staying just west of Cairns over the next day. A tropical cyclone warning is in effect between Coen and Innisfail, including Cooktown, Port Douglas, Cairns, extending inland to Kalinga, Palmerville, Mareeba and Chillagoe. A tropical cyclone watch is in effect between Innisfail to Cardwell, extending inland. ABC reported that the strongest maximum sustained winds around the center of circulation were near 142.9 mph (124.2 knots, or 230 kph) and many trees have been downed and homes damaged. According to ABC, preliminary reports suggest that power may be out for a month in some areas. On April 11 at 5 a.m. EDT (9 a.m. UTC), Tropical Cyclone Ita had maximum sustained winds near 143.8 mph (125 knots, or 231.5 kph). It was centered near 14.8 degrees south latitude and 145.3 degrees east longitude, about 168 miles (146 nautical miles, or 288 km) north of Cairns, Australia, and has tracked south-southwestward at 10.3 mph (9 knots, or 16.6 kph). Ita is moving around a subtropical ridge (elongated area) of high pressure and the Joint Typhoon Warning Center expects Ita to start curving to the southeast around that ridge in the next day before heading back out into the Coral Sea. Credit: NASA/GSFC/Jeff Schmaltz/MODIS Land Rapid Response Team Rob Gutro, NASA's Goddard Space Flight Center, Greenbelt, Md. NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  4. Sun-Earth Day WEBCAST - NASA TV; Host Paul Mortfield, Astronomer Stanford Solar Center and visiting

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Sun-Earth Day WEBCAST - NASA TV; Host Paul Mortfield, Astronomer Stanford Solar Center and visiting students from San Francisco Bay Area Schools Documentation Technology Branch Video communications van (code-JIT)

  5. KENNEDY SPACE CENTER, FLA. - Before the start of the kickoff presentation for Spaceport Super Safety and Health Day, Center Director Jim Kennedy (left) chats with guest speaker Capt. Charles Plumb (USNR retired) and United Space Alliance Vice President and Deputy Program Manager, Florida Operations, Bill Pickavance. Spaceport Super Safety and Health Day is an annual event at KSC and Cape Canaveral Air Force Station dedicated to reinforcing safe and healthful behaviors in the workforce. Safety Awards were also given to individuals and groups.

    NASA Image and Video Library

    2003-10-15

    KENNEDY SPACE CENTER, FLA. - Before the start of the kickoff presentation for Spaceport Super Safety and Health Day, Center Director Jim Kennedy (left) chats with guest speaker Capt. Charles Plumb (USNR retired) and United Space Alliance Vice President and Deputy Program Manager, Florida Operations, Bill Pickavance. Spaceport Super Safety and Health Day is an annual event at KSC and Cape Canaveral Air Force Station dedicated to reinforcing safe and healthful behaviors in the workforce. Safety Awards were also given to individuals and groups.

  6. User participation in the development of the human/computer interface for control centers

    NASA Technical Reports Server (NTRS)

    Broome, Richard; Quick-Campbell, Marlene; Creegan, James; Dutilly, Robert

    1996-01-01

    Technological advances coupled with the requirements to reduce operations staffing costs led to the demand for efficient, technologically-sophisticated mission operations control centers. The control center under development for the earth observing system (EOS) is considered. The users are involved in the development of a control center in order to ensure that it is cost-efficient and flexible. A number of measures were implemented in the EOS program in order to encourage user involvement in the area of human-computer interface development. The following user participation exercises carried out in relation to the system analysis and design are described: the shadow participation of the programmers during a day of operations; the flight operations personnel interviews; and the analysis of the flight operations team tasks. The user participation in the interface prototype development, the prototype evaluation, and the system implementation are reported on. The involvement of the users early in the development process enables the requirements to be better understood and the cost to be reduced.

  7. KSC-05PD-0147

    NASA Technical Reports Server (NTRS)

    2005-01-01

    KENNEDY SPACE CENTER, FLA. NASA Administrator Sean OKeefe (center) is presented with a Deep Impact hat in the Press Site Auditorium following his report to employees on the state of the Agency. He is accompanied on stage by Center Director Jim Kennedy (right). The update was broadcast live via NASA Television. O'Keefe focused on the achievements of 2004 and the goals set for 2005. His remarks emphasized the milestones met in NASA's Vision for Space Exploration, including the launch of the comet-chasing Deep Impact mission and the landing of the Huygens probe on Jupiters moon Titan, both occurring in the past two days, and the progress made in meeting the requirements to return the Space Shuttle to flight. OKeefes briefing included a dialogue with Associate Administrator of NASAs Office of Exploration Systems Craig Steidle and Center Director Jim Kennedy, live; and Manager of the Space Station Office Bill Gerstenmaier and Director of Advanced Planning and Jet Propulsion Laboratory Charles Elachi, via satellite.

  8. [Dialin: infection surveillance network for haemodialysis patients. First results].

    PubMed

    Ayzac, Louis; Béruard, Michel; Girard, Raphaële; Hannoun, Jacques; Kuentz, François; Marc, Jean-Michel; Moreau-Gaudry, Xavier; Roche, Catherine; Tressières, Benoît; Uzan, Marc

    2009-02-01

    To show results of the first year of an infection surveillance network for haemodialysis patients (Dialin). In order to improve the security and quality of care, six haemodialysis centers have organized an infection watching network. The purpose of the network is to compare of the watching results between centers. This comparison includes vascular access infection (VAI), bacteraemia and C viral hepatitis. The heterogeneous pattern has been also taken into account. SURVEY TYPE: Multicenter prospective permanent survey. Six hundred and sixty-four haemodialyzed chronic patients, followed during one year (2005), in six voluntary haemodialysis centers. This survey has based on 71,688 treatment sessions corresponding to 6257.5 months of haemodialysis (HM). As with the heterogeneity among centers, the acquired infection standardized ratios (observed/expected) (AISR) and 95% confidence interval are computed with Cox model which includes confounding factors found in literature or in the preliminary stage of the survey. VAI crude rate was 0.47 per 100HM, 0.10 per 1000 native fistulae utilisation days, 0.45 per 1000 days of prosthetic graft utilisation and 0.44 per 1000 days of catheter utilisation. Bacteraemia crude incidence rate was 0.69 per 100HM, 0.02 per 1000 days of native fistulae utilisation, 0.00 per 1000 days of prosthetic graft utilisation and 0.39 per 1000 days of catheter utilisation. No new case of C viral hepatitis was found. Prevalence rate at the beginning of the survey was 5.3% (35 over 664). Two centers had a significantly high AISR for VAI and two centers had a significantly low AISR for VAI. One center had a significantly high AISR for bacteraemia and one center had a significantly low AISR for bacteraemia. The first year of Dialin running demonstrates the importance of standardised surveillance method in VAI and bacteraemia surveillance but not for viral hepatitis.

  9. Morbidity, outcomes and cost-benefit analysis of wildlife rehabilitation in Catalonia (Spain)

    PubMed Central

    Molina-López, Rafael Angel; Mañosa, Santi; Torres-Riera, Alex; Pomarol, Manel

    2017-01-01

    Background There are few studies of careful examination of wildlife casualties in Wildlife Rehabilitation Centers. These studies are essential for detecting menaces to wild species and providing objective criteria about cost-benefit of treatments in those centers. The release rate is considered the main outcome indicator, but other parameters such as length of stay at the center and a cost-benefit index expressed as number of released animals per euro and day, could be used as reliable estimators of the rehabilitation costs. Methodology A retrospective study based on 54772 admissions recorded from 1995–2013 in the database of the Wildlife Rehabilitation Center of Torreferrussa (Catalonia, NW Spain) assessed the morbidity, outcomes and cost-benefits of the rehabilitation practices. Results Three hundred and two species were included: 232 birds (n = 48633), 37 mammals (n = 3293), 20 reptiles (n = 2705) and 13 amphibians (n = 141). The most frequent causes of admission were: 39.8% confiscation of protected species (89.4% passerines), 31.8% orphaned young animals (35.3% swifts, 21.7% diurnal raptors and owls) and 17.4% trauma casualties (46.7% raptors and owls). The highest proportion of releases was found in the captivity confiscation category [87.4% passerines (median time of stay: 12 days)], followed by the orphaned category [78% owls (66 days), 76.5% diurnal birds of prey (43 days), 75.6% hedgehogs (49 days), 52.7% swifts (19 days) and 52% bats (55 days)]. For the trauma group, 46.8% of releases were hedgehogs (44 days) and 25.6% owls (103 days). As regards the cost-benefit index, the trauma casualties and infectious diseases had the worse values with 1.3 and 1.4 released animals/euro/day respectively, and were particularly low in raptors, waders, marine birds and chiroptera. On the contrary, captivity (4.6) and misplacement (4.1) had the best index, particulary in amphibian, reptiles and passerines. Conclusions/significance Cost-benefit studies including the release rate, the time of stay at the center and the cost-benefit index should be implemented for improving management efficiency of the Wildlife Rehabilitation Centers. PMID:28719647

  10. Space Qualified High Speed Reed Solomon Encoder

    NASA Technical Reports Server (NTRS)

    Gambles, Jody W.; Winkert, Tom

    1993-01-01

    This paper reports a Class S CCSDS recommendation Reed Solomon encoder circuit baselined for several NASA programs. The chip is fabricated using United Technologies Microelectronics Center's UTE-R radiation-hardened gate array family, contains 64,000 p-n transistor pairs, and operates at a sustained output data rate of 200 MBits/s. The chip features a pin selectable message interleave depth of from 1 to 8 and supports output block lengths of 33 to 255 bytes. The UTE-R process is reported to produce parts that are radiation hardened to 16 Rads (Si) total dose and 1.0(exp -10) errors/bit-day.

  11. International Nosocomial Infection Control Consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module.

    PubMed

    Rosenthal, Víctor Daniel; Maki, Dennis George; Mehta, Yatin; Leblebicioglu, Hakan; Memish, Ziad Ahmed; Al-Mousa, Haifaa Hassan; Balkhy, Hanan; Hu, Bijie; Alvarez-Moreno, Carlos; Medeiros, Eduardo Alexandrino; Apisarnthanarak, Anucha; Raka, Lul; Cuellar, Luis E; Ahmed, Altaf; Navoa-Ng, Josephine Anne; El-Kholy, Amani Ali; Kanj, Souha Sami; Bat-Erdene, Ider; Duszynska, Wieslawa; Van Truong, Nguyen; Pazmino, Leonardo N; See-Lum, Lucy Chai; Fernández-Hidalgo, Rosalia; Di-Silvestre, Gabriela; Zand, Farid; Hlinkova, Sona; Belskiy, Vladislav; Al-Rahma, Hussain; Luque-Torres, Marco Tulio; Bayraktar, Nesil; Mitrev, Zan; Gurskis, Vaidotas; Fisher, Dale; Abu-Khader, Ilham Bulos; Berechid, Kamal; Rodríguez-Sánchez, Arnaldo; Horhat, Florin George; Requejo-Pino, Osiel; Hadjieva, Nassya; Ben-Jaballah, Nejla; García-Mayorca, Elías; Kushner-Dávalos, Luis; Pasic, Srdjan; Pedrozo-Ortiz, Luis E; Apostolopoulou, Eleni; Mejía, Nepomuceno; Gamar-Elanbya, May Osman; Jayatilleke, Kushlani; de Lourdes-Dueñas, Miriam; Aguirre-Avalos, Guadalupe

    2014-09-01

    We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line-associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  12. Analysis of Macular and Retinal Nerve Fiber Layer Thickness in Children with Refractory Amblyopia after Femtosecond Laser-assisted Laser In situ Keratomileusis: A Retrospective Study

    PubMed Central

    Zhao, Peng-Fei; Zhou, Yue-Hua; Zhang, Jing; Wei, Wen-Bin

    2017-01-01

    Background: Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK). Methods: In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0–6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis. Results: One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups. No significant difference was found 3 days or 1 week after surgery (P > 0.05). In all three groups, no significant difference was found in the macular inner retinal or peripapillary RNFL thickness 1 day, 3 days, or 1 week after surgery (P > 0.05). Conclusions: The foveal center retinal edema after FS-LASIK is mild and reversible in children, that mostly occurred in the high myopic group with no effect on the visual acuity, and is always relieved within 1 week. PMID:28875960

  13. Renewable Hydrogen for Carbon-Free Data Center

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

    Kurtz, Jennifer M; Ma, Zhiwen; Hammond, Steven W

    NREL, in collaboration with Hewlett Packard Enterprise, has developed a system model for simulating both grid-tied and island microgrid power for hydrogen production and data center operation (assumed at 50 MW, 24 hours a day, 7 days a week).

  14. 2017 A Day of Remembrance

    NASA Image and Video Library

    2017-01-26

    Following Kennedy Space Center's Day of Remembrance ceremony in the Center for Space Education at the Kennedy visitor complex, guests gathered to place flowers at the Space Mirror Memorial. Many of those in attendance were family members of the fallen astronauts.

  15. NASA Space Day in Mississippi - Senate

    NASA Image and Video Library

    2008-01-30

    Astronaut Michael Foale (center) and Stennis Space Center officials met with Mississippi Lt. Gov. Phil Bryant (at rear podium) and Gulf Coast delegation members in Mississippi Senate chambers during NASA Space Day in Mississippi activities at the Capitol on January 30.

  16. NASA Space Day in Mississippi - Senate

    NASA Technical Reports Server (NTRS)

    2008-01-01

    Astronaut Michael Foale (center) and Stennis Space Center officials met with Mississippi Lt. Gov. Phil Bryant (at rear podium) and Gulf Coast delegation members in Mississippi Senate chambers during NASA Space Day in Mississippi activities at the Capitol on January 30.

  17. Who Are the Clients?: Goal Displacement in an Adult Care Center for Elders with Dementia

    ERIC Educational Resources Information Center

    Abramson, Corey M.

    2009-01-01

    This ethnographic study of "goal displacement" in an adult day care center explains how and why certain goals come to surpass others in the organizational practices of elder day care settings. Adult day care is often oriented towards providing family caregivers with respite rather than attempting to directly improve the lives of the elders…

  18. About High-Performance Computing at NREL | High-Performance Computing |

    Science.gov Websites

    Day(s): First Thursday of every month Hours: 11 a.m. - 12 p.m. Location: ESIF B211-Edison Conference Room Contact: Jennifer Southerland Insight Center - Visualization Tools Day(s): Every Monday Hours: 10 Data System Day(s): Every Monday Hours: 10 a.m. - 11 a.m. Location: ESIF B308-Insight Center

  19. The Relationship of Staffing Characteristics to Child Outcomes in Day Care.

    ERIC Educational Resources Information Center

    Oyemade, Ura Jean; Chargois, Michele

    This paper presents evidence of the need to apply specific levels of competence to day care center staff, and describes the impact of these levels of competence on the children receiving care. Nine categories of staff necessary for quality day care are discussed and the duties of each are outlined. The categories are center director, director of…

  20. Stennis Space Center celebrates Diversity Day

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Kendall Mitchell of the Naval Oceanographic Office (right) learns about the culture of Bolivia from Narda Inchausty, president of the Foreign Born Wives Association in Slidell, La., during 2009 Diversity Day events at NASA's John Stennis Space Center. Stennis hosted Diversity Day activities for employees on Oct. 7. The day's events included cultural and agency exhibits, diversity-related performances, a trivia contest and a classic car and motorcycle show. It also featured the first-ever sitewide Stennis Employee Showcase.

  1. Monitoring of Downstream Salmon and Steelhead at Federal Hydroelectric Facilities, 1991 Annual Report.

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

    Hawkes, Lynette A.; Martinson, Rick D.; Smith, W. William

    1992-04-01

    The 1991 smolt monitoring project of the National Marine Fisheries Service provided data on the seaward migration of juvenile salmon and steelhead at John Day, The Dalles and Bonneville Dams. All pertinent fish capture and condition data as well as dam operations and river flow data were provided to Fish Passage Center for use in developing fish passage indices and migration timing, and for water budget and spill management.

  2. 32nd Aerospace Mechanisms Symposium

    NASA Technical Reports Server (NTRS)

    Walker, S. W. (Compiler); Boesiger, Edward A. (Compiler)

    1998-01-01

    The proceedings of the 32nd Aerospace Mechanism Symposium are reported. NASA John F. Kennedy Space Center (KSC) hosted the symposium that was held at the Hilton Oceanfront Hotel in Cocoa Beach, Florida on May 13-15, 1998. The symposium was cosponsored by Lockheed Martin Missiles and Space and the Aerospace Mechanisms Symposium Committee. During these days, 28 papers were presented. Topics included robotics, deployment mechanisms, bearing, actuators, scanners, boom and antenna release, and test equipment.

  3. Precipice of Parity: Future of the USAF Fighter Force Structure

    DTIC Science & Technology

    2014-04-01

    573 to 487 aircraft to conduct combat operations . The total force that one can never expect to get off the ground on a given day is thus 86 of the...AD area denial ADOC Air Defense Operations Center AGM air-to- ground missile ASCM anti-ship cruise missile CAF Combat Air Force CAPES Combat...suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis

  4. Survivorship of Primary Hip Arthroscopy in New York State - A Population-Based Study

    PubMed Central

    Nawabi, Danyal H.; Degen, Ryan; Pan, Ting; Ranawat, Anil S.; Kelly, Bryan T.; Lyman, Stephen

    2016-01-01

    Objectives: Hip arthroscopy utilization has significantly increased over the past decade, with annual rates increasing as much as 300-600% in that time period. While large sample data demonstrates significant improvement in clinical outcomes out to two years post-operatively, with low rates of associated post-operative complications, there is little information on the long-term survival of primary hip arthroscopy procedures. The purpose of this study is to report on the rates of revision hip arthroscopy and conversion to resurfacing or total hip arthroplasty (THA) following hip arthroscopy in the State of New York. We will also report on prognostic variables that may contribute to the need for repeat surgery. Methods: The Statewide Planning and Research Cooperative System (SPARCS) database, a census of all hospital admissions and ambulatory surgery in New York State, was used to identify cases of outpatient primary hip arthroscopy. Demographic information was collected for these patients. After case identification, unique identifiers were utilized to identify those patients that underwent revision hip arthroscopy or subsequent ipsilateral hip resurfacing or THA. The risks of each of these outcomes were modeled with use of age, sex, socio-economic status, hospital and surgeon volume as potential risk factors. Patients were also tracked for 30-day and 90-day complications requiring re-admission. Results: We identified 8,267 hip arthroscopy cases from 1998-2012 performed by 295 surgeons in 137 different surgical centers. Demographics revealed that 46.1% of patients were male, with 80.2% carrying private insurance. Annual hip arthroscopy rates increased 88-fold over the observation period, with a 750% increase over the last 10 years. Revision surgery (scope or arthroplasty) was required in 1,087 cases (13.1%) at a mean of 622 ± 603 days. More specifically, revision hip arthroscopy was required in 310 cases (3.8%) at a mean of 649 ± 586 days after the index procedure, while conversion to either resurfacing or THA was required in 796 (9.7%) cases at an average of 616 ± 616 days. The 30-day complication rate, excluding revision surgery, was 0.2%, while the 90-day complication rate was 0.3%. Thirty-day all-cause re-admission rate was 0.7%. Regression analysis revealed that age > 50 y.o. was associated with increased risk of re-operation (Hazard Ratio[HR] 2.30; CI 2.02-2.62), while males carried a slightly lower risk of re-operation (HR 0.88, CI 0.78 -1.0). Additionally, increased surgical volume, for both surgeon and center (≥75th percentile of annual cases), resulted in a lower risk of re-operation (HR 0.64; CI 0.53-0.77; HR 0.61; CI 0.51-0.73). Conclusion: Hip arthroscopy represents a viable treatment option for femoroacetabular impingement, with low rates of revision surgery and conversion to hip arthroplasty. Age less than 50 and higher surgeon and center surgical volume were associated with lower risk of re-operation.

  5. An evaluation of lead contamination in plastic toys collected from day care centers in the Las Vegas Valley, Nevada, USA.

    PubMed

    Greenway, Joseph A; Gerstenberger, Shawn

    2010-10-01

    Childhood exposure to environmental lead continues to be a major health concern. This study examined lead content within the plastic of children's toys collected from licensed day care centers in the Las Vegas valley, Nevada. It was hypothesized that the use of lead as a plastics stabilizer would result in elevated lead (≥600 ppm) in polyvinyl chloride plastics (PVC) compared to non-PVC plastics. It was also hypothesized that, due to the use of lead chromate as a coloring agent, yellow toys would contain higher concentrations of lead (≥600 ppm) than toys of other colors. Toy samples were limited to those found in day care centers in Las Vegas, Nevada. 10 day care centers were visited and approximately 50 toy samples were taken from each center. Of the 535 toys tested, 29 contained lead in excess of 600 parts per million (ppm). Of those 29 toys, 20 were PVC and 17 were yellow. Both of the two hypotheses were strongly supported by the data.

  6. Daily collection of self-reporting sleep disturbance data via a smartphone app in breast cancer patients receiving chemotherapy: a feasibility study.

    PubMed

    Min, Yul Ha; Lee, Jong Won; Shin, Yong-Wook; Jo, Min-Woo; Sohn, Guiyun; Lee, Jae-Ho; Lee, Guna; Jung, Kyung Hae; Sung, Joohon; Ko, Beom Seok; Yu, Jong-Han; Kim, Hee Jeong; Son, Byung Ho; Ahn, Sei Hyun

    2014-05-23

    Improvements in mobile telecommunication technologies have enabled clinicians to collect patient-reported outcome (PRO) data more frequently, but there is as yet limited evidence regarding the frequency with which PRO data can be collected via smartphone applications (apps) in breast cancer patients receiving chemotherapy. The primary objective of this study was to determine the feasibility of an app for sleep disturbance-related data collection from breast cancer patients receiving chemotherapy. A secondary objective was to identify the variables associated with better compliance in order to identify the optimal subgroups to include in future studies of smartphone-based interventions. Between March 2013 and July 2013, patients who planned to receive neoadjuvant chemotherapy for breast cancer at Asan Medical Center who had access to a smartphone app were enrolled just before the start of their chemotherapy and asked to self-report their sleep patterns, anxiety severity, and mood status via a smartphone app on a daily basis during the 90-day study period. Push notifications were sent to participants daily at 9 am and 7 pm. Data regarding the patients' demographics, interval from enrollment to first self-report, baseline Beck's Depression Inventory (BDI) score, and health-related quality of life score (as assessed using the EuroQol Five Dimensional [EQ5D-3L] questionnaire) were collected to ascertain the factors associated with compliance with the self-reporting process. A total of 30 participants (mean age 45 years, SD 6; range 35-65 years) were analyzed in this study. In total, 2700 daily push notifications were sent to these 30 participants over the 90-day study period via their smartphones, resulting in the collection of 1215 self-reporting sleep-disturbance data items (overall compliance rate=45.0%, 1215/2700). The median value of individual patient-level reporting rates was 41.1% (range 6.7-95.6%). The longitudinal day-level compliance curve fell to 50.0% at day 34 and reached a nadir of 13.3% at day 90. The cumulative longitudinal compliance curve exhibited a steady decrease by about 50% at day 70 and continued to fall to 45% on day 90. Women without any form of employment exhibited the higher compliance rate. There was no association between any of the other patient characteristics (ie, demographics, and BDI and EQ5D-3L scores) and compliance. The mean individual patient-level reporting rate was higher for the subgroup with a 1-day lag time, defined as starting to self-report on the day immediately after enrollment, than for those with a lag of 2 or more days (51.6%, SD 24.0 and 29.6%, SD 25.3, respectively; P=.03). The 90-day longitudinal collection of daily self-reporting sleep-disturbance data via a smartphone app was found to be feasible. Further research should focus on how to sustain compliance with this self-reporting for a longer time and select subpopulations with higher rates of compliance for mobile health care.

  7. The Family Value of Information, Community Support, and Experience Study: Rationale, Design, and Methods of a "Family-Centered" Research Study.

