Do hospital admission rates increase in colder winters? A decadal analysis from an eastern county in England.

PubMed

Patterson, Stephen

2017-07-05

The aim of the study was to measure the effect of colder winters compared to warmer winters on hospital admission rates in Suffolk County. The setting of this study was Suffolk County in eastern England. The period of the study was financial years 2003/04-2012/13. The study was an analytic ecological study. Analysis involved calculation of rate ratios of hospital admission rates in colder winters compared to warmer winters, in all persons and the elderly. The main finding of the study was that all rate ratios for hospital admission rates in colder winters compared to warmer winters were significantly raised with effects of 2-5%. Rate ratios for all admissions in persons of all ages and persons aged 65 years and over were, respectively, 1.02 (99% confidence interval (CI): 1.01, 1.03; P < 0.001) and 1.02 (99% CI: 1.01, 1.04; P < 0.001). Rate ratios for emergency admissions in persons of all ages and persons aged 65 years and over were, respectively, 1.05 (99% CI: 1.03, 1.06; P < 0.001) and 1.04 (99% CI: 1.01, 1.06; P < 0.001). In Suffolk County, hospital admission rates are significantly raised in colder winters compared to warmer winters. This evidence may be useful in planning hospital services. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Doctoring in Eastern Europe

PubMed Central

Wilde, Henry

1983-01-01

Health care in Eastern Europe has not achieved world standards nor the goals of planners of socialist societies. With luck, perseverance, bribes or good connections, it is possible to obtain good medical and surgical care in Eastern Europe for a major illness. Primary and even secondary care usually are substandard, however, and often completely unacceptable to most Western foreigners. The reasons for this are complex but mainly rooted in different attitudes of health workers towards their patients, poor physical plants, poor salary structures, inadequate advancement opportunities for health care workers, poor social status and professional recognition for nurses and almost complete isolation of the average primary care doctor from hospital medicine. PMID:6659504

Atrial fibrillation in Middle Eastern Arab and South Asian patients hospitalized with acute myocardial infarction: experience from a 20-year registry in qatar (1991-2010).

PubMed

Salam, Amar M; Al, Binali Hajar A; Singh, Rajvir; Gehani, Abdurrazzak; Asaad, Nidal; Al-Qahtani, Awad; Suwaidi, Jassim Al

2013-04-01

Recent evidence suggests that there are ethnic variations in atrial fibrillation (AF) susceptibility and incidence following acute myocardial infarction (AMI). The aim of this study was to evaluate the incidence and predictors of AF in the setting of AMI in Middle Eastern Arab and South Asian patients and its impact on in-hospital morbidity and mortality. A retrospective analysis of a prospective registry of all patients hospitalized with AMI in the state of Qatar from 1991 through 2010 was made. Clinical characteristics and outcomes of AMI patients with and without AF were compared. Sub-analysis according to ethnicity was also performed. During the 20-year period; a total of 12,881 patients were hospitalized with AMI. Of these 5028 were Arabs and 5985 were South Asians. A total of 227 had AF during hospitalization with an overall incidence of 1.8% (156 Arabs; incidence 3.1% and 48 South Asians; incidence 0.8%). The mean age of AF patients was 65 years (Arabs 69, South Asians 54). Patients with AF were significantly older and had more cardiovascular co-morbidities than patients without AF, and were more likely to have non-ST elevation AMI on presentation. Patients with AF had significantly higher in-hospital mortality rate (20.3% versus 7.1%; P=0.001) and stroke rates (1.8% versus 0.3%; P=0.001) when compared to patients without AF. Age was the only independent predictor of AF development in patients with AMI in our study. Our study reports variability in the prevalence of AF among AMI patients according to ethnicity using a 20-year registry from a Middle Eastern country. Advancing age was the major independent predictor of AF in our AMI patients. Further prospective studies are required evaluating optimal therapeutic approaches for these high-risk patients in order to reduce the high mortality observed.

Head and Neck Tuberculosis: Scenario in a Tertiary Care Hospital of North Eastern India

PubMed Central

Das, Debajit; Bhuyan, Uttal Taranga; Saikia, Nabajyoti

2016-01-01

Introduction Tuberculosis has affected mankind since time immemorial and with emergence of AIDS both extrapulmonary and pulmonary tuberculosis presents increased morbidity and mortality along with an increased financial burden upon the developing nations. Materials and Methods The study is a hospital based observational study of one year duration carried out in the Department of ENT in a tertiary care hospital of North Eastern India. Results Total of 63 cases were detected. Females comprised 60.3% of the study population as against 39.7% males. Most commonly affected age group were of 15 to 24 years age (57.1%). Cervical tubercular lymphadenitis was the most common lesion 90.5% (57 cases) followed by laryngeal tuberculosis 7.9% (5 cases) and tubercular otitis media with mastoiditis 1.6% (1 case). Level II lymph node was mostly affected either single or in groups (75.4%) followed by level III node (57.9%). Successful outcome of the treatment with Category I regimen was achieved in 96.8% of the cases. Conclusion Head and neck tuberculosis is not an uncommon disease and though cervical lymphadenitis is the most common presentation, isolated involvement of the larynx, ear and other subsites are not an entirely unknown entity. The clinical presentation of tuberculosis of the head and neck region can be varied and often misleading. It is therefore important for the clinician to be aware of the condition and consider it in their differential diagnosis. PMID:26894099

Inflammatory bowel disease in children of middle eastern descent.

PubMed

Naidoo, Christina Mai Ying; Leach, Steven T; Day, Andrew S; Lemberg, Daniel A

2014-01-01

Increasing rates of inflammatory bowel disease (IBD) are now seen in populations where it was once uncommon. The pattern of IBD in children of Middle Eastern descent in Australia has never been reported. This study aimed to investigate the burden of IBD in children of Middle Eastern descent at the Sydney Children's Hospital, Randwick (SCHR). The SCHR IBD database was used to identify patients of self-reported Middle Eastern ethnicity diagnosed between 1987 and 2011. Demographic, diagnosis, and management data was collected for all Middle Eastern children and an age and gender matched non-Middle Eastern IBD control group. Twenty-four patients of Middle Eastern descent were identified. Middle Eastern Crohn's disease patients had higher disease activity at diagnosis, higher use of thiopurines, and less restricted colonic disease than controls. Although there were limitations with this dataset, we estimated a higher prevalence of IBD in Middle Eastern children and they had a different disease phenotype and behavior compared to the control group, with less disease restricted to the colon and likely a more active disease course.

Inflammatory Bowel Disease in Children of Middle Eastern Descent

PubMed Central

Naidoo, Christina Mai Ying; Leach, Steven T.; Day, Andrew S.; Lemberg, Daniel A.

2014-01-01

Increasing rates of inflammatory bowel disease (IBD) are now seen in populations where it was once uncommon. The pattern of IBD in children of Middle Eastern descent in Australia has never been reported. This study aimed to investigate the burden of IBD in children of Middle Eastern descent at the Sydney Children's Hospital, Randwick (SCHR). The SCHR IBD database was used to identify patients of self-reported Middle Eastern ethnicity diagnosed between 1987 and 2011. Demographic, diagnosis, and management data was collected for all Middle Eastern children and an age and gender matched non-Middle Eastern IBD control group. Twenty-four patients of Middle Eastern descent were identified. Middle Eastern Crohn's disease patients had higher disease activity at diagnosis, higher use of thiopurines, and less restricted colonic disease than controls. Although there were limitations with this dataset, we estimated a higher prevalence of IBD in Middle Eastern children and they had a different disease phenotype and behavior compared to the control group, with less disease restricted to the colon and likely a more active disease course. PMID:24987422

Clinical Characteristics and In-Hospital Prognosis of Infective Endocarditis in Two Eastern Counties of Taiwan

PubMed Central

Hsieh, Jen-Che; Wang, Ling-Yi; Chang, Huai-Ren; Chao, Shen-Feng; Wang, Ji-Hung

2014-01-01

Background Infective endocarditis (IE) is a common and potentially serious disease. Although it is an illness that affects populations around the world, narrower descriptions of this disease as it impacts specific regions are uncommon. We analyzed the clinical characteristics of IE patients from two eastern counties in Taiwan and studied the relationship between the isolated pathogens and clinical outcomes in these patients. Methods This is a retrospective chart review study which enrolled patients who received services between January 2007 and December 2010. Subsequent to chart review, IE was confirmed in a total of 55 patients by the modified Duke criteria. Results Of these patients, 17 (31%) had previous traumatic open skin wounds. Pre-existing cardiac abnormalities were found in 47 (85%) patients, 28 of whom had valvular abnormalities. Staphylococcus aureus was isolated from the blood as the leading pathogen in 25 (45%) patients (including 23 methicillin-sensitive and 2 methicillin-resistant). Septic emboli and shock occurred in 27 (49%) of 55 patients; surgery was performed on 11 (20%) of those patients, and 4 (36%) of them died post-operatively. The total in-hospital mortality rate was 40% (n = 22). Staphylococcus aureus infection was associated with significantly higher complication and mortality rate than non-Staphylococcus aureus infection (59% vs. 41% and 64% vs. 36%, respectively; p < 0.05). In addition, patients with complications had a very high mortality rate (81.5%). Conclusions We found that Staphylococcus aureus was the most common pathogen of IE in Eastern Taiwan, and was associated with higher rates of morbidities and mortality. PMID:27122782

Analysing workplace violence towards health care staff in public hospitals using alternative ordered response models: the case of north-eastern Turkey.

PubMed

Çelik, Ali Kemal; Oktay, Erkan; Çebi, Kübranur

2017-09-01

The main objective of this article is to determine key factors that may have a significant effect on the verbal abuse, emotional abuse and physical assault of health care workers in north-eastern Turkey. A self-administered survey was completed by 450 health care workers in three well-established hospitals in Erzurum, Turkey. Because of the discrete and ordered nature of the dependent variable of the survey, the data were analysed using four distinctive ordered response models. Results revealed that several key variables were found to be a significant determinant of workplace violence, such as the type of health institution, occupational position, weekly working hours, weekly shift hours, number of daily patient contacts, age group of the respondents, experience in the health sector, training against workplace violence and current policies of the hospitals and the Turkish Ministry of Health.

Assessment of the Baby Friendly Hospital Initiative Implementation in the Eastern Mediterranean Region.

PubMed

Al-Jawaldeh, Ayoub; Abul-Fadl, Azza

2018-03-11

The Baby-Friendly Hospital Initiative (BFHI) is a global program for promoting support and protection for breastfeeding. However, its impact on malnutrition, especially in countries of the Eastern Mediterranean region (EMR) that are facing the turmoil of conflict and emergencies, deserves further investigation. Having said that, this paper aims to discuss the status and challenges to BFHI implementation in the EMR countries. Data on BFHI implementation, breastfeeding practices, and nutritional status were collected from countries through structured questionnaires, personal interviews, and databases. The 22 countries of the EMR were categorized as follows: 8 countries in advanced nutrition transition stage (group I), 5 countries in early nutrition transition stage (group II), 4 countries with significant undernutrition (group III), and 5 countries in complex emergency (group IV). The challenges to BFHI implementation were discussed in relation to malnutrition. BFHI was not implemented in 22.7% of EMR countries. Designated Baby-Friendly hospitals totaled 829 (group I: 78.4%, group II: 9.05%; group III: 7.36%; group: IV5.19%). Countries with advanced nutrition transition had the highest implementation of BFHI but the lowest breastfeeding continuity rates. On the other hand, poor nutritional status and emergency states were linked with low BFHI implementation and low exclusive breastfeeding rates but high continuity rates. Early initiation and longer duration of breastfeeding correlated negatively with overweight and obesity ( p < 0.001). In countries with emergency states, breastfeeding continues to be the main source of nourishment. However, suboptimal breastfeeding practices prevail because of poor BFHI implementation which consequently leads to malnutrition. Political willpower and community-based initiatives are needed to promote breastfeeding and strengthen BFHI in the region.

Vitamin D deficiency is endemic in Middle Eastern sportsmen.

PubMed

Hamilton, Bruce; Grantham, Justin; Racinais, Sebastien; Chalabi, Hakim

2010-10-01

While vitamin D deficiency is well recognized in Middle Eastern women as a result of cultural norms of remaining covered, Middle Eastern men are an under-reported group. Vitamin D is now known to have multiple effects, including an impact on muscle function, thereby increasing the relevance for sportsmen. The aim of the present study was to evaluate serum 25-hydroxyvitamin D (25(OH)D) levels in young male Middle Eastern athletes. Cross-sectional study. Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar. Ninety-three Middle Eastern men presenting to hospital for an annual screening undertook a blood test to evaluate their vitamin D status. Ninety-one per cent of athletes were found to be deficient in 25(OH)D (serum concentration <20 ng/ml). Athletes with severe deficiencies were significantly younger than those with less marked deficiency. A subset of athletes underwent bone mineral density assessment and 59 % were shown to have at least one Z-score less than -1; despite this, however, no athletes reported a stress fracture. There was no correlation between 25(OH)D concentration and sunlight exposure, skin coverage and skin colouring. The study revealed that 25(OH)D deficiency is very common among otherwise healthy Middle Eastern male athletes. Given the potentially significant long- and short-term effects of 25(OH)D deficiency, serum 25(OH)D evaluation should be part of the routine assessment in this region.

Women hospitalized with atrial fibrillation: gender differences, trends and outcome from a 20-year registry in a Middle Eastern country (1991-2010).

PubMed

Salam, Amar M; AlBinali, Hajar A; Al-Mulla, Abdul Wahid; Asaad, Nidal; Singh, Rajvir; Al-Qahtani, Awad; Al Suwaidi, Jassim

2013-09-30

Most of the published research on atrial fibrillation (AF) is limited to studies in the developed world and included mainly Caucasian patients. Data about women with AF among other ethnicities is very limited. The aim of this study was to compare the clinical characteristics, treatment and outcome of women to men hospitalized with AF in a middle-eastern country. Retrospective analysis of prospective registry of all patients hospitalized with AF in Qatar from 1991 through 2010 was made. Clinical characteristics, management, and outcomes of AF patients were compared according to gender. During the 20-years period; 1417 women and 2432 men were hospitalized for AF. Women were 5 years older and more likely to have diabetes mellitus, hypertension, and chronic renal impairment and were also less likely to be current smokers and to have ischemic heart disease and impaired left ventricular function when compared to men. There was no gender preference in the use of anticoagulation. The prevalence of concomitant ischemic heart disease and hypertension increased, while the prevalence of valvular heart disease and heart failure decreased among patients hospitalized with AF over the study period. In-hospital mortality and stroke rates were comparable between the two groups. Women hospitalized with atrial fibrillation were older in age and had higher prevalence of co-morbid cardiovascular risk factors compared to men whereas, mortality and stroke rates were comparable. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

A cross-sectional study of the clinical characteristics of hospitalized children with community-acquired pneumonia in eight eastern cities in China.

PubMed

Wang, Xue-Feng; Liu, Jian-Ping; Shen, Kun-Ling; Ma, Rong; Cui, Zhen-Ze; Deng, Li; Shang, Yun-Xiao; Zhao, De-Yu; Wang, Li-Bo; Wan, Li-Ya; Sun, Yi-Qiu; Li, Yan-Ning; Jiang, Zhi-Yan; Xu, Hua; Li, Xin-Min; Wu, Zhen-Qi; Liu, Zhao-Lan; Hu, Ying-Hui; Huang, Yan; He, Chun-Hui; Zhang, Han; Jiang, Yong-Hong; Liu, Hua; Wang, Zi

2013-12-23

Community-acquired pneumonia in children is common in China. To understand current clinical characteristics and practice, we conducted a cross-sectional study to analyze quality of care on childhood pneumonia in eight eastern cities in China. Consecutive hospital records between January 1, 2010 and December 31, 2010 were collected from 13 traditional Chinese medicine (TCM) and western medicine (WM) hospitals in February, May, August, and November (25 cases per season, 100 cases over the year), respectively. A predesigned case report form was used to extract data from the hospital medical records. A total of 1298 cases were collected and analyzed. Symptoms and signs upon admission at TCM and WM hospitals were cough (99.3% vs. 98.6%), rales (84.8% vs. 75.0%), phlegm (83.3% vs. 49.1%), and fever (74.9% vs. 84.0%) in frequency. Patients admitted to WM hospitals had symptoms and signs for a longer period prior to admission than patients admitted to TCM hospitals. Testing to identify etiologic agents was performed in 1140 cases (88.4%). Intravenous antibiotics were administered in 99.3% (595/598) of cases in TCM hospitals and in 98.6% (699/700) of cases in WM hospitals. Besides, Chinese herbal extract injection was used more frequently in TCM hospitals (491 cases, 82.1%) than in WM hospitals (212 cases, 30.3%) (p < 0.01). At discharge, 818 cases (63.0%) were clinically cured, with a significant difference between the cure rates in TCM (87.6%) and WM hospitals (42.0%) (OR = 9.8, 95% confidence interval (CI): 7.3 ~ 12.9, p < 0.01). Pathogen and previous medical history were more likely associated with the disappearance of rales (OR = 7.2, 95% CI: 4.8 ~ 10.9). Adverse effects were not reported from the medical records. Intravenous use of antibiotics is highly prevalent in children with community-acquired pneumonia regardless of aetiology. There was difference between TCM and WM hospitals with regard to symptom profile and the use of antibiotics. Intravenous use of herbal

Intracranial suppuration: Review of an 8-year experience at Umtata General Hospital and Nelson Mandela Academic Hospital, Eastern Cape, South Africa.

PubMed

Anwary, M A

2015-09-21

Intracranial suppuration (ICS) is a life-threatening condition caused by various disease processes and consisting of brain abscess and extradural and subdural empyema. The major causes have changed over the decades. To the author's knowledge, the incidence of ICS in South Africa (SA) has not been established. To determine the incidence of ICS, overall and according to age and gender, and to identify the source and distribution of ICS. The archive of the radiology departments at Umtata General Hospital and Nelson Mandela Academic Hospital in the Transkei region, Eastern Cape Province, SA, was searched retrospectively for computed tomography (CT) reports of patients diagnosed with ICS. Cases in which the CT images, patients' clinical information and CT reports were available for an uninterrupted period of at least 1 year were included. Five time frames were established, encompassing 8 years of data. The first time frame established an incidence of ICS of 1/100,000/year for the Transkei region. All the time frames were utilised to determine the incidence according to gender and age, and the source and distribution of ICS. The incidence of ICS was higher among males than females, and highest in the age groups 0-10 and 11-20 years. A seasonal variation in the incidence of sinusitis- and meningitis-related ICS was noted. Numbers of cases declined during the last 3 years of the study period. Sinusitis, head trauma, ear infection and meningitis were the major sources of ICS. A pulmonary source was not a major feature. In the last 4 years, trauma became the commonest source of ICS. A steady decline in ear infection- and meningitis-related ICS was noted.

Identifying patterns of non-communicable diseases in developed eastern coastal China: a longitudinal study of electronic health records from 12 public hospitals.

PubMed

Yu, Dehua; Shi, Jianwei; Zhang, Hanzhi; Wang, Zhaoxin; Lu, Yuan; Zhang, Bin; Pan, Ying; Wang, Bo; Sun, Pengfei

2017-10-05

Few studies have examined the spectrum and trends of non-communicable diseases (NCDs) in inpatients in eastern coastal China, which is transforming from an industrial economy to a service-oriented economy and is the most economically developed region in the country. This study aimed to dynamically elucidate the spectrum and characteristics of severe NCDs in eastern coastal China by analysing patients' longitudinal electronic health records (EHRs). To monitor the spectrum of NCDs dynamically, we extracted the EHR data from 12 general tertiary hospitals in eastern coastal China from 2003 to 2014. The rankings of and trends in the proportions of different NCDs presented by inpatients in different gender and age groups were calculated and analysed. We obtained a total sample of 1 907 484 inpatients with NCDs from 2003 to 2014, 50.05% of whom were men and 81.53% were aged 50 years or older. There was an increase in the number of total NCD inpatients in eastern coastal China from 2003 to 2014. However, the proportion of chronic respiratory diseases and cancer inpatients decreased over the 12-year period. Compared with men, women displayed a significant increase in the proportion of mental and behavioural disorders (p<0.001) over time. Additionally, digestive diseases and sensory organ diseases significantly decreased among men, but not women. The older group accounted for a larger and growing proportion of the NCD inpatients, and the most common conditions in this group were cerebral infarctions, coronary heart disease and hypertension. In addition, the proportion of 21-year-old to 50-year-old inpatients with diabetes, blood diseases or endocrine diseases skyrocketed from 2003 to 2014 (p<0.001). The burden of inpatients' NCDs increased rapidly, particularly among women and younger people. The NCD spectrum observed in eastern coastal China is a good source of evidence for developing prevention guides for regions experiencing transition. © Article author(s) (or their

Annual survey on the level and extent of usage of electronic health records in government-related hospitals in Eastern Province, Saudi Arabia.

PubMed

Bah, Sulaiman; Alharthi, Hana; El Mahalli, Azza Ali; Jabali, Abdelkaream; Al-Qahtani, Mona; Al-kahtani, Nouf

2011-01-01

This study aims to determine the level and extent of usage of electronic health records (EHRs) in government-related hospitals in Eastern Province, Saudi Arabia. Another aim is to develop a Web site to serve as a forum of exchange on the development of EHRs in Saudi Arabia. All government hospitals (n = 19) in the province were included. The information technology (IT) managers in those hospitals made up the target population. An online questionnaire was developed, and the IT managers in all 19 government hospitals were invited to participate in the survey. The responses from the online survey were downloaded and analyzed using descriptive statistics. Of the 19 hospitals, only three (15.8 percent) use EHRs. These hospitals were established in 1984, 1995, and 2005. All three of these hospitals have implemented the same EHR software and were using it successfully, and all three were using the three core features of laboratory, radiology, and pharmacy electronic modules. Some modules were present in the EHR system but were underutilized. Some of the main challenges faced by the IT managers in implementing EHRs in their hospitals were related to the uncooperative attitudes of some physicians and nurses toward EHRs. In fulfillment of the second aim of the study, a Web site, http://ehr2011.weebly.com, was developed to serve as a forum for exchange of information on the development of EHRs in Saudi Arabia. The government of Saudi Arabia has prioritized the development of eHealth (health information technology) and allocated committed funding for it during 2008-2011. During this period, some sectors of government made highly commendable efforts in developing eHealth services. Along these lines, we had hoped to see higher uptake of EHRs than the 15.8 percent found in this study. The rate of implementing EHRs in government hospitals should be accelerated. The aim should be on achieving some basic EHR functionality in these hospitals, and once this has been achieved

Incidence of Hospitalized Stroke in the Czech Republic: The National Registry of Hospitalized Patients.

PubMed

Sedova, Petra; Brown, Robert D; Zvolsky, Miroslav; Kadlecova, Pavla; Bryndziar, Tomas; Kubelka, Tomáš; Weiss, Viktor; Volný, Ondřej; Bednarik, Josef; Mikulik, Robert

2017-05-01

Contemporary stroke incidence data are not available in some countries and regions, including in Eastern Europe. Based on previous validation of the accuracy of the National Registry of Hospitalized Patients (NRHOSP), we report the incidence of hospitalized stroke in the Czech Republic (CR) using the NRHOSP. The results of the prior validation study assessing the accuracy of coding of stroke diagnoses in the NRHOSP were applied, and we calculated (1) the overall incidence of hospitalized stroke and (2) the incidence rates of hospitalized stroke for the three main stroke types: cerebral infarction (International Classification of Diseases Tenth Revision, CI I63), subarachnoid hemorrhage (SAH I60), and intracerebral hemorrhage (ICH I61). We calculated the average annual age- and sex-standardized incidence. The overall incidence of hospitalized stroke was 241 out of 100,000 individuals. The incidence of hospitalized stroke for the main stroke types was 8.2 cases in SAH, 29.5 in ICH, and 211 in CI per 100,000 individuals. The standardized annual stroke incidence adjusted to the 2000 World Health Organization population for overall stroke incidence of hospitalized stroke was 131 per 100,000 individuals. Standardized stroke incidence for stroke subtypes was 5.7 cases in SAH, 16.7 in ICH, and 113 in CI per 100,000 individuals. These studies provide an initial assessment of the burden of stroke in this part of the world. The estimates of hospitalized stroke in the CR and Eastern Europe suggest that ICH is about three times more common than SAH, and hemorrhagic stroke makes up about 18% of strokes. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Stroke in the young: access to care and outcome; a Western versus eastern European perspective.

PubMed

Bhalla, Ajay; Grieve, Richard; Rudd, Anthony G; Wolfe, Charles D A

2008-01-01

To develop effective strategies to address the needs of young patients with stroke, it is important to recognize what components of stroke care they receive. The aims of this study were to describe the provision of stroke care and the factors associated with 3-month mortality and disability (Barthel Index 0-14) in patients younger than 55 years across Western and Eastern Europe. Data from hospital-based stroke registers in Western Europe (7 centers, 6 countries) and Eastern Europe (4 centers, 3 countries) were analyzed. Of 1735 patients admitted to hospital, 201 (11.5%) patients were younger than 55 years (Western European centers 51%, and Eastern European centers 49%). Stroke department care was higher in Western centers (67%) than in Eastern centers (24%) (P < .001). Doctor (P < .001), therapy (P = .01), and nursing (P < .001) time were higher in Western centers. At 3 months, case fatalities between Western and Eastern centers were 8% versus 23% (P = .003). Patients in Eastern European centers were more likely to have disability at 3 months (odds ratio = 24.3, confidence interval = 1.2-494, P = .04). Young patients with stroke in Western Europe are more likely to gain access to a number of components of stroke care compared with those in Eastern Europe. The future challenge is to ensure that recommendations are adopted to ensure all young patients receive evidence-based stroke care across Europe.

Hospital admission following induced abortion in Eastern Highlands Province, Papua New Guinea--a descriptive study.

PubMed

Vallely, Lisa M; Homiehombo, Primrose; Kelly-Hanku, Angela; Kumbia, Antonia; Mola, Glen D L; Whittaker, Andrea

2014-01-01

In Papua New Guinea abortion is restricted under the Criminal Code Act. While safe abortions should available in certain situations, frequently they are not available to the majority of women. Sepsis from unsafe abortion is a leading cause of maternal mortality. Our findings form part of a wider, mixed methods study designed to identify complications requiring hospital treatment for post abortion care and to explore the circumstances surrounding unsafe abortion. Through a six month prospective study we identified all women presenting to the Eastern Highlands Provincial Hospital following spontaneous and induced abortions. We undertook semi-structured interviews with women and reviewed individual case notes, extracting demographic and clinical information. Case notes were reviewed for 56% (67/119) of women presenting for post abortion care. At least 24% (28/119) of these admissions were due to induced abortion. Women presenting following induced abortions were significantly more likely to be younger, single, in education at the time of the abortion and report that the baby was unplanned and unwanted, compared to those reporting spontaneous abortion. Obtained illegally, misoprostol was the method most frequently used to end the pregnancy. Physical and mechanical means and traditional herbs were also widely reported. In a country with a low contraceptive prevalence rate and high unmet need for family planning, all reproductive age women need access to contraceptive information and services to avoid, postpone or space pregnancies. In the absence of this, women are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk and putting an increased strain on an already struggling health system. Women in this setting need access to safe, effective means of abortion.

Survey of tuberculosis hospitals in China: current status and challenges.

PubMed

Du, Jian; Pang, Yu; Liu, Yuhong; Mi, Fengling; Xu, Shaofa; Li, Liang

2014-01-01

Hospitals will play an increasingly important role in delivering TB services in China, however little is known in terms of the current landscape of the hospital system that delivers TB care. In order to examine the status of TB hospitals we performed a study in which a total of 203 TB hospitals, with 30 beds or more, were enrolled from 31 provinces and Xinjiang Production and Construction Corps. Of the 203 hospitals, 93 (45.8%) were located in the eastern region of China, 84 (41.4%) in the central region, and 26 (12.8%) in the western region, while there were 34.6 million TB patients in western China, accounting for 34.6% of the TB burden nationwide. The total number of staff in these 203 hospitals was 83,011, of which 18,899 (22.8%) provided health services for TB patients, (physicians, nurses, lab technicians, etc). Although both the overall number of the health care workers and TB staff in the 203 hospitals increased from the year 1999 to 2009, the former increased by 52%, while the latter increased only by 34%, showing that the percentage of TB staff declined significantly (χ2 = 181.7, P<0.01). The total annual income of the 203 hospitals increased 5.5 fold from 1999 to 2009, while that from TB care increased 3.8 fold during the same period. TB care and control experienced a relatively slower development during this period as shown by the lower percentage of TB staff and the lesser increase in income from TB care in the hospitals. In conclusion, our findings demonstrated that hospital resources are scarcer in western China as compared with eastern China. In view of the current findings, policymakers are urged to address the uneven distribution of medical resources between the underdeveloped west and the more affluent eastern provinces.

A retrospective study on the outcomes of cataract surgery in an Eastern Regional Health Authority hospital of Trinidad and Tobago

PubMed Central

Sonron, Ebiakpo-aboere; Bridgemohan, Petra; Sharma, Subash

2015-01-01

Background. Worldwide, cataract is a major cause of blindness. The paper aims to evaluate factors associated with borderline and poor outcomes of cataract surgery at an Eastern Regional Health Authority (ERHA) hospital in Trinidad and Tobago. Materials and Methods. A hospital-based, retrospective study was done on 401 patients who had undergone cataract surgery (unilateral and bilateral) at an ERHA Hospital between March 2009 and September 2014. Data was collected on variables concerning demographic, medical history, surgical history, ocular findings and visual acuity (VA). The outcome variable of interest was Snellen’s post-operative (presenting) VA which was transformed into a dichotomous variable with borderline and poor outcomes as one and good outcomes as the other. Data were analysed using univariate and multivariate logistic regression analyses. Results. Good outcome (presenting VA 6/18 or better) was seen in 350 (67%) eyes. The fitted model consisted of ocular co-morbidity (OR =2.133; 95% CI [1.346–3.380]), hypertension (OR = 0.520; 95% CI [0.381–0.928]), surgical procedure (OR = 1.56; 95% CI [1.004–2.425]), good preoperative VA (OR = 0.388, 95% CI [0.211–0.714]), borderline preoperative VA (OR = 0.485; 95% CI = [0.278–0.843]) and year of first visit to clinic (OR = 2.243; 95% CI [1.215–4.141]). Conclusion. There is a need for community-based outreach to increase awareness of eye health and diseases. It is recommended that the general population is encouraged to take responsibility for personal management. The facilities at the Hospital should also be enhanced. PMID:26357596

An observational study of cutaneous manifestations in diabetes mellitus in a tertiary care Hospital of Eastern India

PubMed Central

Chatterjee, Nandini; Chattopadhyay, Chandan; Sengupta, Nilanjan; Das, Chanchal; Sarma, Nilendu; Pal, Salil K

2014-01-01

Background: Diabetes mellitus and its impact on the human body have been extensively dissected over the years. However, skin which is the largest organ in the body, has received minimum attention. Therefore, this study was designed to analyze the prevalence and pattern of skin disorders among diabetic patients from Eastern region of India. Materials and Methods: This is an observational study, conducted in the General Medicine and Endocrinology departments of a Medical College and Hospital in Eastern India. The data were collected prospectively and systematically in a pre-established proforma designed by us, where clinical findings along with investigations were recorded. Results: Six hundred and eighty (680) diabetic patients were examined, there were (64.8%) male and (35.1%) were female, of them 95.3% were Type 2 diabetics while 4.7% were Type 1. Five hundred and three patients (503) out of six hundred and eighty. i.e. 73.9% were found to have skin lesions. Thirteen (13) (41%) Type1 diabetics demonstrated skin lesions commonest being diabetic xerosis, infections and diabetic hand. Among Type2 diabetics 490(75.61%) showed skin lesions. Here infections, xerosis, hair loss beneath the knees, diabetic dermopathy were the most frequent. Majority of patients (67%) had combination of more than one type of skin lesion. There was statistically significant correlation of skin lesions with duration of diabetes, however similar correlation could not be demonstrated regarding metabolic control. Conclusion: Involvement of skin is inevitable and multifarious in diabetes mellitus. Higher prevalence is seen in Type 2 diabetic population. The duration of diabetes is positively correlated with lesions and infective dermatologic manifestations were associated with higher HbA1C values. PMID:24741520

Characteristics of acute treatment costs of traumatic brain injury in Eastern China--a multi-centre prospective observational study.

PubMed

Yuan, Qiang; Liu, Hua; Wu, Xing; Sun, Yirui; Yao, Haijun; Zhou, Liangfu; Hu, Jin

2012-12-01

This study investigated acute treatment costs and related factors for traumatic brain injuries (TBI) in eastern China based on a prospective multicentre study. Data were prospectively collected from 80 hospitals in eastern China by standardized structured questionnaires during 2004. Included patients were admitted to hospitals via an emergency service with a diagnosis of TBI. The total acute hospitalization treatment costs derived from unsubsidized total hospital billings were used as the main outcome measure. Univariate and multivariable regression models were used to examine factors associated with each outcome. In total, 13,007 TBI cases were identified from 80 hospitals in eastern China. The median cost per hospitalization was $879 US (range, $72-45,894). The median cost per day was $79 (interquartile range, $49-126). The hospitalization costs varied based on the cause of TBI, with a median of $1017 for traffic accidents, $816 for falls, $490 for blows to the head, and $712 for falls. The hospitalization costs also varied by injury type with a mean of $918 for TBI associated with other injuries and $831 for isolated TBI. Using multiple regression analyses, lower admission Glasgow Coma score, longer hospital stay (LOS), male sex, transient patient status, traffic accident, injury occurring on a construction site, treatment at a tertiary hospital, neurosurgical intensive care unit (NICU) or ICU stay, associated polytrauma, and those who needed a neurosurgical operation had significantly higher total acute hospitalization costs than those of other groups. Good recovery and self-paying patients had lower total costs. A double LOS was associated with a 1.61 (95% confidence interval, 1.59-1.62) times higher hospital cost. Our results have potential implications for health-care resource planning during TBI treatment. Measures to prevent traffic accidents and reduce the LOS may help to reduce acute hospitalization costs. Crown Copyright © 2012. Published by Elsevier

Characterizing pediatric surgical capacity in the Eastern Democratic Republic of Congo: results of a pilot study.

PubMed

Cairo, Sarah B; Kalisya, Luc Malemo; Bigabwa, Richard; Rothstein, David H

2018-03-01

Characterize pediatric surgical capacity in the eastern Democratic Republic of Congo (DRC) to identify areas of potential improvement. The Pediatric Personnel, Infrastructure, Procedures, Equipment, and Supplies (PediPIPES) survey was used in two representative eastern DRC provinces to assess existing surgical infrastructure and capacity. We compared our results to previously published reports from other sub-Saharan African countries. Fourteen hospitals in the eastern DRC and 37 in 19 sub-Saharan African (SSA) countries were compared. The average PediPIPES index for the DRC was 7.7 compared to 13.5 for SSAs. The greatest disparities existed in the areas of personnel and infrastructure. Running water was reportedly available to 57.1% of the hospitals in the DRC, and the majority of hospitals (78.6%) were dependent on generators and solar panels for electricity. Only two hospitals in the DRC (14.3%) reported a pediatric surgeon equivalent on staff, compared to 86.5% of facilities sampled in SSA reporting ≥ 1 pediatric surgeon. Significant barriers in personnel, infrastructure, procedures, equipment, and supplies impede the provision of adequate surgical care to children. Further work is needed to assess allocation and utilization of existing resources, and to enhance training of personnel with specific attention to pediatric surgery.

Exploring in-hospital death from myocardial infarction in Eastern Europe: from the International Registry of Acute Coronary Syndromes in Transitional Countries (ISACS-TC); on the Behalf of the Working Group on Coronary Pathophysiology & Microcirculation of the European Society of Cardiology.

PubMed

Bugiardini, Raffaele; Manfrini, Olivia; Majstorović Stakić, Marta; Cenko, Edina; Boytsov, Sergei; Merkely, Bela; Becker, David; Dilic, Mirza; Vasiljevic, Zorana; Koller, Akos; Badimon, Lina

2014-01-01

The aim of the current study was to investigate the outcomes of coronary reperfusion therapies and ST-segment elevation myocardial infarction (STEMI) in patients of Eastern countries with economies in transition. Federation, and Serbia. The overall population consisted of 23,486 consecutive patients admitted to hospitals from January 1(st) to December 31(st) 2009. Registry data and statistics from the Organization for Economic Cooperation and Development (OECD) countries for the same period were used for comparison (2009-2010). In-hospital mortality was between 4% and 5% in the Western countries. In comparison mortality data were significantly larger in Serbia (10.8%) and Bosnia and Herzegovina (11.2%), intermediate in Russian Federation (7.2%) and similar in Hungary (5.0%). The rates of primary percutaneous coronary intervention (primary PCI) were very low in Bosnia and Herzegovina (18.3%), low in Russian Federation (20.6%) and Serbia (22%), and high in Hungary (70%). Major risk factors for death appear to be lack of reperfusion therapy, longer time delay from symptoms onset to hospital presentation as well as the higher percentage of patients with clinical presentation in Killip class III/IV. In-hospital STEMI case-fatality rates ranges widely in the former Eastern Bloc countries. Beyond the quality of care provided in hospitals, differences in time delay from symptoms onset to hospital admission may strongly influence STEMI patients' outcome.

Hospital admissions in Iran for cardiovascular and respiratory diseases attributed to the Middle Eastern Dust storms.

PubMed

Khaniabadi, Yuef Omidi; Fanelli, Roberto; De Marco, Alessandra; Daryanoosh, Seyed Mohammad; Kloog, Itai; Hopke, Philip K; Conti, Gea Oliveri; Ferrante, Margherita; Mohammadi, Mohammad Javad; Babaei, Ali Akbar; Basiri, Hassan; Goudarzi, Gholamreza

2017-07-01

The main objective of this study was to assess the possible effects of airborne particulate matter less than 10 μm in diameter (PM 10 ) from the Middle Eastern Dust (MED) events on human health in Khorramabad (Iran) in terms of estimated hospital admissions (morbidity) for cardiovascular diseases (HACD) and for respiratory diseases (HARD) during the period of 2015 to 2016. The AirQ program developed by the World Health Organization (WHO) was used to estimate the potential health impacts to daily PM 10 exposures. The numbers of excess cases for cardiovascular/respiratory morbidity were 20/51, 72/185, and 20/53 on normal, dusty, and MED event days, respectively. The highest number of hospital admissions was estimated for PM 10 concentrations in the range of 40 to 49 μg/m 3 , i.e, lower than the daily (50 μg/m 3 ) limit value established by WHO. The results also showed that 4.7% (95% CI 3.2-6.7%) and 4.2% (95% CI 2.6-5.8%) of HARD and HACD, respectively, were attributed to PM 10 concentrations above 10 μg/m 3 . The study demonstrates a significant impact of air pollution on people, which is manifested primarily as respiratory and cardiovascular problems. To reduce these effects, several immediate actions should be taken by the local authorities to control the impacts of dust storms on residents' health, e.g., developing a green beltway along the Iran-Iraq border and management of water such as irrigation of dry areas that would be effective as mitigation strategies.

Current care services provided for patients with COPD in the Eastern province in Saudi Arabia: a descriptive study.

PubMed

Alsubaiei, Mohammed E; Cafarella, Paul A; Frith, Peter A; McEvoy, R Doug; Effing, Tanja W

2015-01-01

COPD is a leading cause of morbidity and mortality worldwide. The prevalence rate of COPD in the general Saudi population is estimated to be 2.4% and 14.2% among smokers. Not much is known about current health care services for patients with COPD in Saudi Arabia. The objective of this study was to determine the current care services for patients with COPD provided by government hospitals in the Eastern province of Saudi Arabia. A cross-sectional study was conducted in the Eastern province of Saudi Arabia. Directors of the Department of Internal Medicine from all 22 general government hospitals that are under the responsibility of the Ministry of Health or the Ministry of Higher Education in this region were asked to participate. Data were collected using a questionnaire. The study results indicated that there are limited hospital facilities for patients with COPD: no respiratory departments in any of the included hospitals, no spirometry in 77.3% of the hospitals, no intensive care units in 63.7% of the hospitals, and no pulmonary rehabilitation program in any of the hospitals. Among the included 22 hospitals, 24 respiratory physicians, 29 respiratory therapists, and three physiotherapists were involved in COPD care. In conclusion, current care services provided by government hospitals in the Eastern province of Saudi Arabia for patients with COPD do not meet international recommendations for COPD management. Increased awareness, knowledge, and implementation of COPD guidelines by health care providers will most probably improve COPD management in Saudi Arabia. In addition, the government could improve dissemination of information about COPD management through national programs and by offering specific education regarding respiratory diseases.

Hospital Admission following Induced Abortion in Eastern Highlands Province, Papua New Guinea – A Descriptive Study

PubMed Central

Vallely, Lisa M.; Homiehombo, Primrose; Kelly-Hanku, Angela; Kumbia, Antonia; Mola, Glen D. L.; Whittaker, Andrea

2014-01-01

Background In Papua New Guinea abortion is restricted under the Criminal Code Act. While safe abortions should available in certain situations, frequently they are not available to the majority of women. Sepsis from unsafe abortion is a leading cause of maternal mortality. Our findings form part of a wider, mixed methods study designed to identify complications requiring hospital treatment for post abortion care and to explore the circumstances surrounding unsafe abortion. Methods Through a six month prospective study we identified all women presenting to the Eastern Highlands Provincial Hospital following spontaneous and induced abortions. We undertook semi-structured interviews with women and reviewed individual case notes, extracting demographic and clinical information. Findings Case notes were reviewed for 56% (67/119) of women presenting for post abortion care. At least 24% (28/119) of these admissions were due to induced abortion. Women presenting following induced abortions were significantly more likely to be younger, single, in education at the time of the abortion and report that the baby was unplanned and unwanted, compared to those reporting spontaneous abortion. Obtained illegally, misoprostol was the method most frequently used to end the pregnancy. Physical and mechanical means and traditional herbs were also widely reported. Conclusion In a country with a low contraceptive prevalence rate and high unmet need for family planning, all reproductive age women need access to contraceptive information and services to avoid, postpone or space pregnancies. In the absence of this, women are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk and putting an increased strain on an already struggling health system. Women in this setting need access to safe, effective means of abortion. PMID:25329982

A Hospital Clinic Early Intervention Program.

ERIC Educational Resources Information Center

Simser, Judith I.; Steacie, Pamela

1993-01-01

The Aural Habilitation Program of Children's Hospital of Eastern Ontario (Canada) provides weekly, individualized aural habilitation sessions for parents of young children with hearing impairments and offers guidance in creating a listening, learning environment in the home. Strategies for developing parents' skills and confidence are described.…

Viral etiology, seasonality and severity of hospitalized patients with severe acute respiratory infections in the Eastern Mediterranean Region, 2007-2014.

PubMed

Horton, Katherine C; Dueger, Erica L; Kandeel, Amr; Abdallat, Mohamed; El-Kholy, Amani; Al-Awaidy, Salah; Kohlani, Abdul Hakim; Amer, Hanaa; El-Khal, Abel Latif; Said, Mayar; House, Brent; Pimentel, Guillermo; Talaat, Maha

2017-01-01

Little is known about the role of viral respiratory pathogens in the etiology, seasonality or severity of severe acute respiratory infections (SARI) in the Eastern Mediterranean Region. Sentinel surveillance for SARI was conducted from December 2007 through February 2014 at 20 hospitals in Egypt, Jordan, Oman, Qatar and Yemen. Nasopharyngeal and oropharyngeal swabs were collected from hospitalized patients meeting SARI case definitions and were analyzed for infection with influenza, respiratory syncytial virus (RSV), adenovirus (AdV), human metapneumovirus (hMPV) and human parainfluenza virus types 1-3 (hPIV1-3). We analyzed surveillance data to calculate positivity rates for viral respiratory pathogens, describe the seasonality of those pathogens and determine which pathogens were responsible for more severe outcomes requiring ventilation and/or intensive care and/or resulting in death. At least one viral respiratory pathogen was detected in 8,753/28,508 (30.7%) samples tested for at least one pathogen and 3,497/9,315 (37.5%) of samples tested for all pathogens-influenza in 3,345/28,438 (11.8%), RSV in 3,942/24,503 (16.1%), AdV in 923/9,402 (9.8%), hMPV in 617/9,384 (6.6%), hPIV1 in 159/9,402 (1.7%), hPIV2 in 85/9,402 (0.9%) and hPIV3 in 365/9,402 (3.9%). Multiple pathogens were identified in 501/9,316 (5.4%) participants tested for all pathogens. Monthly variation, indicating seasonal differences in levels of infection, was observed for all pathogens. Participants with hMPV infections and participants less than five years of age were significantly less likely than participants not infected with hMPV and those older than five years of age, respectively, to experience a severe outcome, while participants with a pre-existing chronic disease were at increased risk of a severe outcome, compared to those with no reported pre-existing chronic disease. Viral respiratory pathogens are common among SARI patients in the Eastern Mediterranean Region. Ongoing surveillance is

[Governance of tertiary referral hospitals in the Democratic Republic of the Congo: a critical interpretive synthesis of the literature].

PubMed

Karemere, H; Kahindo, J B; Ribesse, N; Macq, J

2013-01-01

Because hospitals are complex enterprises requiring adaptive systems, it is appropriate to apply the theory and terminology of governance or even better adaptive governance to the interpretation of their management. This study focused on understanding hospital governance in Logo, Bunia, and Katana, three hospitals in two regions of the eastern DRC, which has been characterized by intermittent armed conflict since 1996. In such a context of war and continuous insecurity, how can governance be interpreted for hospitals required to adapt to a constantly changing environment to be able to continue to provide health care? A critical interpretive synthesis of the literature, identified by searching for keywords related to governance. The concepts of governance, adaptive governance, performance, leadership, and complex adaptive system concepts are defined. The interpretation of the concepts helps us to better understand (1) the hospital as a complex adaptive system, (2) the governance of tertiary referral hospitals, (3) analysis of hospital performance, and (4) leadership for good governance of these hospitals. The interpretation of these concepts raises several questions about their application to the eastern DRC. Conclusion. This critical interpretive synthesis opens the door to a new way of exploring tertiary hospitals and their governance in the eastern DRC.

Viral etiology, seasonality and severity of hospitalized patients with severe acute respiratory infections in the Eastern Mediterranean Region, 2007–2014

PubMed Central

Dueger, Erica L.; Kandeel, Amr; Abdallat, Mohamed; El-Kholy, Amani; Al-Awaidy, Salah; Kohlani, Abdul Hakim; Amer, Hanaa; El-Khal, Abel Latif; Said, Mayar; House, Brent; Pimentel, Guillermo; Talaat, Maha

2017-01-01

Introduction Little is known about the role of viral respiratory pathogens in the etiology, seasonality or severity of severe acute respiratory infections (SARI) in the Eastern Mediterranean Region. Methods Sentinel surveillance for SARI was conducted from December 2007 through February 2014 at 20 hospitals in Egypt, Jordan, Oman, Qatar and Yemen. Nasopharyngeal and oropharyngeal swabs were collected from hospitalized patients meeting SARI case definitions and were analyzed for infection with influenza, respiratory syncytial virus (RSV), adenovirus (AdV), human metapneumovirus (hMPV) and human parainfluenza virus types 1–3 (hPIV1-3). We analyzed surveillance data to calculate positivity rates for viral respiratory pathogens, describe the seasonality of those pathogens and determine which pathogens were responsible for more severe outcomes requiring ventilation and/or intensive care and/or resulting in death. Results At least one viral respiratory pathogen was detected in 8,753/28,508 (30.7%) samples tested for at least one pathogen and 3,497/9,315 (37.5%) of samples tested for all pathogens–influenza in 3,345/28,438 (11.8%), RSV in 3,942/24,503 (16.1%), AdV in 923/9,402 (9.8%), hMPV in 617/9,384 (6.6%), hPIV1 in 159/9,402 (1.7%), hPIV2 in 85/9,402 (0.9%) and hPIV3 in 365/9,402 (3.9%). Multiple pathogens were identified in 501/9,316 (5.4%) participants tested for all pathogens. Monthly variation, indicating seasonal differences in levels of infection, was observed for all pathogens. Participants with hMPV infections and participants less than five years of age were significantly less likely than participants not infected with hMPV and those older than five years of age, respectively, to experience a severe outcome, while participants with a pre-existing chronic disease were at increased risk of a severe outcome, compared to those with no reported pre-existing chronic disease. Conclusions Viral respiratory pathogens are common among SARI patients in the Eastern

Fatal Eastern Equine Encephalitis in a Patient on Maintenance Rituximab: A Case Report.

PubMed

Solomon, Isaac H; Ciarlini, Pedro D S C; Santagata, Sandro; Ahmed, Asim A; De Girolami, Umberto; Prasad, Sashank; Mukerji, Shibani S

2017-01-01

A 63-year-old woman on rituximab maintenance for follicular lymphoma presented with headaches, vomiting, and fever, and was diagnosed with eastern equine encephalomyelitis by cerebrospinal fluid polymerase chain reaction. Eastern equine encephalomyelitis immunoglobulin (Ig)G/IgM remained negative due to rituximab treatment, and magnetic resonance imaging showed minimal abnormalities, making this a diagnostically challenging case. Despite therapy with intravenous Ig, the patient rapidly declined and died on hospital day 12. Autopsy revealed perivascular and parenchymal chronic inflammation, with an absence of B lymphocytes, and virally infected neurons throughout the central nervous system.

Secular trends, treatments, and outcomes of Middle Eastern Arab and South Asian patients hospitalized with atrial fibrillation: insights from a 20-year registry in Qatar (1991-2010).

PubMed

Salam, Amar M; AlBinali, Hajar A; Al-Mulla, Abdul Wahid; Singh, Rajvir; Al Suwaidi, Jassim

2013-10-01

A prospective registry was made of all patients hospitalized with atrial fibrillation (AF) in the State of Qatar from 1991 to 2010. Clinical characteristics, management, and outcomes were compared according to ethnicity (Middle Eastern Arab vs South Asian). During this 20-year period, 2857 Arabs and 548 Asians were hospitalized for AF. Arabs were 9 years older and more likely to have hypertension, diabetes mellitus (DM), chronic renal impairment, and dyslipidemia than the Asians. Valvular heart disease and acute coronary syndromes were more common among Asians, while congestive heart failure was more common in Arabs. The overall inhospital mortality was lower in Asians than that of Arabs, while stroke rates were comparable. There was an increase in the prevalence of DM and hypertension in both the groups in the latter years of the study period, but there was no change in mortality trends. Our findings underscore the need to study AF according to ethnicity.

Clinical and molecular epidemiology of hospital Enterococcus faecalis isolates in eastern France.

PubMed

Mulin, Blandine; Bailly, Pascale; Thouverez, Michelle; Cailleaux, Vincent; Cornette, Christian; Dupont, Marie-Jeanne; Talon, Daniel

1999-03-01

OBJECTIVE: To report on the occurrence of Enterococcus faecalis hospital isolates obtained during 1 year in hospitals in the Franche-Comté region of France. METHODS: Clinical isolates of E. faecalis of different antibiotic susceptibility phenotypes from hospitalized patients were characterized by pulsed-field gel electrophoresis. Patients with positive cultures were investigated by three case-control studies to identify risk factors for colonization/infection. RESULTS: The crude incidence of colonization/infection was 2.37%, and 4-day and 7-day colonization rates after admission were 10.0% and 6.36%, respectively. The rates of high-level resistance to kanamycin (HLKR) and to gentamicin (HLGR) were 47.1% and 7.1%, respectively. No isolate was resistant to glycopeptides or produced beta-lactamase. The 209 hospital isolates obtained during the study yielded 98 major DNA patterns, of which two were major epidemic patterns including HLKR isolates. No single factor was significantly associated with colonization/infection by HLKR isolates. The length of hospitalization before isolation was associated with colonization by HLGR isolates. CONCLUSIONS: The isolation frequency of E. faecalis strains with acquired resistance to aminoglycoside antibiotics, and the wide dissemination of resistant strains with characteristics that allow them to persist and spread, argue for further large prospective surveys of clinical isolates of E. faecalis in hospitals.

Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study.

PubMed

Sisay, Mekonnen; Mengistu, Getnet; Molla, Bereket; Amare, Firehiwot; Gabriel, Tesfaye

2017-02-23

Despite the complexity of drug use, a number of indicators have been developed, standardized and evaluated by the World Health Organization (WHO). These indicators are grouped in to three categories namely: prescribing indicators, patient care indicators and facility indicators. The study was aimed to evaluate rational drug use based on WHO-core drug use indicators in Dilchora referral hospital, Dire Dawa; Hiwot Fana specialized university hospital, Harar and Karamara general hospital, Jigjiga, eastern Ethiopia. Hospital based quantitative cross sectional study design was employed to evaluate rational drug use based on WHO core drug use indicators in selected hospitals. Systematic random sampling for prescribing indicators and convenient sampling for patient care indicators was employed. Taking WHO recommendations in to account, a total of 1,500 prescription papers (500 from each hospitals) were investigated. In each hospital, 200 outpatient attendants and 30 key essential drugs were also selected using the WHO recommendation. Data were collected using retrospective and prospective structured observational check list. Data were entered to EPI Data Version 3.1, exported and analyzed using SPSS version 16.0. Besides, the data were evaluated as per the WHO guidelines. Statistical significance was determined by one way analysis of variance (ANOVA) for some variables. P-value of less than 0.05 was considered statistically significant. Finally, tabular presentation was used to present the data. Mean, 2.34 (±1.08) drugs were prescribed in the selected hospitals. Prescriptions containing antibiotics and that of injectables were 57.87 and 10.9% respectively. The average consultation and dispensing time were 276.5 s and 61.12 s respectively. Besides, 75.77% of the prescribed drugs were actually dispensed. Only 3.3% of prescriptions were adequately labeled and 75.7% patients know about the dosage of the prescription. Not more than, 20(66.7%) key drugs were available in

Unsafe abortion requiring hospital admission in the Eastern Highlands of Papua New Guinea--a descriptive study of women's and health care workers' experiences.

PubMed

Vallely, Lisa M; Homiehombo, Primrose; Kelly-Hanku, Angela; Whittaker, Andrea

2015-03-21

In Papua New Guinea induced abortion is restricted under the Criminal Code Law. Unsafe abortions are known to be widely practiced and sepsis due to unsafe abortion is a leading cause of maternal mortality. We undertook a six month, prospective, mixed methods study at the Eastern Highlands Provincial Hospital. Semi structured and in depth interviews were undertaken with women presenting following induced abortion. This paper describes the reasons why women resorted to unsafe abortion, the techniques used, decision to seek post abortion care and women's reflections post abortion. 28 women were admitted to hospital following an induced abortion. Reasons for inducing an abortion included: wanting to continue with studies, relationship problems and socio-cultural factors. Misoprostol was the most frequently used method to end the pregnancy. Physical and mechanical means, traditional herbs and spiritual beliefs were also reported. Women sought care post abortion due to excessive vaginal bleeding, and severe abdominal pain with some afraid they would die if they did not seek help. In the absence of contraceptive information and services to avoid, postpone or space pregnancies, women in this setting are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk. Women need access to safe, effective means of abortion.

Middle Eastern rhinoplasty.

PubMed

Azizzadeh, Babak; Mashkevich, Grigoriy

2010-02-01

The ethnic appearance of the Middle Eastern nose is defined by several unique visual features, particularly a high radix, wide overprojecting dorsum, and an amorphous hanging nasal tip. These external characteristics reflect distinct structural properties of the osseo-cartilaginous nasal framework and skin-soft tissue envelope in patients of Middle Eastern extraction. The goal, and the ultimate challenge, of rhinoplasty on Middle Eastern patients is to achieve balanced aesthetic refinement, while avoiding surgical westernization. Detailed understanding of the ethnic visual harmony in a Middle Eastern nose greatly assists in preserving native nasal-facial relationships during rhinoplasty on Middle Eastern patients. Esthetic alteration of a Middle Eastern nose follows a different set of goals and principles compared with rhinoplasties on white or other ethnic patients. This article highlights the inherent nasal features of the Middle Eastern nose and reviews pertinent concepts of rhinoplasty on Middle Eastern patients. Essential considerations in the process spanning the consultation and surgery are reviewed. Reliable operative techniques that achieve a successful aesthetic outcome are discussed in detail. Copyright 2010 Elsevier Inc. All rights reserved.

