Science.gov

Sample records for halfa hospital eastern

  1. Morbidity and mortality of severe malnutrition among Sudanese children in New Halfa Hospital, Eastern Sudan.

    PubMed

    Mahgoub, Hyder M; Adam, Ishag

    2012-01-01

    Medical files of children with severe malnutrition admitted at New Halfa hospital, Sudan during 2007-2009 were reviewed. A total of 1097 children (54.9%, 602 male) with severe malnutrition were admitted during the three year period. Oedematous severe malnutrition was found in 179 (16.3%) children. Of these 1097, 796 (72.6%) patients with severe malnutrition were children <2 years old. Out of these 1097 children, 780 (71.1%) and 112 (10.2%) had diarrhoea and malaria, respectively. Sixty-one (5.5%) of these children died, 237 (21.6%) discharged against medical advice and 799 (72.8%) were discharged. Of the 61 children who died 11 (18.0%) had septicaemia following diarrhoea and respiratory tract infections. The case fatality rate was not different with sex or with presence/absence of oedema.

  2. Technical efficiency of selected hospitals in Eastern Ethiopia.

    PubMed

    Ali, Murad; Debela, Megersa; Bamud, Tewfik

    2017-12-01

    This study examines the relative technical efficiency of 12 hospitals in Eastern Ethiopia. Using six-year-round panel data for the period between 2007/08 and 2012/13, this study examines the technical efficiency, total factor productivity, and determinants of the technical inefficiency of hospitals. Data envelopment analysis (DEA) and DEA- based Malmquist productivity index used to estimate relative technical efficiency, scale efficiency, and total factor productivity index of hospitals. Tobit model used to examine the determinants of the technical inefficiency of hospitals. The DEA Variable Returns to Scale (VRS) estimate indicated that 6 (50%), 5 (42%), 3 (25%), 3 (25%), 4 (33%), and 3 (25%) of the hospitals were technically inefficient while 9 (75%), 9 (75%), 7 (58%), 7 (58%), 7 (58%) and 8 (67%) of hospitals were scale inefficient between 2007/08 and 2012/13, respectively. On average, Malmquist Total Factor Productivity (MTFP) of the hospitals decreased by 3.6% over the panel period. The Tobit model shows that teaching hospital is less efficiency than other hospitals. The Tobit regression model further shows that medical doctor to total staff ratio, the proportion of outpatient visit to inpatient days, and the proportion of inpatients treated per medical doctor were negatively related with technical inefficiency of hospitals. Hence, policy interventions that help utilize excess capacity of hospitals, increase doctor to other staff ratio, and standardize number of inpatients treated per doctor would contribute to the improvement of the technical efficiency of hospitals.

  3. Epidemiology of Schistosomiasis among Villagers of the New Halfa Agricultural Scheme, Sudan

    PubMed Central

    AFIFI, Azzam; AHMED, Abdel-Aziz A.; SULIEMAN, Yassir; PENGSAKUL, Theerakamol

    2016-01-01

    Background: Schistosomiasis is one of the major communicable diseases of public health and socioeconomic importance in developing countries. This study assessed the situation of schistosomiasis among villagers of the New Halfa Agricultural Scheme, Sudan. Methods: An epidemiological survey was carried out in three randomly selected residential sites: Village 19, Village 26 and Talat shagrat Camp, from October to December 2013. Feces and urine samples were collected from 2433 individual (1195 male and 1238 female) and examined for schistosomiasis infection. The prevalence and intensity of infection were calculated according to study sites and participants’ sex and age-group. Results: There was no infection with Schistosoma haematobium among the examined individuals, while the overall prevalence of S. mansoni infection was 27.4% and the mean intensity among those infected was 261.1 eggs per gram (epg). A high prevalence and intensity of infection was found among the residents of Talat shagrat Camp, followed by the other two villages. The prevalence of infection among males was 41.4%, and among females was 13.9%. On the other hand, the intensity of infection among females was 293.4 epg and among males 187.6 epg. A high prevalence of infection was found in the age-groups 11–20 years and > 50 years. High intensity of infection was present in the age-groups 31–40 years and > 50 years. Conclusion: The finding of the study shows the need for an integrated control program against schistosomiasis. Mass treatment, provision of adequate clean-water supply and combating the intermediate snail host are suggested. PMID:27095977

  4. Bed utilization fluctuations at a university hospital in eastern saudi arabia and their impact on hospital cost.

    PubMed

    Nour El Din, Moustafa M

    2006-01-01

    As the demand for and complexity of inpatient care increases and hospital beds become more and more expensive and difficult to obtain, the appropriate use of hospital beds becomes increasingly important. The aim of the present study was to assess the actual hospital capacity and to study fluctuations in hospital occupancy rate during the year 2002 at a University Hospital in Eastern Saudi Arabia, and their impact on hospital cost. Results of the present study showed that 61 beds were not conforming to the standard definition of hospital beds; constituting 15.6 % of the actual hospital capacity. Wellborn nursery cribs and delivery beds accounted for the majority of these beds (82.0%). The present study revealed low average hospital occupancy rate in 2002 (62.0%) together with fluctuations in the average occupancy rates of all departments ranging between 30.9% and 77.0%; coefficient of variation ranges from 0.11 to 0.92. The observed low occupancy rate resulted in wasting of a large proportion of the hospital fixed costs amounting to 133, 591, 943 Saudi Riyals. Recommendations for improving the occupancy rate of the hospital and reducing its fluctuations are presented.

  5. Hospital management training for the Eastern Mediterranean Region: time for a change?

    PubMed

    Rabbani, Fauziah; Hashmani, Farah Naz; Mukhi, Aftab A Ali; Gul, Xaher; Pradhan, Nousheen; Hatcher, Peter; Farag, Mounir; Abbas, Farhat

    2015-01-01

    The WHO Eastern Mediterranean Regional Office has emphasized health system strengthening among the top five strategic priorities. One of the integral elements of health systems are the hospitals. The purpose of this paper is to review the need for formalized training in hospital management to improve the quality of care. Literature review and hands on experience of conducting a regional training in hospital management for Eastern Mediterranean Region (EMR) countries. Majority of patients in EMR bypass Primary Health Care facilities due to inadequate quality of services and prefer seeking specialized care at a tertiary level. There is mounting evidence of mediocre to poor patient satisfaction due to inefficient health care practices in hospitals of EMR. Strengthening the management capacity of the hospitals through a formal training programme is therefore necessary for improving the performance of health care delivery and the overall health system. Hospital management encompasses hospital planning and operational activities including development and implementation of organizational strategies to ensure adequate numbers and quality of trained human resources and effective financial management, disaster management, health management information system utilization, support services, biomedical engineering, transport and waste management. Such training will prepare health care professionals with leadership skills to deliver quality hospital services. This is one of the first papers emphasizing the need for a formal structured regional training in hospital management for the countries of EMR. A modular incremental training approach developing an EMR Credit Transfer and Accumulation system is proposed.

  6. Artesunate plus sulfadoxine-pyrimethamine in the treatment of uncomplicated Plasmodium falciparum malaria during pregnancy in eastern Sudan.

    PubMed

    Adam, Ishag; Ali, Daw M; Abdalla, Mohammed A

    2006-07-01

    Malaria during pregnancy is associated with serious adverse effects; these could be avoided with effective treatment. Artesunate plus sulfadoxine-pyrimethamine (AS+SP) is a promising antimalarial combination; however, few data are available on its safety during pregnancy. The present study was carried out in New Halfa Hospital, eastern Sudan, between September 2004 and March 2005. Thirty-two pregnant Sudanese women with uncomplicated Plasmodium falciparum malaria were treated with AS+SP at a mean of 29.7 weeks of gestation. The patients were followed-up until delivery and the babies were followed-up until the age of 1 month. The drug was well tolerated, the parasitaemia was cleared and the patients were symptom-free within 2 days. All the patients delivered full-term live babies. One of the babies died on the fourth day; none of the women died and there was no miscarriage, stillbirth, or congenital abnormalities in the newborn babies. Thus, this small descriptive study failed to detect unintended effects of AS+SP during pregnancy.

  7. Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia.

    PubMed

    El Mahalli, Azza; El-Khafif, Sahar H; Yamani, Wid

    2016-01-01

    The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended.

  8. Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia

    PubMed Central

    El.Mahalli, Azza; El-Khafif, Sahar H.; Yamani, Wid

    2016-01-01

    The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended. PMID:26903780

  9. Filamentous fungi vectored by ants (Hymenoptera: Formicidae) in a public hospital in North-Eastern Brazil.

    PubMed

    Aquino, R S S; Silveira, S S; Pessoa, W F B; Rodrigues, A; Andrioli, J L; Delabie, J H C; Fontana, R

    2013-03-01

    The increase in opportunistic fungal infections has led to the search for putative sources of contamination in hospital environments. Ants in a public hospital in Itabuna, north-eastern Brazil were examined for carriage of filamentous fungi. During a year-long survey, ants from different hospital areas were sampled. Preference was given to locations where it was possible to observe ants actively foraging. The fungi found on the ants' integument were cultured and identified. A total of 106 ant workers belonging to 12 species in 11 genera were collected. A total of 47 fungal strains was isolated from 40% of the ants (N = 42). We found 16 fungal species in 13 genera associated with the ant workers. The prevalent fungal genera were Aspergillus, Purpureocillium and Fusarium. The ants Tapinoma melanocephalum, Paratrechina longicornis and Pheidole megacephala were associated with six fungal genera; and four genera of fungi were associated with Solenopsis saevissima workers. Fungal diversity was higher in the following hospital areas: nursery, hospital beds, breastmilk bank and paediatrics. Ants act as carriers of soil and airborne fungal species, and ant control in hospital areas is necessary to prevent the dissemination of such micro-organisms. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  10. Obstetric hospitalizations among Italian women, regular and irregular immigrants in North-Eastern Italy.

    PubMed

    Fedeli, Ugo; Alba, Natalia; Lisiero, Manola; Zambon, Francesco; Avossa, Francesco; Spolaore, Paolo

    2010-11-01

    Italy has become an important host country for economic immigrants. The study is aimed at providing a descriptive analysis of obstetric hospitalizations among Italian and immigrant women in North-Eastern Italy. Population-based registry descriptive study. Veneto Region, Italy. All obstetric hospitalizations in 2006-2007 were extracted from the regional archive of hospital discharge records (n = 144,698). Discharges for vaginal delivery, cesarean section, threatened abortion and other antepartum diagnoses, miscarriages, and induced abortions were identified among residents with Italian or foreign citizenship, and irregular immigrants. Hospitalization rates for the above diagnostic categories were computed for Italian and foreign Veneto residents. Delivery rates, proportion of cesarean sections, hospitalization rates for antepartum hospitalizations, miscarriage, induced abortion, and hospitalization rate ratios of immigrants versus Italian women. Among Italian women, regular and irregular immigrants, the percentages of teenage deliveries were 0.7, 2.9, and 8.4%; the ratios of miscarriages to deliveries were 0.16, 0.15 and 0.35; the ratios of induced abortions to deliveries were 0.13, 0.24 and 0.81, respectively. Regular immigrants accounted for 10% of population aged 15-49 and for 20% of deliveries. The age-related increase in miscarriage risk was steeper among regular immigrants. The induced abortions to deliveries ratio peaked among Italians aged <25 and regular immigrants aged ≥35 years. 40% of Italians and 30% of regular immigrants sought care outside nearest hospitals. Wide differences in reproductive behavior, health status, and patterns in the access to health services exist between Italians, regular and irregular immigrants even though they represent three connected populations.

  11. Common geriatric emergencies in a rural hospital in South-Eastern Nigeria.

    PubMed

    Iloh, Gup; Amadi, A N; Awa-Madu, J

    2012-01-01

    Geriatric population in rural Nigeria is often challenged by emergency health conditions that predispose them to higher risk of disability and mortality. This study was aimed at describing the common geriatric emergencies in a rural hospital in South-Eastern Nigeria. This was a descriptive hospital-based study of 216 geriatric patients who presented between June 2008 and June 2011 with emergency health conditions at St Vincent De Paul hospital, Amurie-Omanze, a rural Mission General Hospital in Imo state, South-Eastern Nigeria. The geriatric patients seen within the study period who met the selection criteria were studied. Data extracted for analysis included biodata and diagnosis made. A total of 216 geriatric emergencies were seen during the study period. The ages of the patients ranged from 65 years to 98 years with mean age of 72 ± 1.14 years. There were 94 males and 122 females with a male to female ratio of 1: 1.3. The three most common causes of geriatric emergencies were acute malaria (33.8%), hypertensive crises syndrome (19.0%), and acute hypertensive heart failure (18.1%). This study has shown that the three most common geriatric emergencies were medical emergencies (acute malaria, hypertensive crises syndrome, and acute hypertensive heart failure). Improving the quality of geriatric medical care will help in reduction of these emergency medical conditions. Similarly, health education of the geriatric population to embrace early health-seeking behavior, health maintenance, and promotional practices that are needed to promote longevity is invariably advocated.

  12. Evaluation of hospital-learning environment for pediatric residency in eastern region of Saudi Arabia

    PubMed Central

    2015-01-01

    Purpose: No study had been conducted to assess the hospitals’ environment for learning purposes in multicenter sites in Saudi Arabia. It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. Methods: We applied Postgraduate Hospital Educational Environment Measure (PHEEM) to measure the learning environment at six teaching hospitals in the Eastern Region of Saudi Arabia from September to December 2013. Results: The number of respondents was 104 (86.7%) out of 120 residents and 37 females and 67 male residents have responded. The residents’ response scored 100 out of 160 maximum score in rating of PHEEM that showed overall learning environment is favorable for training. There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents. There was a difference among the participant teaching hospitals (p<0.05). Conclusion: The result pointed an overall positive rating. Individual item scores suggested that their social life during residency could be uninspiring. They have the low satisfactory level and they feel racism, and sexual discrimination. Therefore, there is still a room for improvement. PMID:25959654

  13. Indoor air quality levels in a University Hospital in the Eastern Province of Saudi Arabia

    PubMed Central

    El-Sharkawy, Mahmoud F.; Noweir, Mohamed E. H.

    2014-01-01

    Aim of the Study: The complex hospital environment requires special attention to ensure a healthy indoor air quality (IAQ) to protect patients and healthcare workers against hospital-acquired infections and occupational diseases. Poor hospital IAQ may cause outbreaks of building-related illness such as headaches, fatigue, eye, and skin irritations, and other symptoms. The general objective for this study was to assess IAQ inside a large University hospital at Al-Khobar City in the Eastern Province of Saudi Arabia. Materials and Methods: Different locations representing areas where most activities and tasks are performed were selected as sampling points for air pollutants in the selected hospital. In addition, several factors were studied to determine those that were most likely to affect the IAQ levels. The temperature and relative percent humidity of different air pollutants were measured simultaneously at each location. Results: The outdoor levels of all air pollutant levels, except volatile organic compounds (VOCs), were higher than the indoor levels which meant that the IAQ inside healthcare facilities (HCFs) were greatly affected by outdoor sources, particularly traffic. The highest levels of total suspended particulates (TSPs) and those less than 10 microns (PM10) inside the selected hospital were found at locations that are characterized with m4ore human activity. Conclusions: Levels of particulate matter (both PM10 and TSP) were higher than the Air Quality Guidelines (AQGs). The highest concentrations of the fungal species recorded were Cladosporium and Penicillium. Education of occupants of HCF on IAQ is critical. They must be informed about the sources and effects of contaminants and the proper operation of the ventilation system. PMID:24696632

  14. Deaths Rates in Public Hospitals of Eastern Cape Province of South Africa

    PubMed Central

    Buso, DL; Longo-Mbenza, B; Bovet, P; van den Borne, B; Okwe, A Nge; Mzingelwa, M

    2012-01-01

    Background: South Africa (SA) is experiencing a rapid epidemiologic transition as a consequence of political, economic and social changes. In this study we described, based on hospital data, the mortality patterns of Non communicable Diseases (NCD), Communicable Diseases (CD), the NCD/CD ratios, and the trends of deaths. Methods: We conducted a cross-sectional survey of all deaths occurring in several public hospitals in the Eastern Cape Province of SA between 2002 and 2006. Causes of deaths were coded according to the ICD 10 Edition. Results: A total of 107380 admissions responded to the inclusion criteria between 2002 and 2006. The crude death rate was 4.3% (n=4566) with a mean age of 46±21 years and a sex ratio of 3.1 men (n=3453): 1 woman (n=1113). Out of all deaths, there were 62.9% NCD (n=2872) vs. 37.1% CD (n=1694) with NCD/CD ratio of 1.7. The ratio NCD/CD deaths in men was 1.3 (n=1951/1502) vs. NCD/CD deaths in women of 1.9 (n=735/378). The peak of deaths was observed in winter season. The majority of NCD deaths were at age of 30–64 years, whereas the highest rate of CD deaths was at age< 30 years. The trend of deaths including the majority of NCD, increased from 2002 to 2006. There was a tendency of increase in tuberculosis deaths, but a tendency of decrease in HIV/AIDS deaths was from 2002 to 2006. Conclusion: Non-communicable diseases are the leading causes of deaths in rural Eastern Cape province of SA facing Post-epidemiologic transition stages. We recommend overarching priority actions for the response to the Non-communicable Diseases: policy change, prevention, treatment, international cooperation, research, monitoring, accountability, and re-orientation of health systems. PMID:23641386

  15. Job Satisfaction among Doctors of a Government Medical College and Hospital of Eastern India

    PubMed Central

    Ray, Kuntala; Kumar Roy, Jayanta; Mukherjee, Abhijit; Roy, Hironmoy; Datta, Saikat

    2016-01-01

    Background: Job satisfaction expresses the extent of congruence between an individual’s expectation of the job and the reward that the job provides.Job satisfaction among doctors is an issue that is of utmost importance because offactors like patient relationships and time pressures associated with managed care. The current study was done to determine the level of job satisfaction in doctors posted in a tertiary care hospital of eastern India and to find out the factors associated with it. Materials and Methods: A descriptive cross sectional study was conducted among 255 doctors posted in a tertiary care hospital of eastern India. Data werecollected using a self-reported questionnaire consisting of 49 items addressing the seven domains of job satisfaction, where higher values indicated higher level of satisfaction. The average scores of items were computed to construct factor scores for each individual. Two stage cluster analysis was performed to get the proportion of satisfied doctors and binary logistic regression was used for comparison of predictors of job satisfaction. Results: The proportion of job satisfaction was found to be 59.6% and the most important factor was found to be working space. On adjustment, the odds of being satisfied were found to be higher in the older age groups, among males, doctors posted in preclinical or paraclinical departments and those staying in present setting for 5 years or more. Conclusion: More than half of the doctors were found to be satisfied with their job which can help the policy makers to make necessary strategies to increase the level of satisfaction of the employees. . PMID:27822405

  16. Epidemiology of visceral leishmaniasis among children in Gadarif hospital, eastern Sudan.

    PubMed

    Ahmed, Mohammed Ahmed A; Ahmed, Ahmed A; Omar, Saeed M; Adam, Gamal K; Abdallah, Tajeldin M; Ali, AbdelAziem A

    2016-12-07

    Since 1900s, visceral leishmaniasis (VL) has been among the most important health problems in Sudan, particularly in the endemic areas such as eastern and central regions. This was a cross sectional, hospital-based study conducted from 1(st) January 2015 to 31(st) December 2015 to investigate the epidemiological factors of VL in Gadarif hospital, eastern Sudan. During the study period there were 47 identified children with VL among 145 suspected cases. The most common clinical presentations were fever (47, 100%), pallor (47, 100%), weight loss (40, 85.1%), splenomegaly (37, 78.7%), lymphadenopathy (33, 70.2%), vomiting (32, 68%) cough (28, 59%), loss of appetite (22, 46.8%), diarrhoea (17, 36.1%) and jaundice (5, 10.6%). With regard to the outcome after short term follow up 37 patients (78.8%) improved without complications, while 3 (6.4%, 2 (4.3%), 2 (4.3%), 1 (2.1%), 1 (2.1%) and 1 (2.1%) developed pneumonia, otitis media, septicaemia, urinary tract infection, parasitic infestation and PKDL respectively. Lower mean of haemoglobin level was observed among the VL cases in comparison with the suspected cases (in whom VL was excluded) haemoglobin level {8.9 (3.1) Vs 11 (6.3), P = 0.021}. Again more proportion of anaemic (47 (100%) Vs 14 (14.2%), P = 0.000) and severely anaemic (23 (48.9%) Vs 2 (2%), P = 0.006) patients was detected among the infected children. Using logistic regression analyses there was significant association between rural residence (CI = 1.5-24, OR = 19.1, P = 0.023), male gender (CI = 6.6-18.7, OR = 6.4, P = 0.001) and VL among children. While there is an advance in prevention and management of visceral leishmaniasis our results indicate that VL is still a public health problem with its severe complications among children in eastern Sudan.

  17. Turnover intention among hospital-based registered nurses in the Eastern Caribbean.

    PubMed

    Lansiquot, Beverley Anne; Tullai-McGuinness, Susan; Madigan, Elizabeth

    2012-06-01

    Vacancy rates for nurses in the English-speaking Caribbean are estimated at 30% with turnover typically associated with migration. The purpose of this study was to describe the characteristics of hospital-based registered nurses (RNs) in the sub-region, their practice environment and turnover intention in two and five years, respectively, and to determine the relationships among practice environment characteristics and turnover intention. A descriptive correlational design was used with self-reported questionnaires from a convenience sample of 301 RNs working in hospitals in four English speaking Eastern Caribbean countries. Single-item visual analog scales (VAS) were used to measure turnover intention in 2 years and 5 years. The Practice Environment Scale of the Nursing Work Index (PES-NWI) measured the characteristics in the practice environment. The mean age of the nurses was 32.5 (SD = 6.75) years. Most nurses (58.8%) were single and 91.4% had relatives living abroad. Nurses scored three PES-NWI subscales < 2.5, indicating a less positive practice environment: resource adequacy, nurse participation in hospital affairs, and nurse managers' ability, leadership, and support. The subscale for collegial nurse-physician relations received the best rating (mean = 2.61, SD = .62). For 2-year intention to leave, the mean rating on the 100-mm VAS was 63.2, while that for the 5-year intention to leave was 65.6. No significant correlations were found among four of the five PES-NWI subscales and turnover intention in 2 and 5 years. The practice environment, while generally unfavorable, is not associated with the nurses' intention to leave their jobs. These findings support the current policy position that calls for managing turnover among nurses. Nursing and health system administrators should assess, plan, and implement workforce policies to slow the outflow of nurses. Initiatives to improve the work environment and the delivery of high-quality care are important to RNs in

  18. Rationale and design of the cardiorespiratory fitness and hospitalization events in armed forces study in Eastern Taiwan

    PubMed Central

    Lin, Gen-Min; Li, Yi-Hwei; Lee, Chung-Jen; Shiang, Jeng-Chuan; Lin, Ko-Huan; Chen, Kai-Wen; Chen, Yu-Jung; Wu, Ching-Fen; Lin, Been-Sheng; Yu, Yun-Shun; Lin, Felicia; Su, Fung-Ying; Wang, Chih-Hung

    2016-01-01

    AIM To investigate the association between cardiorespiratory fitness and hospitalization events in a cohort of large voluntary arm forces in Taiwan. METHODS The cardiorespiratory fitness and hospitalization events in armed forces (CHIEF) is a retrospective cohort consisting of more than 4000 professional military members aged 18-50 years in Eastern Taiwan. All participants received history taking, physical examination, chest radiography, 12-lead electrocardiography, blood tests for cell counts and fasting glucose, lipid profiles, uric acid, renal function and liver function in the Hualien Armed Forces General Hospital during 2014. In addition, participants were required to undergo two indoor resistant exercise tests including 2-min push-up and 2-min sit-up, both scored by infrared sensing, and one outdoor endurance 3000-m none weight-bearing running test, the main indicator of cardiorespiratory fitness in the Military Physical Training and Testing Center in Eastern Taiwan in 2014. RESULTS Hospitalization events for cardiovascular disease, acute kidney injury, rhabdomyolysis, severe infectious disease, acute psychiatric illness, diabetes, orthopedic surgery and mortality will be identified in the National Insurance Research Database for 10 years. CONCLUSION CHIEF will be among the largest Eastern Asian armed forces cohort, in which physical status was strictly evaluated to follow up the hospitalization events for severe illness. PMID:27621774

  19. Severe Plasmodium falciparum and Plasmodium vivax malaria among adults at Kassala Hospital, eastern Sudan

    PubMed Central

    2013-01-01

    Background There have been few published reports on severe Plasmodium falciparum and Plasmodium vivax malaria among adults in Africa. Methods Clinical pattern/manifestations of severe P. falciparum and P. vivax (according to World Health Organization 2000 criteria) were described in adult patients admitted to Kassala Hospital, eastern Sudan. Results A total of 139 adult patients (80 males, 57.6%) with a mean (SD) age of 37.2 (1.5) years presented with severe P. falciparum (113, 81.3%) or P. vivax (26, 18.7%) malaria. Manifestations among the 139 patients included hypotension (38, 27.3%), cerebral malaria (23, 16.5%), repeated convulsions (18, 13.0%), hypoglycaemia (15, 10.8%), hyperparasitaemia (14, 10.1%), jaundice (14, 10.1%), severe anaemia (10, 7.2%), bleeding (six, 4.3%), renal impairment (one, 0.7%) and more than one criteria (27, 19.4%). While the geometric mean of the parasite count was significantly higher in patients with severe P. vivax than with severe P. falciparum malaria (5,934.2 vs 13,906.6 asexual stage parasitaemia per μL, p = 0.013), the different disease manifestations were not significantly different between patients with P. falciparum or P. vivax malaria. Three patients (2.2%) died due to severe P. falciparum malaria. One had cerebral malaria, the second had renal impairment, jaundice and hypoglycaemia, and the third had repeated convulsions and hypotension. Conclusions Severe malaria due to P. falciparum and P. vivax malaria is an existing entity among adults in eastern Sudan. Patients with severe P. falciparum and P. vivax develop similar disease manifestations. PMID:23634728

  20. 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 (PM10) 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 PM10 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 PM10 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 PM10 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.

  1. 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.

  2. 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

  3. Inpatient Dermatology: Characteristics of Patients and Admissions in a Tertiary Level Hospital in Eastern India

    PubMed Central

    Sen, Arpita; Chowdhury, Satyendranath; Poddar, Indrasish; Bandyopadhyay, Debabrata

    2016-01-01

    Introduction: Dermatology is primarily a non-acute, outpatient-centered clinical specialty, but substantial number of patients need indoor admission for adequate management. Over the years, the need for inpatient facilities in Dermatology has grown manifold; however, these facilities are available only in some tertiary centers. Aims and Objectives: To analyze the characteristics of the diseases and outcomes of patients admitted in the dermatology inpatient Department of a tertiary care facility in eastern India. Materials and Methods: We undertook a retrospective analysis of the admission and discharge records of all patients, collected from the medical records department, admitted to our indoor facility from 2011 to 2014. The data thus obtained was statistically analyzed with special emphasis on the patient's demographic profile, clinical diagnosis, final outcome, and duration of stay. Results and Analysis: A total of 375 patients were admitted to our indoor facility during the period. Males outnumbered females, with the median age in the 5th decade. Immunobullous disorders (91 patients, 24.27%) were the most frequent reason for admissions, followed by various causes of erythroderma (80 patients, 21.33%) and infective disorders (73 patients, 19.47%). Other notable causes included cutaneous adverse drug reactions, psoriasis, vasculitis, and connective tissue diseases. The mean duration of hospital stay was 22.2±15.7 days; ranging from 1 to 164 days. Majority of patients (312, 83.2%) improved after hospitalization; while 29 (7.73%) patients died from their illness. About 133 patients (35.64%) required referral services during their stay, while 8 patients (2.13%) were transferred to other departments for suitable management. Conclusion: Many dermatoses require inpatient care for their optimum management. Dermatology inpatient services should be expanded in India to cater for the large number of cases with potentially highly severe dermatoses. PMID:27688450

  4. Human immune deficiency virus (HIV) infection during pregnancy at Gadarif hospital, Eastern Sudan.

    PubMed

    Adam, Gamal K; Ahmed, Mohammed Ahmed A; Ali, AbdelAziem A

    2016-10-01

    This was a prospective study conducted on all pregnant and parturient women attending Gadarif Maternity Hospital, Sudan from January 2009 to December 2013 to investigate the maternal characteristics, pregnancy outcomes and estimate of maternal to child transmission of HIV among HIV infected women. During the study period, there were 26 HIV positive mothers among 6420 tested women yielding an incidence rate of 0.4%. The majority of these 26 infected women were of urban residence (69.2%), presented with normal CD4+ T cell count; ? 350\\cu. mm3 (96.2%), had less than secondary education (57.7%) and housewives (84.6%). The mean age (SD) was significantly varied between the sero-positive and sero-negative women, 25.9 (5.7) vs. 36.1 (5.7), p = <0.001. More proportion of infected women had maternal anaemia and gave preterm birth, and none of the newborn babies was HIV infected until the age of 96 weeks. It is thus HIV infected women in eastern Sudan were young and likely desire more children.

  5. Multidisciplinary management of hepatocellular carcinoma with portal vein tumor thrombus - Eastern Hepatobiliary Surgical Hospital consensus statement.