    PubMed

    Reeves, Gloria M; Wehring, Heidi J; Connors, Kathleen M; Bussell, Kristin; Schiffman, Jason; Medoff, Deborah R; Tsuji, Thomas; Walker, Jane; Brown, Alicia; Strobeck, Danielle; Clough, Tammy; Rush, Caitlin B; Riddle, Mark A; Love, Raymond C; Zachik, Albert; Hoagwood, Kimberly; Olin, S Serene; Stephan, Sharon; Okuzawa, Nana; Edwards, Sarah; Baquet, Claudia; dosReis, Susan

    2015-12-01

    The Patient Protection and Affordable Care Act focuses on improving consumer engagement and patient-centered care. This article describes the design and rationale of a study targeting family engagement in pediatric mental health services. The study is a 90-day randomized trial of a telephone-delivered Family Navigator services versus usual care for parents of Medicaid-insured youth younger than 13 years with serious mental illness. Youth are identified through a pediatric antipsychotic medication preauthorization program. Family Navigators offer peer support to empower and engage parents in their child's recovery. Outcomes include parent report of empowerment, social support, satisfaction with child mental health services, and child functioning as well as claims-based measures of psychotherapy service utilization and antipsychotic medication dosage. The focus on "family-centered" care in this study is strongly supported by the active role of consumers in study design and implementation.

  8. KSC-05PD-0142

    NASA Technical Reports Server (NTRS)

    2005-01-01

    KENNEDY SPACE CENTER, FLA. NASA Administrator Sean OKeefe (right) is accompanied on stage in the Press Site Auditorium by Center Director Jim Kennedy for a report to employees on the state of the Agency. The update was broadcast live via NASA Television. O'Keefe focused on the achievements of 2004 and the goals set for 2005. His remarks emphasized the milestones met in NASA's Vision for Space Exploration, including the launch of the comet-chasing Deep Impact mission and the landing of the Huygens probe on Jupiters moon Titan, both occurring in the past two days, and the progress made in meeting the requirements to return the Space Shuttle to flight. OKeefes briefing included a dialogue with Associate Administrator of NASAs Office of Exploration Systems Craig Steidle and Center Director Jim Kennedy, live; and Manager of the Space Station Office Bill Gerstenmaier and Director of Advanced Planning and Jet Propulsion Laboratory Charles Elachi, via satellite.

  9. KSC-05PD-0144

    NASA Technical Reports Server (NTRS)

    2005-01-01

    KENNEDY SPACE CENTER, FLA. NASA Administrator Sean OKeefe (right) is accompanied on stage in the Press Site Auditorium by Center Director Jim Kennedy for a report to employees on the state of the Agency. The update was broadcast live via NASA Television. O'Keefe focused on the achievements of 2004 and the goals set for 2005. His remarks emphasized the milestones met in NASA's Vision for Space Exploration, including the launch of the comet-chasing Deep Impact mission and the landing of the Huygens probe on Jupiters moon Titan, both occurring in the past two days, and the progress made in meeting the requirements to return the Space Shuttle to flight. OKeefes briefing included a dialogue with Associate Administrator of NASAs Office of Exploration Systems Craig Steidle and Center Director Jim Kennedy, live; and Manager of the Space Station Office Bill Gerstenmaier and Director of Advanced Planning and Jet Propulsion Laboratory Charles Elachi, via satellite.

  10. KSC-05PD-0143

    NASA Technical Reports Server (NTRS)

    2005-01-01

    KENNEDY SPACE CENTER, FLA. NASA Administrator Sean OKeefe (right) is accompanied on stage in the Press Site Auditorium by Center Director Jim Kennedy for a report to employees on the state of the Agency. The update was broadcast live via NASA Television. O'Keefe focused on the achievements of 2004 and the goals set for 2005. His remarks emphasized the milestones met in NASA's Vision for Space Exploration, including the launch of the comet-chasing Deep Impact mission and the landing of the Huygens probe on Jupiters moon Titan, both occurring in the past two days, and the progress made in meeting the requirements to return the Space Shuttle to flight. OKeefes briefing included a dialogue with Associate Administrator of NASAs Office of Exploration Systems Craig Steidle and Center Director Jim Kennedy, live; and Manager of the Space Station Office Bill Gerstenmaier and Director of Advanced Planning and Jet Propulsion Laboratory Charles Elachi, via satellite.

  11. Space Weather Services and Products of RWC Russia in 2007

    NASA Astrophysics Data System (ADS)

    Burov, Viatcheslav; Avdyushin, Sergei; Denisova, Valentina

    RWC Russia (Institute of Applied Geophysics) - forecasting center unites activity of the National Heliogeophysic Service of Russia and Regional Warning Center ISES. The Center has been operating since 1974. There are several services that carry out gathering, processing and spreading of the total information data flow, (including both Russian and foreign-exchange data), and forecasts. Forecasting activities results are issued in the form of special messages, the major part of which corresponds to standard codes. Our Web page: www.geospace.ru are represented the current data and the forecasts. At present both a weekly 7-day geomagnetic forecast and the actual disturbance activity information for the previous week are available on the Web page. And, the data of some ionosphere and magnetic stations are available on this page too. Various types of our forecast alert and routine observations are considered in the report

  12. Fecal coliforms on environmental surfaces in two day care centers.

    PubMed Central

    Weniger, B G; Ruttenber, A J; Goodman, R A; Juranek, D D; Wahlquist, S P; Smith, J D

    1983-01-01

    A survey of environmental surfaces in two Atlanta area day care centers was conducted to determine the prevalence of fecal coliform bacteria, considered a marker for the presence of fecal contamination which might contain pathogenic parasites, bacteria, or viruses. Fecal coliforms were found in 17 (4.3%) of 398 representative samples of building surfaces, furniture, and other objects. These surfaces may be involved in the chain of transmission of enteric diseases among children. Therefore, disinfection of inanimate objects, in addition to good handwashing, may be important in controlling the spread of enteric diseases in day care centers. PMID:6830225

  13. Center Director Bridges opens Super Safety and Health Day at KSC.

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Center Director Roy Bridges opens the second Super Safety and Health Day at Kennedy Space Center, an entire day when most normal work activities are suspended to allow personnel to attend safety- and health-related activities. The theme, 'Safety and Health Go Hand in Hand,' emphasized KSC's commitment to place the safety and health of the public, astronauts, employees and space- related resources first and foremost. Events included a keynote address, a panel session about related issues, vendor exhibits, and safety training in work groups. The keynote address and panel session were also broadcast internally over NASA television.

  14. Calls to Florida Poison Control Centers about mercury: Trends over 2003-2013.

    PubMed

    Gribble, Matthew O; Deshpande, Aniruddha; Stephan, Wendy B; Hunter, Candis M; Weisman, Richard S

    2017-11-01

    The aim of this analysis was to contrast trends in exposure-report calls and informational queries (a measure of public interest) about mercury to the Florida Poison Control Centers over 2003-2013. Poison-control specialists coded calls to Florida Poison Control Centers by substance of concern, caller demographics, and whether the call pertained to an exposure event or was an informational query. For the present study, call records regarding mercury were de-identified and provided along with daily total number of calls for statistical analysis. We fit Poisson models using generalized estimating equations to summarize changes across years in counts of daily calls to Florida Poison Control Centers, adjusting for month. In a second stage of analysis, we further adjusted for the total number of calls each day. We also conducted analyses stratified by age of the exposed. There was an overall decrease over 2003-2013 in the number of total calls about mercury [Ratio per year: 0.89, 95% CI: (0.88, 0.90)], and calls about mercury exposure [Ratio per year: 0.84, 95% CI: (0.83, 0.85)], but the number of informational queries about mercury increased over this time [Ratio per year: 1.15 (95% CI: 1.12, 1.18)]. After adjusting for the number of calls of that type each day (e.g., call volume), the associations remained similar: a ratio of 0.88 (95% CI: 0.87, 0.89) per year for total calls, 0.85 (0.83, 0.86) for exposure-related calls, and 1.17 (1.14, 1.21) for informational queries. Although, the number of exposure-related calls decreased, informational queries increased over 2003-2013. This might suggest an increased public interest in mercury health risks despite a decrease in reported exposures over this time period. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. 30-day hospital readmission after robotic partial nephrectomy--are we prepared for Medicare readmission reduction program?

    PubMed

    Brandao, Luis Felipe; Zargar, Homayoun; Laydner, Humberto; Akca, Oktay; Autorino, Riccardo; Ko, Oliver; Samarasekera, Dinesh; Li, Jianbo; Rabets, John; Krishnan, Jayram; Haber, Georges-Pascal; Kaouk, Jihad; Stein, Robert J

    2014-09-01

    After CMS introduced the concept of the Hospital Readmissions Reduction Program, hospitals and health care centers became financially penalized for exceeding specific readmission rates. We retrospectively reviewed our institutional review board approved database of patients undergoing robotic partial nephrectomy at our institution and included in our analysis patients who were readmitted to any hospital as an inpatient stay within 30 days from discharge home after robotic partial nephrectomy. From March 2006 to March 2013 a total of 627 patients underwent robotic partial nephrectomy at our center and 28 (4.46%) were readmitted within 30 days of surgery. Postoperative bleeding was responsible for 8 (28.5%) readmissions. Pulmonary embolism was reported in 3 cases and retroperitoneal abscess was diagnosed in 2. Urinary leak requiring surgical intervention developed in 2 patients, pneumonia was diagnosed in 2 and 2 patients were readmitted for chest pain. Overall 9 (32.1%) patients presented with major complications requiring intervention. On multivariable analysis Charlson comorbidity index score was the only factor significantly associated with a higher 30-day readmission rate (p = 0.03). If the Charlson score was 5 or greater the chance of hospital readmission would be 2.7 times higher. Increased comorbidity, specifically a Charlson score of 5 or greater, was the only significant predictor of a higher incidence of 30-day readmission. This information can be useful in counseling patients regarding robotic partial nephrectomy and in determining baseline rates if CMS expands the number of conditions they evaluate for excess 30-day readmissions. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Comparison of ventilator-associated pneumonia (VAP) rates between different ICUs: Implications of a zero VAP rate.

    PubMed

    Sundar, Krishna M; Nielsen, David; Sperry, Paul

    2012-02-01

    Ventilator-associated pneumonia (VAP) is associated with significant morbidity and mortality. Measures to reduce the incidence of VAP have resulted in institutions reporting a zero or near-zero VAP rates. The implications of zero VAP rates are unclear. This study was done to compare outcomes between two intensive care units (ICU) with one of them reporting a zero VAP rate. This study retrospectively compared VAP rates between two ICUs: Utah Valley Regional Medical Center (UVRMC) with 25 ICU beds and American Fork Hospital (AFH) with 9 ICU beds. Both facilities are under the same management and attended by a single group of intensivists. Both ICUs have similar nursing and respiratory staffing patterns. Both ICUs use the same intensive care program for reduction of VAP rates. ICU outcomes between AFH (reporting zero VAP rate) and UVRMC (VAP rate of 2.41/1000 ventilator days) were compared for the years 2007-2008. UVRMC VAP rates during 2007 and 2008 were 2.31/1000 ventilator days and 2.5/1000 ventilator days respectively compared to a zero VAP rate at AFH. The total days of ventilation, mean days of ventilation per patient and mean duration of ICU stay per patient was higher in the UVRMC group as compared to AFH ICU group. There was no significant difference in mean age and APACHE II score between ICU patients at UVRMC and AFH. There was no statistical difference in rates of VAP and mortality between UVRMC and AFH. During comparisons of VAP rate between institutions, a zero VAP rate needs to be considered in the context of overall ventilator days, mean durations of ventilator stay and ICU mortality. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. NLSI Focus Group on Missing ALSEP Data Recovery: Progress and Plans

    NASA Technical Reports Server (NTRS)

    Lewis, L. R.; Nakamura, Y.; Nagihara, S.; Williams, D. R.; Chi, P.; Taylor, P. T.; Schmidt, G. K.; Grayzeck, E. J.

    2011-01-01

    On the six Apollo landed missions, the Astronauts deployed the Apollo Lunar Surface Experiments Package (ALSEP) science stations which measured active and passive seismic events, magnetic fields, charged particles, solar wind, heat flow, the diffuse atmosphere, meteorites and their ejecta, lunar dust, etc. Today's scientists are able to extract new information and make new discoveries from the old ALSEP data utilizing recent advances in computer capabilities and new analysis techniques. However, current-day investigators are encountering problems trying to use the ALSEP data. In 2007 archivists from NASA Goddard Space Flight Center (GSFC) National Space Science Data Center (NSSDC) estimated only about 50 percent of the processed ALSEP lunar surface data-of-interest to current lunar science investigators were in the NSSDC archives. The current-day lunar science investigators found most of the ALSEP data, then in the NSSDC archives. were extremely difficult to use. The data were in forms often not well described in the published reports and rerecording anomalies existed in the data which could only be resolved by tape experts. To resolve this problem, the DPS Lunar Data Node was established in 2008 at NSSDC and is in the process of successfully making the existing archived ALSEP data available to current-day investigators in easily useable forms. In July of 2010 the NASA Lunar Science Institute (NLSI) at Ames Research Center established the Recovery of Missing ALSEP Data Focus Group in recognition of the importance of the current activities to find the raw and processed ALSEP data missing from the NSSDC archives.

  18. Work hours, sleep sufficiency, and prevalence of depression among full-time employees: a community-based cross-sectional study.

    PubMed

    Nakata, Akinori

    2011-05-01

    Depression due to long work hours and sleep deprivation is a major occupational health concern. The extent to which work hours and sleep are associated with depression was investigated in employees of small- and medium-scale businesses in the Japanese city of Yashio, Saitama, and in the Ohta ward of Tokyo, a suburb of Tokyo, controlling for various potential confounders. In this cross-sectional study, a total of 2,643 full-time employees (1,928 men and 715 women), aged 18-79 years (mean = 45 years), in 296 small- and medium-scale businesses were surveyed from August 2002 to December 2002 using a self-administered questionnaire evaluating work hours, sleep status, and covariates including sociodemographic and socioeconomic factors, health behaviors, biological factors, medication usage, and occupational factors. Depression was assessed using the Center for Epidemiologic Studies Depression Scale. Prevalence of depression by work hours, sleep status, and covariates was analyzed by χ² test. Risk of depression by work hours, sleep status, and both combined was estimated by multivariate logistic regression analysis. Participants working > 10 hours per day, sleeping < 6 hours per day, and reporting insufficient sleep were, respectively, 37%, 43%, and 97% more likely to be depressed than those working 6 to 8 hours per day, sleeping 6 to < 8 hours per day, and reporting sufficient sleep (P < .05). Participants working > 10 hours per day or > 8 to 10 hours per day with < 6 hours per day of sleep showed a 41%-169% higher prevalence of depression versus those working 6 to 8 hours per day with 6+ hours per day of sleep (P < .05). Participants reporting insufficient sleep in 3 work-hour categories (6 to 8, > 8 to 10, and > 10 hours per day) showed a 62%-179% increase in the prevalence of depression versus those working 6 to 8 hours per day and reporting sufficient sleep (P < .05). No significant effects on depression were found for subjects in any work-hour category with 6+ hours of sleep or with subjective sufficient sleep. Depression associated with long work hours is primarily a result of sleep deprivation. Greater attention should be paid to management of sleep deprivation to prevent workplace depression. © Copyright 2011 Physicians Postgraduate Press, Inc.

  19. Quasi-experimental Study of Systematic Screening for Family Planning Services among Postpartum Women Attending Village Health and Nutrition Days in Jharkhand, India.

    PubMed

    Balasubramaniam, Sudharsanam; Kumar, Somesh; Sethi, Reena; Charurat, Elaine; Lalchandani, Kamlesh; Schuster, Anne; Sood, Bulbul

    2018-01-25

    Systematic screening helps increase family planning uptake through integration with other services, including immunization. Though successfully demonstrated at health facilities, this strategy has not been demonstrated in communities. This study assessed the effectiveness of systematic screening to increase postpartum family planning use during community health days in India without adversely affecting immunization services. The study was conducted during 180 individual Village Health and Nutrition Days in Jharkhand, India. All health workers were trained in postpartum family planning counseling. Intervention providers were also trained in systematic screening. 217 postpartum women aged 15-49 years participated in baseline and endline exit interviews and routine service statistics were analyzed from 2,485 facility visits at affiliated health centers. No difference in family planning service use was found in the intervention group, but significantly fewer interviewed women reported receiving family planning services at endline in the comparison group (p = 0.014). Family planning acceptance at affiliated health centers increased significantly in intervention areas (p < 0.001) but not in comparison areas, while immunization service use increased in both groups (p = 0.002 intervention, p < 0.001 comparison). The use of the postpartum systematic screening tool appears to increase acceptance of family planning services when integrated with community-based services in Jharkhand.

  20. Effects of obstructive sleep apnea surgery on middle ear function.

    PubMed

    Lin, Hsin-Ching; Friedman, Michael; Chang, Hsueh-Wen; Shao, Chi-Hsin; Pulver, Tanya M; Chen, Yung-Che

    2011-04-01

    To study the effect of Z-palatopharyngoplasty plus radiofrequency of the base of the tongue on middle ear function. A retrospective review of a prospective data set at a tertiary care center. University-affiliated medical center. The study population included 47 patients (42 men and 5 women; mean age, 40.8 years) who underwent Z-palatopharyngoplasty plus radiofrequency of the base of the tongue for obstructive sleep apnea/hypopnea syndrome. All patients had healthy eardrums and no previous history of chronic ear disease. Pure-tone audiometric and tympanometric assessments were performed preoperatively and at 3 days, 7 days, 1 month, and 3 months postoperatively. Levels of baseline and postoperative middle ear pressure were compared. Twelve patients (26%) reported otologic concerns, such as ear pressure and/or otalgia, within 1 week postoperatively. No permanent otologic discomfort occurred. A trend toward reduced middle ear pressure was noted in this study. The decrease in middle ear pressure became apparent on day 3. However, mean pressure changes were no longer significantly different than preoperative values by 1 week after surgery. We found that Z-palatopharyngoplasty plus radiofrequency of the base of the tongue for obstructive sleep apnea/hypopnea syndrome induces changes in middle ear function. However, the changes were temporary and not significant after 3 months of follow-up.

  1. Shot by a Gun … Missed by a Provider.

    PubMed

    Garcia, Eddie; Zaid, Abdul H; Calello, Diane P; McHugh, Lisa; Arzumanov, Grant; Asrar, Najaf; Sapin, Ari; Fless, Kristin G

    2018-04-01

    Botulism is a paralytic disease caused by the neurotoxin produced by Clostridium botulinum. The majority of cases are due to ingestion or injection drug use. Wound botulism from traumatic injury is exceedingly rare, with only one to two cases reported each year in the United States. A 27-year-old man presented to the Emergency Department with diplopia, dysphagia, and progressive weakness 10 days after sustaining a gunshot wound to his right lower leg. He had been evaluated for the same complaints at a different facility the day prior and was discharged. His wound appeared well-healing, but a high suspicion for wound botulism led to rapid consultation with the state Poison Control Center and the Centers for Disease Control and Prevention. The patient developed worsening respiratory insufficiency and required mechanical ventilation. Expeditious treatment with equine heptavalent botulinum antitoxin resulted in significant recovery of strength in 4 days. Serum toxin bioassay tested positive for botulinum neurotoxin type A. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Wound botulism now accounts for the majority of adult botulism in the United States. It should be considered in any patient with signs of neuromuscular disease and a recent injury, even if the wound appears uninfected. Published by Elsevier Inc.

  2. Differences in stress-related ratings between research center and home environments in dementia caregivers using ecological momentary assessment

    PubMed Central

    Fonareva, Irina; Amen, Alexandra M.; Ellingson, Roger M.; Oken, Barry S.

    2012-01-01

    Background Clinicians and researchers working with dementia caregivers typically assess caregiver stress in a clinic or research center, but caregivers’ stress is rooted at home where they provide care. The study aimed to compare ratings of stress-related measures obtained in research setting and home using ecological momentary assessment (EMA). Methods EMA of 18 caregivers (mean age 66.4±7.8, 89% females) and 23 non-caregivers (mean age 66.4±7.9, 87% females) was implemented using a personal digital assistant. Subjects rated their perceived stress, fatigue, coping with current situation, mindfulness, and situational demand once in the research center and again at 3–4 semi-random points during a day at home. The data from several assessments conducted at home were averaged for statistical analyses and compared to the data collected in the research center. Results Testing environment had a differential effect on caregivers and non-caregivers for the ratings of perceived stress (p < 0.01) and situational demand (p = 0.01). When tested in research center, ratings for all measures were similar between groups, but when tested at home, caregivers rated their perceived stress higher than non-caregivers (p = 0.02). Overall, caregivers reported higher perceived stress at home than in the research center (p = 0.02), and non-caregivers reported greater situational demand in the research center than at home (p < 0.01). Conclusions The assessment method and environment affect stress-related outcomes. Evaluating participants in their natural environment provides a more sensitive measure of stress-related outcomes. EMA provides a convenient way to gather data when evaluating dementia caregivers. PMID:21777503

  3. Differences in stress-related ratings between research center and home environments in dementia caregivers using ecological momentary assessment.

    PubMed

    Fonareva, Irina; Amen, Alexandra M; Ellingson, Roger M; Oken, Barry S

    2012-01-01

    Clinicians and researchers working with dementia caregivers typically assess caregiver stress in a clinic or research center, but caregivers' stress is rooted at home where they provide care. This study aimed to compare ratings of stress-related measures obtained in research settings and in the home using ecological momentary assessment (EMA). EMA of 18 caregivers (mean age 66.4 years ±7.8; 89% females) and 23 non-caregivers (mean age 66.4 years ±7.9; 87% females) was implemented using a personal digital assistant. Subjects rated their perceived stress, fatigue, coping with current situation, mindfulness, and situational demand once in the research center and again at 3-4 semi-random points during a day at home. The data from several assessments conducted at home were averaged for statistical analyses and compared with the data collected in the research center. The testing environment had a differential effect on caregivers and non-caregivers for the ratings of perceived stress (p < 0.01) and situational demand (p = 0.01). When tested in the research center, ratings for all measures were similar between groups, but when tested at home, caregivers rated their perceived stress as higher than non-caregivers (p = 0.02). Overall, caregivers reported higher perceived stress at home than in the research center (p = 0.02), and non-caregivers reported greater situational demand in the research center than at home (p < 0.01). The assessment method and environment affect stress-related outcomes. Evaluating participants in their natural environment provides a more sensitive measure of stress-related outcomes. EMA provides a convenient way to gather data when evaluating dementia caregivers.

  4. Self-reported household impacts of large-scale chemical contamination of the public water supply, Charleston, West Virginia, USA.

    PubMed

    Schade, Charles P; Wright, Nasandra; Gupta, Rahul; Latif, David A; Jha, Ayan; Robinson, John

    2015-01-01

    A January 2014 industrial accident contaminated the public water supply of approximately 300,000 homes in and near Charleston, West Virginia (USA) with low levels of a strongly-smelling substance consisting principally of 4-methylcyclohexane methanol (MCHM). The ensuing state of emergency closed schools and businesses. Hundreds of people sought medical care for symptoms they related to the incident. We surveyed 498 households by telephone to assess the episode's health and economic impact as well as public perception of risk communication by responsible officials. Thirty two percent of households (159/498) reported someone with illness believed to be related to the chemical spill, chiefly dermatological or gastrointestinal symptoms. Respondents experienced more frequent symptoms of psychological distress during and within 30 days of the emergency than 90 days later. Sixty-seven respondent households (13%) had someone miss work because of the crisis, missing a median of 3 days of work. Of 443 households reporting extra expenses due to the crisis, 46% spent less than $100, while 10% spent over $500 (estimated average about $206). More than 80% (401/485) households learned of the spill the same day it occurred. More than 2/3 of households complied fully with "do not use" orders that were issued; only 8% reported drinking water against advice. Household assessments of official communications varied by source, with local officials receiving an average "B" rating, whereas some federal and water company communication received a "D" grade. More than 90% of households obtained safe water from distribution centers or stores during the emergency. We conclude that the spill had major economic impact with substantial numbers of individuals reporting incident-related illnesses and psychological distress. Authorities were successful supplying emergency drinking water, but less so with risk communication.

  5. Climate Prediction Center - 6-10 Day Wind Chill Outlook

    Science.gov Websites

    8-14 Day Obsrv'd About Us Our Mission Who We Are Contact Us CPC Information CPC Web Team 6-10 & official Web portal to all federal, state, and local government Web resources and services. 6-10 Day Lowest Park, Maryland 20740 Climate Prediction Center Web Team Page last modified: August 30, 2012 Disclaimer

  6. Cost and Quality Issues in Day Care: A Practical Approach to Assessment. (A Working Paper).

    ERIC Educational Resources Information Center

    Settles, Barbara H.; Cripps, Jean Helmkamp

    Cost and quality issues are analyzed as they relate to provision of group day care. A series of assessment tables for self-evaluation of centers is presented. Three specific aspects are considered: cost of care, quality of care delivered to children and staff use in day care centers. Cost analysis focuses on: (1) the total cost of care per…

  7. Ten Teamwork Terminators and Some Sure Cures.

    ERIC Educational Resources Information Center

    Child Care Information Exchange, 1992

    1992-01-01

    This article describes 10 behaviors of day care center directors that undermine the team performance of the caregiving staff. Also described are three behaviors that are crucial to fostering successful teamwork. A day care center teamwork evaluation form for staff is provided. (BC)

  8. 2012 Earth Day

    NASA Image and Video Library

    2012-04-24

    Bonnie Humphrey of NASA (l to r), Van Ward of NASA, Kim Maddox of the Naval Oceanographic Office, and Al Bryden of the NASA Shared Services Center learn about the Crosby Arboretum in Picayune, Miss., during the Earth Day celebration at Stennis Space Center on April 24, 2012.