Hillary Clinton's visit to Ottawa hospital an exercise in military precision

PubMed Central

Gray, Charlotte

1995-01-01

The Children's Hospital of Eastern Ontario learned that hosting the wife of the US president is more like a military manoeuvre than a typical VIP visit, but Hillary Rodham Clinton brought a unique perspective on universal health care to the Ottawa hospital. CMAJ Contributing Editor Charlotte Gray, who is also vice-chair of the hospital's board of trustees, recounts the experience of listening to “the sharpest, most intense professor of health care management you've ever met.” Imagesp1299-a

New York hospital group striving for brand recognition. HealthStar Network.

PubMed

Herreria, J

1998-01-01

HealthStar Network established a new concept in its eastern market--a group of hospitals forming one association. Marketers of HealthStar are conducting a branding campaign to distinguish individual expertise under one umbrella company.

Antibiotic Susceptibilities of Enterococcus Species Isolated from Hospital and Domestic Wastewater Effluents in Alice, Eastern Cape Province of South Africa

PubMed Central

Iweriebor, Benson Chuks; Gaqavu, Sisipho; Obi, Larry Chikwelu; Nwodo, Uchechukwu U.; Okoh, Anthony I.

2015-01-01

Background: Antimicrobial resistance in microorganisms are on the increase worldwide and are responsible for substantial cases of therapeutic failures. Resistance of species of Enterococcus to antibiotics is linked to their ability to acquire and disseminate antimicrobial resistance determinants in nature, and wastewater treatment plants (WWTPs) are considered to be one of the main reservoirs of such antibiotic resistant bacteria. We therefore determined the antimicrobial resistance and virulence profiles of some common Enterococcus spp that are known to be associated with human infections that were recovered from hospital wastewater and final effluent of the receiving wastewater treatment plant in Alice, Eastern Cape. Methods: Wastewater samples were simultaneously collected from two sites (Victoria hospital and final effluents of a municipal WWTP) in Alice at about one to two weeks interval during the months of July and August 2014. Samples were screened for the isolation of enterococci using standard microbiological methods. The isolates were profiled molecularly after targeted generic identification and speciation for the presence of virulence and antibiotic resistance genes. Results: Out of 66 presumptive isolates, 62 were confirmed to belong to the Enterococcus genusof which 30 were identified to be E. faecalis and 15 E. durans. The remaining isolates were not identified by the primers used in the screening procedure. Out of the six virulence genes that were targeted only three of them; ace, efaA, and gelE were detected. There was a very high phenotypic multiple resistance among the isolates and these were confirmed by genetic analyses. Conclusions: Analyses of the results obtained indicated that hospital wastewater may be one of the sources of antibiotic resistant bacteria to the receiving WWTP. Also, findings revealed that the final effluent discharged into the environment was contaminated with multi-resistant enterococci species thus posing a health hazard

Adherence to ACC/AHA performance measures for myocardial infarction in six Middle-Eastern countries: association with in-hospital mortality and clinical characteristics.

PubMed

Longenecker, Joseph C; Alfaddagh, Abdulhamied; Zubaid, Mohammad; Rashed, Wafa; Ridha, Mustafa; Alenezi, Fahad; Alhamdan, Rashed; Akbar, Mousa; Bulbanat, Bassam Y; Al-Suwaidi, Jassim

2013-08-20

This study assesses adherence to performance measures for acute myocardial infarction (AMI) in six Middle-Eastern countries, and its association with in-hospital mortality. Few studies have previously assessed these performance measures in the Middle East. This cohort study followed 5813 patients with suspected AMI upon admission to discharge. Proportions of eligible participants receiving the following performance measures were calculated: medications within 24 hours of admission (aspirin and beta-blocker) and on discharge (aspirin, beta-blockers, angiotensin converting enzyme inhibitors [ACEI], and lipid-lowering therapy), reperfusion therapy, and low-density lipoprotein (LDL) cholesterol measurement. A composite adherence score was calculated. Associations between performance measures and clinical characteristics were assessed using multivariate logistic regression. Adherence was above 90% for aspirin, reperfusion, and lipid-lowering therapies; between 60% and 82% for beta-blockers, ACEI, statin therapy, time-to-balloon within 90 minutes, and LDL-cholesterol measurement; and 33% for time-to-needle within 30 minutes. After adjustment, factors associated with high composite performance score (>85%) included Asian ethnicity (Odds Ratio, OR=1.3; p=0.01) and history of hyperlipidemia (OR=1.4; p=0.001). Factors associated with a lower score included atypical symptoms (OR=0.6; p=0.003) and high GRACE score (OR=0.6; p<0.001). Lower in-hospital mortality was associated with provision of reperfusion therapy (OR=0.54, p=0.047) and beta-blockers within 24 hours (OR=0.33, p=0.005). Overall adherence was lowest among the highest-risk patients. Lower in-hospital mortality was independently associated with adherence to early performance measures, comprising observational evidence for their effectiveness in a Middle East cohort. These data provide a focus for regional quality improvement initiatives and research. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Age-dependent interaction of apolipoprotein E gene with eastern birthplace in Finland affects severity of coronary atherosclerosis and risk of fatal myocardial infarction--Helsinki Sudden Death Study.

PubMed

Tyynelä, Petri; Goebeler, Sirkka; Ilveskoski, Erkki; Mikkelsson, Jussi; Perola, Markus; Lehtimäki, Terho; Karhunen, Pekka J

2013-05-01

Mortality from coronary heart disease (CHD) has been constantly higher in eastern late settlement regions compared to western early settlements in Finland, unrelated to classical risk factors. In line with this, eastern birthplace was an age-dependent predictor of severe coronary atherosclerosis and pre-hospital sudden coronary death among male residents of Helsinki. We investigated a possible interaction of apolipoprotein E (APOE) gene with birthplace on the risk of myocardial infarction (MI) and coronary atherosclerosis. APOE genotypes were analyzed in the Helsinki Sudden Death Study series comprising out-of-hospital deaths among males aged 33-70 years (n = 577), who were born in high (east, n = 273) or low (west, n = 304) CHD mortality area. Eastern-born men ≤ 55 years carried 30% more often (P = 0.017) and older men 40% less often (P = 0.022) the APOE ϵ4 allele compared to western-born men (P = 0.003 for birthplace-by-age interaction). In multivariate analysis, the ϵ4 allele associated with the risk of out-of-hospital MI (odds ratio 2.58; 95% CI 1.20-5.55; P = 0.016) only in eastern-born men and with advanced atherosclerosis in both regions of origin, respectively. Birthplace-bound risk of CHD was age-dependently modified by APOE ϵ4 allele, suggesting genetic differences in CHD susceptibility between early and late settlement regions in Finland and providing one explanation for the eastern high mortality.

Study of Incidence and Prevalence of Musculoskeletal Anomalies in a Tertiary Care Hospital of Eastern India

PubMed Central

Mohanty, Biswa Bhusan; Sarangi, Rachita; Kumar, Sanjay; Mahapatra, Susanta Kumar; Chinara, Prafulla Kumar

2014-01-01

Introduction: Congenital anomalies or malformations are anatomical. Structural or functional defects present at birth leads to physical and mental disabilities. With the advent of newer drugs, infectious diseases have taken the backseat and congenital defects have emerged as an important cause of neonatal morbidity and mortality. In India, anomalies of musculoskeletal system have been most commonly reported. Aims and Objectives: With this in view, the present study was carried out to find the incidence and types of musculoskeletal defects in a tertiary care hospital in Eastern India. Various maternal factors were also correlated and analyzed. The purpose of this communication is to report these defects so as to help doctors and parents to prevent unexpected fetal loss and better parental counseling. Materials and Methods: This study was done in the Department of Obstetrics and Gynaecology in association with Department of Paediatrics of a tertiary care hospital in Odisha from for a period of 1 year. The newborns were examined within 1st three days of delivery for congenital malformations. The study group included all live borns along with still borns after 28 weeks of gestation or those dead babies whose weight was about 1kg. A thorough physical examination from head to toe was done to look for musculoskeletal defects within 24hrs of delivery. Observation and Results: Out of total 7268 babies delivered, 116 babies were found to have anomalies. Thirty two of these had musculoskeletal defects. Talipes equinovarus was the commonest anomaly observed followed by polydactyly. The ratio of male babies with musculoskeletal defects to female babies was found to be 1.28:1.The malformed babies were mainly born to term mothers (77.6%), who were mostly unbooked (62.5%) and belonged to lower or middle class. But no significant relationship could be established between these factors and defects. Most mothers were in the age group of 20-35 years and there was no history of drug

Assessing health literacy in the eastern and middle-eastern cultures.

PubMed

Nair, Satish Chandrasekhar; Satish, Karthyayani Priya; Sreedharan, Jayadevan; Ibrahim, Halah

2016-08-19

Health literacy is a term employed to assess the ability of people to meet the increasing demands related to health in a rapidly evolving society. Low health literacy can affect the social determinants of health, health outcomes and the use of healthcare services. The purpose of the study was to develop a survey construct to assess health literacy within the context of regional culture. Different socioeconomic status among the Eastern and Middle Eastern countries may restrict, health information access and utilization for those with low literacy. By employing expert panel, Delphi technique, focus group methodologies, and pre-testing using participants (N = 900) from the UAE and India, a survey construct to the Eastern-Middle Eastern cultures was developed. Reliability was assessed using Cronbach's α and validity using Factor analysis. Kiaser-Meyer-Olkin (KMO) sampling adequacy and Bartlett's tests were used to assess the strength of the relationship among the variables. Inclusion of non-health related items were found to be critical in the authentic assessment of health literacy in the Eastern and Middle Eastern population given the influence of social desirability. Thirty-two percentage of the original 19-item construct was eliminated by the focus group for reasons of relevance and impact for the local culture. Field pretesting participants from two countries, indicated overall construct reliability (Cronbach's α =0.85), validity and consistency (KMO value of 0.92 and Bartlett's test of sphericity was significant). The Eastern-Middle Eastern Adult Health Literacy (EMAHL13), screening instrument is brief, simple, a useful indicator of whether or not a patient can read. It assessespatients' ability to comprehend by distinguishing between health and non-health related items. The EMAHL13 will be a useful too for the reliable assessment of health literacy in countries, where culture plays a significant impact. This will be the first steptowards providing

Household catastrophic medical expenses in eastern China: determinants and policy implications

PubMed Central

2013-01-01

Background Much of research on household catastrophic medical expenses in China has focused on less developed areas and little is known about this problem in more developed areas. This study aimed to analyse the incidence and determinants of catastrophic medical expenses in eastern China. Methods Data were obtained from a health care utilization and expense survey of 11,577 households conducted in eastern China in 2008. The incidence of household catastrophic medical expenses was calculated using the method introduced by the World Health Organization. A multi-level logistic regression model was used to identify the determinants. Results The incidence of household catastrophic medical expenses in eastern China ranged from 9.24% to 24.79%. Incidence of household catastrophic medical expenses was lower if the head of household had a higher level of education, labor insurance coverage, while the incidence was higher if they lived in rural areas, had a family member with chronic diseases, had a child younger than 5 years old, had a person at home who was at least 65 years old, and had a household member who was hospitalized. Moreover, the impact of the economic level on catastrophic medical expenses was non-linear. The poorest group had a lower incidence than that of the second lowest income group and the group with the highest income had a higher incidence than that of the second highest income group. In addition, region was a significant determinant. Conclusions Reducing the incidence of household catastrophic medical expenses should be one of the priorities of health policy. It can be achieved by improving residents’ health status to reduce avoidable health services such as hospitalization. It is also important to design more targeted health insurance in order to increase financial support for such vulnerable groups as the poor, chronically ill, children, and senior populations. PMID:24308317

Capacity and equity in cardiac rehabilitation in the eastern region: good and bad news.

PubMed

Jennings, S; Carey, D

2004-01-01

To document current baseline eligibility for Phase 3 cardiac rehabilitation (CR) and the capacity to meet this need in hospitals in the Eastern Regional Health Authority. Information on the eligible population and the capacity for CR was collected in all nine hospitals retrospectively (February-March 2001). Forty-seven per cent of eligible patients were invited to participate with only two-thirds attending. Completion rates were very high (89%) in attenders. Age and health board area were significant independent predictors of being invited to CR. Gender was not independent of age. Fifty-three per cent of the need for this service was met by capacity in the region's nine hospitals in 2000 rising to 59% in 2002. Many eligible patients are not invited to CR. Lack of capacity is a problem. Among the invited, non-participation is a factor. Inequity in age and inter-hospital variation in invitation is noted.

Thromboelastography Utilization in Delayed Recurrent Coagulopathy after Severe Eastern Diamondback Rattlesnake Envenomation.

PubMed

McBride, Katherine M; Bromberg, William; Dunne, James

2017-04-01

Venomous snakebites are fairly common in the United States and can present with a wide range of symptoms. A 48-year-old man presented after Eastern Diamondback rattlesnake envenomation. His hospital course was complicated by right leg compartment syndrome and delayed recurrent coagulopathy, requiring multiple doses of Crotalidae Polyvalent Immune Fab (CroFab) antivenom and transfusions. Thromboelastography was used as an adjunct to standard coagulation studies in monitoring his delayed recurrent coagulopathy.

Epidemiological Study of Orofacial Clefts among Population of Eastern Slovakia during the Period 1996-2013.

PubMed

Pacáková, Diana; Zábavníková, Marianna; Miklošová, Mária; Kúkeľová, Diana; Dankovčík, Róbert

2016-06-01

Over the past 18 years, according to data from the Clinic of Plastic and Reconstructive Surgery, L. Pasteur University Hospital, there have been 493 cases of orofacial clefts (OC) reported in the area of Eastern Slovakia. The aim of this study was to map the occurrence of orofacial clefts reported in the area of Eastern Slovakia during the years 1996-2013. Also, we compared the occurrence of different types of clefts between the groups in relation to gender and ethnicity. The statistical analysis shows relationship between variables of location and gender and gender differences in the occurrence of various types of clefts. Moreover, in comparison with another study which analyzed the years 1985-2000 (1.29/10(3) live births), there was an increase in the incidence (1.42/10(3) live births) of OC in Eastern Slovakia. Our findings seem contradictive to similar studies which discuss ethnic differences in relation to OC. We recognize the relatively high occurrence of OC in Eastern Slovakia, and we link this phenomenon to several extrinsic factors, in particular socioeconomic status and embryotoxic factors. Copyright© by the National Institute of Public Health, Prague 2015.

Eastern Carolina Asthma Prevention Program (ECAPP): An Environmental Intervention Study Among Rural and Underserved Children with Asthma in Eastern North Carolina

PubMed Central

Kearney, Gregory D; Johnson, Lisa C; Xu, Xiaohui; Balanay, Jo Anne G; Lamm, Kevin M; Allen, Daniel L

2014-01-01

OBJECTIVE Asthma is the most common chronic childhood condition affecting 6.3 million (US) children aged less than 18 years. Home-based, multi-component, environmental intervention studies among children with asthma have demonstrated to be effective in reducing asthma symptoms. In this study, a local hospital and university developed an environmental intervention research pilot project, Eastern Carolina Asthma Prevention Program (ECAPP), to evaluate self-reported asthma symptoms, breathing measurements, and number of asthma-related emergency department (ED) visits among low-income, minority children with asthma living in rural, eastern North Carolina. Our goal was to develop a conceptual model and demonstrate any asthma respiratory improvements in children associated with our home-based, environmental intervention. METHODS This project used a single cohort, intervention design approach to compare self-reported asthma-related symptoms, breathing tests, and ED visits over a 6 month period between children with asthma in an intervention study group (n = 12) and children with asthma in a control study group (n = 7). The intervention study group received intense asthma education, three home visits, 2 week follow-up telephone calls, and environmental intervention products for reducing asthma triggers in the home. The control group received education at baseline and 2 week calls, but no intervention products. RESULTS At the end of the study period, significant improvements were observed in the intervention group compared with the control group. Overall, the intervention group experienced a 58% (46 ± SD 26.9) reduction in self-reported asthma symptoms; 76% (34 ± SD 29.7) decrease in rescue medicine; 12% (145 ± SD 11.3) increase in controller medicine; 37% decrease in mean exhaled nitric oxide levels and 33% fewer ED asthma-related visits. CONCLUSION As demonstrated, a combination of efforts appeared effective for improving asthma respiratory symptoms among children in

Estrogen receptor and progesterone receptor status of breast cancer patients of eastern India: A multi-institutional study.

PubMed

Chatterjee, Koushik; Bhaumik, Gautam; Chattopadhyay, Bhargab

2018-01-01

There is a paucity of any significant data on the estrogen receptor (ER) and progesterone receptor (PR) status of breast cancer patients from the eastern part of India. This study aims to document the ER and PR status of breast cancer patients in the eastern Indian population, as catered by two premier tertiary care hospitals in Kolkata. All breast cancer patients registered between January 1, 2013 and December 31, 2015, in the Departments of Oncology, of IPGMER and SSKM Hospitals and R. G. Kar Medical College and Hospital, Kolkata, who had at least undergone a core biopsy or surgery, were analyzed retrospectively for documentation of their ER and PR status, using the 2010 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) interpretation guidelines. Over a period of 3 years, a total of 927 patients were included for the study. A total of 825 (89%) patients had their ER and PR data available for evaluation. ER and PR positive was seen in 312 (37.82%) patients, ER and PR negative in 399 (48.36%) patients, ER positive and PR negative in 71 (8.6%) patients, and ER negative and PR positive results was found in 43 (5.21%) patients. This is the first multi-institutional documentation of ER and PR status from eastern India, having a modest number of patients and one of the earliest documentations using the latest ASCO/CAP interpretation guidelines. These findings resemble the data from the south and also reiterate the fact that majority of the Indian breast cancer patients are still ER and PR negative in spite of the changes in the interpretation guidelines.

Dietary diversity and associated factors among HIV positive adults attending antiretroviral therapy clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia.

PubMed

Weldegebreal, Fitsum; Digaffe, Tesfaye; Mesfin, Frehiwot; Mitiku, Habtamu

2018-01-01

Nutritional care is considered a crucial component of comprehensive care for people living with HIV/AIDS (PLWHA), particularly in resource-limited settings where malnutrition and food insecurity are endemic problems, and low quality monotonous diets are the norm. The findings of this study provide baseline information on dietary diversity and related factors for health care providers so that they will be able to improve nutritional care and support activity. Therefore, the aim of this study was to assess dietary diversity and associated factors among HIV positive adults (18-65 years old) attending antiretroviral therapy (ART) clinics at Hiwot Fana and Dilchora Hospitals, eastern Ethiopia. An institution-based cross-sectional study was conducted from November 2015 to February 2016 at the ART clinics of Hiwot Fana and Dilchora Hospitals. Using a systematic random sampling technique, a total of 303 patients were selected from all adults attending the ART clinics. The data were collected with a 95% CI used to show association between dietary diversity and independent factors. A total of 303 adult HIV positive individuals on ART participated in the study and 62.4% were females. The largest numbers of participants (49.5%) were 30-40 years of age. Eighty-seven (28.7%) participants had low dietary diversity (≤4 food groups). Duration of anti-retroviral treatment was the factor significantly associated with dietary diversity: respondents with a duration of antiretroviral treatment of more than 2 years were almost two times more likely to have high dietary diversity compared with those with less than a year of antiretroviral treatment (adjusted odds ratio =0.490; 95% CI: 0.091, 0.978). Low dietary diversity was found to be a nutritional problem among HIV positive adults. Duration of antiretroviral treatment was the predictor of low dietary diversity. Therefore, appropriate dietary management of side effects of ART is important.

Serum 25 hydroxyvitamin D in employees of a Middle Eastern university hospital.

PubMed

Gannagé-Yared, M-H; Helou, E; Zaraket, V; Abi Akl, S; Antonios, L; Moussalli, M-L; Wakim, S

2014-06-01

The Middle East registers the highest rate of vitamin D deficiency worldwide. In Lebanon, previous studies looked at this deficiency in schoolchildren, university students, young adults and postmenopausal women. However, no previous study was performed in hospital workers. The objective of our study was to evaluate vitamin D status in a Beirut hospital center and to look at the potential factors influencing these measurements. This cross-sectional study was performed on hospital employees who came for a regular checkup at the primary health-care department. 25(OH)D measurements were performed using the Dia-Sorin chemiluminescent assay. 392 subjects (318 women and 74 men) were included in the study. The mean age of the participants was 41.02 ± 11.3 years. The mean 25(OH)D level was 15.61 ± 7.91 ng/ml, with no significant difference according to gender. There were no significant correlations between 25(OH)D and both BMI and age, but 25(OH)D was significantly associated with educational level (p = 0.03). There was a significant difference in 25(OH)D levels according to season (p < 0.001) and a significant association between 25(OH)D and the reported weekly hours of sun exposure (r = 0.1, p = 0.032), but not with the reported sunscreen use. Fish consumption was positively associated with 25(OH)D levels (p = 0.018), while milk, dairy product or egg consumption did not achieve any significant relationship. In a stepwise linear regression analysis, fish consumption and season were the only independent predictors of 25(OH)D levels (p = 0.007 and p = 0.0001 respectively). Vitamin D deficiency is common among hospital workers. This finding reinforces the need for vitamin D supplementation in these high-risk populations.

Hepatitis B and C status among health care workers in the five main hospitals in eastern Libya.

PubMed

Elzouki, Abdel-Nasser; Elgamay, Salwa M; Zorgani, Abdeulaziz; Elahmer, Omer

2014-01-01

The aim of the present study was to determine the frequency of hepatitis B and C transmission to health care workers (HCWs) in five major hospitals in eastern Libya and to analyze how the risk of these infections are affected by the type of occupation, hospital work place and working period. From July 2008 to June 2009, 601 HCWs (mean age: 32.90 ± 8.85 years) were tested for HBV and HCV markers using ELISA techniques. Polymerase chain reaction (PCR) was performed on all positive samples of HBsAg and Anti-HCV antibody to determine the level of HBV-DNA and HCV-RNA viremia, respectively. The overall frequency of HBsAg positivity was 1.8%. Anti-HBc, HBeAg and Anti-HBe antibodies were found in 8.5%, 0.7% and 8.0% of samples, respectively. The HBV-DNA level was positive in 55% of all HBsAg-positive samples. Approximately half of the HCWs (51.4%) were Anti-HBs antibody positive. The overall positivity rate of Anti-HCV antibodies was 2.0%, and HCV-RNA was positive in 33.3% of these samples. Overall, 52% of HCWs reported receiving full vaccination doses (three doses) against HBV infection. Among them, anti-HBs positivity was approximately 98.0%. 3.9% of those who never received any HBV vaccination dose were HBsAg positive, compared to 1.3% HBsAg positive in those HCWs who had received one or two doses of hepatitis B vaccine (p=0.01 for all comparisons). Nurses and nurse-aides had the highest rates of both HBsAg and Anti-HCV among the studied HCWs (HBsAg: 2.1% and 3.2%; Anti-HCV: 3.2% and 4.9%, respectively). It is noteworthy that doctors also had a relatively high prevalence rate of Anti-HCV (2.2%). Obstetric wards, isolation room, dialysis units and dentist work places had higher frequencies of HBV. HCV was found to be higher in the medical and surgical wards (the prevalence varied between 3% and 5.6%). There was no significant difference between HBsAg status and the work period of HCWs. In conclusion, universal precautions should be applied for the care of all patients

Organization of infection control in European hospitals.

PubMed

Hansen, S; Zingg, W; Ahmad, R; Kyratsis, Y; Behnke, M; Schwab, F; Pittet, D; Gastmeier, P

2015-12-01

The Prevention of Hospital Infections by Intervention and Training (PROHIBIT) survey was initiated to investigate the status of healthcare-associated infection (HCAI) prevention across Europe. This paper presents the methodology of the quantitative PROHIBIT survey and outlines the findings on infection control (IC) structure and organization including management's support at the hospital level. Hospitals in 34 countries were invited to participate between September 2011 and March 2012. Respondents included IC personnel and hospital management. Data from 309 hospitals in 24 countries were analysed. Hospitals had a median (interquartile range) of four IC nurses (2-6) and one IC doctor (0-2) per 1000 beds. Almost all hospitals (96%) had defined IC objectives, which mainly addressed hand hygiene (87%), healthcare-associated infection reduction (84%), and antibiotic stewardship (66%). Senior management provided leadership walk rounds in about half of hospitals, most often in Eastern and Northern Europe, 65% and 64%, respectively. In the majority of hospitals (71%), sanctions were not employed for repeated violations of IC practices. Use of sanctions varied significantly by region (P < 0.001), but not by countries' healthcare expenditure. There is great variance in IC staffing and policies across Europe. Some areas of practice, such as hand hygiene, seem to receive considerably more attention than others that are equally important, such as antibiotic stewardship. Programmes in IC suffer from deficiencies in human resources and local policies, ubiquitous factors that negatively impact on IC effectiveness. Strengthening of IC policies in European hospitals should be a public health priority. Copyright © 2015. Published by Elsevier Ltd.

Comparison of seropositivity of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis among Hospital Cornea Retrieval Programme-Donors versus voluntary cornea donors at a large eye bank in Eastern India.

PubMed

Basak, Soham; Basak, Samar K; Biswas, Bani

2017-11-01

To compare the serology profile of donors from Hospital Cornea Retrieval Programme-donors (HCRP-D) and voluntary cornea donors (VC-D) from a large eye bank in Eastern India. This is a retrospective analysis of donor details from January 2011 to December 2016. Donor demographics, cause of death, and serology reports were compiled. Postmortem blood was tested for human immunodeficiency virus 1 and 2 (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis using government-approved kits as per the National Programme for Control of Blindness Standards of Eye Banking. Donors for whom serology was not possible were excluded. A total of 4300 of 4353 donors were included of which 74.3% were hospital donors and 25.7% were voluntary donors. A total of 93 (2.2%) donors with 94 seropositive reports were noted: 79 (84.9%) from HCRP-D and 14 (15.1%) from VC-D which was statistically significantly higher (P = 0.02). Among seropositive reports, HIV, HBV, HCV, and syphilis accounted for 12 (12.8%), 38 (40.4%), 36 (38.3%), and eight (8.5%), respectively. There was no correlation between the cause of death and seropositivity. A statistically significant decreasing trend in seroprevalence among hospital donors was observed over the years (5.3% in 2011 to 1.4% in 2016; P = 0.004). Two (0.47%) of 421 hospital donors with prior negative serology were found to be seropositive. Seropositive rates are significantly higher among hospital donors in spite of medical prescreening compared to nonscreened voluntary donors. Serology should be repeated even when prior reports are available.

Poor practice and knowledge among traditional birth attendants in Eastern Sudan.

PubMed

Ali, A A; Siddig, M F

2012-11-01

To identify and understand knowledge and practice among traditional birth attendants (TBAs), a total of 111 TBAs were interviewed at Kassala, Eastern Sudan between March and April 2011. Hand-washing prior to the delivery was a universal practice but only 25.2% of the interviewed TBAs used sterilised equipment. TBAs in this study appeared to have a low level of awareness about when a mother should be referred to hospital, and lacked basic information on family planning and HIV/AIDS. None of these 111 TBAs knew or used equipment for neonatal resuscitation (such as bag, tube and mask) or knew neonatal signs that needed extra attention such as change in skin colour, weak suckling and respiratory distress, and nearly one-third (28.8%) of the respondents believed in a few days delay in milk production. Thus, substantial effort is needed to improve the knowledge and practice among TBAs in Eastern Sudan, including training programmes, and this might be the best hope to achieve the Millennium Development Goals.

[Brief history of the First Hospital of Harbin City (1913-2013)].

PubMed

Ji, Y; Li, Z P

2017-03-28

In 1913, after the Russian Prostitutes Sanatorium of Harbin Eastern Railway was received by the board of directors, they established the "Harbin City Board Hospital" and funded its expansion. In March 1926, the provisional Committee of the Harbin autonomous renamed the "City Board of First Hospital" to "The Public Hospital" . In November 1926, "The Public Hospital" was renamed as "Harbin Special Municipal Hospital" by the Harbin City Council and further funds were invested in its construction. In 1931, the Japanese invaded Northeast China, and controlled the "City Hospital" . In 1946, when Harbin was liberated, after the Communist's take-over of the Hospital, it developed sustainedly since then. From 1946-1949, The First Hospital of Harbin City dispatched manpower, material resources, and financial resources to support the people's Liberation Army, establishedthe medical service team, received and treated the wounded. From the 1930s, the Hospital was involved in the treatment of cholera, plague, scarlet fever, typhus and other infectious diseases, and participated in the medical rescue in Wenchuan of Sichuan and Xinjiang Aletai area. From 1928, the Hospital took over from Binjiang Hospital as the Teaching Hospital of Harbin Medical School, and later became the Harbin Medical University Teaching Hospital. It made contribution to the training of medical students.

Airway accidents in critical care unit: A 3-year retrospective study in a Public Teaching Hospital of Eastern India

PubMed Central

Dasgupta, Sugata; Singh, Shipti Shradha; Chaudhuri, Arunima; Bhattacharya, Dipasri; Choudhury, Sourav Das

2016-01-01

Background: Although tracheal tubes are essential devices to control and protect airway in a critical care unit (CCU), they are not free from complications. Aims: To document the incidence and nature of airway accidents in the CCU of a government teaching hospital in Eastern India. Methods: Retrospective analysis of all airway accidents in a 5-bedded (medical and surgical) CCU. The number, types, timing, and severity of airway accidents were analyzed. Results: The total accident rate was 19 in 233 intubated and/or tracheostomized patients over 1657 tube days (TDs) during 3 years. Fourteen occurred in 232 endotracheally intubated patients over 1075 endotracheal tube (ETT) days, and five occurred in 44 tracheostomized patients over 580 tracheostomy TDs. Fifteen accidents were due to blocked tubes. Rest four were unplanned extubations (UEs), all being accidental extubations. All blockages occurred during night shifts and all UEs during day shifts. Five accidents were mild, the rest moderate. No major accident led to cardiorespiratory arrest or death. All blockages occurred after 7th day of intubation. The outcome of accidents were more favorable in tracheostomy group compared to ETT group (P = 0.001). Conclusions: The prevalence of airway accidents was 8.2 accidents per 100 patients. Blockages were the most common accidents followed by UEs. Ten out of the 15 blockages and all 4 UEs were in endotracheally intubated patients. Tracheostomized patients had 5 blockages and no UEs. PMID:27076709

Outcomes of Middle Eastern Patients Undergoing Percutaneous Coronary Intervention: The Primary Analysis of the First Jordanian PCI Registry.

PubMed

Alhaddad, Imad A; Tabbalat, Ramzi; Khader, Yousef; Al-Mousa, Eyas; Izraiq, Mahmoud; Nammas, Assem; Jarrah, Mohammad; Saleh, Akram; Hammoudeh, Ayman

2017-01-01

This is a prospective multicenter registry designed to evaluate the incidence of adverse cardiovascular events in Middle Eastern patients undergoing percutaneous coronary interventions (PCI). The registry was also designed to determine the predictors of poor outcomes in such patients. We enrolled 2426 consecutive patients who underwent PCI at 12 tertiary care centers in Jordan between January 2013 and February 2014. A case report form was used to record data prospectively at hospital admission, discharge, and 12 months of follow-up. Mean age was 56 ± 11 years, females comprised 21% of the study patients, 62% had hypertension, 53% were diabetics, and 57% were cigarette smokers. Most patients (77%) underwent PCI for acute coronary syndrome. In-hospital and 1-year mortality rates were 0.78% and 1.94%, respectively. Definite or probable stent thrombosis occurred in 9 patients (0.37%) during hospitalization and in 47 (1.94%) at 1 year. Rates of target vessel repeat PCI and coronary artery bypass graft surgery at 1 year were 3.4% and 0.6%, respectively. The multivariate analysis revealed that cardiogenic shock, congestive heart failure, ST-segment deviation, diabetes, and major bleeding were significantly associated with higher risk of 1-year mortality. In this first large Jordanian registry of Middle Eastern patients undergoing PCI, patients treated were relatively young age population with low in-hospital and 1-year adverse cardiovascular events. Certain clinical features were associated with worse outcomes and may warrant aggressive therapeutic strategies.

Severe acute pulmonary haemorrhage and haemoptysis in ten dogs following eastern brown snake (Pseudonaja textilis) envenomation: Clinical signs, treatment and outcomes.

PubMed

Leong, Oriana S; Padula, Andrew M; Leister, Ellie

2018-05-29

This report describes a series of ten cases of fulminant pulmonary haemorrhage in dogs following envenomation by the eastern brown snake (Pseudonaja textilis) in south eastern Queensland, Australia. All cases were presented for veterinary treatment during 2011-2018 at a specialist veterinary emergency centre. Each case received prompt antivenom treatment and supportive care. Pulmonary haemorrhage was diagnosed based on clinical examination; overt haemoptysis; thoracic radiographic demonstration of a diffuse alveolar pattern; and, the presence of venom induced consumptive coagulopathy. The median elapsed time from hospital admission to onset of haemoptysis was 2 h (range 0-18 h). In 80% (8/10) of cases endotracheal intubation was required, whilst 20% (2/10) were successfully treated with mask oxygen supplementation alone, and 40% (4/10) received mechanical ventilation; but only 25% (1/4) of these survived to hospital discharge. Fresh frozen canine plasma was administered to 70% (7/10) of cases and 43% (3/7) of these survived. Of the total number of cases presented for treatment, 30% (3/10) survived to hospital discharge, 60% (6/10) were euthanised due to poor prognosis and 10% (1/10) died from cardiac arrest. Initial serum brown snake venom antigen levels were retrospectively measured from frozen serum samples by venom specific sandwich ELISA in two dogs at 154 ng/mL (survived) and 3607 ng/mL (euthanised); no free venom was detected post-antivenom. Dogs that survived were discharged from hospital without apparent complications. Pulmonary haemorrhage is an uncommon event following envenomation by P. textilis in dogs and has not been described in similarly envenomed humans. This case series highlights the potential for fulminant and fatal pulmonary haemorrhage in dogs following eastern brown snake envenomation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Transplant tourism among kidney transplant patients in Eastern Nigeria.

PubMed

Okafor, U H

2017-07-05

Transplant tourism entails movement of recipient, donor or both to a transplant centre outside their country of residence. This has been reported in many countries; and has variously been associated with organ trade. The objective of this study is to determine the frequency and pattern of transplant tourism among transplant patients in Eastern Nigeria. This is a non randomized cross sectional study. All kidney transplant patients who presented at Enugu State University Teaching Hospital Parklane Enugu and Hilton Clinics Port Harcourt in Nigeria were recruited. The clinical parameters including the transplant details of all the patients were documented. The data obtained was analysed using SPSS package. A total of one hundred and twenty six patients were studied, 76.2% were males with M:F ratio of 3.2:1 and mean age of 46.9 ± 13.3 years. Fifty four and 58.7% of the patients were managed in a tertiary hospital and by a nephrologist respectively before referral for kidney transplant. Only 15.8% of the patients had their kidney transplant without delay: finance, lack of donor, logistics including delay in obtaining travelling documents were the common causes of the delay. Ninety percent of the patients had their transplant in India with majority of them using commercial donors. India was also the country with cheapest cost ($18,000.00). 69.8% were unrelated donors, 68.2% were commercial donors and 1.6% of the donors were spouse. All the commercial donors received financial incentives and each commercial donor received mean of 7580 ± 1280 dollars. Also 30.2% of the related donors demanded financial incentive. Transplant tourism is prevalent in eastern Nigeria.

Cancer incidence in eastern Morocco: cancer patterns and incidence trends, 2005-2012.

PubMed

Elidrissi Errahhali, Manal; Elidrissi Errahhali, Mounia; Ouarzane, Meryem; Boulouiz, Redouane; Bellaoui, Mohammed

2017-08-29

Cancer is one of the major health problems worldwide. In this article, we present for the first time the cancer incidence trends, the distribution and the socioeconomic profile of incident cancer cases in Eastern Morocco over a period of eight years. Retrospective descriptive study of patients diagnosed with cancer at the Hassan II Regional Oncology Center (ROC) since it was created in October 2005 until December 2012. During the study period, the ROC was the only hospital specialized in cancer care in Eastern Morocco. A total of 7872 incident cases of cancer were registered in Eastern Morocco. Among these incident cases 5220 cases were women and 2652 were men, with a female to male ratio of 1.97. The mean age at diagnosis was 58 years for males and 52 for females and 94% of the patients aged over 30 years. For both sexes combined and for all cancer sites, breast cancer was the commonest followed by cervix uteri, colon-rectum, lung, nasopharynx, and stomach cancers. The most common cancer in women was breast cancer, followed respectively by cervix uteri cancer, colon-rectum cancer, ovary cancer, and stomach cancer. In men, the lung cancer ranked first, followed respectively by colon-rectum cancer, nasopharynx cancer, prostate cancer, and stomach cancer. For most cancers, crude incidence rates (CR) have increased significantly. The CR for all cancers combined has increased from 56.6 to 80.3 per 100,000 females and from 32.3 to 42.6 per 100,000 males during the study period. Patients profile analysis showed that 79% of cancer patients were from urban areas, 83% were unemployed and 85% had no health insurance. The distribution of cancers in Eastern Morocco is different from those observed in other regions of Morocco. Unlike most countries, women were much more affected with cancer than men in Eastern Morocco. More importantly, the rates of many cancers are rising. Therefore, our data justify the need to develop effective programs for cancer control and prevention in

75 FR 68397 - DeQueen and Eastern Railroad, LLC-Acquisition and Operation Exemption-DeQueen and Eastern...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... Eastern Railroad, LLC--Acquisition and Operation Exemption--DeQueen and Eastern Railroad Company DeQueen and Eastern Railroad, LLC (DQE), a noncarrier, has filed a verified notice of exemption under 49 CFR 1150.31 to acquire from DeQueen and Eastern Railroad Company and to operate approximately 47 miles of...

Exploring Geographic Variability in Cancer Prevalence in Eastern Morocco: A Retrospective Study over Eight Years.

PubMed

Elidrissi Errahhali, Manal; Elidrissi Errahhali, Mounia; Abda, Naima; Bellaoui, Mohammed

2016-01-01

Malignant diseases have been believed to be more common in some areas of Eastern Morocco, but until now, cancer patterns have not been reported for this region. In this paper we present for the first time the cancer prevalence analysis in Eastern Morocco. Cross-sectional study carried out among all patients diagnosed and/or treated with cancer at the Hassan II Regional Oncology Center (ROC) since it was established in October 2005 until December 2012. The ROC is the only hospital specialized in cancer care in Eastern Morocco. A total of 8,508 cases of cancer were registered among residents in Eastern Morocco, with a female to male ratio of 2.1. The mean age at diagnosis was 53.9 ± 15.2 years (median age = 53 years). Thus, unlike in Western countries, cancer in Eastern Morocco afflicts younger population. The areas of Eastern Morocco did not differ significantly by mean age at diagnosis (p = 0.061). However, these regions differed significantly by sex ratio (p < 0.001). The highest sex ratio was observed in Figuig, with a female to male ratio of 3.1 (75.4% of the registered case were females), followed respectively by Taourirt, Oujda-Angad, Berkane, Nador-Driouch and Jerada. Clear variation in the distribution of cancer types between areas of Eastern Morocco was observed, both in males and females (p < 0.001). Furthermore, the areas of Eastern Morocco differed significantly by cancer prevalence (p < 0.001). The highest age-standardized five-year prevalence proportion was observed in Oujda-Angad with 420.2 per 100,000, followed respectively by Berkane (311.4), Jerada (287.8), Taourirt (269.3), Nador-Driouch (213.6) and Figuig (194.4). Trends in the five-year prevalence proportions decreased in Oujda-Angad, Berkane and Jerada throughout the study period, while an increasing trend was observed in Nador-Driouch, Taourirt and Figuig. For the first time, our study presents the pattern and distribution of diagnosed cancers in Eastern Morocco. Our study illustrates

Exploring Geographic Variability in Cancer Prevalence in Eastern Morocco: A Retrospective Study over Eight Years

PubMed Central

Abda, Naima; Bellaoui, Mohammed

2016-01-01

Background Malignant diseases have been believed to be more common in some areas of Eastern Morocco, but until now, cancer patterns have not been reported for this region. In this paper we present for the first time the cancer prevalence analysis in Eastern Morocco. Methods Cross-sectional study carried out among all patients diagnosed and/or treated with cancer at the Hassan II Regional Oncology Center (ROC) since it was established in October 2005 until December 2012. The ROC is the only hospital specialized in cancer care in Eastern Morocco. Results A total of 8,508 cases of cancer were registered among residents in Eastern Morocco, with a female to male ratio of 2.1. The mean age at diagnosis was 53.9 ± 15.2 years (median age = 53 years). Thus, unlike in Western countries, cancer in Eastern Morocco afflicts younger population. The areas of Eastern Morocco did not differ significantly by mean age at diagnosis (p = 0.061). However, these regions differed significantly by sex ratio (p < 0.001). The highest sex ratio was observed in Figuig, with a female to male ratio of 3.1 (75.4% of the registered case were females), followed respectively by Taourirt, Oujda-Angad, Berkane, Nador-Driouch and Jerada. Clear variation in the distribution of cancer types between areas of Eastern Morocco was observed, both in males and females (p < 0.001). Furthermore, the areas of Eastern Morocco differed significantly by cancer prevalence (p < 0.001). The highest age-standardized five-year prevalence proportion was observed in Oujda-Angad with 420.2 per 100,000, followed respectively by Berkane (311.4), Jerada (287.8), Taourirt (269.3), Nador-Driouch (213.6) and Figuig (194.4). Trends in the five-year prevalence proportions decreased in Oujda-Angad, Berkane and Jerada throughout the study period, while an increasing trend was observed in Nador-Driouch, Taourirt and Figuig. Conclusions For the first time, our study presents the pattern and distribution of diagnosed cancers in Eastern

Managing Eastern Redceder

Treesearch

E.R. Ferguson; E.R. Lawson; W.R. Maple; C. Mesavage

1968-01-01

Eastern redcedar (Juniperus virginiana L.) is the most widely distributed conifer of tree size in the Eastern United States (48). Its range also extends into southeastern Canada. The wood was once favored for domestic use and export because of its exceptional cutting qualities, durability, rich color, and aroma. It has now lost much of its...

Cancers in Eastern Libya: First results from Benghazi Medical Center

PubMed Central

Bodalal, Zuhir; Azzuz, Raouf; Bendardaf, Riyad

2014-01-01

AIM: To study the pattern of cancer incidence and determine the incidence rates in Eastern Libya (for the first time in a decade). METHODS: A hospital-based registry of cancer patients was formed using records from the primary oncology center in eastern Libya - focusing on those diagnosed in the year 2012. RESULTS: The most common malignancies in men were cancers of the colon (22.3%, n = 90), lung (20.3%, n = 82), prostate (16.1%, n = 65), pancreas (4.2%, n = 17) and liver (4.2%, n = 17). For women, they were found to be cancers of the breast (41.5%, n = 213), colon (16.4%, n = 84), uterus (8%, n = 41), ovary (5.5%, n = 28) and pancreas (3.1%, n = 16). Additionally age-standardized rates (ASR) were determined for Libya. The different cities and towns in eastern Libya were compared for any variation. The city of Beida in particular was found to have a remarkably high incidence of gastric cancer. The different findings were discussed and comparisons were made with past literature as well as the incidence rates for neighbouring countries. The incidence rates given for the eastern region showed differences from previously reported values (i.e., the rate of colon cancer was the highest in North Africa whereas other malignancies occurred less frequently). Potential explanations for the urban-rural difference as well as the difference in incidence rates were put forth. The significance of this study is that it establishes a baseline of cancer incidence which should be the backbone for any future national cancer plan in Libya. CONCLUSION: Proper surveillance programs need to be in place and healthcare policy should be adjusted to take into account the more prevalent and pressing cancers in society. PMID:24876750

Cancers in Eastern Libya: first results from Benghazi Medical Center.

PubMed

Bodalal, Zuhir; Azzuz, Raouf; Bendardaf, Riyad

2014-05-28

To study the pattern of cancer incidence and determine the incidence rates in Eastern Libya (for the first time in a decade). A hospital-based registry of cancer patients was formed using records from the primary oncology center in eastern Libya - focusing on those diagnosed in the year 2012. The most common malignancies in men were cancers of the colon (22.3%, n = 90), lung (20.3%, n = 82), prostate (16.1%, n = 65), pancreas (4.2%, n = 17) and liver (4.2%, n = 17). For women, they were found to be cancers of the breast (41.5%, n = 213), colon (16.4%, n = 84), uterus (8%, n = 41), ovary (5.5%, n = 28) and pancreas (3.1%, n = 16). Additionally age-standardized rates (ASR) were determined for Libya. The different cities and towns in eastern Libya were compared for any variation. The city of Beida in particular was found to have a remarkably high incidence of gastric cancer. The different findings were discussed and comparisons were made with past literature as well as the incidence rates for neighbouring countries. The incidence rates given for the eastern region showed differences from previously reported values (i.e., the rate of colon cancer was the highest in North Africa whereas other malignancies occurred less frequently). Potential explanations for the urban-rural difference as well as the difference in incidence rates were put forth. The significance of this study is that it establishes a baseline of cancer incidence which should be the backbone for any future national cancer plan in Libya. Proper surveillance programs need to be in place and healthcare policy should be adjusted to take into account the more prevalent and pressing cancers in society.

Preferred nasolabial angle in Middle Eastern population.

PubMed

Alharethy, Sami

2017-05-01

To define the preferred nasolabial angle measurement in Middle Eastern population. An observational study was conducted from January 2012 to January 2016 at the Department of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia. A total of 1027 raters, 506 males, and 521 females were asked to choose the most ideal nasolabial angle for 5 males and 5 females lateral photographs whose nasolabial angle were modified with Photoshop into the following angles (85°, 90°, 95°, 100°, 105°, and 110°). Male raters preferred the angle of 89.5° ± 3.5° (mean ± SD) for males and 90.8° ± 5.6° for females. While female raters preferred the angle of 89.3° ± 3.8° for males and 90.5° ± 4.8° for females. ANOVA test compare means among groups: p: 0.342, and there is no statistically significant difference between groups. The results of our study showed an even more acute angles than degrees found in the literature. It shows that what young generation in our region prefers and clearly reflects that what could be explained as under rotation of the nasal tip in other cultures is just the ideal for some Middle Eastern population.

Retail food reform: How to effectively bridge what we say and what we do in our hospital settings.

PubMed

Dojeiji, Laurie; Taylor, Andra; Boland, Cholly; Brennan, Carolyn; Penney, Randy

2017-03-01

Hospital leaders in Eastern Ontario, Canada, have acknowledged the critical role of food to health and the need for progressive change that goes beyond personal responsibility paradigms. The Healthy Foods in Champlain Hospitals program aims to create supportive, healthy nutrition environments in hospital retail food settings. Twenty independent hospital corporations have collectively initiated a plan to transition cafeteria, vending, franchise, and volunteer operations towards healthier offerings. Hospitals are actively implementing a set of progressively phased, evidence-based nutrition criteria, which cover food and beverage categories, preparation methods, product placement, and provision of nutrition information. Implementation strategies and successes, as well as challenges and limitations, are discussed.

Off-label and unlicensed drug use in hospitalized newborns in a Saudi tertiary care hospital: a cohort study.

PubMed

Mazhar, Faizan; Akram, Shahzad; Haider, Nafis; Hadi, Muhammad Abdul; Sultana, Jabeen

2018-06-01

Objective To determine the extent of off-label and unlicensed prescribing in hospitalized newborns and to identify patient-related risk factors associated with off-label prescribing. Methods A prospective cohort study was conducted between January and March 2016 at a neonatology department of a tertiary-care hospital in the Eastern province. All consecutive admissions to all neonatal care levels meeting the inclusion and exclusion criteria were eligible for enrollment. All prescriptions were classified as off-label or unlicensed according to drug product monograph. Clinical and prescription data were extracted using a pilot-tested structured data collection sheet. Results During the study period 583 prescriptions were made for 138 newborns, of which 29.7% (173/583) and 12.9% (75/583) were classified as off-label and unlicensed drugs respectively for use in neonates. Thirty-four percent (47/138) of patients received at least one off-label/unlicensed medicine. Mechanical ventilation, admission to the neonatal intensive care unit and length of hospital stay were identified as independent risk factors associated with prescribing of at least one off-label medication. Conclusion Use of off-label and unlicensed drugs in hospitalized newborns seems to be a common practice in this Saudi hospital. Future research should evaluate safety and efficacy of off-label and/or unlicensed use of drugs in neonates.

Intercontinental and intracontinental biogeography of the eastern Asian - Eastern North American disjunct Panax (the ginseng genus, Araliaceae), emphasizing its diversification processes in eastern Asia.

PubMed

Zuo, Yun-Juan; Wen, Jun; Zhou, Shi-Liang

2017-12-01

The intercontinental biogeography between eastern Asia and eastern North America has attracted much attention from evolutionary biologists. Further insights into understanding the evolution of the intercontinental disjunctions have been hampered by the lack of studies on the intracontinental biogeography in eastern Asia, a region with complex geology, geography, climates and habitats. Herein we studied the biogeographic history of the eastern Asian-eastern North American disjunct genus Panax with special emphasis on the investigation of its uneven diversification in Asia. This study reconstructs the diversification history of Panax and also emphasizes a large clade of Panax taxa, which has a wide distribution in eastern Asia, but was unresolved in previous studies. We examined the noncoding plastid DNA fragments of trnH-psbA, rps16, and psbM-trnD, the mitochondrial b/c intron of NAD1, and the nuclear ribosomal internal transcribed spacer (ITS) region of 356 samples from 47 populations. The results revealed the subtropical Northern Hemisphere origin (Asia or Asia and North America) of Panax in the Paleocene. Intercontinental disjunctions between eastern Asia and eastern North America formed twice in Panax, once estimated in early Eocene for the split of P. trifolius and another in mid-Miocene for the divergence of P. quinquefolius. Intercontinental diversifications in Panax showed temporal correlation with the increase of global temperature. The evolutionary radiation of the P. bipinnatifidus species complex occurred around the boundary of Oligocene and Miocene. Strong genetic structure among populations of the species complex was detected and the populations may be isolated by distance. The backbone network and the Bayesian clustering analysis revealed a major evolutionary radiation centered in the Hengduan Mountains of western China. Our results suggested that the evolutionary radiation of Panax was promoted by geographic barriers, including mountain ranges

[From the history of organization of medical care to population in cities of the north-eastern Caucasus in XIX--early XX centuries].

PubMed

2013-01-01

The article deals with becoming of urban health care in the region of the north-eastern Caucasus in XIX--early XX centuries. The characteristics and stages of development of medical care in cities appeared grew from military fortifications and fortresses in the meddle of XIX century are established. The first curative institutions in cities were military hospitals and infirmaries. Later on appeared clinics of philanthropic societies and even later on hospitals functioning on municipality funds and private curative establishments.

ICT applications as e-health solutions in rural healthcare in the Eastern Cape Province of South Africa.

PubMed

Ruxwana, Nkqubela L; Herselman, Marlien E; Conradie, D Pieter

Information and Communication Technology (ICT) solutions (e.g. e-health, telemedicine, e-education) are often viewed as vehicles to bridge the digital divide between rural and urban healthcare centres and to resolve shortcomings in the rural health sector. This study focused on factors perceived to influence the uptake and use of ICTs as e-health solutions in selected rural Eastern Cape healthcare centres, and on structural variables relating to these facilities and processes. Attention was also given to two psychological variables that may underlie an individual&s acceptance and use of ICTs: usefulness and ease of use. Recommendations are made with regard to how ICTs can be used more effectively to improve health systems at fi ve rural healthcare centres where questionnaire and interview data were collected: St. Lucy&s Hospital, Nessie Knight Hospital, the Tsilitwa Clinic, the Madzikane Ka-Zulu Memorial Hospital and the Nelson Mandela General Hospital.

Within the triangle of healthcare legacies: comparing the performance of South-Eastern European health systems.

PubMed

Jakovljevic, Mihajlo Michael; Arsenijevic, Jelena; Pavlova, Milena; Verhaeghe, Nick; Laaser, Ulrich; Groot, Wim

2017-05-01

Inter-regional comparison of health-reform outcomes in south-eastern Europe (SEE). Macro-indicators were obtained from the WHO Health for All Database. Inter-regional comparison among post-Semashko, former Yugoslavia, and prior-1989-free-market SEE economies was conducted. United Nations Development Program Human Development Index growth was strongest among prior-free-market SEE, followed by former Yugoslavia and post-Semashko. Policy cuts to hospital beds and nursing-staff capacities were highest in post-Semashko. Physician density increased the most in prior-free-market SEE. Length of hospital stay was reduced in most countries; frequency of outpatient visits and inpatient discharges doubled in prior-free-market SEE. Fertility rates fell for one third in Post-Semashko and prior-free-market SEE. Crude death rates slightly decreased in prior-free-market-SEE and post-Semashko, while growing in the former Yugoslavia region. Life expectancy increased by 4 years on average in all regions; prior-free-market SEE achieving the highest longevity. Childhood and maternal mortality rates decreased throughout SEE, while post-Semashko countries recorded the most progress. Significant differences in healthcare resources and outcomes were observed among three historical health-policy legacies in south-eastern Europe. These different routes towards common goals created a golden opportunity for these economies to learn from each other.

Multinational operations of US for-profit hospital chains: trends and implications.

PubMed Central

Berliner, H S; Regan, C

1987-01-01

The expansion of United States for-profit hospital chains into the international arena is a new and important development. Experiences with contract management of middle eastern hospitals in the early 1970s gave the American firms impetus to pursue ownership of health facilities in other parts of the world. US companies now operate over 95 foreign hospitals. The reasons for this involvement include the political receptivity of the government of the host nation; the potential for rapid growth and profits; the lack of indigenous competition; and the ability to occupy a distinct niche within the extant health services organization. The political and ideological implications of the growth of private medicine, particularly in the United Kingdom, in terms of its effects on the National Health Service are discussed. Questions for future research are posed. PMID:3631360

Safety assessment methodology in management of spent sealed sources.

PubMed

Mahmoud, Narmine Salah

2005-02-14

Environmental hazards can be caused from radioactive waste after their disposal. It was therefore important that safety assessment methodologies be developed and established to study and estimate the possible hazards, and institute certain safety methodologies that lead and prevent the evolution of these hazards. Spent sealed sources are specific type of radioactive waste. According to IAEA definition, spent sealed sources are unused sources because of activity decay, damage, misuse, loss, or theft. Accidental exposure of humans from spent sealed sources can occur at the moment they become spent and before their disposal. Because of that reason, safety assessment methodologies were tailored to suit the management of spent sealed sources. To provide understanding and confidence of this study, validation analysis was undertaken by considering the scenario of an accident that occurred in Egypt, June 2000 (the Meet-Halfa accident from an iridium-192 source). The text of this work includes consideration related to the safety assessment approaches of spent sealed sources which constitutes assessment context, processes leading an active source to be spent, accident scenarios, mathematical models for dose calculations, and radiological consequences and regulatory criteria. The text also includes a validation study, which was carried out by evaluating a theoretical scenario compared to the real scenario of Meet-Halfa accident depending on the clinical assessment of affected individuals.

Eastern Europe's Silicon Rush

ERIC Educational Resources Information Center

Woodard, Colin

2007-01-01

This article presents how the fast expansion of information technology industry in eastern Slovakia is putting a strain on its labor supply. Suddenly, computer-science graduates have become one of the former Eastern Bloc's greatest assets, attracting multinational technology companies hungry for skilled programmers, technicians, and engineers.…

Inverted topographic features, now submerged beneath the water of Lake Nasser, document a morphostratigraphic sequence of high-amplitude late-Pleistocene climate oscillation in Egyptian Nubia

NASA Astrophysics Data System (ADS)

Giegengack, Robert; Zaki, Abdallah S.

2017-12-01

The Nile Valley between the Second Cataract at Wadi Halfa and the First Cataract at Aswan has been inundated behind two dams - the Aswan Dam, first built in 1902, and the High Dam (Sa'ad el A'ali), that blocked the flow of the Nile in 1964. The anticipated loss of archeological monuments in Lake Nasser, the reservoir behind the High Dam, initiated an international campaign to protect, move, or at least document as many of those monuments as possible.