    PubMed

    Cheng, Shuqun; Yang, Jiamei; Shen, Feng; Zhou, Weiping; Wang, Yi; Cong, Wenming; Yang, Guang Shun; Cheng, Hongyan; Hu, Heping; Gao, Chunfang; Guo, Jia; Li, Aijun; Meng, Yan; Jiang, Xiaoqing; Yang, Yefa; Qian, Guojun; Luo, Ming; Hu, Bing; Man, Xiaobo; Zhang, Baohua; Su, Changqing; Zhou, Feiguo; Li, Nan; Shi, Jie; Wang, Meng; Zheng, Yaxin; Guo, Weixing; Sun, Juxian; Wang, Hongyang; Lau, Wan-Yee; Wu, Meng-Chao

    2016-06-28

    Hepatocellular carcinoma (HCC) complicated by portal vein tumor thrombus (PVTT) is associated with poor prognosis, early recurrence of HCC, and limited treatment options. Current guidelines do not have standardized diagnostic and treatment modalities, thus creating a need for a multidisciplinary treatment model for standardization of the treatment. Eastern Hepatobiliary Surgical Hospital (China) convened two working parties of experts from all the departments, to consolidate the current evidence, prevailing vision for the future, and experience of the practicing clinicians engaged in HCC management, so as to develop a consensus for PVTT diagnosis and treatment according to the GRADE system. Based on the quality of the existing evidence and the strength of recommendations, the consensus statements were categorized into 3 evidence levels (A/B/C) and 5 classes (I/II/IIa/IIb/III).The panel discussed and provided clarity on the management and research options in the field of HCC with PVTT. In addition, the panel also assessed the quality of the cited studies and assigned grades to the recommendation statements. Among the group of experts, there was excellent agreement with regard to effective diagnosis and treatment of HCC with PVTT. The recommendations of this consensus will provide guidance to physicians and clinical researchers on the effective management of HCC with PVTT.

  6. Infection control and antibiotic stewardship practices reported by south-eastern Mediterranean hospitals collaborating in the ARMed project.

    PubMed

    Borg, M A; Cookson, B D; Gür, D; Ben, Redjeb S; Rasslan, O; Elnassar, Z; Benbachir, M; Bagatzouni, D P; Rahal, K; Daoud, Z

    2008-11-01

    The prevalence of multiply resistant organisms (MROs) reported from south-eastern Mediterranean hospitals highlights the need to identify possible contributory factors to help design control interventions. This was investigated through a structured questionnaire, which examined infection control and antibiotic stewardship practices in hospitals participating or collaborating with the Antibiotic Resistance SurveilLance & Control in the Mediterranean Region (ARMed) project. A total of 45 hospitals (78.9% of invited institutions) responded to the questionnaire; 60% indicated that they faced periods of overcrowding when available bed complement was insufficient to cope with hospital admissions and 62% reported difficulties in isolating patients with MROs due to lack of available beds. Most hospitals relied mainly on washing to achieve hand hygiene, whether by non-medicated or disinfectant soaps. Dependence on solid bars of soap (28.9%) and cloth towels (37.8%) were among the problems identified as well as inconvenient distances of sinks from patient beds (66.6%). Alcohol hand rub was the predominant hand hygiene product in only 7% of hospitals. Programmes for better antibiotic use were mostly limited in scope; 33.3% reported having antibiotic prescribing guidelines and 53.3% of hospitals fed back resistance rates to prescribers. Auditing of antibiotic consumption, whether institution- or unit-based, was carried out in 37.8% of responding hospitals. Multi-faceted approaches aimed at improving isolation of patients with MROs, increasing the emphasis on hand hygiene by encouraging greater use of alcohol hand rubs and introducing effective antibiotic stewardship programmes should be encouraged in south-eastern Mediterranean hospitals.

  7. Aetiology of acute febrile episodes in children attending Korogwe District Hospital in north-eastern Tanzania.

    PubMed

    Mahende, Coline; Ngasala, Billy; Lusingu, John; Butichi, Allvan; Lushino, Paminus; Lemnge, Martha; Premji, Zul

    2014-01-01

    Although the burden of malaria in many parts of Tanzania has declined, the proportion of children with fever has not changed. This situation underscores the need to explore the possible causes of febrile episodes in patients presenting with symptoms at the Korogwe District Hospital (KDH). A hospital based cross-sectional study was conducted at KDH, north-eastern Tanzania. Patients aged 2 to 59 months presenting at the outpatient department with an acute medical condition and fever (measured axillary temperature ≥37.5°C) were enrolled. Blood samples were examined for malaria parasites, human immunodeficiency virus (HIV) and bacterial infections. A urine culture was performed in selected cases to test for bacterial infection and a chest radiograph was requested if pneumonia was suspected. Diagnosis was based on both clinical and laboratory investigations. A total of 867 patients with a median age of 15.1 months (Interquartile range 8.6-29.9) were enrolled from January 2013 to October 2013. Respiratory tract infections were the leading clinical diagnosis with 406/867 (46.8%) of patients diagnosed with upper respiratory tract infection and 130/867 (15.0%) with pneumonia. Gastroenteritis was diagnosed in 184/867 (21.2%) of patients. Malaria infection was confirmed in 72/867 (8.3%) of patients. Bacterial infection in blood and urine accounted for 26/808 (3.2%) infections in the former, and 66/373 (17.7%) infections in the latter. HIV infection was confirmed in 10/824 (1.2%) of patients. Respiratory tract infections and gastroenteritis were frequent in patients under 36 months of age (87.3% and 91.3% respectively). Co-infections were seen in 221/867 (25.5%) of patients. The cause of fever was not identified in 65/867 (7.5%) of these patients. The different proportions of infections found among febrile children reflect the causes of fever in the study area. These findings indicate the need to optimise patient management by developing malaria and non-malaria febrile

  8. Prevalence of Clostridium difficile infection and colonization in a tertiary hospital and elderly community of North-Eastern Peninsular Malaysia.

    PubMed

    Zainul, N H; Ma, Z F; Besari, A; Siti Asma, H; Rahman, R A; Collins, D A; Hamid, N; Riley, T V; Lee, Y Y

    2017-09-11

    Little is known about Clostridium difficile infection (CDI) in Asia. The aims of our study were to explore (i) the prevalence, risk factors and molecular epidemiology of CDI and colonization in a tertiary academic hospital in North-Eastern Peninsular Malaysia; (ii) the rate of carriage of C. difficile among the elderly in the region; (iii) the awareness level of this infection among the hospital staffs and students. For stool samples collected from hospital inpatients with diarrhea (n = 76) and healthy community members (n = 138), C. difficile antigen and toxins were tested by enzyme immunoassay. Stool samples were subsequently analyzed by culture and molecular detection of toxin genes, and PCR ribotyping of isolates. To examine awareness among hospital staff and students, participants were asked to complete a self-administered questionnaire. For the hospital and community studies, the prevalence of non-toxigenic C. difficile colonization was 16% and 2%, respectively. The prevalence of CDI among hospital inpatients with diarrhea was 13%. Out of 22 C. difficile strains from hospital inpatients, the toxigenic ribotypes 043 and 017 were most common (both 14%). In univariate analysis, C. difficile colonization in hospital inpatients was significantly associated with greater duration of hospitalization and use of penicillin (both P < 0·05). Absence of these factors was a possible reason for low colonization in the community. Only 3% of 154 respondents answered all questions correctly in the awareness survey. C. difficile colonization is prevalent in a Malaysian hospital setting but not in the elderly community with little or no contact with hospitals. Awareness of CDI is alarmingly poor.

  9. Mortality Trends in Patients Hospitalized with the Initial Acute Myocardial Infarction in a Middle Eastern Country over 20 Years

    PubMed Central

    Ahmed, Emad; Al Suwaidi, Jassim; El-Menyar, Ayman; AlBinali, Hajar A. H.; Gehani, A. A.

    2014-01-01

    We aimed to define the temporal trend in the initial Acute Myocardial Infarction (AMI) management and outcome during the last two decades in a Middle Eastern country. A total of 10,915 patients were admitted with initial AMI with mean age of 53 ± 11.8 years. Comparing the two decades (1991–2000) to (2001–2010), the use of antiplatelet drugs increased from 84% to 95%, β-blockers increased from 38% to 56%, and angiotensin converting enzyme inhibitors (ACEI) increased from 12% to 36% (P < 0.001 for all). The rates of PCI increased from 2.5% to 14.6% and thrombolytic therapy decreased from 71% to 65% (P < 0.001 for all). While the rate of hospitalization with Initial MI increased from 34% to 66%, and the average length of hospital stay decreased from 6.4 ± 3 to 4.6 ± 3, all hospital outcomes parameters improved significantly including a 39% reduction in in-hospital Mortality. Multivariate logistic regression analysis showed that higher utilization of antiplatelet drugs, β-blockers, and ACEI were the main contributors to better hospital outcomes. Over the study period, there was a significant increase in the hospitalization rate in patients presenting with initial AMI. Evidence-based medical therapies appear to be associated with a substantial improvement in outcome and in-hospital mortality. PMID:24868481

  10. Incidence of endophthalmitis following intravitreal Bevacizumab injection at a tertiary care hospital in Eastern Province of Saudi Arabia

    PubMed Central

    Cheema, Rizwan A.; Alshihry, Ahmad M.; Cheema, Haider R.

    2014-01-01

    The aim of this communication is to report the incidence of endophthalmitis following the use of intravitreal Bevacizumab (IVB) at a tertiary care hospital in the Eastern province of Saudi Arabia. A total of 2769 intravitreal Bevacizumab injections were carried out between January 2009 and April 2014. During this period, one case of endophthalmitis following IVB injection occurred. The overall incidence of clinical endophthalmitis was 0.036% (1/2769; 95% confidence interval: 0.0001–0.002%). This compares favorably with studies reported from other parts of the world. PMID:25892933

  11. The impact of chaplaincy services in selected hospitals in the eastern United States.

    PubMed

    Parkum, K H

    1985-09-01

    Surveys a stratified sample of patients in six different hospitals and compares their perceptions of hospital chaplaincy and other pastoral care efforts with related hospital services. Reports the presence of a strong impact of pastoral care services and discusses these findings from the perspective of a theory of expressive and instrumental social orientations as explicated by the sociologist Talcott Parsons.

  12. Adoption and Barriers to Adoption of Electronic Health Records by Nurses in Three Governmental Hospitals in Eastern Province, Saudi Arabia

    PubMed Central

    Mahalli, Azza El.

    2015-01-01

    Although electronic health records (EHRs) have been implemented in many hospitals and healthcare providers benefit from their effective and efficient data processing, their evaluation from nurses has received little attention. This project aimed to assess the adoption and barriers to the use of an EHR system by nurses at three governmental hospitals implementing the same EHR software and functionalities in Eastern Province, Saudi Arabia. The study was a cross-sectional, paper-based questionnaire study. SPSS version 20 was used for data entry and analysis, and descriptive statistics were calculated. The study found underutilization of almost all functionalities among all hospitals and no utilization of any communication tools with patients. In addition, there were no instances of “allowing patients to use the Internet to access parts of their health records.” The most frequently cited barrier among all hospitals was “loss of access to medical records transiently if computer crashes or power fails” (88.6 percent). This was followed by “lack of continuous training/ support from information technology staff in hospital” (85.9 percent), “additional time required for data entry” (84.9 percent), and “system hanging up problem” (83.8 percent). Complexity of technology (81.6 percent) and lack of system customizability (81.1 percent) were also frequently reported problems. The formation of an EHR committee to discuss problems with the system in Saudi hospitals is recommended. PMID:26604875

  13. 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.

  14. 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

  15. 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

  16. 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

  17. Illicit substance use among persons admitted to probation polyclinic of a regional mental hospital in the Eastern Anatolia, Turkey

    PubMed Central

    Telo, Selda; Kaman, Dilara; Korkmaz, Sevda

    2016-01-01

    Objectives: To investigate the illicit substance use trends by gender and year in Eastern Turkey, Elazığ. Methods: This is a retrospective study designed to assess the drug use prevalence in persons who admitted to the Probation Policlinic of Elazig Mental Health Hospital between January 2011 and December 2014 in Eastern Turkey, Elazığ. Laboratory screening tests for drugs were studied using the cloned enzyme donor immunoassay technique in urine. Results: The study consisted of 10267 males (95.3%) and 510 females (4.7%), with a mean age of 30.42±10.83 years. Overall prevalence was 32.1% for cannabis, 3.8% for opiate, 0.35% for cocaine and 1.2% for polydrug usage. The prevalence of cannabis was significantly higher in males (32.7%, p=0.000). The prevalence of cannabis use was the lowest in the age group of 50-59 while it was significantly higher in the age groups of 20-29 and 30-39 (p=0.000). The prevalence of opiate use showed a significant difference among the years (p=0.000). There was a significant difference in the prevalence of cocaine use among the years (p=0.02). The prevalence of polysubstance use showed a significant difference among years (p=0.000). Conclusion: Cannabis was the most common illicit drug in the east of the Turkey. Further studies are required for comparing the results of various regions of the country and developing early interventions and treatment facilities. PMID:27381538

  18. Complications of traditional circumcision amongst young Xhosa males seen at St Lucy's Hospital, Tsolo, Eastern Cape, South Africa

    PubMed Central

    Anike, Ugochukwu; Ndimande, John V.; Tumbo, John

    2013-01-01

    Abstract Background Traditional circumcision of males is common amongst many societies in sub-Saharan Africa. Circumcision amongst the Xhosa people of South Africa represents a rite of passage to manhood. Traditional male circumcision has an increased risk for complications that include sepsis, genital mutilation, gangrenous penis, excessive bleeding, dehydration, renal failure and death. The aim of this study was to describe the complications of traditional circumcisions amongst Xhosa men as seen at St. Lucy's Hospital in the Eastern Cape Province. Method A cross-sectional descriptive quantitative study was conducted in 2008. Records of 105 males admitted to St. Lucy's Hospital with complications following traditional circumcision were reviewed. Data collected included age, education level, race, reasons for circumcision, complications, the period of circumcision, duration of hospital stay and the outcomes. Descriptive data analysis was performed using statistical software SPSS 17.0. Results The ages ranged from 15–35 years with 68 (64.8%) between 15–19 years. 83 (79%) had a secondary level of education, 16 (15.2%) primary, 5 (4.8%) tertiary and 1% had no education. 60 (57%) were circumcised as initiation to manhood, 21 (20.0%) due to peer pressure, 20 (19.0%) for cultural reasons, and 1 (1.0%) was forced. The complications were sepsis (59 [56.2%]), genital mutilation (28 [26.7%]), dehydration (12 [11.4%]) and amputation of genitalia (6 [5.7%]).Fifty-nine (56.2%) patients were circumcised in winter. 79 (75.2%) were circumcised in the forest, and 25 (23.8%) in initiation centres. Fifty-eight (55.2%) were circumcised by traditionalists, and 47 (44.8%) by tribal elders (initiators). Hospital stays ranged from 8 to 28 days. 66% were healed and discharged, and 29 (27.6%) were referred to higher centres of care. Conclusion Genital sepsis was the most common complication of traditional male circumcision. Complications were related to the circumciser, advanced age of

  19. Pattern of hospital admissions of children with poisoning in the Sudano-Sahelian North eastern Nigeria.

    PubMed

    Oguche, S; Bukbuk, D N; Watila, I M

    2007-06-01

    Poisoning is a major problem in the paediatric population. In view of the paucity of literature on the subject matter in the northeastern part of Nigeria, this retrospective study was undertaken to describe the epidemiological features of accidental poisoning in children less than 13 years old who were admitted to the Emergency Paediatrics Unit (EPU) of the University of Maiduguri Teaching Hospital (UMTH), Maiduguri. The specific objectives included the determination of the age range most vulnerable, the principal agents of poisoning, the annual pattern of occurrence, the commonly administered home remedy and the examination of the need for preventive strategies in this part of the country. Data were extracted from the medical records of 113 patients with accidental poisoning during the period January 1984 to December 2003. One hundred and thirteen (0.74%) out of 15,196 children were admitted for accidental poisoning. Their ages ranged from 6 months to 12 years. Children aged 0 to 2 years accounted for 80 (70%) cases. There were 69 males and 44 females with a male: female ratio of 1.6:1. Fifty-nine (98.3%) out of 60 children were from low social background. Kerosene and food poisoning (Manihot esculenta) accounted for 89 (78.8%) and 19 (16.8%) of all cases of poisoning respectively. Respiratory symptoms dominated the clinical presentation in 71 (62.8%) cases. Seven patients had severely low bicarbonate levels. Home remedies were administered to 50 (44.3%) out of 113 patients. These remedies consisted of milk in 49 (92.5%) and palm oil (oil from Elais guineensis) in 17 (32.1%) cases. The mean duration of hospital stay was 0.66 (1.67) days. Severe neurological sequelae was recorded in one patient. There was no death. The highest frequency of admission was recorded during the hot and dry months of March to June. Kerosene is the commonest cause of childhood poisoning in Northeastern Nigeria and children aged 0 to 2 years are the most vulnerable age group. The highest

  20. Effects of Air Pollution on Hospital Emergency Room Visits for Respiratory Diseases: Urban-Suburban Differences in Eastern China.

    PubMed

    Liu, Peng; Wang, Xining; Fan, Jiayin; Xiao, Wenxin; Wang, Yan

    2016-03-19

    A study on the relationships between ambient air pollutants (PM2.5, SO₂ and NO₂) and hospital emergency room visits (ERVs) for respiratory diseases from 2013 to 2014 was performed in both urban and suburban areas of Jinan, a heavily air-polluted city in Eastern China. This research was analyzed using generalized additive models (GAM) with Poisson regression, which controls for long-time trends, the "day of the week" effect and meteorological parameters. An increase of 10 μg/m³ in PM2.5, SO₂ and NO₂ corresponded to a 1.4% (95% confidence interval (CI): 0.7%, 2.1%), 1.2% (95% CI: 0.5%, 1.9%), and 2.5% (95%: 0.8%, 4.2%) growth in ERVs for the urban population, respectively, and a 1.5% (95%: 0.4%, 2.6%), 0.8% (95%: -0.7%, 2.3%), and 3.1% (95%: 0.5%, 5.7%) rise in ERVs for the suburban population, respectively. It was found that females were more susceptible than males to air pollution in the urban area when the analysis was stratified by gender, and the reverse result was seen in the suburban area. Our results suggest that the increase in ERVs for respiratory illnesses is linked to the levels of air pollutants in Jinan, and there may be some urban-suburban discrepancies in health outcomes from air pollutant exposure.

  1. Multidisciplinary management of hepatocellular carcinoma with portal vein tumor thrombus – Eastern Hepatobiliary Surgical Hospital consensus statement

    PubMed Central

    Cheng, Shuqun; Yang, Jiamei; Shen, Feng; Zhou, Weiping; Wang, Yi; Cong, Wenming; Yang, Guang shun; Cheng, Hongyan; Hu, Heping; Gao, Chunfang; Guo, Jia; Li, Aijun; Meng, Yan; Jiang, Xiaoqing; Yang, Yefa; Qian, Guojun; Luo, Ming; Hu, Bing; Man, Xiaobo; Zhang, Baohua; Su, Changqing; Zhou, Feiguo; Li, Nan; Shi, Jie; Wang, Meng; Zheng, Yaxin; Guo, Weixing; Sun, Juxian; Wang, Hongyang; Lau, Wan-yee; Wu, Meng-chao

    2016-01-01

    Hepatocellular carcinoma (HCC) complicated by portal vein tumor thrombus (PVTT) is associated with poor prognosis, early recurrence of HCC, and limited treatment options. Current guidelines do not have standardized diagnostic and treatment modalities, thus creating a need for a multidisciplinary treatment model for standardization of the treatment. Eastern Hepatobiliary Surgical Hospital (China) convened two working parties of experts from all the departments, to consolidate the current evidence, prevailing vision for the future, and experience of the practicing clinicians engaged in HCC management, so as to develop a consensus for PVTT diagnosis and treatment according to the GRADE system. Based on the quality of the existing evidence and the strength of recommendations, the consensus statements were categorized into 3 evidence levels (A/B/C) and 5 classes (I/II/IIa/IIb/III). The panel discussed and provided clarity on the management and research options in the field of HCC with PVTT. In addition, the panel also assessed the quality of the cited studies and assigned grades to the recommendation statements. Among the group of experts, there was excellent agreement with regard to effective diagnosis and treatment of HCC with PVTT. The recommendations of this consensus will provide guidance to physicians and clinical researchers on the effective management of HCC with PVTT. PMID:27027235

  2. A review of neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

    PubMed Central

    Alhaji, M. A.; Bello, M. A.; Elechi, H. A.; Akuhwa, R. T.; Bukar, F. L.; Ibrahim, H. A.

    2013-01-01

    Background: Neonatal tetanus is a vaccine preventable disease and is a leading cause of neonatal mortality in developing countries. The effectiveness of immunization and hygienic umbilical cord care practices in the prevention of the disease has been established. Objective: The objective of this study was to audit the scourge of neonatal tetanus in a tertiary health facility in a resource-limited setting. Materials and Methods: The study was a retrospective study. Case notes of neonates admitted with clinical diagnosis of tetanus into the Special Care Baby Unit (SCBU) between January 2009 and December 2010 were retrieved and evaluated to identify socio-demographic and clinical characteristics, mode of acquisition and severity of the disease, presence of co-morbidities, duration of hospital stay and outcome. Results: Most of the mothers had no tetanus immunization (66.7%) and the main social class of the children was class V (45.1%) and IV (41.2%), respectively. Only 29.4% of the mothers attended ante-natal care (ANC) while majority of the patients were delivered at home (94.1%). Half of the neonates presented with the severe form of the disease (51.0%). Sepsis is a prominent co-morbidity (59.2%). Morality was high with case fatality of 66.7%. Conclusion: This high prevalence of neonatal tetanus with high mortality is not only disappointing but unacceptable in the 21st century. Therefore, all efforts must be re-focused on current preventive strategies while pursuing new areas such as slow-release mono-dose tetanus vaccine and school health programme as well as advocacy on political will for the sustainability of immunization programmes of women of child-bearing age. PMID:24665154

  3. Profile of HIV infected children: A hospital based study at Eastern Nepal

    PubMed Central

    Poudel, Prakash; Pokharel, Rita; Chitlangia, Mohit; Chaudhary, Shipra

    2014-01-01

    Objective To investigate the clinical, laboratory, epidemiological profiles and outcome in human immunodeficiency virus infected Nepalese children. Methods This was a hospital based prospective study. Human immunodeficiency virus-infected children presenting to pediatric immunology clinic at BP Koirala Institute of Health Sciences were enrolled and followed up. Results Median age at diagnosis among 39 enrolled children was 58 months. All children acquired infection vertically. Unsafe sex (74.4%) and intravenous drug use (25.6%) were the major risk behaviors in fathers. At presentation, 20.8% children were asymptomatic, 54.0% were malnourished, 41.0% were in WHO clinical stage 1, 17.9% were in stage 4, 74.4% were anemic, 17.9% had thrombocytopenia and median CD4 count was 543. Fever, lymphadenopathy, hepatosplenomegaly, skin eruptions and oral lesions were common presenting features (16.2%, 16.2%, 13.5%, 10.8%, and 8.1% respectively out of 74 features). Tuberculosis (16.0%), chronic otitis media (12.0%), scabies (10.7%), bacterial pneumonia (9.3%) and oropharyngeal candidiasis (6.7%) were common opportunistic infections. Antiretroviral treatment was started in 18 (46.2%) cases at median age of 67 months. Median change in CD4 count at follow up was significantly different between the groups receiving and not receiving antiretroviral treatment (+192 vs. -72; P=0.045). Conclusions Infection in children is vertical. Undernutrition, anemia, fever, lymphadenopathy, hepatosplenomegaly, skin eruptions, and ear discharge are common presenting features. Opportunistic infections are common and tuberculosis is the most common opportunistic infection followed by chronic ear infection, scabies, candidiasis and bacterial pneumonia. Timely antiretroviral treatment improves immune response.

  4. Prevalence and outcome of Middle-eastern Arab and South Asian patients hospitalized with heart failure: insight from a 20-year registry in a Middle-eastern country (1991-2010).

    PubMed

    Al Suwaidi, Jassim; Asaad, Nidal; Al-Qahtani, Awad; Al-Mulla, Abdul Wahid; Singh, Rajvir; Albinali, Hajar A

    2012-06-01

    The clinical characteristics and outcome of patients hospitalized with heart failure vary according to ethnicities. Limited epidemiologic data are available about the clinical characteristics and outcome of heart failure (HF) patients among non-Caucasian populations. Between 1 January 1991 and 31 December 2010; 41 453 consecutive patients were hospitalized at Hamad General Hospital, Doha, Qatar for cardiac reasons. Patients were into two groups; hospitalized with HF (n = 7069) and hospitalized for non-HF (no-HF). Among HF patients Sub-analysis was made according to ethnicity; Middle-eastern Arabs (MEA) (n = 5227) versus South Asian (SA) (n = 1289) patients. HF patients were older and more likely to be female when compared to non-HF patients. HF patients were also more likely to have diabetes mellitus (DM), hypertension (HTN), atrial fibrillation (AF) and renal impairment when compared to non-HF patients. SA HF patients younger and less likely to have DM, HTN and AF when compared to MEA patients. Over the 20-years period there was decrease in in-hospital mortality and stroke rates regardless of ethnicity (death; 8.3% to 4.8%, stroke; 0.8% to 0.1%; all P = 0.001). HF patients in the Middle East present at relatively younger age regardless of ethnicity. In-hospital mortality and stroke rates decreased significantly over the 20-years.

  5. The delusion of halitosis: experience at an eastern Nigerian tertiary hospital.

    PubMed

    Uguru, C; Umeanuka, O; Uguru, N P; Adigun, O; Edafioghor, O

    2011-01-01

    Halitosis is a recognized problem in dental practice. Some individuals have the belief that they have offensive mouth odour which neither the dental clinician nor any other person can perceive. This condition is known as delusional halitosis. Delusional halitosis can be classified as either Pseudo halitosis or Halitophobia depending on the response to initial treatment. Halitophobia is an olfactory reference syndrome and is a psychological condition that the dental surgeon is ill equipped to treat alone. This study aimed to analyse patients diagnosed with delusional halitosis, highlight our experiences and make suggestions for improved management of such patients. All patients who presented at the dental clinics of University of Nigeria Teaching Hospital between January 2005 and December 2009 with a primary complaint of oral malodour were examined organoleptically. Those with obvious halitosis and known psychological conditions were excluded from the study Once a diagnosis of delusional halitosis was made, each patient was educated on the nature of halitosis, its causes and prevention. They then received oral prophylaxis and oral hygiene instructions. They were then recalled at one week, four week and six week intervals to establish a definitive classification. 18 out of the 25 patients who presented were diagnosed with delusional halitosis. 61% of them male and 39% of them female with an average age of 30yrs. Pseudo halitosis comprised a majority of the cases seen (13). Halitophobia was seen in the minority (5). Reasons sited for believing that they had mouth odour by the patients studied included, peoples reaction when they were in close proximity and how people tended to avoid them (94.4%), ability to self perceive the foul odour from their mouths (55%) and 27.8 % said they had been told by another person that they had bad breath. All the patients had very good oral hygiene, with a tendency to over indulge on oral care products and tended to use mouthwash

  6. Effects of Air Pollution on Hospital Emergency Room Visits for Respiratory Diseases: Urban-Suburban Differences in Eastern China

    PubMed Central

    Liu, Peng; Wang, Xining; Fan, Jiayin; Xiao, Wenxin; Wang, Yan

    2016-01-01

    A study on the relationships between ambient air pollutants (PM2.5, SO2 and NO2) and hospital emergency room visits (ERVs) for respiratory diseases from 2013 to 2014 was performed in both urban and suburban areas of Jinan, a heavily air-polluted city in Eastern China. This research was analyzed using generalized additive models (GAM) with Poisson regression, which controls for long-time trends, the “day of the week” effect and meteorological parameters. An increase of 10 μg/m3 in PM2.5, SO2 and NO2 corresponded to a 1.4% (95% confidence interval (CI): 0.7%, 2.1%), 1.2% (95% CI: 0.5%, 1.9%), and 2.5% (95%: 0.8%, 4.2%) growth in ERVs for the urban population, respectively, and a 1.5% (95%: 0.4%, 2.6%), 0.8% (95%: −0.7%, 2.3%), and 3.1% (95%: 0.5%, 5.7%) rise in ERVs for the suburban population, respectively. It was found that females were more susceptible than males to air pollution in the urban area when the analysis was stratified by gender, and the reverse result was seen in the suburban area. Our results suggest that the increase in ERVs for respiratory illnesses is linked to the levels of air pollutants in Jinan, and there may be some urban-suburban discrepancies in health outcomes from air pollutant exposure. PMID:27007384

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

    PubMed Central

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

    2016-01-01

    Background: 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. Method: 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. Results: 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. Conclusion: 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.

  8. Contraceptive practices among women seeking termination of pregnancy in one public hospital in Eastern Cape, South Africa

    PubMed Central

    Oluwole, Ebenezer O.

    2016-01-01

    Background There is significantly high contraceptive knowledge in South Africa, but the uptake of contraceptives is average to low with resultant soaring of unplanned pregnancy and rising statistics of termination of pregnancy (TOP) services. This study aimed to establish the contraceptive practices among women in the South African population seeking TOP in one public hospital in Eastern Cape, South Africa. Methods A cross-sectional study was carried out among women seeking TOP in a women’s clinic. Self-administered questionnaires were used as data collection tool, and the data collected were entered into SPSS software for analysis, using descriptive statistics to calculate frequencies and percentages while chi-square test was used to determine the associations between the socio-demography and contraceptive practices of the participants. Results Majority of the women were aged between 20 and 29 years, had secondary education, unemployed, single and resided in townships. Contraceptive uptake prior to termination of pregnancy (CTOP) among them was 44.1%, but 85.8% had good contraceptives knowledge. Their contraceptive practices are determined by partner’s opinion, source and availability of contraceptives, previous CTOP, side effect of contraceptives and having children. Age group, educational level and employment status were found to be related to the contraceptive practices of the participants but were not statistically significant. Conclusion To reduce unplanned pregnancies and subsequent number of women seeking CTOP, the socio-economic factors associated with contraceptive practices as well as the programmes, policies and guidelines of contraceptives need to be improved on for any improvement on the factors determining contraceptive practices. PMID:27608676

  9. 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.