  9. Energy Action Day

    NASA Image and Video Library

    2017-10-25

    NASA Kennedy Space Center employees attend the Energy Action Day event held in the center's Space Station Processing Facility. Part of Energy Awareness Month, the event featured subject matter experts in the area of solar energy, its connections to the space program and options for residential solar power.

  10. Epidemic profile of Shiga-toxin-producing Escherichia coli O104:H4 outbreak in Germany.

    PubMed

    Frank, Christina; Werber, Dirk; Cramer, Jakob P; Askar, Mona; Faber, Mirko; an der Heiden, Matthias; Bernard, Helen; Fruth, Angelika; Prager, Rita; Spode, Anke; Wadl, Maria; Zoufaly, Alexander; Jordan, Sabine; Kemper, Markus J; Follin, Per; Müller, Luise; King, Lisa A; Rosner, Bettina; Buchholz, Udo; Stark, Klaus; Krause, Gérard

    2011-11-10

    We describe an outbreak of gastroenteritis and the hemolytic-uremic syndrome caused by Shiga-toxin-producing Escherichia coli in Germany in May, June, and July, 2011. The consumption of sprouts was identified as the most likely vehicle of infection. We analyzed data from reports in Germany of Shiga-toxin-producing E. coli gastroenteritis and the hemolytic-uremic syndrome and clinical information on patients presenting to Hamburg University Medical Center (HUMC). An outbreak case was defined as a reported case of the hemolytic-uremic syndrome or of gastroenteritis in a patient infected by Shiga-toxin-producing E. coli, serogroup O104 or serogroup unknown, with an onset of disease during the period from May 1 through July 4, 2011, in Germany. A total of 3816 cases (including 54 deaths) were reported in Germany, 845 of which (22%) involved the hemolytic-uremic syndrome. The outbreak was centered in northern Germany and peaked around May 21 to 22. Most of the patients in whom the hemolytic-uremic syndrome developed were adults (88%; median age, 42 years), and women were overrepresented (68%). The estimated median incubation period was 8 days, with a median of 5 days from the onset of diarrhea to the development of the hemolytic-uremic syndrome. Among 59 patients prospectively followed at HUMC, the hemolytic-uremic syndrome developed in 12 (20%), with no significant differences according to sex or reported initial symptoms and signs. The outbreak strain was typed as an enteroaggregative Shiga-toxin-producing E. coli O104:H4, producing extended-spectrum beta-lactamase. In this outbreak, caused by an unusual E. coli strain, cases of the hemolytic-uremic syndrome occurred predominantly in adults, with a preponderance of cases occurring in women. The hemolytic-uremic syndrome developed in more than 20% of the identified cases.

  11. USGS environmental studies of the World Trade Center area, New York City, after September 11, 2001

    USGS Publications Warehouse

    Clark, Roger N.; Meeker, Greg; Plumlee, Geoffrey S.; Swayze, Gregg A.

    2002-01-01

    Two days after the September 11, 2001, attack on World Trade Center (WTC), the U.S. Geological Survey (USGS) was asked by the U.S. Environmental Protection Agency (EPA) and the U.S. Public Health Service to conduct a remote sensing and mineralogical characterization study of lower Manhattan around the WTC. This study, conducted in cooperation with the National Aeronautics and Space Administration (NASA) and the Jet Propulsion Laboratory (JPL), was requested to rapidly provide emergency response teams with information on the concentrations and distribution of asbestos and other materials in the dusts deposited around lower Manhattan after the September 11 WTC building collapse in New York City. Preliminary results of the study were released via the internet to emergency response teams on September 18 and September 27, 2001. After September 27, additional work was done to fill remaining data gaps, and the study report underwent further detailed peer review. The report was released to the general public via the internet on November 27, 2001. This fact sheet summarizes the results of the interdisciplinary study; the full report can be viewed at http://geology.cr.usgs.gov/pub/open-file-reports/ofr-01-0429/ .

  12. Low clouds over the English Channel

    NASA Image and Video Library

    2014-03-19

    A thick blanket of low clouds covered the English Channel, Celtic Sea and Irish Sea on March 13, 2014. The fog also crept over major cities in the United Kingdom and Ireland. While citizens living in parts of Ireland, England, Wales, Scotland and Northern Ireland were posting ground-based photos of fog-shrouded landscape on social media, the internet and news outlets, the scene was also captured from space. The Moderate Resolution Imaging Spectroradiometer (MODIS) aboard NASA’s Aqua captured this true-color image of the cloudy day at 13:00 UTC (1:00 p.m. in London) on that same day. The dense fog (low clouds) affected air travel, causing the cancellation of hundreds of flights going through London City Airport, where visibility was reported at less than 100 meters (328 ft) – less than the length of an American football field. Flights were also cancelled at Heathrow, Gatwick and Manchester. A private helicopter flying to Northern Ireland went down in by the fog near the Norfolk-Suffolk border, with loss of four lives. Driving was little better in many areas, causing the Met Office to issue a yellow weather warning and to caution drivers of difficult conditions. The lowest visibility of the day was reported at Roches Point weather station. Located at the southeastern tip of Cork Harbor, Ireland, the station reported visibility of less than 50 meters (164 ft) – the length of an Olympic size swimming pool. In this image, the fog-covered Celtic Sea is located in the southwest. Ireland lies under tendrils of low cloud in the northwest corner of the image. Banks of clouds part around England, near the center of the image, and southern Wales (top and center) completely under the foggy blanket. Fog also creeps over the coasts of France, Belgium and the Netherlands on the east side of the English Channel. Credit: NASA/GSFC/Jeff Schmaltz/MODIS Land Rapid Response Team NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  13. NASA Day at the Capitol

    NASA Image and Video Library

    2009-02-19

    Astronaut Rex Walheim (center) speaks to members of the Mississippi House of Representatives in chambers during NASA Day at the Capitol in Jackson on Feb. 19. Walheim was joined at the podium by members of the Mississippi House of Representatives Gulf Coast delegation, as well as Stennis Space Center Director Gene Goldman (astronaut's immediate right) and NASA's Shared Services Center Director Rick Arbuthnot and Partners for Stennis Executive Director Tish Williams (astronaut's immediate left).

  14. NASA Day at the Capitol

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Astronaut Rex Walheim (center) speaks to members of the Mississippi House of Representatives in chambers during NASA Day at the Capitol in Jackson on Feb. 19. Walheim was joined at the podium by members of the Mississippi House of Representatives Gulf Coast delegation, as well as Stennis Space Center Director Gene Goldman (astronaut's immediate right) and NASA's Shared Services Center Director Rick Arbuthnot and Partners for Stennis Executive Director Tish Williams (astronaut's immediate left).

  15. A Current Estimation of the Early Risk of Stroke after Transient Ischemic Attack: A Systematic Review and Meta-Analysis of Recent Intervention Studies.

    PubMed

    Valls, Joan; Peiro-Chamarro, Maranta; Cambray, Serafí; Molina-Seguin, Jessica; Benabdelhak, Ikram; Purroy, Francisco

    2017-01-01

    Recent studies have demonstrated that there is a decrease in the risk of subsequent stroke after transient ischemic attack (TIA) when urgent care (UC) is administered. However, no meta-analysis has been developed with contemporaneous TIA studies. We perform a systematic review and a meta-analysis to establish the risk of early stroke recurrence (SR) considering data from studies that offered UC to TIA patients. We searched for studies, without language restriction, from January 2007 to January 2015 according to PRISMA guidelines. We included studies with TIA patients who underwent UC and reported the proportion of SR at 90 days. We excluded studies that were centered on less than 100 patients and cohorts including both stroke and TIA, if stroke risk after TIA was not described. For its relevance, we included the TIAregistry.org study published in 2016. We performed both fixed and random effects meta-analyses to determine SR and assess sources of heterogeneity. From 4,103 identified citations, we selected 15 papers that included 14,889 patients. There was great variation in terms of the number of patients included in each study, ranging from 115 to 4,160. Seven studies were TIA clinic based. The mean age and the percentage of men were similar among studies, ranging from 62.4 to 73.1 years and 45.1-62%, respectively. The reported risk of stroke ranged from 0 to 1.46% 2 days after TIA (9 studies included), 0-2.55% 7 days after TIA (11 studies included), 1.91-2.85% 30 days after TIA (4 studies included), and 0.62-4.76% 90 days after TIA (all studies included). The pooled stroke risk was 3.42% (95% CI 3.14-3.74) at 90 days, 2.78% (95% CI 2.47-3.12) at 30 days, 2.06% (95% CI 1.83-2.33) at 7 days and 1.36% (95% CI 1.15-1.59) at 2 days. Although we did not find statistically significant heterogeneity in SR among studies, those with a higher proportion of patients with motor weakness had a significantly higher risk of SR. No statistically significant association was observed between TIA clinic management and SR. The pooled early SR is lower than in previous meta-analyses and homogeneous for all studies with an urgent assessment and management strategy regardless of vascular risk factors and clinical characteristics. Therefore, the best setting for TIA management can be individualized for each center. © 2016 S. Karger AG, Basel.

  16. Adaptability and reproducibility of a memory disruption rTMS protocol in the PharmaCog IMI European project.

    PubMed

    Martin-Trias, Pablo; Lanteaume, Laura; Solana, Elisabeth; Cassé-Perrot, Catherine; Fernández-Cabello, Sara; Babiloni, Claudio; Marzano, Nicola; Junqué, Carme; Rossini, Paolo Maria; Micallef, Joëlle; Truillet, Romain; Charles, Estelle; Jouve, Elisabeth; Bordet, Régis; Santamaria, Joan; Jovicich, Jorge; Rossi, Simone; Pascual-Leone, Alvaro; Blin, Olivier; Richardson, Jill; Bartrés-Faz, David

    2018-06-19

    Transcranial magnetic stimulation (TMS) can interfere with cognitive processes, such as transiently impairing memory. As part of a multi-center European project, we investigated the adaptability and reproducibility of a previously published TMS memory interfering protocol in two centers using EEG or fMRI scenarios. Participants were invited to attend three experimental sessions on different days, with sham repetitive TMS (rTMS) applied on day 1 and real rTMS on days 2 and 3. Sixty-eight healthy young men were included. On each experimental day, volunteers were instructed to remember visual pictures while receiving neuronavigated rTMS trains (20 Hz, 900 ms) during picture encoding at the left dorsolateral prefrontal cortex (L-DLPFC) and the vertex. Mixed ANOVA model analyses were performed. rTMS to the L-DLPFC significantly disrupted recognition memory on experimental day 2. No differences were found between centers or between fMRI and EEG recordings. Subjects with lower baseline memory performances were more susceptible to TMS disruption. No stability of TMS-induced memory interference could be demonstrated on day 3. Our data suggests that adapted cognitive rTMS protocols can be implemented in multi-center studies incorporating standardized experimental procedures. However, our center and modality effects analyses lacked sufficient statistical power, hence highlighting the need to conduct further studies with larger samples. In addition, inter and intra-subject variability in response to TMS might limit its application in crossover or longitudinal studies.

  17. The Long-term Light Curves of X-ray Binaries Contain Simultaneous Periodic and Random Components

    NASA Technical Reports Server (NTRS)

    White, Nicholas E. (Technical Monitor); Boyd, Patricia T.; Smale, Alan P.

    2002-01-01

    LMC X-3 and Cyg X-2 show large amplitude X-ray fluctuations that have been attributed to a warped accretion disk. Cyg X-3 displays high amplitude, apparently non-periodic oscillations. We reanalyze these systems using RXTE ASM data and time-frequency decomposition techniques. We find that the long-term variations in Cyg X-2 can be completely characterized by excursions whose durations are integer multiples of the orbital period, including one essentially identical to the reported "period" of 78 days. Cyg X-3 can be characterized in terms of integer multiples of a 71-day fundamental period unrelated to the 4.8 day orbital period, but suggestively close to the approximately equal to greater than 60 day reported precession period of the relativistic jet inferred from recent radio observations. The long-term excursions of LMC X-3 are related to each other by rational fractions, suggesting the characteristic time scale is 10.594 days, shorter than any observed excursion to date. We explore the phase space evolution of the light curves using a natural embedding and find that all three systems possess two rotation centers that organize the phase space trajectories, one of low luminosity and the other of high luminosity. The implications of this repeatable behavior on generic models of accretion disk dynamics and mass transfer variability are explored.

  18. Pain during medical abortion: a multicenter study in France.

    PubMed

    Saurel-Cubizolles, Marie-Josèphe; Opatowski, Marion; David, Philippe; Bardy, Françoise; Dunbavand, Annabel

    2015-11-01

    To compare the level of pain reported by women by dose of mifepristone, 200 or 600mg, and describe the main factors related to the pain level in the 5 days after a medical abortion. Observational study in 11 medical centers in France between October 2013 and September 2014. The protocols were 200 or 600mg orally mifepristone on day 1 of the medical abortion and 400, 600 or 800μg orally misoprostol on day 3. Women returned a questionnaire that they completed during 5 days following the abortion; pain was recorded on a visual analog scale (0-10) daily. 453 women were included; the mean age was 29 years (range 18-49 years). Pain was greater with 200 than 600mg mifepristone: 33% of women reported a pain level of ≥8 on day 3 with 200mg as compared with 16% with 600mg. This difference remained after controlling for age, gestational age, gravidity, usual painful menstruation and misoprostol dose. Percentages of symptoms as vomiting or diarrhea were also lower with 600mg mifépristone than 200mg. The mean pain severity experienced by women undergoing medical abortion is high; it is higher with a regimen of 200mg mifepristone. The findings emphasize the need to improve analgesic strategies and invite to opt for a protocol of 600mg instead of 200mg mifepristone. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  19. Sun-Earth Day, 2001

    NASA Technical Reports Server (NTRS)

    Adams, Mitzi L.; Mortfield, P.; Hathaway, D. H.; Whitaker, Ann F. (Technical Monitor)

    2001-01-01

    To promote awareness of the Sun-Earth connection, NASA's Marshall Space Flight Center, in collaboration with the Stanford SOLAR Center, sponsored a one-day Sun-Earth Day event on April 27, 2001. Although "celebrated" on only one day, teachers and students from across the nation, prepared for over a month in advance. Workshops were held in March to train teachers. Students performed experiments, results of which were shared through video clips and an internet web cast. Our poster includes highlights from student experiments (grades 2 - 12), lessons learned from the teacher workshops and the event itself, and plans for Sun-Earth Day 2002.

  20. KENNEDY SPACE CENTER, FLA. - Center Director Jim Kennedy (right) presents a plaque to Conrad Nagel who organized the Spaceport Super Safety and Health Day at KSC, an annual event dedicated to reinforcing safe and healthful behaviors in the workforce. Nagel is chief of the Shuttle Project Office, Shuttle Processing.

    NASA Image and Video Library

    2003-10-15

    KENNEDY SPACE CENTER, FLA. - Center Director Jim Kennedy (right) presents a plaque to Conrad Nagel who organized the Spaceport Super Safety and Health Day at KSC, an annual event dedicated to reinforcing safe and healthful behaviors in the workforce. Nagel is chief of the Shuttle Project Office, Shuttle Processing.

  1. Center-level variability in broad-spectrum antibiotic prescribing for children undergoing hematopoietic cell transplantion for acute leukemia.

    PubMed Central

    Elgarten, Caitlin; Arnold, Staci; Li, Yimei; Huang, Y Vera; Gerber, Jeffrey S; Saber, Wael; Aplenc, Richard; Fisher, Brian T

    2017-01-01

    Abstract Background Antibiotic exposure after allogeneic hematopoietic cell transplant (HCT) is common. Exposure to specific classes of antibiotics after HCT has been associated with mortality, relapse and graft-vs.-host disease. Exploring differences in antibiotic utilization across hospitals could provide opportunities for comparative effectiveness studies and quality improvement interventions. Methods We conducted a retrospective cohort study of patients undergoing HCT for acute leukemia using a dataset merged from two sources: the Pediatric Health Information System and the Center for International Blood and Marrow Transplant Research. Medication use data were obtained from the day of transplant through engraftment. Hospital antibiotic utilization rates were reported as antibiotic days/1000 neutropenic days. Adjusted rates were calculated using a poisson regression controlling for age, sex, race, graft characteristics and days of ICU-level care. Results After adjustment, hospital rates of anti-pseudomonal antibiotic use varied from 410 to 1037 antibiotic days/1000 neutropenic days (Figure 1A) and for Gram-positive antibiotic use from 109 to 771 antibiotic days/1000 neutropenic days (Figure 1B). As shown in Figure 1, within anti-pseudomonal antibiotics, there was variation by hospital in the use of Fourth and 5th generation cephalosporins, anti-pseudomonal penicillins and carbapenems; variation in Gram-positive exposure was driven by vancomycin. Gram-positive antibiotic use was moderately associated with days of ICU-level of care (spearman correlation coefficient = .55) but anti-pseudomonal antibiotic use was not (Figure 2). There was no association between days of antibiotic exposure and 30-day mortality. Conclusion Among a homogenous population of children undergoing transplantation for acute leukemia, both the volume and spectrum of antibiotic exposure in the immediate post-transplant period varied widely. These data present an opportunity for hospitals to benchmark their antibiotic utilization practices and can be further leveraged to assess the clinical impact of differential antibiotic exposure. Disclosures B. T. Fisher, Pfizer, Inc.: Grant Investigator, Research support. Merck, Inc.: Investigator, Research support. T2 Biosystems, Inc.: Investigator, Research support. Ansun Biopharma: Investigator, Research support

  2. 76 FR 49645 - National Health Center Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ... system. Every day, men, women, and children find help at community health centers. These centers lead the... stronger, healthier Nation that drives the work of community health centers and fuels our efforts to...

  3. Success of Urgent-Start Peritoneal Dialysis in a Large Canadian Renal Program

    PubMed Central

    Alkatheeri, Ali M.A.; Blake, Peter G.; Gray, Daryl; Jain, Arsh K.

    2016-01-01

    ♦ Background: Many patients start renal replacement therapy urgently on in-center hemodialysis via a central venous catheter, which is considered suboptimal. An alternative approach to manage these patients is to start them on peritoneal dialysis (PD). In this report, we describe the first reported Canadian experience with an urgent-start PD program. Additionally we reviewed the literature in this area. ♦ Methods: In this prospective observational study, we report on our experience in a single academic center. This program started in July 2010. We included patients who initiated PD urgently, that is within 2 weeks of catheter insertion. We followed all incident PD patients until October 2013 for mechanical and infectious complications. Peritoneal dialysis catheters were inserted either percutaneously or laparoscopically and dialysis was initiated in either an inpatient or outpatient setting. ♦ Results: Thirty patients were started on urgent PD during our study period. Follow-up ranged from 28 to 1,050 days. Twenty insertions (66.7 %) were done percutaneously and 10 (33.3%) were laparoscopic. Dialysis was initiated within 2 weeks (range: 0 – 13 days, median = 6 days). Twenty-four patients (80%) started PD in an outpatient setting and 6 patients (20%) required immediate inpatient PD start. Three patients (10%) developed a minor peri-catheter leak during the first week of training that was managed conservatively. There were no episodes of peritonitis or exit-site/tunnel infection during the first 4 weeks post-insertion. Four patients (13.3 %) from the percutaneous insertion group and 2 patients (6.7%) from laparoscopic insertions developed catheter dysfunction due to migration, which was managed by repositioning, without need for catheter replacement or modality switch. ♦ Conclusions: Our results are consistent with other studies in this area and demonstrate that urgent-start PD is an acceptable and safe alternative to hemodialysis in patients who need to start dialysis urgently without established dialysis access. PMID:26374834

  4. Success of Urgent-Start Peritoneal Dialysis in a Large Canadian Renal Program.

    PubMed

    Alkatheeri, Ali M A; Blake, Peter G; Gray, Daryl; Jain, Arsh K

    2016-01-01

    ♦ Many patients start renal replacement therapy urgently on in-center hemodialysis via a central venous catheter, which is considered suboptimal. An alternative approach to manage these patients is to start them on peritoneal dialysis (PD). In this report, we describe the first reported Canadian experience with an urgent-start PD program. Additionally we reviewed the literature in this area. ♦ In this prospective observational study, we report on our experience in a single academic center. This program started in July 2010. We included patients who initiated PD urgently, that is within 2 weeks of catheter insertion. We followed all incident PD patients until October 2013 for mechanical and infectious complications. Peritoneal dialysis catheters were inserted either percutaneously or laparoscopically and dialysis was initiated in either an inpatient or outpatient setting. ♦ Thirty patients were started on urgent PD during our study period. Follow-up ranged from 28 to 1,050 days. Twenty insertions (66.7%) were done percutaneously and 10 (33.3%) were laparoscopic. Dialysis was initiated within 2 weeks (range: 0-13 days, median = 6 days). Twenty-four patients (80%) started PD in an outpatient setting and 6 patients (20%) required immediate inpatient PD start. Three patients (10%) developed a minor peri-catheter leak during the first week of training that was managed conservatively. There were no episodes of peritonitis or exit-site/tunnel infection during the first 4 weeks post-insertion. Four patients (13.3%) from the percutaneous insertion group and 2 patients (6.7%) from laparoscopic insertions developed catheter dysfunction due to migration, which was managed by repositioning, without need for catheter replacement or modality switch. ♦ Our results are consistent with other studies in this area and demonstrate that urgent-start PD is an acceptable and safe alternative to hemodialysis in patients who need to start dialysis urgently without established dialysis access. Copyright © 2016 International Society for Peritoneal Dialysis.

  5. 2018 NASA Day of Remembrance

    NASA Image and Video Library

    2018-01-25

    A memorial wreath stands in the Center for Space Education during this year's Day of Remembrance ceremony at the Kennedy Space Center Visitor Complex. Each year spaceport employees and guests join others throughout NASA honoring the contributions of astronauts who have perished in the conquest of space.

  6. Physical Activity during the School Day

    ERIC Educational Resources Information Center

    Castelli, Darla M.; Ward, Kimberly

    2012-01-01

    In response to concerns that children are physically inactive, a Centers for Disease Control and Prevention committee developed school-based implementation strategies centered on the components of a Comprehensive School Physical Activity Program (CSPAP), composed of the physical education program, physical activity during the school day, staff…

  7. National Centers for Environmental Prediction

    Science.gov Websites

    / VISION | About EMC EMC > GEFS > COLLABORATORS Home Operational Products Experimental Data ENSEMBLE FORECAST SYSTEM MSC NAEFS Products CPC NAEFS Experimental 8 to 14 Day Temperature Guidance CPC NAEFS Experimental 8 to 14 Day Precip Guidance NOAA / National Weather Service National Centers for

  8. Being Wheeled or Walking: A Qualitative Study of Patients' Spatial Experience in Two Distinct Day Surgery Centers.

    PubMed

    Annemans, Margo; Audenhove, Chantal Van; Vermolen, Hilde; Heylighen, Ann

    2016-04-01

    In this article, we explore what a different way of moving-being wheeled versus walking-means for the spatial experience of day surgery patients. Day surgery centers can be conceived in very different manners. Some are organized similar to traditional hospital admittance; others are located in a specifically designed part of the hospital and receive patients as guests who walk through the entire procedure. We conducted semistructured interviews with 37 patients at two distinct day surgery centers. Despite the different managerial concepts and corresponding spatial designs, in both centers, patients' spatial experience is shaped by the interrelation of material, social, and time-related aspects. However, the chosen concept results in a different experience throughout patients' journey. Based on an analysis of the different journeys, we conclude that patients' interpretation of a hospital's care vision is influenced not only by what the hospital communicates explicitly or how it educates its staff but also by what is implicitly told by the built environment. © The Author(s) 2016.

  9. The relationship between adherence behaviors and recovery time in adolescents after a sports-related concussion: an observational study.