Clinical characteristics and presentation of ameloblastomas: an 8-year retrospective study of 240 cases in Eastern Nigeria.

PubMed

Chukwuneke, F N; Anyanechi, C E; Akpeh, J O; Chukwuka, A; Ekwueme, O C

2016-05-01

Our aim was to summarise the clinical characteristics and presentation of ameloblastomas in eastern Nigeria. We organised a retrospective study of 240 patients who presented with ameloblastomas to the Oral and Maxillofacial Surgery units of five specialist hospitals in the eastern states of Nigeria over an eight-year period (2004-2011). We analysed the casenotes, and categorised the cases by site of tumour, age, sex, and time of presentation. There were 117 men (49%) (mean (SD) age 43 (6.2) years) and 123 women (51%) (mean (SD) age 32 (4.7) years), a male:female ratio of 1:1.1. The largest age group was 20-39 years (n=102, 43%), and the most common site was the anterior mandible (n=140, 58%). Most of the patients presented late. Our results show that the most common site of ameloblastomas in Eastern Nigeria is the anterior mandible and that women are affected more than men, which is at variance with the results of most other studies. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Incidence of multiple Herpesvirus infection in HIV seropositive patients, a big concern for Eastern Indian scenario.

PubMed

Chakraborty, Nilanjan; Bhattacharyya, Sohinee; De, Chandrav; Mukherjee, Anirban; Bhattacharya, Dwipayan; Santra, Shantanu; Sarkar, Rathindra N; Banerjee, Dipanjan; Guha, Shubhasish K; Datta, Utpal K; Chakrabarti, Sekhar

2010-07-06

Human immunodeficiency virus (HIV) infection is associated with an increased risk for human herpes viruses (HHVs) and their related diseases and they frequently cause disease deterioration and therapeutic failures. Methods for limiting the transmission of HHVs require a better understanding of the incidence and infectivity of oral HHVs in HIV-infected patients. This study was designed to determine the seroprevalence of human herpes viruses (CMV, HSV 2, EBV-1, VZV) antibodies and to evaluate their association with age, sex as well as other demographic and behavioral factors. A study of 200 HIV positive patients from Eastern India attending the Calcutta Medical College Hospital, Kolkata, West Bengal, Apex Clinic, Calcutta Medical College Hospital and ART Center, School of Tropical Medicine, Kolkata, West Bengal was done. Serum samples were screened for antibodies to the respective viruses using the indirect ELISA in triplicates.CytoMegalo virus (CMV), Herpes Simplex virus type 2 (HSV-2), Varicella Zoster virus (VZV), and Epstein Barr virus (EBV-1) were detected in 49%, 47%, 32.5%, and 26% respectively. This study has contributed baseline data and provided insights in viral OI and HIV co-infection in Eastern India. This would undoubtedly serve as a basis for further studies on this topic.

A SURVEY OF DISPOSITION OF PHYSICIANS TOWARDS PHYSICAL ACTIVITY PROMOTION AT TWO TERTIARY HOSPITALS IN NORTH-EASTERN NIGERIA.

PubMed

Oyeyemi, A Y; Usman, R B; Oyeyemi, A L

2016-12-01

A general presumption is that any advice from physicians would likely be taken seriously by patients, and patients are more likely to see their doctors in the event of any health complaints than any other health professionals. The perceptions and practice of Nigerian physicians on their role in physical activity promotion are not well known. This study aimed to determine the knowledge of physical activity message, confidence, role perceptions, barriers and feasibility of physical activity promotion among physicians in two tertiary health institutions in North-Eastern Nigeria. A total of 153 (84.5% response) physicians at the University of Maiduguri Teaching Hospital and Federal Medical Center Yola completed a previously developed questionnaire that elicited information on their knowledge, barrier, feasibility, role and confidence in physical activity promotion. Physicians in this study reported fairly good knowledge (mean score=14.7±2.2/20), minimal or little barrier to physical activity promotion (mean score=24.4±3.5/30), perceived physical activity promotion as their role (mean score=12.9±1.6/15), were confident in their ability to discuss and recommend exercises for physical activity promotion (mean score=7.9±1.3/ 10) and believed promoting physical activity was feasible for them (mean score=15.0±2.5/20). The physicians had good disposition to physical activity promotion (Mean score=78.5±6.7/100), but male physicians showed better disposition than their female counterparts. Overall these cohorts of physicians are somewhat knowledgeable on physical activity promotion and are positively disposed to promoting physical activity among their patients. These findings can be leveraged upon to optimize outcome of campaigns or interventions to change physical activity behaviour in Nigerian populace.

Phylogeography of Eastern Grey Kangaroos, Macropus giganteus, Suggests a Mesic Refugium in Eastern Australia.

PubMed

Coghlan, Brett A; Goldizen, Anne W; Thomson, Vicki A; Seddon, Jennifer M

2015-01-01

Phylogeographic studies around the world have identified refugia where fauna were able to persist during unsuitable climatic periods, particularly during times of glaciation. In Australia the effects of Pleistocene climate oscillations on rainforest taxa have been well studied but less is known about the effects on mesic-habitat fauna, such as the eastern grey kangaroo (Macropus giganteus). The eastern grey kangaroo is a large mammal that is common and widespread throughout eastern Australia, preferring dry mesic habitat, rather than rainforest. As pollen evidence suggests that the central-eastern part of Australia (southeast Queensland and northern New South Wales) experienced cycles of expansion in mesic habitat with contraction in rainforests, and vice versa during glacial and interglacial periods, respectively, we hypothesise that the distribution of the eastern grey kangaroo was affected by these climate oscillations and may have contracted to mesic habitat refugia. From 375 mitochondrial DNA control region sequences from across the distribution of eastern grey kangaroos we obtained 108 unique haplotypes. Phylogenetic analysis identified two clades in Queensland, one of which is newly identified and restricted to a small coastal region in southern Queensland north of Brisbane, known as the Sunshine Coast. The relatively limited geographic range of this genetically isolated clade suggests the possibility of a mesic habitat refugium forming during rainforest expansion during wetter climate cycles. Other potential, although less likely, reasons for the genetic isolation of the highly distinct clade include geographic barriers, separate northward expansions, and strong local adaptation.

Determinants of abortion among women admitted to hospitals in Fortaleza, North Eastern Brazil.

PubMed

Misago, C; Fonseca, W; Correia, L; Fernandes, L M; Campbell, O

1998-10-01

Maternal mortality from complications of unsafe abortion constitutes a serious problem in several developing countries. There is, however, a paucity of well-designed and implemented studies in this area, especially in Latin America. The aim of this paper is to present the findings on the determinants and medical characteristics of abortions among women admitted to hospitals. A descriptive cross-sectional hospital-based study was carried out between October 1992 and September 1993 in Fortaleza, Brazil. A Cox's proportional hazard model was used to estimate prevalence rate ratios after adjustment for confounding. Among 2074 (48%) women who admitted to terminating the pregnancy, 66% reported using misoprostol to induce abortion. Women with an induced abortion as compared with those with an unlikely induced abortion are younger, more often not married, have fewer children alive and experienced one or more previous induced abortions. We have not found any important differences with regard to complication or duration of stay in hospital. This finding, at odds with most previous studies, could reflect the special situation in Brazil where misoprostol is used for illegally-induced abortion. The use of misoprostol by this population may have contributed to the reduction of severe complications related to induced abortion which were most prevalent with more invasive methods. Recommendations are made as to the need for confirmatory studies as well as on information regarding cultural perceptions and concepts of abortion, and reasons why poor women fail to adopt available family planning methods.

Validation of patient and nurse short forms of the Readiness for Hospital Discharge Scale and their relationship to return to the hospital.

PubMed

Weiss, Marianne E; Costa, Linda L; Yakusheva, Olga; Bobay, Kathleen L

2014-02-01

To validate patient and nurse short forms for discharge readiness assessment and their associations with 30-day readmissions and emergency department (ED) visits. A total of 254 adult medical-surgical patients and their discharging nurses from an Eastern US tertiary hospital between May and November, 2011. Prospective longitudinal design, multinomial logistic regression analysis. Nurses and patients independently completed an eight-item Readiness for Hospital Discharge Scale on the day of discharge. Patient characteristics, readmissions, and ED visits were electronically abstracted. Nurse assessment of low discharge readiness was associated with a six- to nine-fold increase in readmission risk. Patient self-assessment was not associated with readmission; neither was associated with ED visits. Nurse discharge readiness assessment should be added to existing strategies for identifying readmission risk. © Health Research and Educational Trust.

Through Middle Eastern Eyes.

ERIC Educational Resources Information Center

Pearson, Robert P.; Clark, Leon E., Ed.

This book, intended for use with secondary and college students, presents a Middle Eastern view of the Middle East and the world. Most of the material in the book has been written by Middle Easterners, and it comes from a variety of sources including autobiographies, fiction, poetry, newspaper and magazine articles, letters, diaries,…

49 CFR 71.4 - Eastern zone.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Eastern zone. 71.4 Section 71.4 Transportation Office of the Secretary of Transportation STANDARD TIME ZONE BOUNDARIES § 71.4 Eastern zone. The second zone, the eastern standard time zone, includes that part of the United States that is west of 67°30″ W...

[Device-vigilance at University Hospital in Central Eastern Tunisia: a survey conducted among physicians].

PubMed

Mahjoub, Mohamed; Jedidi, Maher; Masmoudi, Tasnim; Bouafia, Nabiha; Njah, Mansour

2016-01-01

The University Hospital Farhat Hached Sousse (Tunisia), has implemented a device-vigilance (DV) system, according to ANCSEP (National Agency of the Sanitary and Environmental Control of Products) guidelines, in order to manage the risk more effectively in hospital and to improve the quality and safety of patient care. In Tunisia the lack of regulation regarding device vigilance is the major obstacle to caregiver vigilance. The objective of this study is to establish the knowledge, attitudes, and clinical practice of University Hospital physicians regarding the implementation of the DV system. We conducted a descriptive cross-sectional study of KAP (knowledge, attitudes and practices) among all the physicians working at the University Hospital Farhat Hached Sousse (Tunisia) who were users of medical devices (MDs) in the practice of their profession. A self-administered, pre-established and pre-testing questionnaire was developed. Data were collected and analyzed using SPSS20.0 software. The response rate was 51.9 % (183/95). A lack of knowledge about DV has been reported. More than half of the respondents didn't know the local correspondent of health establishment and the existence of a standardized vigilance reporting form. Regarding the attitudes, 89,5% express their interest in setting up a DV system and 37,5% acknowledged that the vigilance reporting form should be filled by the caregiver notifying the incident. Regarding the procedures, the majority of physicians confirmed the absence of an organized maintenance management of the MDs in the practice of their services. 90.5% express their wishes to receive information but few of them express their wishes to receive proper training (57.9%). A lack of information and training in a sensitive field which need to be heavily regulated has been a topic of discussion. The promulgation of regulatory texts is necessary in order to promote MD sector and guarantee the safety of patient and their users.

Spatial Analysis of Hospital Incidence and in Hospital Mortality of Abdominal Aortic Aneurysms in Germany: Secondary Data Analysis of Nationwide Hospital Episode (DRG) Data.

PubMed

Kuehnl, Andreas; Salvermoser, Michael; Erk, Alexander; Trenner, Matthias; Schmid, Volker; Eckstein, Hans-Henning

2018-06-01

This study aimed to analyze the spatial distribution and regional variation of the hospital incidence and in hospital mortality of abdominal aortic aneurysms (AAA) in Germany. German DRG statistics (2011-2014) were analysed. Patients with ruptured AAA (rAAA, I71.3, treated or not) and patients with non-ruptured AAA (nrAAA, I71.4, treated by open or endovascular aneurysm repair) were included. Age, sex, and risk standardisation was done using standard statistical procedures. Regional variation was quantified using systematic component of variation. To analyse spatial auto-correlation and spatial pattern, global Moran's I and Getis-Ord Gi* were calculated. A total of 50,702 cases were included. Raw hospital incidence of AAA was 15.7 per 100,000 inhabitants (nrAAA 13.1; all rAAA 2.7; treated rAAA 1.6). The standardised hospital incidence of AAA ranged from 6.3 to 30.3 per 100,000. Systematic component of variation proportion was 96% in nrAAA and 55% in treated rAAA. Incidence rates of all AAA were significantly clustered with above average values in the northwestern parts of Germany and below average values in the south and eastern regions. Standardised mortality of nrAAA ranged from 1.7% to 4.3%, with that of treated rAAA ranging from 28% to 52%. Regional variation and spatial distribution of standardised mortality was not different from random. There was significant regional variation and clustering of the hospital incidence of AAA in Germany, with higher rates in the northwest and lower rates in the southeast. There was no significant variation in standardised (age/sex/risk) mortality between counties. Copyright © 2018. Published by Elsevier B.V.

The Case of the Suzhou Hospital of National Medicine (1939-41): War, Medicine, and Eastern Civilization.

PubMed

Daidoji, Keiko; Karchmer, Eric I

2017-06-01

This article explores the founding of the Suzhou Hospital of National Medicine in 1939 during the Japanese occupation of Suzhou. We argue that the hospital was the culmination of a period of rich intellectual exchange between traditional Chinese and Japanese physicians in the early twentieth century and provides important insights into the modern development of medicine in both countries. The founding of this hospital was followed closely by leading Japanese Kampo physicians. As the Japanese empire expanded into East Asia, they hoped that they could revitalize their profession at home by disseminating their unique interpretations of the famous Treatise on Cold Damage abroad. The Chinese doctors that founded the Suzhou Hospital of National Medicine were close readers of Japanese scholarship on the Treatise and were inspired to experiment with a Japanese approach to diagnosis, based on new interpretations of the concept of "presentation" ( shō / zheng ). Unfortunately, the Sino-Japanese War cut short this fascinating dialogue on reforming medicine and set the traditional medicine professions in both countries on new nationalist trajectories.

Small mammal communities in eastern redcedar forest

USGS Publications Warehouse

Reddin, Christopher J.; Krementz, David G.

2016-01-01

Eastern redcedar (Juniperus virginiana) is a fire-intolerant tree species that has encroached into grassland ecosystems throughout central and eastern North America. Many land managers are interested in removing eastern redcedar to restore native grasslands. We surveyed small mammals using mark-recapture methods in eastern redcedar forest, warm-season grassland, and oldfield habitats in the Ozark region of northwest Arkansas. We conducted over 3300 trap-nights and captured 176 individuals belonging to eight small mammal species, primarily Peromyscus spp. and Reithrodonotmys fulvescens. While species diversity did not vary among habitats, small mammal species composition in eastern redcedar forest differed from that of warm-season grassland and oldfield habitats. The small mammal community of eastern redcedar forest is as diverse as the warm-season grasslands and oldfields it succeeds but replaces grassland associated small mammal species with forest associated species.

Hospital/clinical ethics committees' notion: an overview

PubMed Central

Hajibabaee, Fatemeh; Joolaee, Soodabeh; Cheraghi, Mohammad Ali; Salari, Pooneh; Rodney, Patricia

2016-01-01

Hospital ethics committees (HECs) help clinicians deal with the ethical challenges which have been raised during clinical practice. A comprehensive literature review was conducted to provide a historical background of the development of HECs internationally and describe their functions and practical challenges of their day to day work. This is the first part of a comprehensive literature review conducted between February 2014 and August 2016 by searching through scientific databases. The keyword ethics committee, combined with hospital, clinic, and institution, was used without a time limitation. All original and discussion articles, as well as other scientific documents were included. Of all the articles and theses found using these keywords, only 56 were consistent with the objectives of the study. Based on the review goals, the findings were divided into three main categories; the inception of HECs in the world, the function of HECs, and the challenges of HECs. According to the results, the Americas Region and European Region countries have been the most prominent considering the establishment of HECs. However, the majority of the Eastern Mediterranean Region and South-East Asia Region countries are only beginning to establish these committees in their hospitals. The results highlight the status and functions of HECs in different countries and may be used as a guide by health policymakers and managers who are at the inception of establishing these committees in their hospitals. PMID:28523118

The prevalence and outcome of excess body weight among Middle Eastern patients presenting with acute coronary syndrome.

PubMed

Hadi, Hadi A R; Zubaid, Mohammad; Al Mahmeed, Wael; El-Menyar, Ayman A; Alsheikh-Ali, Alawi A; Singh, Rajivir; Al-Nabti, Abdulrahman; Assad, Nidal; Sulaiman, Kadhim; Al-Mallah, Mouaz H; Amin, Haitham; Al-Motarreb, Ahmed; Mahmoud, Hisham; Al Suwaidi, Jassim

2010-07-01

We evaluated the effect of body weight on the outcome of Middle Eastern patients presenting with acute coronary syndrome (ACS). Analysis of the Gulf Registry of Acute Coronary Events (Gulf RACE) survey that included 7843 consecutive patients hospitalized with ACS was made. Patients were categorized as normal weight, overweight, or obese based on their body mass index (BMI). Overall, 67% of patients were overweight or obese; obese and overweight patients were more likely to be female and have diabetes mellitus, hypertension, dyslipidemia, and less likely to be smokers. In-hospital mortality, congestive heart failure, cardiogenic shock, and strokes were comparable between the groups, although patients with obesity were more likely to have recurrent ischemia and major bleeding complication in the ST-elevation myocardial infarction group. Excess body weight with ACS is associated with higher risk profile characteristics without an increase in hospital mortality or cardiovascular events.

Eastern Sources of Invitational Education.

ERIC Educational Resources Information Center

Ryback, David

1993-01-01

Presents historical perspective suggesting that invitational theory shares many beliefs with ancient Eastern philosophies. Submits that teachers and other educators who embrace the invitational perspective may benefit from an understanding of Eastern principles. Briefly describes Buddhism, Confucianism, Taoism, Zen Buddhism, and their relevance to…

Prevalence of blood parasites in eastern versus Western house finches: are eastern birds resistant to infection?

PubMed

Davis, Andrew K; Hood, Wendy R; Hill, Geoffrey E

2013-09-01

The rapid spread of the bacterial disease, Mycoplasma gallisepticum (MG), throughout the introduced range of house finches (Carpodacus mexicanus) in eastern North America, compared to its slower spread through the native western range, has puzzled researchers and highlights the need to understand the relative differences in health state of finches from both populations. We conducted a light-microscope survey of hemoparasites in populations of finches from Arizona (within the western range) and from Alabama (within the eastern range), and compared our estimates of prevalence to published reports from house finches sampled in both ranges. Of the 33 Arizona birds examined, we recorded hematozoan infections in 16 (48.5%) individuals, compared to 1 infected Alabama bird out of 30 birds examined (3.3%). Based on independent surveys of seven western North American and five eastern North American populations of house finches the average prevalence of blood parasites in western populations is 38.8% (±17.9 SD), while the average prevalence within the eastern range is only 5.9% (±6.1 SD). The average rate of infection among all songbirds sampled in the east is 34.2% (±4.8 SD). Thus, our surveys of wild birds as well as previously published observations point to eastern house finches having a much lower prevalence of blood parasite infections than their western counterparts. Combined with the fact that eastern finches also tend to have lower rates of avian pox infections than do western birds (based on a literature review), these observations suggest that eastern birds have either strong resistance to these infections or high susceptibility and associated mortality.

Species distribution and antifungal susceptibility patterns of Candida isolates from a public tertiary teaching hospital in the Eastern Cape Province, South Africa.

PubMed

Mnge, P; Okeleye, B I; Vasaikar, S D; Apalata, T

2017-05-15

Candida species are the leading cause of invasive fungal infections, and over the past decade there has been an increased isolation of drug resistant Candida species. This study aimed to identify the species distribution of Candida isolates and to determine their unique antifungal susceptibility and resistance patterns. During a cross-sectional study, 209 Candida isolates (recovered from 206 clinical samples) were collected and their species distribution was determined using ChromAgar Candida. The Vitek-2 system (Biomerieux, South Africa) was used to determine minimum inhibitory concentrations (MICs) to azoles (fluconazole, voriconazole), echinocandins (caspofungin, micafungin), polyenes (amphotericin B) and flucytosine. Four species of Candida were isolated, of which C. albicans was the most frequent, isolated in 45.4% (95/209) of the isolates, followed by C. glabrata: 31.1% (65/209). The MICs of the different antifungal drugs varied amongst the species of Candida. From the 130 isolates tested for MICs, 90.77% (112/130) were susceptible to all antifungal drugs and 6.9% (9/130) of the isolates were multi-drug resistant. C. dubliniensis (n=2) isolates were susceptible to all the above mentioned antifungal drugs. There was no significant difference in species distribution amongst clinical specimens and between patients' genders (P>0.05). An increase in MIC values for fluconazole and flucytosine towards the resistance range was observed. To our knowledge, this is the first report on surveillance of Candida species distribution and antifungal susceptibility at a public tertiary teaching hospital in Eastern Cape, South Africa.

Uniportal video assisted thoracoscopic lobectomy: primary experience from an Eastern center.

PubMed

Feng, Mingxiang; Shen, Yaxing; Wang, Hao; Tan, Lijie; Mao, Xuping; Liu, Yi; Wang, Qun

2014-12-01

Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy is an emerging technique for the surgical resection of non-small cell lung cancer (NSCLC). Besides its wide debates on safety and efficacy throughout the world, there were few report on uniportal VATS from the Eastern countries. In this article, we summarized our primary experience on uniportal VATS lobectomy in an Eastern center. From October 2013 till February 2014, 54 consecutive uniportal VATS lobectomy were performed in the Department of Thoracic Surgery, Zhongshan Hospital of Fudan University. Patients' clinical features and operative details were recorded. Post-operatively, the morbidity and mortality were recorded to analyze the safety and efficacy of uniportal VATS lobectomy for NSCLCs. Among the 54 planned uniportal VATS lobectomy, there was one conversion to mini-thoracotomy due to lymph node sticking. Extra ports were required in two patients. The uniportal VATS lobectomy was achieved in 51 out of 54 patients (94.4%). The average operation duration was 122.2±37.5 min (90-160 min). The average volume of estimated blood loss during the operation was 88.8±47.1 mL (50-200 mL). The mean chest tube duration and hospital stay were 3.2±1.9 days and 4.6±2.0 days, respectively. There was no postoperative mortality in this study. Two patients suffered from prolonged air leakage (5 and 7 days), and one atrial fibrillation was observed in this cohort. Based on our primary experience, uniportal VATS lobectomy is a safe and effective procedure for the surgical resection of NSCLCs. The surgical refinements and instrumental improvements would facilitate the technique. Further studies based on larger population are required to determine its benefits towards patients with NSCLCs.

Clinical and demographic features of pediatric burns in the eastern provinces of Turkey

PubMed Central

2011-01-01

Background The aim of this study is to perform a retrospective analysis of the causes of burns observed in children in the eastern provinces of Turkey. Method In this study, patients were studied retrospectively with regard to their age, sex, cause of burns, seasonal variations, social and economic factors, length of hospital stay, burned body surface area, medical history, site of injury, and mortality. Results A total of 125 patients undergoing inpatient treatment were male, (53.2%) and 110 were female (46.8%). The most common causes of burns in patients treated on an inpatient basis were scald burns (65.5%) and tandir burns (15.7%). The mean total body surface area of all the patients was 12.17+9.86%. When the patients were grouped according to tandir, cauldron, and others burn causes, a significant difference was seen between the in burn percentages caused by tandir and cauldron burns and other causes (p < 0.001). Higher burn percentages were seen for cauldron burns than for tandir burns (p < 0.05). The average length of hospital stay was 17.67+13.64 days. When the patients were grouped according to burn causes (tandir, cauldron, and others), a significant difference was determined between the hospitalization periods of patients with tandir burns and other burn causes (p = 0.001) The most commonly proliferating microorganism in burned areas was Pseudomonas aeruginosa (20.4%). Of the 235 patients, 61 were treated in operating rooms. During the 24-month period of the study, 2 of the 235 patients died (0.85%). Conclusion Pediatric burns in the eastern part of Turkey are different from those in other parts of Turkey, as well as in other countries. Due to the lifestyle of the region, tandir and cauldron burns, which cause extensive burn areas and high morbidity, are frequently seen in children. Therefore, precautions and educational programs related to the use of tandirs and cauldrons are needed in this region. PMID:21244683

Impact of Pruning Eastern Redcedar (Juniperus virginiana)

Treesearch

Thomas L. Schmidt; Tom D. Wardle

2002-01-01

In recent years, eastern redcedar has been the most rapidly expanding tree resource in the Great Plains from Oklahoma to South Dakota, primarily in rangelands and pastures. Based on these increases and potential management-related problems, eastern redcedar is perceived as a threat to the rangeland resource. Pruning eastern redcedar can allow for increased herbaceous...

Gender differences in risk profile and outcome of Middle Eastern patients undergoing percutaneous coronary intervention.

PubMed

Jarrah, Mohamad I; Hammoudeh, Ayman J; Al-Natour, Dalal B; Khader, Yousef S; Tabbalat, Ramzi A; Alhaddad, Imad A; Kullab, Susan M

2017-02-01

To determine the gender differences in cardiovascular risk profile and outcomes among patients undergoing percutaneous coronary intervention (PCI). Methods: In a prospective multicenter study of consecutive Middle Eastern patients managed with PCI from January 2013 to February 2014 in 12 tertiary care centers in Amman and Irbid, Jordan. Clinical and coronary angiographic features, and major cardiovascular events were assessed for both genders from hospital stay to 1 year. Results: Women comprised 20.6% of 2426 enrolled patients, were older (mean age 62.9 years versus 57.2 years), had higher prevalence of hypertension (81% versus 57%), diabetes (66% versus 44%), dyslipidemia (58% versus 46%), and obesity (44% versus 25%) compared with men, p less than 0.001. The PCI for ST-segment elevation myocardial infarction was indicated for fewer women than men (23% versus 33%; p=0.001). Prevalence of single or multi-vessel coronary artery disease was similar in women and men. More women than men had major bleeding during hospitalization (2.2% versus 0.6%; p=0.003) and at one year (2.5% versus 0.9%; p=0.007). There were no significant differences between women and men in mortality (3.1% versus 1.7%) or stent thrombosis (2.1% versus 1.8%) at 1 year. Conclusion: Middle Eastern women undergoing PCI had worse baseline risk profile compared with men.Except for major bleeding, no gender differences in the incidence of major adverse cardiovascular events were demonstrated.

An annotated bibliography of eastern redcedar.

Treesearch

Thomas L. Schmidt; Ronald J. Piva

1995-01-01

Presents a listing of 719 citations related to eastern redcedar through September 1994. Major eastern redcedar subject headings include: physiology, nursery propagation, regeneration / planting, pests, weather-related factors, control, products, wildlife relationship, and ecological relationships.

Pabon Lasso and Data Envelopment Analysis: A Complementary Approach to Hospital Performance Measurement

PubMed Central

Mehrtak, Mohammad; Yusefzadeh, Hasan; Jaafaripooyan, Ebrahim

2014-01-01

Background: Performance measurement is essential to the management of health care organizations to which efficiency is per se a vital indicator. Present study accordingly aims to measure the efficiency of hospitals employing two distinct methods. Methods: Data Envelopment Analysis and Pabon Lasso Model were jointly applied to calculate the efficiency of all general hospitals located in Iranian Eastern Azerbijan Province. Data was collected using hospitals’ monthly performance forms and analyzed and displayed by MS Visio and DEAP software. Results: In accord with Pabon Lasso model, 44.5% of the hospitals were entirely efficient, whilst DEA revealed 61% to be efficient. As such, 39% of the hospitals, by the Pabon Lasso, were wholly inefficient; based on DEA though; the relevant figure was only 22.2%. Finally, 16.5% of hospitals as calculated by Pabon Lasso and 16.7% by DEA were relatively efficient. DEA appeared to show more hospitals as efficient as opposed to the Pabon Lasso model. Conclusion: Simultaneous use of two models rendered complementary and corroborative results as both evidently reveal efficient hospitals. However, their results should be compared with prudence. Whilst the Pabon Lasso inefficient zone is fully clear, DEA does not provide such a crystal clear limit for inefficiency. PMID:24999147

An Analysis of Hospital Accreditation Policy in Iran

PubMed Central

YOUSEFINEZHADI, Taraneh; MOSADEGHRAD, Ali Mohammad; ARAB, Mohammad; RAMEZANI, Mozhdeh; SARI, Ali AKBARI

2017-01-01

Background: Public policymaking is complex and lacks research evidences, particularly in the Eastern Mediterranean Region (EMR). This policy analysis aims to generate insights about the process of hospital accreditation policy making in Iran, to identify factors influencing policymaking and to evaluate utilization of evidence in policy making process. Methods: The study examined the policymaking process using Walt and Gilson framework. A qualitative research design was employed. Thirty key informant interviews with policymakers and stakeholders were conducted. In addition hundred and five related documents were reviewed. Data was analyzed using framework analysis. Results: The accreditation program was a decision made at Ministry of Health and Medical Education in Iran. Many healthcare stakeholders were involved and evidence from leading countries was used to guide policy development. Poor hospital managers’ commitment, lack of physicians’ involvement and inadequate resources were the main barriers in policy implementation. Furthermore, there were too many accreditations standards and criteria, surveyors were not well-trained, had little motivation for their work and there was low consistency among them. Conclusion: This study highlighted the complex nature of policymaking cycle and highlighted various factors influencing policy development, implementation and evaluation. An effective accreditation program requires a robust well-governed accreditation body, various stakeholders’ involvement, sufficient resources and sustainable funds, enough human resources, hospital managers’ commitment, and technical assistance to hospitals. PMID:29308378

The Case of the Suzhou Hospital of National Medicine (1939–41): War, Medicine, and Eastern Civilization

PubMed Central

Daidoji, Keiko; Karchmer, Eric I.

2017-01-01

This article explores the founding of the Suzhou Hospital of National Medicine in 1939 during the Japanese occupation of Suzhou. We argue that the hospital was the culmination of a period of rich intellectual exchange between traditional Chinese and Japanese physicians in the early twentieth century and provides important insights into the modern development of medicine in both countries. The founding of this hospital was followed closely by leading Japanese Kampo physicians. As the Japanese empire expanded into East Asia, they hoped that they could revitalize their profession at home by disseminating their unique interpretations of the famous Treatise on Cold Damage 傷寒論 abroad. The Chinese doctors that founded the Suzhou Hospital of National Medicine were close readers of Japanese scholarship on the Treatise and were inspired to experiment with a Japanese approach to diagnosis, based on new interpretations of the concept of “presentation” (shō / zheng 證). Unfortunately, the Sino-Japanese War cut short this fascinating dialogue on reforming medicine and set the traditional medicine professions in both countries on new nationalist trajectories. PMID:29104703

Cancer Control in Central and Eastern Europe: Current Situation and Recommendations for Improvement.

PubMed

Vrdoljak, Eduard; Bodoky, Gyorgy; Jassem, Jacek; Popescu, Razvan A; Mardiak, Jozef; Pirker, Robert; Čufer, Tanja; Bešlija, Semir; Eniu, Alexandru; Todorović, Vladimir; Kubáčková, Kateřina; Kurteva, Galia; Tomašević, Zorica; Sallaku, Agim; Smichkoska, Snezhana; Bajić, Žarko; Šikić, Branimir I

2016-10-01

: The incidence of many cancers is higher in Western European (WE) countries, but mortality is frequently higher in Central and Eastern European (CEE) countries. A panel of oncology leaders from CEE countries participating in the South Eastern European Research Oncology Group (SEEROG) was formed in 2015, aiming to analyze the current status and trends of oncology care in CEE and to propose recommendations leading to improved care and outcomes. The SEEROG panel, meeting during the 11th Central European Oncology Congress, proposed the following: (a) national cancer control plans (NCCPs) required in all CEE countries, defining priorities in cancer care, including finance allocation considering limited health care budgets; (b) national cancer registries, describing in detail epidemiological trends; (c) efforts to strengthen comprehensive cancer centers; (d) that multidisciplinary care should be mandated by the NCCPs; (e) that smaller hospitals should be connected to multidisciplinary tumor boards via the Internet, providing access to specialized expertise; (f) nationwide primary prevention programs targeting smoking, obesity, and alcohol consumption and centrally evaluated secondary prevention programs for cervical, colorectal, and breast cancers; (g) prioritize education for all involved in cancer care, including oncology nurses, general practitioners, and palliative care providers; (h) establish outpatient care in day hospitals to reduce costs associated with the current inpatient model of care in CEE countries and to improve patients' quality of life; (i) long-term pharmacoeconomic evaluations of new therapies in CEE countries; (j) increase national oncology budgets in view of the higher mortality rates in CEE compared with WE countries; and (k) CEE countries urgently need help from the European Union to increase and monitor overall investment in cancer care. Significant differences in cancer incidence and mortality have been observed between European countries

Forest industries of eastern Washington.

Treesearch

Brian R. Wall; Donald R. Gedney; Robert B. Forster

1966-01-01

A sawmill, built in 1872, marked the beginning of the forest industry in eastern Washington -- almost half a century after the emergence of the lumber industry in western Washington. Since then, this industry has increased in importance to eastern Washington's economy, now furnishing about one-fifth of the total manufacturing employment and wages paid—in...

Health among hospital employees in Europe: a cross-national study of the impact of work stress and work control.

PubMed

Pisljar, Tjasa; van der Lippe, Tanja; den Dulk, Laura

2011-03-01

This article analyses the effect of working conditions on the health of hospital employees across Europe. Hospital employees often have demanding jobs that increase their stress levels and, consequently, their risk of health problems. Work control - typified by employee autonomy and working time flexibility - helps them cope with high levels of work stress. Researchers have traditionally studied the relationship between working conditions, coping strategies and occupational health from an individual perspective. We argue that the individual work-health relationship is closely connected with the social and institutional context. This study explores how work stress and work control influence the health of hospital employees and aims to understand cross-country differences in this respect. Using data on over 1500 hospital employees who participated in the study 'Quality of work and life in a changing Europe' (2007) in eight European countries, we used ordinal regression analyses to test a range of hypotheses. The results show that work stress has a negative effect on the health of hospital employees, while work control is not found to have any effect on their health. Comparative analyses reveal that the effects of working conditions on health vary across European countries. While working overtime is more closely related to poorer health in Eastern European countries, we found evidence of a positive relationship between job autonomy and health in Western Europe only, indicating that circumstances in the working environment have differing effects on employee health in Eastern and Western Europe. Copyright © 2011 Elsevier Ltd. All rights reserved.

NREL Eastern Renewable Generation Integration Study Redefines What's

Science.gov Websites

Eastern Renewable Generation Integration Study Redefines What's Possible for Renewables (Text Version ) NREL Eastern Renewable Generation Integration Study Redefines What's Possible for Renewables (Text Version) This is a text version of the video "Eastern Renewable Generation Integration Study

50 CFR 300.25 - Eastern Pacific fisheries management.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 11 2014-10-01 2014-10-01 false Eastern Pacific fisheries management. 300.25 Section 300.25 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED ACTIVITIES INTERNATIONAL FISHERIES REGULATIONS Eastern Pacific Tuna Fisheries § 300.25 Eastern Pacific fisheries management. Link to...

Nurses' perceptions of leadership style in hospitals: a grounded theory study.

PubMed

Su, Shu-Fen; Jenkins, Mary; Liu, Po-Erh

2012-01-01

This paper explores the leadership style of hospital managers. Leadership has been widely studied in nursing from the perspective of nurses' psychological strain caused by nursing leadership. There is, however, little contained in the Western and Eastern literatures on the leadership style of hospital managers and certainly no study has explored managers' leadership style in Taiwanese hospitals from the nurses' stance. Grounded theory. A sample of 28 nurses from seven teaching hospitals in Taiwan, Republic of China was selected through theoretical sampling. A multi-step analytic procedure based on the grounded theory approach was used to analyse the qualitative data. The Chinese culture was found to affect the leadership style of Taiwanese hospital managers. They had extreme power and led nurses in a hierarchical manner. Nurse managers followed the autocratic leadership style of their hospital managers. The main category found in this study was thus hierarchical leadership. The Confucian principles of authoritarianism and obedience were found to be part of the Taiwanese hospitals' organisational cultures and strongly impacted on the managers' leadership style. Hospital managers' treatment of doctors and nurses was dependent on their social rankings. Nurses' lowly ranking fed into these enculturated managerial tendencies of using power and obedience thus increasing psychological strain on nurses. Managers of the hospitals demonstrate power and misuse obedience through their leadership style, resulting in deterioration of nurses' work environment. Nurses' managers are not given enough power by the hospitals in Taiwan. Subsequently, nurses feel themselves the lowest and most powerless subordinates. This study reveals that the Chinese cultural burdens are embedded in the leadership of Taiwanese hospitals. These findings enhance the knowledge of leadership and add to the understanding of managerial attitudes in Chinese hospitals located worldwide. © 2011 Blackwell

Medication adherence and blood pressure control amongst adults with primary hypertension attending a tertiary hospital primary care clinic in Eastern Nigeria

PubMed Central

Ofoedu, John N.; Njoku, Patrick U.; Amadi, Agwu N.; Godswill-Uko, Ezinne U.

2013-01-01

Abstract Background As the case detection rates of hypertension increase in adult Nigerians, achieving target blood pressure (BP) control has become an important management challenge. Objectives To describe medication adherence and BP control amongst adult Nigerians with primary hypertension attending a primary care clinic of a tertiary hospital in a resource-poor environment in Eastern Nigeria. Methods A cross-sectional study was carried out in 140 adult patients with primary hypertension who have been on treatment for at least 6 months at the primary care clinic of Federal Medical Centre, Umuahia. A patient was said to have achieved goal BP control if the BP was < 140 per 90 mmHg. Adherence was assessed in the previous 30 days using a pretested researcher-administered questionnaire on 30 days of self-reported therapy. Adherence was graded using an ordinal scoring system of 0–4; an adherent patient was one who scored 4 points in the previous 30 days. Reasons for non-adherence were documented. Results Adherence to medication and BP control rates were 42.9% and 35.0% respectively. BP control was significantly associated with medication adherence (p = 0.03), antihypertensive medication duration ≥3 years (p = 0.042), and taking ≥ one form of antihypertensive medication (p = 0.04). BP at the recruitment visit was significantly higher than at the end of the study (p = 0.036). The most common reason for non-adherence was forgetfulness (p = 0.046). Conclusions The rate of BP control amongst the study population was low, which may be connected with low medication adherence. This study urges consideration of factors relating to adherence alongside other factors driving goal BP control.

Examination of Relationships among Organizational Characteristics and Organizational Commitment of Nurses in Western and Eastern Region of Nepal.

PubMed

Joshi, A S; Namba, M; Pokharela, T

2015-01-01

The objective of this study is to identify relationships between three components of organizational commitment and organizational characteristics of nurses in the western and the eastern region of Nepal. A self-administrated questionnaire was used to collect data from 310 nurses currently working at various hospitals in the eastern and the western region of the country. The questionnaire included three sections namely 1) personal characteristics 2) organizational characteristics and 3) organizational commitments scale. Descriptive analysis and multiple regression analysis were performed to identify significance in various relationships. Out of the 240 completed questionnaires, 226 were found valid for analysis. The mean age was 27.4 years. For each depended variable affective, continuance and normative commitment, multiple regression analysis was performed with personal Characteristics and organizational characteristics as independent variables. All independent variables were found significantly related to each of the two dependent variables; affective commitment and normative commitment (R2 adjusted=0.24, p<0.01 and R2 adjusted=0.05, p<0.01 respectively). However, they were not significantly related to the continuance commitment. Both support from boss (β=0.138, p<0.05) and satisfaction with training (β=0.301, p<0.05) were found to be positive and significant with affective commitment. On the other hand, satisfaction with training (β=0.191, p<0.05) was also positive and significant with normative commitment. Since both support from boss and training program were found to be positive and significant with affective commitment, hospitals must encourage supervisors to provide more assistance to the subordinate nurses. Moreover, hospitals should develop more training programs to keep nurses motivated.

Eastern Renewable Generation Integration Study | Grid Modernization | NREL

Science.gov Websites

Eastern Renewable Generation Integration Study Eastern Renewable Generation Integration Study Using perform the Eastern Renewable Generation Integration Study (ERGIS), a scenario-based study of four % targets under the study assumptions sometimes requires coordinating operations from Montreal to Miami and

Household costs of hospitalized dengue illness in semi-rural Thailand

PubMed Central

Ratanawong, Pitcha; Sewe, Maquines Odhiambo; Wilder-Smith, Annelies; Kittayapong, Pattamaporn

2017-01-01

Background Dengue-related illness is a leading cause of hospitalization and death in Thailand and other Southeast Asian countries, imposing a major economic burden on households, health systems, and governments. This study aims to assess the economic impact of hospitalized dengue cases on households in Chachoengsao province in eastern Thailand. Methods We conducted a prospective cost-of-illness study of hospitalized pediatric and adult dengue patients at three public hospitals. We examined all hospitalized dengue cases regardless of disease severity. Patients or their legal guardians were interviewed using a standard questionnaire to determine household-level medical and non-medical expenditures and income losses during the illness episode. Results Between March and September 2015, we recruited a total of 224 hospitalized patients (<5 years, 4%; 5–14 years, 20%, 15–24 years, 36%, 25–34 years, 15%; 35–44 years, 10%; 45+ years, 12%), who were clinically diagnosed with dengue. The total cost of a hospitalized dengue case was higher for adult patients than pediatric patients, and was US$153.6 and US$166.3 for pediatric DF and DHF patients, respectively, and US$171.2 and US$226.1 for adult DF and DHF patients, respectively. The financial burden on households increased with the severity of dengue illness. Conclusions Although 74% of the households reported that the patient received free medical care, hospitalized dengue illness cost approximately 19–23% of the monthly household income. These results indicated that dengue imposed a substantial financial burden on households in Thailand where a great majority of the population was covered by the Universal Coverage Scheme for health care. PMID:28937986

A Holistic, Person-Centred Care Model for Victims of Sexual Violence in Democratic Republic of Congo: The Panzi Hospital One-Stop Centre Model of Care.

PubMed

Mukwege, Denis; Berg, Marie

2016-10-01

Denis Mukwege and Marie Berg describe the One Stop Centre at Panzi Hospital in Eastern Democratic Republic of Congo that provides care for girls and women who have been raped in combination with extreme bodily harm.

Eastern Tent Caterpillar (Pest Alert)

Treesearch

Robert Rabaglia; Daniel Twardus

1990-01-01

The eastern tent caterpillar is often mistaken for the gypsy moth. Though they are similar in appearance, they differ in habits. The fully grown eastern tent caterpillar is about 2 inches long, black with a white stripe along the middle of the back and a row of pale blue oval spots on each side. It is sparsely covered with fine light brown hairs. The gypsy moth...

Rhinoplasty in Middle Eastern Patients.

PubMed

Sajjadian, Ali

2016-01-01

Rhinoplasty in patients of Middle Eastern origin requires complete understanding of nasal morphology and an individualized approach to create a racially congruent and aesthetically pleasing outcome. In this article, common anatomic features and characteristics and detailed steps, surgical techniques, and operative maneuvers that can lead to predictable outcome in rhinoplasty of Middle Eastern patients are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

An Old-Growth Definition for Eastern Riverfront Forests

Treesearch

James S. Meadows; Gregory J. Nowacki

1996-01-01

Eastern riverfront forests fall into one of three types: (1) nearly pure eastern cottonwood stands, (2) nearly pure black willow stands, and (3) typical riverfront hardwood stands containing many species, but generally dominated by sycamore, pecan, green ash, sugarberry, and American elm. The eastern riverfront forest represents an intermediate successional stage...

Risk factors and outcomes of imipenem-resistant Acinetobacter bloodstream infection in North-eastern Malaysia

PubMed Central

Deris, Zakuan Zainy; Shafei, Mohd Nazri; Harun, Azian

2011-01-01

Objective To determine the risk factors and outcomes of imipenem-resistant Acinetobacter baumannii (IRAB) bloodstream infection (BSI) cases, since there is very little publication on Acinetobacter baumannii infections from Malaysia. Methods A cross sectional study of 41 cases (73.2%) of imipenem-sensitive Acinetobacter baumanii (ISAB) and 15 cases (26.8%) of IRAB was conducted in a teaching hospital which was located at North-Eastern state of Malaysia. Results There was no independent risk factor for IRAB BSI identified but IRAB BSI was significantly associated with longer bacteraemic days [OR 1.23 (95% CI 1.01, 1.50)]. Although prior use of carbepenems and cephalosporin were higher among IRAB than ISAB group, statistically they were not significant. There was no significant difference in term of outcomes between the two groups. Conclusions Although statistically not significant, this analysis compliments previous publication highlighting the importance of appropriate empiric antibiotic usage in hospital especially carbepenems and need further evaluation with bigger subjects. PMID:23569782

State of mental healthcare systems in Eastern Europe: do we really understand what is going on?

PubMed Central

Winkler, Petr

2016-01-01

The article examines the current state of mental healthcare systems in countries of Eastern Europe and derives implications for future research and service development. Analysis of available statistics from the World Health Organization’s Mental Health Atlas suggests the need for better-quality data collection. Nonetheless, there appear to be insufficient resources allocated to mental health, lack of involvement of service users in policy-making and, to a large extent, systems continue to rely on mental hospitals. Based on the data presented, a set of directions for future reforms was drafted. PMID:29093919

Babesia microti infection, eastern Pennsylvania, USA.

PubMed

Acosta, Marcela E Perez; Ender, Peter T; Smith, Erin M; Jahre, Jeffrey A

2013-07-01

Infection with Babesia microti has not been well-described in eastern Pennsylvania, USA, despite the vector of this organism being prevalent. We report 3 cases of babesiosis in eastern Pennsylvania in persons without recent travel outside the region or history of blood transfusions, suggesting emergence of this infection.

[ST-segment elevation myocardial infarction in the eastern urban China: from 2001 to 2011].

PubMed

Li, J; Li, X; Hu, S; Yu, Y; Yan, X F; Jiang, L X

2016-04-24

To assess trends in clinical characteristics, treatments, and outcomes for hospitalized patients with ST-segment elevation myocardial infarction(STEMI) in eastern urban China from 2001 to 2011. The data were obtained from the China PEACE-retrospective acute myocardial infarction study. Patients admitted to hospital in the eastern urban China for STEMI were selected via two-stage random sampling. The first phase was to identify participating hospitals via a simple random-sampling procedure. The second stage was to select patients admitted to each participating hospitals for acute myocardial infarction in the year of 2001, 2006 and 2011 with a systematic sampling approach. Then clinical information was obtained via central medical record abstraction for each patient. In all analyses, weight was calculated proportional to the inverse sampling fraction for each period. Multilevel logistic regression models with generalized estimating equations were used for analysis of patient outcomes. This analysis included 5 257 patients with STEMI from 32 hospitals. In 2001, 2006, and 2011, the median age of STEMI patients was 66(57, 72)、67(56, 74)and 63(53, 74)years(trend test P=0.008), the proportion of female was 30.3%, 29.5% and 29.2%(trend test P=0.530), respectively. The proportion of cardiovascular risk factors increased over time(trend test P<0.001); 45.6%, 55.6%, and 56.3% patients had hypertension(trend test P<0.001); 18.8%, 27.7% and 26.2% patients had diabetes(trend test P<0.001); 50.1%, 59.2% and 70.5% patients had dyslipidemia(trend test P<0.001); 30.5%, 35.1% and 44.1% patients are current smokers(trend test P<0.001) in 2001, 2006 and 2011, respectively. Between 2001 and 2011, there were significant increases in aspirin use(80.7% in 2001, 90.4% in 2006, and 91.5% in 2011, trend test P<0.001), clopidogrel use(2.9% in 2001, 64.2% in 2006, and 90.3% in 2011, trend test P<0.001) within 24 hours after admission, statins use rate was 45.8% in 2001, 83.4% in 2006, and 93

76 FR 7833 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

...] Texas Eastern Transmission, LP; Notice of Application Take notice that on January 25, 2011, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056, filed in the above... TEAM 2012 Project. Specifically, Texas Eastern requests: (i) Authorization under NGA sections 7(b) and...

78 FR 43874 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-22

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP13-514-000] Texas Eastern Transmission, LP; Notice of Application On July 2, 2013, Texas Eastern Transmission, LP (Texas Eastern) filed... natural gas facilities no longer in service. As described more fully in the Application, Texas Eastern...

Babesia microti Infection, Eastern Pennsylvania, USA

PubMed Central

Ender, Peter T.; Smith, Erin M.; Jahre, Jeffrey A.

2013-01-01

Infection with Babesia microti has not been well-described in eastern Pennsylvania, USA, despite the vector of this organism being prevalent. We report 3 cases of babesiosis in eastern Pennsylvania in persons without recent travel outside the region or history of blood transfusions, suggesting emergence of this infection. PMID:23764008

76 FR 41755 - Eastern Arizona Counties Resource Advisory; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-15

... DEPARTMENT OF AGRICULTURE Forest Service Eastern Arizona Counties Resource Advisory; Meeting AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eastern Arizona Counties Resource... FURTHER INFORMATION CONTACT: Julia Faith Rivera, RAC Program Manager, Eastern Arizona Counties Resource...

76 FR 28210 - Eastern Arizona Counties Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-16

... DEPARTMENT OF AGRICULTURE Forest Service Eastern Arizona Counties Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eastern Arizona Counties will meet...: Julia Faith Rivera, RAC Program Manager, Eastern Arizona Counties Resource Advisory Committee, Apache...

Evaluation of outpatient service quality in Eastern Saudi Arabia

PubMed Central

Fraihi, Khalid J. Al; FAMCO, Dip; FAMCO, Fellow; Latif, Shahid A.

2016-01-01

Objectives: To investigate perceptions and expectations of patients regarding hospital outpatient services by using a service quality gap model and factors influencing such gaps. Methods: In this cross-sectional descriptive study conducted between October and November 2014 in the outpatient waiting areas of a hospital in the Eastern Province of Saudi Arabia, a sample of 306 patients was selected by convenience sampling technique. The data was collected through an Arabic version of the service quality (SERVQUAL) questionnaire consisting of 2 parts: patients’ demographic characteristics, and 22 items scales of patients’ expectations and perceptions of SERVQUAL. The data was analyzed by confirmatory factor analysis, independent, and paired t samples tests and one way analysis of variance test. Results: The results showed that the proposed model for service quality dimensions had a good fit by satisfying the recommended values. The patients’ expectations exceeded perceptions in all service quality dimensions indicating statistically significant service quality gaps (t=26.3, p<0.000). Findings revealed that the empathy dimension contributed most patients’ expectations (4.7 ± 0.5) and perceptions (3.7 ± 0.8) scores, and responsiveness contributed least to expectations (4.5 ± 0.6) and perceptions (3.2 ± 0.8) scores. Prompt services showed highest service quality gap, while observation of privacy showed the smallest service quality gap in the statements. The study showed a significant association between gender, age, education, multiple visits, and service quality dimensions. Conclusion: The proposed model is valid and reliable and significant service quality gaps of all 5 dimensions need to be prioritized and addressed by focused improvement efforts of hospital management. PMID:27052285

Planning and design for a culture of safety in Thessaloniki's hospitals.

PubMed

Chatzicocoli-Syrakou, Sophia; Syrakoy, Athena-Christina

2004-01-01

Thessaloniki is the second capital of Greece, located in the region of Macedonia, in the northern part of the Greek mainland. After the opening of the boarders of the former 'Eastern Block' countries and following their general open-policy to the European Union, Thessaloniki became an important part of the Balkans Initiative, aiming at attracting patients from abroad to Greece. Thus, some of the most modern hospitals in Greece are near Thessaloniki. Patient safety forms an important issue of the policy attracting patients. With this paper an attempt will be made to examine the characteristics of a culture of safety embodied in the planning and design of two of Thessaloniki's hospitals. These characteristics are to be found in the health care environment of the present clinical processes, on both, a quantitative and a qualitatve basis, and finally, suggestions for further development.

Eastern Kentucky Teacher and Administrative Stress

ERIC Educational Resources Information Center

Wright, Sam; Ballestero, Victor

2011-01-01

The purpose of this research was to survey selected Eastern Kentucky Principals (Elementary, Middle, and High School) to collect data about stress in public schools. A stress survey (Appendix C) was sent to randomly selected elementary, middle, and high school principals located in the Eastern Kentucky region serviced by Morehead State University…

75 FR 18145 - Eastern Arizona Counties Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

... DEPARTMENT OF AGRICULTURE Forest Service Eastern Arizona Counties Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eastern Arizona Counties Resource... Rivera, Coordinator, Eastern Arizona Counties Resource Advisory Committee, c/o Forest Service, USDA, P.O...

Satisfaction with Quality of Care Received by Patients without National Health Insurance Attending a Primary Care Clinic in a Resource-Poor Environment of a Tertiary Hospital in Eastern Nigeria in the Era of Scaling up the Nigerian Formal Sector Health Insurance Scheme.

PubMed

Iloh, Gup; Ofoedu, Jn; Njoku, Pu; Okafor, Goc; Amadi, An; Godswill-Uko, Eu

2013-01-01

The increasing importance of the concept of patients' satisfaction as a valuable tool for assessing quality of care is a current global healthcare concerns as regards consumer-oriented health services. This study assessed satisfaction with quality of care received by patients without national health insurance (NHI) attending a primary care clinic in a resource-poor environment of a tertiary hospital in South-Eastern Nigeria. This was a cross-sectional study carried out on 400 non-NHI patients from April 2011 to October 2011 at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria. Adult patients seen within the study period were selected by systematic sampling using every second non-NHI patient that registered to see the physicians and who met the selection criteria. Data were collected using pretested, structured interviewer administered questionnaire designed on a five points Likert scale items with 1 and 5 indicating the lowest and highest levels of satisfaction respectively. Satisfaction was measured from the following domains: patient waiting time, patient-staff communication, patient-staff relationship, and cost of care, hospital bureaucracy and hospital environment. Operationally, patients who scored 3 points and above in the assessed domain were considered satisfied while those who scored less than 3 points were dissatisfied. The overall satisfaction score of the respondents was 3.1. Specifically, the respondents expressed satisfaction with patient-staff relationship (3.9), patient-staff communication (3.8), and hospital environment (3.6) and dissatisfaction with patient waiting time (2.4), hospital bureaucracy (2.5), and cost of care (2.6). The overall non-NHI patient's satisfaction with the services provided was good. The hospital should set targets for quality improvement in the current domains of satisfaction while the cost of care has implications for government intervention as it mirrors the need to make NHI universal for all Nigerians

National trends in hospital length of stay for acute myocardial infarction in China.

PubMed

Li, Qian; Lin, Zhenqiu; Masoudi, Frederick A; Li, Jing; Li, Xi; Hernández-Díaz, Sonia; Nuti, Sudhakar V; Li, Lingling; Wang, Qing; Spertus, John A; Hu, Frank B; Krumholz, Harlan M; Jiang, Lixin

2015-01-20

China is experiencing increasing burden of acute myocardial infarction (AMI) in the face of limited medical resources. Hospital length of stay (LOS) is an important indicator of resource utilization. We used data from the Retrospective AMI Study within the China Patient-centered Evaluative Assessment of Cardiac Events, a nationally representative sample of patients hospitalized for AMI during 2001, 2006, and 2011. Hospital-level variation in risk-standardized LOS (RS-LOS) for AMI, accounting for differences in case mix and year, was examined with two-level generalized linear mixed models. A generalized estimating equation model was used to evaluate hospital characteristics associated with LOS. Absolute differences in RS-LOS and 95% confidence intervals were reported. The weighted median and mean LOS were 13 and 14.6 days, respectively, in 2001 (n = 1,901), 11 and 12.6 days in 2006 (n = 3,553), and 11 and 11.9 days in 2011 (n = 7,252). There was substantial hospital level variation in RS-LOS across the 160 hospitals, ranging from 9.2 to 18.1 days. Hospitals in the Central regions had on average 1.6 days (p = 0.02) shorter RS-LOS than those in the Eastern regions. All other hospital characteristics relating to capacity for AMI treatment were not associated with LOS. Despite a marked decline over the past decade, the mean LOS for AMI in China in 2011 remained long compared with international standards. Inter-hospital variation is substantial even after adjusting for case mix. Further improvement of AMI care in Chinese hospitals is critical to further shorten LOS and reduce unnecessary hospital variation.