  10. 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

  11. Clinical and Epidemiologic Characteristics of Hospitalized Patients with Laboratory-Confirmed Respiratory Syncytial Virus Infection in Eastern China between 2009 and 2013: A Retrospective Study

    PubMed Central

    Chen, Yu; Lai, Shengjie; Zhang, Zike; Yu, Fei; Zheng, Shufa; Li, Zhongjie; Yu, Hongjie

    2016-01-01

    Respiratory syncytial virus (RSV) is a leading cause of morbidity and mortality worldwide in children aged <5 years and older adults with acute lower respiratory infections (ALRIs). However, few studies regarding the epidemiology of hospitalizations for RSV infection have been performed previously in China. Here, we aimed to describe the clinical and epidemiologic characteristics of hospitalized patients with laboratory-confirmed RSV infection in eastern China. Active surveillance for hospitalized ALRI patients using a broad case definition based on symptoms was performed from 2009–2013 in 12 sentinel hospitals in eastern China. Clinical and epidemiologic data pertaining to hospitalized patients of all ages with laboratory-confirmed RSV infection by PCR assay were collected and analyzed in this study. From 2009 to 2013, 1046 hospitalized patients with laboratory-confirmed RSV infection were enrolled in this study, and 14.7% of patients had subtype A, 24.2% of patients had subtype B, 23.8% of patients with subtype not performed, and 37.3% of patients had RSV coinfections with other viruses. RSV and influenza coinfections (33.3%) were the most common coinfections noted in this study. Moreover, young children aged <5 years (89.1%, 932/1046), particularly young infants aged <1 year (43.3%, 453/1046), represented the highest proportion of patients with RSV infections. In contrast, older adults aged ≥60 years (1.1%, 12/1046) represented the lowest proportion of patients with RSV infections among enrolled patients. The peak RSV infection period occurred mainly during autumn and winter, and 57% and 66% of patients exhibited symptoms such as fever (body temperature ≥38°C) and cough separately. Additionally, only a small number of patients were treated with broad-spectrum antiviral drugs, and most of patients were treated with antimicrobial drugs that were not appropriate for RSV infection. RSV is a leading viral pathogen and a common cause of viral infection in young

  12. 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.

  13. 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.

  14. Coronary artery disease prevalence and outcome in patients hospitalized with acute heart failure: an observational report from seven Middle Eastern countries.

    PubMed

    Salam, Amar M; Sulaiman, Kadhim; Al-Zakwani, Ibrahim; Alsheikh-Ali, Alawi; Aljaraallah, Mohammed; Al Faleh, Husam; Elasfar, Abdelfatah; Panduranga, Prasanth; Singh, Rajvir; Abi Khalil, Charbel; Al Suwaidi, Jassim

    2016-12-01

    The purpose of this study was to report prevalence, clinical characteristics, precipitating factors, management and outcome of patients with coronary artery disease (CAD) among patients hospitalized with heart failure (HF) in seven Middle Eastern countries and compare them to non-CAD patients. Data were derived from Gulf CARE (Gulf aCute heArt failuRe rEgistry), a prospective multicenter study of 5005 consecutive patients hospitalized with acute HF during February-November 2012 in 7 Middle Eastern countries. The prevalence of CAD among Acute Heart Failure (AHF) patients was 60.2% and varied significantly among the 7 countries (Qatar 65.7%, UAE 66.6%, Kuwait 68.0%, Oman 65.9%, Saudi Arabia 62.5%, Bahrain 52.7% and Yemen 49.1%) with lower values in the lower income countries. CAD patients were older and more likely to have diabetes, hypertension, dyslipidemia and chronic kidney disease. Moreover, CAD patients were more likely to have history of cerebrovascular and peripheral vascular disease when compared to non-CAD patients. In-hospital mortality rates were comparable although CAD patients had more frequent re-hospitalization and worse long-term outcome. However, CAD was not an independent predictor of poor outcome. The prevalence of CAD amongst patients with HF in the Middle East is variable and may be related to healthcare sources. Regional and national studies are needed for assessing further the impact of various etiologies of HF and for developing appropriate strategies to combat this global concern.

  15. Pattern of Sexually Transmitted Infections: A Profile from a Sexually Transmitted Infections Clinic of a Tertiary Care Hospital of Eastern India

    PubMed Central

    Sarkar, S; Shrimal, A; Das, J; Choudhury, SR

    2013-01-01

    Background: Sexually transmitted infections (STIs) are public health problems, which significantly increase the risk of HIV transmission. A proper understanding of the pattern of STIs in different geographical regions is important for proper planning of STI control. Aims: To determine the pattern of sexually transmitted diseases in a tertiary care hospital in Eastern India. Subjects and Methods: This is a hospital-based, cross-sectional study done in a tertiary care hospital of Eastern India. All the consecutive patients attending the STI clinic of a tertiary care hospital from January 2011 to December 2011 were included in the study, irrespective of age and sex. Thorough history was taken; proper clinical examination and relevant laboratory investigations were done. STIs were categorized in different syndromes as depicted by National AIDS Control Organization(NACO) in the syndromic management of STIs. The STIs, which were not included in the syndromic management, were also identified by clinical features and investigations. Partner notification and condom promotion was done. The statistical analysis used was Chi-square test using MedcalcR statistical software Version 9.3 (Belgium). Results: The commonest STI was genital herpes. Viral STIs like genital herpes, condyloma acuminata, molluscum contagiosum were more prevalent than the non-viral ones like genital ulcer disease non-herpetic, syphilis. STIs which were not included in the syndromic management like molluscum contagiosum, condyloma acuminata, genital scabies were common. HIV seropositivity in the study population (4.2%) was more than the NACO estimate. Condom promotion, partner notification, and partner management was not adequate. Occurrence of venereophobia was found to be significantly higher in male than in female attendees of STI clinic. Conclusions: The trend for viral STIs is increasing while that for bacterial STIs is decreasing. Proper training of the health care providers regarding minor STIs

  16. 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

  17. Annual Survey on the Level and Extent of Usage of Electronic Health Records in Government-related Hospitals in Eastern Province, Saudi Arabia

    PubMed Central

    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

  18. High Frequency of Blackwater Fever Among Children Presenting to Hospital With Severe Febrile Illnesses in Eastern Uganda.

    PubMed

    Olupot-Olupot, Peter; Engoru, Charles; Uyoga, Sophie; Muhindo, Rita; Macharia, Alex; Kiguli, Sarah; Opoka, Robert O; Akech, Samuel; Ndila, Carolyne; Nyeko, Richard; Mtove, George; Nteziyaremye, Julius; Chebet, Martin; George, Elizabeth C; Babiker, Abdel G; Gibb, Diana M; Williams, Thomas N; Maitland, Kathryn

    2017-04-01

    In the Fluid Expansion as a Supportive Treatment (FEAST) trial, an unexpectedly high proportion of participants from eastern Uganda presented with blackwater fever (BWF). We describe the prevalence and outcome of BWF among trial participants and compare the prevalence of 3 malaria-protective red blood cell polymorphisms in BWF cases vs both trial (non-BWF) and population controls. Of 3170 trial participants, 394 (12.4%) had BWF. The majority (318 [81.0%]) presented in eastern Uganda and were the subjects of further analysis. BWF cases typically presented with both clinical jaundice (254/318 [80%]) and severe anemia (hemoglobin level <5 g/dL) (238/310 [77%]). Plasmodium falciparum parasitemia was less frequent than in non-BWF controls, but a higher proportion were positive for P. falciparum histidine rich protein 2 (192/246 [78.0%]) vs 811/1154 [70.3%]; P = .014), suggesting recent antimalarial treatment. Overall, 282 of 318 (88.7%) received transfusions, with 94 of 282 (33.3%) and 9 of 282 (3.4%) receiving 2 or 3 transfusions, respectively. By day 28, 39 of 318 (12.3%) BWF cases and 154 of 1554 (9.9%) non-BWF controls had died (P = .21), and 7 of 255 (3.0%) vs 13/1212 (1%), respectively, had severe anemia (P = .036). We found no association with G6PD deficiency. The prevalence of both the sickle cell trait (10/218 [4.6%]) and homozygous α+thalassemia (8/216 [3.7%]) were significantly lower among cases than among population controls (334/2123 [15.7%] and 141/2114 [6.6%], respectively), providing further support for the role of malaria. We report the emergence of BWF in eastern Uganda, a condition that, according to local investigators, was rare until the last 7 years. We speculate that this might relate to the introduction of artemisinin-based combination therapies. Further studies investigating this possibility are urgently required.

  19. Prevalence and risk factors for nosocomial infections in hospitals of the Veneto region, north-eastern Italy.

    PubMed

    Pellizzer, G; Mantoan, P; Timillero, L; Allegranzi, B; Fedeli, U; Schievano, E; Benedetti, P; Saia, M; Sax, H; Spolaore, P

    2008-03-01

    The study aimed to assess prevalence and risk factors for nosocomial infection (NI) in 21 hospitals of the Veneto Region (Italy). In May 2003, a one-week-period prevalence study of NI was carried out in 21 hospitals, representing 63% of all hospital beds for acute patients of the Veneto Region. Intensive care units represented 84% of all intensive care beds of the Region. Long term care, neonatal intensive care, burn, psychiatric and dermatology units were excluded. Overall, 6,352 patients were surveyed. The prevalence of NI was 7.6% (range 2.6%-17.7%), while 6.9% of patients (range 2.6%-15.5%) were affected by at least one NI. The prevalence of patients with NI in medical, surgical and intensive care areas was 6.6%, 5.0% and 25.8%, respectively. The sites most frequently affected were the following: urinary tract (28.4%), surgical site (20.3%), blood stream (19.3%), pulmonary and lower respiratory tract (17.6%). At multivariate analysis risk factors independently associated to NI were: Charlson index score >1, severity of underlying disease, exposure to antibiotics, surgical intervention, trauma at admission, presence of central venous catheter >24 h, urinary catheter, intubation, tracheostomy, and duration since admission >15 days. The study provided baseline data of NI in the Veneto Region hospitals. It showed that NI are frequent, and display a wide inter-hospital variability of rates. The highest prevalence has been reported in intensive care units. The unusual high frequency of blood stream infections and the relatively lower prevalence rate of surgical site infections highlighted the limits of prevalence studies.

  20. 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.

  1. 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

  2. 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.

  3. Micro-organisms Associated with Febrile Neutropenia in Patients with Haematological Malignancies in a Tertiary Care Hospital in Eastern India.

    PubMed

    Mandal, Prakas Kumar; Maji, Suman Kumar; Dolai, Tuphan Kanti; De, Rajib; Dutta, Shyamali; Saha, Sandeep; Bhattacharyya, Maitreyee

    2015-03-01

    There is paucity of information from eastern India with regard to observed dominant micro-organisms causing febrile neutropenia (FN) in patients with haematological malignancies. To identify the prevalence of pathogenic microorganisms associated with FN. A total number of 268 episodes of FN were analysed from September'2010 to October'2013. The blood samples were inoculated into brain heart infusion broth, glucose broth, Hicombi dual performance media (Himedia, LQ-12) at 37° C for 168 h and Bactec method was also performed for these samples. Blood agar, chocolate agar, MacConkey's agar and cystine lactose electrolyte deficient agar were used for isolation of the microorganisms. A total number of 78 (29.10 %) episodes revealed positive growths. Gram negative bacilli and Gram positive cocci were isolated in 61.53 and 34.61 % cases respectively. The eight commonest isolates were Pseudomonas aeruginosa (14.10 %), methicillin resistant Staphylococcus aureus (MRSA-12.82 %), Acinetobacter sps (11.53 %), coagulase negative Staphylococcus (10.25 %), Klebsiella pneumoniae (8.97 %), Escherichia coli (8.97 %), ESBL E. coli (6.41 %), methicillin sensitive S. aureus (MSSA-6.41 %). Amongst other less common isolates were Citrobacter kosseri (3.84 %), Citrobacter freundii (2.56 %), Ralstonia paucula (2.56 %), Cedecia neteri (1.28 %), methicillin resistant coagulase negative Staphylococcus (2.56 %). Candida spp. including two cases of Candida non-albicans was isolated in 3.84 % of cases. P. aeruginosa was the commonest pathogenic isolates in FN patients associated with haematological malignancies in this study. Gram negative bacteria were the commonest isolates in FN including significant numbers of rare opportunistic micro-organisms.

  4. Determinants of misconceptions about diabetes among Saudi diabetic patients attending diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia

    PubMed Central

    Alsunni, Ahmed A.; Albaker, Waleed I.; Badar, Ahmed

    2014-01-01

    Objective: To identify the determinants of misconceptions about diabetes in patients registered with a diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia. Materials and Methods: This cross-sectional survey was carried out at a diabetes clinic of a tertiary care hospital in Eastern Saudi Arabia, from January to December 2012. A total of 200 diabetic patients were interviewed using a questionnaire comprising 36 popular misconceptions. The total misconception score was calculated and categorized into low (0-12), moderate (13-24) and high (25-36) scores. The association of misconception score with various potential determinants was calculated using Chi-square test. Step-wise logistic regression was applied to the variables showing significant association with the misconception score in order to identify the determinants of misconceptions. Results: The mean age was 39.62 ± 16.7 and 112 (56%) subjects were females. Type 1 diabetics were 78 (39%), while 122 (61%) had Type 2 diabetes. Insulin was being used by 105 (52.5%), 124 (62%) were self-monitoring blood glucose and 112 (56%) were using diet control. Formal education on diabetes awareness had been received by 167 (83.5%) before the interview. The mean misconception score was 10.29 ± 4.92 with 115 (57.5%) subjects had low misconception scores (<12/36). On the Chi-square test, female gender, rural area of residence, little or no education, <5 or >15 years since diagnosis, no self-monitoring, no dietary control and no diabetes education were all significantly (P < 0.05) associated with higher misconception scores. Step-wise logistic regression suggested that diabetes education, gender, education and time since diagnosis were significant (P < 0.05) predictors of misconception scores. Conclusions: The strongest determinants of misconceptions about diabetes in our study population were female gender, rural area of residence, illiteracy or little education, <5 or >15 years since diagnosis, no self

  5. 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

  6. Prevalence of Clostridium difficile toxin in diarhoeal stool samples of patients from a tertiary hospital in North Eastern Penisular Malaysia.

    PubMed

    Hassan, Siti Asma'; Othman, Norlela; Idris, Fauziah Mohd; Abdul Rahman, Zaidah; Maning, Nurahan; Abdul Rahman, Rosliza; Tiong, Chan Guan

    2012-08-01

    This study describes the prevalence of Clostridium difficile toxin (CDT) in loose stool samples from inpatients aged more than two years of a tertiary hospital. A total of 175 samples that had been examined were from stool samples that were sent to the Medical Microbiology & Parasitology Laboratory for various clinical indications. The toxin was detected by a commercial immunochromatograhic test, and the patients' demography, clinical features, treatment and outcomes were analyzed from their medical records. Clostridium difficile toxin was positive in 24 (13.7%) of the stool samples. Male and female were 11 (45.8%) and 13 (54.2%) respectively, with the majority of them aged more than 50 years. Most were from medical wards (n = 21, 87.5%), with the rest from surgical wards (n = 2, 8.3%) and intensive care units (n = 1, 3.4%). All the CDT positive patients had history of prior antibiotic usage within 6 weeks before the detection of the toxin. The mean duration of antibiotics usage was 17.75 (+/- 13.75) days, while the mean duration of diarrhea was 5.21((+/- 5.85) days. Eighteen patients had underlying medical illnesses that were diabetes mellitus, chronic renal disease, hypertension, ischaemic heart disease, cerebrovascular disease and malignancy; with seven of them being CDT positive while on chemotherapy. Stool occult blood test was positive in 15 patients whereas presence of pus cells in the CD positive stool samples were detected in 21 patients. The duration of hospitalization among the patients was 27.96 (+/- 23.22) days.

  7. Patterns of sexual violence in Eastern Democratic Republic of Congo: reports from survivors presenting to Panzi Hospital in 2006

    PubMed Central

    2010-01-01

    Background Despite the signing of international peace agreements, a deadly war continues in the Democratic Republic of Congo (DRC) and sexual violence is a prominent modus operandi of many military groups operating in the region. Methods Retrospective cohort study of women who presented to Panzi Hospital in 2006 requesting post-sexual violence care. Data was extracted and analyzed to describe the patterns of sexual violence. Results A total of 1,021 medical records were reviewed. A majority of attacks occurred in individual homes (56.5%), with the fields (18.4%) and the forest (14.3%) also being frequent locations of attack. In total, 58.9% of all attacks occurred at night. Of the four primary types of sexual violence, gang rape predominated (59.3%) and rape Not Otherwise Specified (NOS) was also common (21.5%). Sexual slavery was described by 4.9% of the survivors and a combination of gang rape and sexual slavery was described by 11.7%. The mean number of assailants per attack was 2.5 with a range of one to > 15. There were several demographic predictors for sexual slavery. Controlling for age, education level and occupation, a marital status of "single" increased the risk of sexual slavery (OR = 2.97, 95% CI = 1.12-7.85). Similarly, after controlling for other variables, age was a significant predictor of sexual slavery with older women being at a slightly reduced risk (OR = 0.96, 95% CI = 0.92-0.99). Women who experienced sexual slavery were 37 times more likely to have a resultant pregnancy in comparison to those who reported other types of sexual violence (OR = 37.50, 95% CI = 14.57-99.33). Conclusions Among sexual violence survivors presenting to Panzi Hospital in 2006, the majority of attacks occurred in women's own homes, often at night. This represents a pattern of violence that differs from other conflict settings and has important implications regarding protection strategies. Sexual violence in South Kivu was also marked with a predominance of gang rape

  8. Prevalence of multidrug resistant uropathogenic bacteria in pediatric patients of a tertiary care hospital in eastern India.

    PubMed

    Mishra, Monali P; Sarangi, Rachita; Padhy, Rabindra N

    2016-01-01

    Today, because systemic infections such as urinary tract infection (UTI) affect even pediatric patients, antibiotic resistant bacteria have become a constant clinical challenge. In the present study, a total of 1054 urine samples were collected from pediatric patients over 18 months. From these samples, 510 isolates of pathogenic bacteria were collected using HiCrome UTI agar. Antibiotic sensitivity tests of isolates were performed using the Kirby-Bauer method. Two Gram-positive bacteria (Enterococcus faecalis and Staphylococcus aureus) and 7 Gram-negative bacteria (Citrobacter freundii, Enterobacter aerogenes, Escherichia coli, Klebsiella oxytoca, K. pneumoniae, Proteus vulgaris and Pseudomonas aeruginosa) were isolated. Antibiograms of isolated bacteria were ascertained using antibiotics of 4 classes: aminoglycosides, β-lactams, fluoroquinolones and 2 stand-alones (co-trimoxazole and nitrofurantoin). Based on percent values of antibiotic resistance, isolated bacteria were (in decreasing order of number of isolated isolates): E. coli (109)>S. aureus (65)>E. faecalis (82)>E. aerogenes (64)>C. freundii (41)>P. aeruginosa (32)>K. pneumoniae (45)>K. oxytoca (50)>P. vulgaris (22). Surveillance results show that MDR isolates of 9 pathogenic bacteria were prevalent in the environment around the hospital. Thus, revisions to the antimicrobial stewardship program in this area of the country are required to increase clinician confidence in empiric therapy, which is often used for UTI cases.

  9. Socio-demographic and Clinical Characteristics of Patients who Attempt Suicide: A Hospital-based Study from Eastern India.

    PubMed

    Halder, S; Mahato, A K

    2016-09-01

    Suicide has become an important public health concern with a high number of deaths and increasing number of attempted suicides every year. There are multiple factors that underlie a suicide attempt. Although mental illness and severe stress have long been known to be associated with suicide, socio-demographic and clinical characteristics of those attempting suicide can also provide indications of suicidal intent. The present study aimed to explore the socio-demographic and clinical characteristics of patients in Kolkata, India who attempted suicide. Consecutive patients (n = 100) with failed suicide attempt who were referred to the psychiatry department of 2 multispecialty hospitals in Kolkata were included in the study. Their socio-demographic details and clinical characteristics were recorded. Suicidal intent and depressive symptoms were assessed and psychosocial risk factors were identified following detailed clinical interview. Suicide attempt was more frequent among younger female patients. Reaction to stress was the most common risk factor. The majority of attempts were impulsive in nature rather than planned. Young adults under stress are more vulnerable. Early identification of such individuals and psychosocial support to prevent suicidal ideation is vital.

  10. A Prospective Study of Burn Trauma in Adults at the University of Calabar Teaching Hospital, Calabar (South Eastern Nigeria)

    PubMed Central

    Asuquo, Maurice E.; Ekpo, R.; Ngim, Ogbu; Agbor, C.

    2008-01-01

    Background: Burn injuries are among the most devastating injuries seen in the emergency units. The epidemiology of this injury varies from one part of the world to another. This is a 3-year report in an attempt to provide information on the current epidemiology of burns in this center. Method: Patients admitted into the University of Calabar Teaching Hospital, with burn injuries were prospectively studied between February 2005 and January 2008. Results: The 59 patients (33 males and 26 females) accounted for 3.7% of trauma patients and their ages ranged from 15 to 70 years (mean 29.4 years). Flame burn was the commonest injury seen in 48 (81.3%) patients because of petrol and kerosene, whereas chemical burn that involved 7 (11.9%) patients ranked second. Morbidity included burns wound infection in 13 (22%) patients and contractures in 6 (10.2%) patients. The outcome was fatal in 15 (25.4%) patients. Conclusion: The establishment of burn support groups dedicated to publicity on prevention based on areas of risk highlighted in this study and provision of financial aid as well as provision of modern burn care facilities would improve outcome. PMID:18716653

  11. Prevalence of Intestinal Parasitic Infection among HIV Positive Persons Who Are Naive and on Antiretroviral Treatment in Hiwot Fana Specialized University Hospital, Eastern Ethiopia

    PubMed Central

    Teklemariam, Zelalem; Abate, Degu; Mitiku, Habtamu; Dessie, Yadeta

    2013-01-01

    Background. Intestinal parasitic infection affects the health and quality of life of people living with HIV. This study was aimed to determine the prevalence of intestinal parasites among HIV positive individuals who are naive and who are on antiretroviral treatment (ART) in Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Methods. A comparative cross-sectional study was conducted on 371 (112 ART-naive group and 259 on ART) HIV positive individuals. Stool specimens were collected and examined by direct wet mount, formol ether concentration technique, and modified ziehl-Neelsen methods. Results. The overall prevalence of intestinal parasitic infections was 33.7%; it was significantly higher among the study participants who were ART-naive group (45.5%) (AOR: 2.60(1.56,4.34)) and diarrheic (53.3%) (AOR: 2.30(1.34,3.96)) and with CD4 count <200 cells/μL (46%) (AOR: 2.07(1.06,4.04)). The most commonly identified parasites were Entamoeba histolytica/E. dispar (13.5%), Giardia lamblia (8.1%), Strongyloides stercoralis (4.0%), and Cryptosporidium species (2.2%). Conclusion. HIV positive individuals with diarrhea and low CD4 count and ART naive groups were more infected with intestinal parasites than their counterparts. Early stool examination and treatment of intestinal parasites for HIV/AIDS patients is essential. PMID:24052888

  12. Effectiveness of Educational Programs on Nutritional Behavior in Addicts Referring to Baharan Hospital, Zahedan (Eastern of IR Iran)

    PubMed Central

    Karajibani, Mansour; Montazerifar, Farzaneh; Dashipour, Alireza; Lashkaripour, Kobra; Abery, Maryam; Salari, Sajedeh

    2014-01-01

    Background: There are many factors which affect nutritional status of addicted such as lack o f knowledge, incorrect attitude toward modification of food pattern, and careless to food intake. Objectives: The aim of this study was to determine the effectiveness of educational program on nutritional behavior in addicts referring to Baharan hospital in Zahedan. Patients and Methods: Thirty-six addict patients were selected randomly. After recording general demographic data of patients, nutritional behaviors were determined. To determine the effectiveness of nutritional educational program, pre and post-tests were performed. Evaluation of nutritional behavior was determined as poor, fair and satisfactory levels. Statically analysis was performed by SPSS software. Results: Most addict patients had a medium level of education. Improvement in knowledge, attitude and practice (KAP) of patients after intervention was observed as follows; decreasing KAP in poor level (2.8% vs. 30.6%), (3% vs. 50%), (25% vs. 80.6%), respectively; also, increasing KAP in fair level (7% vs. 55.6 %), (15% vs. 15%), (19% vs. 7%), respectively and increasing KAP in satisfactory levels (77.8% vs. 13.8%), (50% vs. 8.3%), and (22.2% vs. 0%), respectively (P < 0.0001). There was a significant difference regarding the grade of KAP in patients based on gender, marital status, and education level after education (P < 0.0001). Conclusions: This study showed that nutritional KAP was improved in addicts. After intervention, there was a significant difference in the score of knowledge, attitude, and practice scores in patients in the current study. KAP was improved in patients after intervention including; decreased KAP in poor level and increased KAP in fair and satisfactory levels. This finding indicates that addict patients would like to modify their life style. PMID:25032162

  13. Antibiotic resistance pattern of Enterococci isolates from nosocomial infections in a tertiary care hospital in Eastern India.

    PubMed

    Chakraborty, Atreyi; Pal, Nishith K; Sarkar, Soma; Gupta, Manideepa Sen

    2015-01-01

    Resistance to commonly used antibiotics by Enterococci causing nosocomial infections is of concern, which necessitates judicious, responsible and evidence-based use of antibiotics. The present study was conducted to review the prevalence and identify therapeutic options for nosocomial Enterococcal infections in our tertiary care hospital. Isolates identified by morphological and biochemical characteristics were tested for antibiotic susceptibility using Kirby-Bauer method. 153 of 2096 culture positive clinical samples comprised of 101 urine, 30 wound swab/pus, 13 blood and 09 high vaginal swab isolates were identified as Enterococcus faecalis (90.85%), Enterococcus faecium (8.50%) and Enterococcus gallinarum (0.65%). Enterococci accounted for 8.45%, 4.53%, 4.23%, 4.43% of urinary, wound swab or pus, blood, high vaginal swab isolates respectively, causing 7.3% of all nosocomial infections. Significant number of Enterococci isolated from nosocomial urinary tract infection (66.01%) and wound infections (19.6%) were multidrug resistant (MDR). Although all isolates were sensitive to vancomycin and linezolid, resistance to erythromycin (71.24%) and ciprofloxacin (49.67%) was frequently observed. High-level gentamicin resistance was observed in 43.88%, and 61.53% of E. faecalis and E. faecium isolates respectively. Minimal inhibitory concentration of vancomycin of all the isolates were ≤1 μg/ml. 7% of the Enterococcal isolates were MDR strains and vancomycin or linezolid were the only effective antibiotics. A combination of vancomycin and/or linezolid were effective against Enterococci causing nosocomial infections in our tertiary care facility, nevertheless continuous and frequent surveillance for resistance patterns are necessary for judicious and evidence based use of antibiotics.

  14. Hepatitis B Virus Infections and Associated Factors among Pregnant Women Attending Antenatal Care Clinic at Deder Hospital, Eastern Ethiopia

    PubMed Central

    Umare, Abdi; Seyoum, Berhanu; Gobena, Tesfaye; Haile Mariyam, Tamirat

    2016-01-01

    Background Hepatitis B virus (HBV) infection is a serious public health problem worldwide. Reports have shown that 68,600 people die of HBV infection and more than 300,000 deaths due to liver cancer secondary to hepatitis B every year globally. Women who are infected with HBV can vertically transmit the infection to their infants. This study aims to determine the prevalence of HBV infection and associated factors among pregnant women. Methods and Findings A hospital-based cross-sectional study was conducted among pregnant women who attended antenatal care clinic (ANC) for routine pregnancy check-up between 18 March 2015 and 15 May 2015. Data were collected by face to face interview using a pre-tested questionnaire. Serum was withdrawn for each study subject and used to test for Hepatitis B Surface Antigen (HBsAg) by an enzyme linked immunosorbent assay (ELISA) test kit. Binary logistic regression analysis was used to examine the association between explanatory variables and outcome variable. The prevalence of HBV infection was found to be 6.9%. Interestingly, the history of abortion (AOR 10.9; 95% CI: 2.2–53.9), nose piercing (AOR 9.1; 95% CI: 1.34–61.79), surgical procedure (AOR 12.8; 95% CI: 1.68–97.06) and history of multiple sexual partners (AOR 16.8; 95% CI: 3.18–89.06) were significant predictors of HBV infection. Conclusions This study determined that the prevalence of HBV infection among pregnant women was 6.9%, implying that it is high-intermediate endemic area, which is important public health issue needs to be addressed. History of abortion, nose piercing, surgical procedures and multiple sexual partners were significantly associated with this viral infection. Accordingly we advocate that health education programs on the mode of HBV transmission, high-risk behaviors and methods of preventions should be instituted at antenatal care clinics to raise the awareness of mothers and limit the spread of infection. It is also advisable to implement

  15. A retrospective quality assessment of pre-hospital emergency medical documentation in motor vehicle accidents in south-eastern Norway

    PubMed Central

    2011-01-01

    Background Few studies have evaluated pre-hospital documentation quality. We retrospectively assessed emergency medical service (EMS) documentation of key logistic, physiologic, and mechanistic variables in motor vehicle accidents (MVAs). Methods Records from police, Emergency Medical Communication Centers (EMCC), ground and air ambulances were retrospectively collected for 189 MVAs involving 392 patients. Documentation of Glasgow Coma Scale (GCS), respiratory rate (RR), and systolic blood pressure (SBP) was classified as exact values, RTS categories, clinical descriptions enabling post-hoc inference of RTS categories, or missing. The distribution of values of exact versus inferred RTS categories were compared (Chi-square test for trend). Results 25% of ground and 11% of air ambulance records were unretrieveable. Patient name, birth date, and transport destination was documented in >96% of ambulance records and 81% of EMCC reports. Only 54% of patient encounter times were transmitted to the EMCC, but 77% were documented in ground and 96% in air ambulance records. Ground ambulance records documented exact values of GCS in 48% and SBP in 53% of cases, exact RR in 10%, and RR RTS categories in 54%. Clinical descriptions made post-hoc inference of RTS categories possible in another 49% of cases for GCS, 26% for RR, and 20% for SBP. Air ambulance records documented exact values of GCS in 89% and SBP in 84% of cases, exact RR in 7% and RR RTS categories in 80%. Overall, for lower RTS categories of GCS, RR and SBP the proportion of actual documented values to inferred values increased (All: p < 0.001). Also, documentation of repeated assessment was more frequent for low RTS categories of GCS, RR, and SBP (All: p < 0.001). Mechanism of injury was documented in 80% of cases by ground and 92% of cases by air ambulance. Conclusion EMS documentation of logistic and mechanistic variables was adequate. Patient physiology was frequently documented only as descriptive text. Our

  16. 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.