    PubMed

    Moor, Heather M; Eisenhauer, Rita C; Killian, Kathleen D; Proudfoot, Nick; Henriques, Ashley A; Congeni, Joseph A; Reneker, Jennifer C

    2015-04-01

    Adherence to rehabilitation is widely accepted as vital for recovery and return to play following sports injuries. Medical management of concussion is centered around physical and cognitive rest, a theory largely based on expert opinion, not empirical evidence. Current research on this topic focuses on factors that are predictive of adherence to rehabilitation, but fails to examine if patient adherence leads to a better outcome. The purpose of this study was to determine the adherence tendencies of adolescents to treatment recommendations provided by a sports-medicine physician after a concussion and to determine if adherence to each recommendation was a predictor of treatment duration. Observational. Participants were enrolled in the study at their initial visit to the Sports-Medicine Center for medical care after a sports-related concussion. Individual treatment recommendations provided by a sports-medicine physician for concussion were recorded over the course of each participant's care. Once released from medical care, each participant was contacted to complete an online questionnaire to measure self-reported adherence tendencies to each treatment recommendation. Adherence was measured by two constructs: 1) the reported receptivity to the recommendation and 2) the frequency of following the recommendation. Exploratory univariate Poisson regression analyses were used to describe the relationship between adherence behaviors and the number of days of treatment required before the participant was returned to play. Fifty-six questionnaires were completed, by 30 male and 26 female adolescent athletes. The self-reported adherence tendencies were very high. None of the measures of adherence to the treatment recommendations were significant predictors of the number of days of treatment; however, there was a clear tendency in five of the six rest parameters (physical rest, cognitive rest with restrictions from electronics, and cognitive rest with restrictions from school), where high levels of adherence to rest resulted in an increased average number of days of treatment (slower recovery) and those who reported being less adherent recovered faster. Adolescents were generally adherent to the physician recommendations. Those participants who reported being less adherent to physical and cognitive rest generally recovered faster than those who reported higher levels of adherence to these recommendations. As time progresses after the initial injury, physical and mental rest may be less effective to hasten recovery than more active treatment recommendations. Level 2.

  10. Workplace health and safety intervention for child care staff: Rationale, design, and baseline results from the CARE cluster randomized control trial.

    PubMed

    Ward, Dianne S; Vaughn, Amber E; Hales, Derek; Viera, Anthony J; Gizlice, Ziya; Bateman, Lori A; Grummon, Anna H; Arandia, Gabriela; Linnan, Laura A

    2018-05-01

    Low-wage workers suffer disproportionately high rates of chronic disease and are important targets for workplace health and safety interventions. Child care centers offer an ideal opportunity to reach some of the lowest paid workers, but these settings have been ignored in workplace intervention studies. Caring and Reaching for Health (CARE) is a cluster-randomized controlled trial evaluating efficacy of a multi-level, workplace-based intervention set in child care centers that promotes physical activity and other health behaviors among staff. Centers are randomized (1:1) into the Healthy Lifestyles (intervention) or the Healthy Finances (attention control) program. Healthy Lifestyles is delivered over six months including a kick-off event and three 8-week health campaigns (magazines, goal setting, behavior monitoring, tailored feedback, prompts, center displays, director coaching). The primary outcome is minutes of moderate and vigorous physical activity (MVPA); secondary outcomes are health behaviors (diet, smoking, sleep, stress), physical assessments (body mass index (BMI), waist circumference, blood pressure, fitness), and workplace supports for health and safety. In total, 56 centers and 553 participants have been recruited and randomized. Participants are predominately female (96.7%) and either Non-Hispanic African American (51.6%) or Non-Hispanic White (36.7%). Most participants (63.4%) are obese. They accumulate 17.4 (±14.2) minutes/day of MVPA and consume 1.3 (±1.4) and 1.3 (±0.8) servings/day of fruits and vegetables, respectively. Also, 14.2% are smokers; they report 6.4 (±1.4) hours/night of sleep; and 34.9% are high risk for depression. Baseline data demonstrate several serious health risks, confirming the importance of workplace interventions in child care. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  11. Workplace health and safety intervention for child care staff: Rationale, design, and baseline results from the CARE cluster randomized control trial

    PubMed Central

    Ward, Dianne S.; Vaughn, Amber E.; Hales, Derek; Viera, Anthony J.; Gizlice, Ziya; Bateman, Lori A.; Grummon, Anna H.; Arandia, Gabriela; Linnan, Laura A.

    2018-01-01

    Background Low-wage workers suffer disproportionately high rates of chronic disease and are important targets for workplace health and safety interventions. Child care centers offer an ideal opportunity to reach some of the lowest paid workers, but these settings have been ignored in workplace intervention studies. Methods Caring and Reaching for Health (CARE) is a cluster-randomized controlled trial evaluating efficacy of a multi-level, workplace-based intervention set in child care centers that promotes physical activity and other health behaviors among staff. Centers are randomized (1:1) into the Healthy Lifestyles (intervention) or the Healthy Finances (attention control) program. Healthy Lifestyles is delivered over six months including a kick-off event and three 8-week health campaigns (magazines, goal setting, behavior monitoring, tailored feedback, prompts, center displays, director coaching). The primary outcome is minutes of moderate and vigorous physical activity (MVPA); secondary outcomes are health behaviors (diet, smoking, sleep, stress), physical assessments (body mass index (BMI), waist circumference, blood pressure, fitness), and workplace supports for health and safety. Results In total, 56 centers and 553 participants have been recruited and randomized. Participants are predominately female (96.7%) and either Non-Hispanic African American (51.6%) or Non-Hispanic White (36.7%). Most participants (63.4%) are obese. They accumulate 17.4 ( ± 14.2) minutes/day of MVPA and consume 1.3 ( ± 1.4) and 1.3 ( ± 0.8) servings/day of fruits and vegetables, respectively. Also, 14.2% are smokers; they report 6.4 ( ± 1.4) hours/night of sleep; and 34.9% are high risk for depression. Conclusions Baseline data demonstrate several serious health risks, confirming the importance of workplace interventions in child care. PMID:29501740

  12. jsc2012e238678

    NASA Image and Video Library

    2012-11-28

    At the Gagarin Cosmonaut Training Center in Star City, Russia, Expedition 34/35 Soyuz Commander Roman Romanenko listens to a question from reporters during the second of two days of flight qualification exams Nov. 28, 2012. He and his crewmates, Flight Engineer Chris Hadfield of the Canadian Space Agency and NASA Flight Engineer Tom Marshburn are preparing for launch Dec. 19 to the International Space Station from the Baikonur Cosmodrome in Kazakhstan aboard the Soyuz TMA-07M spacecraft. NASA/Stephanie Stoll

  13. Science Fairs for Science Literacy

    NASA Astrophysics Data System (ADS)

    Mackey, Katherine; Culbertson, Timothy

    2014-03-01

    Scientific discovery, technological revolutions, and complex global challenges are commonplace in the modern era. People are bombarded with news about climate change, pandemics, and genetically modified organisms, and scientific literacy has never been more important than in the present day. Yet only 29% of American adults have sufficient understanding to be able to read science stories reported in the popular press [Miller, 2010], and American students consistently rank below other nations in math and science [National Center for Education Statistics, 2012].

  14. Gender in relation to work motivation, satisfaction and use of day center services among people with psychiatric disabilities.

    PubMed

    Eklund, Mona; Eklund, Lisa

    2017-05-01

    Day centres can prepare for open-market employment, and attendees' work motivation is key in this. Adopting a gender perspective, this study investigated (1) motivation for day centre attendance, satisfaction with the day centre services, number of hours spent there, and number and type of occupations performed; and (2) whether those factors were related with motivation for open-market employment. Women (n = 164) and men (n = 160) with psychiatric disabilities completed self-report questionnaires. There were no gender differences regarding satisfaction with the day centre services or number of hours spent there, but women engaged in more occupations. More women than men performed externally-oriented services and textile work, while men were in the majority in workshops. Externally oriented services, working in workshops, and low satisfaction with the day centre services were associated with higher motivation for employment. Women and men were equally motivated for employment. Women scored higher on motivation for attending the day centre, something that may deter transition into open-market employment. For men, less motivation for attending day centres may reduce their possibilities of gaining skills that can facilitate transitioning to open-market employment. Thus, the possibility for transitioning from day centre activities to open-market employment may be gendered.

  15. Range Commanders Council Meteorology Group 88th Meeting: NASA Marshall Space Flight Center Task Report, 2004

    NASA Technical Reports Server (NTRS)

    Roberts, Barry C.

    2004-01-01

    Supported Return-to-Flight activities by providing surface climate data from Kennedy Space Center used primarily for ice and dew formation studies, and upper air wind analysis primarily used for ascent loads analyses. The MSFC Environments Group's Terrestrial and Planetary Environments Team documented Space Shuttle day-of-launch support activities by publishing a document in support of SSP Return-to-Flight activities entitled "Space Shuttle Program Flight Operations Support". The team also formalized the Shuttle Natural Environments Technical Panel and chaired the first special session of the SSP Natural Environments Panel meeting at KSC, November 4-7,2003.58 participants from NASA, DOD and other government agencies from across the country attended the meeting.

  16. ASSESSMENT OF DIOXIN INHALATION EXPOSURES AND ...

    EPA Pesticide Factsheets

    In the days following the September 11, 2001, terrorist attack on New York City's World Trade Center (WTC) towers, EPA, other federal agencies, and New York City and New York State public health and environmental authorities initiated numerous air monitoring activities to better understand the ongoing impact of emissions from that disaster. Using these data, EPA conducted an inhalation exposure and human health risk assessment. The overall evaluation focused on particulate matter, metals, polychlorinated biphenyls, dioxin-like compounds, asbestos, and volatile organic compounds. This paper reports on the analysis of dioxin-like compounds only.Lorber, M. 2003. Assessment of Dioxin Inhalation Exposures and Potential Health Impacts Following the Collapse of the World Trade Center Towers. Organohalogen Compounds 63 (no page numbers). journal article

  17. Meeting report: SMART timing--principles of single molecule techniques course at the University of Michigan 2014.

    PubMed

    Bartke, Rebecca M; Cameron, Elizabeth L; Cristie-David, Ajitha S; Custer, Thomas C; Denies, Maxwell S; Daher, May; Dhakal, Soma; Ghosh, Soumi; Heinicke, Laurie A; Hoff, J Damon; Hou, Qian; Kahlscheuer, Matthew L; Karslake, Joshua; Krieger, Adam G; Li, Jieming; Li, Xiang; Lund, Paul E; Vo, Nguyen N; Park, Jun; Pitchiaya, Sethuramasundaram; Rai, Victoria; Smith, David J; Suddala, Krishna C; Wang, Jiarui; Widom, Julia R; Walter, Nils G

    2015-05-01

    Four days after the announcement of the 2014 Nobel Prize in Chemistry for "the development of super-resolved fluorescence microscopy" based on single molecule detection, the Single Molecule Analysis in Real-Time (SMART) Center at the University of Michigan hosted a "Principles of Single Molecule Techniques 2014" course. Through a combination of plenary lectures and an Open House at the SMART Center, the course took a snapshot of a technology with an especially broad and rapidly expanding range of applications in the biomedical and materials sciences. Highlighting the continued rapid emergence of technical and scientific advances, the course underscored just how brightly the future of the single molecule field shines. © 2014 Wiley Periodicals, Inc.

  18. Injury rates and profiles of elite competitive weightlifters.

    PubMed

    Calhoon, G; Fry, A C

    1999-07-01

    To determine injury types, natures, anatomical locations, recommended amount of time missed, and injury rates during weightlifting training. We collected and analyzed medical injury records of resident athletes and during numerous training camps to generate an injury profile. Elite US male weightlifters who were injured during training at the United States Olympic Training Centers. United States Olympic Training Center weightlifting injury reports from a 6-year period were analyzed. Data were expressed as percentages and were analyzed via x(2) tests. The back (primarily low back), knees, and shoulders accounted for the most significant number of injuries (64.8%). The types of injuries most prevalent in this study were strains and tendinitis (68.9%). Injuries of acute (59.6%) or chronic (30.4%) nature were significantly more common than recurrent injuries and complications. The recommended number of training days missed for most injuries was 1 day or fewer (90.5%). Injuries to the back primarily consisted of strains (74.6%). Most knee injuries were tendinitis (85.0%). The majority of shoulder injuries were classified as strains (54.6%). Rates of acute and recurring injuries were calculated to be 3.3 injuries/1000 hours of weightlifting exposure. The injuries typical of elite weightlifters are primarily overuse injuries, not traumatic injuries compromising joint integrity. These injury pattems and rates are similar to those reported for other sports and activities.

  19. Relationship Between the Radio Bursts from the Sun and Ionospheric Propagation

    NASA Astrophysics Data System (ADS)

    West, Mary Lou; Frissell, N.; Papalos, M.

    2006-12-01

    We are monitoring the sun’s radio activity at 20.1 MHz with a Radio Jove rig, and have begun to monitor the Earth’s ionosphere for HF radio propagation using the worldwide network of beacons set up by the Northern California DX Foundation. These 18 beacons transmit at 14.1, 18.11, 21.15, 24.93, and 28.2 MHz on a 3 minute cadence and allow ham radio operators to judge the radio propagation characteristics to distant lands easily. Although the solar activity cycle is now near its bottom, there are occasional outbursts, some spectacular. August 29, 2006, was such a day, prompting the Radio Jove community to post ten times the usual number of reports to the archive at Goddard Space Flight Center. The next day the Earth’s ionosphere suddenly blossomed with HF openings without any X-ray flares reported. The delay time of 26 hours from the most energetic radio event indicated a velocity of 1600 km/s, normal for a coronal mass ejection. Several other events have also shown delays of about 24 hours from the radio sun to the ionosphere, and are especially noticeable at the higher frequency bands and on the events list of the Space Environment Center of NOAA. The 20.1 MHz monitors may serve as a method to predict radio propagation properties of the ionosphere more quickly than previous methods.

  20. Areal-reduction factors for the precipitation of the 1-day design storm in Texas

    USGS Publications Warehouse

    Asquith, William H.

    1999-01-01

    The reduction of the precipitation depth from a design storm for a point to an effective (mean) depth over a watershed often is important for cost-effective design of hydraulic structures by reducing the volume of precipitation. A design storm for a point is the depth of precipitation that has a specified duration and frequency (recurrence interval). The effective depth can be calculated by multiplying the design-storm depth by an areal-reduction factor (ARF). ARF ranges from 0 to 1, varies with the recurrence interval of the design storm, and is a function of watershed characteristics such as watershed size and shape, geographic location, and time of year that the design storm occurs. This report documents an investigation of ARF by the U.S. Geological Survey, in cooperation with the Texas Department of Transportation, for the 1-day design storm for Austin, Dallas, and Houston, Texas. The ?annual maxima-centered? approach used in this report specifically considers the distribution of concurrent precipitation surrounding an annual precipitation maxima. Unlike previously established approaches, the annual maxima-centered approach does not require the spatial averaging of precipitation nor explicit definition of a representative area of a particular storm in the analysis. Graphs of the relation between ARF and circular watershed area (to about 7,000 square miles) are provided, and a technique to calculate ARF for noncircular watersheds is discussed.

  1. The role of day-to-day emotions, sleep, and social interactions in pediatric anxiety treatment.

    PubMed

    Wallace, Meredith L; McMakin, Dana L; Tan, Patricia Z; Rosen, Dana; Forbes, Erika E; Ladouceur, Cecile D; Ryan, Neal D; Siegle, Greg J; Dahl, Ronald E; Kendall, Philip C; Mannarino, Anthony; Silk, Jennifer S

    2017-03-01

    Do day-to-day emotions, social interactions, and sleep play a role in determining which anxious youth respond to supportive child-centered therapy (CCT) versus cognitive behavioral therapy (CBT)? We explored whether measures of day-to-day functioning (captured through ecological momentary assessment, sleep diary, and actigraphy), along with clinical and demographic measures, were predictors or moderators of treatment outcome in 114 anxious youth randomized to CCT or CBT. We statistically combined individual moderators into a single, optimal composite moderator to characterize subgroups for which CCT or CBT may be preferable. The strongest predictors of better outcome included: (a) experiencing higher positive affect when with one's mother and (b) fewer self-reported problems with sleep duration. The composite moderator indicated that youth for whom CBT was indicated had: (a) more day-to-day sleep problems related to sleep quality, efficiency, and waking, (b) day-to-day negative events related to interpersonal concerns, (c) more DSM-IV anxiety diagnoses, and (d) college-educated parents. These findings illustrate the value of both day-to-day functioning characteristics and more traditional sociodemographic and clinical characteristics in identifying optimal anxiety treatment assignment. Future studies will need to enhance the practicality of real-time measures for use in clinical decision making and evaluate additional anxiety treatments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. A Study in Child Care (Case Study from Volume II-A): "A Rolls-Royce of Day Care." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    O'Farrell, Brigid

    The Amalgamated Day Care Center is an independent trust established through a collective bargaining agreement between the Amalgamated Clothing Workers of America, AFL-CIO, and the employers of the garment industry. The free center, open from 6:00 a.m. to 6:00 p.m., is located near the Chicago garment industries to minimize transportation problems…

  3. Stennis Space Center observes Disability Awareness Day

    NASA Image and Video Library

    2009-10-15

    Members of STARC, a non-profit organization in Slidell, La., that seeks to help people with disabilities lead meaningful, productive lives, pose with their appreciation awards during Disability Awareness Day at Stennis Space Center on Oct. 15. The group members received appreciation awards for their dedicated service to the rocket engine testing facility. Disability Awareness Day was hosted by the Stennis Diversity Council and included guest speakers from several area agencies.

  4. Stennis Space Center observes Disability Awareness Day

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Members of STARC, a non-profit organization in Slidell, La., that seeks to help people with disabilities lead meaningful, productive lives, pose with their appreciation awards during Disability Awareness Day at Stennis Space Center on Oct. 15. The group members received appreciation awards for their dedicated service to the rocket engine testing facility. Disability Awareness Day was hosted by the Stennis Diversity Council and included guest speakers from several area agencies.

  5. Climate Prediction Center - 6-10 and 8-14 Day Prognostic Discussions

    Science.gov Websites

    About Us Our Mission Who We Are Contact Us CPC Information CPC Web Team 6-10 Day outlooks are issued DISCUSSIONS FOR 6 TO 10 AND 8 TO 14 DAY OUTLOOKS NWS CLIMATE PREDICTION CENTER COLLEGE PARK MD 300 PM EDT SAT CONSISTENCY ISSUES. IN THESE CASES, FORECASTS ARE MANUALLY DRAWN BUT A FULL DISCUSSION IS NOT ISSUED. THE

  6. America Recycles Day

    NASA Image and Video Library

    2017-11-17

    In the parking lot of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, a member of Goodwill Industries loads used household material for recycling. During the two-day event, employees dropped off items as part of America Recycles Day. The center partnered with Goodwill Industries and several other local organizations to collect items for reprocessing. The annual event is a program of Keep America Beautiful, dedicated to promoting and celebrating recycling.

  7. Visual inspection reliability of transport aircraft

    NASA Astrophysics Data System (ADS)

    Spencer, Floyd W.

    1996-11-01

    The Federal Aviation Administration Technical Center has sponsored a visual inspection reliability program at its airworthiness assurance nondestructive inspection validation center (AANC). We report on the results of the benchmark phase of that program in which 12 inspectors were observed in two days of inspections on a Boeing 737 aircraft. All of the inspectors were currently employed with major airlines and all had experience inspecting the Boeing 737 aircraft. Each inspector spent 2 days at the AANC facility where they inspected to the same ten job cards. Each inspector was videotaped and all nonroutine repair actions were recorded for each inspector. Background information on each of the inspectors, including vision test results, was also gathered. The inspection results were correlated with the background variables. Aviation experience and a test time reflecting visual acuity were significantly correlated with performance factors. An analysis of the video tapes was performed to separate decision errors from search errors. Probability of detection curves were fit to the results of inspecting for cracks from beneath rivet heads in a task using prepared samples with known cracks.

  8. Impact of Latin Dance on Physical Activity, Cardiorespiratory Fitness, and Sedentary Behavior Among Latinos Attending an Adult Day Center.

    PubMed

    Aguiñaga, Susan; Marquez, David X

    2017-09-01

    The aim of this study was to determine whether a Latin dance program with sedentary behavior information would have an impact on physical activity, cardiorespiratory fitness (CRF), and sedentary behavior among older Latinos attending an adult day center (ADC). Participants ( N = 21, 75.4 ± 6.3 years old, Mini-Mental State Examination [MMSE] score = 22.4 ± 2.8) were randomized into a dance or wait-list control group. Participants wore an accelerometer and inclinometer and completed a sedentary behavior questionnaire, and a nonexercise equation was used to calculate CRF. Findings indicate small to medium effect sizes in the desired direction during midpoint of the intervention for physical activity, sedentary behavior-related outcomes, CRF, and self-reported sedentary behavior in the dance group; however; dance participants did not maintain that trajectory for the remaining 2 months of the intervention. Future studies may consider implementing behavioral strategies during midpoint of the intervention to encourage participants attending an ADC to maintain physical activity and sedentary behavior changes.

  9. Zika Virus Can Strongly Infect and Disrupt Secondary Organizers in the Ventricular Zone of the Embryonic Chicken Brain.

    PubMed

    Thawani, Ankita; Sirohi, Devika; Kuhn, Richard J; Fekete, Donna M

    2018-04-17

    Zika virus (ZIKV) is associated with severe neurodevelopmental impairments in human fetuses, including microencephaly. Previous reports examining neural progenitor tropism of ZIKV in organoid and animal models did not address whether the virus infects all neural progenitors uniformly. To explore this, ZIKV was injected into the neural tube of 2-day-old chicken embryos, resulting in nonuniform periventricular infection 3 days later. Recurrent foci of intense infection were present at specific signaling centers that influence neuroepithelial patterning at a distance through secretion of morphogens. ZIKV infection reduced transcript levels for 3 morphogens, SHH, BMP7, and FGF8 expressed at the midbrain basal plate, hypothalamic floor plate, and isthmus, respectively. Levels of Patched1, a SHH-pathway downstream gene, were also reduced, and a SHH-dependent cell population in the ventral midbrain was shifted in position. Thus, the diminishment of signaling centers through ZIKV-mediated apoptosis may yield broader, non-cell-autonomous changes in brain patterning. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Data Day to Day: building a community of expertise to address data skills gaps in an academic medical center

    PubMed Central

    Surkis, Alisa; LaPolla, Fred Willie Zametkin; Contaxis, Nicole; Read, Kevin B.

    2017-01-01

    Background The New York University Health Sciences Library data services team had developed educational material for research data management and data visualization and had been offering classes at the request of departments, research groups, and training programs, but many members of the medical center were unaware of these library data services. There were also indications of data skills gaps in these subject areas and other data-related topics. Case Presentation The data services team enlisted instructors from across the medical center with data expertise to teach in a series of classes hosted by the library. We hosted eight classes branded as a series called “Data Day to Day.” Seven instructors from four units in the medical center, including the library, taught the classes. A multipronged outreach approach resulted in high turnout. Evaluations indicated that attendees were very satisfied with the instruction, would use the skills learned, and were interested in future classes. Conclusions Data Day to Day met previously unaddressed data skills gaps. Collaborating with outside instructors allowed the library to serve as a hub for a broad range of data instruction and to raise awareness of library services. We plan to offer the series three times in the coming year with an expanding roster of classes. PMID:28377684

  11. Further Characterization of CELSS Wastes: A Review of Solid Wastes Present to Support Potential Secondary Biomass Production

    NASA Technical Reports Server (NTRS)

    Muller, Matthew S.

    1996-01-01

    Controlled ecological life support systems (CELSS) may one day play an essential role in extraterrestrial colonies. Key to the success of any CELSS will be the system's ability to approach a self-supporting status through recovery and reuse of basic resources. Primary CELSS solid wastes with potential to support secondary biomass production will be inedible plant biomass and metabolic human wastes. Solid waste production is summarized and reported as 765 g N per day per person, including 300 g C and 37 g N per day per person. One Resource Recovery configuration using the bioprocessing of solid wastes into a Tilapia feed stream is examined. Based on estimated conversion efficiencies, 12 g of protein per day per person is produced as a nutrition supplement. The unique tissue composition of crops produced at the Kennedy Space Center CELSS Program highlights the need to evaluate Resource Recovery components with data generated in the CELSS environment.

  12. Feasibility of using the patient-reported outcomes measurement information system in academic health centers: case series design on pain reduction after chiropractic care.