Integrated Fossil and Molecular Data Reveal the Biogeographic Diversification of the Eastern Asian-Eastern North American Disjunct Hickory Genus (Carya Nutt.)

PubMed Central

Zhang, Jing-Bo; Li, Rui-Qi; Xiang, Xiao-Guo; Manchester, Steven R.; Lin, Li; Wang, Wei; Wen, Jun; Chen, Zhi-Duan

2013-01-01

The hickory genus (Carya) contains ca. 17 species distributed in subtropical and tropical regions of eastern Asia and subtropical to temperate regions of eastern North America. Previously, the phylogenetic relationships between eastern Asian and eastern North American species of Carya were not fully confirmed even with an extensive sampling, biogeographic and diversification patterns had thus never been investigated in a phylogenetic context. We sampled 17 species of Carya and 15 species representing all other genera of the Juglandaceae as outgroups, with eight nuclear and plastid loci to reconstruct the phylogeny of Carya. The phylogenetic positions of seven extinct genera of the Juglandaceae were inferred using morphological characters and the molecular phylogeny as a backbone constraint. Divergence times within Carya were estimated with relaxed Bayesian dating. Biogeographic analyses were performed in DIVA and LAGRANGE. Diversification rates were inferred by LASER and APE packages. Our results support two major clades within Carya, corresponding to the lineages of eastern Asia and eastern North America. The split between the two disjunct clades is estimated to be 21.58 (95% HPD 11.07-35.51) Ma. Genus-level DIVA and LAGRANGE analyses incorporating both extant and extinct genera of the Juglandaceae suggested that Carya originated in North America, and migrated to Eurasia during the early Tertiary via the North Atlantic land bridge. Fragmentation of the distribution caused by global cooling in the late Tertiary resulted in the current disjunction. The diversification rate of hickories in eastern North America appeared to be higher than that in eastern Asia, which is ascribed to greater ecological opportunities, key morphological innovations, and polyploidy. PMID:23875028

Integrated fossil and molecular data reveal the biogeographic diversification of the eastern Asian-eastern North American disjunct hickory genus (Carya Nutt.).

PubMed

Zhang, Jing-Bo; Li, Rui-Qi; Xiang, Xiao-Guo; Manchester, Steven R; Lin, Li; Wang, Wei; Wen, Jun; Chen, Zhi-Duan

2013-01-01

The hickory genus (Carya) contains ca. 17 species distributed in subtropical and tropical regions of eastern Asia and subtropical to temperate regions of eastern North America. Previously, the phylogenetic relationships between eastern Asian and eastern North American species of Carya were not fully confirmed even with an extensive sampling, biogeographic and diversification patterns had thus never been investigated in a phylogenetic context. We sampled 17 species of Carya and 15 species representing all other genera of the Juglandaceae as outgroups, with eight nuclear and plastid loci to reconstruct the phylogeny of Carya. The phylogenetic positions of seven extinct genera of the Juglandaceae were inferred using morphological characters and the molecular phylogeny as a backbone constraint. Divergence times within Carya were estimated with relaxed Bayesian dating. Biogeographic analyses were performed in DIVA and LAGRANGE. Diversification rates were inferred by LASER and APE packages. Our results support two major clades within Carya, corresponding to the lineages of eastern Asia and eastern North America. The split between the two disjunct clades is estimated to be 21.58 (95% HPD 11.07-35.51) Ma. Genus-level DIVA and LAGRANGE analyses incorporating both extant and extinct genera of the Juglandaceae suggested that Carya originated in North America, and migrated to Eurasia during the early Tertiary via the North Atlantic land bridge. Fragmentation of the distribution caused by global cooling in the late Tertiary resulted in the current disjunction. The diversification rate of hickories in eastern North America appeared to be higher than that in eastern Asia, which is ascribed to greater ecological opportunities, key morphological innovations, and polyploidy.

Eastern mosquitofish resists invasion by nonindigenous poeciliids through agonistic behaviors

USGS Publications Warehouse

Thompson, Kevin A.; Hill, Jeffrey E.; Nico, Leo G.

2012-01-01

Florida is a hotspot for nonindigenous fishes with over 30 species established, although few of these are small-bodied species. One hypothesis for this pattern is that biotic resistance of native species is reducing the success of small-bodied, introduced fishes. The eastern mosquitofish Gambusia holbrooki is common in many freshwater habitats in Florida and although small-bodied (<50 mm), it is a predator and aggressive competitor. We conducted four mesocosm experiments to examine the potential for biotic resistance by eastern mosquitofish to two small-bodied nonindigenous fishes, variable platyfish (Xiphophorus variatus) and swordtail (X. hellerii). Experiments tested: (1) effect of eastern mosquitofish density on adult survival, (2) effect of eastern mosquitofish on a stage-structured population, (3) role of habitat structural complexity on nonindigenous adult survival, and (4) behavioral effects of eastern mosquitofish presence and habitat complexity. Eastern mosquitofish attacked and killed non-native poeciliids with especially strong effects on juveniles of both species. Higher eastern mosquitofish density resulted in greater effects. Predation on swordtails increased with increasing habitat complexity. Eastern mosquitofish also actively drove swordtails from cover, which could expose non-native fish to other predators under field conditions. Our results suggest that eastern mosquitofish may limit invasion success.

Occupational Health in Eastern Europe

PubMed Central

Malan, R. M.

1963-01-01

Progress may be fostered as much by spreading information as by research. The aim of this review is to add to the existing knowledge of the pattern of occupational health services in the socialist countries of Eastern Europe. The work consists of two main parts. Part I is based on official information issued by government departments or typewritten reports prepared by government officials, and relates mostly to the Union of Soviet Socialist Republics and to Czechoslovakia. Part II is largely based on direct observation, discussion, and comparison of the occupational health services in Czechoslovakia, of which I have more extensive knowledge than of the other countries of Eastern Europe. This part embodies a number of conclusions and is followed by a list of bibliographical references. Throughout the review I have endeavoured to show how problems which exist all over the world are dealt with in Eastern Europe. PMID:13932439

Remarkable improvement in serum 25-hydroxyvitamin levels among hip fracture patients over a 12-year period: a prospective study in South-eastern Finland.

PubMed

Nurmi-Lüthje, I; Tiihonen, R; Paattiniemi, E-L; Naboulsi, H; Pigg, S; Sarkkinen, H; Kaukonen, J-P; Toivanen, A; Salmio, K; Kataja, M; Lüthje, P

2018-04-01

Hypovitaminosis D is a problem among hip fracture patients. In a 1-year cohort study comprising 245 hip fracture patients (mean age of females 81 years and males 78 years) from south-eastern Finland, the mean 25-hydroxyvitamin D [S-25(OH)D] concentration was 73(SD 31) nmol/L. Vitamin D supplementation has been integrated into our current practice. The objectives of this study are to verify vitamin D levels among hip fracture patients and to compare the results with a similar study conducted in the same two hospitals covering the same geographic area 12 years ago. A prospective cohort comprising 245 Caucasian hip fracture patients was enrolled in the study in two acute hospitals in south-eastern Finland (61° N) over a 12-month period in 2015-2016. The S-25(OH)D was measured using 25-hydroxyvitamin D electrochemiluminescence binding assay. The S-25(OH)D concentrations were compared with the corresponding concentrations of a similar cohort analyzed in the same two hospitals 12 years ago. Of the 245 patients, 70% were women with a mean age of 81 (SD 10) years, while the men had a mean age of 78 (SD 12) years (p < 0.01). The total mean S-25(OH)D concentration was 73 (SD 31.3) nmol/L. Regional differences were found: 15% in hospital A and 36% in hospital B had a S-25(OH(D level < 50 nmol/L, and the mean S-25(OH)D level was 79.2 (SD 31.7) nmol/L in hospital A and 62.4 (SD 27.5) nmol/L in hospital B (p < 0.001). No differences were found in S-25(OH)D concentrations by either the place of residence or the time of year. Overall, the percentage of patients with a sufficient vitamin D level (> 50 nmol/L) was remarkably higher in 2015-2016 (77%) than in 2003-2004 (22%). Our results indicate that vitamin D supplementation has been widely integrated into our current practice. However, regional differences were found in the S-25(OH)D concentrations for which the reasons are unknown.

77 FR 51966 - Eastern Arizona Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-28

... DEPARTMENT OF AGRICULTURE Forest Service Eastern Arizona Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eastern Arizona Resource Advisory Committee...

Lethal domestic violence in eastern North Carolina.

PubMed

Gilliland, M G; Spence, P R; Spence, R L

2000-01-01

reports of violence. A recent national report from the Justice Department found a decline in both lethal and non-lethal DV. The number of men murdered by wives or girlfriends "plunged 60% from 1976 through 1998". FBI data on homicides showed that "intimate partners committed fewer murders each year during 1996, 1997, and 1998 than in any other year since 1976". Nationally, intimate partners caused 3000 deaths in 1976, 1590 (53%) in women; in 1998, they caused 1830 deaths, 1320 (73%) in women. But fatal cases of DV are only the tip of the iceberg, and may pertain only to a particular geographic area. We undertook the present study to assess the prevalence of lethal domestic violence in the 29 counties of eastern North Carolina (ENC) that make up the catchment area for the University Health Systems of Eastern Carolina (UHSEC). UHSEC includes the Brody School of Medicine at East Carolina University (BSM-ECU; previously known as East Carolina University-SOM) and Pitt County Memorial Hospital.

78 FR 6319 - Eastern Hydroelectric Corporation; Notice Rejecting Request for Rehearing

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-30

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Project No. 7019-068] Eastern... an order amending license Article 401 for Eastern Hydroelectric Corporation's (Eastern Hydroelectric....\\1\\ On January 11, 2013, Eastern Hydroelectric filed a request for rehearing of Commission staff's...

Forests of eastern Oregon: an overview.

Treesearch

Sally Campbell; Dave Azuma; Dale. Weyermann

2003-01-01

This publication provides highlights of forest inventories and surveys from 1993 to 2001. About 35 percent of eastern Oregon is forested.The amount of forest land in eastern Oregon has increased by about 650,000 acres from the 1930s, with increases in juniper forest land accounting for most of the change.Thirty-one tree species were tallied in forest inventories during...

Eastern U.S. Infrared, Enhancement 4 - NOAA GOES Geostationary Satellite

Science.gov Websites

Enhancement 4 Eastern U.S. Infrared Enhancements IR Enhancement 1 Eastern U.S. Infrared Enhancement 1 IR Enhancement 2 Eastern U.S. Infrared Enhancement 2 IR Enhancement 3 Eastern U.S. Infrared Enhancement 3 IR large amount of water vapor. » Enhancement types In an infrared (IR) image cold clouds are high clouds

Eastern Equine Encephalitis in Latin America

PubMed Central

Carrera, Jean-Paul; Forrester, Naomi; Wang, Eryu; Vittor, Amy Y.; Haddow, Andrew D.; López-Vergès, Sandra; Abadía, Ivan; Castaño, Elizabeth; Sosa, Nestor; Báez, Carmen; Estripeaut, Dora; Díaz, Yamilka; Beltrán, Davis; Cisneros, Julio; Cedeño, Hector G.; da Rosa, Amelia P. Travassos; Hernandez, Humberto; Martínez-Torres, Alex O.; Tesh, Robert B.; Weaver, Scott C.

2013-01-01

BACKGROUND The eastern equine encephalitis (EEE) and Venezuelan equine encephalitis (VEE) viruses are pathogens that infect humans and horses in the Americas. Outbreaks of neurologic disease in humans and horses were reported in Panama from May through early August 2010. METHODS We performed antibody assays and tests to detect viral RNA and isolate the viruses in serum samples from hospitalized patients. Additional cases were identified with enhanced surveillance. RESULTS A total of 19 patients were hospitalized for encephalitis. Among them, 7 had confirmed EEE, 3 had VEE, and 1 was infected with both viruses; 3 patients died, 1 of whom had confirmed VEE. The clinical findings for patients with EEE included brain lesions, seizures that evolved to status epilepticus, and neurologic sequelae. An additional 99 suspected or probable cases of alphavirus infection were detected during active surveillance. In total, 13 cases were confirmed as EEE, along with 11 cases of VEE and 1 case of dual infection. A total of 50 cases in horses were confirmed as EEE and 8 as VEE; mixed etiologic factors were associated with 11 cases in horses. Phylogenetic analyses of isolates from 2 cases of equine infection with the EEE virus and 1 case of human infection with the VEE virus indicated that the viruses were of enzootic lineages previously identified in Panama rather than new introductions. CONCLUSIONS Cases of EEE in humans in Latin America may be the result of ecologic changes that increased human contact with enzootic transmission cycles, genetic changes in EEE viral strains that resulted in increased human virulence, or an altered host range. (Funded by the National Institutes of Health and the Secretaría Nacional de Ciencia, Tecnología e Innovación, Panama.) PMID:23964935

A Comparitive Study of Anticardiolipin Antibodies among Systemic Lupus Erythematosus Patients from Western and Eastern India.

PubMed

Doley, D; Kakati, S; Saikia, L; Rajadhyaksha, A; Nadkar, Milind; Khadilkar, P; Patwardhan, M; Pradhan, V

2017-03-01

Anti-phospholipid antibodies (APA) like anticardiolipin antibodies (ACA) are important cause of venous and arterial thrombosis and other occlusive vascular diseases. Prevalence of these antibodies in SLE patients at the time of diagnosis is not known in Indian SLE patients. This study was conducted to evaluate the prevalence of ACA in SLE patients from Eastern and Western India and to correlate them with disease activity. Seventy SLE patients from Assam Medical College, Dibrugarh, Assam and 85 SLE patients from Rheumatology Department, KEM Hospital, Mumbai were studied. SLE disease activity was evaluated by SLE Disease Activity Index (SLEDAI) score at the time of evaluation. All patients studied were in an active stage of disease. Demographic data showed significant variations in the clinical manifestations of SLE between two regions. Renal manifestations were higher (42.9%) among SLE patients from Eastern region as compared with 37.6% patients from Western region. These patients were categorized as Lupus Nephritis (LN) and patients that did not show any renal manifestations were categories as non-LN. ACA to IgG and IgM subclasses were tested by ELISA. IgGACA positivity was 20%, 12.9% and IgM-ACA positivity was 18.6%, 12.9% where asIgG + IgM ACA positivity as found in 12.9%, 3.5% patients respectively among SLE patients from Eastern and Western India. ACA positivity was higher among LN patients from Eastern India whereas the same was higher among non-LN patients from Western India. Hence detection of ACA alongwith associated clinical manifestations were helpful to evaluate their possible association with disease severity in SLE patients. A long term follow up of patients having ACA antibodies without thrombotic event is needed to detect their possible thrombotic event in future along with their clinical presentation from these two different geographic regions from India.

The impact of healthcare reform on the efficiency of public county hospitals in China.

PubMed

Jiang, Shuai; Min, Rui; Fang, Peng-Qian

2017-12-20

The new round of Healthcare Reform in China has implemented over 3 years since 2009, and promoted greatly the development of public county hospitals. The purpose of this study is to evaluate county hospitals efficiency before and after the healthcare reform, and further assess the reform effectiveness through the comparative analysis of the efficiency. Data envelopment analysis (DEA) was employed to calculate the efficiency of 1105 sample hospitals which were selected from 31 provinces of China, also, Tobit regression was used to regress against those main external environmental factors. Our results show that the scales and amounts of service of hospitals had increased sharply, however, the efficiency was relatively low and decreased slightly from 2008 to 2012. Thirteen (1.18%) in 2008 and six (0.54%) hospitals in 2012 were defined as technically efficient, and the average scores were 0.2916 and 0.2503. The technical efficiency average score of the post-reform was significantly less than that of the pre-reform (p < 0.001), and the score of eastern region was highest and the western was lowest among three regions of China. It suggests the reform had not well improved county hospital efficiency although hospitals have reached a fair developing scale, and the corresponding policies and measures should be put into effect for improving efficiency, especially in the level and structure of health investment, operation and supervision mechanism of county hospitals.

Event Rates, Hospital Utilization, and Costs Associated with Major Complications of Diabetes: A Multicountry Comparative Analysis

PubMed Central

Clarke, Philip M.; Glasziou, Paul; Patel, Anushka; Chalmers, John; Woodward, Mark; Harrap, Stephen B.; Salomon, Joshua A.

2010-01-01

Background Diabetes imposes a substantial burden globally in terms of premature mortality, morbidity, and health care costs. Estimates of economic outcomes associated with diabetes are essential inputs to policy analyses aimed at prevention and treatment of diabetes. Our objective was to estimate and compare event rates, hospital utilization, and costs associated with major diabetes-related complications in high-, middle-, and low-income countries. Methods and Findings Incidence and history of diabetes-related complications, hospital admissions, and length of stay were recorded in 11,140 patients with type 2 diabetes participating in the Action in Diabetes and Vascular Disease (ADVANCE) study (mean age at entry 66 y). The probability of hospital utilization and number of days in hospital for major events associated with coronary disease, cerebrovascular disease, congestive heart failure, peripheral vascular disease, and nephropathy were estimated for three regions (Asia, Eastern Europe, and Established Market Economies) using multiple regression analysis. The resulting estimates of days spent in hospital were multiplied by regional estimates of the costs per hospital bed-day from the World Health Organization to compute annual acute and long-term costs associated with the different types of complications. To assist, comparability, costs are reported in international dollars (Int$), which represent a hypothetical currency that allows for the same quantities of goods or services to be purchased regardless of country, standardized on purchasing power in the United States. A cost calculator accompanying this paper enables the estimation of costs for individual countries and translation of these costs into local currency units. The probability of attending a hospital following an event was highest for heart failure (93%–96% across regions) and lowest for nephropathy (15%–26%). The average numbers of days in hospital given at least one admission were greatest for

Clinico-epidemiological Study on Pesticide Poisoning in a Tertiary Care Hospital in Eastern Nepal.

PubMed

Agrawaal, K K; Karki, P

2014-01-01

Pesticide poisoning is a major health problem worldwide. In Nepal the most common cause is suicidal and pesticides account for more than fifty percent of cases. The objective of the study was to look in detail regarding the pesticide poisoning cases admitted at BPKIHS; their epidemiological profile, presentation, treatment and their outcome during the hospital stay. It was a retrospective study which included 2621 patients with poisoning of which 1661 cases were related to pesticides. The mean duration of hospital stay was 6.7 days. The majority of patients 81.16% showed improvement whereas 6.6% of patients died within 24 hours of admission and 3.54% after 48 hours of admission. Among all the patients 0.5% patients were given ICU care and all others were managed in the different units of medicine ward. The total amount of atropine administered varied considerably. Most of the cases were under the influence of alcohol. All the patients had a psychiatry evaluation before discharge. Pesticide poisoning is increasing in incidence and it is one of the preventable public health problems and includes mainly the patients' age group 20-30 years. Due to easy availability of pesticides it is the most preferred method of suicide and the main reasons being impulsive act and increased indebtedness in the society.

Labor support: an overlooked maternal health need in Enugu, south-eastern Nigeria.

PubMed

Dim, Cyril C; Ikeme, Arthur C; Ezegwui, Hyginus U; Nwagha, Uchenna I

2011-03-01

The current call for continuous support by women for women during labor takes for granted that women prefer to be supported by other women rather than their husbands. This study aimed at identifying the experiences and preferences of parturients as regards support in labor. Questionnaires were administered to 395 parturients at the University of Nigeria Teaching Hospital, Enugu, south-eastern Nigeria from January to August 2006. Data analysis was both descriptive and inferential at 95% confidence level. None of the respondents' husband, relations or friends was allowed into the labor room. Ninety-five (24.1%) parturients did not wish to be supported in labor by their husbands. Sixty-five (68.4%) of this group preferred to be supported in labor by medical/midwifery staff only, while the remaining 30 (31.6%) would have preferred a relation. Three hundred (75.9%) parturients, if permitted, would have preferred labor support by their husbands. The preference for labor support by husband was significantly associated with maternal educational status (p=0.003), parity groups (p=0.022), and age category (p=0.037). Labor support by a non-medical employee of health institutions is not practiced in Enugu, south-eastern Nigeria. Most women would prefer to be supported by their husbands during labor. There is a strong desire by mothers for a policy change as regards labor support by family and friends.

Agreement Between Eastern Michigan University and the Eastern Michigan Chapter of the American Association of University Professors, December 1974.

ERIC Educational Resources Information Center

Eastern Michigan Univ., Ypsilanti.

This contractual agreement between Eastern Michigan University and the Eastern Michigan Chapter of the American Association of University Professors is effective until August 31, 1976. The agreement covers the areas of definitions; general purposes and intent; recognition of agent; past practices; agent rights; personnel files; grievance…

[Prevalence of ESBL-positive enterobacteriaceae in large moravian hospitals (Czech Republic)].

PubMed

Kolář, Milan; Chromá, Magdaléna; Hricová, Kristýna; Husičková, Vendula; Lovečková, Yvona; Chmelařová, Eva; Bartoníková, Nataša; Rybníkářová, Petra

2010-10-01

bacterial infections have become an important issue in current medicine. Recently, their frequency and severity have significantly increased as a result of the rising number of resistant bacteria. One of important mechanisms of resistance is production of broad-spectrum beta-lactamases, namely the ESBL type. The study aimed at determining the frequency of ESBL-positive Enterobacteriaceae in three large hospitals in Moravia, the eastern part of the Czech Republic. enterobacteriaceae were isolated from clinical material obtained from patients hospitalized in the University Hospital Olomouc, Teaching Hospital Ostrava and Bata Regional Hospital Zlín throughout 2009. Standard microbiology techniques were used for identification. The production of ESBLs was determined by the modified Double-Disk Synergy Test. ESBL-positive isolates of Escherichia coli from ICU patients were subjected to basic genetic analysis. during the study period, a total of 12,922 strains from the Enterobacteriaceae family were detected. The ESBL phenotype was found in 907 cases, i.e. 7 % of all isolates. The most prevalent species of ESBL-producing Enterobacteriaceae were Klebsiella pneumoniae, Klebsiella oxytoca and Escherichia coli. A comparison of general wards and ICUs revealed a higher percentage of ESBL-positive strains of Klebsiella pneumoniae and a lower proportion of ESBL-positive Escherichia coli isolates in intensive care patients. When assessing the patients' clinical material, ESBL-producing strains were most frequently detected in urine. Genetic analysis of ESBL-positive Escherichia coli strains from ICU patients revealed the CTX-M type of ESBL production in most isolates.

Validation of the GRACE Risk score for hospital mortality in patients with acute coronary syndrome in the Arab Middle East.

PubMed

Yusufali, Afzalhussein; Zubaid, Mohammad; Al-Zakwani, Ibrahim; Alsheikh-Ali, Alawi A; Al-Mallah, Mouaz H; Al Suwaidi, Jassim; AlMahmeed, Wael; Rashed, Wafa; Sulaiman, Kadhim; Amin, Haitham

2011-07-01

Our objective was to validate the Global Registry of Acute Coronary Events (GRACE) risk score for in-hospital mortality in a Middle Eastern acute coronary syndrome (ACS) population enrolled in the Gulf Registry of Acute Coronary Events (Gulf RACE). Out of 8176, unselected, consecutive patients with ACS, during 6 months in 2006 and 2007 from 63 hospitals in 6 Arab countries in the Middle East Gulf region, 7709 (94.3%) with available data were included. The main outcome measures were discriminatory performance (using C-index) and calibration of the GRACE risk score (in-hospital mortality predicted by GRACE risk score versus the actual mortality). In-hospital mortality in the Gulf RACE was 3.09% (n = 238). The discriminatory performance of the GRACE risk scores in the Gulf RACE was good overall (C-index = 0.86). Observed and predicted risk corresponded well in each stratum of risk of in-hospital mortality. This suggests its suitability for clinical use in this patient population.

Outcomes of Children Adopted from Eastern Europe

ERIC Educational Resources Information Center

Miller, Laurie; Chan, Wilma; Tirella, Linda; Perrin, Ellen

2009-01-01

Behavioral problems are frequent among post-institutionalized Eastern European adoptees. However, risk factors related to outcomes have not been fully delineated. We evaluated 50 Eastern European adoptees, age 8-10 years, with their adoptive families for more than five years. Cognitive and behavioral outcomes and parenting stress were evaluated in…

Variability of the recent climate of eastern Africa

NASA Astrophysics Data System (ADS)

Schreck, Carl J., III; Semazzi, Fredrick H. M.

2004-05-01

The primary objective of this study is to investigate the recent variability of the eastern African climate. The region of interest is also known as the Greater Horn of Africa (GHA), and comprises the countries of Burundi, Djibouti, Eritrea, Ethiopia, Kenya, Rwanda, Somalia, Sudan, Uganda, and Tanzania.The analysis was based primarily on the construction of empirical orthogonal functions (EOFs) of gauge rainfall data and on CPC Merged Analysis of Precipitation (CMAP) data, derived from a combination of rain-gauge observations and satellite estimates. The investigation is based on the period 1961-2001 for the short rains season of eastern Africa of October through to December. The EOF analysis was supplemented by projection of National Centers for Environmental Prediction wind data onto the rainfall eigenmodes to understand the rainfall-circulation relationships. Furthermore, correlation and composite analyses have been performed with the Climatic Research Unit globally averaged surface-temperature time series to explore the potential relationship between the climate of eastern Africa and global warming.The most dominant mode of variability (EOF1) based on CMAP data over eastern Africa corresponds to El Niño-southern oscillation (ENSO) climate variability. It is associated with above-normal rainfall amounts during the short rains throughout the entire region, except for Sudan. The corresponding anomalous low-level circulation is dominated by easterly inflow from the Indian Ocean, and to a lesser extent the Congo tropical rain forest, into the positive rainfall anomaly region that extends across most of eastern Africa. The easterly inflow into eastern Africa is part of diffluent outflow from the maritime continent during the warm ENSO events. The second eastern African EOF (trend mode) is associated with decadal variability. In distinct contrast from the ENSO mode pattern, the trend mode is characterized by positive rainfall anomalies over the northern sector of

Cross-cultural challenges for assessing medical professionalism among clerkship physicians in a Middle Eastern country (Bahrain): feasibility and psychometric properties of multisource feedback.

PubMed

Al Ansari, Ahmed; Al Khalifa, Khalid; Al Azzawi, Mohamed; Al Amer, Rashed; Al Sharqi, Dana; Al-Mansoor, Anwar; Munshi, Fadi M

2015-01-01

We aimed to design, implement, and evaluate the feasibility and reliability of a multisource feedback (MSF) system to assess interns in their clerkship year in the Middle Eastern culture, the Kingdom of Bahrain. The study was undertaken in the Bahrain Defense Force Hospital, a military teaching hospital in the Kingdom of Bahrain. A total of 21 interns (who represent the total population of the interns for the given year) were assessed in this study. All of the interns were rotating through our hospital during their year-long clerkship rotation. The study sample consisted of nine males and 12 females. Each participating intern was evaluated by three groups of raters, eight medical intern colleagues, eight senior medical colleagues, and eight coworkers from different departments. A total of 21 interns (nine males and 12 females) were assessed in this study. The total mean response rates were 62.3%. A factor analysis was conducted that found that the data on the questionnaire grouped into three factors that counted for 76.4% of the total variance. These three factors were labeled as professionalism, collaboration, and communication. Reliability analysis indicated that the full instrument scale had high internal consistency (Cronbach's α 0.98). The generalizability coefficients for the surveys were estimated to be 0.78. Based on our results and analysis, we conclude that the MSF tool we used on the interns rotating in their clerkship year within our Middle Eastern culture provides an effective method of evaluation because it offers a reliable, valid, and feasible process.

Cross-cultural challenges for assessing medical professionalism among clerkship physicians in a Middle Eastern country (Bahrain): feasibility and psychometric properties of multisource feedback

PubMed Central

Al Ansari, Ahmed; Al Khalifa, Khalid; Al Azzawi, Mohamed; Al Amer, Rashed; Al Sharqi, Dana; Al-Mansoor, Anwar; Munshi, Fadi M

2015-01-01

Background We aimed to design, implement, and evaluate the feasibility and reliability of a multisource feedback (MSF) system to assess interns in their clerkship year in the Middle Eastern culture, the Kingdom of Bahrain. Method The study was undertaken in the Bahrain Defense Force Hospital, a military teaching hospital in the Kingdom of Bahrain. A total of 21 interns (who represent the total population of the interns for the given year) were assessed in this study. All of the interns were rotating through our hospital during their year-long clerkship rotation. The study sample consisted of nine males and 12 females. Each participating intern was evaluated by three groups of raters, eight medical intern colleagues, eight senior medical colleagues, and eight coworkers from different departments. Results A total of 21 interns (nine males and 12 females) were assessed in this study. The total mean response rates were 62.3%. A factor analysis was conducted that found that the data on the questionnaire grouped into three factors that counted for 76.4% of the total variance. These three factors were labeled as professionalism, collaboration, and communication. Reliability analysis indicated that the full instrument scale had high internal consistency (Cronbach’s α 0.98). The generalizability coefficients for the surveys were estimated to be 0.78. Conclusion Based on our results and analysis, we conclude that the MSF tool we used on the interns rotating in their clerkship year within our Middle Eastern culture provides an effective method of evaluation because it offers a reliable, valid, and feasible process. PMID:26316836

76 FR 18210 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-138-000] Texas Eastern Transmission, LP; Notice of Application On March 15, 2011, Texas Eastern Transmission Corporation (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056-5310, filed with the Federal Energy Regulatory...

Health resource allocation and productive efficiency of Chinese county hospitals: data from 1993 to 2005.

PubMed

Gai, Ruoyan Y; Zhou, Chengchao C; Xu, Lingzhong Z; Zhu, Min; Wang, Xingzhou Z; Li, Shixue X; Zheng, Wengui G; Song, Peipei P; Yang, Xuelai L; Fang, Liyi Y; Zhen, Yancheng C; Tang, Wei

2010-10-01

This study aims to assess trends in the productive efficiency of China's county hospitals during the economic transition using data from 1993 to 2005. A data envelopment analysis (DEA) framework was used to calculate the efficiency score of county hospitals in all 31 provinces. A C²R model and a BC² model were devised to respectively calculate overall and scale efficiency and pure technical efficiency at the hospital's current scale. Models included four inputs (number of medical staff; number of beds; value of fixed capital; and hospital expenditures) and three outputs (outpatient and emergency visits, number of inpatients, and hospital revenue) in total. As the results, geographical disparities in health resource allocation and county hospital productivity were noted. From 1993 to 2005, the number of county hospitals increased and their inputs, e.g. fixed capital in particular, grew rapidly. However, the amount of both outpatient and inpatient services declined somewhat especially in the middle and the western regions. The overall efficiency at the national level decreased slightly. County hospitals in the eastern region tended to have better overall, scale, and technical efficiency in comparison to the middle and the western regions. In conclusion, county hospitals are inefficient due to their enlarged scale and the reduced amount of health care services they provide. This issue should be addressed especially in the middle and the western regions, where health resources are far more limited and yet wasted. The effects of ongoing health sector reform on the productivity of county hospitals must be monitored and evaluated.

Emergency management of patients with ST-segment elevation myocardial infarction in Eastern Austria: a descriptive quality control study.

PubMed

Trimmel, Helmut; Bayer, Thomas; Schreiber, Wolfgang; Voelckel, Wolfgang G; Fiedler, Lukas

2018-05-09

Myocardial infarction is a time-critical condition and its outcome is determined by appropriate emergency care. Thus we assessed the efficacy of a supra-regional ST-segment elevation myocardial infarction (STEMI) network in Easternern Austria. The Eastern Austrian STEMI network serves a population of approx. 766.000 inhabitants within a region of 4186 km 2 . Established in 2007, it now comprises 20 pre-hospital emergency medical service (EMS) units (10 of these physician-staffed), 4 hospitals and 3 cardiac intervention centres. Treatment guidelines were updated in 2012 and documentation within a web-based STEMI registry became mandatory. For this retrospective qualitative control study, data from February 2012-April 2015 was assessed. A total of 416 STEMI cases were documented, and 99% were identified by EMS within 6 (4.0-8.0) minutes after arrival. Median time loss between onset of pain and EMS call was 54 (20-135) minutes; response, pre-hospital and door-to-balloon times were 14 (10-20), 46 (37-59) and 45 (32-66) minutes, respectively. When general practitioners were involved, time between onset of pain and balloon inflation significantly increased from 180 (135-254) to 218 (155-348) minutes (p < .001). A pre-hospital time < 30 min was achieved in 25.8% of all patients during the day vs. 11.6% during the night (p < .001). Three hundred forty-five patients (83%) were subjected to primary percutaneous coronary intervention (PPCI), and 6.5% were thrombolysed by EMS. Pre-hospital complication rate was 18% (witnessed cardiac arrest 7%, threatening arrhythmias 6%, cardiogenic shock 5%). Twenty-four hours and hospital mortality rate were 1.2 and 2.8%, respectively. Optimal patient care and subsequently outcome of STEMI is strongly determined by a short patient-decision time to call EMS and by the first medical contact to balloon time (FMCBT). Supra-regional networks are key in order to increase the efficacy and efficiency of health care. The goal of 120�

Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran

PubMed Central

Sargazi, Aliyeh; Sargazi, Atefeh; Nadakkavukaran Jim, Prigil Kumar; Danesh, HoseinAli; Aval, ForoughSargolzaee; Kiani, Zohre; Lashkarinia, AmirHosein; Sepehri, Zahra

2016-01-01

Objective: To determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran. Methods: This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics. Results: Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3%) men and 482 (41.7%) women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections. Conclusion: With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden. PMID:27162926

Adequacy and pattern of blood donations in north-eastern Nigeria: the implications for blood safety.

PubMed

Ahmed, S G; Ibrahim, U A; Hassan, A W

2007-12-01

In a retrospective analysis, the quantities, patterns and adequacy of blood donations made, between 1984 and 2006, at the University of Maiduguri Teaching Hospital in north-eastern Nigeria were explored and related to blood safety in the study area. The types of blood donor were reviewed and the annual increments in the number of donations made were estimated and compared with the annual increments in the numbers of in-patients managed at the study hospital. The mean annual increment in the number of blood donations (4%) fell well below the mean annual increment in in-patient numbers (11%). The blood donations received at the hospital fell into four types: voluntary, family-replacement, commercial and pre-deposit autologous donations. Over the study period, the percentage of donations falling into the voluntary and family-replacement categories fell from 31% to 5% and from 49% to 23%, respectively. These falls were matched by increases in the percentages of donations categorised as commercial and autologous, which rose from 20% to 63%, and from 1% to 9%, respectively. By the end of the study period, the quantity of blood being donated at the hospital was grossly inadequate and predominantly derived from family and commercial donors, who were found to be generally inferior, in terms of blood safety, to voluntary donors. There is an urgent need to rectify this situation by setting up a functional and national blood-transfusion service in Nigeria.

Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran.

PubMed

Sargazi, Aliyeh; Sargazi, Atefeh; Nadakkavukaran Jim, Prigil Kumar; Danesh, HoseinAli; Aval, ForoughSargolzaee; Kiani, Zohre; Lashkarinia, AmirHosein; Sepehri, Zahra

2016-01-01

To determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran. This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics. Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3%) men and 482 (41.7%) women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections. With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.

75 FR 54910 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30... of Land Management-Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153. Attn...

75 FR 33635 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-14

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000-L14200000-BJ0000] Eastern States... described below in the BLM--Eastern States office in Springfield, Virginia, 30 calendar days from the date...--Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153. Attn: Cadastral Survey. SUPPLEMENTARY...

76 FR 6816 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30... of Land Management--Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153. Attn...

77 FR 58575 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-21

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice... the BLM-Eastern States office in Springfield, Virginia, 30 calendar days from the date of publication in the Federal Register. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management-Eastern States...

76 FR 49760 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-11

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-524-000] Texas Eastern Transmission, LP; Notice of Application Take notice that on July 29, 2011, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056-5310, filed with the Federal Energy...

75 FR 42459 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30... of Land Management-Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153. Attn...

75 FR 4412 - Eastern States: Filing of Plats of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000-L14200000-BJ0000] Eastern States... survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30... of Land Management-Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153. Attn...

76 FR 2133 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30... of Land Management-Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153. Attn...

76 FR 77846 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-14

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30... of Land Management-Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153. Attn...

Formant frequencies in Middle Eastern singers.

PubMed

Hamdan, Abdul-latif; Tabri, Dollen; Deeb, Reem; Rifai, Hani; Rameh, Charbel; Fuleihan, Nabil

2008-01-01

This work was conducted to describe the formant frequencies in a group of Middle Eastern singers and to look for the presence of the singer's formant described in operatic singers. A total of 13 Middle Eastern singers were enrolled in this study. There were 5 men and 8 women. Descriptive analysis was performed to report the various formants (F1, F2, F3, and F4) in both speaking and singing. The Wilcoxon test was used to compare the means of the formants under both conditions. For both sexes combined, for the /a/ vowel, F1 singing was significantly lower than F1 speaking (P = .05) and F3 singing was significantly higher than F3 speaking (P = .046). For the /u/ vowel, only F2 singing was significantly higher than F2 speaking (P = .012). For the /i/ vowel, both F2 and F3 singing were significantly lower than F2 and F3 speaking, respectively (P = .006 and .012, respectively). There was no clustering of the formants in any of the Middle Eastern sung vowels. Formant frequencies for the vowels /a/, /i/, and /u/ differ between Middle Eastern singing vs speaking. There is absence of the singer's formant.

77 FR 63856 - Eastern States: Filing of Plats of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

...] Eastern States: Filing of Plats of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... plats of survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia... CONTACT: Bureau of Land Management-Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153...

78 FR 70573 - Eastern States: Filing of Plats of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-26

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000 L14200000.BJ0000 14X] Eastern... BLM-Eastern States office in Springfield, Virginia, 30 calendar days from the date of publication in the Federal Register. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management-Eastern States, 7450...

78 FR 23952 - Eastern States: Filing of Plats of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

...] Eastern States: Filing of Plats of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... file the plats of survey of the lands described below in the BLM-Eastern States office in Springfield... CONTACT: Bureau of Land Management-Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153...

77 FR 20015 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-03

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP12-88-000] Texas Eastern Transmission, LP; Notice of Application Take notice that on March 19, 2012, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056-5310, filed an application in Docket No...

75 FR 18234 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-09

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of...) will file the plats of survey of the lands described below in the BLM-Eastern States office in... INFORMATION CONTACT: Bureau of Land Management--Eastern States, 7450 Boston Boulevard, Springfield, Virginia...

77 FR 12045 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-28

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP12-68-000] Texas Eastern Transmission, LP; Notice of Application Take notice that on February 16, 2012, Texas Eastern Transmission, LP (Texas Eastern), PO Box 1642, Houston, Texas 77056 filed an application in the above referenced docket...

76 FR 6816 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... in the Federal Register, Volume 76, Number 8, on page 2133 a notice entitled ``Eastern States: Filing... 1, 2011 is official filed. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management--Eastern...

75 FR 39579 - Eastern States: Filing of Plats of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-09

...] Eastern States: Filing of Plats of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... file the plats of survey of the lands described below in the BLM-Eastern States office in Springfield... CONTACT: Bureau of Land Management-Eastern States, 7450 Boston Boulevard, Springfield, Virginia 22153...

76 FR 38381 - Texas Eastern Transmission, LP; Notice of Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-30

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-67-001] Texas Eastern Transmission, LP; Notice of Amendment Take notice that on June 13, 2011, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056, filed in the above referenced docket an amendment...

Midwifery education in Central-Eastern Europe.

PubMed

Mivšek, Polona; Baškova, Martina; Wilhelmova, Radka

2016-02-01

Problems in midwifery in many Central-Eastern European countries are very similar; it is possible to speak about the evolving Central-Eastern model of midwifery care. The educational models of this region have a relatively strong theoretical part; however, there is an insufficient practical dimension. Theoretical part of midwifery education in the universities is relatively autonomous and is slowly changing the professional identity of graduates. Copyright © 2015 Elsevier Ltd. All rights reserved.

Water quality in the eastern Iowa basins

USGS Publications Warehouse

Kalkhoff, Stephen J.; Barnes, Kimberlee K.; Becher, Kent D.; Savoca, Mark E.; Schnoebelen, Douglas J.; Sadorf, Eric M.; Porter, Stephen D.; Sullivan, Daniel J.; Creswell, John

2001-01-01

The Eastern Iowa Basins Study Unit includes the Wapsipinicon, Cedar, Iowa, and Skunk River basins and covers approximately 19,500 square miles in eastern Iowa and southern Minnesota. More than 90 percent of the land in the study unit is used for agricultural purposes. Forested areas account for only 4 percent of the land area.

77 FR 26534 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP12-164-000] Texas Eastern Transmission, LP; Notice of Application Take notice that on April 19, 2012, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056, filed in Docket No. CP12-164-000, a request...

75 FR 72837 - Eastern States: Filing of Plats of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-26

...] Eastern States: Filing of Plats of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... (BLM) will file the plats of survey of the lands described below in the BLM-Eastern States office in... INFORMATION CONTACT: Bureau of Land Management-Eastern States, 7450 Boston Boulevard, Springfield, Virginia...

76 FR 26767 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-09

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000-L14200000-BJ0000] Eastern States... described below in the BLM-Eastern States office in Springfield, Virginia, 30 calendar days from the date of publication in the Federal Register. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management-Eastern States...

78 FR 66352 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP14-9-000] Texas Eastern Transmission, LP; Notice of Application Take notice that on October 17, 2013, Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056, filed an application in Docket No. CP14-9...

76 FR 3651 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-20

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000-L14200000-BJ0000] Eastern States... described below in the BLM-Eastern States office in Springfield, Virginia, 30 calendar days from the date of publication in the Federal Register. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management-Eastern States...

76 FR 2133 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000-L14200000-BJ0000] Eastern States... described below in the BLM-Eastern States office in Springfield, Virginia, 30 calendar days from the date of publication in the Federal Register. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management-Eastern States...

Satisfaction with Quality of Care Received by Patients without National Health Insurance Attending a Primary Care Clinic in a Resource-Poor Environment of a Tertiary Hospital in Eastern Nigeria in the Era of Scaling up the Nigerian Formal Sector Health Insurance Scheme

PubMed Central

Iloh, GUP; Ofoedu, JN; Njoku, PU; Okafor, GOC; Amadi, AN; Godswill-Uko, EU

2013-01-01

Background: The increasing importance of the concept of patients’ satisfaction as a valuable tool for assessing quality of care is a current global healthcare concerns as regards consumer-oriented health services. Aim: This study assessed satisfaction with quality of care received by patients without national health insurance (NHI) attending a primary care clinic in a resource-poor environment of a tertiary hospital in South-Eastern Nigeria. Subject and Methods: This was a cross-sectional study carried out on 400 non-NHI patients from April 2011 to October 2011 at the primary care clinic of Federal Medical Centre, Umuahia, Nigeria. Adult patients seen within the study period were selected by systematic sampling using every second non-NHI patient that registered to see the physicians and who met the selection criteria. Data were collected using pretested, structured interviewer administered questionnaire designed on a five points Likert scale items with 1 and 5 indicating the lowest and highest levels of satisfaction respectively. Satisfaction was measured from the following domains: patient waiting time, patient–staff communication, patient-staff relationship, and cost of care, hospital bureaucracy and hospital environment. Operationally, patients who scored 3 points and above in the assessed domain were considered satisfied while those who scored less than 3 points were dissatisfied. Results: The overall satisfaction score of the respondents was 3.1. Specifically, the respondents expressed satisfaction with patient–staff relationship (3.9), patient–staff communication (3.8), and hospital environment (3.6) and dissatisfaction with patient waiting time (2.4), hospital bureaucracy (2.5), and cost of care (2.6). Conclusion: The overall non-NHI patient's satisfaction with the services provided was good. The hospital should set targets for quality improvement in the current domains of satisfaction while the cost of care has implications for government

Silvical characteristics of eastern hemlock (Tsuga canadensis)

Treesearch

Ashbel F. Hough

1960-01-01

The eastern hemlock (Tsuga canadensis (L.) Carr.), as its common and scientific names imply, is a native of the eastern United States and adjacent Canada. It is one of the four North American species of this genus. The genus name means "yew-leaved" and is of Japanese origin. In 1763 the species was named Pinus canadensis...

76 FR 33342 - Eastern States; Filing of Plats of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

...] Eastern States; Filing of Plats of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... published in the Federal Register, Volume 75, Number 174, on page 54910 a notice entitled ``Eastern States..., 2011 and the plat of survey accepted June 22, 2010, was officially filed in Eastern States Office...

76 FR 16444 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000-L14200000-BJ0000] Eastern States... described below in the BLM-Eastern States office in Springfield, Virginia. DATES: BLM will file the plat of survey on April 22, 2011. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management-Eastern States, 7450...

Habitat Suitability Index Models: Eastern meadowlark

USGS Publications Warehouse

Schroeder, Richard L.; Sousa, Patrick J.

1982-01-01

Habitat preferences of the eastern meadowlark (Sturnella magna) are described in this publication, which is one of a series of Habitat Suitability Index (HSI) models. Habitat use information is presented in a synthesis of the literature on the species-habitat requirements of the eastern meadowlark, followed by the development of the HSI model. The model is presented in three formats: graphic, word, and mathematical, and is designed to provide information for use in impact assessment and habitat management activities.

The Eastern Québec Telepathology Network: a three-year experience of clinical diagnostic services

PubMed Central

2014-01-01

Background The Eastern Quebec Telepathology Network (called Réseau de Télépathologie de l'Est du Québec in French) was created to provide uniform diagnostic telepathology services in a huge territory with low population density. We report our first 3-year experience. Methods The network was funded equally by the Québec ministry of Health and Canada Health Infoway, a federal telehealth funding agency. The coverage includes intraoperative consultations (IOC), expert opinions, urgent analyses and supervision of macroscopic description. The deployment of the equipment and software started in 2010 and clinical activities began in January 2011. This network comprises 24 hospitals providing oncologic surgery, of which 7 have no pathology laboratory and 4 have a pathology laboratory but no pathologist. The real-time gross evaluation during IOC was performed using a macroscopy station and the sample selection was performed distantly by a technician, a pathology assistant or the surgeon under on-site pathologist supervision. Slides were scanned into whole-slide images (WSI). Results As per March 2014, 7,440 slides had been scanned for primary/urgent diagnosis; 1,329 for IOC cases and 2,308 for expert opinions. A 98% concordance rate was found for IOC compared to paraffin material and the average turnaround time was 20 minutes. Expert opinion reports were signed out within 24 hours in 68% of cases and within 72 hours in 85%. A recent multi-method evaluation study of the Network demonstrated that, thanks to telepathology: 1. interruption of IOC service was prevented in hospitals with no pathologist on site; 2. two-stage surgeries and patients transfers were prevented according to surgeons and pathologists; 3. retention and recruitment of surgeons in remote hospitals were facilitated; and 4. professional isolation among pathologists working alone was reduced. This study also demonstrated that wider adoption of telepathology would require technological improvement and that

Qualitative study exploring surgical team members' perception of patient safety in conflict-ridden Eastern Democratic Republic of Congo

PubMed Central

Labat, Francoise; Sharma, Anjali

2016-01-01

Objective To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC). Design In-depth interviews were conducted and analysed using qualitative content analysis. Setting Governmental referral teaching hospital in Eastern DRC. Participants We purposively selected 2–4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed. Results Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs’ reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance. Conclusions The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all. PMID:27113232

50 CFR 300.225 - Eastern High Seas Special Management Area.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 11 2013-10-01 2013-10-01 false Eastern High Seas Special Management Area... Eastern High Seas Special Management Area. (a) Entry notices. The owner and operator of a fishing vessel... at least six hours prior to entering the Eastern High Seas Special Management Area. The owner or...

Association of ring shake in eastern hemlock with tree attributes

Treesearch

John P. Brown; Paul E. Sendak

2006-01-01

Eastern hemlock (Tsuga canadensis (L.) Carr.) is a major or minor associate in many forest types in northeastern North America. There has never been the high level of demand for eastern hemlock lumber that characterizes competing softwoods like white pine and spruce. Nevertheless, periodically interest in greater utilization of eastern hemlock for...

Quebec's Ice Storm '98: "all cards wild, all rules broken" in Quebec's shell-shocked hospitals

PubMed Central

Hamilton, J

1998-01-01

The remarkable ice storm that brought life to a standstill in most of Eastern Ontario and Quebec in January had a huge impact on medical services. Hospitals that lost power found themselves serving as shelters not only for patients but also for staff members and nearby residents. Doctors' offices were forced to close and a large number of operations were cancelled. The 2 articles that follow detail the huge impact the "ice storm of the century" had on health care. PMID:9627567

A survey of blood conservation methods in clinical practice in some urban south-eastern government hospitals in Nigeria.

PubMed

Amucheazi, A O; Ajuzeiogu, V O; Ezike, H A; Odiakosa, M C; Nwoke, O M; Onyia, E

2011-01-01

GENERAL OBJECTIVE: To assess the practice of blood conservation. To determine the methods of blood conservation in use, to assess the lower limit for hemoglobin for elective procedures, to determine transfusion trigger point in practice, to find out limitations in practice and ways to improve clinical practice. This was conducted in February 2009. Self-administered questionnaires were distributed among the surgeons and anesthetists in practice at the University of Nigeria Teaching Hospital, Enugu State University Teaching Hospital, Ebonyi State University Teaching Hospital and National Orthopaedic Hospital, Enugu. The data gathered was analyzed using the SPSS software. : Of participants who agreed to fill the questionnaires, more than 50% were males. The most prevalent specialty was general surgery (24.2%), followed by orthopedics (22.6%), obstetrics and gynecology (20.7%), and anesthesia (17.7%). The lowest hemoglobin limit before the patient was allowed into the theatre for elective procedures was 10 g/dl while individual transfusion trigger points ranged from hemoglobin of 6 to 10 g/dl. Majority of the doctors would avoid homologous blood transfusion in order to avoid transfusion-related diseases and reaction. Regarding knowledge of blood conservation methods and means of avoiding homologous blood, the use of diathermy was highest (12.33%), followed by preoperative blood donation (11.87%), use of hematinics (10.96%), and tourniquet 10.5%. Also, in practice, diathermy was the most frequently used (18.69%), followed by preoperative blood donation (16.16%), use of tourniquet (15.15%), while the Ovadje cell saver was least with 0.01%. Suggestions from respondents on the ways of limiting transfusion-related problems included optimization of patients (24.5%), improvement of standard of living (17.7%), and personnel training (13.3%). There is an agreement with the global trend geared toward minimizing the use of homologous blood by doctors in these hospitals. However

Correlation of measles and dengue infection in Kassala, Eastern Sudan.

PubMed

Abdalla, Tajeldin M; Karsany, Mubarak S; Ali, AbdelAziem A

2015-01-01

Using the clinical case definition adopted by the World Health Organization, a total of 275 suspected cases of measles were enrolled in this study during January-March 2012 in Kassala Teaching Hospital, Eastern Sudan. Various clinical manifestations (fever, headache, cough, coryza, conjunctivitis, skin rash, vomiting, diarrhoea, convulsion, and hemorrhagic manifestations) were reported among these patients. Blood was withdrawn from the first 64 (23.3%) patients. Two samples were hemolyzed and only 60 samples (21.8%) were investigated for measles and dengue IgM antibodies. Antibodies for measles, dengue, and co-infection were detected in the plasma of 12 (20%), seven (11.7%), and 10 (16.7%) samples, respectively. Although there was no significant difference in age, residence, occupation, and vaccination status among the different groups, a high proportion of male patients (P = 0.011), severe cases (P = 0.004), and death ((P = 0.001) were reported among co-infected cases. © 2014 Wiley Periodicals, Inc.

Eastern Devonian shales: Organic geochemical studies

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

Berger, I.A.; Hatchner, P.G.; Miknis, F.P.

The Eastern Devonian shales are represented by a sequence of sediments extending from New York state, south to the northern regions of Georgia and Alabama, and west into Ohio and to the Michigan and Illinois Basins. Correlatives are known in Texas. The shale is regionally known by a number of names: Chattanooga, Dunkirk, Rhinestreet, Huron, Antrim, Ohio, Woodford, etc. These shales, other than those in Texas, have elicited much interest because they have been a source of unassociated natural gas. It is of particular interest, however, that most of these shales have no associated crude oil, in spite of themore » fact that they have some of the characteristics normally attributed to source beds. This paper addresses some of the organic geochemical aspects of the kerogen in these shales, in relation to their oil generating potential. Past organic geochemical studies on Eastern Devonian shales are reviewed. Recent solid state /sup 13/C NMR studies on the nature of the organic matter in Eastern Devonian shales show that Eastern Devonian shales contain a larger fraction of aromatic carbon in their chemical composition. Thus, despite their high organic matter contents, their potential as a petroleum source rock is low, because the kerogen in these shales is of a ''coaly'' nature and hence more prone to producing natural gas.« less

Utilization options for decadent eastern hemlock timber

Treesearch

Matthew F. Winn; Philip A. Araman

2007-01-01

The hemlock woolly adelgid (Adelges tsugae Annand) is a non-native pest that is decimating the eastern hemlock (Tsuga canadensis L.) population in the forests of the eastern United States. Nearly one third of the area inhabited by native hemlocks in the Central Hardwoods region is infested with the insect. Once a tree is heavily infected, it is estimated that tree...

Exotic pests of eastern forests conference proceedings

Treesearch

Kerry O. Britton

1998-01-01

Invasive exotic pest plants, diseases, and insects, have had a dramatic impact on the health and composition of the Eastern forests for many decades. Chestnut blight was discovered in the United States in 1904. Since then, it has virtually destroyed the chestnut population, which once occupied 25 percent of the eastern forest. In the 1860's, the gypsy moth was...

77 FR 54557 - Eastern Idaho Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... DEPARTMENT OF AGRICULTURE Forest Service Eastern Idaho Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Easern Idaho Resource Advisory Committee will meet... between 8 a.m. and 8 p.m., Eastern Standard Time, Monday through Friday. SUPPLEMENTARY INFORMATION: The...

Impact of Nutritional Status and Sleep Quality on Hospital Utilisation in the Oldest Old with Heart Failure.

PubMed

Selan, S; Hellström, A; Fagerström, C

2016-02-01

To describe three-year trends in nutritional status and sleep quality and their impact on hospital utilisation in the oldest old (80 +) with heart failure (HF). Single-centred longitudinal observational study. South-eastern Sweden. 90 elderly (80+) with objectively verified HF. Baseline data from the Mini Nutritional Assessment (MNA) and on sleep quality were collected through structured interviews following the HF diagnosis (n=90) and at a three-year follow-up (n=41). Data on hospital utilisation during the three years following the HF diagnosis were also collected. Nineteen percent of the participants were found to have impaired nutritional status, a condition that increased hospital utilisation by four bed days per year. A majority (85%) had impaired sleep quality, but no impact on hospital utilisation was found. Nutritional status and sleep quality were stable over the three-year period. In the oldest old with HF, impaired nutritional status and impaired sleep quality are already common at HF diagnosis. Impaired nutritional status increases hospital utilisation significantly. Therefore, it is of supreme importance to systematically evaluate nutritional status and sleep quality in the oldest old when they are diagnosed with HF, as well as to take action if impairments are present.

78 FR 79687 - Texas Eastern Transmission, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP14-29-000] Texas Eastern Transmission, LP; Notice of Application Take notice that on December 10, 2013 Texas Eastern Transmission, LP (Texas Eastern), at 5400 Westheimer Court, Houston, Texas 77056, filed an application in Docket No. CP14-29-000 pursuant to section 7(b) of...