  17. Clinico-radiological profile and outcome of dengue patients with central nervous system manifestations: A case series in an Eastern India tertiary care hospital

    PubMed Central

    Pal, Souren; Sen, Kaushik; Biswas, Nirendra Mohan; Ghosal, Anirban; Rousan Jaman, S. K.; Yashavantha Kumar, K. Y.

    2016-01-01

    Background and Objective: Dengue, an acute viral disease, transmitted by Aedes mosquitoes, has a variable clinical spectrum ranging from asymptomatic infection to life-threatening dengue hemorrhagic fever and dengue shock syndrome. However, neurological complications, in general, are unusual but have been observed more frequently in the recent past, and some studies highlighted varied neurological complications during the course of illness. Although dengue is classically considered a nonneurotropic virus, there is increasing evidence for dengue viral neurotropism. In this study, we have evaluated clinico-radiological profile and outcome of nine serologically confirmed dengue patients having varied manifestations of central nervous system (CNS) involvement. Materials and Methods: All the consecutive patients presented with neurological complications with positive serology for dengue infection (IgM positivity) in Department of Medicine, in a tertiary care hospital in Eastern India from August 2013 to October 2014 were included in the study. These patients were subjected to a detailed clinical evaluation, laboratory assessment including complete hemogram, coagulation profile, liver function test, serum electrolytes, and routine CSF (Cerebrospinal Fluid) study with the exclusion of other common neuroinvasive pathogens. Results: Out of 9 patients with neurological complications associated with confirmed dengue infection, 2 (22%) patients had dengue encephalopathy, 5 (56%) patients have dengue encephalitis, 1 (11%) patient had dengue meningitis, and 1 (11%) patient had postdengue immune-mediated CNS involvement. Conclusion: This case series reaffirms the occurrence of varied CNS manifestations in dengue virus infection and underlines the importance of inclusion of dengue in the differential diagnosis of acute encephalitis syndrome. PMID:26933357

  18. The Magnitude of Under-five Emergencies in a Resource-poor Environment of a Rural Hospital in Eastern Nigeria: Implication for Strengthening the House-hold and Community-integrated Management of Childhood Illnesses

    PubMed Central

    Iloh, Gabriel UP; Ofoedu, John N; Njoku, Patrick U; Amadi, Agwu N; Godswill-Uko, Ezinne U

    2012-01-01

    Background: Under-five in Nigeria are the most vulnerable group that are often challenged by emergency health conditions. Aim: The study was to describe the magnitude of under-five emergencies in a resource-poor environment of a rural hospital in eastern Nigeria. Materials and Methods: A descriptive cross-sectional hospital-based study of 282 under-five patients with emergency health conditions at a rural Hospital in Imo state, eastern Nigeria. Data extracted included bio-data and diagnosis. Results: A total of 282 under-five emergencies were studied. The ages of the patients ranged from 12 days to 58 months with mean age of 34 ± 9.4 months. There were 153 (54.3%) males and 129 (45.7%) females with male to female ratio of 1.2: 1. The three most common causes of under-five emergencies were acute uncomplicated malaria (29.1%), severe malaria anemia (24.5%), and acute respiratory infections (22.7%). The predominant outcome of emergency admission was discharged home (83.0%). The preeminent cause of death was severe malaria anemia (81.8%). All deaths occurred within 24 hours of hospitalization. Conclusion: The three most common under-five emergencies were infectious medical emergencies and the preeminent cause of death was malaria-related. Strengthening the quality of the Roll Back Malaria Initiative, household and community-integrated management of childhood illnesses will help to reduce these preventable medical emergencies and deaths. PMID:22912942

  19. A study investigating the level of satisfaction with the health services provided by the Pharmacist at ENT hospital, Eastern Region Alahsah, Kingdom of Saudi Arabia

    PubMed Central

    Alturki, Mansour; Khan, Tahir M.

    2012-01-01

    The current study aims to evaluate the patient’s level of satisfaction with health care services provided by the pharmacist at Aljaber ENT hospital, Eastern Region Alahsah, Kingdom of Saudi Arabia. A cross sectional study was planned from 1st March 2011 until 31st May 2011. A 27 item questionnaire was used, scoring of the responses was done to classify the patient satisfaction into sublevels. The maximum possible score was 36; those scoring less than twenty were graded as poor satisfaction level followed by moderate satisfaction level 21–25, good satisfaction level 26–30 and high satisfaction level 31–36. Statistical package for social science version 13® was used to analyze data, One-way ANOVA and independent sample t-test were applied to see the differences in the level of satisfaction. Every third patient visiting pharmacy was given a chance to participate in this study. A total of N = 991 patients were randomized using the pharmacy appointment number. Of whom 657 patients have shown willingness to participate in this study. The response rate of this study was 66.30%, most of the respondents 383 (58.1%) were male ranging from the age group of 21–40 years with a mean age of 32 years SD 9.73. The mean score for all patients was 26.15 SD ±3.4. Among all the demographic variables a significant difference in satisfaction level was found among in terms of age (df = 8, F = 8.36, p = <0.001∗), gender (t = −4.089, df = 656, p=<0.001∗) and race (df = 2, F = 8.47, p = <0.001. The satisfaction level among Saudi nationals was least in comparison to Egyptians and others. In general, it is seen that respondents of age 56–60 years were most satisfied with the healthcare services provided by the pharmacist. In addition, the satisfaction level was higher among female patients in comparison to men. PMID:23960841

  20. 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

  1. Malaria Parasite Density Estimation using Actual and Assumed White Blood Cells Count in Children in Eastern Sudan.

    PubMed

    Bilal, Jalal A; Gasim, Gasim I; Karsani, Amani H; Elbashir, Leana M; Adam, Ishag

    2016-04-01

    Estimating malaria parasite count is needed for estimating the severity of the disease and during the follow-up. This study was conducted to determine the malaria parasite density among children using actual white blood cell (WBC) and the assumed WBC counts (8.0 × 10(9)/l). A cross-sectional study was conducted at New Halfa Hospital, Sudan. WBC count and count of asexual malaria parasite were performed on blood films. One hundred and three children were enrolled. The mean (SD) WBCs was 6.2 (2.9) cells × 10(9)/l. The geometric mean (SD) of the parasite count using the assumed WBCs (8.0 × 10(9)/l cells/μl) was significantly higher than that estimated using the actual WBC count [7345.76 (31,038.56) vs. 5965 (28,061.57) rings/μl,p = 0.042]. Malaria parasitemia based on assumed (8.0 × 10(9)/) WBCs is higher than parasitemia based on actual WBCs. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Anaemia, folate, zinc and copper deficiencies among adolescent schoolgirls in eastern Sudan.

    PubMed

    Abdelrahim, Ishraga I; Mahgoub, Hyder M; Mohamed, Ayoub A; Ali, Naji I; Elbashir, Mustafa I; Adam, I

    2009-12-01

    Anaemia is a widespread problem especially in the tropics. Among adolescent girls, it has negative consequences on growth, school performance, morbidity and reproductive performance. A cross-sectional study was conducted to investigate the prevalence of anaemia, iron, folate, zinc and copper deficiencies amongst adolescent schoolgirls in New Halfa, eastern Sudan, and to examine the relationship of these micronutrients with haemoglobin (Hb) levels. Out of 187 adolescent schoolgirls, 181 (96.8%) had anaemia (Hb<12 g/dl); 21% had mild anaemia (Hb 11.0-11.9 g/dl); 66.8.1% had moderate anaemia (Hb 8.0-10.9 g/dl), and 12.1% had severe anaemia (Hb<8 g/dl), respectively. Iron deficiency (S-ferritin<12 μg/l), iron deficiency anaemia (<12 m/dl and S- ferritin<12 μg/l) and folate deficiency (S-folate<3 ng/ml) were prevalent in 17.6%, 16.5% and 69% of these girls, respectively. Nine percent and 5.9% of these girls had zinc (<75 μg/ml) and copper deficiency (<75 μg/ml), respectively. Twenty-six (14%) girls had ≥ 2 micronutrient deficiencies. S-ferritin and zinc were significantly lower in patients with severe anaemia. Haemoglobin levels were significantly positively correlated with zinc levels (r=0.161, P=0.03) and with copper levels (r=0.151, P=0.03). Thus, interventions are required to prevent and control anaemia in this setting. Further research is needed.

  3. 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.

  4. Eastern Alaska

    NASA Technical Reports Server (NTRS)

    2002-01-01

    In this SeaWiFS image of eastern Alaska, the Aleutian Islands, Kodiak Island, Yukon and Tanana rivers are clearly visible. Also visible, but slightly hidden beneath the clouds, is a bloom in Bristol Bay. Credit: Provided by the SeaWiFS Project, NASA/Goddard Space Flight Center, and ORBIMAGE

  5. The secular trend in the incidence of hemorrhagic stroke in the region of Osijek, Eastern Croatia in the period 1988-2000--a hospital based study.

    PubMed

    Kadojić, D; Barac, B; Trkanjec, Z; Kadojić, M

    2002-12-01

    The purpose of the study was to establish the possible environmental influences in the observed peculiar rising and falling oscillations in the numbers of hemorrhagic stroke (HS) in Eastern Croatia (region of Osijek) during the last thirteen-years' period (1988-2000). In this period 1,222 HS were registered and treated. A constant increase in the incidence of HS was observed, from 60 (in 1988) to 139 (in 1998), with an average annual proportion of 16.5% of all stroke cases. A sharp increase in proportion of HS in total stroke incidence was recorded during the war in Croatia (1991-1995), with a peak incidence of 27.4% in 1993. Typical hypertensive intracerebral hemorrhage (ICH) was the most common (57.1%), atypical ICH occurred in 26.4%, subarachnoid hemorrhage (SAH) in 16.5%. Analysis of the annual number of hypertensive-ICH and SAH disclosed peculiar rising and falling oscillations. These variations were in correlation with heavy living conditions. During the war-period the SAH incidence sharply rose. Immediately after the war it suddenly decreased. The authors named this phenomenon a "pool depletion", supposing the relatively stable proportion of the bearers of aneurysms in population. The observed variations seem to be the consequence of the war stress and other negative psychosocial and economic factors in post-war period, which increases the risk for SAH and typical hypertensive-ICH through complex pathophysiological mechanisms.

  6. Gender differential on characteristics and outcome of leprosy patients admitted to a long-term care rural hospital in South-Eastern Ethiopia

    PubMed Central

    2012-01-01

    Introduction In previous studies, women are less aware of causation and symptoms of leprosy and have less access to health care coverage than men, thus contributing to their delay in seeking for treatment. We assess the gender differences in leprosy cases admitted to a rural referral hospital in Ethiopia for 7 and a half years. Methods Retrospective data of the leprosy patients admitted to referral hospital were collected using leprosy admission registry books from September 2002 to January 2010. Variables were entered in an Excel 97 database. Results During the period of study, 839 patients with leprosy were admitted; 541 (64.5%) were male, and 298 (35.6%) female. Fifteen per cent of female patients, and 7.3% of male patients were paucibacillary leprosy cases while 84.8% of female patients and 92.7% of males were multibacillary leprosy cases (p<0.001). Female leprosy patients were younger than male ones (median: 36 versus 44 years) (p<0.001). In the multivariate analysis, age (odds ratio [OR]: 0.97; 95% confidence interval [CI]: 0.96-0.98; p<0.001), admission for cardiovascular diseases (OR: 7.6, 95% CI: 1.9-29.3; p=0.004), admission for gastroenteritis (OR: 14.0; 95% CI: 1.7-117; p=0.02), admission from out patients clinic (OR: 2.04; 95% CI: 1.1-4.01; p=0.02), and mortality as final outcome (OR: 3.1, 95% CI: 1.2-8.0; p=0.02) were independently associated with female gender. Conclusions Female patients with leprosy admitted to hospital were younger, had a different profile of admission and a higher mortality rate than male ones. PMID:23035879

  7. Bacterial flora of combat wounds from eastern Ukraine and time-specified changes of bacterial recovery during treatment in Ukrainian military hospital.

    PubMed

    Valentine, Kovalchuk P; Viacheslav, Kondratiuk M

    2017-04-07

    Microbiology of modern war wounds is unique for each military conflict. Climatic and geographical features of the theater of war, contemporary warfare as well as wound management affect the microbial flora of wounds. This study was designed to determine time-specific microbial flora of combat wounds of upper and lower extremities obtained during the war in eastern Ukraine. The patients enrolled in study had combat wounds of upper or lower extremities which were treated in the Military Medical Clinical Center of Central Region. The wounds were swab-cultured and measured at each surgical debridement. The recovered microorganisms were identified and their antimicrobial resistance profiles were evaluated by disc diffusion method. Forty-nine patients with battle-field wounds were enrolled in the study from July to November 2014; all patients were male with a mean Injury Severity Score and arrival APACHE II scores of 16.2 ± 10.7 and 7.4 ± 4.2 respectively. Among 128 swab cultures, 100 swab cultures were positive. Swab cultures were obtained from 57 wounds of 49 patients. The results of the test showed that 87.7% of all positive swab cultures contained a single-organism while the rest of the swab-culture results showed polymicrobial growth. Among the isolated microorganisms 65% (76 strains) were Gram-negative rods, 22.2% (26 strains) of Gram-positive cocci, followed by Gram-positive rods (12.8%, 15 strains). We found that epidemiology of wound infection changes with the time after injury. The most common bacterial isolates cultured during the first week were Gram-positive microbes with low pathogenicity. The number of Gram-negative rods increased during the wound healing process. The incidence of Gram-positive microorganisms' growth fell after the first week and increased after third week. During wound healing, bacterial microflora of wounds changes with increasing number of Gram-negative rods with predominance of Acinetobacter species. Predominant microorganisms in

  8. Factors influencing the exit knowledge of patients for dispensed drugs at outpatient pharmacy of Hiwot Fana Specialized University Hospital, Eastern Ethiopia

    PubMed Central

    Hirko, Nigatu; Edessa, Dumessa

    2017-01-01

    Background A satisfactory counseling process between the patient and pharmacist is critical for rational use of dispensed drug(s) and is highly influenced by many factors including the experience of pharmacist in dispensing process. To improve patients’ knowledge of dispensed drugs, it is necessary to understand the factors that optimize a pharmacist interaction with a patient in each activity of the dispensing process. Therefore, the aim of this study was to identify the pharmacist and patient factors that influence knowledge of dispensed drugs by ambulatory patients at Hiwot Fana Specialized University Hospital, Harar, Ethiopia. Materials and methods A cross-sectional study was conducted on 422 respondents. Data were collected by interviews using a structured questionnaire that measures “exit knowledge” of the ambulatory patients for dispensed drugs. The collected data were analyzed using SPSS Version 20.0. Potential covariates were identified using χ2 test, and logistic regression analyses were undertaken to adjust for the covariates. Results Our findings showed significant proportions of the patients did not recall the name of their dispensed medication (53.6%), major side effects (66.4%), and what to do in case of missed doses (65.4%). Patients’ knowledge of dispensed drugs was significantly associated with their educational level (adjusted odds ratio [AOR]: 1.97; 95% confidence interval [CI]: 1.01–3.84 [primary], AOR: 2.04; 95% CI: 1.04–4.04 [secondary], and AOR: 2.71; 95% CI: 1.35–5.46 [tertiary]); clear instruction from the pharmacist (AOR: 3.36; 95% CI: 1.16–9.72); and the politeness of the pharmacist (AOR: 2.02; 95% CI: 1.04–4.04). Conclusion We found that the majority of patients poorly understood the name of the dispensed medication, side effects, and what to do in case of missed doses. In addition, the formal educational level of the patient, clear instruction from the pharmacist, and the politeness of pharmacist were the factors

  9. North side, eastern section, looking southwest at east ramp and ...

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

    North side, eastern section, looking southwest at east ramp and pavilion in CO-172-BR-17. - Fitzsimons General Hospital, Infirmary, Northwest Corner of East Bushnell Avenue & South Page Street, Aurora, Adams County, CO

  10. Eastern American Indian Communities.

    ERIC Educational Resources Information Center

    Thomas, Robert K.

    Identification of social and cultural commonalities among American Indians of the eastern U.S. reveal 4 geographical areas--(1) the eastern seaboard (the largest group in both number of distinct groups and population); (2) the inland area; (3) Louisiana (a combination of inland and seaboard characteristics); (4) the eastern Great Lakes area…

  11. 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...

  12. 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.…

  13. 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.…

  14. 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,…

  15. Eastern Equine Encephalitis

    MedlinePlus

    ... Facebook Tweet Share Compartir Image of Culiseta melanura mosquito, photo taken by Jason Williams, reproduced by permission from the Virginia Mosquito Control Association. Eastern equine encephalitis virus (EEEV) is ...

  16. 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

  17. Norovirus - hospital

    MedlinePlus

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  18. Eastern Pacific Ocean Conference

    NASA Astrophysics Data System (ADS)

    The promotion of interaction among investigators of all oceanographic disciplines studying the eastern Pacific Ocean was the goal of the 1990 Eastern Pacific Ocean Conference (EPOC), held October 17-19 on the snow-covered slopes of Mt. Hood, Oreg. Thirty oceanographers representing all disciplines attended.Dick Barber, Duke University Marine Lab, Beaufort, N.C., chaired a session on the eastern equatorial Pacific Ocean, emphasizing issues related to biological activity. Steve Ramp of the Naval Postgraduate School in Montery, Calif., chaired a session on recent results from northern and central California experiments. On October 19, following an early morning earthquake, a business meeting and discussions regarding a collaboration in future experiments were held.

  19. Early demographic and clinical predictors of developing acute kidney injury in snake bite patients: A retrospective controlled study from an Indian tertiary care hospital in North Eastern Uttar Pradesh India

    PubMed Central

    Singh, R. R.; Uraiya, Dharmendra; Kumar, Anoop; Tripathi, Neeraj

    2016-01-01

    Aims: This study was conducted retrospectively to define early demographic and clinical predictors for acute kidney injury (AKI) among snake bite patients at the time of hospital admission. Materials and Methods: We analyzed 138 cases with a poisonous snake bite. Patients were classified into two groups according to the presence and absence of AKI. The data regarding clinical features and demographic profile of these patients were collected from the hospital records in a prestructured pro forma and statistically compared. Results: Of the 138 patients of venomous snake bite, 62 developed AKI (44.92%). Patients who developed AKI were older in age. Moreover, prolonged bite to anti-snake venom (ASV) time had a significant relationship in developing AKI (P < 0.05). Among the clinical features, there was an independent positive association of AKI with abdomen pain, tenderness and vomiting, cellulitis, bleeding tendencies, myalgia, and black or brown urine (P < 0.05). Neurological features were inversely associated with renal involvement. Conclusion: We found that marked abdominal pain, tenderness and vomiting, myalgia, black or brown urine, bite site cellulitis, bleeding tendencies, and prolonged (>2 h) bite to ASV time were significantly associated with the development of AKI in snake bite patients. PMID:27555694

  20. 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...

  1. 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,...

  2. Eastern Frequency Response Study

    SciTech Connect

    Miller, N.W.; Shao, M.; Pajic, S.; D'Aquila, R.

    2013-05-01

    This study was specifically designed to investigate the frequency response of the Eastern Interconnection that results from large loss-of-generation events of the type targeted by the North American Electric Reliability Corp. Standard BAL-003 Frequency Response and Frequency Bias Setting (NERC 2012a), under possible future system conditions with high levels of wind generation.

  3. Earth - Eastern Australia Coast

    NASA Image and Video Library

    2001-02-28

    This false color image of the Eastern Coast of Australia was obtained by NASA’s Galileo spacecraft at about 3:00 p.m. PST, Dec. 8, 1990, at a range of more than 35,000 miles. http://photojournal.jpl.nasa.gov/catalog/PIA00121

  4. Pricing objectives in nonprofit hospitals.

    PubMed Central

    Bauerschmidt, A D; Jacobs, P

    1985-01-01

    This article reports on a survey of 60 financial managers of nonprofit hospitals in the eastern United States relating to the importance of a number of factors which influence their pricing decisions and the pricing objectives which they pursue. Among the results uncovered by the responses: that trustees are the single most important body in the price-setting process (doctors play a relatively unimportant role); that hospital pricing goals are more related to target net revenue than profit maximizing; and that regional factors seem to play an important role in management differences. PMID:4008272

  5. Pricing objectives in nonprofit hospitals.

    PubMed

    Bauerschmidt, A D; Jacobs, P

    1985-06-01

    This article reports on a survey of 60 financial managers of nonprofit hospitals in the eastern United States relating to the importance of a number of factors which influence their pricing decisions and the pricing objectives which they pursue. Among the results uncovered by the responses: that trustees are the single most important body in the price-setting process (doctors play a relatively unimportant role); that hospital pricing goals are more related to target net revenue than profit maximizing; and that regional factors seem to play an important role in management differences.

  6. Understanding hospitality.

    PubMed

    Patten, C S

    1994-03-01

    Bridging patient/"customer" issues and business aspects can be aided through developing a specific nursing basis for hospitality. The ancient practice of hospitality has evolved into three distinct levels: public, personal and therapeutic. Understanding these levels is helpful in integrating various dimensions of guest relations programs in hospitals into a more comprehensive vision. Hospitality issues must become a greater part of today's nursing management.

  7. Eastern diamondback rattlesnake

    NASA Image and Video Library

    2007-11-13

    An eastern diamondback rattlesnake slithers through the grass near the NASA News Center at NASA's Kennedy Space Center. The diamondback is Florida's largest venomous snake and may exceed six feet in length. It lives throughout Florida in a variety of dry habitats, such as pinelands, scrub and golf courses. Kennedy shares a boundary with the Merritt Island Wildlife Nature Refuge, which is a habitat for more than 310 species of birds, 25 mammals, 117 fishes and 65 amphibians and reptiles.

  8. Eastern diamondback rattlesnake

    NASA Image and Video Library

    2007-11-13

    An eastern diamondback rattlesnake warms in the sun near the NASA News Center at NASA's Kennedy Space Center. The diamondback is Florida's largest venomous snake and may exceed six feet in length. It lives throughout Florida in a variety of dry habitats, such as pinelands, scrub and golf courses. Kennedy shares a boundary with the Merritt Island Wildlife Nature Refuge, which is a habitat for more than 310 species of birds, 25 mammals, 117 fishes and 65 amphibians and reptiles.

  9. Paleotsunamis in Eastern Taiwan

    NASA Astrophysics Data System (ADS)

    Yen, Jiun-Yee; Yu, Neng-Ti; Hirakawa, Kazuomi; Chyi, Shyh-Jeng; Huang, Shao-Yi

    2017-04-01

    Although Taiwan is located in the active collision zone between Eurasian and the Philippine Sea plate with very high seismicity in and surrounding the island, and supposedly highly susceptible to tsunami hazard. However, there is no record of tsunami hazard in the past one hundred years, and only very few historical records show some possible extreme event occurred. Therefore study of tsunami was scarce in Taiwan. Although historical records do show possible tsunami events, the records were too sparse and incomplete to confidently reconstruct the paleotsunami events. In the past few years, numerical simulations based on possible tsunami-genic zones near Taiwan show that the island could be affected by the correctly directed tsunami. Nevertheless, there is no detail, scientific research of paleotsunami records yet in Taiwan. Our field survey in eastern Taiwan (facing the western Pacific Ocean) along the coast uncovered several outcrops contain gravels embedded in well-developed soil layers. The rounded meta-sandstone gravels are clearly beach-origin and were brought to their current location upon extreme wave events, which is composed of either volcanic-clastic deposits from nearby hills or organic soil layers formed locally. Our investigation indicates that there are at least 3 events in the northern half of eastern Taiwan and at least 2 events in southern part of eastern Taiwan. Although these outcrops are next to the shoreline and Taiwan is susceptible from typhoons, these gravels could be farther away from the beach at the time of their deposition due to current high retreat rate of the sea cliff. Further investigations are needed to delineate possible sources of tsunamis that caused the deposits.

  10. Eastern European risk management

    SciTech Connect

    Honey, J.A. )

    1992-01-01

    Here the authors assess Eastern European risk management practices through the evaluation of the nuclear power plants in the region. This evaluation is limited to the Soviet-designed and -built VVER-440 pressurized water reactors (PWRs) that are currently operating in Bulgaria, Czechoslovakia, Hungary, Russia, and the Ukraine and until recently operated at Greifswald in the former East Germany. This evaluation is based on the basic design of the plants, a safety evaluation of the Greifswald facility by representatives from the Federal Republic of Germany and personal visits by the author to Greifswald and Loviisa.

  11. 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

  12. Hospital diversification.

    PubMed

    Eastaugh, Steven R

    2005-01-01

    Hospital diversification and its impact on the operating ratio are studied for 168 hospitals during the period from 1999 to 2004. Diversification and the operating ratio are modeled in a two-stage least squares (TSLS) framework as being jointly dependent. Institutional diversification is found to yield a better financial position, and the better operating ratio allows the institution the wherewithal to diversify. The impact of external government planning and hospital competition are also measured. An institution lifecycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification and divestiture, occasionally leading to closure or merger. Management's attitude concerning risk and reward is considered.

  13. Eastern Europe scenario

    SciTech Connect

    Hafele, W.

    1996-12-31

    The Russian situation is key to Eastern Europe if present trends continue. Its strategy for the establishment of the nuclear fuel cycle was conceived decades ago when the former USSR still existed. It was based on the fuel recycle with attention given to the requirements of the military. The former Warsaw Pact Countries (WPC) were not meant to have independent fuel cycles, and their irradiated fuel elements were scheduled to go back to Russian territory. In 1976 a fuel cycle center was built at Mayak/Chelyabinsk, centered on the RT-1 plant with a nominal capacity of 400 tonnes/yr plant for the reprocessing of spent fuel from VVER-440 reactors, fast reactors (BN-350 and BN-600) icebreaker and submarine transport units, research reactors, and other power units. The plan provided for the reprocessing of spent fuel from the WPC all having VVER-440 reactors. All together, 3000 tonnes of spent fuel have been processed there. Nuclear waste went to vitrification. A new reprocessing facility is under construction in the neighborhood of Krasnoyarsk 26, the RT-2 plant. It is scheduled to operate after 2005, and its design capacity is 1500 tonne/yr. A storage for 6000 tonnes of spent fuel from VVER-1000 reactors is in operation since 1985. A second mixed-oxide plant for VVER-1000 reactors is under consideration. Now, there are no fuel cycle facilities in the newly independent countries. The fuel cycle problems in Eastern Europe and Russia are discussed.

  14. 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.

  15. 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…

  16. 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...

  17. CromixSun: un nuovo strumento per osservare il Sole in luce H-alfa

    NASA Astrophysics Data System (ADS)

    Lugli, Marcello

    2005-08-01

    The paper illustrates the possibility to achieve positive and useful results also beyond any imagination and out of any orthodox scheme. More than true what A. Einstein said: "Imagination is more important than knowledge". Only by using and assembling together the simplest filters that actual technology is able to produce it was possible to create a narrow bandpass H-alpha instrument which has nothing to envy other similar devices and probably, it may offer something more than others.

  18. Eastern Colorado Health Care System (VA Hospital) NPDES Permit

    EPA Pesticide Factsheets

    Under NPDES permit CO-0034991, the U.S. Department of Veterans Affairs (VA) is authorized to discharge from its wastewater treatment facility in Adams County, Colorado, to a storm sewer to Toll Gate Creek, a tributary of Sand Creek.

  19. Aerosols over Eastern Asia

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This Sea-viewing Wide Field-of-view Sensor (SeaWiFS) image of eastern Asia from October 14, 2001, shows large amounts of aerosol in the air. A few possible point sources of smoke, probably fires, are visible north of the Amur River at the very top of the image. One of the larger of these plumes can be seen down river of the confluence of the Songhua and Amur rivers. At lower left, the Yangtze River plume in the East China Sea is also very prominent. Sediment suspended in the ocean water is quite brown near the shore, but becomes much greener as it diffuses into the water. The increasing greenness of the river plume is probably an indication of enhanced phytoplankton growth driven by the nutrients in the river runoff. Image courtesy the SeaWiFS Project, NASA/Goddard Space Flight Center, and ORBIMAGE

  20. Eastern Iowa, Northwestern Illinois

    NASA Image and Video Library

    1973-06-22

    SL2-10-250 (May-June 1973) --- A vertical view of eastern Iowa and northwestern Illinois, as photographed from Skylab space station in Earth orbit. Davenport, Burlington and Muscatine, Iowa; and Rock Island and Moline, Illinois can be delineated on opposite sides of the Mississippi River. The Iowa River and tributaries of it can also be delineated. This photograph was taken with one of six lenses of the Itek-furnished Multispectral Photographic Facility Experiment S190-A mounted in the Multiple Docking Adapter (MDA) of the space station. A six-inch lens, using 70mm medium speed Ektachrome (SO-356) film, was used. Agencies participating with NASA on the EREP project are the Departments of Agriculture, Commerce and Interior; the Environmental Protection Agency and the Corps of Engineers. All EREP photography is available to the public through the Department of Interior's Earth Resources Observations Systems Data Center, Sioux Falls, South Dakota, 57198. Photo credit: NASA

  1. From a balcony of building 500, looking north. Eastern and ...

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

    From a balcony of building 500, looking north. Eastern and middle portions of building 511 are in the foreground. The movie theater (building 521) and the steam plant (building 215) are to the right rear. The commissary (building 520) is directly behind building 511. - Fitzsimons General Hospital, Bounded by East Colfax to south, Peoria Street to west, Denver City/County & Adams County Line to north, & U.S. Route 255 to east, Aurora, Adams County, CO

  2. From a balcony of building 500, looking northeast. The eastern ...

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

    From a balcony of building 500, looking northeast. The eastern half of building 511 is in the foreground, with the movie theater (building 521) beyond it to the right and the commissary (building 520) is directly beyond 511 to the left of the theater. - Fitzsimons General Hospital, Bounded by East Colfax to south, Peoria Street to west, Denver City/County & Adams County Line to north, & U.S. Route 255 to east, Aurora, Adams County, CO

  3. Hospital fundamentals.

    PubMed

    Althausen, Peter L; Hill, Austin D; Mead, Lisa

    2014-07-01

    Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols.