    PubMed

    Burke, Jeanmarie R

    2014-09-01

    The purpose of this study was to test the utility of Patient-Reported Outcomes Measurement Information System (PROMIS) as a resource for collecting data on patient-reported outcomes (PRO) within academic health centers at a chiropractic college; and, to describe changes in PRO following pragmatic chiropractic care incorporating instrument-assisted soft tissue mobilization (IASTM) on pain symptoms. This was a pre-post intervention design without a control group (case series) involving 25 patients (14 females and 11 males; 40.5 ± 16.39 years, range 20-70 years) who completed their chiropractic care and their baseline and post-treatment pain assessments. The pragmatic chiropractic care intervention included both spinal manipulation and IASTM to treat pain symptoms. PRO's were collected using PROMIS to measure pain behavior, pain interference and pain intensity. The average pre-post assessment interval was 33 ± 22.5 days (95% CI, 23-42 days). The durations of treatments ranged from one week to 10 weeks. The median number of IASTM treatments was six. Pre-post decreases in T-scores for pain behavior and pain interference were 55.5 to 48.4 and 57.7 to 48.4, respectively (P < .05). Only 12 patients had a baseline T-score for pain intensity greater than 50. The pre-post decrease in pain intensity T-scores for these 12 patients was from 53.4 to 40.9. Within the limitations of a case series design, these data provide initial evidence on the utility of PROMIS instruments for clinical and research outcomes in chiropractic patients.

  13. Dialysis Modality and Readmission Following Hospital Discharge: A Population-Based Cohort Study.

    PubMed

    Perl, Jeffrey; McArthur, Eric; Bell, Chaim; Garg, Amit X; Bargman, Joanne M; Chan, Christopher T; Harel, Shai; Li, Lihua; Jain, Arsh K; Nash, Danielle M; Harel, Ziv

    2017-07-01

    Readmissions following hospital discharge among maintenance dialysis patients are common, potentially modifiable, and costly. Compared with patients receiving in-center hemodialysis (HD), patients receiving peritoneal dialysis (PD) have fewer routine dialysis clinic encounters and as a result may be more susceptible to a hospital readmission following discharge. Population-based retrospective-cohort observational study. Patients treated with maintenance dialysis who were discharged following an acute-care hospitalization during January 1, 2003, to December 31, 2013, across 164 acute-care hospitals in Ontario, Canada. For those with multiple hospitalizations, we randomly selected a single hospitalization as the index hospitalization. Dialysis modality PD or in-center HD. Propensity scores were used to match each patient on PD therapy to 2 patients on in-center HD therapy to ensure that baseline indicators of health were similar between the 2 groups. All-cause 30-day readmission following the index hospital discharge. 28,026 dialysis patients were included in the study. 4,013 PD patients were matched to 8,026 in-center HD patients. Among the matched cohort, 30-day readmission rates were 7.1 (95% CI, 6.6-7.6) per 1,000 person-days for patients on PD therapy and 6.0 (95% CI, 5.7-6.3) per 1,000 person-days for patients on in-center HD therapy. The risk for a 30-day readmission among patients on PD therapy was higher compared with those on in-center HD therapy (adjusted HR, 1.19; 95% CI, 1.08-1.31). The primary results were consistent across several key prespecified subgroups. Lack of information for the frequency of nephrology physician encounters following discharge from the hospital in both the PD and in-center HD cohorts. Limited validation of International Classification of Diseases, Tenth Revision codes. The risk for 30-day readmission is higher for patients on home-based PD compared to in-center HD therapy. Interventions to improve transitions in care between the inpatient and outpatient settings are needed, particularly for patients on PD therapy. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  14. Impact of extrinsic factors on fine motor performance of children attending day care.

    PubMed

    Corsi, Carolina; Santos, Mariana Martins Dos; Marques, Luísa de Andrade Perez; Rocha, Nelci Adriana Cicuto Ferreira

    2016-12-01

    To assess the impact of extrinsic factors on fine motor performance of children aged two years old. 73 children attending public and 21 private day care centers were assessed. Day care environment was evaluated using the Infant/Toddler Environment Rating Scale - Revised Edition (ITERS-R), fine motor performance was assessed through the Bayley Scales of Infant and Toddler Development - III (BSITD-III), socioeconomic data, maternal education and time of start at the day care were collected through interviews. Spearman's correlation coefficient was calculated to assess the association between the studied variables. The time at the day care was positively correlated with the children's performance in some fine motor tasks of the BSITD-III, showing that the activities developed in day care centers were important for the refinement of specific motor skills, while the overall fine motor performance by the scale was associated with maternal education and the ITERS-R scale sub-item "language and understanding". Extrinsic factors such as higher maternal education and quality of day care centers are associated with fine motor performance in children attending day care. Copyright © 2016 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  15. Day Treatment for Emotionally Disturbed Adolescents: Follow-up and Analysis of the Effect of Placement.

    ERIC Educational Resources Information Center

    Freedman, Marsha

    1982-01-01

    The philosophy, rationale, and evaluation of the Union County (NJ) Learning Center is presented. The center is an intensive day-treatment program to effect changes that would allow the emotionally disturbed individual to return to the mainstream. (Author/PN)

  16. MULTIMEDIA CONCENTRATIONS OF PAH IN SEVERAL DAY CARE CENTERS

    EPA Science Inventory

    Concentrations of polycyclic aromatic hydrocarbons were measured in nine day care centers in the spring of 1997. Indoor and outdoor air, food and beverages, indoor dust, and outdoor play area soil were sampled. The mean sums of 20 target PAH concentrations were 265 and 199 ng...

  17. Understanding the Broader Sexual and Reproductive Health Needs of Female Sex Workers in Dhaka, Bangladesh.

    PubMed

    Katz, Karen R; McDowell, Misti; Green, Mackenzie; Jahan, Shamim; Johnson, Laura; Chen, Mario

    2015-12-01

    Little is known about the sexual and reproductive health care needs of female sex workers in Dhaka, Bangladesh. Survey data were collected from 354 hotel-based and 323 street-based female sex workers using a venue-based stratified cluster sampling approach. In addition, in-depth interviews were conducted with 20 female sex workers recruited from drop-in centers. We calculated unmet need for family planning and examined fertility desires, use of condoms and other contraceptive methods, experiences with gender-based violence, sexual and reproductive health service needs, and preferences on where to receive services. The prevalence of unmet need was 25% among hotel-based female sex workers and 36% among street-based female sex workers. Almost all participants reported having used condoms in the past 30 days, and 44% of hotel-based sex workers and 30% of street-based sex workers reported dual method use during that period. Condom use was inconsistent, however, and condom breakage and nonuse for extra money were common. Many women reported experiencing gender-based violence. Sexual and reproductive health services had been obtained by 64% of hotel-based and 89% of street-based sex workers in the past six months; drop-in centers were their preferred site for receiving health services. Female sex workers in Dhaka need family planning and other sexual and reproductive health services and prefer receiving them from drop-in centers.

  18. Which sexual abuse victims receive a forensic medical examination? The impact of Children's Advocacy Centers.

    PubMed

    Walsh, Wendy A; Cross, Theodore P; Jones, Lisa M; Simone, Monique; Kolko, David J

    2007-10-01

    This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse. This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of Children's Advocacy Centers, which evaluated four CACs relative to within-state non-CAC comparison communities. Case abstractors collected data on forensic medical exams in 1,220 child sexual abuse cases through review of case records. Suspected sexual abuse victims at CACs were two times more likely to have forensic medical examinations than those seen at comparison communities, controlling for other variables. Girls, children with reported penetration, victims who were physically injured while being abused, White victims, and younger children were more likely to have exams, controlling for other variables. Non-penetration cases at CACs were four times more likely to receive exams as compared to those in comparison communities. About half of exams were conducted the same day as the reported abuse in both CAC and comparison communities. The majority of caregivers were very satisfied with the medical professional. Receipt of a medical exam was not associated with offenders being charged. Results of this study suggest that CACs are an effective tool for furthering access to forensic medical examinations for child sexual abuse victims.

  19. Reproductive technology: in Britain, the debate after the Warnock Report.

    PubMed

    Gillon, Raanan

    1987-06-01

    Gillon contributes an article on Great Britain to the Hastings Center Report series on reproductive technologies outside the United States. In 1984 the Warnock Committee's report represented the first attempt by a national government to formulate a policy on reproductive issues such as artificial insemination, in vitro fertilization, surrogate mothers, and research on human embryos. Reaction to the Warnock report has focused on its recommendations to ban commercial surrogacy and to allow experimentation on embryos up to 14 days after fertilization. Legislation on surrogacy was passed in 1985, while bills banning embryo research failed in 1986. A 1986 government consultation paper called for discussion of other aspects of the Warnock report, including its recommendation that a statutory licensing authority to regulate reproductive technologies be established. Gillon predicts that no new legislation will be enacted under the present government.

  20. Stennis Space Center observes 2009 Safety and Health Day

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Sue Smith, a medical clinic employee at NASA's John C. Stennis Space Center, takes the temperature of colleague Karen Badon during 2009 Safety and Health Day activities Oct. 22. Safety Day activities included speakers, informational sessions and a number of displays on safety and health issues. Astronaut Dominic Gorie also visited the south Mississippi rocket engine testing facility during the day to address employees and present several Silver Snoopy awards for outstanding contributions to flight safety and mission success. The activities were part of an ongoing safety and health emphasis at Stennis.

  1. 2016 America's Recycle Day

    NASA Image and Video Library

    2016-11-15

    Computers, monitors, vacuum cleaners and other electronics have been donated by employees at NASA's Kennedy Space Center in Florida in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more. The two-day event was sponsored by Kennedy's Sustainability team.

  2. 2016 America's Recycle Day

    NASA Image and Video Library

    2016-11-15

    A sign tells NASA Kennedy Space Center employees they have come to the right place to donate items for reuse or recycling in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more. The two-day event was sponsored by Kennedy's Sustainability team.

  3. 2016 America's Recycle Day

    NASA Image and Video Library

    2016-11-15

    Members of the Sustainability team at NASA's Kennedy Space Center in Florida set up giveaway items and sort through donations for reuse or recycling in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more. The two-day event was sponsored by Kennedy's Sustainability team.

  4. A report from the American Academy of Neurology 2014 Annual Meeting (April 26-May 3 - Philadelphia, Pennsylvania, USA).

    PubMed

    Rabasseda, X

    2014-06-01

    Not far from the Liberty Bell Hall and the historical parks of old Philadelphia, the Pennsylvania Convention Center hosted this year's American Academy of Neurology Annual Meeting for a full week of integrated science, symposium and general poster sessions. A great amount of research papers were presented and discussed during the meeting by attendees taking refuge from the downpour outside during at least 2 days. But the science was worth staying indoors to witness high-quality research, as summarized in this report. Copyright 2014 Prous Science, S.A.U. or its licensors. All rights reserved.

  5. Strategic performance management: development of a performance measurement system at the Mayo Clinic.

    PubMed

    Curtright, J W; Stolp-Smith, S C; Edell, E S

    2000-01-01

    Managing and measuring performance become exceedingly complex as healthcare institutions evolve into integrated health systems comprised of hospitals, outpatient clinics and surgery centers, nursing homes, and home health services. Leaders of integrated health systems need to develop a methodology and system that align organizational strategies with performance measurement and management. To meet this end, multiple healthcare organizations embrace the performance-indicators reporting system known as a "balanced scorecard" or a "dashboard report." This discrete set of macrolevel indicators gives senior management a fast but comprehensive glimpse of the organization's performance in meeting its quality, operational, and financial goals. The leadership of outpatient operations for Mayo Clinic in Rochester, Minnesota built on this concept by creating a performance management and measurement system that monitors and reports how well the organization achieves its performance goals. Internal stakeholders identified metrics to measure performance in each key category. Through these metrics, the organization links Mayo Clinic's vision, primary value, core principles, and day-to-day operations by monitoring key performance indicators on a weekly, monthly, or quarterly basis.

  6. Report of the workshop on Aviation Safety/Automation Program

    NASA Technical Reports Server (NTRS)

    Morello, Samuel A. (Editor)

    1990-01-01

    As part of NASA's responsibility to encourage and facilitate active exchange of information and ideas among members of the aviation community, an Aviation Safety/Automation workshop was organized and sponsored by the Flight Management Division of NASA Langley Research Center. The one-day workshop was held on October 10, 1989, at the Sheraton Beach Inn and Conference Center in Virginia Beach, Virginia. Participants were invited from industry, government, and universities to discuss critical questions and issues concerning the rapid introduction and utilization of advanced computer-based technology into the flight deck and air traffic controller workstation environments. The workshop was attended by approximately 30 discipline experts, automation and human factors researchers, and research and development managers. The goal of the workshop was to address major issues identified by the NASA Aviation Safety/Automation Program. Here, the results of the workshop are documented. The ideas, thoughts, and concepts were developed by the workshop participants. The findings, however, have been synthesized into a final report primarily by the NASA researchers.

  7. Declining morbidity and mortality of carotid endarterectomy. The Wake Forest University Medical Center experience.

    PubMed

    Till, J S; Toole, J F; Howard, V J; Ford, C S; Williams, D

    1987-01-01

    The 30-day mortality as well as morbidity for stroke and myocardial infarction were determined by review of the charts for every carotid endarterectomy (N = 389 operations on 356 patients) performed at Wake Forest University Medical Center from 1979 through 1983 to ascertain whether the 16% morbidity and 6% mortality documented in our previous report of 1978 had changed over time. For endarterectomies performed on asymptomatic patients (n = 155), major morbidity included 2 myocardial infarctions and 1 stroke (1.9%). There were 3 fatalities--2 myocardial infarctions and 1 stroke (1.9%). For the symptomatic group (n = 234), major morbidity was 2.1%, mortality 2.6%. The combined morbidity for asymptomatic and symptomatic carotid stenosis was 2%, mortality 2.3%. Perioperative stroke rate (morbidity plus mortality) was 2.6%, 9 ipsilateral to the carotid endarterectomy, suggesting distal embolism as its probable cause. We contend that quality control measures implemented to correct the unacceptable rates reported in 1978 have contributed to dramatic and sustained reductions in complication rates.

  8. Day care quality and children's free play activities.

    PubMed

    Vandell, D L; Powers, C P

    1983-07-01

    Social and nonsocial behavior of white, middle-class preschoolers in high, moderate, and low quality day care centers were contrasted. Children in high quality centers were more likely to interact positively with adults, while children in lower quality programs were more likely to engage in solitary play and aimless wandering.

  9. CTEPP DATA COLLECTION FORM 03:HOUSE/BUILDING CHARACTERISTICS OBSERVATION SURVEY FOR THE DAY CARE CENTER

    EPA Science Inventory

    This data collection form is used to document the physical characteristics of the day care center and identify and inventory possible sources of pollutants.

    The Children's Total Exposure to Persistent Pesticides and Other Persistent Pollutant (CTEPP) study was one of the large...

  10. CTEPP NC DATA COLLECTED ON FORM 03:HOUSE/BUILDING CHARACTERISTICS OBSERVATION SURVEY FOR THE DAY CARE CENTER

    EPA Science Inventory

    This data set contains data concerning the physical characteristics of the day care center and identified possible sources of pollutants.

    The Children’s Total Exposure to Persistent Pesticides and Other Persistent Pollutant (CTEPP) study was one of the largest aggregate exposu...

  11. CTEPP STANDARD OPERATING PROCEDURE FOR COLLECTION OF PERSONAL INTERVIEW DATA (SOP-2.21)

    EPA Science Inventory

    This SOP describes the general method for collecting personal interview data from the child's parent (and the day care center staff, if applicable). Study participants, both parents and day care center teachers, will be interviewed by the project staff at a scheduled appointment ...

  12. Child Care Centres.

    ERIC Educational Resources Information Center

    Australian Dept. of Labour and National Service, Melbourne. Women's Bureau.

    This document is an English-language abstract (approximately 1,500 words) in which Australian child care facilities are surveyed to include those providing full-day care and therefore excludes kindergartens, play centers, nursery schools, and child minding centers that provide care for only part of the day. The document presents a breakdown of…

  13. Association Between Baseline Affective Disorders and 30-Day Readmission Rates in Patients Undergoing Elective Spine Surgery.

    PubMed

    Adogwa, Owoicho; Elsamadicy, Aladine A; Mehta, Ankit I; Vasquez, Raul A; Cheng, Joseph; Karikari, Isaac O; Bagley, Carlos A

    2016-10-01

    There is a growing understanding of the prevalence and impact of affective disorders on perception of health status in patients undergoing elective spine surgery. However, the role of these disorders in early readmission is unclear. The aim of this study is to investigate the influence of psychiatric comorbidities on 30-day all-cause readmissions after elective spine surgery. The medical records of 400 patients undergoing elective spine surgery at a major academic medical center were reviewed, of which 107 patients had comprehensive 1- and 2-year patient-reported outcomes data. We identified all unplanned readmissions within 30 days of discharge. The prevalence of affective disorders, such as depression and anxiety, were also assessed. All-cause readmissions within 30 days of discharge was the primary outcome variable. Baseline characteristics were similar between groups. Approximately 6% of patients in this study were readmitted within 30 days of discharge. The rate of readmission was 3-fold more for individuals with a psychiatric comorbidity compared with those without a psychiatric comorbidity (10.34% vs. 3.84%, P = 0.03). In a univariate analysis, race, body mass index, gender, patient age, smoking, diabetes, and fusion levels were associated with increased 30-day readmission rates. However, in a multivariate logistic regression model, depression was an independent predictor of readmission within 30 days of discharge. In addition, there was no significant difference in baseline, 1- and 2-year patient-reported outcomes measures between groups. Our study suggests that psychologic disorders, like depression and anxiety, are independently associated with higher all-cause 30-day readmission rates after elective spine surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Childcare service centers' preferences and intentions to use a web-based program to implement healthy eating and physical activity policies and practices: a cross-sectional study.

    PubMed

    Yoong, Sze Lin; Williams, Christopher Michael; Finch, Meghan; Wyse, Rebecca; Jones, Jannah; Freund, Megan; Wiggers, John Henry; Nathan, Nicole; Dodds, Pennie; Wolfenden, Luke

    2015-04-30

    Overweight and obesity is a significant public health problem that impacts a large number of children globally. Supporting childcare centers to deliver healthy eating and physical activity-promoting policies and practices is a recommended strategy for obesity prevention, given that such services provide access to a substantial proportion of children during a key developmental period. Electronic Web-based interventions represent a novel way to support childcare service providers to implement such policies and practices. This study aimed to assess: (1) childcare centers' current use of technology, (2) factors associated with intention to use electronic Web-based interventions, and (3) Web-based features that managers rated as useful to support staff with implementing healthy eating and physical activity-promoting policies and practices. A computer-assisted telephone interview (CATI) was conducted with service managers from long day care centers and preschools. The CATI assessed the following: (1) childcare center characteristics, (2) childcare centers' use of electronic devices, (3) intention to use a hypothetical electronic Web-based program-assessed using the Technology Acceptance Model (TAM) with ratings between 1 (strongly disagree) and 7 (strongly agree), and (4) features rated as useful to include in a Web-based program. Overall, 214 service centers out of 277 (77.3%) consented to participate. All service centers except 2 reported using computers (212/214, 99.1%), whereas 40.2% (86/214) used portable tablets. A total of 71.9% (151/210) of childcare service managers reported a score of 6 or more for intention to use a hypothetical electronic Web-based program. In a multivariable logistic regression analysis, intention to use the program was significantly associated with perceived ease of use (P=.002, odds ratio [OR] 3.9, 95% CI 1.6-9.2) and perceived usefulness (P<.001, OR 28,95% CI 8.0-95.2). Features reported by service managers as useful or very useful for a Web-based program included decision-support tools to support staff with menu planning (117/129, 90.7%), links to relevant resources (212/212, 100%), updated information on guidelines (208/212, 98.1%), and feedback regarding childcare center performance in relation to other childcare centers (212/212, 100%). Childcare service managers reported high intention to use a Web-based program and identified several useful features to support staff to implement healthy eating and physical activity policies and practices. Further descriptive and intervention research examining the development and use of such a program to support childcare centers with the implementation of healthy eating and physical activity-promoting policies and practices is warranted.

  15. NASA newsletters for the Weber Student Shuttle Involvement Project

    NASA Technical Reports Server (NTRS)

    Morey-Holton, E. R.; Sebesta, P. D.; Ladwig, A. M.; Jackson, J. T.; Knott, W. M., III

    1988-01-01

    Biweekly reports generated for the Weber Student Shuttle Involvement Project (SSIP) are discussed. The reports document the evolution of science, hardware, and logistics for this Shuttle project aboard the eleventh flight of the Space Transportation System (STS-41B), launched from Kennedy Space Center on February 3, 1984, and returned to KSC 8 days later. The reports were intended to keep all members of the team aware of progress in the project and to avoid redundancy and misunderstanding. Since the Weber SSIP was NASA's first orbital rat project, documentation of all actions was essential to assure the success of this complex project. Eleven reports were generated: October 3, 17 and 31; November 14 and 28; and December 12 and 17, 1983; and January 3, 16, and 23; and May 1, 1984. A subject index of the reports is included. The final report of the project is included as an appendix.

  16. Defibrotide for Treatment of Severe Veno-Occlusive Disease in Pediatrics and Adults: An Exploratory Analysis Using Data from the Center for International Blood and Marrow Transplant Research.

    PubMed

    Strouse, Christopher; Richardson, Paul; Prentice, Grant; Korman, Sandra; Hume, Robin; Nejadnik, Bijan; Horowitz, Mary M; Saber, Wael

    2016-07-01

    Veno-occlusive disease (VOD) is an early and serious complication of hematopoietic cell transplantation (HCT) that is associated with inferior survival, particularly when it is complicated by multiorgan failure (severe VOD). We evaluated the efficacy of defibrotide in the treatment of severe VOD using observational data from the Center for International Blood and Marrow Transplant Research (CIBMTR). Eight thousand three hundred forty-one patients treated by HCT between 2008 and 2011 were identified from the CIBMTR clinical database; 3.2% met criteria for VOD and 1.2% met criteria for severe VOD. Patients with a diagnosis of VOD as reported to the CIBMTR by their transplanting centers, who had no prior history of cirrhosis, and who had a maximum total bilirubin level > 2.0 mg/dL by day +100 post-HCT were selected for study. Severe VOD was defined as VOD occurring in the setting of renal impairment requiring dialysis or any noninfectious pulmonary abnormality. Patients with severe VOD were divided into 2 groups for analysis: those treated with defibrotide (n = 41) and those not treated with defibrotide (n = 55). Patients in the nondefibrotide group were older, were more likely to be male, were more likely to have a history of previous fungal infection, and had a higher proportion of clinically significant pre-existing disease or organ impairment. Survival rate at day +100 was 39% (95% CI, 24.8% to 54.3%) in patients receiving defibrotide and 30.9% (95% CI, 19.5% to 43.6%) in those not receiving defibrotide. Resolution rate of VOD at day +100 was 51% in the defibrotide group and 29% in the nondefibrotide group (difference, 22.1%; 95% CI, 2.6% to 42%). The results of our study are consistent with previously reported experiences with defibrotide, confirm the poor outcome of this syndrome, and suggest defibrotide is effective in the treatment of severe VOD. Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  17. KSC-06pd1422

    NASA Image and Video Library

    2006-07-04

    KENNEDY SPACE CENTER, FLA. - In Firing Room 4 of the Launch Control Center, Shuttle Launch Director Mike Leinbach (center) and Center Director Jim Kennedy congratulate the launch team after the successful launch of Space Shuttle Discovery on mission STS-121. The launch was the first ever to take place on Independence Day. During the 12-day mission, the STS-121 crew of seven will test new equipment and procedures to improve shuttle safety, as well as deliver supplies and make repairs to the International Space Station. Landing is scheduled for July 16 or 17 at Kennedy's Shuttle Landing Facility. Photo credit: NASA/Kim Shiflett

  18. KSC-06pd1421

    NASA Image and Video Library

    2006-07-04

    KENNEDY SPACE CENTER, FLA. - In Firing Room 4 of the Launch Control Center, Shuttle Launch Director Mike Leinbach (center) congratulates the launch team after the successful launch of Space Shuttle Discovery on mission STS-121. The launch was the first ever to take place on Independence Day. At far right is Center Director Jim Kennedy. During the 12-day mission, the STS-121 crew of seven will test new equipment and procedures to improve shuttle safety, as well as deliver supplies and make repairs to the International Space Station. Landing is scheduled for July 16 or 17 at Kennedy's Shuttle Landing Facility. Photo credit: NASA/Kim Shiflett

  19. 2017 A Day of Remembrance

    NASA Image and Video Library

    2017-01-26

    NASA officials, family members and other invited guests listen to remarks during Kennedy Space Center's Day of Remembrance ceremony. From left to right are Kennedy Space Center Director Bob Cabana; contemporary Christian musician Brandon Heath; Apollo launch team member John Tribe; Sheryl Chaffee, daughter of Apollo 1 astronaut Roger Chaffee; astronaut Michael Collins; NASA Acting Administrator Robert Lightfoot; and astronaut Charlie Duke. Held this year in the Center for Space Education at the Kennedy Space Center Visitor Complex in Florida, the annual event honors the contributions of all astronauts who lost their lives in the quest for space exploration.