Reduction in inappropriate hospital use based on analysis of the causes

PubMed Central

2012-01-01

Background To reduce inappropriate admissions and stays with the application of an improvement cycle in patients admitted to a University Hospital. The secondary objective is to analyze the hospital cost saved by reducing inadequacy after the implementation of measures proposed by the group for improvement. Methods Pre- and post-analysis of a sample of clinical histories studied retrospectively, in which the Appropriateness Evaluation Protocol (AEP) was applied to a representative hospital sample of 1350 clinical histories in two phases. In the first phase the AEP was applied retrospectively to 725 admissions and 1350 stays. The factors associated with inappropriateness were analysed together with the causes, and specific measures were implemented in a bid to reduce inappropriateness. In the second phase the AEP was reapplied to a similar group of clinical histories and the results of the two groups were compared. The cost of inappropriate stays was calculated by cost accounting. Setting: General University Hospital with 426 beds serving a population of 320,000 inhabitants in the centre of Murcia, a city in south-eastern Spain. Results Inappropriate admissions were reduced significantly: 7.4% in the control group and 3.2% in the intervention group. Likewise, inappropriate stays decreased significantly from 24.6% to 10.4%. The cost of inappropriateness in the study sample fell from 147,044 euros to 66,642 euros. The causes of inappropriateness for which corrective measures were adopted were those that showed the most significant decrease. Conclusions It is possible to reduce inadequacy by applying measures based on prior analysis of the situation in each hospital. PMID:23075150

Eastern red cedar: Cedarwood oil extraction and bioactivity

USDA-ARS?s Scientific Manuscript database

Eastern red cedar (ERC), Juniperus virginana L. (Cupressaceae) is a common coniferous evergreen tree and is a very abundant natural resource in the United States. Because of its encroachment onto pastures and rangeland, ERC is considered an invasive species. Eastern red cedar, however, is highly pri...

Issues in Health Care of Middle Eastern Patients

PubMed Central

Lipson, Juliene G.; Meleis, Afaf I.

1983-01-01

Relationships between Middle Eastern patients and Western health care professionals are often troubled by mutual misunderstanding of culturally influenced values and communication styles. Although Middle Easterners vary ethnically, they do share a core of common values and behavior that include the importance of affiliation and family, time and space orientations, interactional style and attitudes toward health and illness. Problems in providing health care involve obtaining adequate information, “demanding behavior” by a patient's family, conflicting beliefs about planning ahead and differing patterns of communicating grave diagnoses or “bad news.” There are guidelines that will provide an understanding of the cultural characteristics of Middle Easterners and, therefore, will improve rather than impede their health care. A personal approach and continuity of care by the same health care professional help to bridge the gap between Middle Eastern cultures and Western medical culture. In addition, periodic use of cultural interpreters helps ameliorate the intensity of some cultural issues. PMID:6364575

Molecular phylogenetic analysis of Fasciola flukes from eastern India.

PubMed

Hayashi, Kei; Ichikawa-Seki, Madoka; Mohanta, Uday Kumar; Singh, T Shantikumar; Shoriki, Takuya; Sugiyama, Hiromu; Itagaki, Tadashi

2015-10-01

Fasciola flukes from eastern India were characterized on the basis of spermatogenesis status and nuclear ITS1. Both Fasciola gigantica and aspermic Fasciola flukes were detected in Imphal, Kohima, and Gantoku districts. The sequences of mitochondrial nad1 were analyzed to infer their phylogenetical relationship with neighboring countries. The haplotypes of aspermic Fasciola flukes were identical or showed a single nucleotide substitution compared to those from populations in the neighboring countries, corroborating the previous reports that categorized them in the same lineage. However, the prevalence of aspermic Fasciola flukes in eastern India was lower than those in the neighboring countries, suggesting that they have not dispersed throughout eastern India. In contrast, F. gigantica was predominant and well diversified, and the species was thought to be distributed in the area for a longer time than the aspermic Fasciola flukes. Fasciola gigantica populations from eastern India were categorized into two distinct haplogroups A and B. The level of their genetic diversity suggests that populations belonging to haplogroup A have dispersed from the west side of the Indian subcontinent to eastern India with the artificial movement of domestic cattle, Bos indicus, whereas populations belonging to haplogroup B might have spread from Myanmar to eastern India with domestic buffaloes, Bubalus bubalis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Coastal Changes, Eastern Lake Michigan, 1970-74.

DTIC Science & Technology

1981-01-01

an effective shore protection agent during the stormiest months of January, February, and March. Till and mixed till bluffs tended to erode less than...final report of a 4-year study of 17 profile lines located along the eastern shore of Lake Michigan. The work v-as carried out under the coastal...26 5 Sediment statistics sum~mary, eastern Lake Michigan (October 1973 to December 1974

78 FR 15797 - Eastern Band of Cherokee Indians Disaster #NC-00049

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13513 and 13514] Eastern Band of Cherokee... Notice of the Presidential declaration of a major disaster for Public Assistance Only for the Eastern... adversely affected by the disaster: Primary Areas: Eastern Band of Cherokee Indians and Associated Lands...

[The effects of a new model of hospital management on undergraduate teaching of urology].

PubMed

Bogado S, Justo; Bogado C, Mariana; López C, Ilse; Rosselot J, Eduardo

2010-04-01

Since January 2005, a new model for hospital coordinated assistance was implanted in Chile, denominated Self Managed Hospitals in net, to improve resource use effectiveness and efficiency. This new design changed health care and teaching models. To analyze, understand and to reflect on how teachers and students of the Urology Unit of the Eastern Campus of the Faculty of Medicine in the University of Chile, perceive learning in this new hospital scenario. A qualitative methodology was used, including semi-structured interviews to chief teachers and focal groups of teachers and students. Also, a written structured questionnaire was answered by a group of 5th year students and interns. University teachers perceive that undergraduate learning is affected in the new hospital scenario. Students think that they have less opportunities to directly interact with patients, and therefore have fewer possibilities to take medical histories, perform physical examinations, and fewer occasions to discuss cases with their tutors. The new health system that runs hospitals under a network could jeopardize undergraduate teaching. This is the case for the Urology Service at Hospital and the corresponding Department of Specialties, where the dominant perception of teachers and a number of students is that their clinical learning is endangered by these innovations. To obtain the learning objectives of the undergraduate program in this subject, reorientation of their ambulatory practice and derivation skills must be rationally elaborated to improve students accomplishment.

Schistosomiasis Sustained Control Program in Ethnic Groups Around Ninefescha (Eastern Senegal).

PubMed

N'Diaye, Monique; Dioukhane, Elhadji M; Ndao, Babacar; Diedhiou, Kemo; Diawara, Lamine; Talla, Idrissa; Vernet, Charlotte; Bessin, François; Barbier, Dominique; Dewavrin, Patrick; Klotz, Francis; Georges, Pierre

2016-09-07

Schistosomiasis is the second most significant parasitic disease in children in several African countries. For this purpose, the "Programme National de Lutte contre les Bilharzioses" (PNLB) was developed in partnership with the World Health Organization (WHO) to control this disease in Senegal. However, geographic isolation of Bedik ethnic groups challenged implementation of the key elements of the schistosomiasis program in eastern Senegal, and therefore, a hospital was established in Ninefescha to improve access to health care as well as laboratory support for this population. The program we have implemented from 2008 in partnership with the PNLB/WHO involved campaigns to 1) evaluate schistosomiasis prevalence in children of 53 villages around Ninefescha hospital, 2) perform a mass drug administration following the protocol established by the PNLB in school-aged children, 3) monitor annual prevalence, 4) implement health education campaigns, and 5) oversee the building of latrines. This campaign led to a drop in schistosomiasis prevalence but highlighted that sustainable schistosomiasis control by praziquantel treatment, awareness of the use of latrines, and inhabitants' voluntary commitment to the program are crucial to improve Schistosoma elimination. Moreover, this study revealed that preschool-aged children, for whom praziquantel was not recommended until 2014 in Senegal, constituted a significant reservoir for the parasite. © The American Society of Tropical Medicine and Hygiene.

Fire in Eastern North American Oak Ecosystems: Filling the Gaps

Treesearch

Julian (Morgan) Varner; Mary Arthur; Stacy Clark; Daniel C. Dey; Justin Hart; Callie Schweitzer

2016-01-01

This special issue of Fire Ecology is focused on the fire ecology of eastern USA oak (Quercus L.) forests, woodlands, and savannas. The papers were presented as part of the Fifth Fire in Eastern Oak Forests Conference in Tuscaloosa, Alabama, USA, in 2015. The topic of fire in eastern oak ecosystems is one that has received insufficient interest from the...

Comparing Western and Eastern criteria for sarcopenia and their association with survival in patients with pancreatic cancer.

PubMed

Wu, Chih-Horng; Chang, Ming-Chu; Lyadov, Vladimir K; Liang, Po-Chin; Chen, Chyi-Mong; Shih, Tiffany Ting-Fang; Chang, Yu-Ting

2018-02-20

Sarcopenia and cachexia are associated with pancreatic cancer and serve as important adverse prognostic factors. Body composition can be analyzed by routine computed tomography (CT) for cancer staging and has been used to study many types of cancer. The CT measurements are robust, but the diagnostic criteria for sarcopenia vary among different studies. Age, sex and race are important factors that affect muscle and fat masses. This study aimed to analyze the effect of different sarcopenia diagnostic criteria on the prognosis of patients with pancreatic cancer. Patients with newly diagnosed pancreatic cancer at National Taiwan University Hospital between October 2013 and October 2016 were retrospectively reviewed in this study. Body composition was assessed using cross-sectional CT images to calculate the total skeletal muscle (TSM) index. The concordance and interobserver variability of the TSM measurements were evaluated using both the Western criteria and the Eastern criteria. Kaplan-Meier analyses and the Cox proportional hazard ratio with two different diagnostic criteria for sarcopenia were used to compare the effect on overall survival (OS). A total of 146 patients with pancreatic cancer were enrolled. The TSM index measured by the Western institute was highly correlated with that measured by the Eastern institute (r = 0.953, p < 0.001). The prevalence of sarcopenia in the patient group at baseline was 66.4% (97/146) by the Western criteria and 11.0% (16/146) by the Eastern criteria, and only low agreement was found between the Western and Eastern criteria (Kappa value = 0.028, p = 0.149). Patients who were sarcopenic by the Western criteria showed no significant difference in OS versus those who were not sarcopenic (p = 0.807). However, patients who were sarcopenic by the Eastern criteria showed a significant difference in OS versus those who were not sarcopenic in a univariate analysis (p = 0.008) and multivariate analysis after adjustment for

50 CFR 300.23 - Eastern Pacific fisheries - Persons and vessels exempted.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Eastern Pacific fisheries - Persons and vessels exempted. 300.23 Section 300.23 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED ACTIVITIES INTERNATIONAL FISHERIES REGULATIONS Eastern Pacific Tuna Fisheries § 300.23 Eastern Pacific...

50 CFR 300.23 - Eastern Pacific fisheries - Persons and vessels exempted.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 11 2013-10-01 2013-10-01 false Eastern Pacific fisheries - Persons and vessels exempted. 300.23 Section 300.23 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED ACTIVITIES INTERNATIONAL FISHERIES REGULATIONS Eastern Pacific Tuna Fisheries § 300.23 Eastern Pacific...

50 CFR 300.23 - Eastern Pacific fisheries - Persons and vessels exempted.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 11 2012-10-01 2012-10-01 false Eastern Pacific fisheries - Persons and vessels exempted. 300.23 Section 300.23 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED ACTIVITIES INTERNATIONAL FISHERIES REGULATIONS Eastern Pacific Tuna Fisheries § 300.23 Eastern Pacific...

50 CFR 300.23 - Eastern Pacific fisheries - Persons and vessels exempted.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 11 2014-10-01 2014-10-01 false Eastern Pacific fisheries - Persons and vessels exempted. 300.23 Section 300.23 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED ACTIVITIES INTERNATIONAL FISHERIES REGULATIONS Eastern Pacific Tuna Fisheries § 300.23 Eastern Pacific...

Establishing strategic alliance among hospitals through SAIS: a case study in Taiwan.

PubMed

Hung, Won-Fu; Hwang, Hsin-Ginn; Liao, Chechen

2005-01-01

Due to a reformed healthcare insurance system and a gradually decreasing public affairs' budget by the government year by year, Central Taiwan Office (CTO), the Department of Health (DOH) in Taiwan, initiated a strategic alliance project of the hospitals subordinated to the DOH in November, 2001. This project was a five-year plan with an attempt to expand and develop three more strategic alliances covering the northern, southern and eastern regions of Taiwan respectively. Through a cooperative system, such an alliance allows the following: resource sharing, technique collaboration, marketing affiliations and so on. In order to decrease operation management costs and improve the quality of service at hospitals, the strategic alliance practice is supported by IS. We call this alignment the IS-enabled strategic alliance. All the IS-enabled functions are supported by the Strategic Alliance Information System (SAIS). In this article, the SAIS developed by the CTO of the DOH is introduced.

Childhood mortality in federal medical centre umuahia, South eastern Nigeria.

PubMed

Charles, Nwafor Chukwuemeka; Chuku, Abali; Anazodo, Nnoli Martin

2014-09-01

This study aimed to evaluate the mortality pattern in children seen at Federal Medical Centre Umuahia (FMCU) Abia state, South Eastern Nigeria. A retrospective cross sectional descriptive study over a 5-year period from January 1, 2004 to December 31, 2008 using data retrieved from the hospital's medical records department. A total of 3,814 children were admitted in the hospital and 434 of them died giving a mortality rate of 11%. The mean age was 1.7 (Std D of 3.19). Two hundred and thirty eight of them were males while 196 of them were females giving a sex ratio of 1.2:1. Majority of the mortality (49%) occurred within 24 hours of admission. The major causes of death during neonatal period were birth asphyxia (34%), prematurity (24%) and neonatal sepsis (24%). Malaria was the leading cause of death beyond the neonatal period accounting for 42% of cases. Other common mortality causes were pneumonia, septicaemia, diarrhea, HIV AIDS and meningitis each accounting for 10%, 10%, 7%, 7% and 5% respectively. The months of July, May and March accounted for most deaths (12%, 12% and 11% respectively). Birth asphyxia and malaria associated deaths were responsible for most deaths during neonatal and beyond neonatal periods respectively. Presence of trained personal at all deliveries will help to reduce neonatal asphyxia. Efforts should be made to reinforce the existing effective malaria control tools.

Introduction to Eastern Philosophy, Social Studies: 6414.23.

ERIC Educational Resources Information Center

Payne, Judy Reeder

Major Eastern philosophies and/or religions consisting of Hinduism, Buddhism, Confucianism, Taoism, and Shintoism are investigated by 10th through 12th grade students in this general social studies quinmester course. Since Eastern philosophical ideas are already influencing students, this course aims to guide students in a universal search for…

78 FR 26652 - Eastern States: Filing of Plat of Survey; Mississippi

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-07

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000 .L1420] Eastern States: Filing of...-Eastern States office in Springfield, Virginia, 30 calendar days from the date of publication in the Federal Register. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management-Eastern States, 7450 Boston...

77 FR 65542 - Eastern Shore Natural Gas Company; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP13-6-000] Eastern Shore Natural Gas Company; Notice of Application Take notice that on October 12, 2012, Eastern Shore Natural Gas Company (Eastern Shore), 1110 Forrest Avenue, Dover, Delaware 19904, filed in the above referenced docket...

77 FR 67021 - Eastern States: Filing of Plat of Survey; Maine

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-08

...] Eastern States: Filing of Plat of Survey; Maine AGENCY: Bureau of Land Management, Interior. ACTION... below in the BLM-Eastern States office in Springfield, Virginia, 30 calendar days from the date of publication in the Federal Register. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management--Eastern...

77 FR 22773 - Texas Eastern Transmission, L.P.; Notice of Response

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-17

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [ Docket No. RP12-318-001] Texas Eastern... order of the Federal Energy Regulatory Commission in the above- captioned proceeding Texas Eastern Transmission, LP (Texas Eastern) submits its response to show cause why it should not be required to file...

78 FR 16293 - Eastern States: Filing of Plat of Survey; Mississippi

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-14

...] Eastern States: Filing of Plat of Survey; Mississippi AGENCY: Bureau of Land Management, Interior. ACTION... below in the BLM-Eastern States office in Springfield, Virginia, 30 calendar days from the date of publication in the Federal Register. FOR FURTHER INFORMATION CONTACT: Bureau of Land Management-Eastern States...

An estimate of syphilis incidence in Eastern Europe

PubMed Central

Herbert, Liam J.; Middleton, Stephen I.

2012-01-01

Aim Eastern Europe experienced epidemic levels of syphilis after the collapse of the Soviet Union. Presently data are less comprehensive outside the European Union (EU) and European Free Trade Association (EFTA). This review aims to identify published papers with suitable data to estimate a regional burden of disease for syphilis in the 19 member countries of Eastern Europe. Methods A systematic literature review was conducted to identify published data relating to syphilis incidence in Eastern Europe through Web of Knowledge, PubMed and Google Scholar databases in addition to the latest surveillance report from the European Center for Disease Prevention and Control. A total of 381 papers fitted our search criteria; 30 papers were subjected to full text analysis. Results Seven papers were included in this study and provided useable data for 13 out of 19 member countries. There was a high level of heterogeneity observed in the incidence rates from the member countries. Gross, population weighted and geographically subdivided incidence rate estimates were carried out but the comprehensiveness of some of the included data is doubtful. Conclusions Despite the limits of the data, the incidence of syphilis in Eastern Europe is still substantially larger than that observed in the EU15 countries. This indicates that efforts to control syphilis in Eastern Europe can be enhanced; however, such goals would require significant investment in infrastructure, technology and surveillance mechanisms. PMID:23198131

The role of birds in the epizootiology of eastern encephalitis

USGS Publications Warehouse

Herman, C.M.

1962-01-01

Eastern encephalitis is a disease of horses, man, birds, and reptiles caused by a virus that in some hosts results in an inflammation of the brain. The causative virus belongs to a group classified as mosquito-borne encephalitides. This disease, more commonly called eastern equine encephalitis in the past, occurs from Wisconsin and Texas to the Atlantic coast and is particularly prevalent on our eastern seaboard.

Pregnant women's experiences of routine counselling and testing for HIV in Eastern Uganda: a qualitative study.

PubMed

Rujumba, Joseph; Neema, Stella; Tumwine, James K; Tylleskär, Thorkild; Heggenhougen, Harald K

2013-05-24

Routine HIV counselling and testing as part of antenatal care has been institutionalized in Uganda as an entry point for pregnant women into the prevention of mother-to-child transmission of HIV (PMTCT) programme. Understanding how women experience this mode of HIV testing is important to generate ideas on how to strengthen the PMTCT programme. We explored pregnant HIV positive and negative women's experiences of routine counselling and testing in Mbale District, Eastern Uganda and formulated suggestions for improving service delivery. This was a qualitative study conducted at Mbale Regional Referral Hospital in Eastern Uganda between January and May 2010. Data were collected using in-depth interviews with 30 pregnant women (15 HIV positive and 15 HIV negative) attending an antenatal clinic, six key informant interviews with health workers providing antenatal care and observations. Data were analyzed using a content thematic approach. Prior to attending their current ANC visit, most women knew that the hospital provided HIV counselling and testing services as part of antenatal care (ANC). HIV testing was perceived as compulsory for all women attending ANC at the hospital but beneficial, for mothers, especially those who test HIV positive and their unborn babies. Most HIV positive women were satisfied with the immediate counselling they received from health workers, but identified the need to provide follow up counselling and support after the test, as areas for improvement. However, most HIV negative women mentioned that they were given inadequate attention during post-test counselling. This left them with unanswered questions and, for some, doubts about the negative test results. In this setting, routine HIV counselling and testing services are known and acceptable to mothers. There is need to strengthen post-test and follow up counselling for both HIV positive and negative women in order to maximize opportunities for primary and post exposure HIV prevention

76 FR 14387 - Texas Eastern Transmission, LP; Notice of Request Under Blanket Authorization

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-118-000] Texas Eastern... Eastern Transmission, LP (Texas Eastern), Post Office Box 1642, Houston, Texas 77251-1642, filed in Docket... West Cameron Blocks 566, 565, and 548, offshore Louisiana, under Texas Eastern's blanket certificate...

Lipid levels among African and Middle-Eastern Bedouin populations.

PubMed

Dreiher, Jacob; Cohen, Arnon D; Weitzman, Shimon; Sharf, Amir; Shvartzman, Pesach

2008-06-01

Previous studies observed higher high-density lipoprotein (HDL) levels and lower triglycerides levels among people of African ancestry. The goal of this study was to characterize lipid levels in Bedouins of African vs. Middle-Eastern ethnicity. A cross-sectional study was conducted in a Bedouin primary care clinic in southern Israel, with 4470 listed individuals over the age of 21, of whom 402 (9%) were of African origin. A stratified random sample was included in the analysis. Associations between ethnicity, age, gender and lipid levels were assessed. Multiple linear regression and logistic regression models were used for multivariate analysis. The study included 261 African Bedouins and 406 Middle-Eastern Bedouins. (median age: 37 years, 58.6% females). The average total cholesterol and low-density lipoprotein (LDL) levels were 10 mg/dl lower among African Bedouins as compared to Middle-Eastern Bedouins (total cholesterol: 168.6 vs. 179.6 mg/dl, p<0.001; LDL: 99.5 vs. 109.0 mg/dl, respectively, p<0.001). Average triglycerides levels were 36 mg/dl lower among African Bedouins as compared to Middle-Eastern Bedouins (102.8 vs. 138.9 mg/dl, respectively, p<0.001). Average HDL levels were 3 mg/dl higher among African Bedouins as compared to Middle-Eastern Bedouins (48.3 vs. 44.6 mg/dl, respectively, p<0.001). A lower prevalence of dyslipidemia was found in African Bedouins, as compared with Middle-Eastern Bedouins.

Ungulate predation and ecological roles of wolves and coyotes in eastern North America.

PubMed

Benson, John F; Loveless, Karen M; Rutledge, Linda Y; Patterson, Brent R

2017-04-01

Understanding the ecological roles of species that influence ecosystem processes is a central goal of ecology and conservation biology. Eastern coyotes (Canis latrans) have ascended to the role of apex predator across much of eastern North America since the extirpation of wolves (Canis spp.) and there has been considerable confusion regarding their ability to prey on ungulates and their ecological niche relative to wolves. Eastern wolves (C. lycaon) are thought to have been the historical top predator in eastern deciduous forests and have previously been characterized as deer specialists that are inefficient predators of moose because of their smaller size relative to gray wolves (C. lupus). We investigated intrinsic and extrinsic influences on per capita kill rates of white-tailed deer (Odocoileus virginianus) and moose (Alces alces) during winter by sympatric packs of eastern coyotes, eastern wolves, and admixed canids in Ontario, Canada to clarify the predatory ability and ecological roles of the different canid top predators of eastern North America. Eastern coyote ancestry within packs negatively influenced per capita total ungulate (deer and moose combined) and moose kill rates. Furthermore, canids in packs dominated by eastern coyote ancestry consumed significantly less ungulate biomass and more anthropogenic food than packs dominated by wolf ancestry. Similar to gray wolves in previous studies, eastern wolves preyed on deer where they were available. However, in areas were deer were scarce, eastern wolves killed moose at rates similar to those previously documented for gray wolves at comparable moose densities across North America. Eastern coyotes are effective deer predators, but their dietary flexibility and low kill rates on moose suggest they have not replaced the ecological role of wolves in eastern North America. © 2017 by the Ecological Society of America.

Ozone and carbon monoxide budgets over the Eastern Mediterranean.

PubMed

Myriokefalitakis, S; Daskalakis, N; Fanourgakis, G S; Voulgarakis, A; Krol, M C; Aan de Brugh, J M J; Kanakidou, M

2016-09-01

The importance of the long-range transport (LRT) on O3 and CO budgets over the Eastern Mediterranean has been investigated using the state-of-the-art 3-dimensional global chemistry-transport model TM4-ECPL. A 3-D budget analysis has been performed separating the Eastern from the Western basins and the boundary layer (BL) from the free troposphere (FT). The FT of the Eastern Mediterranean is shown to be a strong receptor of polluted air masses from the Western Mediterranean, and the most important source of polluted air masses for the Eastern Mediterranean BL, with about 40% of O3 and of CO in the BL to be transported from the FT aloft. Regional anthropogenic sources are found to have relatively small impact on regional air quality in the area, contributing by about 8% and 18% to surface levels of O3 and CO, respectively. Projections using anthropogenic emissions for the year 2050 but neglecting climate change calculate a surface O3 decrease of about 11% together with a surface CO increase of roughly 10% in the Eastern Mediterranean. Copyright © 2016 Elsevier B.V. All rights reserved.

Dust-wind interactions can intensify aerosol pollution over eastern China.

PubMed

Yang, Yang; Russell, Lynn M; Lou, Sijia; Liao, Hong; Guo, Jianping; Liu, Ying; Singh, Balwinder; Ghan, Steven J

2017-05-11

Eastern China has experienced severe and persistent winter haze episodes in recent years due to intensification of aerosol pollution. In addition to anthropogenic emissions, the winter aerosol pollution over eastern China is associated with unusual meteorological conditions, including weaker wind speeds. Here we show, based on model simulations, that during years with decreased wind speed, large decreases in dust emissions (29%) moderate the wintertime land-sea surface air temperature difference and further decrease winds by -0.06 (±0.05) m s -1 averaged over eastern China. The dust-induced lower winds enhance stagnation of air and account for about 13% of increasing aerosol concentrations over eastern China. Although recent increases in anthropogenic emissions are the main factor causing haze over eastern China, we conclude that natural emissions also exert a significant influence on the increases in wintertime aerosol concentrations, with important implications that need to be taken into account by air quality studies.

Dust-wind interactions can intensify aerosol pollution over eastern China

PubMed Central

Yang, Yang; Russell, Lynn M.; Lou, Sijia; Liao, Hong; Guo, Jianping; Liu, Ying; Singh, Balwinder; Ghan, Steven J.

2017-01-01

Eastern China has experienced severe and persistent winter haze episodes in recent years due to intensification of aerosol pollution. In addition to anthropogenic emissions, the winter aerosol pollution over eastern China is associated with unusual meteorological conditions, including weaker wind speeds. Here we show, based on model simulations, that during years with decreased wind speed, large decreases in dust emissions (29%) moderate the wintertime land–sea surface air temperature difference and further decrease winds by −0.06 (±0.05) m s−1 averaged over eastern China. The dust-induced lower winds enhance stagnation of air and account for about 13% of increasing aerosol concentrations over eastern China. Although recent increases in anthropogenic emissions are the main factor causing haze over eastern China, we conclude that natural emissions also exert a significant influence on the increases in wintertime aerosol concentrations, with important implications that need to be taken into account by air quality studies. PMID:28492276

The MERMLS leadership institute for hospital librarians: a new concept in extension service.

PubMed Central

Snelbecker, G E; Timour, J A; Vick, K

1977-01-01

This paper describes a pilot Leadership Institute conducted by the Mid-Eastern Regional Medical Library Service (MERMLS) and a consultant group from Temple University. The purpose of the institute was to instill some basic group leadership techniques in a selected group of geographically dispersed hospital librarians. The institute was conducted in two sessions totalling three days, with two months separating the two sessions. Extensive evaluations by participants at the end of both sessions resulted in general endorsement that the institute's objectives had been attained and that more institutes of this type should be provided. PMID:576208

40 CFR 81.220 - Eastern Oregon Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 18 2014-07-01 2014-07-01 false Eastern Oregon Intrastate Air Quality... Quality Control Regions § 81.220 Eastern Oregon Intrastate Air Quality Control Region. The Eastern Oregon... outermost boundaries of the area so delimited): In the State of Oregon: Baker County, Gilliam County, Grant...

40 CFR 81.220 - Eastern Oregon Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Eastern Oregon Intrastate Air Quality... Quality Control Regions § 81.220 Eastern Oregon Intrastate Air Quality Control Region. The Eastern Oregon... outermost boundaries of the area so delimited): In the State of Oregon: Baker County, Gilliam County, Grant...

40 CFR 81.220 - Eastern Oregon Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 18 2012-07-01 2012-07-01 false Eastern Oregon Intrastate Air Quality... Quality Control Regions § 81.220 Eastern Oregon Intrastate Air Quality Control Region. The Eastern Oregon... outermost boundaries of the area so delimited): In the State of Oregon: Baker County, Gilliam County, Grant...

40 CFR 81.220 - Eastern Oregon Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 17 2011-07-01 2011-07-01 false Eastern Oregon Intrastate Air Quality... Quality Control Regions § 81.220 Eastern Oregon Intrastate Air Quality Control Region. The Eastern Oregon... outermost boundaries of the area so delimited): In the State of Oregon: Baker County, Gilliam County, Grant...

40 CFR 81.220 - Eastern Oregon Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 18 2013-07-01 2013-07-01 false Eastern Oregon Intrastate Air Quality... Quality Control Regions § 81.220 Eastern Oregon Intrastate Air Quality Control Region. The Eastern Oregon... outermost boundaries of the area so delimited): In the State of Oregon: Baker County, Gilliam County, Grant...

Cultural Clues to the Middle Eastern Student. Occasional Paper No. 2.

ERIC Educational Resources Information Center

Parker, Orin D.; And Others

This paper discusses characteristics common to all Middle Eastern students with the exception of Israelis, and addresses itself to those working with Middle Eastern students on American college and university campuses. Middle Eastern students will show themselves to be highly adaptable, but they may demonstrate a formality of manner, particularly…

40 CFR 81.190 - Eastern Idaho Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Eastern Idaho Intrastate Air Quality... Quality Control Regions § 81.190 Eastern Idaho Intrastate Air Quality Control Region. The Eastern Idaho... outermost boundaries of the area so delimited): In the State of Idaho: Bannock County, Bear Lake County...

Eastern Kentucky Teacher and Administrative Stress: Part II

ERIC Educational Resources Information Center

Wright, Sam; Ballestero, Victor

2012-01-01

The purpose of this research was to survey selected Eastern Kentucky Teachers (Elementary, Middle, and High School) to collect data about stress in public schools. This was a continuation study for Eastern Kentucky that collected data on how men and women teachers and men and women administrators handle stress. A stress survey (Appendix C) was…

Eastern and Western Data Sets | Grid Modernization | NREL

Science.gov Websites

and Western Data Sets Eastern and Western Data Sets The Eastern Wind Integration Data Set and Western Wind Integration Data Set were designed to perform wind integration studies and estimate power production from hypothetical wind power plants in the United States. These data sets can help energy

Influences of eastern hemlock mortality on nutrient cycling

Treesearch

Thad E. Yorks; Jennifer C. Jenkins; Donald J. Leopold; Dudley J. Raynal; David A. Orwig

2000-01-01

Mortality of eastern hemlock (Tsuga canadensis (L.) Carriere) may be caused by a variety of agents, but hemlock trees of all sizes over a large geographic area are currently threatened by an outbreak of the hemlock woolly adelgid (HWA: Adelges tsugae Annand) in the eastern United States. In this paper, we review what is currently...

Hemlock woolly adelgid: a threat to eastern forests

Treesearch

Nathan P. Havill; Ligia C. Vieira; Scott M. Salom

2014-01-01

The hemlock woolly adelgid (HWA) (Adelges tsugae Annand) is a destructive, non-native pest of forest and ornamental hemlock trees in eastern North America. It was first collected in the eastern United States in 1951 in Richmond, Virginia, arriving sometime earlier directly from southern Japan, probably on live plant material. Other than its new...

76 FR 25330 - Texas Eastern Transmission, LP; Notice of Request Under Blanket Authorization

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-04

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-216-000] Texas Eastern... Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056, filed in Docket No... in the termination of any services to Texas Eastern's customers, all as more fully set forth in the...

Gravity observations and Bouguer anomaly values for eastern Tennessee

USGS Publications Warehouse

Watkins, J.S.; Yuval, Zvi

1971-01-01

Principal facts for gravity data in eastern Tennessee are presented in computer printout format. These data were used in preparation of Watkins, J. S., 1964, Regional geologic implications of the gravity and magnetic fields of a part of eastern Tennessee.

Comparison of Lamiaceae medicinal uses in eastern Morocco and eastern Andalusia and in Ibn al-Baytar's Compendium of Simple Medicaments (13th century CE).

PubMed

El-Gharbaoui, Asmae; Benítez, Guillermo; González-Tejero, M Reyes; Molero-Mesa, Joaquín; Merzouki, Abderrahmane

2017-04-18

Transmission of traditional knowledge over time and across culturally and historically related territories is an important topic in ethnopharmacology. Here, we contribute to this knowledge by analysing data on medicinal uses in two neighbouring areas of the Western Mediterranean in relation to a historical text that has been scarcely mentioned in historical studies despite its interest. This paper discusses the sharing of popular knowledge on the medicinal uses of plants between eastern Morocco and eastern Andalusia (Spain), focusing on one of the most useful plant families in the Mediterranean area: Lamiaceae. Moreover, we used the classical work of Ibn al-Baytar (13th century CE) The Compendium of Simple Medicaments and Foods as a basis to contrast the possible link of this information, analysing the influence of this historical text on current popular tradition of medicinal plant use in both territories. For data collection, we performed ethnobotanical field research in the eastern part of Morocco, recording current medicinal uses for the Lamiaceae. In addition, we systematically reviewed the ethnobotanical literature from eastern Andalusia, developing a database. We investigated the possible historical link of the shared uses and included in this database the information from Ibn al-Baytar's Compendium. To compare the similarity and diversity of the data, we used Jaccard's similarity index. Our field work provided ethnobotanical information for 14 Lamiaceae species with 95 medicinal uses, serving to treat 13 different pathological groups. Of the total uses recorded in Morocco, 30.5% were shared by eastern Andalusia and found in Ibn al-Baytar's work. There was a higher similarity when comparing current uses of the geographically close territories of eastern Morocco and eastern Andalucía (64%) than for eastern Morocco and this historical text (43%). On the other hand, coincidences between current uses in eastern Andalusia and the ones related in the Compendium

Qualitative study exploring surgical team members' perception of patient safety in conflict-ridden Eastern Democratic Republic of Congo.

PubMed

Labat, Francoise; Sharma, Anjali

2016-04-25

To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC). In-depth interviews were conducted and analysed using qualitative content analysis. Governmental referral teaching hospital in Eastern DRC. We purposively selected 2-4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed. Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs' reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance. The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Prevalence of intestinal parasitic infections in the population of Central Asia on the example of inhabitants of Eastern Afghanistan

PubMed

Korzeniewski, Krzysztof

Parasitic diseases of the gastrointestinal tract are a major health problem worldwide, especially in the Third World countries, where poor standards of hygiene and sanitation as well as the lack of medical care facilitate the spread of food and waterborne infections. To estimate the prevalence of intestinal parasitic infections in Central Asia on the example of the population inhabiting the Ghazni Province in eastern part of the country and to assess the validity of the WHO recommended mass deworming campaign carried out in Afghanistan. Taking into consideration the fact that hundreds of thousands of immigrants from Asia and Africa have recently been flooding into Europe, it has become necessary to investigate the epidemiology of intestinal parasitoses in areas characterized by different climatic conditions and poor standards of sanitation. The study was conducted in eastern Afghanistan between November 2011 and April 2014. Parasitological examination was performed on 3 different study groups: 110 soldiers from the Afghan National Army (adults), 1,167 patients hospitalized at the Ghazni Provincial Hospital (807 children and adolescents aged 1–18 and 360 adults), and 1,869 students (7–18 years) frequenting local schools. The study involved 3,146 people including: 2,248 females and 898 males; 2,676 children and adolescents (1–18 years) and 460 adults (19–85 years). Three stool samples were collected from each study subject at the intervals of 2 to 3 days. The samples were fixed in 10% formalin and then transported by air to the Department of Epidemiology and Tropical Medicine (Military Institute of Medicine) in Poland, where they were examined by light microscopy using 3 different diagnostic methods (direct smear in Lugol’s solution, decantation with distilled water, Fülleborn’s flotation). In total, 1,220 Afghans were found to be infected with pathogenic intestinal parasites (38.8%): 44/110 soldiers (40.0%), 322/807 hospitalized children and adolescents

Eastern Kentucky Teacher and Administrative Stress: Part III

ERIC Educational Resources Information Center

Wright, Sam; Ballestero, Victor

2012-01-01

The purpose of this research was to survey randomly selected Eastern Kentucky Superintendents to collect data about stress in public schools. This was the third year of a continuation study for Eastern Kentucky that collected data on how men and women teachers and men and women administrators handle stress. A stress survey (Appendix A) was sent to…

Assessment of human resources management practices in Lebanese hospitals.

PubMed

El-Jardali, Fadi; Tchaghchagian, Victoria; Jamal, Diana

2010-01-01

the status of employees at their organizations. The upcoming accreditation survey of Lebanese hospitals (2010-2011) presents an opportunity to strengthen HR management and enhance competencies of existing HR managers. Recognizing HR challenges and the importance of effective HR strategies should become a priority to policy-makers and top managers alike. Study findings may extend to other countries in the Eastern Mediterranean region.

Assessment of human resources management practices in Lebanese hospitals.

PubMed

El-Jardali, Fadi; Tchaghchagian, Victoria; Jamal, Diana

2009-11-12

the status of employees at their organizations. The upcoming accreditation survey of Lebanese hospitals (2010-2011) presents an opportunity to strengthen HR management and enhance competencies of existing HR managers. Recognizing HR challenges and the importance of effective HR strategies should become a priority to policy makers and top managers alike. Study findings may extend to other countries in the Eastern Mediterranean region.

Assessment of human resources management practices in Lebanese hospitals

PubMed Central

2009-01-01

responsibilities and who can continuously improve the status of employees at their organizations. The upcoming accreditation survey of Lebanese hospitals (2010-2011) presents an opportunity to strengthen HR management and enhance competencies of existing HR managers. Recognizing HR challenges and the importance of effective HR strategies should become a priority to policy makers and top managers alike. Study findings may extend to other countries in the Eastern Mediterranean region. PMID:19909527

Polyphyly of the Padus group of Prunus (Rosaceae) and the evolution of biogeographic disjunctions between eastern Asia and eastern North America.

PubMed

Liu, Xiao-Lin; Wen, Jun; Nie, Ze-Long; Johnson, Gabriel; Liang, Zong-Suo; Chang, Zhao-Yang

2013-05-01

Prunus subgenus Padus is a group with a wide distribution in temperate eastern Asia and eastern North America with one species extending to Europe and one to Central America. Phylogenetic relationships of subgenus Padus were reconstructed using sequences of nuclear ribosomal ITS, and plastid ndhF gene, and rps16 intron and rpl16 intron. Prunus subgenus Padus is shown to be polyphyletic. Taxa of subgenus Padus and subgenus Laurocerasus are highly intermixed in both the ITS and the plastid trees. The results support two disjunctions between eastern North America and Eurasia within the Padus group. One disjunction is between Prunus virginiana of eastern North America and P. padus of Eurasia, estimated to have diverged at 2.99 (95 % HPD 0.59-6.15)-4.1 (95 % HPD 0.63-8.59) mya. The other disjunction is between P. serotina and its Asian relatives. The second disjunction may have occurred earlier than the former one, but the age estimate is difficult due to the unresolved phylogenetic position of the P. serotina complex.

Optimizing eastern gamagrass forage harvests using growing degree days

USDA-ARS?s Scientific Manuscript database

Tripsacum dactyloides (L.) L., commonly known as eastern gamagrass is useful for grazing, stored forage, soil amelioration and conservation, and potentially as a biofuel feedstock. Our goal was to calculate accumulated growing degree days (GDD) from existing datasets collected for eastern gamagrass...

9 CFR 113.207 - Encephalomyelitis Vaccine, Eastern, Western, and Venezuelan, Killed Virus.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Encephalomyelitis Vaccine, Eastern... PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.207 Encephalomyelitis Vaccine, Eastern, Western, and Venezuelan, Killed Virus. Encephalomyelitis Vaccine, Eastern, Western, and...

9 CFR 113.207 - Encephalomyelitis Vaccine, Eastern, Western, and Venezuelan, Killed Virus.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Encephalomyelitis Vaccine, Eastern... PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.207 Encephalomyelitis Vaccine, Eastern, Western, and Venezuelan, Killed Virus. Encephalomyelitis Vaccine, Eastern, Western, and...

9 CFR 113.207 - Encephalomyelitis Vaccine, Eastern, Western, and Venezuelan, Killed Virus.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Encephalomyelitis Vaccine, Eastern... PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.207 Encephalomyelitis Vaccine, Eastern, Western, and Venezuelan, Killed Virus. Encephalomyelitis Vaccine, Eastern, Western, and...

9 CFR 113.207 - Encephalomyelitis Vaccine, Eastern, Western, and Venezuelan, Killed Virus.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Encephalomyelitis Vaccine, Eastern... PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.207 Encephalomyelitis Vaccine, Eastern, Western, and Venezuelan, Killed Virus. Encephalomyelitis Vaccine, Eastern, Western, and...

Pachybrachis (Coleoptera, Chrysomelidae, Cryptocephalinae) of Eastern Canada

PubMed Central

Barney, Robert J.; LeSage, Laurent; Savard, Karine

2013-01-01

Abstract Seventeen Pachybrachis species occurring in eastern Canada [Ontario (ON), Québec (QC), New Brunswick (NB), Nova Scotia (NS), and Prince Edward Island (PE)] are treated by the authors. Two new national records were discovered, both from southernmost Ontario: P. cephalicus Fall and P. luctuosus Suffrian. Four species were new provincial records: P. cephalicus (ON), P. luctuosus (ON, QC), P. obsoletus Suffrian (NB), P. peccans (PE). A fully illustrated key to the Pachybrachis of eastern Canada is provided and supported with extensive photographs, distribution maps, and plant associations. Three species were distributed from southern Ontario into at least one province in the Maritimes (P. nigricornis (Say), P. obsoletus Suffrianand P. peccans Suffrian). Six species were distributed along the shores of the Great Lakes (Erie, Michigan, and Ontario) and rivers (Ottawa, Saguenay and St. Lawrence), but unknown from central and northern ON and QC (P. bivittatus (Say), P. hepaticus hepaticus (F. E. Melsheimer), P. othonus othonus (Say), P. pectoralis (F. E. Melsheimer), P. spumarius Suffrianand P. trinotatus (F. E. Melsheimer)). Seven species were rare, five being found exclusively from southern ON (P. calcaratus Fall, P. cephalicus, P. luridus (Fabricius), P. subfasciatus (J. E. LeConte)and P. tridens (F. E. Melsheimer)), with two having, in addition, a disjunct population in QC (P. atomarius (F. E. Melsheimer)and P. luctuosus). One species was found to be the northern most extension of an eastern United States (US) distribution into the eastern townships of QC (P. m-nigrum (F. E. Melsheimer)). There were no Pachybrachis that could be considered arctic, subarctic, or boreal species; no specimens were found from Labrador and Newfoundland, and all species had southern affinities. Pachybrachis atomarius, P. calcaratus, P. luridus, P. subfaciatus, and P. tridens, not seen over the last 30–70 years, may be extirpated from eastern Canada. PMID:24163583

Silviculture of forests in the Eastern United States

Treesearch

Daniel C. Dey; John C. Brissette; Callie J. Schweitzer; James M. Guldin

2012-01-01

The forests of the Eastern United States are diverse and provide many products and amenities for people living in the area and beyond. Eastern temperate forests play an important role in determining water yield and quality. They have the potential to sequester large quantities of carbon and influence air quality, and thus climate. Our standard of living is very much...

Hospital activity and hospital profits.

PubMed

Hegji, Charles E

2007-01-01

The paper uses data from a cross section of southeastern hospitals to examine which activities are profitable for hospitals. The analysis suggests that hospitals may operate at less than profit-maximizing levels of output. In addition, contrary to popular belief emergency rooms are shown to be profit generating centers for hospitals.

Difference of clinical phenotypes and immunological features of 22q11.2 deletion syndrome in north-eastern Thai children compare to western countries.

PubMed

Wichajam, Khunton; Kampan, Jureeporn

2014-10-01

22q11.2 deletion syndrome is a common microdeletion syndrome that affected various systems. To determine clinical phenotypes and immunologicalfeatures of 22q11.2 deletion syndrome in north-eastern Thai children compare to western countries. The authors described the clinical and immunological features in 20 north-eastern Thai children with 22q11.2 deletion syndrome that were followed-up at Srinagarind Hospital. Clinical phenotypes were facial dysmorphism (100%), congenital heart disease (80%) and cleft palate (30%). Prevalence of tetralogy of Fallot (TOF) in this syndrome was higher than in western. Serious infections were found including pneumonia, septicemia and brain abscess. Only a patient had panhypogammaglobulinemia and subsequently died. Selective IgA deficiency was not found. There was a twin patient conceivedfrom intracytoplasmic sperm injection (ICSI). TOF is more common in Asian patients than in western which different to selective IgA deficiency. The 22q11.2 deletion syndrome could be consequence from ICSI.

Characterization and susceptibility patterns of clinically important Enterococcus species in eastern Nepal.

PubMed

Acharya, A; Khanal, A; Kanungo, R; Mohapatra, T

2007-12-01

Life threatening infections caused by enterococcus species with multidrug resistance has emerged as a threat to medical care in the present era. This study was conducted to characterize enterococcus species isolated from different clinical samples and to detect the pattern of susceptibility to some of the commonly used antibiotics in B.P Koirala Institute of Health Sciences (BPKIHS), a tertiary care hospital in eastern Nepal. Clinical samples submitted to the microbiology unit of Central Laboratory Service (CLS) for culture and sensitivity during March 2002 - February 2003 was analyzed. Enterococcus species were identified by colony characteristics, gram staining and relevant biochemical tests. Antibiotic susceptibility test was done by the Kirby Bauer disc diffusion technique. Of 50 Enterococcus species isolated, E. faecalis was the predominant isolate (48.0%) followed by E. faecium (32.0%) and E. avium (20.0%). Eighty-eight percent of E. faecalis showed sensitivity to cephotaxime and 87.0% to vancomycin. Multiple drug resistance was observed most commonly in E. faecium. Seventeen percent of E. faecium were resistant to vancomycin and 63.0% to ciprofloxacin and 44.0% to ampicillin. On the contrary E. avium rarely showed resistance to the antimicrobials tested including vancomycin. Enterococcal infections are common nowadays specially in hospitalized patients. Inappropriate use of antibiotics in clinical practice and poultry should be discouraged to prevent the emergence of multidrug resistant species.

Dust-wind interactions can intensify aerosol pollution over eastern China

DOE PAGES

Yang, Yang; Russell, Lynn M.; Lou, Sijia; ...

2017-05-11

Eastern China has experienced severe and persistent winter haze episodes in recent years due to intensification of aerosol pollution, which has adverse impacts on hundreds of millions of people across China1–4. In addition to anthropogenic emissions, the winter aerosol pollution over eastern China is associated with abnormal meteorological conditions, including weaker wind speeds5–9. Using a global climate model and a chemical transport model, we show that variations in dust emissions decrease the wintertime land-sea surface air temperature difference between eastern China and the South China Sea and weaken winds below the lowest 10th percentile of wind speed by 0.06 mmore » s-1. Here, the weakened winds enhance stagnation and account for 13% of the increases in PM2.5 aerosol concentrations over eastern China. Although recent increases in anthropogenic emissions are the main factor causing haze over eastern China, we conclude that natural emissions also exert a significant influence on the increases in wintertime PM2.5 concentrations, with important implications that should be considered in air quality studies.« less

Dust-wind interactions can intensify aerosol pollution over eastern China

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

Yang, Yang; Russell, Lynn M.; Lou, Sijia

Eastern China has experienced severe and persistent winter haze episodes in recent years due to intensification of aerosol pollution, which has adverse impacts on hundreds of millions of people across China1–4. In addition to anthropogenic emissions, the winter aerosol pollution over eastern China is associated with abnormal meteorological conditions, including weaker wind speeds5–9. Using a global climate model and a chemical transport model, we show that variations in dust emissions decrease the wintertime land-sea surface air temperature difference between eastern China and the South China Sea and weaken winds below the lowest 10th percentile of wind speed by 0.06 mmore » s-1. Here, the weakened winds enhance stagnation and account for 13% of the increases in PM2.5 aerosol concentrations over eastern China. Although recent increases in anthropogenic emissions are the main factor causing haze over eastern China, we conclude that natural emissions also exert a significant influence on the increases in wintertime PM2.5 concentrations, with important implications that should be considered in air quality studies.« less

Pregnant women’s experiences of routine counselling and testing for HIV in Eastern Uganda: a qualitative study

PubMed Central

2013-01-01

Background Routine HIV counselling and testing as part of antenatal care has been institutionalized in Uganda as an entry point for pregnant women into the prevention of mother-to-child transmission of HIV (PMTCT) programme. Understanding how women experience this mode of HIV testing is important to generate ideas on how to strengthen the PMTCT programme. We explored pregnant HIV positive and negative women’s experiences of routine counselling and testing in Mbale District, Eastern Uganda and formulated suggestions for improving service delivery. Methods This was a qualitative study conducted at Mbale Regional Referral Hospital in Eastern Uganda between January and May 2010. Data were collected using in-depth interviews with 30 pregnant women (15 HIV positive and 15 HIV negative) attending an antenatal clinic, six key informant interviews with health workers providing antenatal care and observations. Data were analyzed using a content thematic approach. Results Prior to attending their current ANC visit, most women knew that the hospital provided HIV counselling and testing services as part of antenatal care (ANC). HIV testing was perceived as compulsory for all women attending ANC at the hospital but beneficial, for mothers, especially those who test HIV positive and their unborn babies. Most HIV positive women were satisfied with the immediate counselling they received from health workers, but identified the need to provide follow up counselling and support after the test, as areas for improvement. However, most HIV negative women mentioned that they were given inadequate attention during post-test counselling. This left them with unanswered questions and, for some, doubts about the negative test results. Conclusions In this setting, routine HIV counselling and testing services are known and acceptable to mothers. There is need to strengthen post-test and follow up counselling for both HIV positive and negative women in order to maximize opportunities for

14 CFR 95.13 - Eastern United States Mountainous Area.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Eastern United States Mountainous Area. 95.13 Section 95.13 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Eastern United States Mountainous Area. All of the following area excluding those portions specified in...

14 CFR 95.13 - Eastern United States Mountainous Area.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Eastern United States Mountainous Area. 95.13 Section 95.13 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Eastern United States Mountainous Area. All of the following area excluding those portions specified in...

75 FR 68398 - Texas, Oklahoma & Eastern Railroad, LLC-Acquisition and Operation Exemption-Texas, Oklahoma...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... & Eastern Railroad, LLC--Acquisition and Operation Exemption--Texas, Oklahoma & Eastern Railroad Company Texas, Oklahoma & Eastern Railroad, LLC (TOE), a noncarrier, has filed a verified notice of exemption under 49 CFR 1150.31 to acquire from Texas, Oklahoma & Eastern Railroad Company and to operate...

78 FR 66265 - Drawbridge Operation Regulation; Elizabeth River, Eastern Branch, Norfolk, VA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... Operation Regulation; Elizabeth River, Eastern Branch, Norfolk, VA AGENCY: Coast Guard, DHS. ACTION: Notice... Elizabeth River Eastern Branch, mile 1.1, at Norfolk, VA. This deviation is necessary to facilitate... maintenance. The Norfolk Southern 5 railroad Bridge, at mile 1.1, across the Elizabeth River (Eastern Branch...

Racial sexual mixing and factors associated with condom use among Middle Eastern-Canadians.

PubMed

Schoueri, Nour; Bullock, Sandra L; Dubin, Joel A

2010-02-01

Interracial relationships in Canada have increased over the years. However, little research has focused on comparing STI/HIV risk and condom use between those in intra- and interracial relationships, specifically among Middle Eastern-Canadians. A web-based survey was administered to Middle Eastern-Canadians. Logistic regression analysis was used to assess factors associated with consistent condom use. Analyses were stratified by partner's race (Middle Eastern or non-Middle Eastern). The analysis sub-sample consisted of 92 participants. Factors associated with consistent condom use varied between the stratified groups. Among those with Middle Eastern partners, attitude towards marriage and the family and control in the relationship were associated with condom use. Among participants with non-Middle Eastern partners, acculturation and HIV knowledge were found to be associated with condom use. Factors associated with condom use varied between Middle Eastern-Canadians in intra- and interracial relationships. These differences illustrate the need for tailored interventions aimed at increasing condom use among this racial group.

Insect suppression in Eastern Region national forests: 1930-1980.

Treesearch

Richard F. Fowler; Louis F. Wilson; Donna M. Paananen

1986-01-01

Reports on insect suppression in 16 Eastern Region national forests over a 50-year period. Identifies 27 target insects attacked, insecticides used, acreages treated, and results obtained by suppression attempts. Notes that only 3.4% of Eastern national forest land has been chemically treated during the years studied.

Seismic hazard in the eastern United States

USGS Publications Warehouse

Mueller, Charles; Boyd, Oliver; Petersen, Mark D.; Moschetti, Morgan P.; Rezaeian, Sanaz; Shumway, Allison

2015-01-01

The U.S. Geological Survey seismic hazard maps for the central and eastern United States were updated in 2014. We analyze results and changes for the eastern part of the region. Ratio maps are presented, along with tables of ground motions and deaggregations for selected cities. The Charleston fault model was revised, and a new fault source for Charlevoix was added. Background seismicity sources utilized an updated catalog, revised completeness and recurrence models, and a new adaptive smoothing procedure. Maximum-magnitude models and ground motion models were also updated. Broad, regional hazard reductions of 5%–20% are mostly attributed to new ground motion models with stronger near-source attenuation. The revised Charleston fault geometry redistributes local hazard, and the new Charlevoix source increases hazard in northern New England. Strong increases in mid- to high-frequency hazard at some locations—for example, southern New Hampshire, central Virginia, and eastern Tennessee—are attributed to updated catalogs and/or smoothing.

Risk factors for childhood asthma deaths from the UK Eastern Region Confidential Enquiry 2001-2006.

PubMed

Anagnostou, Katherine; Harrison, Brian; Iles, Richard; Nasser, Shuaib

2012-03-01

Confidential enquiries into asthma deaths can identify inadequacies in medical management and factors which contribute to patients' death. To identify risk factors for paediatric asthma deaths over a 6-year period. Observational case-series study of paediatric asthma deaths between 2001-2006 in the UK Eastern Region. Hospital, primary care and post-mortem data were obtained for every child (≤17 yrs) with asthma recorded on the death certificate, and a detailed questionnaire was completed. Information was obtained on asthma severity, medications, hospital admissions, GP and hospital follow-up, adherence, psychosocial / behavioural factors, allergies, details of the terminal attack and precipitating factors. 20 children (10 male; 8-17 yrs; median: 11.5 yrs) died of asthma between 2001-2006. 9/20 had mild to moderate asthma (BTS/ SIGN criteria), 10/20 had severe asthma and 1 child was not known to have asthma. 13/20 were clinically atopic. Only 3 had undergone allergy assessment. 10/20 died between June and August. 12/20 children had adverse psychosocial and behavioural factors. 7/20 children were on non-combination long-acting β2-agonist (LABA) treatment without inhaled corticosteroids (ICS). Almost half the deaths occurred in children with mild/moderate asthma. We recommend that allergic factors and seasonal allergy should be identified early, non-combination LABAs avoided, and speculate that overuse of short-acting β2-agonists (SABAs) may indicate non-adherence with ICS. Asthma deaths in children can be avoided if risk factors are identified early.

Dementia in Eastern Mediterranean countries: A systematic review.

PubMed

Yaghmour, Sara Mahmoud; Bartlett, Ruth; Brannelly, Tula

2018-01-01

Globally, there is an increase in the older population, whose lives are affected by local cultural norms. In Eastern Mediterranean countries, dementia is conventionally hidden from view with few dedicated services or recognition for diagnosis. The aim of this systematic review is to explore the limited literature on dementia and cognitive impairment among older people in Eastern Mediterranean countries to present an evaluation of current practices and to consolidate knowledge for future planning. Thirty-three studies were identified for inclusion in the review, and four themes were apparent. Firstly, prevalence, comorbidity and gender: In Eastern Mediterranean countries, many studies identify that the prevalence of dementia is high. As is the case elsewhere, many older adults in Eastern Mediterranean countries have at least one coexisting long-term condition, and some experience low life-satisfaction. Secondly, culture: In Eastern Mediterranean countries, the older adult is highly respected, and placement outside of the family home is considered an abandonment of family duty. The term dementia carries stigma, and it is widely believed that dementia is caused by 'fate'. Thirdly, recognition and tools: There is a lack of verified assessment instruments to assess for dementia. Despite concerns about the cultural appropriateness of the Mini-Mental State Exam, particularly for people who have low literacy levels, and low literacy being the norm in Eastern Mediterranean countries, the Mini-Mental State Examination is the main assessment instrument. Translation and transition of non-Arabic assessment instruments and tools with psychometric properties presents a challenge for clinicians. Finally, workforce issues: health care workers lack knowledge about dementia, as dementia care is a relatively recent addition to the nursing and medical syllabi. While there were some inconsistencies in the papers published, many of the articles call for increasing educational programmes

76 FR 61682 - Panhandle Eastern Pipe Line Company, LP; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-05

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-546-000] Panhandle Eastern Pipe Line Company, LP; Notice of Application On September 16, 2011, Panhandle Eastern Pipe Line... free). For TTY, call (202) 502-8659. Comment Date: 5 p.m. Eastern Time on October 19, 2011. Dated...