  4. Hospital philanthropy.

    PubMed

    Smith, Dean G; Clement, Jan P

    2013-01-01

    It remains an open question whether hospital spending on fundraising efforts to garner philanthropy is a good use of funds. Research and industry reports provide conflicting results. We describe the accounting and data challenges in analysis of hospital philanthropy, which include measurement of donations, measurement of fundraising expenses, and finding the relationships among organizations where these cash flows occur. With these challenges, finding conflicting results is not a surprise.

  5. Hospital marketing.

    PubMed

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  6. Eastern Han's Cunning Depiction

    NASA Astrophysics Data System (ADS)

    Chiu, B. C.

    1998-09-01

    It is still only speculation, but an earlier visit to a Han dynasty (202 BC - 220 AD) tomb has started the idea, and a recently found study of another Han tomb has convinced me it is worth pursuing. What it is is that the ancient Chinese Sky Animal which represents North was not the turtle or tortoise until about the time of Han. My own visit was to an Eastern (later period) Han tomb which had been moved to a museum near the ancient capital of Luoyang. The ceiling of the inner chamber was rounded, made of brick. Drawings of a tiger and a red bird were clear to the west and south. A rounded object was at the north. Outside the tomb was a sign which said it was 'cun,' which means village. Chinese characters often have homonyms, but 'cun' has few. I have also visited the neolithic village of Banpo, near the Yellow River in the north. It has noticeably large and deep trenches to keep out wild animals, and one separates the residential area from the business area. This village is dated earlier than 4000 BC. The trenches definitely remind me of later depictions of the turtle with a snake wound about it. The recent findings of a tomb at Puyang with shapes of tiger and dragon have dated it to 3000 BC. Nothing was placed at the south side. Something was at the north, but one might argue about that. Finally, I found this article in Chinese Studies in Archaeology (1979), translated by S. Cahill of UC, Berkeley, called "Analysis of the Western Han Murals in the Luouyang Tomb of Bo Qianqiu" by Sun Zuoyun. Although Western Han is earlier than Eastern, the pictures in the tomb were well preserved. There were tiger, dragon, vermilion bird, and other animals, but no tortoise. Instead, there was a sun with a bird inside, and the moon with a frog. Several hundred miles north of the Yellow River, there is the Amur River. The natives there had robes decorated with snakes, lizards, and frogs, and other animals, but no turtle. Later reasons for having the turtle or tortoise is a separate

  7. Eastern Siberia terrain intelligence

    USGS Publications Warehouse

    ,

    1942-01-01

    The following folio of terrain intelligence maps, charts and explanatory tables represent an attempt to bring together available data on natural physical conditions such as will affect military operations in Eastern Siberia. The area covered is the easternmost section of the U.S.S.R.; that is the area east of the Yenisei River. Each map and accompanying table is devoted· to a specialized set of problems; together they cover such subjects as geology, construction materials, mineral fuels, terrain, water supply, rivers and climate. The data is somewhat generalized due to the scale of treatment as well as to the scarcity of basic data. Each of the maps are rated as to reliability according to the reliability scale on the following page. Considerable of the data shown is of an interpretative nature, although precise data from literature was used wherever possible. The maps and tables were compiled  by a special group from the United States Geological Survey in cooperation with the Intelligence Branch of the Office, Chief of Engineers, War Department.

  8. Fires in Eastern Siberia

    NASA Image and Video Library

    2017-09-27

    NASA image acquired August 1, 2010 Intense fires continued to burn in the boreal forests of eastern Siberia on August 1, 2010. The fires are outlined in red in this image, acquired by the Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA’s Aqua satellite. The fires span the borders of Russia’s Chukotskiy, Magadan, and Koryakskiy provinces. Burning in coniferous (evergreen) forests, the fires blanketed northeastern Siberia with thick brown smoke. The smoke hugs the ground near the fires, filling valleys, and soars over clouds farther away from the flames. On August 1, the smoke flowed north from the fires and over the Arctic Ocean. A wide view of the Arctic shows the smoke crossing the Bering Strait and clouding skies over northern Alaska. This image is available in additional resolutions from the MODIS Rapid Response Team here: rapidfire.sci.gsfc.nasa.gov/gallery/?2010213-0801/Russia.... To view more images from this event go to: earthobservatory.nasa.gov/NaturalHazards/event.php?id=44561 NASA image courtesy Jeff Schmaltz, MODIS Rapid Response Team at NASA GSFC. Caption by Holli Riebeek Instrument: Aqua - MODIS NASA Goddard Space Flight Center is home to the nation's largest organization of combined scientists, engineers and technologists that build spacecraft, instruments and new technology to study the Earth, the sun, our solar system, and the universe. Follow us on Twitter Join us on Facebook

  9. Haze over eastern China

    NASA Image and Video Library

    2015-10-26

    On October 17, 2015, the Moderate Resolution Imaging Spectroradiometer (MODIS) aboard NASA’s Terra satellite captured this true-color image of a thick haze hanging over eastern China. In the north, the large city of Beijing is completely obscured from view, as is much of the landscape. The haze thins slightly over the Bohai Sea. Further south, sediment pours into the East China Sea near the city of Shanghai. Heavy haze is common in this region, and tends to worsen in October through January, when cold, heavy air traps pollutants near the surface of the Earth. It is likely that this scene was caused by such a temperature inversion. Normally, air is warmest near the surface of the Earth. But sometimes a mass of warm air will move the cooler air, so the atmosphere actually warms with the altitude. Cool air does not have energy to rise through the warm air, vertical circulation slows and air becomes trapped near the surface. Any pollution that is emitted into the cooler air will also get trapped, increasing low-level air pollution and haze. Credit: NASA/GSFC/Jeff Schmaltz/MODIS Land Rapid Response Team

  10. Survey report: Eastern Caribbean.

    PubMed

    Yinger, N

    1991-01-01

    Over 1 million people live on 8 small islands in the Eastern Caribbean: St. Kitts-Nevis, Montserrat, Grenada, St. Vincent, Antigua, Barbados, St. Lucia, and Dominica. Starting in 1985 the International Planned Parenthood Federation, Western Hemisphere Region has carried out a series of contraceptive prevalence surveys in these countries. Current information is provided by these surveys in the areas of fertility levels and preferences, contraceptive knowledge and use. Also, socioeconomic, historical and demographic background and analysis such as fertility patterns, desire for additional children, and breastfeeding data; contraceptive awareness including family planning methods and sources; contraceptive use by method, source, and timing, satisfaction, and male attitudes are provided in the surveys, but not in the report abstracted here. The total fertility rate (TFR) and the contraceptive prevalence rate (CPR) for the 8 islands are as follows: St. Kitts-Nevis (1984) 2.9 TFR, 40.6 CPR; St. Vincent (1988) 2.9 TFR, 58.3 CPR; Antigua (1988) 1.8 TFR, 52.6 CPR; Barbados (1988) not given, 55.0 CPR; St. Lucia (1988) 3.2 TFR, 47.3 CPR; Dominica (1987) 3.2 TFR, 49.8 CPR. The islands have unusual demographic patterns related to extensive out-migration.

  11. Haze over eastern China

    NASA Image and Video Library

    2017-09-28

    On October 17, 2015, the Moderate Resolution Imaging Spectroradiometer (MODIS) aboard NASA’s Terra satellite captured this true-color image of a thick haze hanging over eastern China. In the north, the large city of Beijing is completely obscured from view, as is much of the landscape. The haze thins slightly over the Bohai Sea. Further south, sediment pours into the East China Sea near the city of Shanghai. Heavy haze is common in this region, and tends to worsen in October through January, when cold, heavy air traps pollutants near the surface of the Earth. It is likely that this scene was caused by such a temperature inversion. Normally, air is warmest near the surface of the Earth. But sometimes a mass of warm air will move the cooler air, so the atmosphere actually warms with the altitude. Cool air does not have energy to rise through the warm air, vertical circulation slows and air becomes trapped near the surface. Any pollution that is emitted into the cooler air will also get trapped, increasing low-level air pollution and haze. Credit: NASA/GSFC/Jeff Schmaltz/MODIS Land Rapid Response Team NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  12. Hospital information system survey in qatar.

    PubMed

    Al-Ali, Rashid; Reti, Shane; Feldman, Henry; Safran, Charles; Niaz, Rashid; Erskine, Alistair; Elmagarmid, Ahmed; Al-Musleh, Abdulwahab

    2013-01-01

    Healthcare can be enhanced by the effective use of information technology to improve the quality and safety of care and many healthcare providers are adopting advanced health information technology to improve their healthcare delivery process. Qatar is a relatively young Middle Eastern country with an ambitious and progressive national strategy to develop its healthcare system, including an advanced e-health infrastructure delivering the right medical information at the right time to clinicians and patients. To assess the effectiveness of such programs, it is important to have a pre-intervention baseline from which comparisons, performance against target measures and forward thinking strategic planning can be grounded. This study presents the first published campus wide survey of Hospital Information Systems in large public and private hospitals in Qatar. To qualitatively assess and describe the current state of Hospital Information Systems in large hospitals in Qatar, and to establish a baseline or reference point for Qatar's readiness for, and adoption of Hospital Information Systems.

  13. 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...

  14. Antibiotic policies in Central Eastern Europe.

    PubMed

    Cizman, Milan; Beovic, Bojana; Krcmery, Vladimir; Barsic, Bruno; Tamm, Eda; Ludwig, Endre; Pelemis, Mojimir; Karovski, Kliment; Grzesiowski, Pavel; Gardovska, Dace; Volokha, Alla; Keuleyan, Emma; Stratchounski, Leonid; Dumitru, Carstina; Titov, Leonid P; Usonis, Vytantas; Dvorák, Peter

    2004-09-01

    To assess the antibiotic policies in Central Eastern European (CEE) countries, a questionnaire on the prevalence of resistance, antibiotic consumption data for ambulatory and hospital care and antibiotic policies, was mailed to national representatives. Data on antibiotic resistance and consumption of antibiotics at national levels are limited and vary considerably among countries. The importance of surveillance data in altering perceptions of the prevalence of resistance is shown by the comparison of surveillance data and interview data. Interview data without surveillance data produced the widest range of estimates of the prevalence of resistance in streptococcus pneumonia -5% in Lithuania and 82% in Belarus. The average consumption of antibiotics in ambulatory care in eight CEE countries in 2001 was 19.35 defined daily doses (DDD)/1000 inhabitants per day, (range 13.1 - 24.8 DDD) and in hospitals in six CEE countries was 2.2 DDD/1000 inhabitants per day (range 1.3-4.5). Over the counter sales of antibiotics are available in some countries. Antibiotic policy interventions do not exist or only apply to specific problems or interventions. Better implementation of antibiotic interventions and education on antibiotic use should be a high priority in this region. An effective strategy requires close co-operation, consultations and partnership at national and international level in particular, via existing international organisations.

  15. Hospital finance.

    PubMed

    Herman, M J

    1998-01-01

    This article summarizes key areas of focus for the analysis of risk in the hospital segment of the health care industry. The article is written from a commercial bank lending perspective. Both for-profit (C-corporations) and 501 (c)(3) not-for-profit segments are addressed.

  16. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  17. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  18. Academic Hospitality

    ERIC Educational Resources Information Center

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  19. Academic Hospitality

    ERIC Educational Resources Information Center

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  20. 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.

  1. Arboreal spiders in eastern hemlock.

    PubMed

    Mallis, Rachael E; Rieske, Lynne K

    2011-12-01

    Eastern hemlock [Tsuga canadensis (L.) Carrière] is a foundation species in forests of eastern North America that plays a key role in ecosystem function. It is highly susceptible to the exotic invasive hemlock woolly adelgid (Adelges tsugae Annand), which is causing widespread hemlock mortality. We surveyed the spider communities of eastern hemlock and deciduous canopies over 2 yr, collecting over 4,000 spiders from 21 families. We found that eastern hemlock canopies harbored a more abundant, rich, and diverse spider community than did deciduous canopies. Five spider families were present in our hemlock collections that were absent from the deciduous collections, including Mysmenidae, Theridiosomatidae, Mimetidae, Lycosidae, and Agelenidae. In hemlock canopies there were 4× the number of web builders, consisting primarily of the Tetragnathidae and Araneidae, than active hunters, consisting primarily of the Anyphaenidae and the Salticidae. Ours is the first in depth study of the spider community in eastern hemlock. Spider abundance in hemlock canopies suggest that they may play a role regulating herbivore populations, and could possibly affect the invasive hemlock woolly adelgid, either through direct consumption of the adelgids themselves or through interactions with classical biological control agents.

  2. Science, Eastern Orthodoxy, and Protestantism.

    PubMed

    Harrison, Peter

    2016-09-01

    This essay considers some of the major theological differences between Eastern and Western traditions of Christianity and puts forward proposals about how these might be related to the divergent trajectories of the formal study of nature in these two cultural contexts. A key difference lies in the “other-worldly” orientation of Eastern Orthodoxy and its emphasis on deification, which contrast sharply with ideas of original sin and fall–redemption theology in the West. These latter ideas came to play a significant role in the rise of Western science, with the sciences being understood as part of a practical redemptive exercise that could help alleviate the material consequences of original sin.

  3. Concurrent Phaeohyphomycosis and Ranavirus Infection in an Eastern Box Turtle ( Terrapene carolina ) in Athens, Georgia, USA.

    PubMed

    Perpiñán, David; Blas-Machado, Uriel; Sánchez, Susan; Miller, Debra L

    2016-07-01

    An eastern box turtle (Terrapene carolina) was found in a stream in the southeastern US, with a mass affecting the distal right forelimb. The turtle developed complications during hospitalization, including lethargy and oral caseous plaques and eventually died. Postmortem analyses diagnosed a mixed infection of phaeohyphomycosis and Ranavirus.

  4. 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.

  5. 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...

  6. 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.

  7. 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...

  8. From Eastern to Western Arabic.

    ERIC Educational Resources Information Center

    Omar, Margaret

    This manual is designed to provide instruction for persons who have learned well a dialect of Eastern Arabic, Levantine, and who desire to use a Western Arabic dialect, Moroccan. Special features of Western Arabic pronunciation, grammar, vocabulary, and social usage are listed. Attention is given to the recognition of correspondences between the…

  9. Eastern New Mexico University. Exemplars.

    ERIC Educational Resources Information Center

    Iannozzi, Maria

    This report describes efforts by Eastern New Mexico University (ENMU) to recast its mission more narrowly while at the same time reducing the sense of remoteness and disconnection, as well as geographic isolation, between the main campus and its branch campuses. In the early 1980s, ENMU suffered from mission drift, in part as a result of its…

  10. 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...

  11. 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…

  12. Citizenship Norms in Eastern Europe.

    PubMed

    Coffé, Hilde; van der Lippe, Tanja

    2010-05-01

    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 Survey data. We investigate mean levels of civic mindedness in these countries and perform regression analyses to investigate whether factors traditionally associated with civic and political participation are also correlated with citizenship norms across Eastern Europe. We show that mean levels of civic mindedness differ significantly across the four Eastern European countries. We find some support for theories on civic and political participation when explaining norms of citizenship, but also demonstrate that individual-level characteristics are differently related to citizenship norms across the countries of our study. Hence, our findings show that Eastern Europe is not a monolithic and homogeneous bloc, underscoring the importance of taking the specificities of countries into account.

  13. 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…

  14. 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...

  15. 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...

  16. 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...

  17. Language in Education in Eastern Africa.

    ERIC Educational Resources Information Center

    Gorman, T. P., Ed.

    This volume contains the papers given at the first Eastern Africa Conference on Language and Linguistics, held in Dar es Salaam in December 1968, under the auspices of the Survey of Language Use and Language Teaching in Eastern Africa. The chief aim of the Conference was to bring together scholars and teachers working in Eastern Africa interested…

  18. Tuberculosis Hospitalization Fees and Bed Utilization in China from 1999 to 2009: The Results of a National Survey of Tuberculosis Specialized Hospitals

    PubMed Central

    Ma, Yan; Mi, Fengling; Liu, Yuhong; Li, Liang

    2015-01-01

    Background China is transitioning towards concentrating tuberculosis (TB) diagnostic and treatment services in hospitals, while the Centers of Disease Control and Prevention (CDC) system will retain important public health functions. Patient expenditure incurred through hospitalization may lead to barriers to TB care or interruption of treatment. Methodology/Principal Findings We conducted a national survey of TB specialized hospitals to determine hospitalization fees and hospital bed utilization in 1999, 2004, and 2009. Hospitalization of TB patients increased 185.3% from 1999 to 2009. While the average hospitalization fees also increased, the proportion of those fees in relation to GDP per capita decreased. Hospitalization fees differed across the three regions (eastern, central, and western). Using a least standard difference (LSD) paired analysis, in 2004, the difference in hospitalization fees was significant when comparing eastern and central provinces (p<0.001) as well as to western provinces (p<0.001). In 2009, the difference remained statistically significant when comparing eastern province hospitalization fees with central provinces (p<0.001) and western provinces (p = 0.008). In 2004 and 2009, the cost associated with hospitalization as a proportion of GDP per capita was highest in the western region. The average in-patient stay decreased from 33 days in 1999 to 26 and 27 days in 2004 and 2009 respectively. Finally, hospital bed utilization in all three regions increased over this period. Conclusions/Significance Our findings show that both the total number of in-patients and hospitalization fees increased from 1999 to 2009, though the proportion of hospitalization fees to GDP per capita decreased. As diagnostic services move to hospitals, regulatory and monitoring mechanisms should be established, and hospitals should make use of the experience garnered by the CDC system through continued strong collaborations. Infrastructure and social protection

  19. Eastern equine encephalitis in Latin America.

    PubMed

    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; Travassos da Rosa, Amelia P; Hernandez, Humberto; Martínez-Torres, Alex O; Tesh, Robert B; Weaver, Scott C

    2013-08-22

    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. 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. 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. 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.).

  20. 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

  1. Building A Middle Eastern Alliance

    DTIC Science & Technology

    2015-02-12

    implementation of NATO model to METO by reviewing NATO and suggesting some applications . Thesis This paper proposes building a Middle Eastern alliance to...ranging from terror activity and insurgency to a full- scale conventional war. The US contribution to the alliance may also include extending its...and alliance history is no different. NATO was founded to oppose a Soviet threat. The threat is long gone but NATO is still extremely relevant and

  2. Eastern Europe: Please stand by

    NASA Astrophysics Data System (ADS)

    Dougan, D. L.; Hoagland, J.; Koehler, J.; Marshall, T.; Sekulow, E.

    1990-05-01

    The objectives of the Task Force on Telecommunications and Broadcasting in Eastern Europe are: (1) to assess and evaluate the current infrastructure, policies, and plans for telecommunications and broadcasting; (2) to make recommendations to the Department of State for short and long-term U.S. private sector involvement and initiatives; and (3) to share with key host country leaders perspectives and expertise of senior U.S. corporate leaders on potential opportunities and obstacles of telecommunications and broadcasting in economic development.

  3. Military Spending in Eastern Europe,

    DTIC Science & Technology

    1987-05-01

    on defense (the sums are less than the corresponding expenditures by the republics) or whether they involve military spending above and beyond that...certain military expenditures on personnel are included in budgetary categories other than defense spending . Transportation of soldiers to their first... expenditures and forces and military spending decisions in Eastern Europe. iii L SUMMARY Although the Soviet Union is the most threatening potential

  4. 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.

  5. 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

  6. 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.

  7. Habitat Suitability Index Models: Eastern cottontail

    USGS Publications Warehouse

    Allen, Arthur W.

    1984-01-01

    The eastern cottontail (Sylvilagus floridanus) is the most widely distributed cottontail in North America (Chapman et al. 1982). The species is considered to be a generalist that occupies a variety of habitats from southern Canada southward into South America (Chapman et al. 1980). The eastern cottontail's range overlaps that of six other species of cottontails (Sylvilagus spp.) and six species of hares (Lepus spp.). Eastern cottontails have been widely transplanted and are believed to be expanding their range northward, particularly in the Northeast (Chapman et al. 1982). The eastern cottontail has been successfully introduced into portions of Oregon and Washington which are outside of the species' natural range (Chapman and Morgan 1973). The eastern cottontail is primarily nocturnal and is a principal game species in the eastern United States.

  8. 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.

  9. Changing hospital payments: implications for teaching hospitals.

    PubMed

    Bentley, J D

    1983-09-01

    Hospitals cannot continue to view themselves only as social institutions whose performance will be assessed on the good they do. Teaching hospitals, in particular, cannot view themselves simply as distinctive combinations of social and educational institutions. Under Medicare's prospective pricing system, the hospital's role as production system is enhanced, and all hospitals must learn to balance the new economic realities as they work with their medical staff to adapt to a changed future.

  10. Multiple Hospital Systems and the Teaching Hospital.

    ERIC Educational Resources Information Center

    Levitan, Mark S.

    1979-01-01

    Although a substantial portion of hospital beds are in institutions that are in multiple hospital systems, the possible benefits to be gained through participation in such systems do not appear to be of sufficient magnitude to either core teaching hospitals or their parent universities to persuade them to join or form a multiple system.…

  11. Critical Access Hospitals (CAH)

    MedlinePlus

    ... Access Hospital from CMS and Critical Access Hospital Finance 101 Manual from TASC. Furthermore, the Joint Commission ... Hospital Mortgage Insurance Program – helps rural healthcare facilities finance new construction, refinance debt, or purchase new equipment ...

  12. Understanding your hospital bill

    MedlinePlus

    ... medlineplus.gov/ency/patientinstructions/000881.htm Understanding your hospital bill To use the sharing features on this ... help you save money. Charges Listed on Your Hospital Bill A hospital bill will list the major ...

  13. Going to the Hospital

    MedlinePlus

    ... Happens in the Operating Room? Going to the Hospital KidsHealth > For Kids > Going to the Hospital Print ... you flowers, balloons, or other treats! previous continue Hospital People You'll meet lots of people in ...

  14. 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

  15. 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

  16. Patterns of Stroke Between University Hospitals and Nonuniversity Hospitals in Mainland China: Prospective Multicenter Hospital-Based Registry Study.

    PubMed

    Wang, Deren; Liu, Junfeng; Liu, Ming; Lu, Chuanzhen; Brainin, Michael; Zhang, Juying

    2017-02-01

    In China, stroke has risen to the first commonest cause of death. Currently published data on stroke come mainly from university hospitals and less from community hospitals, especially lacking information on stroke focusing on the differences between university hospitals and nonuniversity hospitals. Therefore we aimed to investigate the patterns and differences of acute stroke between university hospitals and nonuniversity hospitals in China. The survey was conducted in 281 hospitals in China: 62 in the west, 85 in the middle, and 134 in the eastern regions. The participating hospitals were sorted into university hospitals (n = 93) and nonuniversity hospitals (n = 118). We prospectively registered patients with acute stroke within 7 days of symptom onset between 1 April and 20 May 2006. The diagnosis of stroke was defined by World Health Organization criteria, and the pathologic types of stroke were determined by clinical and computed tomography/magnetic resonance imaging findings. The demographic data, pathologic types of stroke, and outcomes (death or disability) at discharge (or 30 days if not discharged) were collected. Disability was defined as modified Rankin Scale (mRs) score >2. Basic characteristics, pathologic types of stroke, and functional outcomes were compared between university hospitals and nonuniversity hospitals. We enrolled 5273 patients (3135 males; mean age, 65 ± 12 years), of which ischemic stroke accounted for 70.8% (3733), intracranial hemorrhage for 25.7% (1357), and subarachnoid hemorrhage for 3.5% (183). Most of the patients (3555, or 67.4%) were from nonuniversity hospitals, and 1718 patients (32.6%) came from university hospitals. There were no significant differences between university hospitals and nonuniversity hospitals in terms of age, sex, pathologic types of stroke, and history of stroke (all P > 0.05), except the less stroke severity (mRS) on admission (3.1 ± 1.4 vs. 3.2 ± 1.3; P = 0.005) in patients from nonuniversity

  17. Income Tax--Section 501 (c) (3)--Qualification of Hospitals for Tax Exempt Status as Charitable Organizations, Eastern Kentucky Welfare Rights Organization v. Simon, 506 F. 2d 1278 (D.C. Cir. 1974), cert. granted, 95 S. Ct. 1974 (1975) (No. 74-1124)

    ERIC Educational Resources Information Center

    Dwyer, Kevin J.

    1975-01-01

    The Court of Appeals for the District of Columbia upheld the validity of the Internal Revenue Service ruling that allows nonprofit hospitals to qualify as charitable institutions without requiring them to provide services at reduced rates for persons unable to pay. This is a reversal of existing law regarding tax exempt status for charitable…

  18. Relations between ethnic Croats and ethnic Serbs at Vukovar General Hospital in wartime and peacetime.

    PubMed

    Bloom, Joshua D; Sondorp, Egbert

    2006-01-01

    This article examines war and peacetime ethnic relations at Vukovar General Hospital in Croatia's Eastern Slavonia region. A negotiated peace agreement paved the way for a multi-sectored approach to the reintegration of Eastern Slavonia back into the state and rapprochement between ethnic groups under the supervision of a United Nations transitional administration. This case study provides a glimpse into the realities of those peace-building processes on an institutional level in Eastern Slavonia's healthcare system. The reintegration of Vukovar hospital, the transition of Eastern Slavonia's health sector and peace-building in the region in general received much deserved accolades despite some flaws and minor setbacks. These experiences can still serve as a model for the rest of Croatia and for other countries emerging from civil conflicts.

  19. The Soviet Economic Dilemma of Eastern Europe.

    DTIC Science & Technology

    1986-05-01

    terms of trade, overinvestment, the hard currency debt crisis , and problems in adopting and diffusing new technologies. At times Soviet policies have...Surpluses with Eastern Europe ........... 31 10. Soviet Trade Surpluses with East European Countries in Crisis ...trade until 1979, and then again in 1981 dur- ing the Polish crisis . Moreover, Soviet terms of trade with Eastern Europe have improved very rapidly

  20. Reduction in Force in Rural Eastern Kentucky.

    ERIC Educational Resources Information Center

    Prickett, R. L.; And Others

    This paper examines factors related to the reduction of certified school personnel in Eastern Kentucky rural school districts. The economy of Eastern Kentucky has relied heavily on the coal industry, which during the past several years has suffered losses resulting in job layoffs and closure of companies. Economic distress caused a declining…

  1. Reduction in Force in Rural Eastern Kentucky.

    ERIC Educational Resources Information Center

    Prickett, R. L.; And Others

    This paper examines factors related to the reduction of certified school personnel in Eastern Kentucky rural school districts. The economy of Eastern Kentucky has relied heavily on the coal industry, which during the past several years has suffered losses resulting in job layoffs and closure of companies. Economic distress caused a declining…

  2. Water quality in the eastern Iowa basins

    USGS Publications Warehouse

    Kalkhoff, Stephen J.; Barnes, Kymm 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.

  3. 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...

  4. 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...

  5. 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...

  6. 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…

  7. 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…

  8. The Eratosthenes Seamount - Eastern Mediterranean

    NASA Astrophysics Data System (ADS)

    Ehrhardt, A.; Schnabel, M.; Damm, V.

    2012-04-01

    The Eratosthenes Seamount forms a prominent landmark in the Eastern Mediterranean. It is located south of Cyprus with the Levantine Basin on its eastern side, the Herodotus Basin on its western side and the Nile Cone south of the seamount. The Eratosthenes Seamount rises up to 750 m below sea surface and is about 1200 m higher than the surrounding seafloor of the Levantine Basin and the Nile Cone sediments. The Eratosthenes Seamount is considered as a continental fragment of the former African-Nubian Plate that was rifted to its present position relative to Africa during the formation of the Tethyan Ocean. In 2010 a detailed geophysical survey was carried out in the area of the Eratosthenes Seamount by the Federal Institute for Geosciences and Natural Resources of Germany including multichannel seismic (MCS), refraction seismics, magnetic, gravity and magnetotelluric data acquisition. First results show a highly deformed seamount, with a plateau-like top that is impacted by west-east trending graben formation. The slopes of the seamount are eroded showing deep incised ripple patterns and recent submarine landslides. The Eratosthenes Seamount produces also a prominent magnetic and gravity anomaly, both supporting its uniqueness in the area of the Eastern Mediterranean. Velocity information by refraction seismic modeling, as well as the models of the magnetic and gravity data show evidence for a volcanic core of the seamount with carbonate layers on top of the volcanic core. The slopes of the seamount terminate against a conspicuous rim-like escarpment that forms in addition the northern and western termination of the Messinian Evaporites in the study area. The MCS and refraction seismic data show a very deep Levantine Basin with maximum acoustic basement depths of 12 to 14 km very close to the slope of the Eratosthenes Seamount. The deepest sediments resolved by the MCS data are of Lower Cretaceous to Jurassic age. The refraction seismic model shows a 14 km thick

  9. Specialty hospitals: can general hospitals compete?

    PubMed

    Dummit, Laura A

    2005-07-13

    The rapid increase in specialty cardiac, surgical, and orthopedic hospitals has captured the attention of general hospitals and policymakers. Although the number of specialty hospitals remains small in absolute terms, their entry into certain health care markets has fueled arguments about the rules of "fair" competition among health care providers. To allow the smoke to clear, Congress effectively stalled the growth in new specialty hospitals by temporarily prohibiting physicians from referring Medicare or Medicaid patients to specialty hospitals in which they had an ownership interest. During this 18-month moratorium, which expired June 8, 2005, two mandated studies of specialty hospitals provided information to help assess their potential effect on health care delivery. This issue brief discusses the research on specialty hospitals, including their payments under Medicare's hospital inpatient payment system, the quality and cost of care they deliver, their effect on general hospitals and on overall health care delivery, and the regulatory and legal environment in which they have proliferated. It concludes with open issues concerning physician self-referral and the role of general hospitals in providing a range of health care services.