  20. KSC-94PC-0901

    NASA Image and Video Library

    1994-07-20

    KENNEDY SPACE CENTER, FLA. -- Dr. Irene Duhart Long is the director, Biomedical Operations and Research Office, at the Kennedy Space Center effective July 24, 1994. She is responsible for the program management of the center's aerospace and occupational medicine, life sciences research, environmental health programs and the operations management of the life sciences support facilities. Dr. Long also is responsible for providing the coordinating medical, environmental monitoring and environmental health support to launch and landing activities and day-to-day institutional functions.

  1. View of Mission Control on first day of ASTP docking in Earth orbit

    NASA Technical Reports Server (NTRS)

    1975-01-01

    An overall view of the Mission Operations Control Room in the Mission Control Center, bldg 30, JSC, on the first day of the Apollo Soyuz Test Project (ASTP) docking in Earth orbit. This photograph was taken shortly before the American ASTP launch from the Kennedy Space Center. The television monitor in the center background shows the ASTP Apollo-Saturn 1B space vehicle on Pad B at KSC's Launch Complex 39.

  2. FAQ about Recreational Therapy (RT)

    MedlinePlus

    ... increasing number are being hired in residential facilities, community mental health centers, adult day care programs, substance abuse centers, hospice care, community centers, and in school systems. There is a ...

  3. Self-reported adherence and associated factors to isoniazid preventive therapy for latent tuberculosis among people living with HIV/AIDS at health centers in Gondar town, North West Ethiopia.

    PubMed

    Ayele, Asnakew Achaw; Asrade Atnafie, Seyfe; Balcha, Demis Driba; Weredekal, Asegedech Tsegaw; Woldegiorgis, Birhanu Alemayehu; Wotte, Mulgeta Melaku; Gebresillasie, Begashaw Melaku

    2017-01-01

    This study aimed to assess self-reported adherence and associated factors to isoniazid preventive therapy (IPT) for latent tuberculosis among people living with HIV/AIDS (PLWHA) at health centers in Gondar town, North West Ethiopia. An institution-based prospective cross-sectional study was conducted from March 10 to June 11, 2016. A total of 154 eligible participants were included in the study, using the simple random sampling method, from the available four health centers and one teaching referral hospital that provided antiretroviral therapy (ART) for HIV/AIDS patients. Adherence was measured by self-report of isoniazid (INH) tablets taken for the preceding 7 days. Participants were recruited through in-depth interviews. The collected data were entered and analyzed using the statistical packages for social sciences (SPSS) version 20. The adherence level to IPT was 90.3% for the last 7 days of the study. ART was initiated for 84.4%, and all of them were on a first-line regimen. Isoniazid-related side effects were reported by 48 (31.2%) participants, of which the most commonly identified were abdominal pain, vomiting, skin rash, jaundice, and numbness. Only 3 (2%) participants discontinued from the study. In the bivariate logistic regression analysis, respondents who had received an explanation about IPT were 83% times more likely to be adherent compared to those who had not received it (95% CI, AOR: 0.266 [0.23-3.127]). Respondents who had taken IPT for ≥5 months were more likely to be adherent than those who had taken it for 1-2 months [95% CI, COR: 1.484]. On the other hand, respondents who experienced side effects were 36% less likely to be adherent compared to those who did not experience any. The level of adherence to IPT among PLWHA was high. Among the predictors reported, carelessness and/or forgetfulness, side effects, and absence from home were the major factors identified for being nonadherent. Health professionals and the Ministry of Health should design and deliver appropriate health education tips and messages. Moreover, counseling of patients who are in their first 2 months of therapy should be strengthened further.

  4. 2013 NASA Range Safety Annual Report

    NASA Technical Reports Server (NTRS)

    Dumont, Alan G.

    2013-01-01

    Welcome to the 2013 edition of the NASA Range Safety Annual Report. Funded by NASA Headquarters, this report provides an Agency overview for current and potential range users. This report contains articles which cover a variety of subject areas, summaries of various activities performed during the past year, links to past reports, and information on several projects that may have a profound impact on the way business will be conducted in the future. Specific topics discussed in the 2013 NASA Range Safety Annual Report include a program overview and 2013 highlights, Range Safety Training, Independent Assessments, support to Program Operations at all ranges conducting NASA launch/flight operations, a continuing overview of emerging range safety-related technologies, and status reports from all of the NASA Centers that have Range Safety responsibilities. Every effort has been made to include the most current information available. We recommend this report be used only for guidance and that the validity and accuracy of all articles be verified for updates. As is the case each year, we had a wide variety of contributors to this report from across our NASA Centers and the national range safety community at large, and I wish to thank them all. On a sad note, we lost one of our close colleagues, Dr. Jim Simpson, due to his sudden passing in December. His work advancing the envelope of autonomous flight safety systems software/hardware development leaves a lasting impression on our community. Such systems are being flight tested today and may one day be considered routine in the range safety business. The NASA family has lost a pioneer in our field, and he will surely be missed. In conclusion, it has been a very busy and productive year, and I look forward to working with all of you in NASA Centers/Programs/Projects and with the national Range Safety community in making Flight/Space activities as safe as they can be in the upcoming year.

  5. Day Care Centers for Seniors in Singapore: Looking Back and Looking Ahead.

    PubMed

    Liu, Germaine; Yap, Philip; Wong, Gabriel H Z; Wei, Heng Xiao; Hua, Ee Chye

    2015-07-01

    The burden of care for frail elderly persons on families and the society is ever real as our population ages. Given the dual-income nature of many working families, day care centers offer a strong alternative to nursing homes for families wishing to provide custodial care and meaningful engagement for seniors while continuing to uphold their filial duties. Recognizing this, several initiatives, such as SPICE (Singapore Programme for Integrated Care for the Elderly) and Weekend Respite Care, have been launched to enhance the services of Singapore's day care centers. This article traces the evolution of this process, distills current challenges, and offers policy recommendations to improve Singapore's day care services for seniors. Copyright © 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  6. Patient safety event reporting in critical care: a study of three intensive care units.

    PubMed

    Harris, Carolyn B; Krauss, Melissa J; Coopersmith, Craig M; Avidan, Michael; Nast, Patricia A; Kollef, Marin H; Dunagan, W Claiborne; Fraser, Victoria J

    2007-04-01

    To increase patient safety event reporting in three intensive care units (ICUs) using a new voluntary card-based event reporting system and to compare and evaluate observed differences in reporting among healthcare workers across ICUs. Prospective, single-center, interventional study. A medical ICU (19 beds), surgical ICU (24 beds), and cardiothoracic ICU (17 beds) at a 1,371-bed urban teaching hospital. Adult patients admitted to these three study ICUs. Use of a new, internally designed, card-based reporting program to solicit voluntary anonymous reporting of medical errors and patient safety concerns. During a 14-month period, 714 patient safety events were reported using a new card-based reporting system, reflecting a significant increase in reporting compared with pre-intervention Web-based reporting (20.4 reported events/1,000 patient days pre-intervention to 41.7 reported events/1,000 patient days postintervention; rate ratio, 2.05; 95% confidence interval, 1.79-2.34). Nurses submitted the majority of reports (nurses, 67.1%; physicians, 23.1%; other reporters, 9.5%); however, physicians experienced the greatest increase in reporting among their group (physicians, 43-fold; nurses, 1.7-fold; other reporters, 4.3-fold) relative to pre-intervention rates. There were significant differences in the reporting of harm by job description: 31.1% of reports from nurses, 36.2% from other staff, and 17.0% from physicians described events that did not reach/affect the patient (p = .001); and 33.9% of reports from physicians, 27.2% from nurses, and 13.0% from other staff described events that caused harm (p = .005). Overall reported patient safety events per 1,000 patient days differed by ICU (medical ICU = 55.5, cardiothoracic ICU = 25.3, surgical ICU = 40.2; p < .001). This card-based reporting system increased reporting significantly compared with pre-intervention Web-based reporting and revealed significant differences in reporting by healthcare worker and ICU. These differences may reveal important preferences and priorities for reporting medical errors and patient safety events.

  7. Impact of Policies on Physical Activity and Screen Time Practices in 50 Child-Care Centers in North Carolina.

    PubMed

    Erinosho, Temitope; Hales, Derek; Vaughn, Amber; Mazzucca, Stephanie; Ward, Dianne S

    2016-01-01

    This study assessed physical activity and screen time policies in child-care centers and their associations with physical activity and screen time practices and preschool children's (3-5 years old) physical activity. Data were from 50 child-care centers in North Carolina. Center directors reported on the presence/absence of written policies. Trained research assistants observed physical activity and screen time practices in at least 1 preschool classroom across 3 to 4 days. Children (N = 544) wore accelerometers to provide an objective measure of physical activity. Physical activity and screen time policies varied across centers. Observational data showed 82.7 min/d of active play opportunities were provided to children. Screen time provided did not exceed 30 min/d/child at 98% of centers. Accelerometer data showed children spent 38 min/d in moderate-to-vigorous physical activity and 206 min/d in sedentary activity. Policies about staff supervision of media use were negatively associated with screen time (P < .05). Contrary to expectation, policies about physical activity were associated with less time in physical activity. Clear strategies are needed for translating physical activity policies to practice. Further research is needed to evaluate the quality of physical activity policies, their impact on practice, and ease of operationalization.

  8. Care Coordination with Schools: The Role of Family-Centered Care for Children with Special Health Care Needs.

    PubMed

    Barnard-Brak, Lucy; Stevens, Tara; Carpenter, Julianna

    2017-05-01

    Objectives Family-centered care has been associated with positive outcomes for children with special health care needs. The purpose of the current study was to examine the relationship of family-centered care as associated with care coordination with schools and school absences (e.g., missed days) as reported by parents of children with special health care needs. Methods The current study utilized data from the National Survey of Children with Special Health Care Needs 2009-201 (N = 40,242) to achieve this purpose. The National Survey of Children with Special Health Care Needs may be considered a nationally-representative and community-based sample of parent responses for children with special health care needs across the United States. Results Results from the current study indicate that family-centered care is associated with fewer absences and improved care coordination with schools when applicable. The variables of functional difficulties, poverty level, and the number of conditions were statistically controlled. Conclusions We suggest that the positive influence of family-centered care when practiced extends beyond the family and interacts with educational outcomes. We also suggest that the role of schools appears to be under-studied given the role that schools can play in family-centered care.

  9. Examining human rights and mental health among women in drug abuse treatment centers in Afghanistan

    PubMed Central

    Abadi, Melissa Harris; Shamblen, Stephen R; Johnson, Knowlton; Thompson, Kirsten; Young, Linda; Courser, Matthew; Vanderhoff, Jude; Browne, Thom

    2012-01-01

    Denial of human rights, gender disparities, and living in a war zone can be associated with severe depression and poor social functioning, especially for female drug abusers. This study of Afghan women in drug abuse treatment (DAT) centers assesses (a) the extent to which these women have experienced human rights violations and mental health problems prior to entering the DAT centers, and (b) whether there are specific risk factors for human rights violations among this population. A total of 176 in-person interviews were conducted with female patients admitted to three drug abuse treatment centers in Afghanistan in 2010. Nearly all women (91%) reported limitations with social functioning. Further, 41% of the women indicated they had suicide ideation and 27% of the women had attempted suicide at least once 30 days prior to entering the DAT centers due to feelings of sadness or hopelessness. Half of the women (50%) experienced at least one human rights violation in the past year prior to entering the DAT centers. Risk factors for human rights violations among this population include marital status, ethnicity, literacy, employment status, entering treatment based on one’s own desire, limited social functioning, and suicide attempts. Conclusions stemming from the results are discussed. PMID:22532779

  10. Examining human rights and mental health among women in drug abuse treatment centers in Afghanistan.

    PubMed

    Abadi, Melissa Harris; Shamblen, Stephen R; Johnson, Knowlton; Thompson, Kirsten; Young, Linda; Courser, Matthew; Vanderhoff, Jude; Browne, Thom

    2012-01-01

    Denial of human rights, gender disparities, and living in a war zone can be associated with severe depression and poor social functioning, especially for female drug abusers. This study of Afghan women in drug abuse treatment (DAT) centers assesses (a) the extent to which these women have experienced human rights violations and mental health problems prior to entering the DAT centers, and (b) whether there are specific risk factors for human rights violations among this population. A total of 176 in-person interviews were conducted with female patients admitted to three drug abuse treatment centers in Afghanistan in 2010. Nearly all women (91%) reported limitations with social functioning. Further, 41% of the women indicated they had suicide ideation and 27% of the women had attempted suicide at least once 30 days prior to entering the DAT centers due to feelings of sadness or hopelessness. Half of the women (50%) experienced at least one human rights violation in the past year prior to entering the DAT centers. Risk factors for human rights violations among this population include marital status, ethnicity, literacy, employment status, entering treatment based on one's own desire, limited social functioning, and suicide attempts. Conclusions stemming from the results are discussed.

  11. Radiotherapy in Italy after conservative treatment of early breast cancer. A survey by the Italian Society of Radiation Oncology (AIRO).

    PubMed

    Aristei, Cynthia; Amichetti, Maurizio; Ciocca, Mario; Nardone, Luigia; Bertoni, Filippo; Vidali, Cristiana

    2008-01-01

    The aim of surveys on clinical practice is to stimulate discussion and optimize practice. In this paper the current Italian radiotherapy practice after breast-conserving surgery for early breast cancer is described and adherence to national and international guidelines is assessed. Furthermore, results are compared with an earlier survey in northern Italy and international reports. A multiple-choice questionnaire sent to all 138 Italian radiation oncology centers. 48% of centers responded. Most performed breast-conserving surgery when tumor size was < or =3 cm. All centers routinely performed axillary dissection; 45 carried out sentinel node biopsy followed by axillary dissection when the sentinel node was positive. Most centers re-excised when resection margins were positive. The median interval between surgery and radiotherapy, when chemotherapy was not administered, was 60 days. Adjuvant chemotherapy was preferably administered before radiotherapy. Regional lymph nodes were never irradiated in 10 centers; in all others irradiation depended on the number of positive lymph nodes and/or involvement of axillary fat and/or tumor location in medial quadrants. All centers used standard fractionation; hypofractionated schemes were available in 6. Most centers used 4-6 MV photons. In 59 centers the boost dose of 10 Gy could be increased if margins were not negative. All centers ensured patient setup reproducibility. Treatment planning was computerized in 59 centers. The irradiation dose was prescribed at the ICRU point in 56 centers and portal films were made in 54 centers. Intraoperative radiotherapy was used in 4 centers: for partial breast irradiation in 1 and for boost administration in 3 centers. Although the quality of radiotherapy delivery has improved in Italy in recent years, approaches that do not conform to international standards persist.

  12. Assessment of food, nutrition, and physical activity practices in Oklahoma child-care centers.

    PubMed

    Sisson, Susan B; Campbell, Janis E; May, Kellie B; Brittain, Danielle R; Monroe, Lisa A; Guss, Shannon H; Ladner, Jennifer L

    2012-08-01

    The purpose of the current study was to determine the obesogenic practices in all-day child-care centers caring for preschool-aged children. This study used a cross-sectional, self-reported survey mailed to centers across Oklahoma (n=314). Frequency of responses and χ(2) were calculated comparing region and star rating. Items where the majority of centers frequently report best practices include: daily fruits served (76%), daily nonfried vegetables served (71%), rarely/never served sugary drinks (92%), rarely/never used food to encourage good behaviors (88%), staff join children at table most of the time (81%), staff rarely eat different foods in view of children (69%), visible self-serve or request availability of water (93%), regular informal communication about healthy eating (86%), opportunities for outdoor play (95%), not withholding activity for punishment (91%), accessible play equipment (59% to 80% for different types of equipment), and minimization of extended sitting time (78%). Practices where centers can improve include increasing variety of vegetables (18%), reducing frequency of high-fat meats served (74% serve more than once per week), increasing high-fiber and whole-grain foods (35% offer daily), serving style of "seconds" (28% help kids determine whether they are still hungry), nonfood holiday celebrations (44% use nonfood treats), having toys and books that encourage healthy eating (27%) and physical activity (25%) in all rooms in the center, a standard nutrition (21%) and physical education (50%) curriculum, and following a written physical activity policy (43%). Practitioners can use these data to develop benchmarks and interventions, as this was the first study to assess statewide obesogenic practices in child care. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  13. Repetitive Pediatric Anesthesia in a Non-Hospital Setting

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

    Buchsbaum, Jeffrey C., E-mail: jbuchsba@iupui.edu; Indiana University Health Proton Therapy Center, Bloomington, Indiana; McMullen, Kevin P.

    2013-04-01

    Purpose: Repetitive sedation/anesthesia (S/A) for children receiving fractionated radiation therapy requires induction and recovery daily for several weeks. In the vast majority of cases, this is accomplished in an academic center with direct access to pediatric faculty and facilities in case of an emergency. Proton radiation therapy centers are more frequently free-standing facilities at some distance from specialized pediatric care. This poses a potential dilemma in the case of children requiring anesthesia. Methods and Materials: The records of the Indiana University Health Proton Therapy Center were reviewed for patients requiring anesthesia during proton beam therapy (PBT) between June 1, 2008,more » and April 12, 2012. Results: A total of 138 children received daily anesthesia during this period. A median of 30 fractions (range, 1-49) was delivered over a median of 43 days (range, 1-74) for a total of 4045 sedation/anesthesia procedures. Three events (0.0074%) occurred, 1 fall from a gurney during anesthesia recovery and 2 aspiration events requiring emergency department evaluation. All 3 children did well. One aspiration patient needed admission to the hospital and mechanical ventilation support. The other patient returned the next day for treatment without issue. The patient who fell was not injured. No patient required cessation of therapy. Conclusions: This is the largest reported series of repetitive pediatric anesthesia in radiation therapy, and the only available data from the proton environment. Strict adherence to rigorous protocols and a well-trained team can safely deliver daily sedation/anesthesia in free-standing proton centers.« less

  14. One-electron oxidation of electronically diverse manganese(III) and nickel(II) salen complexes: transition from localized to delocalized mixed-valence ligand radicals.

    PubMed

    Kurahashi, Takuya; Fujii, Hiroshi

    2011-06-01

    Ligand radicals from salen complexes are unique mixed-valence compounds in which a phenoxyl radical is electronically linked to a remote phenolate via a neighboring redox-active metal ion, providing an opportunity to study electron transfer from a phenolate to a phenoxyl radical mediated by a redox-active metal ion as a bridge. We herein synthesize one-electron-oxidized products from electronically diverse manganese(III) salen complexes in which the locus of oxidation is shown to be ligand-centered, not metal-centered, affording manganese(III)-phenoxyl radical species. The key point in the present study is an unambiguous assignment of intervalence charge transfer bands by using nonsymmetrical salen complexes, which enables us to obtain otherwise inaccessible insight into the mixed-valence property. A d(4) high-spin manganese(III) ion forms a Robin-Day class II mixed-valence system, in which electron transfer is occurring between the localized phenoxyl radical and the phenolate. This is in clear contrast to a d(8) low-spin nickel(II) ion with the same salen ligand, which induces a delocalized radical (Robin-Day class III) over the two phenolate rings, as previously reported by others. The present findings point to a fascinating possibility that electron transfer could be drastically modulated by exchanging the metal ion that bridges the two redox centers. © 2011 American Chemical Society

  15. 2016 Annual Report of the University of Kansas Health System Poison Control Center.

    PubMed

    Thornton, Stephen L; Oller, Lisa; Coons, Doyle M

    2018-05-01

    This is the 2016 Annual Report of the University of Kansas Health System Poison Control Center (PCC). The PCC is one of 55 certified poison control centers in the United States and serves the state of Kansas 24-hours a day, 365 days a year, with certified specialists in poison information and medical toxicologists. The PCC receives calls from the public, law enforcement, health care professionals, and public health agencies. All calls to the PCC are recorded electronically in the Toxicall® data management system and uploaded in near real-time to the National Poison Data System (NPDS), which is the data repository for all poison control centers in the United States. All encounters reported to the PCC from January 1, 2016 to December 31, 2016 were analyzed. Data recorded for each exposure includes caller location, age, weight, gender, substance exposed to, nature of exposure, route of exposure, interventions, medical outcome, disposition and location of care. Encounters were classified further as human exposure, animal exposure, confirmed non-exposure, or information call (no exposure reported). The PCC logged 21,965 total encounters in 2016, including 20,713 human exposure cases. The PCC received calls from every county in Kansas. The majority of human exposure cases (50.4%, n = 10,174) were female. Approximately 67% (n = 13,903) of human exposures involved a child (defined as age 19 years or less). Most encounters occurred at a residence (94.0%, n = 19,476) and most calls (72.3%, n = 14,964) originated from a residence. The majority of human exposures (n = 18,233) were acute cases (exposures occurring over eight hours or less). Ingestion was the most common route of exposure documented (86.3%, n = 17,882). The most common reported substance in pediatric encounters was cosmetics/personal care products (n = 1,362), followed by household cleaning product (n = 1,301). For adult encounters, sedatives/hypnotics/antipsychotics (n = 1,130) and analgesics (n = 1,103) were the most frequently involved substances. Unintentional exposures were the most common reason for exposures (81.3%, n = 16,836). Most encounters (71.1%, n = 14,732) were managed in a non-healthcare facility (i.e., a residence). Among human exposures, 14,679 involved exposures to pharmaceutical agents while 10,176 involved exposure to non-pharmaceuticals. Medical outcomes were 32% (n = 6,582) no effect, 19% (n = 3,911) minor effect, 8% (n = 1,623) moderate effect, and 2% (n = 348) major effects. There were 15 deaths in 2016 reported to the PCC. Number of exposures, calls from healthcare facilities, cases with moderate or major medical outcomes, and deaths all increased in 2016 compared to 2015. The results of the 2016 University of Kansas Health System Poison Control annual report demonstrates that the center receives calls from the entire state of Kansas totaling over 20,000 human exposures per year. While pediatric exposures remain the most common, there is an increasing number of calls from healthcare facilities and for cases with serious outcomes. The experience of the PCC is similar to national data. This report supports the continued value of the PCC to both public and acute health care in the state of Kansas.

  16. 2016 Annual Report of the University of Kansas Health System Poison Control Center

    PubMed Central

    Thornton, Stephen L.; Oller, Lisa; Coons, Doyle M.

    2018-01-01

    Introduction This is the 2016 Annual Report of the University of Kansas Health System Poison Control Center (PCC). The PCC is one of 55 certified poison control centers in the United States and serves the state of Kansas 24-hours a day, 365 days a year, with certified specialists in poison information and medical toxicologists. The PCC receives calls from the public, law enforcement, health care professionals, and public health agencies. All calls to the PCC are recorded electronically in the Toxicall® data management system and uploaded in near real-time to the National Poison Data System (NPDS), which is the data repository for all poison control centers in the United States. Methods All encounters reported to the PCC from January 1, 2016 to December 31, 2016 were analyzed. Data recorded for each exposure includes caller location, age, weight, gender, substance exposed to, nature of exposure, route of exposure, interventions, medical outcome, disposition and location of care. Encounters were classified further as human exposure, animal exposure, confirmed non-exposure, or information call (no exposure reported). Results The PCC logged 21,965 total encounters in 2016, including 20,713 human exposure cases. The PCC received calls from every county in Kansas. The majority of human exposure cases (50.4%, n = 10,174) were female. Approximately 67% (n = 13,903) of human exposures involved a child (defined as age 19 years or less). Most encounters occurred at a residence (94.0%, n = 19,476) and most calls (72.3%, n = 14,964) originated from a residence. The majority of human exposures (n = 18,233) were acute cases (exposures occurring over eight hours or less). Ingestion was the most common route of exposure documented (86.3%, n = 17,882). The most common reported substance in pediatric encounters was cosmetics/personal care products (n = 1,362), followed by household cleaning product (n = 1,301). For adult encounters, sedatives/hypnotics/antipsychotics (n = 1,130) and analgesics (n = 1,103) were the most frequently involved substances. Unintentional exposures were the most common reason for exposures (81.3%, n = 16,836). Most encounters (71.1%, n = 14,732) were managed in a non-healthcare facility (i.e., a residence). Among human exposures, 14,679 involved exposures to pharmaceutical agents while 10,176 involved exposure to non-pharmaceuticals. Medical outcomes were 32% (n = 6,582) no effect, 19% (n = 3,911) minor effect, 8% (n = 1,623) moderate effect, and 2% (n = 348) major effects. There were 15 deaths in 2016 reported to the PCC. Number of exposures, calls from healthcare facilities, cases with moderate or major medical outcomes, and deaths all increased in 2016 compared to 2015. Conclusion The results of the 2016 University of Kansas Health System Poison Control annual report demonstrates that the center receives calls from the entire state of Kansas totaling over 20,000 human exposures per year. While pediatric exposures remain the most common, there is an increasing number of calls from healthcare facilities and for cases with serious outcomes. The experience of the PCC is similar to national data. This report supports the continued value of the PCC to both public and acute health care in the state of Kansas. PMID:29796151

  17. [Topiramate in substance-related and addictive disorders].