Conservation assessments for five forest bat species in the Eastern United States

Treesearch

Frank R., III Thompson

2006-01-01

Assesses the status, distribution, conservation, and management considerations for five Regional Forester Sensitive Species of forest bats on national forests in the Eastern United States: eastern pipistrelle, evening bat, southeastern myotis, eastern small-footed myotis, and northern long-eared bat. Includes information on the taxonomy, description, life history,...

Characterization of Powassan viruses from Far Eastern Russia.

PubMed

Leonova, Galina N; Kondratov, Ilia G; Ternovoi, Vladimir A; Romanova, Elena V; Protopopova, Elena V; Chausov, Eugene V; Pavlenko, Elena V; Ryabchikova, Elena I; Belikov, Sergey I; Loktev, Valery B

2009-01-01

We report the isolation and detailed characterization of the novel strain, Partizansk/2006, of Powassan virus (POWV) from a human case of infection, which occurred in Primorsky krai, Russia, in 2006. Comparative complete genome sequence analysis of the Far Eastern strains Spassk-9 (1975), Nadezdinsk-1991 and Partizansk/2006 of POWV revealed that these strains are 99.8% similar to the LB strain, which was isolated in Canada in 1958. Phylogenetic analysis of 5' UTR sequences of five other strains of POWV isolated from 1972 to 1986 in Primorsky krai produced similar results. Presumably, Far Eastern POWV has common putative ancestor with LB strain POWV from North America, and the time of divergence of these POWVs is relatively short. We conclude that POWV has become endemic in Far Eastern Russia.

Epidemiology and Outcomes of Hospitalized Burn Patients in Gaza Strip: A Descriptive Study.

PubMed

Elsous, Aymen; Ouda, Mahmoud; Mohsen, Samah; Al-Shaikh, Mohammed; Mokayad, Siham; Abo-Shaban, Nafiz; Hamad, Abed Al-Rahman

2016-01-01

Burns are serious health problems and leading causes of mortality and morbidity in the Eastern Mediterranean Region. This study aimed to overview the epidemiological profile and to present outcomes among hospitalized burn patients in AL Alamy burn center in Gaza. This was a cross-sectional retrospective study of medical records of hospitalized patients from July 2013 to June 2014. Descriptive analysis for studied variables was applied and P ≤ 0.05 considered statistically significant. One humdred eighty nime admissions, 60.8% were males and 63% were under 10 years old. Burn patients in the age range between 19-40 years represented 25.9%. Most common burn injuries were accidental (86.2%), located at home (88.9%), caused by scald (66.1%) and by fire flame (23.8%). On admission, the majority of cases presented with second degree burn (45.5%) or mixed burn (38.6%). The mean TBSA was 11.86 (SD ± 10.78) ranging from 1% to 75% whereas, the mean hospital length of stay was 11.45 (SD ± 12.60) ranging from 1 to 115 days. Total in hospital mortality rate was 2.1% and length of stay was significantly associated with TBSA (P < 0.001). Young children below 10 years seem to be at a higher risk for burn injuries. A significant improvement in burn patients care is observed and practiced and in hospital mortality rate is better compared to neighbouring countries. Preventive programs focusing on safety measures, especially for mothers working in the home, should be implemented urgently to save our children.

Cost of hospitalization for childbirth in India: how equitable it is in the post-NRHM era?

PubMed

Tripathy, Jaya Prasad; Shewade, Hemant D; Mishra, Sanskruti; Kumar, A M V; Harries, A D

2017-08-15

Information on out-of-pocket (OOP) expenditure during childbirth in public and private health facilities in India is needed to make rational decisions for improving affordability to maternal care services. We undertook this study to evaluate the OOP expenditure due to hospitalization from childbirth and its impact on households. This is a secondary data analysis of a nationwide household survey by the National Sample Survey Organization in 2014. The survey reported health service utilization and health care related expenditure by income quintiles and type of health facility. The recall period for hospitalization expenditure was 365 days. OOP expenditure amounting to more than 10% of annual consumption expenditure was termed as catastrophic. Median expenditure per episode of hospitalisation due to childbirth was US$54. The expenditure incurred was about six times higher among the richest quintile compared to the poorest quintile. Median private sector OOP hospitalization expenditure was nearly nine times higher than in the public sector. Hospitalization in a private sector facility leads to a significantly higher prevalence of catastrophic expenditure than hospitalization in a public sector (60% vs. 7%). Indirect cost (43%) constituted the largest share in the total expenditure in public sector hospitalizations. Urban residence, poor wealth quintile, residing in eastern and southern regions of India and delivery in private hospital were significantly associated with catastrophic expenditure. We strongly recommend cash transfer schemes with effective pro-poor targeting to reduce the impact of catastrophic expenditure. Strengthening of public health facilities is required along with private sector regulation.

Volcanism in Eastern Africa

NASA Technical Reports Server (NTRS)

Cauthen, Clay; Coombs, Cassandra R.

1996-01-01

In 1891, the Virunga Mountains of Eastern Zaire were first acknowledged as volcanoes, and since then, the Virunga Mountain chain has demonstrated its potentially violent volcanic nature. The Virunga Mountains lie across the Eastern African Rift in an E-W direction located north of Lake Kivu. Mt. Nyamuragira and Mt. Nyiragongo present the most hazard of the eight mountains making up Virunga volcanic field, with the most recent activity during the 1970-90's. In 1977, after almost eighty years of moderate activity and periods of quiescence, Mt. Nyamuragira became highly active with lava flows that extruded from fissures on flanks circumscribing the volcano. The flows destroyed vast areas of vegetation and Zairian National Park areas, but no casualties were reported. Mt. Nyiragongo exhibited the same type volcanic activity, in association with regional tectonics that effected Mt. Nyamuragira, with variations of lava lake levels, lava fountains, and lava flows that resided in Lake Kivu. Mt. Nyiragongo, recently named a Decade volcano, presents both a direct and an indirect hazard to the inhabitants and properties located near the volcano. The Virunga volcanoes pose four major threats: volcanic eruptions, lava flows, toxic gas emission (CH4 and CO2), and earthquakes. Thus, the volcanoes of the Eastern African volcanic field emanate harm to the surrounding area by the forecast of volcanic eruptions. During the JSC Summer Fellowship program, we will acquire and collate remote sensing, photographic (Space Shuttle images), topographic and field data. In addition, maps of the extent and morphology(ies) of the features will be constructed using digital image information. The database generated will serve to create a Geographic Information System for easy access of information of the Eastem African volcanic field. The analysis of volcanism in Eastern Africa will permit a comparison for those areas from which we have field data. Results from this summer's work will permit

Uplift of quaternary shorelines in eastern Patagonia: Darwin revisited

NASA Astrophysics Data System (ADS)

Pedoja, Kevin; Regard, Vincent; Husson, Laurent; Martinod, Joseph; Guillaume, Benjamin; Fucks, Enrique; Iglesias, Maximiliano; Weill, Pierre

2011-04-01

During his journey on the Beagle, Darwin observed the uniformity in the elevation of coastal Eastern Patagonia along more than 2000 km. More than one century later, the sequences of Quaternary shorelines of eastern Patagonia have been described and their deposits dated but not yet interpreted in terms of geodynamics. Consequently, we i) mapped the repartition of the Quaternary coastal sequences in Argentinean Patagonia, ii) secured accurate altitudes of shoreline angles associated with erosional morphologies (i.e. marine terraces and notches), iii) took into account previous chrono-stratigraphical interpretations in order to calculate mean uplift rates since ~ 440 ka (MIS 11) and proposed age ranges for the higher and older features (up to ~ 180 m), and iv) focused on the Last Interglacial Maximum terrace (MIS 5e) as the best constrained marine terrace (in terms of age and altitude) in order to use it as a tectonic benchmark to quantify uplift rates along the entire passive margin of Eastern South America. Our results show that the eastern Patagonia uplift is constant through time and twice the uplift of the rest of the South American margin. We suggest that the enhanced uplift along the eastern Patagonian coast that interested Darwin during his journey around South America on the Beagle could originate from the subduction of the Chile ridge and the associated dynamic uplift.

Pathogenesis of Aerosolized Eastern Equine Encephalitis Virus Infection in Guinea Pigs

DTIC Science & Technology

2009-01-01

BioMed CentralVirology Journal ss Approved for public release. Distribution is unlimitedOpen AcceResearch Pathogenesis of aerosolized Eastern Equine ...NJ1959 or ArgM) of eastern equine encephalitis virus (EEEV) at two exclusive particle size distributions. Mice were more susceptible to either strain...fatal human infection and thus should serve as a suitable animal model for aerosol exposure to EEEV. Introduction Eastern equine encephalitis (EEE) virus

78 FR 9729 - Eastern States: Filing of Plat of Survey, North Carolina

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-11

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000-L14200000-BJ0000] Eastern States..., on pages 318 through 319 a notice entitled ``Eastern States: Filing of Plats of Survey''. In said... Boundary, lands held in trust for the Eastern Band of Cherokee Indians, Swain County, in the State of North...

Networking technology and health care in Eastern North Carolina.

PubMed

Brinn, Jack E

2004-01-01

Eastern North Carolina, roughly the northern half of the region east of Interstate 95, is a largely rural region that is in transition from a family farm-related economy to small manufacturing and retirement communities. Poor education and the typical poverty-related diseases are endemic. It is served by one academic medical center, the Brody School of Medicine at East Carolina University, and a network of hospitals affiliated with the primary referral site, a 740-bed facility in Greenville. Broadband connectivity in the region is virtually absent outside the small urban centers; therefore, network-enhanced health care delivery is a challenge. ECU has maintained a successful and nationally recognized telemedicine center since 1994, averaging between 600 and 700 interactive consults per year, mostly between ECU physicians and institutional patients. Modernization of the center concept has begun with decentralization - placing videoconferencing equipment in our physicians' offices. With the development of a gigabit Ethernet network in the region new opportunities will soon be available to link off-campus physicians' offices to the medical center. Additional challenges await us in the arena of shared patient databases, home health monitoring, etc. Developments in these areas will be discussed.

The prevalence of extreme Middle Eastern ideologies around the world.

PubMed

Loza, Wagdy; Abd-el-Fatah, Youssef; Prinsloo, Johan; Hesselink-Louw, Anni; Seidler, Katie

2011-02-01

The Belief Diversity Scale (BDS) was administered to Australian, Canadian, Egyptian, and South African participants of different religious backgrounds. The BDS is a 33-item, six subscale instrument that is designed to quantitatively measure Middle Eastern extremist ideologies on risk areas that are reported in the literature. Results demonstrated the reliability and validity of the BDS, thus suggesting that the BDS could be used as an objective tool to measure Middle Eastern extremist ideologies. Results also supported the hypothesis of prevalence of Middle Eastern extremist ideologies around different parts of the world.

Eastern Thought and Movement Forms: Possible Implications for Western Sport.

ERIC Educational Resources Information Center

Case, Bob

1984-01-01

Eastern thought and movement forms can serve as a model for Western sports. Possible implications for physical education that stem from Eastern philosophic beliefs include practical and utilitarian concerns, hidden dimensions, metaphysical concerns, competition concerns, and pedagogical concerns. (DF)

Eastern Spruce Dwarf Mistletoe

Treesearch

F. Baker; Joseph O' Brien; R. Mathiasen; Mike Ostry

2006-01-01

Eastern spruce dwarf mistletoe (Arceuthobium pusillum) is a parasitic flowering plant that causes the most serious disease of black spruce (Picea mariana) throughout its range. The parasite occurs in the Canadian provinces of Saskatchewan, Manitoba, Ontario, Quebec, New Brunswick, Nova Scotia, Prince Edward Island, and Newfoundland; in the Lake States of Minnesota,...

Evaluation of outpatient service quality in Eastern Saudi Arabia. Patient's expectations and perceptions.

PubMed

Al Fraihi, Khalid J; Latif, Shahid A

2016-04-01

To investigate perceptions and expectations of patients regarding hospital outpatient services by using a service quality gap model and factors influencing such gaps. In this cross-sectional descriptive study conducted between October and November 2014 in the outpatient waiting areas of a hospital in the Eastern Province of Saudi Arabia, a sample of 306 patients was selected by convenience sampling technique. The data was collected through an Arabic version of the service quality (SERVQUAL) questionnaire consisting of 2 parts: patients' demographic characteristics, and 22 items scales of patients' expectations and perceptions of SERVQUAL. The data was analyzed by confirmatory factor analysis, independent, and paired t samples tests and one way analysis of variance test The results showed that the proposed model for service quality dimensions had a good fit by satisfying the recommended values. The patients' expectations exceeded perceptions in all service quality dimensions indicating statistically significant service quality gaps (t=26.3, p less than 0.000). Findings revealed that the empathy dimension contributed most patients' expectations (4.7 ± 0.5) and perceptions (3.7 ± 0.8) scores, and responsiveness contributed least to expectations (4.5 ± 0.6) and perceptions (3.2 ± 0.8) scores. Prompt services showed highest service quality gap, while observation of privacy showed the smallest service quality gap in the statements. The study showed a significant association between gender, age, education, multiple visits, and service quality dimensions. The proposed model is valid and reliable and significant service quality gaps of all 5 dimensions need to be prioritized and addressed by focused improvement efforts of hospital management.

Eastern Tropical Pacific Precipitation Response to Zonal SPCZ events

NASA Astrophysics Data System (ADS)

Durán-Quesada, A. M.; Lintner, B. R.

2014-12-01

Extreme El Niño events and warming conditions in the eastern tropical Pacific have been linked to pronounced spatial displacements of the South Pacific Convergence Zone known as "zonal SPCZ" events.. Using a global dataset of Lagrangian back trajectories computed with the FLEXPART model for the period 1980-2013, comprehensive analysis of the 3D circulation characteristics associated with the SPCZ is undertaken. Ten days history of along-trajectory specific humidity, potential vorticity and temperature are reconstructed for zonal SPCZ events as well as other states,, with differences related to El Niño intensity and development stage as well as the state of the Western Hemisphere Warm Pool. How zonal events influence precipitation over the Eastern Tropical Pacific is examined using back trajectories, reanalysis, TRMM precipitation, and additional satellite derived cloud information. It is found that SPCZ displacements are associated with enhanced convection over the Eastern Tropical Pacific in good agreement with prior work. The connection between intensification of precipitation over the eastern Tropical Pacific during zonal events and suppression of rainfall over the Maritime continent is also described.

Bacterial profile of urinary tract infection and antimicrobial susceptibility pattern among pregnant women attending at Antenatal Clinic in Dil Chora Referral Hospital, Dire Dawa, Eastern Ethiopia

PubMed Central

Derese, Behailu; Kedir, Haji; Teklemariam, Zelalem; Weldegebreal, Fitsum; Balakrishnan, Senthilkumar

2016-01-01

Purpose The aim of this study was to determine the bacterial profile of urinary tract infection (UTI) and antimicrobial susceptibility pattern among pregnant women attending at antenatal clinic in Dil Chora Referral Hospital, Dire Dawa, Eastern Ethiopia. Patients and methods An institutional-based cross-sectional study was conducted from February 18, 2015 to March 25, 2015. Clean-catch midstream urine specimens were collected from 186 pregnant women using sterile containers. Then, culture and antimicrobial susceptibility tests were performed by standard disk diffusion method. Patient information was obtained using pretested structured questionnaire. Data were entered and cleaned using EpiData Version 3 and then exported to Statistical Package for Social Science (Version 16) for further analysis. Results The prevalence of significant bacteriuria was 14%. Gram-negative bacteria were more prevalent (73%). Escherichia coli (34.6%), coagulase-negative staphylococci (19.2%), Pseudomonas aeruginosa (15.4%), and Klebsiella spp. (11.5%) were common bacterial isolates, where most of them were resistant against ampicillin, amoxicillin, tetracycline, trimethoprim–sulfamethoxazole, and chloramphenicol. Multidrug resistance (resistance in ≥2 drugs) was seen in 100% of the isolated bacteria. A majority of the bacterial isolates were sensitive to ciprofloxacin, ceftriaxone, erythromycin, and gentamicin. Conclusion This study found a number of bacterial isolates with very high resistance to the commonly prescribed drugs from pregnant women with and without symptoms of UTI. Therefore, the early routine detection of causative agents of UTI and determining their drug susceptibility pattern are important for pregnant women to avoid complications in mother and fetus. Ciprofloxacin, ceftriaxone, gentamicin, and erythromycin can be used with great care for the empirical treatment of UTI. PMID:26937197

PEDIATRIC OCULAR TOXOCARIASIS IN JIANGSU PROVINCE, EASTERN CHINA.

PubMed

Zhang, Hai-Fang; Hua, Hai-Yong; Wang, Wei

2015-01-01

Ocular toxocariasis is caused by migration of a Toxocara larva through the posterior eye. We report the first case of pediatric ocular toxocariasis caused by T. canis in Jiangsu Province, eastern China. A 6-year-old girl presented to Suzhou Municipal Children's Hospital with a complaint of right eye redness, minimal white discharge, no photophobia, eye pain, visual impairment, fever or arthralgia. She was initially diagnosed as having conjunctivitis; however, a 2-month treatment with lomefloxacin 0.3% eye drops gave no improvements. The diagnosis was made based on medical history (contact with dogs), clinical features and detection of T. canis IgG antibodies with an enzyme-linked immunosorbent assay (ELISA). Anthelmintic therapy with albendazole in combination with prednisolone resulted in improvement of the ocular symptoms. Ocular toxocariasis is rarely reported in China. However, the rapid economic development in China, could mean an increase in pet dogs with the potential increased risk of contracting toxocariasis if no control measures are taken. Disposal of pet litter, deworming of infected pets, complete cooking of meats, thorough rinsing of fruits and vegetables, and good hand-washing may help prevent human infections. Ocular toxocariasis should be considered in the differential diagnosis of patients with conjunctivitis that does not resolve with treatment.

Drinking water quality and hospital admissions of elderly people for gastrointestinal illness in Eastern Massachusetts, 1998-2008.

PubMed

Beaudeau, Pascal; Schwartz, Joel; Levin, Ronnie

2014-04-01

We used a Poisson regression to compare daily hospital admissions of elderly people for acute gastrointestinal illness in Boston against daily variations in drinking water quality over an 11-year period, controlling for weather, seasonality and time trends. The Massachusetts Water Resources Authority (MWRA), which provides non-filtered water to 1.5 million people in the greater Boston area, changed its disinfection method from chlorination to ozonation during the study period so we were also able to evaluate changes in risk associated with the change in disinfection method. Other available water quality data from the MWRA included turbidity, fecal coliforms, UV-absorbance, and planktonic algae and cyanobacteriae concentrations. Daily weather, rainfall data and water temperature were also available. Low water temperature, increases in turbidity and, to a lesser extent, in fecal coliform and cyanobacteriae were associated with a higher risk of hospital admissions, while the shift from chlorination to ozonation has possibly reduced the health risk. The MWRA complied with US drinking water regulations throughout the study period. Copyright © 2014 Elsevier Ltd. All rights reserved.

Agreement between Eastern Michigan University and the Eastern Michigan University Chapter of the American Association of University Professors, September 1, 1985-August 31, 1987.

ERIC Educational Resources Information Center

American Association of Univ. Professors, Washington, DC.

The collective bargaining agreement between Eastern Michigan University and the Eastern Michigan University Chapter of the American Association of University Professors (AAUP) covering the period September 1, 1985-August 31, 1987 is presented. Items covered in the agreement include: definitions, unit recognition, management rights, union rights,…

Influence of fire on mammals in eastern oak forests

Treesearch

Patrick D. Keyser; W. Mark Ford

2006-01-01

With the exception of small mammals, little research has been conducted in eastern oak forests on the influence of fire on mammals. Several studies have documented little or no change inrelative abundance or community measures for non-volant small mammals in eastern oak (Quercus spp.) forests following fires despite reductions in leaf litter, small woody debris, and...

Education and Social Transformation in Central and Eastern Europe

ERIC Educational Resources Information Center

Halász, Gábor

2015-01-01

This article evaluates the outcomes of the efforts of Central and Eastern European (CEE) countries to make their education systems more effective in enhancing broader social and economic goals. It focuses on those 11 Central and Eastern European countries which became members of the EU in 2004 or following this date. First, it presents a short…

Referral hospitals in the Democratic Republic of Congo as complex adaptive systems: similar program, different dynamics.

PubMed

Karemere, Hermès; Ribesse, Nathalie; Kahindo, Jean-Bosco; Macq, Jean

2015-01-01

In many African countries, first referral hospitals received little attention from development agencies until recently. We report the evolution of two of them in an unstable region like Eastern Democratic Republic of Congo when receiving the support from development aid program. Specifically, we aimed at studying how actors' network and institutional framework evolved over time and what could matter the most when looking at their performance in such an environment. We performed two cases studies between 2006 and 2010. We used multiple sources of data: reports to document events; health information system for hospital services production, and "key-informants" interviews to interpret the relation between interventions and services production. Our analysis was inspired from complex adaptive system theory. It started from the analysis of events implementation, to explore interaction process between the main agents in each hospital, and the consequence it could have on hospital health services production. This led to the development of new theoretical propositions. Two events implemented in the frame of the development aid program were identified by most of the key-informants interviewed as having the greatest impact on hospital performance: the development of a hospital plan and the performance based financing. They resulted in contrasting interaction process between the main agents between the two hospitals. Two groups of services production were reviewed: consultation at outpatient department and admissions, and surgery. The evolution of both groups of services production were different between both hospitals. By studying two first referral hospitals through the lens of a Complex Adaptive System, their performance in a context of development aid takes a different meaning. Success is not only measured through increased hospital production but through meaningful process of hospital agents'" network adaptation. Expected process is not necessarily a change; strengthened

Status of infection control policies and organisation in European hospitals, 2001: the ARPAC study.

PubMed

Struelens, M J; Wagner, D; Bruce, J; MacKenzie, F M; Cookson, B D; Voss, A; van den Broek, P J; Gould, I M

2006-08-01

Patient safety in hospital care depends on effective infection control (IC) programmes. The Antimicrobial Resistance Prevention and Control (ARPAC) study assessed the organisation, components and human resources of IC programmes in European hospitals. A questionnaire survey of policies and procedures implemented in 2001 for the surveillance and control of nosocomial infection and antibiotic resistance was completed by 169 acute-care hospitals from 32 European countries, categorised by five geographical regions. A formal IC programme existed in 72% of hospitals, and a multidisciplinary IC committee was operational in 90%. Trained IC nurses (ICNs) were present in 80% of hospitals (ranging from 54% in south-east and central-eastern Europe, to 100% in northern Europe), whereas 74% had one or more trained IC doctors (ICDs) (ranging from 46% in south-east Europe to 84% in western Europe). Median staffing levels were 2.33 ICNs/1,000 beds and 0.94 ICDs/1,000 beds. The intensity of IC programmes scored higher in centres from northern and western Europe than from other European regions. Written guidelines promoted hand hygiene for healthcare workers in 89% of hospitals, education in 85%, and audit in 46%. Guidelines recommended use of alcohol-based solutions (70%) and/or medicated/antiseptic soap (43%) for decontamination of non-soiled hands. Use of alcohol-based solutions varied according to region, from 41% in southern Europe to 100% in northern Europe, compared with use of medicated soap from 77% in southern Europe to 11% in northern Europe (p < 0.01). These findings showed that IC programmes in European hospitals suffer from major deficiencies in human resources and policies. Staffing levels for ICNs were below recommended standards in the majority of hospitals. Education programmes were incomplete and often not supported by audit of performance. Hand hygiene procedures were sub-standard in one-third of centres. Strengthening of IC policies in European hospitals should

A study of melanoma in Eastern European migrants in Italy.

PubMed

Astrua, Chiara; Fava, Paolo; Brizio, Matteo; Savoia, Paola

2017-04-01

Cancer survival rates are lower in Eastern Europe. To describe, based on a single-centre database in northern Italy, clinical, histopathological, and prognostic features of melanoma in a migrant population from Eastern Europe. We retrospectively analysed data from 18,190 consecutive foreign patients who visited our institution, with 49 cases of melanoma from Eastern Europe. The control group was represented by 1,003 Italian melanoma patients diagnosed and followed at our centre during the same time period. Patients from Eastern Europe were mainly females with lower median age, without significant differences regarding primary melanoma site, relative to the control group. Diagnosis was made at the place of birth in 30.6% and in our centre for the remainder. Median Breslow thickness was greater (p = 0.0178), and aggressive histotypes (p = 0.0017) and ulcerated melanomas (p = 0.002) were significantly over-represented, particularly when diagnosed in the patients' native country. Disease was more advanced at diagnosis (p = 0.0001), regardless of the place of initial diagnosis (51% had a progressive disease within one year which rose to 80% if diagnosed before admission to our centre), and the percentage of patients who died within one year was significantly higher (p = 0.022), relative to the control group. Our study shows a poor prognosis for melanoma patients diagnosed in Eastern Europe. Moreover, for migrant populations moving from Eastern to Western European countries, financial difficulties, poor social integration, and language barriers, with consequent late access to healthcare facilities, may account for a worse prognosis.

Eastern Denali Fault surface trace map, eastern Alaska and Yukon, Canada

USGS Publications Warehouse

Bender, Adrian M.; Haeussler, Peter J.

2017-05-04

We map the 385-kilometer (km) long surface trace of the right-lateral, strike-slip Denali Fault between the Totschunda-Denali Fault intersection in Alaska, United States and the village of Haines Junction, Yukon, Canada. In Alaska, digital elevation models based on light detection and ranging and interferometric synthetic aperture radar data enabled our fault mapping at scales of 1:2,000 and 1:10,000, respectively. Lacking such resources in Yukon, we developed new structure-from-motion digital photogrammetry products from legacy aerial photos to map the fault surface trace at a scale of 1:10,000 east of the international border. The section of the fault that we map, referred to as the Eastern Denali Fault, did not rupture during the 2002 Denali Fault earthquake (moment magnitude 7.9). Seismologic, geodetic, and geomorphic evidence, along with a paleoseismic record of past ground-rupturing earthquakes, demonstrate Holocene and contemporary activity on the fault, however. This map of the Eastern Denali Fault surface trace complements other data sets by providing an openly accessible digital interpretation of the location, length, and continuity of the fault’s surface trace based on the accompanying digital topography dataset. Additionally, the digitized fault trace may provide geometric constraints useful for modeling earthquake scenarios and related seismic hazard.

77 FR 50157 - Notice of Public Meeting, Eastern Washington Resource Advisory Council Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-20

...; HAG 12-0260] Notice of Public Meeting, Eastern Washington Resource Advisory Council Meeting AGENCY.... Department of the Interior, Bureau of Land Management (BLM) Eastern Washington Resource Advisory Council... Bureau of Land Management's Eastern Washington and San Juan Resource Management Plan and the U.S. Forest...

75 FR 42125 - Notice of Public Meeting, Eastern Montana Resource Advisory Council Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-20

... Public Meeting, Eastern Montana Resource Advisory Council Meeting AGENCY: Bureau of Land Management... Interior, Bureau of Land Management (BLM) Eastern Montana Resource Advisory Council (RAC) will meet as indicated below. DATES: The next regular meeting of the Eastern Montana Resource Advisory Council will be...

Eastern Renewable Generation Integration Study: Redefining What’s Possible for Renewable Energy

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

Bloom, Aaron

NREL project manager Aaron Bloom introduces NREL’s Eastern Renewable Generation Integration Study (ERGIS) and high-performance computing capabilities and new methodologies that allowed NREL to model operations of the Eastern Interconnection at unprecedented fidelity. ERGIS shows that the Eastern Interconnection can balance the variability and uncertainty of wind and solar photovoltaics at a 5-minute level, for one simulated year.

Eastern Pine Shoot Borer

Treesearch

Louis F. Wilson

1978-01-01

The eastern pineshoot borer Eucosma gloriola Heinrich 2, also known as the white pine tip moth, American pine shoot moth, white pine shoot borer, and Tordeuse americaine, du pin, injures young conifers in Northeastern North America. Because it infests the new shoots of sapling conifers, this insect is particularly destructive on planted trees destined for the Christmas...

77 FR 23495 - Notice of Public Meeting, Eastern Washington Resource Advisory Council Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-19

...; HAG 12-0164] Notice of Public Meeting, Eastern Washington Resource Advisory Council Meeting AGENCY... 1972, the U.S. Department of the Interior, Bureau of Land Management (BLM) Eastern Washington Resource... of Land Management's Eastern Washington and San Juan Resource Management Plan, and the U.S. Forest...

40 CFR 81.100 - Eastern Washington-Northern Idaho Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Eastern Washington-Northern Idaho... Designation of Air Quality Control Regions § 81.100 Eastern Washington-Northern Idaho Interstate Air Quality Control Region. The Eastern Washington-Northern Idaho Interstate Air Quality Control Region consists of...

76 FR 13271 - DeQueen and Eastern Railroad, LLC-Corporate Family Transaction Exemption-Texas, Oklahoma...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-10

... Eastern Railroad, LLC--Corporate Family Transaction Exemption--Texas, Oklahoma & Eastern Railroad, LLC DeQueen and Eastern Railroad, LLC (DQ&E) and Texas, Oklahoma & Eastern Railroad, LLC (TOE), have filed a... the competitive balance with carriers outside the corporate family. Under 49 U.S.C. 10502(g), the...

Fire ecology and bird populations in eastern deciduous forests

Treesearch

Vanessa L. Artman; Todd F. Hutchinson; Jeffrey D. Brawn; Jeffrey D. Brawn

2005-01-01

Eastern deciduous forests are located across the central portion of eastern North America and provide habitat for a wide diversity of bird species. The occurrence of fi re in the region has been associated with the presence of humans for over 10,000 yr. While pre-European fire regimes are poorly understood, fire is widely thought to have promoted and maintained large...

Surface Deformation and Lower Crustal Flow in Eastern Tibet

PubMed

Royden; Burchfiel; King; Wang; Chen; Shen; Liu

1997-05-02

Field observations and satellite geodesy indicate that little crustal shortening has occurred along the central to southern margin of the eastern Tibetan plateau since about 4 million years ago. Instead, central eastern Tibet has been nearly stationary relative to southeastern China, southeastern Tibet has rotated clockwise without major crustal shortening, and the crust along portions of the eastern plateau margin has been extended. Modeling suggests that these phenomena are the result of continental convergence where the lower crust is so weak that upper crustal deformation is decoupled from the motion of the underlying mantle. This model also predicts east-west extension on the high plateau without convective removal of Tibetan lithosphere and without eastward movement of the crust east of the plateau.

7. DETAIL OF INTAKE PIER, LOOKING SOUTHWEST FROM EASTERN SACRAMENTO ...

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

7. DETAIL OF INTAKE PIER, LOOKING SOUTHWEST FROM EASTERN SACRAMENTO LEVEE. - Sacramento River Water Treatment Plant Intake Pier & Access Bridge, Spanning Sacramento River approximately 175 feet west of eastern levee on river; roughly .5 mile downstream from confluence of Sacramento & American Rivers, Sacramento, Sacramento County, CA

A 12-Month Prospective, Observational Study of Treatment Regimen and Quality of Life Associated with ADHD in Central and Eastern Europe and Eastern Asia

ERIC Educational Resources Information Center

Goetz, Michal; Yeh, Chin-Bin; Ondrejka, Igor; Akay, Aynur; Herczeg, Ilona; Dobrescu, Iuliana; Kim, Boong Nyun; Jin, Xingming; Riley, Anne W.; Martenyi, Ferenc; Harrison, Gavan; Treuer, Tamas

2012-01-01

Objectives: This prospective, observational, non-randomized study aimed to describe the relationship between treatment regimen prescribed and the quality of life (QoL) of ADHD patients in countries of Central and Eastern Europe (CEE) and Eastern Asia over 12 months. Methods: 977 Male and female patients aged 6-17 years seeking treatment for…

75 FR 54910 - Eastern States: Filing of Plats of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLES956000-L14200000-BJ0000-LXSITRST0000] Eastern States: Filing of Plats of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of... Federal Register, Volume 75, Number 131, on page 39579 a notice entitled ``Eastern States: Filing of Plats...

78 FR 17422 - Eastern Band of Cherokee Indians; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

.... FEMA-4103-DR; Docket ID FEMA-2013-0001] Eastern Band of Cherokee Indians; Major Disaster and Related... Presidential declaration of a major disaster for the Eastern Band of Cherokee Indians (FEMA-4103-DR), dated... ``Stafford Act''), as follows: I have determined that the damage to the lands associated with the Eastern...

76 FR 29234 - Texas Eastern Transmission, LP; Notice of Request Under Blanket Authorization

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-20

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-477-000] Texas Eastern Transmission, LP; Notice of Request Under Blanket Authorization Take notice that on May 10, 2011 Texas Eastern Transmission, LP (Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056, filed in Docket No. CP11-477-000...

Anthracnose Diseases of Eastern Hardwoods

Treesearch

Frederick H. Berry

1985-01-01

Anthracnose diseases of hardwood trees are widespread throughout the Eastern United States. The most common symptom of these diseases is dead areas or blotches on the leaves. Because of the brown and black, scorched appearance of the leaves, the diseases are sometimes called leaf blight.

Patient experiences of in-hospital preparations for follow-up care at home.

PubMed

Keller, Gretchen; Merchant, Alefia; Common, Carol; Laizner, Andrea M

2017-06-01

To examine patient experiences of hospital-based discharge preparation for referral for follow-up home care services. To identify aspects of discharge preparation that will assist patients with their transition from hospital-based care to home-based follow-up care. To improve patients' transitions from hospital-based care to community-based home care, hospitals incorporate home care referral processes into discharge planning. This includes patient preparation for follow-up home care services. While there is evidence to support that such preparation needs to be more patient-centred to be effective, there is little knowledge of patient experiences of preparation that would guide improvements. Qualitative descriptive study. The study was carried out at a supra-regional hospital in Eastern Canada. Findings are based on thematic content analysis of 13 semi-structured interviews of patients requiring home care after hospitalisation on a medical or surgical unit. Most interviews were held within one week of discharge. Patient experiences were associated with patient attitudes and levels of engagement in preparation. Attitudes and levels of engagement were seen as related to one another. Those who 'didn't really think about it', had low engagement, while those with the attitude 'guide me', looked for partnership. Those who had an attitude of 'this is what I want', had a very high level of engagement. Previous experience with home care services influenced patients' level of trust in the health care system, and ultimately shaped their attitudes towards and levels of engagement in preparation. Patient preparation for follow-up home care can be improved by assessing their knowledge of and previous experiences with home care. Patients recognised as using a proactive approach may be highly vulnerable. © 2016 John Wiley & Sons Ltd.

Crust-mantle mechanical coupling in Eastern Mediterranean and eastern Turkey.

PubMed

Özeren, M Sinan

2012-05-29

Present-day crust-mantle coupling in the Eastern Mediterranean and eastern Turkey is studied using the Global Positioning System (GPS) and seismic anisotropy data. The general trend of the shear wave fast-splitting directions in NE Turkey and Lesser Caucaus align well with the geodetic velocities in an absolute plate motion frame of reference pointing to an effective coupling in this part of the region of weak surface deformation. Farther south, underneath the Bitlis Suture, however, there are significant Pn delays with E-W anisotropy axes indicating significant lateral escape. Meanwhile, the GPS reveals very little surface deformation. This mismatch possibly suggests a decoupling along the suture. In the Aegean, the shear wave anisotropy and the Pn anisotropy directions agree with the extensional component of the right-lateral shear strains except under the Crete Basin and other parts of the southern Aegean Sea. This extensional direction matches perfectly also with the southward pulling force vectors across the Hellenic trench; however, the maximum right-lateral shear directions obtained from the GPS data in the Aegean do not match either of these anisotropies. Seismic anisotropy from Rayleigh waves sampled at 15 s, corresponding to the lower crust, match the maximum right-lateral maximum shear directions from the GPS indicating decoupling between the crust and the mantle. This decoupling most likely results from the lateral variations of the gravitational potential energies and the slab-pull forces.

Crust-mantle mechanical coupling in Eastern Mediterranean and Eastern Turkey

PubMed Central

Sinan Özeren, M.

2012-01-01

Present-day crust-mantle coupling in the Eastern Mediterranean and eastern Turkey is studied using the Global Positioning System (GPS) and seismic anisotropy data. The general trend of the shear wave fast-splitting directions in NE Turkey and Lesser Caucaus align well with the geodetic velocities in an absolute plate motion frame of reference pointing to an effective coupling in this part of the region of weak surface deformation. Farther south, underneath the Bitlis Suture, however, there are significant Pn delays with E-W anisotropy axes indicating significant lateral escape. Meanwhile, the GPS reveals very little surface deformation. This mismatch possibly suggests a decoupling along the suture. In the Aegean, the shear wave anisotropy and the Pn anisotropy directions agree with the extensional component of the right-lateral shear strains except under the Crete Basin and other parts of the southern Aegean Sea. This extensional direction matches perfectly also with the southward pulling force vectors across the Hellenic trench; however, the maximum right-lateral shear directions obtained from the GPS data in the Aegean do not match either of these anisotropies. Seismic anisotropy from Rayleigh waves sampled at 15 s, corresponding to the lower crust, match the maximum right-lateral maximum shear directions from the GPS indicating decoupling between the crust and the mantle. This decoupling most likely results from the lateral variations of the gravitational potential energies and the slab-pull forces. PMID:22592788

76 FR 55700 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-08

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Filing of Plat of Survey; Louisiana. SUMMARY: The Bureau of Land Management (BLM) will file the plat of survey of the lands described below in the BLM--Eastern States office in Springfield, Virginia, 30...

76 FR 45293 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Filing of Plat of Survey; Wisconsin. SUMMARY: The Bureau of Land Management (BLM) will file the plat of survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30...

76 FR 65533 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-21

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of filing of plat of survey; North Carolina. SUMMARY: The Bureau of Land Management (BLM) will file the plat of survey of the land described below in the BLM-Eastern States office in Springfield, Virginia, 30...

75 FR 65028 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-21

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Filing of Plat of Survey; North Carolina. SUMMARY: The Bureau of Land Management (BLM) will file the plat of survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30...

75 FR 13302 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of filing of plats of survey; North Carolina and Wisconsin. SUMMARY: The Bureau of Land Management (BLM) will file the plat of survey of the lands described below in the BLM-Eastern States office in...

76 FR 55700 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-08

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Filing of Plat of Survey; Minnesota. SUMMARY: The Bureau of Land Management (BLM) will file the plat of survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30...

76 FR 45292 - Eastern States: Filing of Plats of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-28

...] Eastern States: Filing of Plats of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Filing of Plats of Survey; Alabama and Wisconsin. SUMMARY: The Bureau of Land Management (BLM) will file the plats of survey of the lands described below in the BLM-Eastern States office in Springfield...

76 FR 48882 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-09

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice Of Filing Of Plat Of Survey; Wisconsin. SUMMARY: The Bureau of Land Management (BLM) will file the plat of survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30...

78 FR 48900 - Eastern States: Filing of Plat of Survey

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-12

...] Eastern States: Filing of Plat of Survey AGENCY: Bureau of Land Management, Interior. ACTION: Notice of filing of plat of survey; New York. SUMMARY: The Bureau of Land Management (BLM) will file the plat of survey of the lands described below in the BLM-Eastern States office in Springfield, Virginia, 30...

Eastern Europe in Western Civilization Textbooks: The Example of Poland

ERIC Educational Resources Information Center

Kulczycki, John J.

2005-01-01

Over a decade ago the newsletter of the American Historical Association "Perspectives" carried a long lead article entitled "Teaching 'Eastern Europe' without the Iron Curtain." Referring to the challenge posed by the revolutions of 1989 in Eastern Europe to the teaching of European history, the author, Larry Wolff, saw it as…

Differences in development among children and adolescents in eastern and western China.

PubMed

Zhang, Ying-Xiu; Wang, Shu-Rong

2010-01-01

There are wide-ranging differences in human growth, not only between ethnic groups but also between regions. China covers a vast area and has a very large population. However, no studies on the differences in development among children and adolescents in eastern and western China have been reported. This study assessed the differences in stature and body weight in children and adolescents in eastern and western China. Using data derived from two national surveys on students' constitution and health carried out by the Chinese government in 1985 and 2005, the average stature and body weight for children and adolescents aged 7-18 years in eastern and western China were calculated. The differences of mean values between eastern and western China were compared. Boys and girls in eastern China were taller and heavier than their counterparts in western China in all age groups (7-18 years) in 2005, the average differences being 3.56 cm, 4.56 kg (urban boys), 3.05 cm, 2.92 kg (urban girls), 4.04 cm, 4.19 kg (rural boys) and 3.48 cm, 2.96 kg (rural girls). In 18-year-old groups, the differences in the stature and body weight between eastern and western China were 2.82 cm, 5.17 kg for urban boys, 1.86 cm, 2.11 kg for urban girls, 2.26 cm, 3.38 kg for rural boys and 1.96 cm, 1.38 kg for rural girls, respectively. From 1985 to 2005, differences in stature and body weight of children and adolescents between eastern and western China have continuously expanded. There have been obvious regional variations in development in children and adolescents in China, the variations in development in children and adolescents between eastern and western China being related to regional economic status and living standards of residents.

Introduction: Postcolonial studies and postsocialism in Eastern Europe

PubMed Central

Owczarzak, Jill

2010-01-01

The introduction to this special section explores the ways in which postcolonial studies contribute a deeper understanding of postsocialist change in Central and Eastern Europe. Since the collapse of socialism, anthropological and other social science studies of Eastern Europe have highlighted deep divides between “East” and “West” and drawn attention to the ways in which socialist practices persist into the postsocialist period. We seek to move beyond discourses of the East/West divide by examining the postsocialist context through the lens of postcolonial studies. We look at four aspects of postcolonial studies and explore their relevance for understanding postsocialist Eastern Europe: orientalism, nation and identity, hybridity, and voice. These themes are particular salient from the perspective of gender and sexuality, key concepts through which both postcolonialism and postsocialism can be understood. We thus pay particular attention to the exchange of ideas between East/West, local/global, and national/international arenas. PMID:20651941

Radiation Oncology in the Developing Economies of Central and Eastern Europe.

PubMed

Esiashvili, Natia

2017-04-01

Eastern Europe is represented by 22 countries of significant variability in population density and degree of economic development. They have been affected by past geopolitical isolation due to their association with the "Soviet Block." Currently, all Eastern European countries except Slovenia are low- or middle-income level and 10 of them are part of European Union. Health care systems in Central and Eastern Europe have been influenced by the legacy of centralized soviet-era governance; however, most countries, particularly in European Union zone, have gone through health care reforms directed toward modernizing infrastructure and staffing. The level of health financing available through health insurance has increased in the region, although still lags behind the Western European levels. After adjusting for differing population age structures, overall incidence rates in both sexes are lower in Eastern and Central Europe compared with the Northern and Western European countries; however, mortality remains higher. There is an ongoing shortage of oncology services in Eastern Europe, including radiotherapy equipment and personnel. Eastern European radiotherapy field is highly diverse with large differences among countries regarding staffing structure, training, accreditation, and defined roles and responsibilities. The rapid diffusion of technological innovations has been identified as one of the most important factors driving the escalating health care expenses, and the need for better cost-effective solutions applicable to the local health care systems and levels of economic development. Copyright © 2017 Elsevier Inc. All rights reserved.

Optimising recovery after surgery: Predictors of early discharge and hospital readmission.

PubMed

Carter, Jonathan; Philp, Shannon; Wan, King M

2016-10-01

Fast track surgery (FTS) programs minimise the stress response after surgery and allow for enhanced recovery. To document the frequency and incidence of adverse events in patients enrolled on a FTS program and to investigate factors associated with shorter length of stay and readmission to hospital. A seven-year updated surgical audit of patients undergoing laparotomy for suspected or confirmed malignancy on a FTS program. Five hundred and fifty patients comprise the study group. Average age and body mass index (BMI) were 55 years and 28, respectively. Mean length of stay (LOS) was 3.4 days with 194 (35%) patients discharged on day 2. Six (1%) patients had confirmed venous thromboembolism (VTE), three of whom were diagnosed on pre-operative imaging. Overall, transfusion rate was 5%. Adverse events in decreasing frequency were hospital readmission (4%) and significant wound infection (3%). All other adverse events were uncommon with rates <0.5%. Factors associated with a discharge on or after day 3 include age, pathology, Eastern Cooperative Oncology Group performance status, incision type, operating time, blood transfusion and cyclo-oxygenase 2 inhibitors. Factors associated with hospital readmission include longer operating time, performance of lymph node sampling/dissection, longer LOS, development of wound infection, febrile morbidity, return to the operating room, unplanned intensive care unit admission and presence of other complications. Patients managed by a FTS protocol can expect enhanced outcomes when compared to historical controls. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART) Clients in Bale Zone Hospitals, South Eastern Ethiopia.

PubMed

Haile, Demewoz; Takele, Abulie; Gashaw, Ketema; Demelash, Habtamu; Nigatu, Dabere

2016-01-01

Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can't control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia. Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM) curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure. The incidence rate of treatment failure was found 9.38 (95% CI 7.79-11.30) per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61-7.73)].Similarly, lower CD4 count (<100 m3/dl) at initiation of ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46-5.84).Bedridden [AHR = 5.02; 95% CI: (1.98-12.73)] and ambulatory [AHR = 2.12; 95% CI: (1.08-4.07)] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72-5.44)]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99-9.54]. Having other opportunistic infection during ART initiation was also associated with higher odds of experiencing

Predictors of Treatment Failure among Adult Antiretroviral Treatment (ART) Clients in Bale Zone Hospitals, South Eastern Ethiopia

PubMed Central

Takele, Abulie; Gashaw, Ketema; Demelash, Habtamu; Nigatu, Dabere

2016-01-01

Background Treatment failure defined as progression of disease after initiation of ART or when the anti-HIV medications can’t control the infection. One of the major concerns over the rapid scaling up of ART is the emergence and transmission of HIV drug resistant strains at the population level due to treatment failure. This could lead to the failure of basic ART programs. Thus this study aimed to investigate the predictors of treatment failure among adult ART clients in Bale Zone Hospitals, South east Ethiopia. Methods Retrospective cohort study was employed in four hospitals of Bale zone named Goba, Robe, Ginir and Delomena. A total of 4,809 adult ART clients were included in the analysis from these four hospitals. Adherence was measured by pill count method. The Kaplan Meier (KM) curve was used to describe the survival time of ART patients without treatment failure. Bivariate and multivariable Cox proportional hazards regression models were used for identifying associated factors of treatment failure. Result The incidence rate of treatment failure was found 9.38 (95% CI 7.79–11.30) per 1000 person years. Male ART clients were more likely to experience treatment failure as compared to females [AHR = 4.49; 95% CI: (2.61–7.73)].Similarly, lower CD4 count (<100 m3/dl) at initiation of ART was found significantly associated with higher odds of treatment failure [AHR = 3.79; 95% CI: (2.46–5.84).Bedridden [AHR = 5.02; 95% CI: (1.98–12.73)] and ambulatory [AHR = 2.12; 95% CI: (1.08–4.07)] patients were more likely to experience treatment failure as compared to patients with working functional status. TB co-infected clients had also higher odds to experience treatment failure [AHR = 3.06; 95% CI: (1.72–5.44)]. Those patients who had developed TB after ART initiation had higher odds to experience treatment failure as compared to their counter parts [AHR = 4.35; 95% CI: (1.99–9.54]. Having other opportunistic infection during ART initiation was also

Complete Mitochondrial DNA Analysis of Eastern Eurasian Haplogroups Rarely Found in Populations of Northern Asia and Eastern Europe

PubMed Central

Derenko, Miroslava; Malyarchuk, Boris; Denisova, Galina; Perkova, Maria; Rogalla, Urszula; Grzybowski, Tomasz; Khusnutdinova, Elza; Dambueva, Irina; Zakharov, Ilia

2012-01-01

With the aim of uncovering all of the most basal variation in the northern Asian mitochondrial DNA (mtDNA) haplogroups, we have analyzed mtDNA control region and coding region sequence variation in 98 Altaian Kazakhs from southern Siberia and 149 Barghuts from Inner Mongolia, China. Both populations exhibit the prevalence of eastern Eurasian lineages accounting for 91.9% in Barghuts and 60.2% in Altaian Kazakhs. The strong affinity of Altaian Kazakhs and populations of northern and central Asia has been revealed, reflecting both influences of central Asian inhabitants and essential genetic interaction with the Altai region indigenous populations. Statistical analyses data demonstrate a close positioning of all Mongolic-speaking populations (Mongolians, Buryats, Khamnigans, Kalmyks as well as Barghuts studied here) and Turkic-speaking Sojots, thus suggesting their origin from a common maternal ancestral gene pool. In order to achieve a thorough coverage of DNA lineages revealed in the northern Asian matrilineal gene pool, we have completely sequenced the mtDNA of 55 samples representing haplogroups R11b, B4, B5, F2, M9, M10, M11, M13, N9a and R9c1, which were pinpointed from a massive collection (over 5000 individuals) of northern and eastern Asian, as well as European control region mtDNA sequences. Applying the newly updated mtDNA tree to the previously reported northern Asian and eastern Asian mtDNA data sets has resolved the status of the poorly classified mtDNA types and allowed us to obtain the coalescence age estimates of the nodes of interest using different calibrated rates. Our findings confirm our previous conclusion that northern Asian maternal gene pool consists of predominantly post-LGM components of eastern Asian ancestry, though some genetic lineages may have a pre-LGM/LGM origin. PMID:22363811

Fall management of eastern gamagrass

USDA-ARS?s Scientific Manuscript database

Recent research has suggested that eastern gamagrass (EGG) may be an effective alternative to chopped straw in the blended diets of dairy heifers and cows. Most extension materials discussing appropriate fall management of EGG recommend avoiding harvest within 6 weeks of first frost. Using this guid...

The eastern migratory caribou: the role of genetic introgression in ecotype evolution.

PubMed

Klütsch, Cornelya F C; Manseau, Micheline; Trim, Vicki; Polfus, Jean; Wilson, Paul J

2016-02-01

Understanding the evolutionary history of contemporary animal groups is essential for conservation and management of endangered species like caribou (Rangifer tarandus). In central Canada, the ranges of two caribou subspecies (barren-ground/woodland caribou) and two woodland caribou ecotypes (boreal/eastern migratory) overlap. Our objectives were to reconstruct the evolutionary history of the eastern migratory ecotype and to assess the potential role of introgression in ecotype evolution. STRUCTURE analyses identified five higher order groups (i.e. three boreal caribou populations, eastern migratory ecotype and barren-ground). The evolutionary history of the eastern migratory ecotype was best explained by an early genetic introgression from barren-ground into a woodland caribou lineage during the Late Pleistocene and subsequent divergence of the eastern migratory ecotype during the Holocene. These results are consistent with the retreat of the Laurentide ice sheet and the colonization of the Hudson Bay coastal areas subsequent to the establishment of forest tundra vegetation approximately 7000 years ago. This historical reconstruction of the eastern migratory ecotype further supports its current classification as a conservation unit, specifically a Designatable Unit, under Canada's Species at Risk Act. These findings have implications for other sub-specific contact zones for caribou and other North American species in conservation unit delineation.

The eastern migratory caribou: the role of genetic introgression in ecotype evolution

PubMed Central

Klütsch, Cornelya F. C.; Manseau, Micheline; Trim, Vicki; Polfus, Jean; Wilson, Paul J.

2016-01-01

Understanding the evolutionary history of contemporary animal groups is essential for conservation and management of endangered species like caribou (Rangifer tarandus). In central Canada, the ranges of two caribou subspecies (barren-ground/woodland caribou) and two woodland caribou ecotypes (boreal/eastern migratory) overlap. Our objectives were to reconstruct the evolutionary history of the eastern migratory ecotype and to assess the potential role of introgression in ecotype evolution. STRUCTURE analyses identified five higher order groups (i.e. three boreal caribou populations, eastern migratory ecotype and barren-ground). The evolutionary history of the eastern migratory ecotype was best explained by an early genetic introgression from barren-ground into a woodland caribou lineage during the Late Pleistocene and subsequent divergence of the eastern migratory ecotype during the Holocene. These results are consistent with the retreat of the Laurentide ice sheet and the colonization of the Hudson Bay coastal areas subsequent to the establishment of forest tundra vegetation approximately 7000 years ago. This historical reconstruction of the eastern migratory ecotype further supports its current classification as a conservation unit, specifically a Designatable Unit, under Canada’s Species at Risk Act. These findings have implications for other sub-specific contact zones for caribou and other North American species in conservation unit delineation. PMID:26998320

Magnet hospital recognition in hospital systems over time.

PubMed

Lasater, Karen B; Richards, Michael R; Dandapani, Nikila B; Burns, Lawton R; McHugh, Matthew D

2017-06-13

Magnet hospitals are recognized for nursing excellence and high-value patient outcomes, yet little is known about which and when hospitals pursue Magnet recognition. Concurrently, hospital systems are becoming a more prominent feature of the U.S. health care landscape. The aim of the study was to examine Magnet adoption among hospital systems over time. Using American Hospital Association surveys (1998-2012), we characterized the proportion of Magnet hospitals belonging to systems. We used hospital level fixed-effects regressions to capture changes in a given system hospital's Magnet status over time in relation to a variety of conditions, including prior Magnet adoption by system affiliates and nonaffiliates in local and geographically distant markets and whether these relationships varied by degree of system centralization. The proportion of Magnet hospitals belonging to a system is increasing. Prior Magnet adoption by a hospital within the local market was associated with an increased likelihood of a given system hospital becoming Magnet, but the effect was larger if there was prior adoption by affiliates (7.4% higher likelihood) versus nonaffiliates (2.7% higher likelihood). Prior adoption by affiliates and nonaffiliates in geographically distant markets had a lesser effect. Hospitals belonging to centralized systems were more reactive to Magnet adoption of nonaffiliate hospitals as compared with those in decentralized systems. Hospital systems take an organizational perspective toward Magnet adoption, whereby more system affiliates achieve Magnet recognition over time. The findings are relevant to health care and nursing administrators and policymakers interested in the diffusion of an empirically supported organizational innovation associated with quality outcomes, particularly in a time of increasing hospital consolidation and system expansion. We identify factors associated with Magnet adoption across system hospitals and demonstrate the importance of

Human paleoecological integration in subarctic eastern Beringia

NASA Astrophysics Data System (ADS)

Lanoë, François B.; Reuther, Joshua D.; Holmes, Charles E.; Hodgins, Gregory W. L.

2017-11-01

We contribute to the understanding of megafauna extinction and human dispersal in subarctic eastern Beringia by focusing on changes in the trophic dynamics of the large mammal community as well as the ecological role of humans as a predator and competitor. We reconstruct habitat use by megafauna and humans throughout the Pleistocene-Holocene boundary based on zooarchaeological data and stable isotope ratios of collagen. Our results are consistent with habitat heterogeneity and availability being important factors in the changing abundance of large herbivores. We argue that an increase in herbivore diversity and biomass at the beginning of the Bølling-Allerød interstadial and a relative lack of competitors favored the initial human colonization of subarctic eastern Beringia. As herbivore resources dwindled later in the Late Glacial, people increasingly relied on bison and wapiti. By efficiently extracting some of the highest-ranked resources in the landscape, people are likely to have contributed to the trophic displacement or regional extirpation of other large predators. The ecological patterns that we observe in subarctic eastern Beringia are consistent with a mixture of both top-down and bottom-up controls over biotic turnover.

Evaluation of flood preparedness in government healthcare facilities in Eastern Province, Sri Lanka

PubMed Central

Farley, Jessica M.; Suraweera, Inoka; Perera, W. L. S. P.; Hess, Jeremy; Ebi, Kristie L.