  10. Hospital marketing revisited.

    PubMed

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.

  11. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

    Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

    2004-01-01

    Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

  12. Measuring Rural Hospital Quality

    ERIC Educational Resources Information Center

    Moscovice, Ira; Wholey, Douglas R.; Klingner, Jill; Knott, Astrid

    2004-01-01

    Increased interest in the measurement of hospital quality has been stimulated by accrediting bodies, purchaser coalitions, government agencies, and other entities. This paper examines quality measurement for hospitals in rural settings. We seek to identify rural hospital quality measures that reflect quality in all hospitals and that are sensitive…

  13. Hospital libraries in perspective.

    PubMed Central

    Holst, R

    1991-01-01

    The proliferation of hospital libraries since World War II has created a generation of librarians who take for granted the existence of libraries in hospitals. A literature review for the first half of the twentieth century presents a picture of uncertainty and struggle for identity for the hospital library. Then as now, hospital libraries reflect the institutions within which they operate. A brief history of the development of the American hospital provides a context for describing the various roles that the hospital library has played within its parent institution during the twentieth century. Some personal reflections on working in a hospital library are also presented. PMID:1998812

  14. Competition among hospitals.

    PubMed

    Noether, M

    1988-09-01

    The traditional view of hospital competition has posited that hospitals compete primarily along 'quality' dimensions, in the form of fancy equipment to attract admitting physicians and pleasant surroundings to entice patients. Price competition among hospitals is thought to be non-existent. This paper estimates the effects of various hospital market characteristics on hospital prices and expenses in an attempt to determine the form of hospital competition. The results suggest that both price and quality competition are greater in markets that are less concentrated, although the net effect of the two on prices is insignificant. It appears, therefore, that, despite important distortions, hospital markets are not immune to standard competitive forces.

  15. Predicting the Eastern Mediterranean Basin

    NASA Astrophysics Data System (ADS)

    Royden, L.

    2011-12-01

    From ~30 Ma onwards, the evolution of the Mediterranean region has been dominated by the rapid migration of thin-skinned thrust-belts. Thrust belt migration has been accommodated by the opening of "back arc type" basins within the upper plate of the thrust belts. Migration of these thrust belts is associated with the migration of subduction systems where subduction and thrusting are driven largely by negative slab buoyancy. Where the subducting slab has large negative buoyancy, thrust belt migration is commonly rapid. Where buoyant continental lithosphere enters the subduction system, subduction ceases quickly. Hence the large-scale tectonic evolution of the Mediterranean basin is largely pre-conditioned by its paleogeography. This can be quantitatively illustrated for the Hellenic subduction system where the post Eocene evolution of the Hellenic thrust belt can be ascribed to the buoyancy of the lithosphere subducted. Entry of the Ionian oceanic lithosphere into a slow-moving trench at 10-15 Ma explains the increase in subduction rate along the central part of the trench, to ~35 mm/yr at present, while subduction rates along strike to the northeast, where continental/transitional crust is subducted, remain less than ~10 mm/yr. Using quantitative modeling of the Hellenic subduction system in post Eocene time, it is possible to approximate how this thrust belt, and the active subduction belt of the eastern Mediterranean, will evolve over the next 10 m.y. This exercise suggests that the large-scale evolution of the eastern Mediterranean basin will be strikingly similar to that of the western Mediterranean basin from 20-0 Ma. This highlights the common dynamic mechanism that shapes the large scale deformation and morphology of the Mediterranean basin.

  16. 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.

  17. Reference equation for spirometry interpretation for Eastern India.

    PubMed

    Dasgupta, Angira; Ghoshal, Aloke Gopal; Mukhopadhyay, Ansuman; Kundu, Susmita; Mukherjee, Subhadip; Roychowdhury, Sushmita; Dhar, Raja; Sengupta, Sumit

    2015-01-01

    Spirometry measurements are interpreted by comparing with reference values for healthy individuals that have been derived from multiple regression equations from earlier studies. There are only two such studies from Eastern India, both by Chatterjee et al., one each for males and females. These are however single center and approximately two decades old studies. (1) to formulate a new regression equation for predicting FEV1 and FVC for eastern India and (2) to compare the results to the previous two studies by Chatterjee et al. Healthy nonsmokers were recruited through health camps under the initiative of four large hospitals of Kolkata. Predicted equations were derived for FEV1, FVC and FEV1/FVC in males and females separately using multiple linear regression, which were then compared with the older equations using Bland-Altman method. The Bland-Altman analyses show that the mean bias for females for FVC was 0.39 L (95% limits of agreement 1.32 to -0.54 L) and for FEV1 was 0.334 L (95% limits of agreement of 1.08 to -0.41 L). For males the mean bias for FEV1 was -0.141 L, (95% limits of agreement 0.88 to -1.16 L) while that for FVC was -0.112 L (95% limits of agreement 0.80 to -1.08 L). New updated regression equations are needed for predicting reference values for spirometry interpretation. The regression equations proposed in this study may be considered appropriate for use in current practice for eastern India until further studies are available.

  18. 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.

  19. [Convent nursing in Polish hospitals from 1939].

    PubMed

    Halat, M

    2000-01-01

    The author, Sister of Charity and Mother Superior of the Children's Home in Tarnów, describes the attitude of the authorities of the Polish People's Republic towards convent nursing in hospitals. The problem is exemplified by the situation of the Cracow Province of the Order of the Sisters of Charity. Apart from this main theme, Sister Mirosława Hałat says a little about the establishment of the Order and the role it played in Polish hospital care. Before presenting the fundamental problems related to the topic of the article, the author presents numerical data showing the Sisters of Charity's involvement in hospital care between World War I and World War II. This facilitates a comparison of the possibilities of providing hospital care by the Sisters of Charity at a later time. The author also describes the persecutions of the Sister of Charity by the German occupiers. Her main reflections are divided into several parts. The period from 1945 to 1949 covers the time when the Sisters of Charity tried to engage actively in the reconstruction of the ruined Polish hospital system. This involved leaving the former Polish eastern borderland and taking up duties in the so-called Regained Territories. The period from 1950 to 1989 describes the conscious, planned and ideologically directed policies of the authorities of the Polish People's Republic to nullify or at least diminish the role of the Sisters of Charity in Polish hospitals. Quoting numerous accounts and documents, the author tries to recreate the atmosphere of those times. She also writes about the Sisters of Charity's preparation for work in hospitals as well as the possibilities of their education after the war. The article presents the Sisters of Charity's activity under very difficult political conditions and is complemented by a great number of figures, graphs and source documents.

  20. Seasonal variation and hypertensive disorders of pregnancy in eastern Sudan.

    PubMed

    Ali, A A; Adam, G K; Abdallah, T M

    2015-02-01

    The aim of this study was to investigate the seasonal variation and hypertensive disorders of pregnancy in eastern Sudan, in the period between January 2008 and December 2010. The medical files of women attending at Kassala hospital, eastern Sudan with hypertension, with or without proteinuria were retrospectively retrieved. The data of patients with hypertensive disorders of pregnancy were compared with a similar number of controls that were normotensive and non-proteinuric. During the study period, there were 9,578 deliveries; 153 patients had hypertensive disorders of pregnancy, yielding an incidence rate of 1.6%. Of all cases and controls (306), there were 183 (59.8%) deliveries in winter, 84 (27.5%) in summer and 39 (12.7%) in autumn. The highest rate of pre-eclampsia was in winter (1.1%) (CI = 1.1-2.7, OR = 1.7, p = 0.004) and the lowest rate was in autumn (0.2%) (CI = 0.4-1.8, OR = 0.8, p = 0.758.). Our study revealed significant association between the incidence of hypertensive disorders of pregnancy and the winter season (103 (67.3%) vs 80 (52.3%), p = 0.001). Thus, more attention in the winter season might reduce the morbidity and mortality of hypertensive disorders of pregnancy.

  1. Habitat Suitability Index Models: Eastern brown pelican

    USGS Publications Warehouse

    Hingtgen, Terrence M.; Mulholland, Rosemarie; Zale, Alexander V.

    1985-01-01

    A review and synthesis of existing information were used to develop a habitat model for the eastern brown pelican (Pelecanus occidentalis carolinensis). The model is scaled to produce an index of habitat suitability between 0 (unsuitable habitat) and 1.0 (optimal habitat) for coastal areas within the eastern brown pelican's breeding range. Habitat suitability indices are designed for use with the Habitat Evaluation Procedures previously developed by the U.S. Fish and Wildlife Service. Guidelines for application of the eastern brown pelican habitat model and techniques for measuring model variables are described.

  2. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    ERIC Educational Resources Information Center

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  3. Suicides following inpatient psychiatric hospitalization: A nationwide case control study.

    PubMed

    Winkler, Petr; Mladá, Karolína; Csémy, Ladislav; Nechanská, Blanka; Höschl, Cyril

    2015-09-15

    Research shows the elevated risk of suicide associated with current or recent inpatient psychiatric hospitalization. However, it is unclear whether this applies in the area of post-communist Central and Eastern Europe where mental health care has not been deinstitutionalized yet. The present study aims to examine the rates of suicides among psychiatric patients during and shortly after discharge from inpatient hospitalization in the Czech Republic. All inpatient psychiatric hospitalizations and all suicides committed between 2008 and 2012 have been merged on an individual data basis. The time horizon between the admission and two months after the discharge from inpatient psychiatric facility was utilized and multiple logistic regression was performed to calculate the odds of committing suicide. A total of 137,290 inpatients were hospitalized in Czech psychiatric facilities between 2008 and 2012, and 402 of the inpatients committed suicide during the hospitalization or within the 2 months after the discharge. Highly elevated risks of suicides were found to be associated with being a male, having a history of multiple hospitalizations, and having a diagnosis of affective, anxiety, or personality disorder. Limitations are related to the design of the study, and its reliance on routinely collected data. Also, it was not possible to assess the odds of suicide associated with inpatient psychiatric hospitalization against the odds of suicide in general population. During psychiatric treatment and recovery, suicial behavior and idealiation is increased. In psychiatry, hospitalization may be a risky period for suicide behavior. Suicide rates during and soon after the psychiatric hospitalization identified in this study from Central and Eastern Europe are similar to the findings from Western Europe. Preventive strategies should be tailored accordingly. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Dust Shrouds the Eastern Mediterranean

    NASA Technical Reports Server (NTRS)

    2002-01-01

    On October 18, 2002, a large dust plume extended across countries bordering the eastern Mediterranean Sea. Information on the horizontal and vertical extent of the dust are provided by these views from the Multi-angle Imaging SpectroRadiometer (MISR). The left-hand panel portrays the scene as viewed by the instrument's vertical-viewing (nadir) camera. Here only some of the dust over eastern Syria and southeastern Turkey can be discerned. The dust is much more obvious in the center panel, which is a view from MISR's most steeply forward-looking camera. In addition, this perspective makes shadows cast by clouds onto the dust layer more apparent, providing a visual clue that the dust is at a lower altitude than these clouds.

    The right-hand panel is an elevation field derived from automated MISR stereoscopic processing, in which the heights of clouds and certain parts of the dust plume are retrieved. Because the stereoscopic approach makes use of features within the images that exhibit spatial contrast, heights for much of the dust plume (as well as the ocean surface) could not be retrieved, and these areas are shown in dark gray. Clouds within the image area are situated between about 2 and 5.5 kilometers above sea level, and the dust is located below most of the cloud, at heights of about 1.5 kilometers or less. When the stereo retrieval determines that a location is at a near-surface altitude, digital terrain elevation data are displayed instead. The highest clouds in this scene appear as the orange and red areas, and mountainous regions are displayed in light blue and green.

    The Multi-angle Imaging SpectroRadiometer observes the daylit Earth continuously from pole to pole, and every 9 days views the entire globe between 82 degrees north and 82 degrees south latitude. These data products were generated from a portion of the imagery acquired during Terra orbit 15072. The panels cover an area of about 380 kilometers x 827 kilometers, and utilize data from

  5. Eastern Renewable Generation Integration Study

    SciTech Connect

    Bloom, Aaron; Townsend, Aaron; Palchak, David; Novacheck, Joshua; King, Jack; Barrows, Clayton; Ibanez, Eduardo; O'Connell, Matthew; Jordan, Gary; Roberts, Billy; Draxl, Caroline; Gruchalla, Kenny

    2016-08-01

    The Eastern Interconnection (EI) is one of the largest power systems in the world, and its size and complexity have historically made it difficult to study in high levels of detail in a modeling environment. In order to understand how this system might be impacted by high penetrations (30% of total annual generation) of wind and solar photovoltaic (PV) during steady state operations, the National Renewable Energy Laboratory (NREL) and the U.S. Department of Energy (DOE) conducted the Eastern Renewable Generation Integration Study (ERGIS). This study investigates certain aspects of the reliability and economic efficiency problem faced by power system operators and planners. Specifically, the study models the ability to meet electricity demand at a 5-minute time interval by scheduling resources for known ramping events, while maintaining adequate reserves to meet random variation in supply and demand, and contingency events. To measure the ability to meet these requirements, a unit commitment and economic dispatch (UC&ED) model is employed to simulate power system operations. The economic costs of managing this system are presented using production costs, a traditional UC&ED metric that does not include any consideration of long-term fixed costs. ERGIS simulated one year of power system operations to understand regional and sub-hourly impacts of wind and PV by developing a comprehensive UC&ED model of the EI. In the analysis, it is shown that, under the study assumptions, generation from approximately 400 GW of combined wind and PV capacity can be balanced on the transmission system at a 5-minute level. In order to address the significant computational burdens associated with a model of this detail we apply novel computing techniques to dramatically reduce simulation solve time while simultaneously increasing the resolution and fidelity of the analysis. Our results also indicate that high penetrations of wind and PV (collectively variable generation (VG

  6. Eastern Floor of Holden Crater

    NASA Technical Reports Server (NTRS)

    2002-01-01

    (Released 15 April 2002) The Science Today's THEMIS image covers territory on the eastern floor of Holden Crater, which is located in region of the southern hemisphere called Noachis Terra. Holden Crater is 154 km in diameter and named after American Astronomer Edward Holden (1846-1914). This image shows a mottled surface with channels, hills, ridges and impact craters. The largest crater seen in this image is 5 km in diameter. This crater has gullies and what appears to be horizontal layers in its walls. The Story With its beautiful symmetry and gullies radially streaming down to the floor, the dominant crater in this image is an impressive focal point. Yet, it is really just a small crater within a much larger one named Holden Crater. Take a look at the context image to the right to see just how much bigger Holden Crater is. Then come back to the image strip that shows the mottled surface of Holden Crater's eastern floor in greater detail, and count how many hills, ridges, channels, and small impact craters can be seen. No perfectly smooth terrain abounds there, that's for sure. The textured terrain of Holden Crater has been particularly intriguing ever since the Mars Orbital Camera on the Mars Global Surveyor spacecraft found evidence of sedimentary rock layers there that might have formed in lakes or shallow seas in Mars' ancient past. This finding suggests that Mars may have been more like Earth long ago, with water on its surface. Holden Crater might even have held a lake long ago. No one knows for sure, but it's an exciting possibility. Why? If water was once on the surface of Mars long enough to form sedimentary materials, maybe it was there long enough for microbial life to have developed too. (Life as we know it just isn't possible without the long-term presence of liquid water.) The question of life on the red planet is certainly tantalizing, but scientists will need to engage in a huge amount of further investigation to begin to know the answer. That

  7. 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.

  8. 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.

  9. Attenuation Tomography in Eastern Russia

    NASA Astrophysics Data System (ADS)

    Rowe, C. A.; Phillips, W. S.; Hartse, H. E.; Steck, L. K.; Begnaud, M. L.; Mackey, K. G.; Fujita, K.

    2006-12-01

    We are using catalog amplitude parameters to derive a 2D function that maps laterally-varying attenuation features for eastern Siberia and the Russian Far East. Our information is from the Michigan State University (MSU) Siberia database, compiled through cooperative efforts of MSU, Russian network operators and Los Alamos researchers. The database also includes information from teleseismic bulletins, such as those provided by the International Seismological Centre, U.S. Geological Survey and Alaska Earthquake Information Center. For Siberia we have ~242,000 S and Sg amplitude readings and ~140,000 P and Pg amplitude readings for source-to-receiver distances in the local to regional range (0 to 15 degrees). In Kamchatka, ~155,000 S amplitude measurements and 85,000 P amplitudes are reported. We derive the 2D attenuation mapping using tomographic methods. The results of our inversion will be compared with known tectonic features in northeastern Russia and with velocity perturbation features derived for the region in previous work.

  10. Social Epidemiology and Eastern Wisdom

    PubMed Central

    Brunner, Eric; Hiyoshi, Ayako; Cable, Noriko; Honjo, Kaori; Iso, Hiroyasu

    2012-01-01

    Social epidemiology is the field of study that attempts to understand the social determinants of health and the dynamics between societal settings and health. In the past 3 decades, large-scale studies in the West have accumulated a range of measures and methodologies to pursue this goal. We would like to suggest that there may be conceptual gaps in the science if Western research models are applied uncritically in East Asian studies of socioeconomic, gender, and ethnic inequalities in health. On one hand, there are common concerns, including population aging and gendered labor market participation. Further, international comparison must be built on shared concepts such as socioeconomic stratification in market economies. On the other hand, some aspects of health, such as common mental disorders, may have culturally specific manifestations that require development of perspectives (and perhaps novel measures) in order to reveal Eastern specifics. Exploring and debating commonalities and differences in the determinants of health in Oriental and Occidental cultures could offer fresh inspiration and insight for the next phase of social epidemiology in both regions. PMID:22790787

  11. The Eastern Region Public Health Observatory.

    PubMed

    Wright, Kerri

    2014-06-03

    The Eastern Region Public Health Observatory (ERPHO) became part of Public Health England on April 1 2013. Its website provides population health data, analysis and interpretation to support healthcare professionals in commissioning, prioritising and improving health outcomes.

  12. LIMITATIONS TO EASTERN REDCEDAR SURVIVAL AND GROWTH

    EPA Science Inventory

    Invasive woody plant species are degrading the structure and function of rangeland ecosystems throughout the world. A species of particular concern in Great Plains grasslands is eastern redcedar (Juniperus virginiana), which has rapidly spread due to fire suppression and intenti...

  13. Tropical Storm Gilma in Eastern Pacific

    NASA Image and Video Library

    An animation of satellite observations shows the progression of Tropical Storm Gilma from August 7-10, 2012, along the coast of the Eastern Pacific Ocean. This visualization was created by the NASA...

  14. Morbidity pattern among refugees in Eastern Ethiopia.

    PubMed

    Bisrat, F; Berhane, Y; Mamo, A; Asefa, E

    1995-11-01

    The population of refugees in eastern Africa and the health problems affecting them are enormous. This study was conducted to document the morbidity pattern among refugees in eastern Ethiopia. The study was conducted to document the morbidity pattern among refugees in eastern Ethiopia. The study utilized a descriptive cross sectional design. Data were collected using a uniform format from all refugee camps in the eastern Ethiopia. Respiratory tract infection and diarrhoeal diseases were identified to be the major causes of morbidity, accounting for 31.8% and 27.3% respectively in children under five years, and for 34.9% and 8.5% respectively in the other age groups. The findings were consistent with other studies done in refugee populations elsewhere. Universality of the problems was noted and a coordinated multidisciplinary approach is recommended to alleviate the health problems of refugees.

  15. LIMITATIONS TO EASTERN REDCEDAR SURVIVAL AND GROWTH

    EPA Science Inventory

    Invasive woody plant species are degrading the structure and function of rangeland ecosystems throughout the world. A species of particular concern in Great Plains grasslands is eastern redcedar (Juniperus virginiana), which has rapidly spread due to fire suppression and intenti...

  16. 75 FR 45611 - Texas Eastern Transmission LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-03

    ... Energy Regulatory Commission Texas Eastern Transmission LP; Notice of Application July 27, 2010. Take notice that on July 15, 2010, Texas Eastern Transmission (Texas Eastern), P.O. Box 1642, Houston, Texas... enable Texas Eastern to provide up to 112,000 dekatherms per day (Dth/d) of firm lateral line...

  17. 76 FR 7833 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... Energy Regulatory Commission 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... Gas Act (NGA) for its proposed TEAM 2012 Project. Specifically, Texas Eastern requests: (i...

  18. 78 FR 43874 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... Energy Regulatory Commission Texas Eastern Transmission, LP; Notice of Application On July 2, 2013, Texas Eastern Transmission, LP (Texas Eastern) filed with the Federal Energy Regulatory Commission (Commission... more fully in the Application, Texas Eastern states that it lacks the documentation to confirm the...

  19. 76 FR 38381 - Texas Eastern Transmission, LP; Notice of Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-30

    ... Energy Regulatory Commission 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... proposed TEAM 2012 Project. Specifically, Texas Eastern's original application is amended to reduce the...

  20. 76 FR 44898 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-27

    ...] Texas Eastern Transmission, LP; Notice of Application Take notice that on July 1, 2011, Texas Eastern Transmission (Texas Eastern), P.O. Box 1642, Houston, Texas 77251-1642, filed in Docket No. CP11-508-000, an... associated facilities to enable Texas Eastern to provide up to 27,000 dekatherms per day (Dth/d) of firm...

  1. 78 FR 79687 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-31

    ...-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... offshore Gulf of Mexico. Specifically, Texas Eastern proposes to abandon 29.82 miles of 20-inch diameter...

  2. 76 FR 49760 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-11

    ... Energy Regulatory Commission 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... Uniontown Compressor Station located in Fayette County, Pennsylvania. Texas Eastern states that there will...

  3. 77 FR 20015 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-03

    ... Energy Regulatory Commission 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... Federal offshore waters in the Gulf of Mexico offshore Louisiana. Texas Eastern proposes to abandon its 13...

  4. 77 FR 26534 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-04

    ... Energy Regulatory Commission 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... directed to Marcy F. Collins, Associate General Counsel, Texas Eastern Transmission, LP, P.O. Box...

  5. 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...

  6. 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.

  7. 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.

  8. Eastern shelf exploration yields to multiple techniques

    SciTech Connect

    Verseckes, M.S.; Wilson, G.E.

    1995-06-01

    Hydrocarbon exploration along the Eastern Shelf of Texas is challenging, particularly in multi-pay areas. One group of Eastern Shelf explorationists is improving their drilling results using an innovative multi-technique approach. They are combining seismic and near surface geochemical data with subsurface geologic information and dramatically increasing their commercial success. Using this method has yielded total success rates over 70% in an area that typically exhibits completion ratios of some 30%. Two case histories show this approach.

  9. Alabama successes spur interest in eastern Gulf

    SciTech Connect

    Redden, J.

    1985-11-01

    The shallow waters of the eastern fringe of the Gulf of Mexico are becoming a world-class offshore gas play. Spurred by the success ratio offshore Alabama, the water off Mississippi and Florida are drawing intense interest as oil companies attempt to extend the prolific Norphlet formation. Sitting at the heart of the recent interest in the eastern Gulf are the state and federal waters off Alabama. Exploration and drilling activity in the area are discussed.

  10. Hospitals as health educators

    MedlinePlus

    ... than your local hospital. From health videos to yoga classes, many hospitals offer information families need to ... care and breastfeeding Parenting Baby sign language Baby yoga or massage Babysitting courses for teens Exercise classes ...

  11. Help prevent hospital errors

    MedlinePlus

    ... www.ncbi.nlm.nih.gov/pubmed/23330698 . The Joint Commission. Hospital: 2014 National Patient Safety Goals. www.jointcommission. ... October 24, 2014. Accessed October 27, 2016. The Joint Commission. Hospital: 2016 National Patient Safety Goals. Updated January ...

  12. Hospital Dermatology, Introduction.

    PubMed

    Fox, Lindy P

    2017-03-01

    Inpatient dermatology is emerging as a distinct dermatology subspecialty where dermatologists specialize in caring for patients hospitalized with skin disease. While the main focus of inpatient dermatology is the delivery of top-quality and timely dermatologic care to patients in the hospital setting, the practice of hospital-based dermatology has many additional components that are critical to its success.

  13. 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

    ... Surface Transportation Board DeQueen and 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...

  14. Russian romances: emotionalism and spirituality in the writings of "Eastern Front" nurses, 1914-1918.

    PubMed

    Hallett, Christine

    2009-01-01

    The nursing work of the First World War is usually associated with the trench warfare of the Western Front. Nurses were based within fairly permanent casualty clearing stations and field hospitals, and patients were moved "down the line" to base hospitals, and then to convalescent hospitals "at home." The nurses and volunteers who worked on the Eastern Front and offered their services to the letuchka or "flying columns" of the Russian medical services had a very different experience. They worked with highly mobile units, following a rapidly moving "front line." The diaries of three British (one Anglo-Russian) nurses who worked alongside Russian nursing sisterhoods in three different flying columns-Violetta Thurstan (Field Hospital and Flying Column), Florence Farmborough (With the Armies of the Tsar) and Mary Britnieva (One Woman's Story)--stand as an important corpus of nursing writing. Written in a highly romantic style, they take up similar themes around their work on the Eastern Front as a heroic journey through a dreamlike landscape. Each nurse offers a portrayal of the Russian character as fine and noble. The most important themes deal with the romance of nursing itself, in which nursing work is portrayed as both character-testing and a highly spiritual pursuit.

  15. Positioning hospitals: a model for regional hospitals.

    PubMed

    Reddy, A C; Campbell, D P

    1993-01-01

    In an age of marketing warfare in the health care industry, hospitals need creative strategies to compete successfully. Lately, positioning concepts have been added to the health care marketer's arsenal of strategies. To blend theory with practice, the authors review basic positioning theory and present a framework for developing positioning strategies. They also evaluate the marketing strategies of a regional hospital to provide a case example.

  16. 2. View northwest of main hospital building complex, hospital building ...

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

    2. View northwest of main hospital building complex, hospital building (Building 90), administration and clinical hospital building (Building 88), and hospital building (Building 91) - National Home for Disabled Volunteer Soldiers Western Branch, 4101 South Fourth Street, Leavenworth, Leavenworth County, KS

  17. [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.

  18. Syphilis in prostitutes from Eastern Europe.

    PubMed

    Smacchia, C; Parolin, A; Di Perri, G; Vento, S; Concia, E

    1998-02-21

    During the 1990s, a striking increase in the notification rate for syphilis has been observed in the Russian Federation and Eastern Europe. Given easier current access to international travel and migration from Eastern Europe, this trend is likely to involve Western Europe as well. To investigate this possibility, 110 foreign-born prostitutes (32 from Albania, 34 from tropical Africa, and 44 from Eastern Europe) presenting to an outpatient clinic in Verona, Italy, over a 19-month period were screened for sexually transmitted diseases (STDs). At their initial visit, HIV infection was detected in 2 prostitutes (both African); 9 women were positive for serologic markers of active syphilis (5 from the former Soviet Union, 1 from Romania, 1 from Croatia, and 2 from Africa). By country of origin, the incidence of active syphilis was highest among immigrants from the former Soviet Union (5/18 or 27.8%). Although 65.9% of Eastern European women compared with 56.1% of women from other regions had been prostitutes for less than 1 year, Eastern European prostitutes were significantly more likely than their counterparts from Africa and Albania to have had more than 30 partners per week (70.5% vs. 51.5%) and to have become pregnant during the study period (40.9% vs. 11.8% of Africans and 18.7% of Albanians). Compared with their other Eastern European counterparts, Russian women had the least past experience in prostitution (77.8% had less than 1 year) and the highest incidence of pregnancy (50%). These findings indicate that Eastern European immigrants, especially those from the former Soviet Union, have little knowledge of STD risks or effective contraceptive use.

  19. Eastern and Western Approaches to Medicine

    PubMed Central

    Tsuei, Julia J.

    1978-01-01

    An objective comparison of Eastern and Western approaches to medicine is necessary to further evaluate the validity of Oriental medical techniques such as acupuncture. The development of medicine in Western nations follows the way of hypothetical deduction and the Eastern approach uses the inductive method. The Western approach clearly divides the health from the disease, yet the Eastern approach considers health as a balanced state versus disease as an unbalanced state. The Western approach tends to change the environment and the Eastern way is to prefer to adapt to the environment. There are numerous difficulties in comparing these two approaches. The same terminology may apply to entirely different facts, the teaching and learning methods are quite different, and the evaluation of the treatment is almost not comparable. In order to help understand the Eastern approach better, an understanding is needed of the basic Chinese concepts: the concept of a small universe living in a large universe; the duality concept of yin and yang; the concept of anatomy; the concept of physiology in Chinese medicine—the state of equilibrium expressed by the five elements; the concept of pathophysiology expressed by the external and internal insults; the concept of maintaining and promoting health expressed by the circulation of chi and hsieh; the therapeutic concept in Chinese medicine—the normalization or reestablishment of balance of the body function; the concept of preventive medicine. PMID:664653

  20. Subseasonal predictions of eastern US hot weather

    NASA Astrophysics Data System (ADS)

    McKinnon, K. A.; Rhines, A. N.; Tingley, M.; Huybers, P. J.