    PubMed

    Cohen, Johan; Dervaux, Alain; Laqueille, Xavier

    2014-09-01

    Drug treatments used in substance use disorders are not effective in all patients. To assess the effectiveness of topiramate use in the treatment of substance use disorders. Medline database from January 1966 to December 2013, Cochrane database and clinicaltrials.gov. We used keywords topiramate, addiction, substance abuse, alcohol, tobacco, nicotine, cocaine, methamphetamine, opiate, heroin, benzodiazepine, cannabis, bulimia nervosa, binge eating disorder, gambling. All clinical trials were included. Animal trials, laboratory tests, reviews, answers to writers, case-reports, case series and publications unrelated to the topic were excluded. Twenty-eight articles investigating the efficacy of topiramate in substance use were included. In alcohol-related disorder, several trials and a meta-analysis showed a reduction of days of consumption. In a single-center trial on tobacco-related disorder, topiramate was not found effective in reducing the carbon monoxide expired. In cocaine-related disorder, one single-center trial showed a reduction of days of consumption and two single-center trials have found a trend in favour of topiramate. In alcohol and cocaine co-dependency, a single-center trial found a trend in favour of topiramate. In methamphetamine-related disorder, a multicenter trial found a trend in favour of topiramate. In bulimia nervosa, two single-center trials showed a reduction in binge eating and compensatory behaviours. In binge eating disorder, several trials showed a reduction of binge eating and weight. In gambling, one single-center trial did not show any significant results. There were no randomized controlled trials found in opioid-related disorder, benzodiazepines-related disorder, and cannabis-related disorder. Definition of abstinence and methods to assess the efficacy of topiramate differed between trials. The methodological quality of included trials was variable, especially with no double-blind procedure in eight trials. Topiramate showed interest mainly in alcoholism, binge eating disorder and bulimia nervosa. No definitive conclusions can be reached for other substance use disorders such as nicotine dependence, cocaine dependence, amphetamine dependence or cannabis dependence and for gambling. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. United European Gastroenterology Week (UEGW) 2017 - 25th Annual Conference (October 28-November 1, 2017 - Barcelona, Spain).

    PubMed

    Torramadé, E

    2017-11-01

    The 25th United European Gastroenterology Week (UEGW), the largest European conference centered on diseases of the stomach, bowel, esophagus, liver, pancreas and gallbladder, was held in Barcelona, Spain. This 5-day meeting attracted over 13,000 delegates to share recent research in the treatment of gastrointestinal and liver diseases. The conference provided teaching material, workshops and live sessions to all the attendants. The reports will cover the latest research into treatments for these diseases.

  19. Military Occupational Speciality Training Cost Handbook (MOSB)

    DTIC Science & Technology

    1983-10-01

    FINANCE & ACCOUNTING CENTER "JUN 1 i 184’, l APPROVED:_ . A " W. M. ALLENi T - DIRECTOR OF COST ANALYSIS _ "OFFICE OF THE COMPTROLLER OF THE ARMYj 84 04 16 ...COVERED j14. DATE OF REPORT (Yr.. Alo.. Day) 15 AE COUNT 16 . SUPPLEMENTARY NOTAOMION IFROM TO 83/10 43o Supersedes Volumes I and II, MOSB, dated 81... depreciation of equipment, minimum consumption of utilities, pay of minimum grounds staff, etc. Of course, per capita fixed cost will rise with a decreasing

  20. Building a Metric

    NASA Technical Reports Server (NTRS)

    Spencer, Shakira

    2007-01-01

    Launch Services Program is a Kennedy Space Center based program whose job it is to undertake all the necessary roles required to successfully launch Expendable Launch Vehicles. This project was designed to help Launch Services Program accurately report how successful they have been at launching missions on time or +/- 2 days from the scheduled launch date and also if they weren't successful, why. This information will be displayed in the form of a metric, which answers these questions in a clear and accurate way.

  1. Work closely with the business office.

    PubMed

    2011-05-01

    At the University of Pittsburgh Medical Center, members of the case management department work closely with the contracting and business department by pointing out payer issues and keeping the chief financial officer informed about payer requirements that could affect reimbursement. Case managers track payer issues on a dayto-day basis and report trends to the contracting department. Contracting staff obtain input from members of the case management department when negotiating or renegotiating contracts. Changes in payer contracts are communicated to the case management staff.

  2. Adult Day Care

    MedlinePlus

    ... Page Resize Text Printer Friendly Online Chat Adult Day Care Adult Day Care Centers are designed to provide care and ... adults who need assistance or supervision during the day. Programs offer relief to family members and caregivers, ...

  3. Methicillin-Resistant and Susceptible Staphylococcus aureus Bacteremia and Meningitis in Preterm Infants

    PubMed Central

    Hansen, Nellie I.; Stoll, Barbara J.; Bell, Edward F.; Sánchez, Pablo J.; Shankaran, Seetha; Laptook, Abbot R.; Das, Abhik; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Schrag, Stephanie J.; Higgins, Rosemary D.

    2012-01-01

    BACKGROUND: Data are limited on the impact of methicillin-resistant Staphylococcus aureus (MRSA) on morbidity and mortality among very low birth weight (VLBW) infants with S aureus (SA) bacteremia and/or meningitis (B/M). METHODS: Neonatal data for VLBW infants (birth weight 401–1500 g) born January 1, 2006, to December 31, 2008, who received care at centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network were collected prospectively. Early-onset (≤72 hours after birth) and late-onset (>72 hours) infections were defined by blood or cerebrospinal fluid cultures and antibiotic treatment of ≥5 days (or death <5 days with intent to treat). Outcomes were compared for infants with MRSA versus methicillin-susceptible S aureus (MSSA) B/M. RESULTS: Of 8444 infants who survived >3 days, 316 (3.7%) had SA B/M. Eighty-eight had MRSA (1% of all infants, 28% of infants with SA); 228 had MSSA (2.7% of all infants, 72% of infants with SA). No infant had both MRSA and MSSA B/M. Ninety-nine percent of MRSA infections were late-onset. The percent of infants with MRSA varied by center (P < .001) with 9 of 20 centers reporting no cases. Need for mechanical ventilation, diagnosis of respiratory distress syndrome, necrotizing enterocolitis, and other morbidities did not differ between infants with MRSA and MSSA. Mortality was high with both MRSA (23 of 88, 26%) and MSSA (55 of 228, 24%). CONCLUSIONS: Few VLBW infants had SA B/M. The 1% with MRSA had morbidity and mortality rates similar to infants with MSSA. Practices should provide equal focus on prevention and management of both MRSA and MSSA infections among VLBW infants. PMID:22412036

  4. Assessing early unplanned reoperations in neurosurgery: opportunities for quality improvement.

    PubMed

    McLaughlin, Nancy; Jin, Peng; Martin, Neil A

    2015-07-01

    Review of morbidities and mortality has been the primary method used to assess surgical quality by physicians, hospitals, and oversight agencies. The incidence of reoperation has been proposed as a candidate quality indicator for surgical care. The authors report a comprehensive assessment of reoperations within a neurosurgical department and discuss how such data can be integrated into quality improvement initiatives to optimize value of care delivery. All neurosurgical procedures performed in the main operating room or the outpatient surgery center at the Ronald Reagan UCLA Medical Center and UCLA Santa Monica Medical Center from July 2008 to December 2012 were considered for this study. Interventional radiology and stereotactic radiosurgery procedures were excluded. Early reoperations within 7 days of the index surgery were reviewed and their preventability status was evaluated. The incidence of early unplanned reoperation was 2.6% (occurring after 183 of 6912 procedures). More than half of the patients who underwent early unplanned reoperation initially had surgery for shunt-related conditions (34.4%) or intracranial tumor (23.5%). Shunt failure was the most common indication for early unplanned reoperation (34.4%), followed by postoperative bleeding (20.8%) and postoperative elevated intracranial pressure (9.8%). The average time interval (± SD) between the index surgery and reoperation was 3.0 ± 1.9 days. The average length of stay following reoperation was 12.1 ± 14.4 days. This study enabled an in-depth assessment of reoperations within an academic neurosurgical practice and identification of strategic opportunities for department-wide quality improvement initiatives. The authors provide a nuanced discussion regarding the use of absolute reoperations as a quality indicator for neurosurgical patient populations.

  5. High mortality after ALPPS for perihilar cholangiocarcinoma: case-control analysis including the first series from the international ALPPS registry

    PubMed Central

    Olthof, Pim B.; Coelen, Robert J.S.; Wiggers, Jimme K.; Koerkamp, Bas Groot; Malago, Massimo; Hernandez-Alejandro, Roberto; Topp, Stefan A.; Vivarelli, Marco; Aldrighetti, Luca A.; Campos, Ricardo Robles; Oldhafer, Karl J.; Jarnagin, William R.; van Gulik, Thomas M.

    2017-01-01

    Introduction Resection of perihilar cholangiocarcinoma (PHC) entails high-risk surgery with substantial postoperative mortality reported up to 18%, even in specialized centers. The aim of this study was to compare outcomes of PHC patients who underwent associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) to patients with a small functional liver remnant who underwent resection without ALPSS. Methods All patients who underwent ALPPS for PHC were identified from the international ALPPS registry and matched controls were selected from a standard resection cohort from two centers based on future remnant liver size. Outcomes included morbidity, mortality, and overall survival. Results Of the 37 patients who had undergone ALPPS for PHC in the registry, 29 had sufficient data for analyses. ALPPS for PHC was associated with a 48% (14/29) 90-day mortality and median OS of 6 months. A total of 257 patients underwent major liver resection for PHC without ALPPS. The 90-day mortality was 13% and median OS 46 months. The 29 ALPPS patients were matched to 29 patients resected without ALPPS, with similar future liver remnant volume (P=0.480). Mortality in the matched control group was 24% (P=0.100) and median OS was 27 months (P = 0.064). Discussion Outcomes of ALPPS for PHC appear inferior when compared to standard extended resections in high-risk patients. Considering these outcomes, portal vein embolization should remain the preferred method to increase future remnant liver volume in PHC patients. ALPPS is not recommended for PHC due to the 48% 90-day mortality in expert centers. PMID:28279621

  6. Clinical and Geographic Characterization of 30-Day Readmissions in Pediatric Sickle Cell Crisis Patients.

    PubMed

    McMillan, Jefferson E; Meier, Emily R; Winer, Jeffrey C; Coco, Megan; Daymont, Mary; Long, Sierra; Jacobs, Brian R

    2015-08-01

    Sickle cell disease (SCD) is a blood disorder affecting many US children that is often associated with hospital readmission. Although previous studies have reported on the clinical factors that influence readmission risk, potential geographic factors have not been fully investigated. The goal of this study was to investigate the importance of geographic risk factors and to confirm previously derived clinical risk factors that influence readmissions for SCD pain crises. Retrospective analyses were performed on pediatric inpatients with sickle cell crises at a single center. Readmission rates and risk factors were assessed. Geospatial analysis was conducted on point variables that represented health service access, and multivariable logistic regression models were constructed. The study identified 373 patients experiencing sickle cell crises, with 125 (33.5%) having at least one 30-day readmission. Age (mean difference: 2.2 years; P<0.001), length of stay (median difference: 1 day; P<.001), admission pain score>7 of 10 (odds ratio [OR]: 2.21; P<0.01), discharge pain score>4 of 10 (OR: 2.098; P<.01), living within 5 miles of the center's main hospital (OR: 0.573; P=.04), and >3 hospital utilizations in the previous 12 months (OR: 5.103; P<.001) were identified as potential indicators of 30-day readmission risk. Logistic regression models for 30-day readmissions yielded similar results. Increased age, high admission and discharge pain scores, decreased length of stay, and increased hospital utilizations were found to be associated with an increased risk of readmission for sickle cell crisis. Patient's residence was also found to be a significant risk indicator, supporting the utility of geospatial analysis in assessing readmission risk. Copyright © 2015 by the American Academy of Pediatrics.

  7. Trauma Transitional Care Coordination: protecting the most vulnerable trauma patients from hospital readmission

    PubMed Central

    Hall, Erin C; Tyrrell, Rebecca; Scalea, Thomas M; Stein, Deborah M

    2018-01-01

    Background Unplanned hospital readmissions increase healthcare costs and patient morbidity. We hypothesized that a program designed to reduce trauma readmissions would be effective. Methods A Trauma Transitional Care Coordination (TTCC) program was created to support patients at high risk for readmission. TTCC interventions included call to patient (or caregiver) within 72 hours of discharge to identify barriers to care, complete medication reconciliation, coordination of appointments, and individualized problem solving. Information on all 30-day readmissions was collected. 30-day readmission rates were compared with center-specific readmission rates and population-based, risk-adjusted rates of readmission using published benchmarks. Results 260 patients were enrolled in the TTCC program from January 2014 to September 2015. 30.8% (n=80) of enrollees were uninsured, 41.9% (n=109) reported current substance abuse, and 26.9% (n=70) had a current psychiatric diagnosis. 74.2% (n=193) attended outpatient trauma appointments within 14 days of discharge. 96.3% were successfully followed. Only 6.6% (n=16) of patients were readmitted in the first 30 days after discharge. This was significantly lower than both center-specific readmission rates before start of the program (6.6% vs. 11.3%, P=0.02) and recently published population-based trauma readmission rates (6.6% vs. 27%, P<0.001). Discussion A nursing-led TTCC program successfully followed patients and was associated with a significant decrease in 30-day readmission rates for patients with high-risk trauma. Targeted outpatient support for these most vulnerable patients can lead to better utilization of outpatient resources, increased patient satisfaction, and more consistent attainment of preinjury level of functioning or better. Level of evidence Level IV. PMID:29766133

  8. Item response theory analysis of Centers for Disease Control and Prevention Health-Related Quality of Life (CDC HRQOL) items in adults with arthritis.

    PubMed

    Mielenz, Thelma J; Callahan, Leigh F; Edwards, Michael C

    2016-03-12

    Examine the feasibility of performing an item response theory (IRT) analysis on two of the Centers for Disease Control and Prevention health-related quality of life (CDC HRQOL) modules - the 4-item Healthy Days Core Module (HDCM) and the 5-item Healthy days Symptoms Module (HDSM). Previous principal components analyses confirm that the two scales both assess a mix of mental (CDC-MH) and physical health (CDC-PH). The purpose is to conduct item response theory (IRT) analysis on the CDC-MH and CDC-PH scales separately. 2182 patients with self-reported or physician-diagnosed arthritis completed a cross-sectional survey including HDCM and HDSM items. Besides global health, the other 8 items ask the number of days that some statement was true; we chose to recode the data into 8 categories based on observed clustering. The IRT assumptions were assessed using confirmatory factor analysis and the data could be modeled using an unidimensional IRT model. The graded response model was used for IRT analyses and CDC-MH and CDC-PH scales were analyzed separately in flexMIRT. The IRT parameter estimates for the five-item CDC-PH all appeared reasonable. The three-item CDC-MH did not have reasonable parameter estimates. The CDC-PH scale is amenable to IRT analysis but the existing The CDC-MH scale is not. We suggest either using the 4-item Healthy Days Core Module (HDCM) and the 5-item Healthy days Symptoms Module (HDSM) as they currently stand or the CDC-PH scale alone if the primary goal is to measure physical health related HRQOL.

  9. KSC-2012-1123

    NASA Image and Video Library

    2012-01-26

    CAPE CANAVERAL, Fla. -- Kennedy Space Center Deputy Director Janet Petro, at left, Kennedy Center Director Robert Cabana, and United Space Alliance’s Vice President for Aerospace Services/Florida Site Director Mark Nappi, place a wreath at the Space Mirror Memorial at the Kennedy Space Center Visitor Complex during Kennedy’s NASA Day of Remembrance. The Day of Remembrance honors members of the NASA family who lost their lives while furthering the cause of exploration and discovery, including the astronaut crews of Apollo 1 and space shuttles Challenger and Columbia. Kennedy civil service and contractor employees, along with the general public, paid their respects throughout the day. The visitor complex provided flowers for visitors to place at the memorial. Photo credit: NASA/Kim Shiflett

  10. [Study on the timeliness of detection and reporting on public health emergency events in China].

    PubMed

    Li, Ke-Li; Feng, Zi-Jian; Ni, Da-Xin

    2009-03-01

    To analyze the timeliness of detection and reporting on public health emergency events, and to explore the effective strategies for improving the relative capacity on those issues. We conducted a retrospective survey on 3275 emergency events reported through Public Health Emergency Events Surveillance System from 2005 to the first half of 2006. Developed by county Centers for Disease Control and Prevention, a uniformed self-administrated questionnaire was used to collect data, which would include information on the detection, reporting of the events. For communicable diseases events, the median of time interval between the occurrence of first case and the detection of event was 6 days (P25 = 2, P75 = 13). For food poisoning events and clusters of disease with unknown origin, the medians were 3 hours (P25, P75 = 16) and 1 days (P25 = 0, P75 = 5). 71.54% of the events were reported by the discoverers within 2 hours after the detection. In general, the ranges of time intervals between the occurrence, detection or reporting of the events were different, according to the categories of events. The timeliness of detection and reporting of events could have been improved dramatically if the definition of events, according to their characteristics, had been more reasonable and accessible, as well as the improvement of training program for healthcare staff and teachers.

  11. Sick child care options: what do working mothers prefer?

    PubMed

    Landis, S E; Earp, J A

    1987-01-01

    More than half of all mothers with children under age 6 are in the labor force. Working mothers must take off anywhere from 5.6 days to 28.8 days per employee per year to care for their sick children. In a survey of 134 working mothers with children in day care centers, 70% expressed an interest in sick child care options outside the home, especially a sick room at the child's regular day care center or an infirmary at the parent's workplace. Mothers who chose "out-of home care" were more likely to: be minority (p less than 0.01); be single parents (p = 0.06); earn less than $10,000 annually (p = 0.03); want their children with temperatures of 100-100.9 F to remain in school until the end of the day (p less than 0.01). Communities and day care centers serving especially lower income, minority or single-parent working mothers should consider investigating these out-of-home sick child care options; the savings to employers could be $2 to $12 billion per year, not to speak of the personal savings to the mothers themselves.

  12. Observations of Undergraduate Geoscience Instruction in the US: Measuring Student Centered Teaching

    NASA Astrophysics Data System (ADS)

    Teasdale, R.; Manduca, C. A.; Mcconnell, D. A.; Bartley, J. K.; Bruckner, M. Z.; Farthing, D.; Iverson, E. A. R.; Viskupic, K. M.

    2014-12-01

    The Reformed Teaching Observation Protocol (RTOP; Swada, et al., 2002) has been used by a trained team of On the Cutting Edge (CE) observers to characterize the degree of student-centered teaching in US college and university geoscience classrooms. Total RTOP scores are derived from scores on 25 rubric items used to characterize teaching practices in categories of lesson design, content delivery, student-instructor and student-student interactions. More than 200 classroom observations have been completed by the RTOP team in undergraduate courses at a variety of US institution types (e.g., community colleges, research universities). A balanced mix of early career, mid-career, and veteran faculty are included, and the study examines class sizes ranging from small (<30) to large (>80 students). Observations are limited to one class session and do not include laboratories or field activities. Data include RTOP scores determined by a trained observer during the classroom observation and an online survey in which the observed instructors report on their teaching practices. RTOP scores indicate that the observed geoscience classes feature varying degrees of student-centered teaching, with 30% of observed classes categorized as teacher-centered (RTOP scores ≤30), 45% of observed classes categorized as transitional classrooms (RTOP scores 31-49) and 25% are student-centered (RTOP scores ≥ 50). Instructor self-report survey data and RTOP scores indicate that geoscience faculty who have participated in one or more CE professional development event and use the CE website have an average RTOP score of 49, which is significantly higher (> 15 points) than the average score of faculty who have not participated in CE events and have not used the website. Approximately 60% of student-centered classes (those with high RTOP scores) use some traditional lecture nearly every day, but are also are likely to include an in-class activity or group discussion (e.g. Think-Pair-Share). More than 50% of instructors in student-centered classes report spending 30% or less of their class time on such activities (e.g. ≤ 15 minutes of a 50 minute class period), indicating that a relatively small investment can yield important impacts in engaging undergraduate geoscience students.

  13. A Study in Child Care (Case Study from Volume II-B): "...While [They Took] Care of Our Children, Theirs Weren't Being Cared For." Day Care Programs Reprint Series.

    ERIC Educational Resources Information Center

    Rosenthal, Kristine

    The Mecklenburg County Department of Social Services in Charlotte, North Carolina, operates nine child development day care centers and 5 day homes which provide care for 257 Black and Anglo children, 2- to 5-years-old, primarily from low-income homes. The centers are located in churches, schools, and facilities in low income housing projects. The…

  14. 2016 America's Recycle Day

    NASA Image and Video Library

    2016-11-15

    Members of the Sustainability team at NASA's Kennedy Space Center in Florida accept items donated by employees in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more.

  15. 2016 America's Recycle Day

    NASA Image and Video Library

    2016-11-15

    Members of the Sustainability team at NASA's Kennedy Space Center in Florida shred a disposed hard drive in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more.

  16. International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module.

    PubMed

    Rosenthal, Víctor Daniel; Al-Abdely, Hail M; El-Kholy, Amani Ali; AlKhawaja, Safa A Aziz; Leblebicioglu, Hakan; Mehta, Yatin; Rai, Vineya; Hung, Nguyen Viet; Kanj, Souha Sami; Salama, Mona Foda; Salgado-Yepez, Estuardo; Elahi, Naheed; Morfin Otero, Rayo; Apisarnthanarak, Anucha; De Carvalho, Braulio Matias; Ider, Bat Erdene; Fisher, Dale; Buenaflor, Maria Carmen S G; Petrov, Michael M; Quesada-Mora, Ana Marcela; Zand, Farid; Gurskis, Vaidotas; Anguseva, Tanja; Ikram, Aamer; Aguilar de Moros, Daisy; Duszynska, Wieslawa; Mejia, Nepomuceno; Horhat, Florin George; Belskiy, Vladislav; Mioljevic, Vesna; Di Silvestre, Gabriela; Furova, Katarina; Ramos-Ortiz, Gloria Y; Gamar Elanbya, May Osman; Satari, Hindra Irawan; Gupta, Umesh; Dendane, Tarek; Raka, Lul; Guanche-Garcell, Humberto; Hu, Bijie; Padgett, Denis; Jayatilleke, Kushlani; Ben Jaballah, Najla; Apostolopoulou, Eleni; Prudencio Leon, Walter Enrique; Sepulveda-Chavez, Alejandra; Telechea, Hector Miguel; Trotter, Andrew; Alvarez-Moreno, Carlos; Kushner-Davalos, Luis

    2016-12-01

    We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  17. Alleged sexual abuse at a day care center: impact on parents.

    PubMed

    Dyb, Grete; Holen, Are; Steinberg, Alan M; Rodriguez, Ned; Pynoos, Robert S

    2003-08-01

    This report describes the cascade of stressful events and secondary life changes experienced by parents in a case of alleged sexual abuse at a day care program. The study evaluated parents' Posttraumatic Stress Disorder (PTSD) symptoms and general psychological responses to the stressful events 4 years after the alleged abuse, and explored predictive factors of parental distress. A total of 39 parents were interviewed about stressful events, life changes, and social support. Current distress reactions, psychological wellbeing, and locus of control were assessed with a battery of standardized measures. Hearing about the sexual abuse, testifying in court, hearing the verdict, and being exposed in media reports were all rated by the parents as distressing events. The majority of the parents experienced secondary life changes after the alleged sexual abuse. Four years after the alleged sexual abuse, one-third of the parents reported a high level of PTSD Intrusive symptoms and one-fourth reported a high level of PTSD Avoidance symptoms. There was a significant positive correlation between a measure of psychological wellbeing and PTSD. Secondary life changes and locus of control significantly predicted PTSD. This study demonstrates that the alleged sexual abuse of children in day care and the resulting events in the legal system and the media constitute significant and chronic stressors in the lives of the children's parents. These findings underscore the need to expand the focus of trauma-related sequelae from the child victim to their parents and family.