2017-01-01

ABSTRACT Background: Sri Lanka is vulnerable to floods and other hydro-meteorological disasters. Climate change is projected to increase the intensity of these events. Objective: This study aimed to assess the flood preparedness in healthcare facilities in Eastern Province. Design: This was a cross-sectional, descriptive, mixed methods study conducted in Trincomalee District. Surveys were conducted in 31 government healthcare facilities, using a pre-tested, structured questionnaire covering the last 5 years. Seven in-depth interviews were conducted with randomly selected Medical Officers in Charge or their equivalent, and 3 interviews were conducted with Medical Offices of Health. Results: Two general hospitals, 3 base hospitals, 11 divisional hospitals, and 15 primary care units were included. Six respondents (19.4%) reported flooding in their facility, and 19 (61.3%) reported flooding in their catchment area. For the health workforce, 77.4% of respondents reported not enough staff to perform normal service delivery during disasters, and 25.5% reported staff absenteeism due to flooding. Several respondents expressed a desire for more disaster-specific and general clinical training opportunities for themselves and their staff. Most respondents (80.7%) reported no delays in supply procurement during weather emergencies, but 61.3% reported insufficient supplies to maintain normal service delivery during disasters. Four facilities (12.9%) had disaster preparedness plans, and 4 (12.9%) had any staff trained on disaster preparedness or management within the last year. One quarter (25.8%) of respondents had received any written guidance on disaster preparedness from the regional, provincial, or national level in the last year. Conclusions: While there is a strong health system operating in Sri Lanka, improvements are needed in localized and appropriate disaster-related training, resources for continuing clinical education, and investments in workforce to strengthen flood

Evaluation of flood preparedness in government healthcare facilities in Eastern Province, Sri Lanka.

PubMed

Farley, Jessica M; Suraweera, Inoka; Perera, W L S P; Hess, Jeremy; Ebi, Kristie L

2017-01-01

Sri Lanka is vulnerable to floods and other hydro-meteorological disasters. Climate change is projected to increase the intensity of these events. This study aimed to assess the flood preparedness in healthcare facilities in Eastern Province. This was a cross-sectional, descriptive, mixed methods study conducted in Trincomalee District. Surveys were conducted in 31 government healthcare facilities, using a pre-tested, structured questionnaire covering the last 5 years. Seven in-depth interviews were conducted with randomly selected Medical Officers in Charge or their equivalent, and 3 interviews were conducted with Medical Offices of Health. Two general hospitals, 3 base hospitals, 11 divisional hospitals, and 15 primary care units were included. Six respondents (19.4%) reported flooding in their facility, and 19 (61.3%) reported flooding in their catchment area. For the health workforce, 77.4% of respondents reported not enough staff to perform normal service delivery during disasters, and 25.5% reported staff absenteeism due to flooding. Several respondents expressed a desire for more disaster-specific and general clinical training opportunities for themselves and their staff. Most respondents (80.7%) reported no delays in supply procurement during weather emergencies, but 61.3% reported insufficient supplies to maintain normal service delivery during disasters. Four facilities (12.9%) had disaster preparedness plans, and 4 (12.9%) had any staff trained on disaster preparedness or management within the last year. One quarter (25.8%) of respondents had received any written guidance on disaster preparedness from the regional, provincial, or national level in the last year. While there is a strong health system operating in Sri Lanka, improvements are needed in localized and appropriate disaster-related training, resources for continuing clinical education, and investments in workforce to strengthen flood and other disaster resilience within the government

Characteristic of low vision patients attending an eye hospital in eastern region of Nepal.

PubMed

Labh, R K; Adhikari, P R; Karki, P; Singh, S K; Sitoula, R P

2015-01-01

Low vision is an important public health problem. To study the profile of low vision patients in a hospital of Nepal. Information related to the patients' profile, visual status, ocular disease and, low vision devices prescribed were obtained retrospectively from the records of 1,860 visually- impaired patients, regardless of the cause, presenting to the low vision department of the Biratnagar Eye Hospital, Biratnagar, Nepal, over a period of four years. These patients, after a comprehensive ocular examination, underwent low vision examination by an ophthalmologist and a low vision specialist. Of 1,860 patients, males comprised 1298 (70 %), while 562 (30 %) patients were female. Six hundred and one (32.3%) patients were of less than 20 years while 398(21.4%) were more than 60 years of age. Agriculture (500, 27 %), household work (341, 18 %) and students (308, 17 %) were the common occupations. Retinal diseases were the commonest cause of low vision. They were: macular disorders 408 (22 %), retinitis pigmentosa 226 (12.1 %) and other retinal causes 361 (19.4 %) (diabetic retinopathy, choroidal coloboma, post laser for retinal vasculitis and central retinal/branch retinal vein occlusion, healed macular chorioretinal scar secondary to retinochroiditis and choroiditis). Refractive error 215 (11.5 %), amblyopia 49 (2.6 %), optic atrophy 144 (7.8 %) and microphthalmos 105 (5.6 %) were the other causes. Uncorrected distance visual acuity was between 6/24 and 6/60 in 509 (27.4 %) and between 5/60 and PL in 1,327 (71.3 %) patients. Similarly, near visual acuity with vision better than 2.50 M (N 20) and worse than 2.50 M (N20) was present in 643(34.5%) and 1,217(65.5%) patients. About 67% and 54.5% of the patients had some improvement in their distance and near visual acuity with glasses and low vision aids. Distance spectacles 909 (49 %), near spectacles 106 (5.7 %), hand held magnifiers 78 (4 %) and telescopes 18 (1 %) were the optical devices prescribed. The prevalence of

Air pollution or global warming: Attribution of extreme precipitation changes in eastern China—Comments on "Trends of extreme precipitation in Eastern China and their possible causes"

NASA Astrophysics Data System (ADS)

Wang, Yuan

2015-10-01

The recent study "Trends of Extreme Precipitation in Eastern China and Their Possible Causes" attributed the observed decrease/increase of light/heavy precipitation in eastern China to global warming rather than the regional aerosol effects. However, there exist compelling evidence from previous long-term observations and numerical modeling studies, suggesting that anthropogenic pollution is closely linked to the recent changes in precipitation intensity because of considerably modulated cloud physical properties by aerosols in eastern China. Clearly, a quantitative assessment of the aerosol and greenhouse effects on the regional scale is required to identify the primary cause for the extreme precipitation changes.

Can hospitals compete on quality? Hospital competition.

PubMed

Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

2015-09-01

In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

Slab detachment under the Eastern Alps seen by seismic anisotropy

PubMed Central

Qorbani, Ehsan; Bianchi, Irene; Bokelmann, Götz

2015-01-01

We analyze seismic anisotropy for the Eastern Alpine region by inspecting shear-wave splitting from SKS and SKKS phases. The Eastern Alpine region is characterized by a breakdown of the clear mountain-chain-parallel fast orientation pattern that has been previously documented for the Western Alps and for the western part of the Eastern Alps. The main interest of this paper is a more detailed analysis of the anisotropic character of the Eastern Alps, and the transition to the Carpathian–Pannonian region. SK(K)S splitting measurements reveal a rather remarkable lateral change in the anisotropy pattern from the west to the east of the Eastern Alps with a transition area at about 12°E. We also model the backazimuthal variation of the measurements by a vertical change of anisotropy. We find that the eastern part of the study area is characterized by the presence of two layers of anisotropy, where the deeper layer has characteristics similar to those of the Central Alps, in particular SW–NE fast orientations of anisotropic axes. We attribute the deeper layer to a detached slab from the European plate. Comparison with tomographic studies of the area indicates that the detached slab might possibly connect with the lithosphere that is still in place to the west of our study area, and may also connect with the slab graveyard to the East, at the depth of the upper mantle transition zone. On the other hand, the upper layer has NW–SE fast orientations coinciding with a low-velocity layer which is found above a more-or-less eastward dipping high-velocity body. The anisotropy of the upper layer shows large-scale NW–SE fast orientation, which is consistent with the presence of asthenospheric flow above the detached slab foundering into the deeper mantle. PMID:25843968

Slab detachment under the Eastern Alps seen by seismic anisotropy

NASA Astrophysics Data System (ADS)

Qorbani, Ehsan; Bianchi, Irene; Bokelmann, Götz

2015-01-01

We analyze seismic anisotropy for the Eastern Alpine region by inspecting shear-wave splitting from SKS and SKKS phases. The Eastern Alpine region is characterized by a breakdown of the clear mountain-chain-parallel fast orientation pattern that has been previously documented for the Western Alps and for the western part of the Eastern Alps. The main interest of this paper is a more detailed analysis of the anisotropic character of the Eastern Alps, and the transition to the Carpathian-Pannonian region. SK(K)S splitting measurements reveal a rather remarkable lateral change in the anisotropy pattern from the west to the east of the Eastern Alps with a transition area at about 12°E. We also model the backazimuthal variation of the measurements by a vertical change of anisotropy. We find that the eastern part of the study area is characterized by the presence of two layers of anisotropy, where the deeper layer has characteristics similar to those of the Central Alps, in particular SW-NE fast orientations of anisotropic axes. We attribute the deeper layer to a detached slab from the European plate. Comparison with tomographic studies of the area indicates that the detached slab might possibly connect with the lithosphere that is still in place to the west of our study area, and may also connect with the slab graveyard to the East, at the depth of the upper mantle transition zone. On the other hand, the upper layer has NW-SE fast orientations coinciding with a low-velocity layer which is found above a more-or-less eastward dipping high-velocity body. The anisotropy of the upper layer shows large-scale NW-SE fast orientation, which is consistent with the presence of asthenospheric flow above the detached slab foundering into the deeper mantle.

Secular trends in Cherokee cranial morphology: Eastern vs Western bands.

PubMed

Sutphin, Rebecca; Ross, Ann H; Jantz, Richard L

2014-01-01

The research objective was to examine if secular trends can be identified for cranial data commissioned by Boas in 1892, specifically for cranial breadth and cranial length of the Eastern and Western band Cherokee who experienced environmental hardships. Multiple regression analysis was used to test the degree of relationship between each of the cranial measures: cranial length, cranial breadth and cephalic index, along with predictor variables (year-of-birth, location, sex, admixture); the model revealed a significant difference for all craniometric variables. Additional regression analysis was performed with smoothing Loess plots to observe cranial length and cranial breadth change over time (year-of-birth) separately for Eastern and Western Cherokee band females and males born between 1783-1874. This revealed the Western and Eastern bands show a decrease in cranial length over time. Eastern band individuals maintain a relatively constant head breadth, while Western Band individuals show a sharp decline beginning around 1860. These findings support negative secular trend occurring for both Cherokee bands where the environment made a detrimental impact; this is especially marked with the Western Cherokee band.

Indo-Pacific echinoids in the tropical eastern Pacific

NASA Astrophysics Data System (ADS)

Lessios, H. A.; Kessing, B. D.; Wellington, G. M.; Graybeal, A.

1996-06-01

The existing literature reports that only one species of Indo-Pacific echinoid ( Echinometra oblonga), occurs in the eastern Pacific. In this study we confirm the presence of this species at Islas Revillagigedo and also report the presence of two species of Echinothrix (a genus hitherto unknown outside the Indo-Pacific) at Isla del Coco and at Clipperton Island. We also present evidence from isozymes and from mitochondrial DNA sequences indicating that at least one individual of Diadema at Clipperton may belong to a maternal lineage characteristic of the west Pacific species D. savignyi. These data are consistent with the hypothesis that the observed populations of Indo-Pacific echinoid species are recent arrivals to the eastern Pacific, as opposed to the view that they are relicts of Tethyan pan-tropical distributions. Echinothrix diadema, in particular, may have arrived at Isla del Coco during the 1982-1983 El Nifio. In addition to Indo-Pacific species, Clipperton, Isla del Coco and the Revillagigedos contain a complement of eastern Pacific echinoids. The echinoid faunas of these islands should, therefore, be regarded as mixtures of two biogeographic provinces. Though none of the Indo-Pacific species are known to have reached the coast of the American mainland, their presence at the offshore islands of the eastern Pacific suggests that, for some echinoids, the East Pacific Barrier is not as formidable an obstacle to migration as was previously thought.

Sexuality and spirituality: the relevance of eastern traditions.

PubMed

Francoeur, R T

1992-01-01

This article outlines some of the major Eastern sexual and spiritual traditions (primarily Hinduism, Taoism and Tantrism), and discusses their relevance for the contemporary Western world. The article begins by examining the sources of Eastern sexual traditions, before and after the "Axial" period, the turning point at which male consciousness and power gained ascendancy over the female principle. Although a phallocentric view of the world came to dominate the East, Eastern cultures -- unlike the West -- maintained a respect for nature. According to this view, health and spirituality are gained only when humanity respects its place in the cosmos and lives in harmony with nature. The article then examines the sexual traditions of Hinduism, in which sexual asceticism not only coexisted but also complimented the celebration of sexual desire and pleasure. The article then discusses the Taoist traditions, which, among other things, stressed the importance of female sexual satisfaction. Taoism argued that men cannot experience true sexual ecstasy unless they develop the ability to control their ejaculation. The Tantric sexual tradition, the article explains, maintained that ultimate sexual pleasure would enable one to experience the true nature of reality. The article then goes on to review variations of these traditions: the Hindu Tantric Doctrine (Shaktism), the Buddhist Tantric Doctrine, and Tantra and Yoga. Finally, the article considers the relevance of these Eastern philosophies to the Western sexual tradition, which has tended to view sexuality as antagonistic to spiritual liberation.

The gender gap in heart disease: lessons from Eastern Europe.

PubMed

Weidner, Gerdi; Cain, Virginia S

2003-05-01

Why are men more susceptible to heart disease than women? Traditional risk factors cannot explain the gender gap in coronary heart disease (CHD) or the rapid increase in CHD mortality among middle-aged men in many of the newly independent states of Eastern Europe. However, Eastern European men score higher on stress-related psychosocial factors than men living in the West. Comparisons between the sexes also reveal differences in psychosocial and behavioral coronary risk factors favoring women, indicating that women's coping with stressful events may be more cardioprotective. Men's greater susceptibility to heart disease, particularly observable in many Eastern European countries, poses unique threats to public health and points to solutions in the behavioral and social arena.

[Decrease in hospitalizations due to polyvalent medical day hospital].

PubMed

Escobar, M A; García-Egido, A A; Carmona, R; Lucas, A; Márquez, C; Gómez, F

2012-02-01

The day hospital is an alternative to hospitalization. This alternative improves accessibility and comfort of the patients, and avoids hospitalizations. Nevertheless, the efficacy of the polyvalent medical day hospital in avoiding hospitalizations has not been evaluated. To analyze hospital stays avoided by the polyvalent medical day hospital of a university hospital of the Andalusian Health Service. An observational prospective study of the patients studied and/or treated in the polyvalent medical day hospital of the Hospital Universitario Puerto Real over a one year period. A total of 9640 patients were attended to, with 1413 procedures and 4921 i.v. treatments. There were 3182 visits to the priority consultation of the polyvalent medical day hospital. The most frequent consultation complaints were constitutional symptoms (15.9%) and anemia (14.5%). After the first visit, 21.5% of the patients were discharged and fewer than 3% were hospitalized. Hospitalization was avoided in 16.8% of the patients, there being a 6.0% decrease in the need for hospital beds (5.0% reduction in the internal medicine unit). Inadequate hospitalizations and 30-day readmissions decreased 93.3% and 4.2%, respectively. The most frequent diagnosis was neoplasm (26.0%), and most of the beds freed up were generated by patients diagnosed of neoplasm (26.7%). With this type of polyvalent medical day hospital, we have observed improved efficiency of health care, freeing up hospital beds by reducing hospitalizations, inadequate hospitalizations and re-admissions in the medical units involved. Copyright © 2011 Elsevier España, S.L. All rights reserved.

ANTIMICROBIAL ACTIVITY OF COPPER AND ZINC ACCUMULATED BY EASTERN OYSTER AMEBOCYTES

EPA Science Inventory

Fisher, William S. Submitted. Antimicrobial Activity of Copper and Zinc Accumulated by Eastern Oyster Amebocytes. J. Shellfish Res. 54 p. (ERL,GB 1196).

The distribution of eastern oysters Crassostrea virginica near terrestrial watersheds has led to a general impression t...

Eastern Devonian shales: Organic geochemical studies, past and present

USGS Publications Warehouse

Breger, I.A.; Hatcher, P.G.; Romankiw, L.A.; Miknis, F.P.

1983-01-01

The Eastern Devonian shales are represented by a sequence of sediments extending from New York state, south to the northern regions of Georgia and Alabama, and west into Ohio and to the Michigan and Ilinois Basins. Correlatives are known in Texas. The shale is regionally known by a number of names: Chattanooga, Dunkirk, Rhinestreet, Huron, Antrim, Ohio, Woodford, etc. These shales, other than those in Texas, have elicited much interest because they have been a source of unassociated natural gas. It is of particular interest, however, that most of these shales have no associated crude oil, in spite of the fact that they have some of the characteristics normally attributed to source beds. This paper addresses some of the organic geochemical aspects of the kerogen in these shales, in relation to their oil generating potential. Past organic geochemical studies on Eastern Devonian shales will be reviewed. Recent solid state 13C NMR studies on the nature of the organic matter in Eastern Devonian shales show that Eastern Devonian shales contain a larger fraction of aromatic carbon in their chemical composition. Thus, despite their high organic matter contents, their potential as a petroleum source rock is low, because the kerogen in these shales is of a "coaly" nature and hence more prone to producing natural gas.

Eastern hemlock decline in riparian areas from Maine to Alabama

Treesearch

Daniel Evans; Michael Aust; C. Dolloff; Ben Templeton; John Peterson

2011-01-01

Eastern hemlock (Tsuga canadensis) in the Appalachian mountain range is threatened by the introduced hemlock woolly adelgid (Adelges tsugae). Potential impacts on riparian systems are great because of eastern hemlock’s role as a foundation species that influences site soil, vegetation, and stream characteristics. We installed permanent research sites at 49 locations in...

Conservation and management of eastern big-eared bats: a symposium

Treesearch

Susan C. Loeb; Michael J. Lacki; Darren A. Miller

2011-01-01

Big-eared bats (genus Corynorhinus) in the Eastern United States are species of special conservation concern. These species are at risk due to many factors, including lack of knowledge about their basic biology, population numbers or trends, and distribution. This volume contains five synthesis papers on the status, ecology, and conservation of eastern big-eared bats...

Use of stock to maintain and construct trails in the eastern United States

Treesearch

Eric Sandeno

2007-01-01

Trail construction and reconstruction utilizing stock is rare in the eastern United States. The Hoosier National Forest is the only forest in the Eastern Region of the Forest Service with its own pack string. The Hoosier is also the only forest in the eastern United States to utilize pack strings from western forests to complete trail work within wilderness. For the...

Maintenance of eastern hemlock forests: Factors associated with hemlock vulnerability to hemlock woolly adelgid

Treesearch

Mary Ann Fajvan; Petra Bohall Wood

2010-01-01

Eastern hemlock (Tsuga canadensis [L.]) is the most shade-tolerant and long-lived tree species in eastern North America. The hemlock woolly adelgid (Adelges tsugae) (HWA), is a nonnative invasive insect that feeds on eastern hemlock and Carolina hemlock (Tsuga caroliniana Engelm.). HWA currently is established in...

Y-chromosome evidence supports widespread signatures of three-species Canis hybridization in eastern North America.

PubMed

Wilson, Paul J; Rutledge, Linda Y; Wheeldon, Tyler J; Patterson, Brent R; White, Bradley N

2012-09-01

There has been considerable discussion on the origin of the red wolf and eastern wolf and their evolution independent of the gray wolf. We analyzed mitochondrial DNA (mtDNA) and a Y-chromosome intron sequence in combination with Y-chromosome microsatellites from wolves and coyotes within the range of extensive wolf-coyote hybridization, that is, eastern North America. The detection of divergent Y-chromosome haplotypes in the historic range of the eastern wolf is concordant with earlier mtDNA findings, and the absence of these haplotypes in western coyotes supports the existence of the North American evolved eastern wolf (Canis lycaon). Having haplotypes observed exclusively in eastern North America as a result of insufficient sampling in the historic range of the coyote or that these lineages subsequently went extinct in western geographies is unlikely given that eastern-specific mtDNA and Y-chromosome haplotypes represent lineages divergent from those observed in extant western coyotes. By combining Y-chromosome and mtDNA distributional patterns, we identified hybrid genomes of eastern wolf, coyote, gray wolf, and potentially dog origin in Canis populations of central and eastern North America. The natural contemporary eastern Canis populations represent an important example of widespread introgression resulting in hybrid genomes across the original C. lycaon range that appears to be facilitated by the eastern wolf acting as a conduit for hybridization. Applying conventional taxonomic nomenclature and species-based conservation initiatives, particularly in human-modified landscapes, may be counterproductive to the effective management of these hybrids and fails to consider their evolutionary potential.

Macro-scale assessment of demographic and environmental variation within genetically derived evolutionary lineages of eastern hemlock (Tsuga canadensis), an imperiled conifer of the eastern United States

Treesearch

Anantha M. Prasad; Kevin M. Potter

2017-01-01

Eastern hemlock (Tsuga canadensis) occupies a large swath of eastern North America and has historically undergone range expansion and contraction resulting in several genetically separate lineages. This conifer is currently experiencing mortality across most of its range following infestation of a non-native insect. With the goal of better...

Clinico-immunochemical studies on airborne Areca catechu L. Pollen, a probable risk factor in emergency asthma hospitalization from Eastern India.

PubMed

Chakraborty, Pampa; Mandal, Jyotshna; Sarkar, Eva; Chowdhury, Indrani; Gupta-Bhattacharya, Swati

2009-01-01

The pollen grain of the Areca catechu L. tree is airborne and allergenic. This study aimed to know the role of this pollen as a source of aeroallergen with effect on emergency asthma hospitalization, to isolate its important allergic fraction and to check its cross-reaction with betel nut. Areca pollen was monitored with a Burkard sampler. Determination of allergenic activities was studied by in vivo and in vitro analyses. Asthma hospitalization data were collected from two nearby hospitals. The pollen extract was fractionated by a combination of DEAE-Sephadex and Sephacryl S-200 column. The protein components were observed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Cross-reactivity of Areca pollen and betel nut was shown by IgE enzyme-linked immunosorbent assay (ELISA) inhibition. The Areca pollen was perennially airborne. Skin test results of respiratory allergic patients showed 38.6% positivity. The detected aeroallergen spots in particle immunoblotting correlated significantly with airborne pollen count. Areca pollen showed a significant positive correlation with asthma hospitalization. There are 6 IgE-reactive protein components in the whole-pollen extract. IgE-reactive fraction 1 was resolved into 4 subfractions. Subfraction 1a showing IgE reactivity contained 3 protein components, among which 2 of 48 and 118 kDa were IgE reactive. The 48-kDa component was reported to be cross-reactive with other palm pollen types. In IgE ELISA inhibition, the betel nut extract showed 50% inhibition with about 110 ng/ml concentration. A. catechu pollen is a significant contributor to the aeroallergen load in India. Its partially purified IgE-reactive fraction may be useful in therapeutics. The betel nut extract showed remarkable cross-reactivity with Areca pollen. Copyright (C) 2009 S. Karger AG, Basel.

50 CFR 300.23 - Eastern Pacific fisheries - Persons and vessels exempted.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Eastern Pacific fisheries - Persons and vessels exempted. 300.23 Section 300.23 Wildlife and Fisheries INTERNATIONAL FISHING AND RELATED ACTIVITIES INTERNATIONAL FISHERIES REGULATIONS Pacific Tuna Fisheries § 300.23 Eastern Pacific fisheries...

Western juniper in eastern Oregon.

Treesearch

Donald R. Gedney; David L. Azuma; Charles L. Bolsinger; Neil McKay

1999-01-01

This report analyzes and summarizes a 1988 inventory of western juniper (Juniperus occidentalis Hook.) in eastern Oregon. This inventory, conducted by the Pacific Northwest Research Station of the USDA Forest Service, was intensified to meet increased need for more information about the juniper resource than was available in previous inventories. A...

Genetic Improvement of Eastern Cottonwood

Treesearch

Robert E. Farmer; Carl A. Mohn

1970-01-01

Eastern cottonwood (Populus deltoides Bartt.) genetics research has moved during the past decade from formal statements of its promise to long-term formal tests of commercially promising material. Much of this research has been conducted in the Lower Mississippi Valley. wh.ere cottonwood has major commercial importance. but there have been...

Eastern hemlock: a market perspective

Treesearch

Theodore Howard; Paul Sendak; Claudia Codrescu

2000-01-01

Although it is an important component of the northern forest, eastern hemlock (Tsuga canadensis (L.) Carr.) is a secondary species in its regions' markets. In this paper, we examine the markets for hemlock, analyze price trends for stumpage, and suggest implications of market forces for management of forests containing hemlock. The...

Specialty hospital market proliferation: Strategic implications for general hospitals.

PubMed

Al-Amin, Mona; Zinn, Jacqueline; Rosko, Michael D; Aaronson, William

2010-01-01

Since the early 1990s, specialty hospitals have been continuously increasing in number. A moratorium was passed in 2003 that prohibited physicians' referrals of Medicare patients to newly established specialty hospitals if the physician has ownership stakes in the hospital. Although this moratorium expired in effect in 2007, many are still demanding that the government pass new policies to discourage the proliferation of specialty hospitals. This study aimed at examining the regulatory and environmental forces that influence specialty hospitals founding rate. Specifically, we use the resource partitioning theory to investigate the relationship between general hospitals closure rates and the market entry of specialty hospitals. This study will help managers of general hospitals in their strategic thinking and planning. We rely on secondary data resources, which include the American Hospital Association, Area Resource file, census, and Center for Medicare and Medicaid Services data, to perform a longitudinal analysis of the founding rate of specialty hospital in the 48 states. Specifically, we use the negative binomial generalized estimating equation approach available through Stata 9.0 to study the effect of general hospitals closure rate and environmental variables on the proliferation of specialty hospitals. Specialty hospitals founding rate seems to be significantly related to general hospitals closure rates. Moreover, results indicate that economic, supply, regulatory, and financial conditions determine the founding rate of specialty hospitals in different states. The results from this study indicate that the closure of general hospitals creates market conditions that encourage the market entry of specialized health care delivery forms such as specialty hospitals. Managers of surviving general hospitals have to view the closure of other general hospitals not just as an opportunity to increase market share but also as a threat of competition from new forms of

Tsutsugamushi Disease (Scrub Typhus) Meningoencephalitis in North Eastern India: A Prospective Study.

PubMed

Sharma, S R; Masaraf, H; Lynrah, K G; Lyngdoh, M

2015-01-01

Scrub typhus is rampant in northern, eastern, and southern India. Central nervous system involvement in the form of meningitis or meningoencephalitis is common in scrub typhus. As specific laboratory methods remain inadequate or inaccessible in developing countries, prompt diagnosis is often difficult. The aim of this study was to characterize neurological complications in scrub typhus from northeastern region of India. We did a prospective study of scrub meningoencephalitis at North Eastern Indira Gandhi Regional Institute of Medical Sciences among patients admitted to hospital between October 2009 and November 2011. The diagnosis was made based on the clinical pictures, presence of an eschar, and a positive Weil-Felix test (WFT) with a titer of >1:160 and if required a positive scrub IgM enzyme-linked immunosorbent assay. Lumbar puncture was performed in patients with headache, nuchal rigidity, altered sensorium or cranial nerve deficits, and magnetic resonance imaging (MRI) brain performed if needed. Twenty-three patients of scrub typhus meningitis that were serologically confirmed were included in the study. There were 13 males and 10 females. Fever ≥1 week was the most common manifestation (39.1%). Interestingly, none had an eschar. Median cerebrospinal fluid (CSF) cell count, lymphocyte percentage, CSF protein, CSF glucose/blood glucose, CSF ADA were 17 cells/μL, 90%, 86 mg/dL, 0.6605 and 3.6 U/mL, respectively. All patients were treated with doxycycline. There was no mortality in our study. Absence of Eschar does not rule out scrub typhus. Clinical features and CSF findings can mimic tuberculous meningitis so misdiagnosis may lead to unwarranted prolonged empirical antituberculous therapy in cases of lymphocytic meningoencephalitis. Delay in treatment can be potentially fatal. WFT still serves as a useful and affordable diagnostic tool for this disease in resource-poor countries.

Reliable positioning in a sparse GPS network, eastern Ontario

NASA Astrophysics Data System (ADS)

Samadi Alinia, H.; Tiampo, K.; Atkinson, G. M.

2013-12-01

Canada hosts two regions that are prone to large earthquakes: western British Columbia, and the St. Lawrence River region in eastern Canada. Although eastern Ontario is not as seismically active as other areas of eastern Canada, such as the Charlevoix/Ottawa Valley seismic zone, it experiences ongoing moderate seismicity. In historic times, potentially damaging events have occurred in New York State (Attica, 1929, M=5.7; Plattsburg, 2002, M=5.0), north-central Ontario (Temiskaming, 1935, M=6.2; North Bay, 2000, M=5.0), eastern Ontario (Cornwall, 1944, M=5.8), Georgian Bay (2005, MN=4.3), and western Quebec (Val-Des-Bois,2010, M=5.0, MN=5.8). In eastern Canada, the analysis of detailed, high-precision measurements of surface deformation is a key component in our efforts to better characterize the associated seismic hazard. The data from precise, continuous GPS stations is necessary to adequately characterize surface velocities from which patterns and rates of stress accumulation on faults can be estimated (Mazzotti and Adams, 2005; Mazzotti et al., 2005). Monitoring of these displacements requires employing high accuracy GPS positioning techniques. Detailed strain measurements can determine whether the regional strain everywhere is commensurate with a large event occurring every few hundred years anywhere within this general area or whether large earthquakes are limited to specific areas (Adams and Halchuck, 2003; Mazzotti and Adams, 2005). In many parts of southeastern Ontario and western Québec, GPS stations are distributed quite sparsely, with spacings of approximately 100 km or more. The challenge is to provide accurate solutions for these sparse networks with an approach that is capable of achieving high-accuracy positioning. Here, various reduction techniques are applied to a sparse network installed with the Southern Ontario Seismic Network in eastern Ontario. Recent developments include the implementation of precise point positioning processing on acquired

The unexpected finding of Parapholidoptera castaneoviridis in south-eastern Romania (Insecta, Orthoptera, Tettigoniidae).

PubMed

Iorgu, Ionuț Ștefan; Chobanov, Dragan Petrov; Iorgu, Elena Iulia

2017-01-01

The Balkano-Anatolian genus Parapholidoptera comprises 21 species and the westernmost one, Parapholidoptera castaneoviridis , previously recognized to occur in western Turkey, north-eastern Greece and south-eastern Bulgaria is recorded for the first time from south-eastern Romania, almost 300 km away from the closest known locality. Illustrations and measurements of morphological characters are given and the male calling song from this new, northernmost population is described.

50 CFR 300.22 - Eastern Pacific fisheries recordkeeping and written reports.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ACTIVITIES INTERNATIONAL FISHERIES REGULATIONS Eastern Pacific Tuna Fisheries § 300.22 Eastern Pacific... fishing vessel or commercial passenger fishing vessel (CPFV) authorized to fish for tuna and tuna-like... st (362.8 mt) carrying capacity that are authorized to purse seine for tuna in the Convention Area...

50 CFR 300.22 - Eastern Pacific fisheries recordkeeping and written reports.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ACTIVITIES INTERNATIONAL FISHERIES REGULATIONS Eastern Pacific Tuna Fisheries § 300.22 Eastern Pacific... fishing vessel or commercial passenger fishing vessel (CPFV) authorized to fish for tuna and tuna-like... st (362.8 mt) carrying capacity that are authorized to purse seine for tuna in the Convention Area...

A Cultural Look at Information and Communication Technologies in Eastern Education

ERIC Educational Resources Information Center

Zhang, Jianwei

2007-01-01

The Eastern cultural tradition, together with other social factors, has shaped a group-based, teacher-dominated, and centrally organized pedagogical culture. Drawing upon this cultural perspective, this article reviews the development of information and communication technologies (ICT) in Eastern schools, including ICT planning and management,…

Fire scars reveal variability and dynamics of eastern fire regimes

Treesearch

Richard P. Guyette; Daniel C. Dey; Michael C. Stambaugh; Rose-Marie Muzika

2006-01-01

Fire scar evidence in eastern North America is sparse and complex but shows promise in defining the dynamics of these fire regimes and their influence on ecosystems. We review fire scar data, methods, and limitations, and use this information to identify and examine the factors influencing fire regimes. Fire scar data from studies at more than 40 sites in Eastern North...

Large-Scale Evaluation of Quality of Care in 6 Countries of Eastern Europe and Central Asia Using Clinical Performance and Value Vignettes.

PubMed

Peabody, John W; DeMaria, Lisa; Smith, Owen; Hoth, Angela; Dragoti, Edmond; Luck, Jeff

2017-09-27

A significant determinant of population health outcomes is the quality of care provided for noncommunicable diseases, obstetric, and pediatric care. We present results on clinical practice quality in these areas as measured among nearly 4,000 providers working at more than 1,000 facilities in 6 Eastern European and Central Asian countries. This study was conducted between March 2011 and April 2013 in Albania, Armenia, Georgia, Kazakhstan, Kirov Province in Russia, and Tajikistan. Using a probability proportional-to-size sampling technique, based on number of hospital beds, we randomly selected within each country 42 hospitals and their associated primary health care clinics. Physicians and midwives within each clinical area of interest were randomly selected from each hospital and clinic and asked how they would care for simulated patients using Clinical Performance and Value (CPV) vignettes. Facility administrators were also asked to complete a facility survey to collect structural measures of quality. CPV vignettes were scored on a scale of 0% to 100% for each provider. We used descriptive statistics and t tests to identify significant differences in CPV scores between hospitals and clinics and rural vs. urban facilities, and ANOVA to identify significant differences in CPV scores across countries. We found that quality of care, as concurrently measured by performance on CPV vignettes, was generally poor and widely variable within and between countries. Providers in Kirov Province, Russia, had the highest overall performance, with an average score of 70.8%, while providers in Albania and Tajikistan had the lowest average score, each at 50.8%. The CPV vignettes with the lowest scores were for multiple noncommunicable disease risk factors and birth asphyxia. A considerable proportion (11%) of providers performed well on the CPV vignettes, regardless of country, facility, or structural resources available to them. Countries of Eastern Europe and Central Asia are

Contrasting cooling and exhumation histories of tectonic blocks in the eastern part of the Eastern Alps and its possible relationships with lithospheric dynamics

NASA Astrophysics Data System (ADS)

Wölfler, Andreas; Glotzbach, Christoph

2017-04-01

In the European Alps two fundamental changes in the lithospheric structure controlled the geodynamic evolution of the orogen: (1) Late Eocene to Early Oligocene rupturing of the European slab and (2) Early Miocene change in subduction polarity between the Western and Eastern Alps. In particular, the eastern part of the Eastern Alps is a key area which will provide both, information about the surface response to the Eocene/Oligocene slab breakoff and the response to a proposed isostatic rebound due to slab detachment of the European lithosphere in the Miocene (Handy et al., 2015). The eastern part of the Eastern Alps is characterized by fault-bounded blocks with different thermochronological ages, mean elevations and hillslope angles, indicating a variable spatial and temporal evolution throughout the Cenozoic era. The topographic pattern of the study area can be described in terms of (1) high relief with a rugged surface and steep slopes in the Niedere Tauern and (2) lower relief and distinctly smoother topography in the Seckauer Tauern, the Gurktal, Saualpe and Koralpe blocks. Generally, tectonic blocks with higher relief and rugged topography display the youngest apatite fission track (AFT) and apatite (U-Th)/He data (AHe); the Niedere Tauern concurs with middle Miocene AFT and late Miocene/Pliocene AHe ages (Wölfler et al., 2016). The other tectonic blocks generally show Eocene to Oligocene AFT ages (Wölfler et al., 2016 and references therein) and Oligocene to early Miocene AHe ages (Legrain et al., 2014, own preliminary work). New AFT and AHe data from the Gurktal block and Seckauer Tauern indicate that substantial parts of the study area where at near-surface conditions since the Eocene and Oligocene. Thermal history models suggest fast cooling through the AFT and AHe closure temperatures in the Oligocene as a possible response to slab breakoff that was followed by thermal stagnation until the present. In contrast, the neighboring Niedere Tauern experienced

Annual survival rate estimate of satellite transmitter–marked eastern population greater sandhill cranes

USGS Publications Warehouse

Fronczak, David L.; Andersen, David E.; Hanna, Everett E.; Cooper, Thomas R.

2015-01-01

Several surveys have documented the increasing population size and geographic distribution of Eastern Population greater sandhill cranes Grus canadensis tabida since the 1960s. Sport hunting of this population of sandhill cranes started in 2012 following the provisions of the Eastern Population Sandhill Crane Management Plan. However, there are currently no published estimates of Eastern Population sandhill crane survival rate that can be used to inform harvest management. As part of two studies of Eastern Population sandhill crane migration, we deployed solar-powered global positioning system platform transmitting terminals on Eastern Population sandhill cranes (n  =  42) at key concentration areas from 2009 to 2012. We estimated an annual survival rate for Eastern Population sandhill cranes from data resulting from monitoring these cranes by using the known-fates model in the MARK program. Estimated annual survival rate for adult Eastern Population sandhill cranes was 0.950 (95% confidence interval  =  0.885–0.979) during December 2009–August 2014. All fatalities (n  =  5) occurred after spring migration in late spring and early summer. We were unable to determine cause of death for crane fatalities in our study. Our survival rate estimate will be useful when combined with other population parameters such as the population index derived from the U.S. Fish and Wildlife Service fall survey, harvest, and recruitment rates to assess the effects of harvest on population size and trend and evaluate the effectiveness of management strategies.

Cultural Clues to the Middle Eastern Student

ERIC Educational Resources Information Center

Parker, Orin D.; And Others

1976-01-01

Cultural patterns and characteristics of Middle Eastern students indicate their adaptability ease or difficulty in American society. Manners, paternalistic patterns, religion, and social relationships are discussed. (LBH)

Timber resource of Missouri's Eastern Ozarks.

Treesearch

Earl C. Leatherberry

1990-01-01

In 1989 the fourth forest inventory of the Eastern Ozarks found 4.3 million acres of forest land, of which 4.1 million acres (96%) was timberland. This bulletin presents highlights and statistics on area, volume, growth, removals, mortality.

Burnout among rural hospital doctors in the Western Cape: Comparison with previous South African studies.

PubMed

Liebenberg, Andrew R; Coetzee Jnr, Johan F; Conradie, Hofmeyr H; Coetzee, Johan F

2018-05-24

Burnout among doctors negatively affects health systems and, ultimately,patient care. To determine the prevalence of burnout among doctors working in the district health system in the Overberg and Cape Winelands districts of the Western Cape Province and to compare the findings with those of previous South African studies. Rural district hospitals. During 2013, a validated questionnaire (Maslach Burnout Inventory) was sent to 42 doctors working in the district health system within the referral area of the Worcester Hospital, consisting of the Overberg health district and the eastern half of the Cape Winelands. Response rate was 85.7%. Clinically significant burnout was found among 81% of respondents. High levels of burnout on all three subscales were present in 31% of participants.Burnout rates were similar to those of a previous study conducted among doctors working in the Cape Town Metropolitan Municipality primary health care facilities. Scores for emotional exhaustion (EE) and depersonalisation (DP) were greater than those of a national survey;however, the score for personal accomplishment (PA) was greater. EE and PA scores weresimilar to that of a study of junior doctors working in the Red Cross Children's Hospital;however, EE was smaller. This study demonstrates high burnout rates among doctors working at district level hospitals, similar to the prevalence thereof in the Cape Town Metropolitan primary health care facilities. Health services planning should include strategies to address and prevent burnout of which adequate staffing and improved work environment are of prime importance.

Evaluating palliative care needs in Middle Eastern countries.

PubMed

Silbermann, Michael; Fink, Regina M; Min, Sung-Joon; Mancuso, Mary P; Brant, Jeannine; Hajjar, Ramzi; Al-Alfi, Nesreen; Baider, Lea; Turker, Ibrahim; ElShamy, Karima; Ghrayeb, Ibtisam; Al-Jadiry, Mazin; Khader, Khaled; Kav, Sultan; Charalambous, Haris; Uslu, Ruchan; Kebudi, Rejin; Barsela, Gil; Kuruku, Nilgün; Mutafoglu, Kamer; Ozalp-Senel, Gulsin; Oberman, Amitai; Kislev, Livia; Khleif, Mohammad; Keoppi, Neophyta; Nestoros, Sophia; Abdalla, Rasha Fahmi; Rassouli, Maryam; Morag, Amira; Sabar, Ron; Nimri, Omar; Al-Qadire, Mohammad; Al-Khalaileh, Murad; Tayyem, Mona; Doumit, Myrna; Punjwani, Rehana; Rasheed, Osaid; Fallatah, Fatimah; Can, Gulbeyaz; Ahmed, Jamila; Strode, Debbie

2015-01-01

Cancer incidence in Middle Eastern countries, most categorized as low- and middle-income, is predicted to double in the next 10 years, greater than in any other part of the world. While progress has been made in cancer diagnosis/treatment, much remains to be done to improve palliative care for the majority of patients with cancer who present with advanced disease. To determine knowledge, beliefs, barriers, and resources regarding palliative care services in Middle Eastern countries and use findings to inform future educational and training activities. Descriptive survey. Fifteen Middle Eastern countries; convenience sample of 776 nurses (44.3%), physicians (38.3%) and psychosocial, academic, and other health care professionals (17.4%) employed in varied settings. Palliative care needs assessment. Improved pain management services are key facilitators. Top barriers include lack of designated palliative care beds/services, community awareness, staff training, access to hospice services, and personnel/time. The nonexistence of functioning home-based and hospice services leaves families/providers unable to honor patient wishes. Respondents were least satisfied with discussions around advance directives and wish to learn more about palliative care focusing on communication techniques. Populations requiring special consideration comprise: patients with ethnic diversity, language barriers, and low literacy; pediatric and young adults; and the elderly. The majority of Middle Eastern patients with cancer are treated in outlying regions; the community is pivotal and must be incorporated into future plans for developing palliative care services. Promoting palliative care education and certification for physicians and nurses is crucial; home-based and hospice services must be sustained.

78 FR 39719 - Eastern Shore Natural Gas Company; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-02

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [ Docket No. CP13-498-000] Eastern Shore Natural Gas Company; Notice of Application Take notice that on June 13, 2013, Eastern Shore Natural Gas...(c) of the Natural Gas Act to construct, and operate its White Oak Lateral Project (Project) located...

77 FR 32624 - Eastern Shore Natural Gas Company; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... Natural Gas Company; Notice of Application Take notice that on May 14, 2012, Eastern Shore Natural Gas... Natural Gas Act (NGA) and Part 157 of the Commission's regulations, requesting authorization to construct..., Eastern Shore Natural Gas Company, 1110 Forrest Avenue, Suite 201, Dover, Delaware, 19904, or by calling...

Hospital Readmission Risk: Isolating Hospital from Patient Effects

PubMed Central

Krumholz, Harlan M.; Wang, Kun; Lin, Zhenqiu; Dharmarajan, Kumar; Horwitz, Leora I.; Ross, Joseph S.; Drye, Elizabeth E.; Bernheim, Susannah M.; Normand, Sharon-Lise T.

2017-01-01

Background To isolate hospital effects on hospitals’ risk-standardized readmission rates, we examined readmission outcomes among patients with multiple admissions for a similar diagnosis at >1 hospital within a given year. Methods We divided the Centers for Medicare & Medicaid Services hospital-wide readmission measure cohort from July 2014–June 2015 into 2 random samples. We used the first sample to calculate each hospital’s risk-standardized readmission rate and classified hospitals into performance quartiles. In the second sample, we identified patients with 2 admissions for similar diagnoses at different hospitals that occurred more than a month and less than a year apart, and compared observed readmission rates for those admitted to hospitals in different performance quartiles. Results In the sample used to characterize hospital performance, the median risk-standardized readmission rate was 15.5% (IQR 15.3%–15.8%). The other sample included 37,508 patients with 2 admissions for similar diagnoses at 4,272 different hospitals. The observed readmission rate was consistently higher when patients were admitted to hospitals in the worse performing quartile, but the only statistically significant difference was observed when the same patients were admitted to hospitals in the best and worst performing quartiles, in which the absolute readmission rate difference was 1.95 percentage points (95% CI, 0.39%–3.50%). Conclusions When the same patients were admitted with similar diagnoses to hospitals in the best performing quartile compared with the worst performing quartile for hospital readmission performance, there is a significant difference in rates of readmission within 30 days. The findings suggest that hospital quality contributes in part to readmission rates independent of patient factors. PMID:28902587

Synoptic regimes associated with the eastern Mediterranean wet season cyclone tracks

NASA Astrophysics Data System (ADS)

Almazroui, Mansour; Awad, Adel M.

2016-11-01

The main synoptic patterns associated with the wet season (October-May) eastern Mediterranean cyclones have been analyzed and described using NCEP/NCAR reanalysis datasets for the period 1958-2013. The cyclone tracks detected in the eastern Mediterranean are classified into two types based on their positions: the local tracks and the long tracks. The local tracks are either stationary or short tracks. The long tracks distinguished into eleven very closed and highly correlated clusters, which are presented into three regimes namely the northern, the southern and the eastern border Mediterranean regimes. Among the 940 (44.78% of a total of 2099) long tracks, the northern, southern, and eastern border regime contributes respectively about 53.62%, 41.81% and 5% of the long tracks. In addition, the distribution of the long tracks reveals that a larger proportion of the cyclones are generated at the northern coast during November and spring months, while few cyclones are developed over the eastern Mediterranean border in warm months (April and May). Further, their synoptic features show that the regimes are associated with the extension of Azores high, specifically for each regime, the cyclogenesis areas of its clusters are controlled by the intersection of low level (850 hPa) trough and the position of the upper level (250 hPa) maximum wind. Furthermore, the orientations of clusters are controlled by the extension of Siberian high and the shape of cyclonic trough at 850 hPa. In addition, the synoptic study shows that most of the southern cyclones generated externally by African and Red Sea troughs, while most of the northern and eastern border cyclones are generated internally.

The unexpected finding of Parapholidoptera castaneoviridis in south-eastern Romania (Insecta, Orthoptera, Tettigoniidae)

PubMed Central

Iorgu, Ionuț Ștefan; Chobanov, Dragan Petrov; Iorgu, Elena Iulia

2017-01-01

Abstract The Balkano-Anatolian genus Parapholidoptera comprises 21 species and the westernmost one, Parapholidoptera castaneoviridis, previously recognized to occur in western Turkey, north-eastern Greece and south-eastern Bulgaria is recorded for the first time from south-eastern Romania, almost 300 km away from the closest known locality. Illustrations and measurements of morphological characters are given and the male calling song from this new, northernmost population is described. PMID:28144178

Diagnostic accuracy of HbA1c in diabetes between Eastern and Western.

PubMed

Yan, Shuang; Liu, Siying; Zhao, Yashuang; Zhang, Wencui; Sun, Xiaohui; Li, Jianing; Jiang, Fuli; Ju, Jiaming; Lang, Ning; Zhang, Yingqi; Zhou, Weiyu; Li, Qiang

2013-07-01

In 2010, the American Diabetes Association recommended the use of HbA1c as a diagnostic criterion for diabetes. However, HbA1c is not an accepted diagnostic tool for diabetes in Eastern Asia, because genetic differences compromise the standardization of the diagnostic cut-off point. This study evaluated differences in the use of HbA1c for diagnosing diabetes in Eastern and Western populations and investigated whether HbA1c cut-off point of ≥ 6.5% is diagnostic of diabetes in patients from Eastern Asia. Literature was obtained from MEDLINE, EMBASE and Cochrane databases. The pooled sensitivity and specificity of each HbA1c cut-off point were extracted and compared between Western and Eastern populations. Differences in the cut-off point for diagnosing diabetes in each region were compared by examining differences in the area under summary receiver operating characteristic (SROC) curves. Twelve publications from Eastern countries (n = 59,735) and 13 from Western countries (n = 22,954) were included in the analysis. Areas under SROC curves in the Eastern and Western groups were 0.9331 and 0.9120, respectively (P = 0.98). The cut-off point of the highest Youden index was 6.0%. At the HbA1c cut-off point of 6.5%, the pooled sensitivity and specificity were 58.7% and 98.4% for Eastern countries and 65.5% and 98.1% for Western countries, respectively. HbA1c exhibits the same diagnostic value for diabetes in Eastern and Western populations. In both populations, HbA1c levels > 6.0% identify the population at high risk of diabetes, and HbA1c > 6.5% is diagnostic of clinically established diabetes. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

The HBsAg Prevalence Among Blood Donors From Eastern Mediterranean and Middle Eastern Countries: A Systematic Review and Meta-Analysis.

PubMed

Babanejad, Mehran; Izadi, Neda; Najafi, Farid; Alavian, Seyed Moayed

2016-03-01

The world health organization (WHO) recommends that all blood donations should be screened for evidence of infections, such as hepatitis B. The present study aimed to determine the prevalence of hepatitis B surface antigen (HBsAg) in blood donors at the eastern Mediterranean region office (EMRO) of the WHO and middle eastern countries. A meta-analysis was carried out based on the results of an electronic literature search of PubMed, Ovid, Scopus, and Google Scholar for articles published from January 1, 2000, to August 31, 2015. In accordance with a significant homogeneity test and a large value of I2, the random effects model was used to aggregate data from the studies and produce the pooled estimates using the "Metan" command. We included 66 eligible studies. The pooled prevalence of HBsAg in blood donors of both EMRO and middle eastern (E and M) countries was 2.03% (95% confidence interval [CI]: 1.79 - 2.26). In addition, the prevalence rates in the EMRO countries was 1.99% (95% CI: 1.84 - 2.14) and 1.62% in the Middle Eastern countries (95% CI: 1.36 - 1.88). The prevalence among blood donors with more than one study was 1.58% in Egypt, 0.58% in Iran, 0.67% in Iraq, 2.84% in Pakistan, 3.02% in Saudi Arabia, 1.68% in Turkey, and 5.05% in Yemen. Based on the WHO classification of hepatitis B virus (HBV) prevalence, the prevalence of HBsAg in blood donors from E and M countries reached an intermediate level. However, there were low prevalence levels in some E and M countries.

Validation of Stroke Diagnosis in the National Registry of Hospitalized Patients in the Czech Republic.

PubMed

Sedova, Petra; Brown, Robert D; Zvolsky, Miroslav; Kadlecova, Pavla; Bryndziar, Tomas; Volny, Ondrej; Weiss, Viktor; Bednarik, Josef; Mikulik, Robert

2015-09-01

Stroke is a common cause of mortality and morbidity in Eastern Europe. However, detailed epidemiological data are not available. The National Registry of Hospitalized Patients (NRHOSP) is a nationwide registry of prospectively collected data regarding each hospitalization in the Czech Republic since 1998. As a first step in the evaluation of stroke epidemiology in the Czech Republic, we validated stroke cases in NRHOSP. Any hospital in the Czech Republic with a sufficient number of cases was included. We randomly selected 10 of all 72 hospitals and then 50 patients from each hospital in 2011 stratified according to stroke diagnosis (International Classification of Diseases Tenth Revision [ICD-10] cerebrovascular codes I60, I61, I63, I64, and G45). Discharge summaries from hospitalization were reviewed independently by 2 reviewers and compared with NRHOSP for accuracy of discharge diagnosis. Any disagreements were adjudicated by a third reviewer. Of 500 requested discharge summaries, 484 (97%) were available. Validators confirmed diagnosis in NRHOSP as follows: transient ischemic attack (TIA) or any stroke type in 82% (95% confidence interval [CI], 79-86), any stroke type in 85% (95% CI, 81-88), I63/cerebral infarction in 82% (95% CI, 74-89), I60/subarachnoid hemorrhage in 91% (95% CI, 85-97), I61/intracerebral hemorrhage in 91% (95% CI, 85-96), and G45/TIA in 49% (95% CI, 39-58). The most important reason for disagreement was use of I64/stroke, not specified for patients with I63. The accuracy of coding of the stroke ICD-10 codes for subarachnoid hemorrhage (I60) and intracerebral hemorrhage (I61) included in a Czech Republic national registry was high. The accuracy of coding for I63/cerebral infarction was somewhat lower than for ICH and SAH. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Earthquake and Tsunami History and Hazards of Eastern Indonesia

NASA Astrophysics Data System (ADS)

Major, J. R.; Robinson, J. S.; Harris, R. A.

2008-12-01

Western Indonesia (i.e. Java and Sumatra) has received much attention by geoscientists, especially in recent years due to events such as the Sumatra-Andaman event of 2004. However, the seismic history of eastern Indonesia is not widely known, notwithstanding the high rate of seismic activity in the area and high convergence rates. Not only do geologic hazards (i.e. strong earthquakes, tsunami, and explosive volcanoes) comparable to those in western part of the country exist, but population has increased nearly 10 fold in the last century. Our historical research of earthquakes and tsunami in eastern Indonesia based primarily on records of Dutch Colonists has uncovered a violent history of earthquakes and tsunami from 1608 to 1877. During this time eastern Indonesia experienced over 30 significant earthquakes and 35 tsunamis. Most of these events are much larger than any recorded in the last century. Due to this marked quiescence over the past century, and recent events in the Sunda arc over the past several years, we have initiated a new investigation of the region that integrates these historic events, field investigations, and, in the future, tsunami modeling. A more complete and comprehensive seismic history of eastern Indonesia is necessary for effective risk assessment. This information, along with renewed efforts by scientists and government will be crucial for disaster mitigation and to save lives.

Ancient west Eurasian ancestry in southern and eastern Africa.

PubMed

Pickrell, Joseph K; Patterson, Nick; Loh, Po-Ru; Lipson, Mark; Berger, Bonnie; Stoneking, Mark; Pakendorf, Brigitte; Reich, David

2014-02-18

The history of southern Africa involved interactions between indigenous hunter-gatherers and a range of populations that moved into the region. Here we use genome-wide genetic data to show that there are at least two admixture events in the history of Khoisan populations (southern African hunter-gatherers and pastoralists who speak non-Bantu languages with click consonants). One involved populations related to Niger-Congo-speaking African populations, and the other introduced ancestry most closely related to west Eurasian (European or Middle Eastern) populations. We date this latter admixture event to ∼900-1,800 y ago and show that it had the largest demographic impact in Khoisan populations that speak Khoe-Kwadi languages. A similar signal of west Eurasian ancestry is present throughout eastern Africa. In particular, we also find evidence for two admixture events in the history of Kenyan, Tanzanian, and Ethiopian populations, the earlier of which involved populations related to west Eurasians and which we date to ∼2,700-3,300 y ago. We reconstruct the allele frequencies of the putative west Eurasian population in eastern Africa and show that this population is a good proxy for the west Eurasian ancestry in southern Africa. The most parsimonious explanation for these findings is that west Eurasian ancestry entered southern Africa indirectly through eastern Africa.

Ancient west Eurasian ancestry in southern and eastern Africa

PubMed Central

Pickrell, Joseph K.; Patterson, Nick; Loh, Po-Ru; Lipson, Mark; Berger, Bonnie; Stoneking, Mark; Pakendorf, Brigitte; Reich, David

2014-01-01

The history of southern Africa involved interactions between indigenous hunter–gatherers and a range of populations that moved into the region. Here we use genome-wide genetic data to show that there are at least two admixture events in the history of Khoisan populations (southern African hunter–gatherers and pastoralists who speak non-Bantu languages with click consonants). One involved populations related to Niger–Congo-speaking African populations, and the other introduced ancestry most closely related to west Eurasian (European or Middle Eastern) populations. We date this latter admixture event to ∼900–1,800 y ago and show that it had the largest demographic impact in Khoisan populations that speak Khoe–Kwadi languages. A similar signal of west Eurasian ancestry is present throughout eastern Africa. In particular, we also find evidence for two admixture events in the history of Kenyan, Tanzanian, and Ethiopian populations, the earlier of which involved populations related to west Eurasians and which we date to ∼2,700–3,300 y ago. We reconstruct the allele frequencies of the putative west Eurasian population in eastern Africa and show that this population is a good proxy for the west Eurasian ancestry in southern Africa. The most parsimonious explanation for these findings is that west Eurasian ancestry entered southern Africa indirectly through eastern Africa. PMID:24550290

Citizenship Norms in Eastern Europe

ERIC Educational Resources Information Center

Coffe, Hilde; van der Lippe, Tanja

2010-01-01

Research on Eastern Europe stresses the weakness of its civil society and the lack of political and social involvement, neglecting the question: What do people themselves think it means to be a good citizen? This study looks at citizens' definitions of good citizenship in Poland, Slovenia, the Czech Republic and Hungary, using 2002 European Social…

Revised Distribution of Bactrocera tryoni in Eastern Australia and Effect on Possible Incursions of Mediterranean Fruit Fly: Development of Australia's Eastern Trading Block.