    2016-12-01

    Midlatitude summertime heat extremes negatively impact human health and agriculture, but are challenging to predict at lead times longer than those of weather models. Longer lead time predictions could emerge from statistical relationships between slowly-varying components of the climate system, such as the ocean or land surface, and specific extreme events. We identify a sea surface temperature (SST) anomaly pattern in the midlatitude Pacific that tends to precede very hot weather in the eastern US, allowing for skillful probabilistic predictions of hot days at lead times up to 50 days. The occurrence of the SST anomaly pattern is associated with the diversion of moisture from the eastern US, priming the region for hot temperatures. More generally, the midlatitude Pacific and eastern US are linked by specific circumglobal circulation anomalies steered by the summer atmospheric wave guide. The role of the summer wave guide in the observed link between midlatitude Pacific SST anomalies and eastern US hot weather is explored through an examination of models in the CMIP5 archive. Models with weaker-than-observed summer jets exhibit SST precursors to hot weather that are distinct from the observed relationship, with greater linkages to the eastern tropical Pacific and similarity to the Pacific Decadal Oscillation.

  1. Hospital diversification strategy.

    PubMed

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.

  2. 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

  3. [Eurothemes. Love, lust and suffering in Eastern Europe].

    PubMed

    Spanjer, J M

    1991-03-23

    In the Soviet Union, Poland, Romania, and Bulgaria contraceptives are often in short supply or unavailable. In Russia alone, 700 women/year suffer the consequences of illegal abortion. In 1988 there were 4.5 million births and 7.5 million abortions performed in state-subsidized hospitals. There are long waiting lists for free abortions, a 3-day stay is customary, and the employer is notified about the cause of hospitalization. Minor-age girls must sign a letter to their parents about how possible harmful effects of abortion in young age. In state hospitals, hygiene is below standard, there is a great need for analgesics, and humane treatment of patients is lacking. Only 1.5 million out of 7.5 million abortions were done by vacuum aspiration, the rest required a more invasive procedure. Condoms are rarely available, and they are expensive. East Germany and Czechoslovakia, the traditional condom exporters in Eastern Europe, have stopped deliveries. Hungary produces condoms under license, and imports them from Japan and the US. Only 11% of the demand in the Soviet Union is met by domestic production according to official data. In 1989, the Armavir condom plant produced only 24 million pieces instead of the 200 million planned. Recently, $7.5 million were arranged for the London Rubber Co. (maker of Durex condoms) to equip[ 2 condom factories in the Soviet Union. Together with a 3rd Japanese plant, an expected 400 million condoms will be manufactured soon. In 1989, the production of Russian-made contraceptive pills was discontinued because of inferior quality. Only 20% of the demand for pills is met mostly from Poland and Hungary. Tampons are not yet available, but they have a reputation among some young people as a wonder agent against pregnancy. Other alternative methods Russian women use are douching with water and lemon after intercourse, or immediately thereafter sitting in a hot bath.

  4. [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.

  5. Intraplate seismicity in the eastern United States

    SciTech Connect

    Bollinger, G.A.; Ehlers, E.G. Jr.; Moses, M.J.

    1987-07-01

    Causes for intraplate earthquakes in the eastern United States are indeed complex. Spatially, the seismicity occurs in distinct zones superposed on a less active regional background level. Epicentral patterns tend to be linear within the Valley and Ridge Province (Giles County and eastern Tennessee), diffuse in the Piedmont (central Virginia), and cluster in the Coastal Plain Province (Charleston, South Carolina area). Historically, moderate to large earthquakes have occurred within the seismic zones as defined by microseismicity. Recent paleoseismicity studies suggest that these larger earthquakes can reasonably be expected to occur into the future. Earthquake focal depths in the eastern US tend to occur within the upper crust with little relation to the surficial features. Most hypotheses on the causes for seismicity invoke the idea of preexisting zones of weakness favorably oriented with respect to the ambient stress field. Because most eastern US seismic zones are buried in the subsurface, geophysical methods are used to infer the presence of possible causal geologic structures at depth. Gravity data are useful in locating density (lithologic) changes within the crust and seismic activity tends to concentrate within gravity saddles formed at the intersection of northeast and northwest trending gravity anomalies. Seismically important plutons and Triassic basins which are associated with seismic activity have been located by their magnetic signatures. The eastern US is interpreted to be composed of a mosaic of allochthonous suspect terranes. This hypothesis suggests that block boundaries are zones of crustal weakness. Seismicity tends to concentrate along the Avalon-Piedmont boundary in the southeastern US. Many earthquakes in the eastern US occur in paleorift zones and/or at the intersection of multiple tectonic features.

  6. Measuring hospital competition.

    PubMed

    White, S L; Chirikos, T N

    1988-03-01

    This paper appraises the use of the Herfindahl market share index as an exogenous competition variable in empirical studies of the hospital sector. An analysis of cross-sectional Florida data shows that this index itself is significantly influenced by the demand and supply factors commonly included in econometric models of hospital performance. The analysis then illustrates that biased inferences about the effects of market competition on the costs of hospital care may result unless the values of the Herfindahl Index are treated endogenously in hospital cost models.

  7. Central line infections - hospitals

    MedlinePlus

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

  8. Crustal Anisotropy in Eastern Tibet

    NASA Astrophysics Data System (ADS)

    Ritzwoller, M. H.; Xie, J.; Shen, W.; Molnar, P. H.; Yang, Y.; Zhou, L.; Zheng, Y.

    2012-12-01

    A growing list and wide variety of evidence suggests that the Tibetan middle and lower crust is warm and presumably ductile. This list includes extensive Cenozoic volcanism, low electrical resistivity, satellite magnetic anomalies consistent with a raised Curie isotherm, and the lack of mid- to lower-crustal earthquakes. Seismological observations include strong P-to-S conversion bright-spots on active source wide-angle reflection data, strong crustal attenuation, pervasive crustal low velocity zones (LVZs) inferred from receiver functions or surface wave dispersion that are strongest near the periphery of the Plateau, and strong radial anisotropy, characteristic of significant shear strains, in the middle crust. Yet, surface strain rates and finite strains, as measured by GPS and SKS splitting fast axis orientations, respectively, appear to imply a vertical coherence of deformation from the uppermost crust into the upper mantle. Thus, questions about the mechanism of deformation of the Tibetan crust remain, including: (1) To what extent is deformation of the middle crust localized in a channel (channel flow) and hence different from that above and perhaps below it? (2) Or, conversely, to what extent is deformation of the entire lithosphere vertically coherent? Observations of crustal anisotropy can help to answer these questions, but although such observations are widespread, for the most part they remain either localized or so poorly resolved that exploiting such observations to answer these questions remains difficult. We summarize recently constructed models of radial and azimuthal anisotropy in the middle and lower crust beneath eastern Tibet. The models result from Bayesian Monte Carlo inversion of surface wave dispersion derived from ambient noise cross-correlations for Rayleigh and Love waves using Chinese Earthquake Array and PASSCAL data in and surrounding Tibet. (1) Significant middle-to-lower crustal radial anisotropy characterizes the crust beneath

  9. Food habits of bobcats in eastern Tennessee

    SciTech Connect

    Story, J.D.; Galbraith, W.J.; Kitchings, J.T.

    1982-01-01

    Food habits of bobcats (Lynx rufus) in eastern Tennessee were determined from analyzing 176 cat samples collected on the Oak Ridge National Environmental Research Park. Remains of cottontail rabbits (Sylvilagus floridanus) were the most frequently occurring food item. White-tail deer (Odocoileus virginianus) and pine vole (Microtus pinetorum) remains also were found frequently in samples. Data obtained from this study indicated that food preferences for bobcats in eastern Tennessee are similar to those in other southeastern states where the habitat is similar to the Oak Ridge area and somewhat different from those with significantly different habitat.

  10. Tectonic Uplift and Eastern Africa Aridification

    NASA Astrophysics Data System (ADS)

    Sepulchre, Pierre; Ramstein, Gilles; Fluteau, Frédéric; Schuster, Mathieu; Tiercelin, Jean-Jacques; Brunet, Michel

    2006-09-01

    The history of Eastern African hominids has been linked to a progressive increase of open grassland during the past 8 million years. This trend was explained by global climatic processes, which do not account for the massive uplift of eastern African topography that occurred during this period. Atmosphere and biosphere simulations quantify the role played by these tectonic events. The reduced topographic barrier before 8 million years ago permitted a zonal circulation with associated moisture transport and strong precipitation. Our results suggest that the uplift itself led to a drastic reorganization of atmospheric circulation, engendering the strong aridification and paleoenvironmental changes suggested by the data.

  11. Acid rain reduced in eastern United States

    SciTech Connect

    Bowersox, V.C.; Lynch, J.A.; Grimm, J.W.

    1997-12-31

    Sulfate and free hydrogen ion concentrations in precipitation decreased 10 to 25 percent over large areas of the eastern United States in 1995. The largest decreases in both ions occurred in and downwind of the Ohio River Valley, the same area where Phase I of the 1990 Clean Air Act Amendments set limitations, effective January 1, 1995, on sulfur dioxide emissions from affected coal-fired sources. Based on our analysis of precipitation chemistry and emissions data, we conclude that substantial declines in acid rain occurred in the eastern United States in 1995 because of large reductions in sulfur dioxide emissions in the same region.

  12. Church Orientations in Central and Eastern Europe

    NASA Astrophysics Data System (ADS)

    Laužikas, Rimvydas

    The objective of this case study is to discuss church orientation in Central and Eastern Europe. Due to its geographical situation, this region is a specific part of European cultural space: it is remote from the main cultural centers, it was the last to adopt Christianity, and it experienced intensive interactions with Byzantine culture. Therefore, we can assess church orientation in Central and Eastern Europe as a tradition affected by multicultural interactions and in which there is an interlacement of Catholicism from Western Europe, Byzantinism, local pagan faiths and, in part, the ideas of conception of geographical space of the Jews, Karaites, and Muslims.

  13. ANTIGENIC VARIANTS OF EASTERN EQUINE ENCEPHALITIS VIRUS

    PubMed Central

    Casals, Jordi

    1964-01-01

    A study by hemagglutination-inhibition test showed that 19 strains of eastern equine encephalitis virus grouped themselves in two main types, which have been designated North American and South American. The former consists of ten strains from the eastern half of the United States, from Massachusetts to Florida; Jamaica, the Dominican Republic, and, subject to confirmation, Thailand. The South American type comprises nine strains from Panama, Trinidad, British Guiana, Brazil, and Argentina. The strains were isolated from different natural hosts over a period of 30 years. PMID:14151098

  14. Recommended modifications and applications of the Hospital Emergency Incident Command System for hospital emergency management.

    PubMed

    Arnold, Jeffrey L; Dembry, Louise-Marie; Tsai, Ming-Che; Dainiak, Nicholas; Rodoplu, Ulkümen; Schonfeld, David J; Paturas, James; Cannon, Christopher; Selig, Scott

    2005-01-01

    The Hospital Emergency Incident Command System (HEICS), now in its third edition, has emerged as a popular incident command system model for hospital emergency response in the United States and other countries. Since the inception of the HEICS in 1991, several events have transformed the requirements of hospital emergency management, including the 1995 Tokyo Subway sarin attack, the 2001 US anthrax letter attacks, and the 2003 Severe Acute Respiratory Syndrome (SARS) outbreaks in eastern Asia and Toronto, Canada. Several modifications of the HEICS are suggested to match the needs of hospital emergency management today, including: (1) an Incident Consultant in the Administrative Section of the HEICS to provide expert advice directly to the Incident Commander in chemical, biological, radiological, nuclear (CBRN) emergencies as needed, as well as consultation on mental health needs; (2) new unit leaders in the Operations Section to coordinate the management of contaminated or infectious patients in CBRN emergencies; (3) new unit leaders in the Operations Section to coordinate mental health support for patients, guests, healthcare workers, volunteers, and dependents in terrorism-related emergencies or events that produce significant mental health needs; (4) a new Decedent/Expectant Unit Leader in the Operations Section to coordinate the management of both types of patients together; and (5) a new Information Technology Unit Leader in the Logistics Section to coordinate the management of information technology and systems. New uses of the HEICS in hospital emergency management also are recommended, including: (1) the adoption of the HEICS as the conceptual framework for organizing all phases of hospital emergency management, including mitigation, preparedness, response, and recovery; and (2) the application of the HEICS not only to healthcare facilities, but also to healthcare systems. Finally, three levels of healthcare worker competencies in the HEICS are suggested

  15. Eastern Renewable Generation Integration Study: Initial Results (Poster)

    SciTech Connect

    Bloom, A.; Townsend, A.; Hummon, M.; Weekley, A.; Clark, K.; King, J.

    2013-10-01

    This poster presents an overview of the Eastern Renewable Generation Integration Study, which aims to answer critical questions about the future of the Eastern Interconnection under high levels of solar and wind generation penetration.

  16. Virtual Pediatric Hospital

    MedlinePlus

    ... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

  17. [Music in the hospital].

    PubMed

    Bouteloup, Philippe

    2010-01-01

    Occasional events, regular workshops, concerts, shows, artists in residence, cultural outings...Hospital does not necessarily have to be a place of silence and sadness. But this situation has not always been so straightforward as on the face of it, nothing is more incompatible with a hospital environment than music, which, by definition, is festive and noisy.

  18. Handbook on Hospital Television.

    ERIC Educational Resources Information Center

    Prynne, T. A.

    Designed for both hospital personnel interested in television and audiovisual personnel entering the medical field, this handbook is a verbal and pictorial survey of what is being done with TV within the medical profession. After an introduction which answers technical questions about medical TV posed during the American Hospital Association's…

  19. Hospitality Occupations. Curriculum Guide.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Bureau of Homemaking Education.

    This curriculum guide on the hospitality occupations was developed to help secondary and postsecondary home economics teachers prepare individuals for entry-level jobs in the hospitality industry. The content is in seven sections. The first section presents organizational charts of a medium-size hotel, food and beverage division, housekeeping and…

  20. Hospitality, Tourism, and Recreation.

    ERIC Educational Resources Information Center

    Novachek, James

    The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

  1. Hospitality Services. Curriculum Guide.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  2. Hospitality Services Reference Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

  3. Hospitality Services. Curriculum Guide.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  4. Hospitality Services Reference Book.

    ERIC Educational Resources Information Center

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This reference book provides information needed by employees in hospitality services occupations. It includes 29 chapters that cover the following topics: the hospitality services industry; professional ethics; organization and management structures; safety practices and emergency procedures; technology; property maintenance and repair; purchasing…

  5. Hospitals are dangerous places.

    PubMed

    de Richemond, Albert L

    2010-01-01

    Hospital fire dangers are real, widespread, and ever present, the article demonstrates, spelling out the locations, conditions, and ignition potentials which exist in such a setting. Knowledge of codes and standards, good maintenance practices, and frequent drills in fire prevention and suppression are among the practices recommended for keeping a hospital fire from becoming a disaster, the author says.

  6. Handbook on Hospital Television.

    ERIC Educational Resources Information Center

    Prynne, T. A.

    Designed for both hospital personnel interested in television and audiovisual personnel entering the medical field, this handbook is a verbal and pictorial survey of what is being done with TV within the medical profession. After an introduction which answers technical questions about medical TV posed during the American Hospital Association's…

  7. Preventing falls in hospital.

    PubMed

    Pearce, Lynne

    2017-01-04

    Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 per day, according to the Royal College of Physicians (RCP).

  8. Preventing falls in hospital.

    PubMed

    Pearce, Lynne

    2017-01-31

    Essential facts Falls are the most frequently reported adverse events in hospitals, especially among older patients. According to the Royal College of Physicians (RCP) more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wale.

  9. Hospitality services generate revenue.

    PubMed

    Bizouati, S

    1993-01-01

    An increasing number of hospitals are undertaking external revenue-generating activities to supplement their shrinking budgets. Written at the request of Leadership, this article outlines an example of a successful catering service -- a money-generating business that more Canadian hospitals could profitably consider.

  10. Leading a hospital closure.

    PubMed

    Lucey, Paula A

    2002-01-01

    Hospital closures have become more common. The challenges facing a nursing leader in this situation are complex and difficult. This author suggests that looking for new beginnings rather than focusing on endings created an approach to closing a public hospital. The article includes approaches to employee morale, staffing, and patient care.

  11. Hospital benefit segmentation.

    PubMed

    Finn, D W; Lamb, C W

    1986-12-01

    Market segmentation is an important topic to both health care practitioners and researchers. The authors explore the relative importance that health care consumers attach to various benefits available in a major metropolitan area hospital. The purposes of the study are to test, and provide data to illustrate, the efficacy of one approach to hospital benefit segmentation analysis.

  12. Competition among hospitals.

    PubMed

    Gaynor, Martin; Vogt, William B

    2003-01-01

    We examine competition in the hospital industry, in particular the effect of ownership type (for-profit, not-for-profit, government). We estimate a structural model of demand and pricing in the hospital industry in California, then use the estimates to simulate the effect of a merger. California hospitals in 1995 face an average price elasticity of demand of -4.85. Not-for-profit hospitals face less elastic demand and act as if they have lower marginal costs. Their prices are lower than those of for-profits, but markups are higher. We simulate the effects of the 1997 merger of two hospital chains. In San Luis Obispo County, where the merger creates a near monopoly, prices rise by up to 53%, and the predicted price increase would not be substantially smaller were the chains not-for-profit.

  13. Medication safety in hospitals.

    PubMed

    Kirke, C

    2009-01-01

    Medication error and adverse drug reactions occur frequently, leading to a high burden of patient harm in the hospital setting. Many Irish hospitals have established medication safety initiatives, designed to encourage reporting and learning to improve medication use processes and therefore patient safety. Eight Irish hospitals or hospital networks provided data from voluntary medication safety incident and near miss reporting programmes for pooled analysis of events occurring between 1st January 2006 and 30th June 2007. 6179 reports were received in total (mean 772 per hospital; range 96-1855). 95% of reports did not involve patient harm. Forty seven percent of reports related to the prescribing stage of the medication use process, 40% to the administration stage and 9% to the pharmacy dispensing stage. This data is published to increase awareness of this key patient safety issue, to share learning from these incidents and near misses and to encourage a more open patient safety culture.

  14. What's known about managing eastern white pine

    Treesearch

    Charles R. Lockard

    1959-01-01

    At the 1957 meeting of the Northeastern Forest Research Advisory Council the comment was made that although Eastern white pine has been the most studied forest tree species in the Northeast, the only literature on the management of the species was in reports on isolated and uncoordinated studies. There was no comprehensive compendium of knowledge.

  15. Pathogenic Hantaviruses, Northeastern Argentina and Eastern Paraguay

    PubMed Central

    Martinez, Valeria P.; Bellomo, Carla; Maidana, Silvina; San Juan, Jorge; Tagliaferri, Paulina; Bargardi, Severino; Vazquez, Cynthia; Colucci, Norma; Estévez, Julio; Almiron, María

    2007-01-01

    We describe the first, to our knowledge, cases of hantavirus pulmonary syndrome in northeastern Argentina and eastern Paraguay. Andes and Juquitiba (JUQ) viruses were characterized. JUQV was also confirmed in 5 Oligoryzomys nigripes reservoir species from Misiones. A novel Akodon-borne genetic hantavirus lineage was detected in 1 rodent from the Biologic Reserve of Limoy. PMID:17953094

  16. AIR QUALITY OVER THE EASTERN UNITED STATES

    EPA Science Inventory

    Atmospheric concentrations of ozone and fine particulate matter continue to exceed their standards in many parts of the eastern United States. However, the peak concentration levels and number of ozone exceedances have decreased substantially in recent years due, in part, to the...

  17. Volume and Availability of Eastern Hardwoods

    Treesearch

    Raymond M. Sheffield; William A. Bechtold

    1990-01-01

    In the Eastern United States, some 354 million acres of timberland are classified as a hardwood or pine-hardwood forest type. The inventory of hardwood growing stock totals 275 billion cubic feet, or 90 percent of the hardwood inventory in the United States. Whereas hardwood inventories have increased by 70 percent since 1952, the availability of this resource for use...

  18. 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…

  19. Educational Film Guide for Middle Eastern Studies.

    ERIC Educational Resources Information Center

    Greenman, Joseph; Joachim, Ann

    This annotated guide lists 16mm. films on the Middle East for use in grades K-12 and with adults. The Middle East refers to a vast area extending from eastern Afghanistan and the northern Caucasus to the western coast of Morocco and the southern periphery of the Sahara. The guide does not list films according to their merits. Rather, it includes…

  20. AIR QUALITY OVER THE EASTERN UNITED STATES

    EPA Science Inventory

    Atmospheric concentrations of ozone and fine particulate matter continue to exceed their standards in many parts of the eastern United States. However, the peak concentration levels and number of ozone exceedances have decreased substantially in recent years due, in part, to the...

  1. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2014

    PubMed Central

    Tsvetkova, E.; Sud, S.; Aucoin, N.; Biagi, J.; Burkes, R.; Samson, B.; Brule, S.; Cripps, C.; Colwell, B.; Falkson, C.; Dorreen, M.; Goel, R.; Halwani, F.; Maroun, J.; Michaud, N.; Tehfe, M.; Thirlwell, M.; Vickers, M.; Asmis, T.

    2015-01-01

    The annual Eastern Canadian Colorectal Cancer Consensus Conference was held in Montreal, Quebec, 23–25 October 2014. Expert radiation, medical, and surgical oncologists and pathologists involved in the management of patients with gastrointestinal malignancies participated in presentations and discussions resulting in consensus statements on such hot topics as management of neuroendocrine tumours, advanced and metastatic pancreatic cancer, and metastatic colorectal cancer. PMID:26300681

  2. Reforms in Higher Education Disappoint Eastern Europeans.

    ERIC Educational Resources Information Center

    Bollag, Burton

    1999-01-01

    Reviews changes in higher education in Eastern Europe since the fall of communism and finds less than expected change, although enrollment has increased and there is minimal government interference. Obstacles to change include lack of quality controls, falling financial support, and emigration of scholars to other countries or business fields. (DB)

  3. Nut production handbook for Eastern black walnut

    Treesearch

    James E. Jones; Rita Mueller; J.W. Van Sambeek

    1998-01-01

    Interest in the species of Eastern Black Walnut (Juglans nigra L.) for commercial nut production continues to increase. During the past several years interested growers have intensified tree care and evaluated several varieties and selections. It is believed that we have arrived at an economically viable threshold for commercial nut production. While we are...

  4. Coccidia of coyotes in eastern Colorado.

    PubMed

    Arther, R G; Post, G

    1977-01-01

    Eighty-two coyote fecal samples were collected from eastern Colorado and examined for coccidia. Sporocysts of Sarcocystis were observed in 17 of the samples and oocysts of Isospora ohioensis were observed in two samples. Ten fecal samples contained eimerian coccidia thought to be pseudoparasites of the coyote acquired while ingesting heavily infected rabbits.

  5. Mineralogy of Saudi Arabian soils: eastern region

    SciTech Connect

    Lee, S.Y.; Dixon, J.B.; Aba-Husayn, M.M.

    1983-03-01

    Mineralogical properties of soils along a 500 km east-west transect of an eastern province of Saudi Arabia were examined. Mineralogical composition of soils along the eastern coastal playa near Al Qatif is mostly gypsum or calcite in the whole soil, and smectite among layer silicate minerals in the clay fraction (<2mm). In soils of the Harad area palygorskite and smectite are the major layer silicate minerals. In the Al Kharj area kaolinite and smectite are the major clay minerals. Small amounts of chlorite occur in all soils studied although it varies in thermal stability and the amount is very small in Al Kharj 11 and Al Kharj Mountain surface soils. In the entire eastern region mica and vermiculite are present in the soil clays. The results of transmission electron microscpoy and x-ray diffraction analyses show that acicular palygorskite is widely distributed in the eastern-region soils. Palygorskite is believed to originate from the underlying Mio-Pliocene limestone in the basin, and to be redistributed by alluvial and eolian processes.

  6. TREEGRAD: a grading program for eastern hardwoods

    Treesearch

    J.W. Stringer; D.W. Cremeans

    1991-01-01

    Assigning tree grades to eastern hardwoods is often a difficult task for neophyte graders. Recently several "dichotomous keys" have been developed for training graders in the USFS hardwood tree grading system. TREEGRAD uses the Tree Grading Algorithm (TGA) for determining grades from defect location data and is designed to be used as a teaching aid.

  7. Anemia among school children in eastern Nepal.

    PubMed

    Khatiwada, Saroj; Gelal, Basanta; Gautam, Sharad; Tamang, Man Kumar; Shakya, Prem Raj; Lamsal, Madhab; Baral, Nirmal

    2015-06-01

    Anemia is one of the most common public health problems in developing countries like Nepal. This study was done to find the prevalence of anemia among the children aged 4-13 years in eastern Nepal. A cross-sectional study was conducted in 2012 in four districts (Morang, Udayapur, Bhojpur and Ilam) of eastern Nepal to find the prevalence of anemia among the school children of eastern Nepal. Children aged 4-13 years were selected randomly from different schools of above districts and 618 venous blood samples were collected. Hemoglobin level was estimated by using cyanmethemoglobin method. The mean hemoglobin level was 12.2 ± 1.82 gm/dl. About 37.9% (n = 234) children were found anemic. Anemia prevalence was 42.4% (n = 78), 31.6% (n = 60), 45.3% (n = 48) and 34.8% (n = 48) among school children of Morang, Udayapur, Bhojpur and Ilam district, respectively. The study finds anemia as a significant health problem among the school children of eastern Nepal.

  8. Eastern medicine approaches to male infertility.

    PubMed

    Hu, Min; Zhang, Yuehui; Ma, Hongli; Ng, Ernest H Y; Wu, Xiao-Ke

    2013-07-01

    Male factor is a common cause of infertility and the male partner must be systematically evaluated in the workup of every infertile couple. Various Eastern medical strategies have been tried with variable success. This article describes the clinical effects of Eastern medicine approaches including acupuncture, Chinese herbal medicine, massage, yoga, tai chi, and qi gong, which could improve the sperm parameters and motility, genital inflammatory conditions, as well as immune system disorders, sexual dysfunction, and varicocele. Acupuncture reduces inflammation, increases sperm motility, improves semen parameters, modulates the immune system, and improves sexual and ejaculatory dysfunction in male infertility. The clinical effects may be mediated via activation of somatic afferent nerves innervating the skin and muscle. Chinese herbal medicines may also exert helpful effects in male infertility, and it is worth noting that some herbal drugs may result in male infertility. Massage also exerts positive effects in male infertility. Nevertheless, the mechanisms of clinical effects are unclear. Tai chi, qi gong, and yoga have not been investigated in male infertility, but it has been reported to regulate endocrine and central or autonomic nervous systems. In conclusion, Eastern medical approaches have beneficial on reproductive effects in male infertility. However, future well-designed, randomized, clinical control trials are needed to evaluate the safety, efficacy, and mechanisms of Eastern medical approaches for male infertility. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. A stocking guide for eastern white pine

    Treesearch

    James S. Philbrook; James P. Barrett; William B. Leak

    1973-01-01

    A stocking chart for eastern white pine is presented and described. The chart shows basal areas and numbers of trees by mean stand diameter, representing the upper limit in stocking for practical management (A curve) and minimum stocking for full site utilization (B curve).

  10. Eastern forest environmental threat assessment center

    Treesearch

    Southern Research Station. USDA Forest Service

    2010-01-01

    The Eastern Forest Environmental Threat Assessment Center (EFETAC) provides the latest research and expertise concerning threats to healthy forests – such as insects and disease, wildland loss, invasive species, wildland fire, and climate change – to assist forest landowners, managers and scientists throughout the East. Established in 2005, EFETAC is a joint effort of...

  11. Diseases of intensively managed eastern black walnut

    Treesearch

    Manfred E. Mielke; Michael E. Ostry

    2004-01-01

    Eastern black walnut has few serious disease problems in its natural woodland setting. However, trees in plantations are subjected to various cultural activities that can create stand conditions that increase pathogen populations and abiotic injuries that often interfere with landowner's objectives.

  12. Numerical modeling of eastern connecticut's visual resources

    Treesearch

    Daniel L. Civco

    1979-01-01

    A numerical model capable of accurately predicting the preference for landscape photographs of selected points in eastern Connecticut is presented. A function of the social attitudes expressed toward thirty-two salient visual landscape features serves as the independent variable in predicting preferences. A technique for objectively assigning adjectives to landscape...

  13. Forest Area in Eastern South Dakota, 1980

    Treesearch

    Thomas L. Castonguay

    1982-01-01

    In 1980 eastern South Dakota's forest resources covered 266,300 acres of land, a slight decline from the 296,600 acres reported in 1965. The area of commercial forest land also dropped from 165,400 acres to 113,600 acres. The elm-ash-locust forest type covers 40 percent of the commercial forest area.

  14. Termination and the Eastern Band of Cherokees.

    ERIC Educational Resources Information Center

    Finger, John R.

    1991-01-01

    During the 1940s and 1950s, local factors helped the Eastern Cherokees to resist termination of tribal status and federal responsibilities in Indian affairs. Factors include the belief that area tourism depended on Cherokee tribal identity, reluctance of local public schools to accept Indian students, and the band's complex legal status and…

  15. INORGANIC ELEMENTS AND DISTRIBUTION OF EASTERN OYSTERS.

    EPA Science Inventory

    Fisher, William S. In press. Inorganic Elements and Distribution of Eastern Oysters (Abstract). To be presented at the 96th Annual Meeting (Aquaculture 2004) of the National Shellfisheries Association, 1-5 March 2004, Honolulu, HI. 1 p. (ERL,GB R962).

    For over a century w...

  16. 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…

  17. Termination and the Eastern Band of Cherokees.

    ERIC Educational Resources Information Center

    Finger, John R.