  18. STS-114: Discovery L-2 Countdown Status Briefing

    NASA Technical Reports Server (NTRS)

    2005-01-01

    George Diller of NASA Public Affairs hosted this briefing. Pete Nickolenko, NASA Test Director; Scott Higgenbotham, STS-114 Payload-Mission Manager; Cathy Winters, Shuttle Weather Officer were present. Pete reports his team has completed the avionics system check ups, servicing of the cryogenic tanks will take about seven hours that day, and will perform engine system checks and pad close outs come evening. Pete also summarized other standard close out activities: check ups of the Orbiter and ground communications network, rotary service, structure retraction, and external tank load (ETL). Pete reported that the mission will be 12 days with two weather contingency days, and end of mission landing scheduled at Kennedy Space Center (KSC) at approximately 11:00 in the morning, Eastern time on July 25th. Scott briefly reported that all hardware is on board Discovery, closed out, and ready to fly. Cathy reported that hurricane Dennis moved to the North and looking forward to launch. She mentioned of a new hurricane looming and will be named Emily, spotted some crosswinds which will migrate to the west, there is 30% probability weather prohibiting launch. Cathy further gave current weather forecast supported with charts: the Launch Forecast, Tanking Forecast, SRB (Shuttle Solid Rocket Booster) Forecast, CONUS and TAL Launch Sites Forecast, and with 24 hours and 48 hours turn around plan. Launch constraints, weather, crosswinds, cloud cover, ground imagery system, launch countdown, launch crews, mission management simulations, launch team simulations were topics covered with the News Media.

  19. Infant Group Care Risks.

    ERIC Educational Resources Information Center

    Kendall, Earline D.

    Children under 3 years of age who are in group care face special health risks. The U.S. Centers for Disease Control indicate the existence of a causal relationship between infant group day care and certain diseases that are spread through contact at day care centers. Children in group care who are still in diapers are especially vulnerable to…

  20. Regulations for Child Day Care Centers Operated by Religious Bodies or Groups.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Social Services, Columbia.

    As set forth in this manual, the regulations for child day care centers operated by religious bodies or groups constitute the minimum requirements to be met and maintained by each such facility in South Carolina. Regulation 114-5-20 sets out definitions and procedures for preapplication consultation, original registration, inspection, and…

  1. CTEPP-OH DATA COLLECTED ON FORM 03:HOUSE/BUILDING CHARACTERISTICS OBSERVATION SURVEY FOR THE DAY CARE CENTER

    EPA Science Inventory

    This data set contains data concerning the physical characteristics of the day care center and identified possible sources of pollutants for CTEPP-OH.

    The Children’s Total Exposure to Persistent Pesticides and Other Persistent Pollutant (CTEPP) study was one of the largest agg...

  2. CTEPP DATA COLLECTION FORM 10 (PERIODS 1-3): DAY CARE CENTER CHILD ACTIVITY DIARY AND FOOD SURVEY

    EPA Science Inventory

    This data collection form collects information on the child's activities at the day care center over the 48-hr monitoring period. The diary is divided into three time periods over the 48-monitoring interval. The Food Survey collects information on the frequency and types of frui...

  3. TEACHER'S GUIDE TO OUTDOOR EDUCATION.

    ERIC Educational Resources Information Center

    RYAN, ARTHUR J.

    INCLUDED ARE (1) A DESCRIPTIVE BROCHURE, AND (2) A TEACHER'S GUIDE FOR THE UNION COUNTY OUTDOOR EDUCATION CENTER. THE PROGRAM CONSISTS OF A DAY CENTER, WHICH PROVIDES ONE- AND TWO-DAY SESSIONS OF AT LEAST FOUR HOURS DURATION FOR GRADE 5 STUDENTS FROM PUBLIC AND NON-PROFIT SCHOOLS IN UNION COUNTY. THE DESCRIPTIVE BROCHURE RELATES (1) THE LOCATION…

  4. Sorting Recycled Trash: An Activity for Earth Day 2007

    ERIC Educational Resources Information Center

    Harris, Mary E.; Harris, Harold H.

    2007-01-01

    Middle or high school students celebrate Earth Day on April 22, 2007 by participating in the activity to separate commingled recyclable trash to simulate sorting in a recycling center. Students would gain an appreciation for recyclable trash, after it is taken to a recycling center and learn about properties of recyclables.

  5. Adult Day Health Center Participation and Health-Related Quality of Life

    ERIC Educational Resources Information Center

    Schmitt, Eva M.; Sands, Laura P.; Weiss, Sara; Dowling, Glenna; Covinsky, Kenneth

    2010-01-01

    Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable…

  6. Energy Action Day

    NASA Image and Video Library

    2017-10-25

    John Sherwin of the Florida Solar Energy Center in Cocoa speaks during the Energy Action Day employee event held in NASA Kennedy Space Center's Space Station Processing Facility. Part of Energy Awareness Month, the event featured subject matter experts in the area of solar energy, its connections to the space program and options for residential solar power.

  7. 76 FR 20688 - Guidance for Industry and Food and Drug Administration Staff; 30-Day Notices, 135-Day Premarket...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-13

    ... Assistance, Center for Devices and Radiological Health (CDRH), Food and Drug Administration, 10903 New... CDRH: Anastacia Bilek, Center for Devices and Radiological Health, Food and Drug Administration, 10903... PMA Supplements for Manufacturing Method or Process Changes, Guidance for Industry and CDRH,'' that...

  8. Families as Partners in Hospital Error and Adverse Event Surveillance

    PubMed Central

    Khan, Alisa; Coffey, Maitreya; Litterer, Katherine P.; Baird, Jennifer D.; Furtak, Stephannie L.; Garcia, Briana M.; Ashland, Michele A.; Calaman, Sharon; Kuzma, Nicholas C.; O’Toole, Jennifer K.; Patel, Aarti; Rosenbluth, Glenn; Destino, Lauren A.; Everhart, Jennifer L.; Good, Brian P.; Hepps, Jennifer H.; Dalal, Anuj K.; Lipsitz, Stuart R.; Yoon, Catherine S.; Zigmont, Katherine R.; Srivastava, Rajendu; Starmer, Amy J.; Sectish, Theodore C.; Spector, Nancy D.; West, Daniel C.; Landrigan, Christopher P.

    2017-01-01

    IMPORTANCE Medical errors and adverse events (AEs) are common among hospitalized children. While clinician reports are the foundation of operational hospital safety surveillance and a key component of multifaceted research surveillance, patient and family reports are not routinely gathered. We hypothesized that a novel family-reporting mechanism would improve incident detection. OBJECTIVE To compare error and AE rates (1) gathered systematically with vs without family reporting, (2) reported by families vs clinicians, and (3) reported by families vs hospital incident reports. DESIGN, SETTING, AND PARTICIPANTS We conducted a prospective cohort study including the parents/caregivers of 989 hospitalized patients 17 years and younger (total 3902 patient-days) and their clinicians from December 2014 to July 2015 in 4 US pediatric centers. Clinician abstractors identified potential errors and AEs by reviewing medical records, hospital incident reports, and clinician reports as well as weekly and discharge Family Safety Interviews (FSIs). Two physicians reviewed and independently categorized all incidents, rating severity and preventability (agreement, 68%–90%; κ, 0.50–0.68). Discordant categorizations were reconciled. Rates were generated using Poisson regression estimated via generalized estimating equations to account for repeated measures on the same patient. MAIN OUTCOMES AND MEASURES Error and AE rates. RESULTS Overall, 746 parents/caregivers consented for the study. Of these, 717 completed FSIs. Their median (interquartile range) age was 32.5 (26–40) years; 380 (53.0%) were nonwhite, 566 (78.9%) were female, 603 (84.1%) were English speaking, and 380 (53.0%) had attended college. Of 717 parents/caregivers completing FSIs, 185 (25.8%) reported a total of 255 incidents, which were classified as 132 safety concerns (51.8%), 102 nonsafety-related quality concerns (40.0%), and 21 other concerns (8.2%). These included 22 preventable AEs (8.6%), 17 nonharmful medical errors (6.7%), and 11 nonpreventable AEs (4.3%) on the study unit. In total, 179 errors and 113 AEs were identified from all sources. Family reports included 8 otherwise unidentified AEs, including 7 preventable AEs. Error rates with family reporting (45.9 per 1000 patient-days) were 1.2-fold (95%CI, 1.1–1.2) higher than rates without family reporting (39.7 per 1000 patient-days). Adverse event rates with family reporting (28.7 per 1000 patient-days) were 1.1-fold (95%CI, 1.0–1.2; P=.006) higher than rates without (26.1 per 1000 patient-days). Families and clinicians reported similar rates of errors (10.0 vs 12.8 per 1000 patient-days; relative rate, 0.8; 95%CI, .5–1.2) and AEs (8.5 vs 6.2 per 1000 patient-days; relative rate, 1.4; 95%CI, 0.8–2.2). Family-reported error rates were 5.0-fold (95%CI, 1.9–13.0) higher and AE rates 2.9-fold (95% CI, 1.2–6.7) higher than hospital incident report rates. CONCLUSIONS AND RELEVANCE Families provide unique information about hospital safety and should be included in hospital safety surveillance in order to facilitate better design and assessment of interventions to improve safety. PMID:28241211

  9. 2016 America's Recycle Day

    NASA Image and Video Library

    2016-11-15

    A sign points the way to the electronic waste collection site, where NASA Kennedy Space Center employees donated computers, monitors, vacuum cleaners and other electronics in conjunction with America Recycles Day. America Recycles Day is a nationally recognized initiative dedicated to promoting recycling in the United States. Kennedy partnered with several organizations in order to donate as many of the items as possible to those who could use them the most in the Space Coast community. Space center personnel brought in electronic waste, gently used household goods, clothing and more. The two-day event was sponsored by Kennedy's Sustainability team.

  10. Postoperative Endophthalmitis Caused by Staphylococcus haemolyticus following Femtosecond Cataract Surgery

    PubMed Central

    Wong, Margaret; Baumrind, Benjamin R.; Frank, James H.; Halpern, Robert L.

    2015-01-01

    A 53-year-old Caucasian man underwent femtosecond cataract surgery and then presented with pain and hand motions vision 1 day following surgery. Anterior segment examination showed a 2-mm-layered hypopyon, a well-centered intraocular lens in the sulcus, and an obscured view to the fundus. B-scan ultrasonography showed significant vitritis and that the retina was attached. A tap and an injection of vancomycin 1 mg per 0.1 ml and of ceftazidime 2.25 mg per 0.1 ml were performed. The tap eventually yielded culture results positive for Staphylococcus haemolyticus, which was sensitive to vancomycin. We report a case of endophthalmitis that occurred on postoperative day 1 following complicated cataract surgery. This is an uncommon bacterium that is not widely reported in the literature as a cause of endophthalmitis in the postoperative period. We urge clinicians to consider S. haemolyticus as an offending agent, especially when the infection presents very early and aggressively in the postoperative period. PMID:26951642

  11. Postoperative Endophthalmitis Caused by Staphylococcus haemolyticus following Femtosecond Cataract Surgery.

    PubMed

    Wong, Margaret; Baumrind, Benjamin R; Frank, James H; Halpern, Robert L

    2015-01-01

    A 53-year-old Caucasian man underwent femtosecond cataract surgery and then presented with pain and hand motions vision 1 day following surgery. Anterior segment examination showed a 2-mm-layered hypopyon, a well-centered intraocular lens in the sulcus, and an obscured view to the fundus. B-scan ultrasonography showed significant vitritis and that the retina was attached. A tap and an injection of vancomycin 1 mg per 0.1 ml and of ceftazidime 2.25 mg per 0.1 ml were performed. The tap eventually yielded culture results positive for Staphylococcus haemolyticus, which was sensitive to vancomycin. We report a case of endophthalmitis that occurred on postoperative day 1 following complicated cataract surgery. This is an uncommon bacterium that is not widely reported in the literature as a cause of endophthalmitis in the postoperative period. We urge clinicians to consider S. haemolyticus as an offending agent, especially when the infection presents very early and aggressively in the postoperative period.

  12. Bringing work home: the emotional experiences of mothers and fathers.

    PubMed

    Matjasko, Jennifer L; Feldman, Amy F

    2006-03-01

    Given the salience of work in our society, this study investigated how intrinsic work motivation, work hours, and taking time for self influenced the interplay between the emotional climates of work and home. The authors examined day-to-day emotional transmission between work and home (spillover) for 143 families using the experience sampling method and interview data from the Sloan Center's 500 Family Study (L. J. Waite & B. Schneider, 1997). Intrinsic work motivation, work hours, and taking time for self were used as predictors of spillover. There was evidence of emotional transmission from work to home for mothers' happiness, anger, and anxiety as well as for father's anxiety. Also, fathers scoring higher on intrinsic work motivation tended to report greater overall anxiety at home after the workday. Anxiety from work was less likely to spill over to the home when fathers reported working longer hours. These findings have practice implications for improving worker productivity and the well-being of two-working-parent families. Copyright 2006 APA, all rights reserved.

  13. Plague meningitis--a retrospective analysis of cases reported in the United States, 1970-1979.

    PubMed

    Becker, T M; Poland, J D; Quan, T J; White, M E; Mann, J M; Barnes, A M

    1987-11-01

    Meningitis caused by Yersinia pestis developed in 6 (6%) of a total of 105 patients with plague reported to the Centers for Disease Control from 1970 to 1979. Five of the six cases occurred in children aged 10 to 15 years. All six patients received antibiotic therapy before meningitis developed, which appeared between the 9th and 14th days after the onset of acute illness in five of the six patients. There were no neurologic sequelae. The antigenic and biochemical profiles of the Y pestis strains isolated from cerebrospinal fluid in the meningitis cases did not differ from those of the Y pestis strains obtained from blood and bubo aspirates in the other 99 patients, and neither did in vitro studies suggest antibiotic resistance. While plague meningitis is an uncommon complication of acute plague infection, physicians in the western United States should be aware that it may develop as much as 14 days after antibiotic therapy for the acute plague infection has been initiated.

  14. Plague Meningitis—A Retrospective Analysis of Cases Reported in the United States, 1970-1979

    PubMed Central

    Becker, Thomas M.; Poland, Jack D.; Quan, Thomas J.; White, Mark E.; Mann, Jonathan M.; Barnes, Allan M.

    1987-01-01

    Meningitis caused by Yersinia pestis developed in 6 (6%) of a total of 105 patients with plague reported to the Centers for Disease Control from 1970 to 1979. Five of the six cases occurred in children aged 10 to 15 years. All six patients received antibiotic therapy before meningitis developed, which appeared between the 9th and 14th days after the onset of acute illness in five of the six patients. There were no neurologic sequelae. The antigenic and biochemical profiles of the Y pestis strains isolated from cerebrospinal fluid in the meningitis cases did not differ from those of the Y pestis strains obtained from blood and bubo aspirates in the other 99 patients, and neither did in vitro studies suggest antibiotic resistance. While plague meningitis is an uncommon complication of acute plague infection, physicians in the western United States should be aware that it may develop as much as 14 days after antibiotic therapy for the acute plague infection has been initiated. PMID:3424819

  15. Chemotherapy-induced nausea and vomiting in routine practice: a European perspective.

    PubMed

    Glaus, Agnes; Knipping, Cornelia; Morant, Rudolf; Böhme, Christel; Lebert, Burkhard; Beldermann, Frank; Glawogger, Bernhard; Ortega, Paz Fernandez; Hüsler, André; Deuson, Robert

    2004-10-01

    The aim of this study was to evaluate the occurrence of chemotherapy-induced nausea and vomiting (CINV) and its effect on patients' ability to carry out daily life activities following moderately to highly emetogenic, first-cycle chemotherapy in routine practice in cancer centers of four different European countries. This was a prospective, cross-sectional, nonrandomized, self-assessment study in 249 patients enrolled from cancer centers in Spain, Austria, Germany, and Switzerland. The study population consisted of 78% women, with a mean age of 54. Breast, lung, and ovarian cancers made up 75% of all cancers in the study. Patients received a mean of 2.0 chemotherapy agents and 2.5 antiemetic drugs. A total of 450 emetic episodes experienced by 243 patients was recorded over 5 days following chemotherapy, with an average of 1.8 episodes per patient (range: 0-28). A higher percentage of patients (38%) suffered from delayed compared to acute emesis (13%). Between 42% and 52% of all patients suffered from nausea (visual analogue scale > or = 5 mm) on any one day, peaking at day 3. Using the Functional Living Index for Emesis (FLIE) questionnaire, 75% of patients with nausea and 50% with vomiting reported a negative impact of these conditions on performance of daily living. CINV remains a significant problem in routine practice, particularly in the delayed phase posttreatment. Overall, CINV had a negative impact on patients' daily life.

  16. Effect of Social Support and Marital Status on Perceived Surgical Effectiveness and 30-Day Hospital Readmission.

    PubMed

    Adogwa, Owoicho; Elsamadicy, Aladine A; Vuong, Victoria D; Mehta, Ankit I; Vasquez, Raul A; Cheng, Joseph; Bagley, Carlos A; Karikari, Isaac O

    2017-12-01

    Retrospective cohort review. To determine whether higher levels of social support are associated with improved surgical outcomes after elective spine surgery. The medical records of 430 patients (married, n = 313; divorced/separated/widowed, n = 71; single, n = 46) undergoing elective spine surgery at a major academic medical center were reviewed. Patients were categorized by their marital status at the time of surgery. Patient demographics, comorbidities, and postoperative complication rates were collected. All patients had prospectively collected outcomes measures and a minimum of 1-year follow-up. Patient reported outcomes instruments (Oswestry Disability Index, Short Form-36, and visual analog scale-back pain/leg pain) were completed before surgery, then at 1 year after surgery. Baseline characteristics were similar in all cohorts. There was no statistically significant difference in the length of hospital stay across all 3 cohorts, although "single patients" had longer duration of in-hospital stays that trended toward significance (single 6.24 days vs married 4.53 days vs divorced/separated/widowed 4.55 days, P = .05). Thirty-day readmission rates were similar across all cohorts (married 7.03% vs divorced/separated/widowed 7.04% vs single 6.52%, P = .99). Additionally, there were no significant differences in baseline and 1-year patient reported outcomes measures between all groups. Increased social support did not appear to be associated with superior short and long-term clinical outcomes after spine surgery; however, it was associated with a shorter duration of in-hospital stay with no increase in 30-day readmission rates.

  17. Associations of World Trade Center exposures with pulmonary and cardiometabolic outcomes among children seeking care for health concerns

    PubMed Central

    Trasande, Leonardo; Fiorino, Elizabeth Kajunski; Attina, Teresa; Berger, Kenneth; Goldring, Roberta; Chemtob, Claude; Levy-Carrick, Nomi; Shao, Yongzhao; Liu, Mengling; Urbina, Elaine; Reibman, Joan

    2015-01-01

    Objective Prior research on the physical health of children exposed to the World Trade Center (WTC) attacks has largely relied on parental report via questionnaire. We examined the impact of clinically-reported exposures on the physical health of children who lived and/or attended school in downtown Manhattan on September 11, 2001. Study design We performed a cross-sectional study of 148 patients who presented to the WTC Environmental Health Center/Survivors Health Program, and were ≤18 years old on September 11, 2001. Results 38.5% were caught in the dust cloud from the collapsing buildings on September 11; over 80% spent ≥1 day in their home between September 11 and 18, 2001; and 25.7% reported home dust exposure. New-onset nasal/sinus congestion was reported in 52.7%, while nearly one-third reported new gastroesophageal reflux (GERD) symptoms. Prehypertension or hypertension was identified in 45.5%. Multivariable regression with exposure variables, body mass index category, and age as covariates identified strongest associations of dust cloud with spirometry (17.1% decrease in maximum midexpiratory flow). Younger children experienced increased peripheral eosinophils (+0.098% per year, p=0.023), while older children experienced more new-onset GERD (OR 1.17, p=0.004), headaches (OR 1.10, p=0.011), and prehypertension (OR 1.09, p=0.024). Home dust exposure was associated with reduced high-density lipoprotein (−10.3 mg/dL, p=0.027) and elevated triglycerides (+36.3 mg/dL, p=0.033). Conclusions While these findings cannot be assumed to generalize to all children exposed to the WTC attacks, they strongly suggest the need for more extensive study of respiratory, metabolic, and cardiovascu lar consequences. PMID:23280289

  18. Hematuria and clot retention after transvaginal oocyte aspiration: a case report.

    PubMed

    Modder, Joshua; Kettel, L Michael; Sakamoto, Kyoko

    2006-09-01

    To report a case of bladder injury with hematuria and urinary retention after transvaginal oocyte aspiration. Case report. Emergency room in a university medical center. A 28-year-old woman presented with urinary retention and suprapubic pain 8 hours after oocyte aspiration. Foley catheter, intravenous fluid bolus, bladder irrigation, and computed tomography with postvoid films that showed a blood clot in the bladder. Patient was discharged home with antibiotics and catheter in place. Clinical follow-up. Patient passed voiding trial 4 days later and was artificially inseminated. No further hematuria or voiding problems were reported, and she had a successful pregnancy. Patients who elect to undergo oocyte aspiration should be warned about the possibility of bladder injury because of the close proximity of the ovaries to the bladder, and physicians should have an appropriate treatment plan.

  19. Giant ovarian serous cystadenoma in a postmenopausal woman: a case report

    PubMed Central

    Babu, Sunkavalli Chinna

    2009-01-01

    A case of 66-year-old South Indian post menopausal woman presenting a giant ovarian serous cyst adenoma weighing 23 kg is reported here. A 66-year-old woman was referred to our clinic from a local medical center. When she was seen first at our outpatient clinic, she had gross abdominal distension since 2 years and she was unable to walk. On abdominal ultrasound, a giant cyst was found which encompassed the whole abdomen. At laparotomy, a giant, totally cystic, vascularized and smooth mass attached to the right ovary was encountered. Staging laparotomy was performed. On the postoperative tenth day, she was discharged without any problem. Her pathology report disclosed a 60×47×30 cm serous cyst adenoma weighing 23 kg. This is the largest ovarian cyst that ever reported from our hospital and one of the largest among the reported cases in the literature. PMID:19830023

  20. Statewide ban on recreational fires resulted in a significant decrease in campfire-related summer burn center admissions.

    PubMed

    Hoang, David Manh; Reid, Dixie; Lentz, Christopher William

    2013-01-01

    Every summer, there is an increase in the number of burn injuries caused by accidents around campfires. Because of the prevalence of drought, high winds, and uncontrolled wild fires, a statewide ban on recreational fires was instituted in New Mexico from June to July 2011. We hypothesized that this legislation would have a significant impact on burn admissions caused by campfire-related injuries. A retrospective review of summer admissions to a state burn center was conducted to assess the effect of this ban on recreational fire injuries, and these data were compared with that of the previous summer when no ban was in effect. All burn admissions to a state burn center were reviewed from Memorial Day to Labor Day in 2010 and 2011. Data collected included cause, % TBSA, age, days of hospitalization, intensive care unit days, and total surface area grafted. Nonparametric statistical analysis was performed with Fisher exact test for dichotomous data and Mann-Whitney test for continuous data with significance at P < .05. There were 164 burn center admissions between Memorial Day and Labor Day in 2010 (n = 82) and 2011 (n = 82). Compared with all summer burn center admissions, patients injured by campfires were younger (18 vs 37 years; P = .002) with smaller total surface area burns (3.2 vs 6.2%; P = .41) and had shorter lengths of stay (10-11 vs 6-7 days; P = .62). There was more than a 3-fold decrease in burn admissions due to recreational fires during the study period (n = 14 [17%] in 2010 and 4 [5%] in 2011; P = .02). This resulted in a decrease in the number of patient-days from 91 in 2010 to 25 in 2011. Half of the camp fire admissions required skin grafts to definitively close the wounds (6/14 in 2010 and 2/4 in 2011). Recreational fire bans targeted at controlling wildfires during conditions favoring rapid spread were associated with a 3- to 4-fold decrease in campfire-related burn admissions. Compared with a summer when no fire ban was in effect, the number of patient-days decreased from 91 to 25.

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