PubMed

Dominiak, Bernard C; Mapson, Richard

2017-12-05

Bactrocera tryoni (Froggatt) (Diptera: Tephritidae), commonly called 'Queensland fruit fly' in Australia, and Mediterranean fruit fly (Ceratitis capitata Wiedemann) (Diptera: Tephritidae) are the two most economically important fruit fly in Australia with B. tryoni in the east and Mediterranean fruit fly in the west. The two species coexisted for several decades, but it is believed that B. tryoni displaced Mediterranean fruit fly. In southeastern Australia, this was deemed inadequate for export market access, and a large fruit fly free zone (fruit fly exclusion zone) was developed in 1996 where B. tryoni was eradicated by each state department in their portion of the zone. This zone caused an artificial restricted distribution of B. tryoni. When the fruit fly exclusion zone was withdrawn in Victoria and New South Wales in 2013, B. tryoni became endemic once again in this area and the national distribution of B. tryoni changed. For export markets, B. tryoni is now deemed endemic to all eastern Australian states, except for the Greater Sunraysia Pest-Free Area. All regulatory controls have been removed between eastern states, except for some small zones, subject to domestic market access requirements. The eastern Australian states now form a B. tryoni endemic trading group or block. All Australian states and territories maintain legislation to regulate the movement of potentially infested host fruit into their states. In particular, eastern states remain active and regulate the entry of commodities possibly infested with Mediterranean fruit fly. The combination of regulatory controls limits the chances of Mediterranean fruit fly entering eastern states, and if it did, Mediterranean fruit fly is unlikely to establish in the opposition to a well-established B. tryoni population. © The Author(s) 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The prevalence of the Middle-Eastern extreme ideologies among some Canadians.

PubMed

Loza, Wagdy

2011-05-01

A total of 183 Canadian participants of different religious backgrounds completed the Belief Diversity Scale (BDS). The BDS is an 80-item, 6-subscale instrument designed to quantitatively measure the religious attitudes, beliefs, and ideologies of Middle-Eastern extremists' on risk areas that are reported in the literature. The results demonstrated the reliability and validity of the BDS as well as indicated the prevalence of Middle-Eastern extremists' ideologies among Muslim Canadians. Results were similar to those obtained from similar study completed on South African participants. These findings suggested that the BDS has the potential to be used as an objective tool to measure Middle-Eastern religious extremism.

75 FR 13524 - Eastern Shore Natural Gas Company; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... Natural Gas Company; Notice of Application March 15, 2010. Take notice that on March 5, 2010, Eastern Shore Natural Gas Company, (Eastern Shore), 1110 Forrest Avenue, Dover, Delaware 19904, pursuant to section 7(c) of the Natural Gas Act (NGA), as amended, and Part 157 of the Federal Energy Regulatory...

Use of water by eastern hemlock: implications for systemic insecticide application

Treesearch

Chelcy R. Ford; James M. Vose; Michael Daley; Nathan Phillips

2007-01-01

The hemlock woolly adelgid (HWA, Adelges tsugae Annand) is causing widespread decline and mortality of eastern hemlock (Tsuga canadensis (L.) Carr.) throughout most of the range of eastern hemlock. Stem injection of insecticide is widely used as a chemical control measure, but the effectiveness of this method depends on the...

Phylogenetic diversity anomaly in angiosperms between eastern Asia and eastern North America.

PubMed

Qian, Hong; Jin, Yi; Ricklefs, Robert E

2017-10-24

Although eastern Asia (EAS) and eastern North America (ENA) have similar climates, plant species richness in EAS greatly exceeds that in ENA. The degree to which this diversity difference reflects the ages of the floras or their rates of evolutionary diversification has not been quantified. Measures of species diversity that do not incorporate the ages of lineages disregard the evolutionary distinctiveness of species. In contrast, phylogenetic diversity integrates both the number of species and their history of evolutionary diversification. Here we compared species diversity and phylogenetic diversity in a large number of flowering plant (angiosperm) floras distributed across EAS and ENA, two regions with similar contemporary environments and broadly shared floristic history. After accounting for climate and sample area, we found both species diversity and phylogenetic diversity to be significantly higher in EAS than in ENA. When we controlled the number of species statistically, we found that phylogenetic diversity remained substantially higher in EAS than in ENA, although it tended to converge at high latitude. This pattern held independently for herbs, shrubs, and trees. The anomaly in species and phylogenetic diversity likely resulted from differences in regional processes, related in part to high climatic and topographic heterogeneity, and a strong monsoon climate, in EAS. The broad connection between tropical and temperate floras in southern Asia also might have played a role in creating the phylogenetic diversity anomaly.

The application of hospitality elements in hospitals.

PubMed

Wu, Ziqi; Robson, Stephani; Hollis, Brooke

2013-01-01

In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

Two new carnivores from an unusual late Tertiary forest biota in eastern North America.

PubMed

Wallace, Steven C; Wang, Xiaoming

2004-09-30

Late Cenozoic terrestrial fossil records of North America are biased by a predominance of mid-latitude deposits, mostly in the western half of the continent. Consequently, the biological history of eastern North America, including the eastern deciduous forest, remains largely hidden. Unfortunately, vertebrate fossil sites from this vast region are rare, and few pertain to the critically important late Tertiary period, during which intensified global climatic changes took place. Moreover, strong phylogenetic affinities between the flora of eastern North America and eastern Asia clearly demonstrate formerly contiguous connections, but disparity among shared genera (eastern Asia-eastern North America disjunction) implies significant periods of separation since at least the Miocene epoch. Lacustrine sediments deposited within a former sinkhole in the southern Appalachian Mountains provide a rare example of a late Miocene to early Pliocene terrestrial biota from a forested ecosystem. Here we show that the vertebrate remains contained within this deposit represent a unique combination of North American and Eurasian taxa. A new genus and species of the red (lesser) panda (Pristinailurus bristoli), the earliest and most primitive so far known, was recovered. Also among the fauna are a new species of Eurasian badger (Arctomeles dimolodontus) and the largest concentration of fossil tapirs ever recorded. Cladistical analyses of the two new carnivores strongly suggest immigration events that were earlier than and distinct from previous records, and that the close faunal affinities between eastern North America and eastern Asia in the late Tertiary period are consistent with the contemporaneous botanical record.

77 FR 21835 - Savage, Bingham & Garfield Railroad Company-Trackage Rights Exemption-Elgin, Joliet and Eastern...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

... & Garfield Railroad Company--Trackage Rights Exemption--Elgin, Joliet and Eastern Railway Company Pursuant to a written trackage rights agreement dated March 5, 2012, Elgin, Joliet and Eastern Railway Company... Subdivision in Whiting, Ind. \\1\\ Elgin, Joliet and Eastern Railway Company is an indirect subsidiary of...

Forest statistics of eastern Kentucky

Treesearch

The Forest Survey Organization Central States Forest Experiment Station

1952-01-01

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

Biomass chipping for eastern redcedar

Treesearch

David Baker; Mathew Smidt; Dana Mitchell

2017-01-01

Eastern redcedar expansion is a significant economic and environmental problem in much of the Great Plains. Mechanical control measures are quite common and widely available, but application is costly and the often large piles of trees are significant issues for landowners. Biomass production from redcedar has the potential to lower costs and dispose of the material....

49 CFR 71.5 - Boundary line between eastern and central zones.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Boundary line between eastern and central zones... BOUNDARIES § 71.5 Boundary line between eastern and central zones. (a) Minnesota-Michigan-Wisconsin. From the junction of the western boundary of the State of Michigan with the boundary between the United States and...

Molecular epidemiology of eastern equine encephalitis Virus, New York

USGS Publications Warehouse

Young, David S.; Kramer, Laura D.; Maffei, Joseph G.; Dusek, Robert J.; Backenson, P. Bryon; Mores, Christopher N.; Bernard, Kristen A.; Ebel, Gregory D.

2008-01-01

Perpetuation, overwintering, and extinction of eastern equine encephalitis virus (EEEV) in northern foci are poorly understood. We therefore sought to describe the molecular epidemiology of EEEV in New York State during current and past epizootics. To determine whether EEEV overwinters, is periodically reintroduced, or both, we sequenced the E2 and partial NSP3 coding regions of 42 EEEV isolates from New York State and the Eastern Seaboard of the United States. Our phylogenetic analyses indicated that derived subclades tended to contain southern strains that had been isolated before genetically similar northern strains, suggesting southern to northern migration of EEEV along the Eastern Seaboard. Strong clustering among strains isolated during epizootics in New York from 2003–2005, as well as from 1974–1975, demonstrates that EEEV has overwintered in this focus. This study provides molecular evidence for the introduction of southern EEEV strains to New York, followed by local amplification, perpetuation, and overwintering.

The Impact of Hospital Size on CMS Hospital Profiling.

PubMed

Sosunov, Eugene A; Egorova, Natalia N; Lin, Hung-Mo; McCardle, Ken; Sharma, Vansh; Gelijns, Annetine C; Moskowitz, Alan J

2016-04-01

The Centers for Medicare & Medicaid Services (CMS) profile hospitals using a set of 30-day risk-standardized mortality and readmission rates as a basis for public reporting. These measures are affected by hospital patient volume, raising concerns about uniformity of standards applied to providers with different volumes. To quantitatively determine whether CMS uniformly profile hospitals that have equal performance levels but different volumes. Retrospective analysis of patient-level and hospital-level data using hierarchical logistic regression models with hospital random effects. Simulation of samples including a subset of hospitals with different volumes but equal poor performance (hospital effects=+3 SD in random-effect logistic model). A total of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 heart failure admissions in 4930 hospitals between July 1, 2005 and June 30, 2008. CMS methodology was used to determine the rank and proportion (by volume) of hospitals reported to perform "Worse than US National Rate." Percent of hospitals performing "Worse than US National Rate" was ∼40 times higher in the largest (fifth quintile by volume) compared with the smallest hospitals (first quintile). A similar gradient was seen in a cohort of 100 hospitals with simulated equal poor performance (0%, 0%, 5%, 20%, and 85% in quintiles 1 to 5) effectively leaving 78% of poor performers undetected. Our results illustrate the disparity of impact that the current CMS method of hospital profiling has on hospitals with higher volumes, translating into lower thresholds for detection and reporting of poor performance.

Watermarks within the Middle Eastern Manuscript Collection of the Baillieu Library

ERIC Educational Resources Information Center

Lewincamp, Sophie

2012-01-01

The University of Melbourne's Middle Eastern Manuscript collection housed at the Baillieu Library was acquired by Professor John Bowman in the 1950s as part of a teaching collection to promote greater learning of Middle Eastern culture and civilisation (Pryde 2007, 3). The collection is a rare example within Australia and represents many different…

How the eastern US National Forests were formed [Book review

Treesearch

Louis R. Iverson

2014-01-01

As a landscape ecologist conducting research on eastern forests for the US Forest Service (e.g., www.nrs.fs.fed.us/atlas), I was eager to learn about how the eastern National Forests came to be, as these forests now play such an important part of the natural world and provide a large carbon sink. The book did not disappoint and I'm confident that it will be...

EPA's Role with the Regional Environmental Center (REC) for Central and Eastern Europe

EPA Pesticide Factsheets

The Regional Environmental Center (REC) for Central and Eastern Europe provides assistance in solving environmental problems in Central and Eastern Europe by promoting cooperation among governments, non-governmental organizations, businesses and others.

Ring Shake in Eastern Hemlock: Frequency and Relationship to Tree Attributes

Treesearch

John E. Baumgras; Paul E. Sendak; David L. Sonderman; David L. Sonderman

2000-01-01

Ring shake is a barrier to improved utilization of eastern hemlock, an important component of the total softwood timber resource in the Eastern United States and Canada. Ring shake is the lengthwise separation of wood that occurs between and parallel to growth rings, diminishing lumber yields and values. Evaluating the potential for ring shake is essential to improving...

Ring shake in eastern hemlock: frequency and relationship to tree attributes

Treesearch

John E. Baumgras; Paul E. Sendak; David L. Sonderman

2000-01-01

Ring shake is a barrier to improved utilization of eastern hemlock, an important component of the total softwood timber resource in the Eastern United States and Canada. Ring shake is the lengthwise separation of wood that occurs between and parallel to growth rings, diminishing lumber yields and values. Evaluating the potential for ring shake is essential to improving...

History of fire in eastern oak forests and implications for restoration

Treesearch

Justin L. Hart; Megan L. Buchanan

2012-01-01

Our understanding of long-term fire history in the eastern United States is derived from the interpretation of a variety of archives. While cultural records are available for some sites, biological archives are most frequently used to reconstruct long-term historical fire regimes. The three most commonly used biological archives in eastern oak forests include: the...

Restoration of southern Appalachian riparian forest affected by eastern hemlock mortality

Treesearch

Katherine Elliott; Chelcy F. Miniat; Jennifer Knoepp; Michael A. Crump; C. Rhett Jackson

2016-01-01

Widespread mortality of eastern hemlock (Tsuga canadensis) through hemlock woolly adelgid (HWA) infestation has altered riparian forest structure and function throughout the southern Appalachians. Eastern hemlock and Rhododendron maximum often co-occur in these riparian forests, where the latter species is highly shade tolerant, forms a dense shrub layer that strongly ...

Teleseismic P-wave tomography and mantle dynamics beneath Eastern Tibet

NASA Astrophysics Data System (ADS)

Lei, Jianshe; Zhao, Dapeng

2016-05-01

We determined a new 3-D P-wave velocity model of the upper mantle beneath eastern Tibet using 112,613 high-quality arrival-time data collected from teleseismic seismograms recorded by a new portable seismic array in Yunnan and permanent networks in southwestern China. Our results provide new insights into the mantle structure and dynamics of eastern Tibet. High-velocity (high-V) anomalies are revealed down to 200 km depth under the Sichuan basin and the Ordos and Alashan blocks. Low-velocity (low-V) anomalies are imaged in the upper mantle under the Kunlun-Qilian and Qinling fold zones, and the Songpan-Ganzi, Qiangtang, Lhasa and Chuan-Dian diamond blocks, suggesting that eastward moving low-V materials are extruded to eastern China after the obstruction by the Sichuan basin, and the Ordos and Alashan blocks. Furthermore, the extent and thickness of these low-V anomalies are correlated with the surface topography, suggesting that the uplift of eastern Tibet could be partially related to these low-V materials having a higher temperature and strong positive buoyancy. In the mantle transition zone (MTZ), broad high-V anomalies are visible from the Burma arc northward to the Kunlun fault and eastward to the Xiaojiang fault, and they are connected upward with the Wadati-Benioff seismic zone. These results suggest that the subducted Indian slab has traveled horizontally for a long distance after it descended into the MTZ, and return corner flow and deep slab dehydration have contributed to forming the low-V anomalies in the big mantle wedge. Our results shed new light on the dynamics of the eastern Tibetan plateau.

Eastern South African hydroclimate over the past 270,000 years

NASA Astrophysics Data System (ADS)

Simon, Margit H.; Ziegler, Martin; Bosmans, Joyce; Barker, Stephen; Reason, Chris J. C.; Hall, Ian R.

2015-12-01

Processes that control the hydrological balance in eastern South Africa on orbital to millennial timescales remain poorly understood because proxy records documenting its variability at high resolution are scarce. In this work, we present a detailed 270,000 year-long record of terrestrial climate variability in the KwaZulu-Natal province based on elemental ratios of Fe/K from the southwest Indian Ocean, derived from X-ray fluorescence core scanning. Eastern South African climate variability on these time scales reflects both the long-term effect of regional insolation changes driven by orbital precession and the effects associated with high-latitude abrupt climate forcing over the past two glacial-interglacial cycles, including millennial-scale events not previously identified. Rapid changes towards more humid conditions in eastern South Africa as the Northern Hemisphere entered phases of extreme cooling were potentially driven by a combination of warming in the Agulhas Current and shifts of the subtropical anticyclones. These climate oscillations appear coherent with other Southern Hemisphere records but are anti-phased with respect to the East Asian Monsoon. Numerical modelling results reveal that higher precipitation in the KwaZulu-Natal province during precession maxima is driven by a combination of increased local evaporation and elevated moisture transport into eastern South Africa from the coast of Mozambique.

Eastern South African hydroclimate over the past 270,000 years.

PubMed

Simon, Margit H; Ziegler, Martin; Bosmans, Joyce; Barker, Stephen; Reason, Chris J C; Hall, Ian R

2015-12-21

Processes that control the hydrological balance in eastern South Africa on orbital to millennial timescales remain poorly understood because proxy records documenting its variability at high resolution are scarce. In this work, we present a detailed 270,000 year-long record of terrestrial climate variability in the KwaZulu-Natal province based on elemental ratios of Fe/K from the southwest Indian Ocean, derived from X-ray fluorescence core scanning. Eastern South African climate variability on these time scales reflects both the long-term effect of regional insolation changes driven by orbital precession and the effects associated with high-latitude abrupt climate forcing over the past two glacial-interglacial cycles, including millennial-scale events not previously identified. Rapid changes towards more humid conditions in eastern South Africa as the Northern Hemisphere entered phases of extreme cooling were potentially driven by a combination of warming in the Agulhas Current and shifts of the subtropical anticyclones. These climate oscillations appear coherent with other Southern Hemisphere records but are anti-phased with respect to the East Asian Monsoon. Numerical modelling results reveal that higher precipitation in the KwaZulu-Natal province during precession maxima is driven by a combination of increased local evaporation and elevated moisture transport into eastern South Africa from the coast of Mozambique.

Eastern South African hydroclimate over the past 270,000 years

PubMed Central

Simon, Margit H.; Ziegler, Martin; Bosmans, Joyce; Barker, Stephen; Reason, Chris J.C.; Hall, Ian R.

2015-01-01

Processes that control the hydrological balance in eastern South Africa on orbital to millennial timescales remain poorly understood because proxy records documenting its variability at high resolution are scarce. In this work, we present a detailed 270,000 year-long record of terrestrial climate variability in the KwaZulu-Natal province based on elemental ratios of Fe/K from the southwest Indian Ocean, derived from X-ray fluorescence core scanning. Eastern South African climate variability on these time scales reflects both the long-term effect of regional insolation changes driven by orbital precession and the effects associated with high-latitude abrupt climate forcing over the past two glacial-interglacial cycles, including millennial-scale events not previously identified. Rapid changes towards more humid conditions in eastern South Africa as the Northern Hemisphere entered phases of extreme cooling were potentially driven by a combination of warming in the Agulhas Current and shifts of the subtropical anticyclones. These climate oscillations appear coherent with other Southern Hemisphere records but are anti-phased with respect to the East Asian Monsoon. Numerical modelling results reveal that higher precipitation in the KwaZulu-Natal province during precession maxima is driven by a combination of increased local evaporation and elevated moisture transport into eastern South Africa from the coast of Mozambique. PMID:26686943

Challenge for Mesozoic hydrocarbon exploration in the Eastern Indonesia

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

Abdullah, S.; Rukmiati, M.G.; Sitompul, N.

1996-12-31

The eastern part of Indonesia covers approximately 3 million square kilometers, 35 percent being landmass and 65 percent covered by ocean. Only three of 38 sedimentary basins are producing hydrocarbon (Salawati, Bintuni, and Seram Basins). Oil and gas have discovered in the Lariang, Bone, Timor, Banggai, Sula and Biak Basins, however the discoveries have not developed yet. Hydrocarbon systems in Northern Australia and Papua New Guinea give the major contributions to the geological idea of Pre-Tertiary section in the less explored area in the Eastern Indonesia. The Triassic-Middle Jurassic marine carbonaceous shale sequences are the main hydrocarbon source rock inmore » the Irian Jaya and surrounding area (Buton, gula and Seram basins). The main Mesozoic reservoir are the Kembelangan Formation in the Bintuni Basin of Irian Jaya and Bobong Formation in the North Sula Region. Exploration play types in the Eastern Indonesia can be divided into five types: 1 - Peri Cratonic, 2 - Marginal Rift Graben, 3 - Thrust Fold Belt Island Arc, 4 - Early Collision and 5 -Microcontinental Block - Advanced Collision. Recent discoveries through Mesozoic section in Eastern Indonesia are: Roabiba-1 (1990) in Bintuni Basin-Irian Jaya (Kambelangan Formation); Loku- 1 (1990) in North Sula region (Pre-Tertiary sediments); Oseil-1 (1993/94) in Bula-Seram Basin (Jurassic Manusela Formation); Elang-1 (1 994); Kakaktua-1 (1994) and Laminaria-1 in North Bonaparte Basin (Upper Jurassic Sands).« less

Why Is It So Difficult? Misconceptions about Eastern European Education in Transition.

ERIC Educational Resources Information Center

Sandi, Ana Maria

1992-01-01

Examines misconceptions in both Western and Eastern countries about educational systems in postcommunist Eastern Europe. Discusses issues of slow pace of educational reform, change through formal power structures, centralization versus decentralization, role of tradition, macro- and micro-level problems, Western assistance, and the relationship…

Role of the Hospital Library Within the Hospital System *†

PubMed Central

Lorenzi, Nancy M.

1969-01-01

The results of a survey of hospital administrators, attending staff and house staff physicians, librarians, library committee chairmen, and nursing staff in five Northeastern Ohio hospitals concerning the status of the hospital library within the total hospital system are related. Results indicate that hospital libraries operate in the “fringe” area of the hospital system. A concentric-circle figure indicates the present position of the majority of hospital libraries surveyed. The future relationship of the library within the hospital system has also been represented by a concentric-circle figure. PMID:5778727

A study of regional waveform calibration in the eastern Mediterranean

NASA Astrophysics Data System (ADS)

Di Luccio, F.; Pino, N. A.; Thio, H. K.

2003-06-01

We modeled P nl phases from several moderate magnitude earthquakes in the eastern Mediterranean to test methods and develop path calibrations for determining source parameters. The study region, which extends from the eastern part of the Hellenic arc to the eastern Anatolian fault, is dominated by moderate earthquakes that can produce significant damage. Our results are useful for analyzing regional seismicity as well as seismic hazard, because very few broadband seismic stations are available in the selected area. For the whole region we have obtained a single velocity model characterized by a 30 km thick crust, low upper mantle velocities and a very thin lid overlaying a distinct low velocity layer. Our preferred model proved quite reliable for determining focal mechanism and seismic moment across the entire range of selected paths. The source depth is also well constrained, especially for moderate earthquakes.

Epidemiological studies of cognitive impairment and dementia across Eastern and Middle European countries (epidemiology of dementia in Eastern and Middle European Countries).

PubMed

Kiejna, A; Frydecka, D; Adamowski, T; Bickel, H; Reynish, E; Prince, M; Caracciolo, B; Fratiglioni, L; Georges, J

2011-02-01

To determine the availability and the consistency of prevalence findings of epidemiological studies on cognitive impairment and dementia conducted in Eastern and Middle Europe. We adopted a stepwise multimethod study approach consisting of iterative literature searches for epidemiological articles published between 1990 and 2006 and subsequent data analyses of published material, reanalyses of existing accessible epidemiological data sets and expert inquiries in Eastern and Middle European countries. Systematic computer-assisted searches used the keywords: "dementia", "Alzheimer", "cognitive impairment", "incidence", "prevalence", "epidemiology" in combination with the name of the relevant countries or "Europe" in English and Polish language. We supplemented the literature search with a review of the references in the articles that were identified during the initial search. We were able to find few regional and country-specific epidemiological studies of various kinds (population-based, cohort, cross-sectional studies) and conducted on different restricted population groups of patients (from neurological units, out-patients units, residential homes). No studies were identified from most of the countries taken under consideration and the ones we found were characterized by an immense diversity with a considerable degree of clinical and methodological variations. The few studies that there are suggest prevalence rates of dementia in Eastern Europe similar to those in Western Europe. There is strong need for epidemiological studies in Eastern and Middle Europe, as well as for greater coordination and standardization of methods to improve the quality and comparability of epidemiological data to determine the prevalences' rates of dementia in all the EU countries. Copyright © 2010 John Wiley & Sons, Ltd.

Evaluating the Risk of Re-identification of Patients from Hospital Prescription Records.

PubMed

Emam, Khaled El; Dankar, Fida K; Vaillancourt, Régis; Roffey, Tyson; Lysyk, Mary

2009-07-01

Pharmacies often provide prescription records to private research firms, on the assumption that these records are de-identified (i.e., identifying information has been removed). However, concerns have been expressed about the potential that patients can be re-identified from such records. Recently, a large private research firm requested prescription records from the Children's Hospital of Eastern Ontario (CHEO), as part of a larger effort to develop a database of hospital prescription records across Canada. To evaluate the ability to re-identify patients from CHEO'S prescription records and to determine ways to appropriately de-identify the data if the risk was too high. The risk of re-identification was assessed for 18 months' worth of prescription data. De-identification algorithms were developed to reduce the risk to an acceptable level while maintaining the quality of the data. The probability of patients being re-identified from the original variables and data set requested by the private research firm was deemed quite high. A new de-identified record layout was developed, which had an acceptable level of re-identification risk. The new approach involved replacing the admission and discharge dates with the quarter and year of admission and the length of stay in days, reporting the patient's age in weeks, and including only the first character of the patient's postal code. Additional requirements were included in the data-sharing agreement with the private research firm (e.g., audit requirements and a protocol for notification of a breach of privacy). Without a formal analysis of the risk of re-identification, assurances of data anonymity may not be accurate. A formal risk analysis at one hospital produced a clinically relevant data set that also protects patient privacy and allows the hospital pharmacy to explicitly manage the risks of breach of patient privacy.

Biotechnological studies in the Far-Eastern Region of Russia.

PubMed

Stonik, Valentin A; Mikhailov, Valery V; Bulgakov, Victor P; Zhuravlev, Yuri N

2007-07-01

Achievements and problems in both the studies on natural bioactive compounds from the Far-Eastern higher plants and marine invertebrates and development of the corresponding biotechnologies concerning new drugs and food supplements, as well as pharmaceutical leads are discussed. Special emphasis is made on recent results from the Far-eastern Institutions belonging to the Russian Academy of Sciences, and their application in both medicine and the food industry, as well as on peculiarities of biological and chemical diversity in the North-Western part of Asia and adjoining seas.

Pediatric environmental medicine in Eastern Central Europe.

PubMed

Muceniece, S; Muszynska, M; Otto, M; Rozentale, G; Rudkowski, Z; Skerliene, B; Slotova, K; Suurorg, L; Tur, I; von Mühlendahl, K E

2007-10-01

Pediatric environmental medicine in Central Eastern Europe needs support and development on national, institutional and individual basis. This situation is quantitatively, but not fundamentally different from what is to be found in Central Europe.

Pyogenic liver abscesses associated with nonmetastatic colorectal cancers: An increasing problem in Eastern Asia

PubMed Central

Qu, Kai; Liu, Chang; Wang, Zhi-Xin; Tian, Feng; Wei, Ji-Chao; Tai, Ming-Hui; Zhou, Lei; Meng, Fan-Di; Wang, Rui-Tao; Xu, Xin-Sen

2012-01-01

AIM: To elaborate the clinicopathologic features of colorectal cancer-related pyogenic liver abscess (PLA). METHODS: Reported cases of colorectal cancer-related PLAs were collected from the literature published up to October 2011 and evaluated for their clinicopathologic features. Data of collected cases included demographics, clinical presentation, microbial findings and treatment. Categorical variables were compared by χ2 analysis and continuous variables were evaluated using Student’s t test. RESULTS: A total 96 cases of colorectal cancer-related PLA were collected from the previous literature. Most patients (60%) were male and 40% cases occurred in the age group of 61-70 years. Apart from some special types of PLA, there were significant differences in the microbiological spectrum between Eastern Asia and non-Eastern Asian countries, which implied different risk factors and courses of the disease. Gram negative bacteria especially Klebsiella pneumoniae (K. pneumoniae) PLA was predominant in Eastern Asia (80.0%) in contrast to non-Eastern Asian countries (P < 0.01). Meanwhile, most of the Eastern Asian patients exhibited smaller size of liver abscess and atypical presentation. Sigmoid colon and rectum (72.73%) were the main sites of tumor in Eastern Asian patients, whereas tumor sites were uneven among most of the non-Easter Asian PLA patients. CONCLUSION: K. pneumoniae PLA was strongly associated with colorectal cancer, especially those occurring in sigmoid colon and rectum, in elderly Eastern Asian male patients. PMID:22736918

Increase in winter haze over eastern China in recent decades: Roles of variations in meteorological parameters and anthropogenic emissions: INCREASE IN WINTER HAZE IN EASTERN CHINA

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

Yang, Yang; Liao, Hong; Lou, Sijia

The increase in winter haze over eastern China in recent decades due to variations in meteorological parameters and anthropogenic emissions was quantified using observed atmospheric visibility from the National Climatic Data Center Global Summary of Day database for 1980–2014 and simulated PM2.5 concentrations for 1985–2005 from the Goddard Earth Observing System (GEOS) chemical transport model (GEOS-Chem). Observed winter haze days averaged over eastern China (105–122.5°E, 20–45°N) increased from 21 d in 1980 to 42 d in 2014, and from 22 to 30 d between 1985 and 2005. The GEOS-Chem model captured the increasing trend of winter PM2.5 concentrations for 1985–2005,more » with concentrations averaged over eastern China increasing from 16.1 μg m -3 in 1985 to 38.4 μg m -3 in 2005. Considering variations in both anthropogenic emissions and meteorological parameters, the model simulated an increase in winter surface-layer PM2.5 concentrations of 10.5 (±6.2) μg m -3 decade -1 over eastern China. The increasing trend was only 1.8 (±1.5) μg m -3 decade -1 when variations in meteorological parameters alone were considered. Among the meteorological parameters, the weakening of winds by -0.09 m s -1 decade -1 over 1985–2005 was found to be the dominant factor leading to the decadal increase in winter aerosol concentrations and haze days over eastern China during recent decades.« less

Steering Patients to Safer Hospitals? The Effect of a Tiered Hospital Network on Hospital Admissions

PubMed Central

Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B

2008-01-01

Objective To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. Data Sources/Study Setting A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety “leaps.” The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Study Design Changes in hospital admissions’ patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Principal Findings Patients affiliated with the engineers’ union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists’ union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Conclusions Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear. PMID:18761676

Crossing eastern cottonwood in the greenhouse

Treesearch

R. E. Farmer; W. L. Nance

1968-01-01

Eastern cottonwood (Populus deltoides Bartr.) is the subject of breeding programs designed to develop planting stock with potential for rapid growth, desirable wood properties, and pest resistance (4). Techniques for making controlled crosses within the species are essential to breeding, and their development constitutes an early phase of genetics...

Temperature Relationships in Eastern Skunk Cabbage

ERIC Educational Resources Information Center

Nicholson, Barbara J.; Halkin, Sylvia L.

2007-01-01

A laboratory exercise is presented in which students determine where metabolic heat is primarily generated in blooming eastern skunk cabbage ("Symplocarpus foetidus") plants. Students consider how color, shape, and orientation of spathes, and stage of flower maturation, may affect metabolic heat production and retention of both metabolic and solar…

Biomass productivity improvement for eastern cottonwood

Treesearch

Terry L. Robison; Randy J. Rousseau; Jianwei Zhang

2006-01-01

Eastern cottonwood ( Populus deltoides Marsh.) is grown in plantations by MeadWestvaco for use at its Wickliffe Kentucky Fine Papers Mill1. Genetic and productivity research over the past two decades have led to significant increases in biomass yield while reducing production costs.Initially, genetic research identified fast growing...

Eastern Airlines LOFT program

NASA Technical Reports Server (NTRS)

Beach, B. E.

1981-01-01

Beginning with scenario design and development issues, Eastern Airlines committed itself to the full four-hour LOFT training format without the additional time for specific maneuvers. Abnormals and emergency conditions, pacing, and quiet periods are included in the scenarios which are written for the instructor to follow verbatim. Simulator capabilities, performance assessment; training vs. checking; crew composition and scheduling; satisfactory completion; the use of video performance printouts; the number of instructors; instructor training and standardization; and initial, transition, and upgrade training are discussed.

78 FR 17229 - Notice of Public Meeting, Eastern Washington Resource Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-20

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLORW00000 L102000000.ML0000 13XL1109AF.HAG13-0139] Notice of Public Meeting, Eastern Washington Resource Advisory Council AGENCY: Bureau of... the Eastern Washington Resource Advisory Council. The meeting on March 21, 2013, has been cancelled...

A real-time PCR assay for early detection of eastern filbert blight

USDA-ARS?s Scientific Manuscript database

Eastern filbert blight (EFB) is a devastating disease of European hazelnut, Corylus avellana, which causes economic losses in Oregon where 99% of the U.S. crop is produced. The causal fungus, Anisogramma anomala, is native to eastern North America, where it is found associated with the American haz...

Proteomic landscape in Central and Eastern Europe: the 9th Central and Eastern European Proteomic Conference, Poznań, Poland.

PubMed

Gadher, Suresh Jivan; Marczak, Łukasz; Łuczak, Magdalena; Stobiecki, Maciej; Widlak, Piotr; Kovarova, Hana

2016-01-01

Every year since 2007, the Central and Eastern European Proteomic Conference (CEEPC) has excelled in representing state-of-the-art proteomics in and around Central and Eastern Europe, and linking it to international institutions worldwide. Its mission remains to contribute to all approaches of proteomics including traditional and often-revisited methodologies as well as the latest technological achievements in clinical, quantitative and structural proteomics with a view to systems biology of a variety of processes. The 9th CEEPC was held from June 15th to 18th, 2015, at the Institute of Bioorganic Chemistry, Polish Academy of Sciences in Poznań, Poland. The scientific program stimulated exchange of proteomic knowledge whilst the spectacular venue of the conference allowed participants to enjoy the cobblestoned historical city of Poznań.

Waterpipe Tobacco Smoking Prevalence and Correlates in 25 Eastern Mediterranean and Eastern European Countries: Cross-Sectional Analysis of the Global Youth Tobacco Survey.

PubMed

Jawad, Mohammed; Lee, John Tayu; Millett, Christopher

2016-04-01

Waterpipe tobacco smoking is highly prevalent among young people in some settings. There is an absence of nationally representative prevalence studies of waterpipe tobacco use and dual use with other tobacco products in young people. We conducted a secondary analysis of the Global Youth Tobacco Survey, a nationally representative cross-sectional study of students aged 13-15 years. Of 180 participating countries, 25 included optional waterpipe tobacco smoking questions: 15 Eastern Mediterranean and 10 Eastern European countries. We calculated the prevalence of current (past 30-day) waterpipe tobacco use, including dual waterpipe and other tobacco use, and used logistic regression models to identify sociodemographic correlates of waterpipe tobacco smoking. Individual country results were combined in a random effects meta-analysis. Waterpipe tobacco smoking prevalence was highest in Lebanon (36.9%), the West Bank (32.7%) and parts of Eastern Europe (Latvia 22.7%, the Czech Republic 22.1%, Estonia 21.9%). These countries also recorded greater than 10% prevalence of dual waterpipe and cigarette use. In a meta-analysis, higher odds of waterpipe tobacco smoking were found among males (Adjusted odds ratio [AOR] = 1.37, 95% confidence interval [CI] = 1.18% to 1.59%), cigarette users (AOR = 6.95, 95% CI = 5.74% to 8.42%), those whose parents (AOR = 1.54, 95% CI = 1.31% to 1.82%) or peers smoked (AOR = 3.53, 95% CI = 2.97% to 4.20%) and those whose parents had higher educational attainment (Father, AOR = 1.47, 95% CI = 1.14% to 1.89%; Mother, AOR = 1.62, 95% CI = 1.07% to 2.46%). We report on regional- and country income-level differences. Waterpipe tobacco smoking, including dual waterpipe and cigarette use, is alarmingly high in several Eastern Mediterranean and Eastern European countries. Ongoing waterpipe tobacco smoking surveillance is warranted. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All

Clinical and molecular epidemiology of hospital Enterococcus faecium isolates in eastern France. Members of Réseau Franc-Comtois de Lutte contr les Infections Nosocomiales.

PubMed

Bertrand, X; Thouverez, M; Bailly, P; Cornette, C; Talon, D

2000-06-01

We carried out a surveillance study of Enterococcus faecium isolates in the Franche-Comtéregion of France over three years. Clinical and epidemiological strains were characterized by antibiotype and genotype (pulsed field gel electrophoresis, PFGE). Three case-control studies were performed to identify risk factors for colonization/infection with three defined resistant phenotypes (amoxycillin, high-level gentamicin and high-level kanamycin). The crude incidence of colonization/infection was 0.156%, and 68.8% of cases were classified as hospital-acquired. Incidence did not differ according to the type of hospitalization (middle term or acute care). The urinary tract was the major site of infection. Resistance rates were: 45.8% (amoxycillin), 18.7% (high-level gentamicin), 61.4% (high-level kanamycin) and 3.1% (vancomycin). No isolate produced b-lactamase and one isolate carried the vanA gene. PFGE revealed two major epidemic patterns each including resistant strains isolated in different hospitals and during different periods in the study. Previous antimicrobial treatment was not identified as a risk factor for colonization/infection with any resistant phenotype. Despite the low frequency of vancomycin-resistant isolates in this study, resistant strains were widely disseminated and had characteristics enabling them to persist and spread. If these strains acquired the vanA gene, the risk of an outbreak would be large. So, the prevalence of vancomycin-resistant E. faecium in hospitals should be carefully monitored in the future. Copyright 2000 The Hospital Infection Society.

Nationwide Increase in Hospitalizations for Heroin-related Soft Tissue Infections: Associations with Structural Market Conditions

PubMed Central

Ciccarone, Dan; Unick, George Jay; Cohen, Jenny; Mars, Sarah G.; Rosenblum, Dan

2016-01-01

Introduction Little is known about trends in national rates of injection-related skin and soft tissue infections (SSTI) and their relationship to the structural risk environment for heroin users. Use of Mexican-sourced “Black Tar” heroin, predominant in western US states, may have greater risk for SSTI compared with eastern US powder heroin (Colombian-sourced) due to its association with non-intravenous injection or from possible contamination. Methods Using nationally representative hospital admissions data from the Nationwide Inpatient Sample and heroin price and purity data from the Drug Enforcement Administration, we looked at rates of hospital admissions for opiate-related SSTI (O-SSTI) between 1993 and 2010. Regression analyses examined associations between O-SSTI and heroin source, form and price. Results Hospitalization rates of O-SSTI doubled from 4 to 9 per 100,000 nationally between 1993 and 2010; the increase concentrated among individuals aged 20 to 40. Heroin market features were strongly associated with changes in the rate of SSTI. Each $100 increase in yearly heroin price-per–gram-pure was associated with a 3% decrease in the rate of heroin-related SSTI admissions. Mexican-sourced-heroin-dominant cities had twice the rate of O-SSTI compared to Colombian-sourced-heroin-dominant cities. Discussion Heroin-related SSTI are increasing and structural factors, including heroin price and source-form, are associated with higher rates of SSTI hospital admissions. Clinical and harm reduction efforts should educate heroin users on local risk factors, e.g., heroin type, promote vein health strategies and provide culturally sensitive treatment services for persons suffering with SSTI. PMID:27155756

Further clinical evidence for the existence of neurotoxicity in a population of the European adder (Vipera berus berus) in eastern Hungary: second authenticated case.

PubMed

Malina, Tamás; Babocsay, Gergely; Krecsák, László; Erdész, Csaba

2013-12-01

We report a recent case of common adder (Vipera berus) envenoming causing paralytic signs and symptoms. A 12-year-old girl was bitten by the nominate subspecies of the common adder (V. berus berus) in eastern Hungary on May 2, 2012, 22 km away from where the first neurotoxic V. berus berus envenoming was reported in 2008. The patient developed unambiguous cranial nerve disturbances, manifested in bilateral impairment characterized by oculomotor paralysis with partial ptosis, gaze paresis, and diplopia. Drowsiness and photophobia were her additional symptoms; both occurred only during the first day of envenoming. Until now among viper envenomings in Europe, photophobia has only been documented by victims of Vipera aspis. Supportive and symptomatic treatments were administered during 3 days of hospitalization. Although case reports of V. berus berus envenomings are often published, clinical experience with neurotoxicity by this subspecies still remains rare. Population-based and geographic variation of venom composition in V. berus berus seems to include neurotoxic envenomings in certain populations. This second authenticated case provides new clinical evidence for the existence of a possible neurotoxic V. berus berus population in a restricted geographical area in eastern Hungary. Wilderness Medical Society.

On the frontline of eastern Burma's chronic conflict--listening to the voices of local health workers.

PubMed

Footer, Katherine H A; Meyer, Sarah; Sherman, Susan G; Rubenstein, Leonard

2014-11-01

Globally, attacks on and interferences with health workers and healthcare delivery, including targeted violence towards providers, attacks on hospitals and delays and denial of health care, represent a serious humanitarian and human rights issue. However, gaps in research about these events persist, limiting the evidence base from which to understand and address the problem. This paper focuses on experiences of local health workers in eastern Burma's chronic conflict, including their strategies for addressing security and ensuring access to vulnerable ethnic communities in the region. Face-to-face in-depth interviews were conducted in June and August 2012 with 27 health workers from three health organizations that operate throughout eastern Burma, with their operational head quarters located in Mae Sot, Tak Province, Thailand. Qualitative analysis found that health workers in this setting experience violent and non-violent interferences with their work, and that the Burmese government's military activities in the region have severely impacted access to care, which remains restricted. Data show that innovative security strategies have emerged, including the important role of the community in ensuring securer access to health care. This study underscores health workers' concern for improved data collection to support the rights of health workers to provide health care, and the rights of community members to receive health care in conflict-affected settings. Findings will inform the development of an incident reporting form to improve systematic data collection and documentation of attacks on health in this setting. Copyright © 2014 Elsevier Ltd. All rights reserved.

Hospital variation in survival trends for in-hospital cardiac arrest.

PubMed

Girotra, Saket; Cram, Peter; Spertus, John A; Nallamothu, Brahmajee K; Li, Yan; Jones, Philip G; Chan, Paul S

2014-06-10

During the past decade, survival after in-hospital cardiac arrest has improved markedly. It remains unknown whether the improvement in survival has occurred uniformly at all hospitals or was driven by large improvements at only a few hospitals. We identified 93 342 adults with an in-hospital cardiac arrest at 231 hospitals in the Get With The Guidelines(®)-Resuscitation registry during 2000-2010. Using hierarchical regression models, we evaluated hospital-level trends in survival to discharge. Mean age was 66 years, 59% were men, and 21% were black. Between 2000 and 2010, there was a significant decrease in age, prevalence of heart failure and myocardial infarction, and cardiac arrests due to shockable rhythms (P<0.001 for all) and an increase in prevalence of sepsis, respiratory insufficiency, renal insufficiency, intensive care unit location, and mechanical ventilation before arrest (P<0.001 for all). After adjustment for temporal trends in baseline characteristics, hospital rates of in-hospital cardiac arrest survival improved by 7% per year (odds ratio [OR] 1.07, 95% CI 1.06 to 1.08, P<0.001). Improvement in survival varied markedly and ranged from 3% in the bottom hospital quartile to 11% in the top hospital quartile. Compared with minor teaching hospitals (OR 1.04, 95% CI 1.02 to 1.06), hospital rate of survival improvement was greater at major teaching (OR 1.08, 95% CI 1.06 to 1.10) and nonteaching hospitals (OR 1.07, 95% CI 1.05 to 1.09, P value for interaction=0.03). Although in-hospital cardiac arrest survival has improved during the past decade, the magnitude of improvement varied across hospitals. Future studies are needed to identify hospital processes that have led to the largest improvement in survival. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Nonequilibrium Theory: Implications for Educational Systems Undergoing Radical Change in Eastern Europe.

ERIC Educational Resources Information Center

Rust, Val D.

The change processes involving schools that are currently experiencing turbulent social reconstruction in eastern Europe are examined in this paper, which calls for the development of a new paradigm for social change. The first section describes recent educational reform activities and their flaws in three eastern European countries--Russia,…

Is Eastern Hardwood Sawtimber Becoming Scarcer?

Treesearch

William G. Luppold; Gilbert P. Dempsey; Gilbert P. Dempsey

1996-01-01

In recent years the hardwood lumber industry has become increasingly concerned about the availability and quality of hardwood sawtimber. However, these concerns seem to contradict USDA Forest Service estimates of increased volume and quality of hardwood sawtimber. This paper examines changes in eastern hardwood sawtimber inventories and the apparent contradiction...

CETA in Eastern Massachusetts. Final Report.

ERIC Educational Resources Information Center

Barocci, Thomas A.; Myers, Charles A.

A study regarding the implementation of the Comprehensive Employment and Training Act (CETA) in four eastern Massachusetts prime sponsor areas (Cambridge, Lowell, New Bedford, and the Balance of State) was done to (1) examine the impact of the decisions made during the implementation of CETA on manpower services and institutions, program…

Laptop Circulation at Eastern Washington University

ERIC Educational Resources Information Center

Munson, Doris; Malia, Elizabeth

2008-01-01

In 2001, Eastern Washington University's Libraries began a laptop circulation program with seventeen laptops. Today, there are 150 laptops in the circulation pool, as well as seventeen digital cameras, eleven digital handycams, and thirteen digital projectors. This article explains how the program has grown to its present size, the growing pains…

Pediatric hypertension in the Eastern Province of Saudi Arabia

PubMed Central

Alkahtani, Shaea A.

2015-01-01

Objectives: To compare the levels of blood pressure (BP) between male and female adolescents in the Eastern Province of Saudi Arabia and reference percentiles for Saudi adolescents. A secondary aim was to explore the distribution of BP among the participants based on age and gender. Methods: This cross-sectional study was conducted among 146 boys and girls attending intermediate and secondary schools in 2 regions (Al-Mallaha and Al-Mubarraz) in the Eastern Province of Saudi Arabia. Weight, random blood glucose, and BP were collected by a team of health educators in the morning of the school day between April and May 2014. Results: Of the current sample of adolescents originally from the Eastern Province, 30% had systolic blood pressure (SBP) of ≥140 mm Hg and 22% had diastolic blood pressure of ≥90 mm Hg. For girls between 13 and 16 years old, the SBP was greater than the 95th percentile of Saudi national norms. Participants were classified by gender and school stage, and one-way analysis of variance showed significant differences in the means of SBP between intermediate boys (127±2.5 mm Hg) and secondary boys (136±2.1 mm Hg) (p<0.05), and between intermediate boys and intermediate girls (138±1.6 mm Hg) (p<0.01). Conclusion: The increased level of BP among adolescents originally from the Eastern Province raises the need to update the current BP nomograms, considering possible differences for specific geographic areas across the country. Implementing therapeutic life style management in girls’ schools is recommended. PMID:25987114

The relationship of hospital ownership and service composition to hospital charges

PubMed Central

Eskoz, Robin; Peddecord, K. Michael

1985-01-01

The relationship of hospital ownership and service composition to hospital charges was examined for 456 general acute hospitals in California. Ancillary services had higher profit margins, both gross and net profits, than daily hospital services. Ancillary services accounted for 55.3 percent of total patient revenue. Charges per day were 23 percent higher for ancillary services than for daily hospital services. Net profits for daily and ancillary services were lowest at county hospitals. Proprietary hospitals had the highest net profits for total ancillary services and the highest mean charges. Not-for-profit hospitals had the highest profit margins for daily hospital services. Neither direct nor total costs for ancillary services were significantly different among ownership groups, although direct costs for daily hospital services were significantly higher at proprietary hospitals. PMID:10311161

Eastern Renewable Generation Integration Study: Redefining What’s Possible for Renewable Energy

ScienceCinema

Bloom, Aaron

2018-01-16

NREL project manager Aaron Bloom introduces NREL’s Eastern Renewable Generation Integration Study (ERGIS) and high-performance computing capabilities and new methodologies that allowed NREL to model operations of the Eastern Interconnection at unprecedented fidelity. ERGIS shows that the Eastern Interconnection can balance the variability and uncertainty of wind and solar photovoltaics at a 5-minute level, for one simulated year.

Eastern Hemlock Forests: Guidelines to Minimize the Impacts of Hemlock Woolly Adelgid

Treesearch

Jeffrey S. Ward; Michael E. Montgomery; Carole A.S.-J. Cheah; Brad P. Onken; Richard S. Cowles

2004-01-01

Eastern hemlock (Tsuga canadensis) is the most shade-tolerant and long-lived tree species in Eastern North America. Its unsurpassed ability to tolerate low light enables it to form dense canopies and stands that provide a unique habitat for many plant and wildlife species. Carolina hemlock (Tsuga caroliniana) is a relic species...

Evaluation of promoters and visual markers for transformation of eastern white pine

Treesearch

Allan Zipf; Alex M. Diner; Rufina Ward; Suman Bharara; George Brown; R. Nagmani; L.K. Pareek; Govind C. Sharma

2001-01-01

This report serves to evaluate possible promoters for use in the production of trmsgenic eastern white pine (Pinus strobus L.). Embryogenic cultures of eastern white pine were bombarded with gold particles coated separately with a variety of gene constructs containing the Uida B-glucoronidase (GUS) or green flourescent protein (GFP) reporter gene....

The fire—oak literature of eastern North America: synthesis and guidelines

Treesearch

Patrick H. Brose; Daniel C. Dey; Thomas A. Waldrop

2014-01-01

Guidelines for using prescribed fire to regenerate and restore upland oak forests, woodlands, and savannas in eastern North America were developed by synthesizing the results of more than 100 scientific publications. The first four chapters provide background information on the values of oak ecosystems, eastern fire history, oak's adaptations to fire, and the...

Hospital output forecasts and the cost of empty hospital beds.

PubMed Central

Pauly, M V; Wilson, P

1986-01-01

This article investigates the cost incurred when hospitals have different levels of beds to treat a given number of patients. The cost of hospital care is affected by both the forecasted level of admissions and the actual number of admissions. When the relationship between forecasted and actual admissions is held constant, it is found that an empty hospital bed at a typical hospital in Michigan has a relatively low cost, about 13 percent or less of the cost of an occupied bed. However, empty beds in large hospitals do add significantly to cost. If hospital beds are closed, whether by closing beds at hospitals which remain in business or by closing entire hospitals, cost savings are estimated to be small. PMID:3759473

[Demographic processes in the countries of Eastern Europe 1945-1990].

PubMed

Shchepin, O P; Vladimirova, L I

1990-01-01

An analysis is made of changes in the demographic processes in the countries of Eastern Europe over the period from 1945 to 1990 within both the general regularities and national peculiarities according to the parameters of statics and dynamics of population movement. The positive tendencies in the demographic processes are pointed out, first of all in infant mortality rates and mean expectation of life at birth in Eastern European countries by decades reflecting the peculiarities of changes as compared with developed countries.

Unprecedented decline in measles morbidity and mortality in Calabar, south-eastern Nigeria.

PubMed

Ekanem, E E; Ochigbo, S O; Kwagtsule, J U

2000-10-01

The features of measles presenting at the University of CalabarTeaching Hospital, in south-eastern Nigeria between January 1992 to December 1996, were compared with those of a previous period (January 1984 to December 1987) in the same institution. The aim was to detect any changes in trends, morbidity and mortality from the infection in this environment. There were only 36 cases (7.2 per year) in the current period compared with 436 (109 per year) in the previous period (chi2=48.4, P<0.001). There were also highly significant falls in the incidence of malnutrition and bronchopneumonia (P<0.05) in the current period. Notably, there were no cases of dehydration or keratomalacia in the current period. The case fatality rate was 2.8% compared with 20.0% in the previous period (P<0.02). These unprecedented changes in the incidence, morbidity and mortality from measles are attributed to the continuing Expanded Programme on Immunization, oral rehydration therapy, appropriate nutritional management and vitamin A prophylaxis. With maintenance and strengthening of these strategies, the elimination of measles and measles deaths in the near future is feasible in this environment.

Hospital Variation in Survival Trends for In‐hospital Cardiac Arrest

PubMed Central

Girotra, Saket; Cram, Peter; Spertus, John A.; Nallamothu, Brahmajee K.; Li, Yan; Jones, Philip G.; Chan, Paul S.

2014-01-01

Background During the past decade, survival after in‐hospital cardiac arrest has improved markedly. It remains unknown whether the improvement in survival has occurred uniformly at all hospitals or was driven by large improvements at only a few hospitals. Methods and Results We identified 93 342 adults with an in‐hospital cardiac arrest at 231 hospitals in the Get With The Guidelines®‐Resuscitation registry during 2000–2010. Using hierarchical regression models, we evaluated hospital‐level trends in survival to discharge. Mean age was 66 years, 59% were men, and 21% were black. Between 2000 and 2010, there was a significant decrease in age, prevalence of heart failure and myocardial infarction, and cardiac arrests due to shockable rhythms (P<0.001 for all) and an increase in prevalence of sepsis, respiratory insufficiency, renal insufficiency, intensive care unit location, and mechanical ventilation before arrest (P<0.001 for all). After adjustment for temporal trends in baseline characteristics, hospital rates of in‐hospital cardiac arrest survival improved by 7% per year (odds ratio [OR] 1.07, 95% CI 1.06 to 1.08, P<0.001). Improvement in survival varied markedly and ranged from 3% in the bottom hospital quartile to 11% in the top hospital quartile. Compared with minor teaching hospitals (OR 1.04, 95% CI 1.02 to 1.06), hospital rate of survival improvement was greater at major teaching (OR 1.08, 95% CI 1.06 to 1.10) and nonteaching hospitals (OR 1.07, 95% CI 1.05 to 1.09, P value for interaction=0.03). Conclusion Although in‐hospital cardiac arrest survival has improved during the past decade, the magnitude of improvement varied across hospitals. Future studies are needed to identify hospital processes that have led to the largest improvement in survival. PMID:24922627

Bacterial Meningitis Surveillance in the Eastern Mediterranean Region, 2005–2010: Successes and Challenges of a Regional Network

PubMed Central

Teleb, Nadia; Pilishvili, Tamara; Van Beneden, Chris; Ghoneim, Amani; Amjad, Khawaja; Mostafa, Amani; Estighamati, Abdul Reza; Smeo, Mohamed Najib; Barkia, Abdelaziz; ElKhatib, Mutaz; Mujaly, Abdellatif; Ashmony, Hossam; Jassim, Kifah Ahmed; Hajjeh, Rana A.

2018-01-01

Objective To describe epidemiology of bacterial meningitis in the World Health Organization Eastern Mediterranean Region countries and assist in introduction of new bacterial vaccines. Study design A laboratory-based sentinel surveillance was established in 2004, and up to 10 countries joined the network until 2010. Personnel at participating hospitals and national public health laboratories received training in surveillance and laboratory methods and used standard clinical and laboratory-confirmed case definitions. Results Over 22 000 suspected cases of meningitis were reported among children ≤5 years old and >6600 among children >5 years old. In children ≤5 years old, 921 of 13 125 probable cases (7.0%) were culture-confirmed. The most commonly isolated pathogens were S pneumoniae (27% of confirmed cases), N meningitidis (22%), and H influenzae (10%). Among culture-confirmed case-patients with known outcome, case-fatality rate was 7.0% and 12.2% among children ≤5 years old and those >5 years old, respectively. Declining numbers of Haemophilus influenzae type b meningitis cases within 2 years post-Haemophilus influenzae type b conjugate vaccine introduction were observed in Pakistan. Conclusions Bacterial meningitis continues to cause significant morbidity and mortality in the Eastern Mediterranean Region. Surveillance networks for bacterial meningitis ensure that all sites are using standardized methodologies. Surveillance data are useful to monitor impact of various interventions including vaccines, but maintaining data quality requires consistent reporting and regular technical support. PMID:23773590