    1991-01-01

    During the 1940s and 1950s, local factors helped the Eastern Cherokees to resist termination of tribal status and federal responsibilities in Indian affairs. Factors include the belief that area tourism depended on Cherokee tribal identity, reluctance of local public schools to accept Indian students, and the band's complex legal status and…

  18. 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…

  19. Rhinoplasty in the Middle Eastern nose.

    PubMed

    Apaydin, Fazil

    2014-08-01

    In this article, the main characteristics of Middle Eastern patients seeking rhinoplasty are reported. Besides the preoperative preparation, surgical techniques that can be used to obtain good results are discussed. The pitfalls of profile alignment, tip procedures and skin have been noted as well. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Diagnosing injury to eastern forest trees

    Treesearch

    John M. Skelly; Donald D. Davis; William Merrill; E. Alan Cameron; H. Daniel Brown; David B. Drummond; Leon S., eds. Dochinger

    1987-01-01

    The purpose of this manual is to assist members of the National Vegetation Survey in recognizing air pollutant-induced injury and in identifying disease and insect damage that may be confused with air pollutant-induced injury to forest vegetation in the eastern United States. Ozone, sulfur dioxide, and, to a limited geographic extent, hydrogen fluoride, are all...

  1. The Lamaholot Language of Eastern Indonesia

    ERIC Educational Resources Information Center

    Nagaya, Naonori

    2011-01-01

    This study presents the grammar of the Lewotobi dialect of Lamaholot, an Austronesian language spoken in the eastern part of Flores Island and neighboring islands of Indonesia. Lamaholot belongs to the Central Malayo-Polynesian subgroup of Austronesian, within which it is in a subgroup with the languages of Timor and Roti. The number of speakers…

  2. Eastern Europe: Pronatalist Policies and Private Behavior.

    ERIC Educational Resources Information Center

    David, Henry P.

    1982-01-01

    This bulletin reviews recent fertility-related trends in the nine Eastern European socialist countries where official policy is explicitly pronatalist to varying degrees in all but Yugoslavia. That fertility was generally higher here than in Western Europe in the mid-1970s is credited to pronatalist measures undertaken when fertility fell below…

  3. Tree grades for eastern white pine

    Treesearch

    Robert L. Brisbin; David L. Sonderman; David L. Sonderman

    1971-01-01

    In 1957 the Forest Service Log Grade Committee recommended a service-wide action program in log and tree grade research. Approval of the program late in 1958 resulted in the establishment of five species-oriented timber- quality research projects covering the several groups of commercially important timber species. The eastern softwood timber-quality project was...

  4. Culture and Language Learning: Middle Eastern Students.

    ERIC Educational Resources Information Center

    Magrath, Douglas

    Middle Eastern students face cultural conflicts in adapting to the western value system. While feeling obligated to maintain their native culture they also need to feel comfortable with the culture of their target language. In attempting to identify with a new group, ESL students may sense a loss of membership in their native group. Culture stress…

  5. INORGANIC ELEMENTS AND DISTRIBUTION OF EASTERN OYSTERS.

    EPA Science Inventory

    Fisher, William S. In press. Inorganic Elements and Distribution of Eastern Oysters (Abstract). To be presented at the 96th Annual Meeting (Aquaculture 2004) of the National Shellfisheries Association, 1-5 March 2004, Honolulu, HI. 1 p. (ERL,GB R962).

    For over a century w...

  6. Migrant Farmworkers on Virginia's Eastern Shore.

    ERIC Educational Resources Information Center

    Virginia Advisory Committee to the U.S. Commission on Civil Rights, Richmond.

    The living and working conditions of migrant farmworkers on the Eastern Shore of Virginia have been described as deplorable and possibly the worst in the nation. At the same time, growers in this region have complained of duplication, even triplication, of federal and state regulations designed to improve living and working conditions of these…

  7. 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...

  8. The Lamaholot Language of Eastern Indonesia

    ERIC Educational Resources Information Center

    Nagaya, Naonori

    2011-01-01

    This study presents the grammar of the Lewotobi dialect of Lamaholot, an Austronesian language spoken in the eastern part of Flores Island and neighboring islands of Indonesia. Lamaholot belongs to the Central Malayo-Polynesian subgroup of Austronesian, within which it is in a subgroup with the languages of Timor and Roti. The number of speakers…

  9. Eastern North Carolina: An Education Atlas.

    ERIC Educational Resources Information Center

    Wilms, Douglas C.

    To provide school systems, organizations, and individuals interested in improving rural education with current information on local conditions, the Rural Education Institute of East Carolina University has compiled demographic and educational data on 41 eastern North Carolina counties into this educational atlas. The 32 maps show the 41 counties…

  10. Juniper for Streambank Stabilization in Eastern Oregon

    Treesearch

    Guy R. Sheeter; Errol W. Claire

    1989-01-01

    Cut juniper trees (Juniperous osteosperma Hook.) anchored along eroded streambanks proved beneficial in stabilizing 96 percent of the erosion on eight streams evaluated in eastern Oregon over a 14-year-period. Juniper revetment was a successful substitute for costly rock structures on straight or slightly curved banks, but failed when placed on outside curves or when...

  11. 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…

  12. Natural regeneration of eastern hemlock: a review

    Treesearch

    Daniel L. Goerlich; Ralph D. Nyland

    2000-01-01

    Successful regeneration of eastern hemlock involves a complex biophysical process that commonly spans many years. Critical factors include a reliable source of seed, a suitable seedbed, a partially shaded environment, and several years of favorable moisture. Surface scarification appears critical as a means of site preparation. Even then, young hemlocks grow slowly,...

  13. Regenerating eastern hemlock in the Lake States

    Treesearch

    Richard M. Godman

    1992-01-01

    The eastern hemlock type is declining in area faster than any other. Growing-stock volume, for example, declined 71 percent in only 20 years in Michigan, and has declined similarly in Wisconsin. Many land management agencies have stopped cutting hemlock until satisfactory regeneration can be assured.

  14. Eastern Boundary Effects on General Circulation Structure

    NASA Technical Reports Server (NTRS)

    Dewar, William K.

    1997-01-01

    My NASA proposal included plans to examine the dynamics of the eastern oceanic boundary, with a view towards those processes important to the interior. Several relevant tasks have been completed and either have appeared or will appear soon in the refereed literature.

  15. Extractives in eastern hardwoods : a review

    Treesearch

    John W. Rowe

    1979-01-01

    This report extensively reviews the chemistry of extractives from wood and bark of hardwoods from the eastern United States. While such extractives are not used to a great extent commercially, they may influence properties of the wood and performance of wood products. For example, extractives can protect wood from decay, add color and odor to wood, accent grain pattern...

  16. Educational Film Guide for Middle Eastern Studies.

    ERIC Educational Resources Information Center

    Greenman, Joseph; Joachim, Ann

    This annotated guide lists 16mm. films on the Middle East for use in grades K-12 and with adults. The Middle East refers to a vast area extending from eastern Afghanistan and the northern Caucasus to the western coast of Morocco and the southern periphery of the Sahara. The guide does not list films according to their merits. Rather, it includes…

  17. Behavioral Discourse Strategy in Eastern Bontoc.

    ERIC Educational Resources Information Center

    Fukuda, Takashi

    1992-01-01

    This paper is an analysis of behavioral texts (speech directed obligatorily to a second person in a communication situation) and a discussion of the persuasive devices employed by the speakers in an effort to effect a change in the listener's behavior. This study deals with two Eastern Bontoc behavioral texts. Several nonlinguistic persuasive…

  18. Astroparticle physics at the Eastern Colombia region

    NASA Astrophysics Data System (ADS)

    Asorey, Hernán; Núñez, Luis A.

    2015-12-01

    We present the emerging panorama of Astroparticle Physics at the Eastern Colombia region, and describe several ongoing projects, most of them related to the Latin American Giant Observatory (LAGO) Project. This research work is carried out at the Grupo de Investigaciones en Relatividad y Gravitacin of Universidad Industrial de Santander.

  19. Timber resource statistics for eastern Oregon, 1999.

    Treesearch

    David L. Azuma; Paul A. Dunham; Bruce A. Hiserote; Charles F. Veneklase

    2004-01-01

    This report is a summary of timber resource statistics for eastern Oregon, which includes Baker, Crook, Deschutes, Gilliam, Grant, Harney, Jefferson, Klamath, Lake, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wasco, and Wheeler Counties. Data were collected as part of a statewide multiresource inventory. The inventory sampled all private and public lands except...

  20. Eastern Equine Encephalitis Treated With Intravenous Immunoglobulins

    PubMed Central

    Mukerji, Shibani S.; Lam, Alice D.

    2016-01-01

    We report the case of a 68-year-old man from southeastern Massachusetts presenting with encephalitis due to eastern equine encephalitis (EEE) virus. Despite the high morbidity and mortality rate of EEE, the patient made a near complete recovery in the setting of receiving early intravenous immunoglobulins. PMID:26740855

  1. Eastern Equine Encephalitis Treated With Intravenous Immunoglobulins.

    PubMed

    Mukerji, Shibani S; Lam, Alice D; Wilson, Michael R

    2016-01-01

    We report the case of a 68-year-old man from southeastern Massachusetts presenting with encephalitis due to eastern equine encephalitis (EEE) virus. Despite the high morbidity and mortality rate of EEE, the patient made a near complete recovery in the setting of receiving early intravenous immunoglobulins.

  2. 3-D Image of Vesta Eastern Hemisphere

    NASA Image and Video Library

    2012-01-23

    This anaglyph shows the topography of Vesta eastern hemisphere; equatorial troughs are visible around asteroid Vesta equator and north of these troughs there are a number of highly degraded, old, large craters. You need 3-D glasses to view this image.

  3. Gluing of Eastern Hardwoods: A Review

    Treesearch

    Terry Sellers; James R. McSween; William T. Nearn

    1988-01-01

    Over a period of years, inrreasing demand for softwoods in the Eastern United States has led to an increase in the growth of hardwoods on cut-over softwood sites. Unfortunately these hardwood trees are often of a size and shape unsuitable for the production of high-grade lumber and veneer. They do, however, represent a viable, economic soures of raw material for...

  4. Commercial Spanish at Eastern Michigan University.

    ERIC Educational Resources Information Center

    Voght, Geoffrey M.

    The commercial Spanish courses at Eastern Michigan University, examinations in commercial Spanish, and cooperative education exchange programs are described, and the university's new programs that combine the study of foreign language and business are briefly addressed. A six-course sequence offered on the junior, senior, and graduate levels cover…

  5. Subsurface structure of the eastern Arkoma basin

    SciTech Connect

    Vanarsdale, R.B. ); Schweig, E.S. III )

    1990-07-01

    Analysis of 425 km of seismic reflection data in the eastern Arkoma basin reveals a structure and history quite different from those previously reported for the Arkoma basin. The eastern Arkoma basin has three structural styles that formed in the following chronological order: deep, steep normal faults; shallow listric normal faults; and thrust faults. The origin of the structural styles and the Paleozoic history of the eastern Arkoma basin may be summarized as follows. Late Proterozoic or Early Cambrian rifting was followed by deposition of Cambrian through Upper Mississippian strata on a passive plate margin. The Mississippian-Pennsylvanian boundary marks a time of major down-to-the-south normal faulting with coincident folding of the footwall blocks and truncation of the faulted and folded terrain by a pre-Morrowan (Mississippian-Pennsylvanian) unconformity. The unconformity slopes southward and steepens locally across the erosionally truncated footwall blocks. During the Pennsylvanian, down-to-the-south listric normal faults cut the Atokan and Morrowan sections and merged with, but did not displace, the steeper segments of the sub-Morrowan unconformity. Surface folds north of the Ross Creek thrust are rollover anticlines overlying these listric normal faults. Major deformation in the eastern Arkoma basin terminated with emplacement of the Ross Creek thrust in the Late Pennsylvanian. 4 figs., 1 tab.

  6. Fragmentation of eastern United States forest types

    Treesearch

    Kurt H. Riitters; John W. Coulston

    2013-01-01

    Fragmentation is a continuing threat to the sustainability of forests in the Eastern United States, where land use changes supporting a growing human population are the primary driver of forest fragmentation (Stein and others 2009). While once mostly forested, approximately 40 percent of the original forest area has been converted to other land uses, and most of the...

  7. 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...

  8. Flexural Properties of Eastern Hardwood Pallet Parts

    Treesearch

    John A. McLeod; Marshall S. White; Paul A. Ifju; Philip A. Araman

    1991-01-01

    Accurate estimates of the flexural properties of pallet parts are critical to the safe, yet efficient, design of wood pallets. To develop more accurate data for hardwood pallet parts, 840 stringers and 2,520 deckboards, representing 14 hardwood species, were sampled from 35 mills distributed throughout the Eastern United States. The parts were sorted by species,...

  9. Eastern national forests: managing for nontimber products

    Treesearch

    James L. Chamberlain; Robert J. Bush; A.L. Hammett; Philip A. Araman

    2002-01-01

    Many products are harvested from the forests of the eastern United States that are not timber-based but originate from plant materials. Over the past decade, concern has grown about the sustainability of the forest resources from which these products originate, and an associated interest in managing for these products has materialized. A content analysis of the...

  10. Efficient silvicultural practices for eastern hardwood management

    Treesearch

    Gary W. Miller; John E. Baumgras

    1994-01-01

    Eastern hardwood forests are now managed to meet a wide range of objectives, resulting in the need for silvicultural alternatives that provide timber, wildlife, aesthetics, recreation, and other benefits. However, forest management practices must continue to be efficient in terms of profiting from current harvests, protecting the environment, and sustaining production...

  11. 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...

  12. Susceptibility of Peruvian Mosquitoes to Eastern Equine Encephalitis virus

    DTIC Science & Technology

    2008-07-01

    VECTOR/PATHOGEN/HOST INTERACTION, TRANSMISSION Susceptibility of Peruvian Mosquitoes to Eastern Equine Encephalitis Virus M. J. TURELL,1 M. L...the Amazon Basin, near Iquitos, Peru, and used in experimental studies to evaluate their susceptibility to strains of eastern equine encephalitis virus...enzootic vector of EEEV in this region. KEY WORDS Peru, eastern equine encephalitis virus, transmission, mosquito Eastern equine encephalitis virus (EEEV

  13. 77 FR 12045 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-28

    ... Energy Regulatory Commission 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... appurtenances located in federal waters offshore in the Gulf of Mexico near Louisiana. Specifically, Texas...

  14. 78 FR 66352 - Texas Eastern Transmission, LP; Notice of Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... Federal Energy Regulatory Commission 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. CP14-9-000 pursuant to Section 7(b) and Section7...

  15. 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...

  16. 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...

  17. 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...

  18. Management of ischemic stroke in Central and Eastern Europe.

    PubMed

    Budincevic, Hrvoje; Tiu, Cristina; Bereczki, Daniel; Kõrv, Janika; Tsiskaridze, Alexander; Niederkorn, Kurt; Czlonkowska, Anna; Demarin, Vida

    2015-10-01

    Stroke is one of the leading causes of disability in Europe. Central and Eastern European countries have the highest incidence and mortality rates through Europe. The improvements in stroke prevention and treatment in Central and Eastern European countries did not completely reach the quality parameters present in Western European countries. We present features of current management of stroke in Central and Eastern European countries.

  19. Timing the eastern Asian-eastern North American floristic disjunction: molecular clock corroborates paleontological estimates.

    PubMed

    Xiang, Q Y; Soltis, D E; Soltis, P S; Manchester, S R; Crawford, D J

    2000-06-01

    Sequence data of the chloroplast gene rbcL were used to estimate the time of the well-known eastern Asian-eastern North American floristic disjunction. Sequence divergence of rbcL was examined for 22 species of 11 genera (Campsis, Caulophyllum, Cornus, Decumaria, Liriodendron, Menispermum, Mitchella, Pachysandra, Penthorum, Podophyllum, and Phryma) representing a diverse array of flowering plants occurring disjunctly in eastern Asia and eastern North America. Divergence times of putative disjunct species pairs were estimated from synonymous substitutions, using rbcL molecular clocks calibrated for Cornus. Relative rate tests were performed to assess rate constancy of rbcL evolution among lineages. Corrections of estimates of divergence times for each species pair were made based on rate differences of rbcL between Cornus and other species pairs. Results of these analyses indicate that the time of divergence of species pairs examined ranges from 12.56 +/- 4.30 million years to recent (<0.31 million years), with most within the last 10 million years (in the late Miocene and Pliocene). These results suggest that the isolation of most morphologically similar disjunct species in eastern Asia and eastern North America occurred during the global climatic cooling period that took place throughout the late Tertiary and Quaternary. This estimate is closely correlated with paleontological evidence and in agreement with the hypothesis that considers the eastern Asian-eastern North American floristic disjunction to be the result of the range restriction of a once more or less continuously distributed mixed mesophytic forest of the Northern Hemisphere that occurred during the late Tertiary and Quaternary. This implies that in most taxa the disjunction may have resulted from vicariance events. However, long-distance dispersal may explain the disjunct distribution of taxa with low divergence, such as Menispermum. Copyright 2000 Academic Press.

  20. 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

  1. 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

  2. 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

    2010-01-01

    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.

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

    PubMed Central

    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. PMID:26024370

  4. 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

  5. Avoidable hospitalizations and socio-economic status in Galveston County, Texas.

    PubMed

    Begley, C E; Slater, C H; Engel, M J; Reynolds, T F

    1994-10-01

    Population-based hospitalization rates for preventable conditions are derived for a low-income population in Galveston County, Texas using discharge data from four area hospitals and demographic data from the U.S. Census. Comparisons are made with similar rates for the general populations of two eastern states (Maryland and Massachusetts) and New York City. Results support the hypothesis that low-income persons lack access to primary care, leading to higher rates of hospitalization for preventable conditions. Alternative explanations for differences found are examined.

  6. 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

  7. Guide to Choosing a Hospital

    MedlinePlus

    ... you visit Hospital Compare, finding information about the quality of hospitals is just a few steps away: • Click on “Find and Compare Hospitals,” and decide if you want to look for hospitals by the hospital name, or by ZIP Code, City, State or Territory, or County. • Select General Search, ...

  8. Hospitality as an Environmental Metaphor.

    ERIC Educational Resources Information Center

    Horwood, Bert

    1991-01-01

    Compares stewardship and hospitality as they relate to the biosphere. Traces the origin of the word "hospitality," discusses cultural traditions of hospitality, and applies the concept of hospitality to the natural world. Considers forms of symbiosis in nature: commensals, mutualism, and parasitism. Hospitality promotes respect,…

  9. Low Seroprevalence Indicates Vulnerability of Eastern and Central Sudan to Infection with Chikungunya Virus.

    PubMed

    Adam, Awadalkareem; Seidahmed, Osama M E; Weber, Christopher; Schnierle, Barbara; Schmidt-Chanasit, Jonas; Reiche, Sven; Jassoy, Christian

    2016-04-01

    Outbreaks of infections with chikungunya virus (CHIKV) have previously been reported from Sudan but the prevalence in the general population is unknown. We investigated the seroprevalence of CHIKV infection in 379 serum samples from patients with fever in the outpatient clinics of three hospitals in eastern and central Sudan. The seroprevalence was 1.8%, indicating that CHIKV infections are rare in these parts of Sudan. As the vector Aedes aegypti is endemic in this area, the population is at risk for a CHIKV epidemic.

  10. Philanthropy and hospital financing.

    PubMed Central

    Smith, D G; Clement, J P; Wheeler, J R

    1995-01-01

    OBJECTIVE. This study explores the relationships among donations to not-for-profit hospitals, the returns provided by these hospitals, and fund-raising efforts. It tests a model of hospital behavior and addresses an earlier debate regarding the supply price of donations. DATA SOURCES. The main data source is the California Office of Statewide Health Planning data tapes of hospital financial disclosure reports for fiscal years 1980/1981 through 1986/1987. Complete data were available for 160 hospitals. STUDY DESIGN. Three structural equations (donations, returns, and fund-raising) are estimated as a system using a fixed-effects, pooled cross-section, time-series least squares regression. PRINCIPAL FINDINGS. Estimation results reveal the expected positive relation between donations and returns. The reverse relation between returns and donations is insignificant. The estimated effect of fund-raising on donations is insignificantly different from zero, and the effect of donations on fund-raising is negative. Fund-raising and returns are negatively associated with one another. CONCLUSION. The empirical results presented here suggest a positive donations-returns relations and are consistent with a positive supply price for donations. Hospitals appear to view a trade-off between providing returns and soliciting donations, but donors do not respond equally to these two activities. Attempts to increase free cash flow through expansion of community returns or fund-raising activity, at least in the short run, are not likely to be highly successful financing strategies for many hospitals. PMID:8537223

  11. Hospitals' Internal Accountability

    PubMed Central

    Kraetschmer, Nancy; Jass, Janak; Woodman, Cheryl; Koo, Irene; Kromm, Seija K.; Deber, Raisa B.

    2014-01-01

    This study aimed to enhance understanding of the dimensions of accountability captured and not captured in acute care hospitals in Ontario, Canada. Based on an Ontario-wide survey and follow-up interviews with three acute care hospitals in the Greater Toronto Area, we found that the two dominant dimensions of hospital accountability being reported are financial and quality performance. These two dimensions drove both internal and external reporting. Hospitals' internal reports typically included performance measures that were required or mandated in external reports. Although respondents saw reporting as a valuable mechanism for hospitals and the health system to monitor and track progress against desired outcomes, multiple challenges with current reporting requirements were communicated, including the following: 58% of survey respondents indicated that performance-reporting resources were insufficient; manual data capture and performance reporting were prevalent, with the majority of hospitals lacking sophisticated tools or technology to effectively capture, analyze and report performance data; hospitals tended to focus on those processes and outcomes with high measurability; and 53% of respondents indicated that valuable cross-system accountability, performance measures or both were not captured by current reporting requirements. PMID:25305387

  12. Burden of rotavirus disease: A population-based study in Eastern Townships, Quebec

    PubMed Central

    Bernard, Sylvain; Valiquette, Louis; De Wals, Philippe; Nault, Vincent; Babakissa, Corentin; Cyr, Claude; Boileau, Thérèse Côté; Gagneur, Arnaud

    2013-01-01

    BACKGROUND: Since July 2010, the National Advisory Committee on Immunization of Canada has recommended rotavirus vaccination for all healthy infants. However, before implementing this vaccine in routine health programs, Canadian provinces need to establish current epidemiological data on rotavirus-associated acute gastroenteritis (AGE). METHODS: A retrospective cohort study of children <5 years of age with AGE from 2002 to 2008 was performed in Eastern Townships, Quebec (population in 2006: 298,780). Data were collected on visits to outpatient clinics, emergency department (ED) visits, hospitalizations (standard and short-stay units) and nosocomial AGE. The winter residual estimation and Brandt methods were used to estimate the proportion of AGE attributable to rotaviruses. RESULTS: During the six-year study period, a total of 1435 hospitalizations, 3631 ED visits and 6220 ambulatory care visits were attributed to AGE. The specific rotavirus burden was estimated to be 449 to 666 for hospitalizations, 1050 to 1361 for ED visits and 1633 to 1687 for outpatient visits. The epidemic curve showed a periodicity with higher incidence in March and April. Short-stay unit hospitalizations represented 58% of all hospitalizations. The annual incidence rate of rotaviruses was estimated to be 50 to 74 per 10,000 children for hospitalizations, 117 to 152 per 10,000 children for ED visits and 182 to 188 per 10,000 children for outpatient visits. CONCLUSION: Most available retrospective studies probably underestimate rotavirus-associated hospitalizations because they do not take into account short-stay unit hospitalizations. Furthermore, these data on emergency and outpatient visits provide an exhaustive appraisal of the rotavirus burden, which serves as crucial information for the evaluation of immunization programs. PMID:24421824

  13. Hospitalizations for pediatric anaphylaxis.

    PubMed

    Calvani, M; Di Lallo, D; Polo, A; Spinelli, A; Zappalà, D; Zicari, A M

    2008-01-01

    The aim of the study is to examine the epidemiology of anaphylaxis in hospitalized children in Lazio (Central Italy) and to evaluate the incidence and case fatality rate. We also verified the concordance of diagnosis between the Emergency Department and Ordinary hospitalizations. In order to obtain these results, we reviewed all ICD-9 codes indicative of anaphylaxis in all primary and secondary diagnoses from 2000 to 2003 in all Emergency Departments, Ordinary Hospitalizations and Day Hospitals in Lazio. We then identified 203 ICD-9 diagnoses of anaphylaxis in children aged between 0 and 17 years. Anaphylactic shock (995.0) accounted for 109 (53.7%) of cases. Food anaphylaxis (995.60 onwards) accounted for 87 (43.0%) of cases. Food anaphylaxis was more frequent in the first years of life. In fact, it decreased from 12.5/100,000 resident children/year in the first year of life to 6.1/100,000 resident children/year in the first two years of life, and less than 3/100,000 resident children/year after the seventh year (p <0.001). Only 12.5% of cases of anaphylaxis diagnosed in Ordinary Hospitalizations were subsequently diagnosed by the Emergency Department as anaphylaxis. Moreover, only 42.3% of the diagnoses of anaphylaxis made in the Emergency Department were later confirmed during ordinary hospitalization. In the four years of study, one child died from anaphylaxis. Thus, mortality was 0.038 cases/100,000 resident children/year. In conclusion, the incidence of hospitalization was highest in the first years of life, during which food anaphylaxis accounted for most hospitalizations. The inconsistency of diagnoses between Emergency Departments and Ordinary Hospitalizations suggests the need to increase awareness of anaphylaxis among health workers.

  14. Predicting hospital accounting costs

    PubMed Central

    Newhouse, Joseph P.; Cretin, Shan; Witsberger, Christina J.

    1989-01-01

    Two alternative methods to Medicare Cost Reports that provide information about hospital costs more promptly but less accurately are investigated. Both employ utilization data from current-year bills. The first attaches costs to utilization data using cost-charge ratios from the previous year's cost report; the second uses charges from current year's bills. The first method is the more accurate of the two, but even using it, only 40 percent of hospitals had predicted costs within plus or minus 5 percent of actual costs. The feasibility and cost of obtaining cost reports from a small, fast-track sample of hospitals should be investigated. PMID:10313352

  15. Hospital service recovery.

    PubMed

    Gutbezahl, Cary; Haan, Perry

    2006-01-01

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

  16. Hospital capital funding.

    PubMed

    Hebert, M

    1992-01-01

    It is critical that hospitals have a long-range plan in place to ensure that buildings and equipment are replaced when necessary. A study undertaken in British Columbia contrasted the Greater Vancouver Regional Hospital District's capital plan (past and future) to a proposed capital replacement model. The model, developed using accepted industry standards and criteria, provided an asset value that was used for comparison purposes. Building and equipment expenditures of the Surrey Memorial Hospital were also compared against the model. Findings from both studies are presented in this article.

  17. 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

  18. Decadal variability in the Eastern North Atlantic

    NASA Astrophysics Data System (ADS)

    Köllner, Manuela; Klein, Birgit; Kieke, Dagmar; Klein, Holger; Rhein, Monika; Roessler, Achim; Denker, Claudia

    2016-04-01

    The strong warming and salinification of the Eastern North Atlantic starting in the mid 1990s has been attributed to a westward contraction of the subpolar gyre and stronger inflow of waters from the subtropical gyre. Temporal changes in the shape and strength of the two gyres have been related to the major mode of atmospheric variability in the Atlantic sector, the NAO. Hydrographic conditions along the Northwest European shelf are thus the result of different processes such as variations in transports, varying relative contributions of water masses from the two gyres and property trends in the source water masses. We examine the decadal variability in the eastern North Atlantic based on Argo data from 2000-2015 and have constructed time series for four water masses (Subpolar Mode Water (SPMW), Intermediate Water (IW), upper Labrador Sea Water (uLSW) and deep Labrador Sea Water (dLSW)) at selected locations along the Northwest European shelf. Data from the Rockall Trough and the Iceland Basin are chosen to represent advective pathways in the subpolar gyre at two major branches of the North Atlantic Current towards the Nordic Seas and the Arctic Ocean. Temporal variability of subtropical waters transported northward along the eastern boundary is studied at Goban Spur around 48°N. The Argo data are extended in time with long-term hydrographic observations such as the Extended Ellet Line data and other climatological sources in the region. For the study of transport fluctuations time series from the RACE (Regional circulation and Global change) program (2012-2015) and predecessor programs have been used. These programs have monitored the subpolar gyre in the western basin and provide time series of transports and hydrographic anomalies from moored instruments at the western flank of the Mid Atlantic Ridge (MAR). First results show that the temperatures and salinities remained at high levels for the upper waters (SPMW and IW) until 2010 and have been decreasing since

  19. Hospital free cash flow.

    PubMed

    Kauer, R T; Silvers, J B

    1991-01-01

    Hospital managers may find it difficult to admit their investments have been suboptimal, but such investments often lead to poor returns and less future cash. Inappropriate use of free cash flow produces large transaction costs of exit. The relative efficiency of investor-owned and tax-exempt hospitals in the product market for hospital services is examined as the free cash flow theory is used to explore capital-market conditions of hospitals. Hypotheses concerning the current competitive conditions in the industry are set forth, and the implications of free cash flow for risk, capital-market efficiency, and the cost of capital to tax-exempt institution is compared to capital-market norms.

  20. American Hospital Association

    MedlinePlus

    ... Educational Trust HRET Main page HRET Hospital Improvement Innovation Network Equity of Care Huddle for Care The Symposium for Leaders in Healthcare Quality SLHQ Main page Research & Trends Research & Trends AHA Policy Research Reports Chartbook Financial ...

  1. General Practitioners in Hospital

    PubMed Central

    Smith, J. Weston; O'Donovan, J. B.

    1970-01-01

    An acute general hospital of 68 beds at Tamworth, a Midland town of 50,000 people, is staffed by general practitioners for both inpatient and casualty work. During the period 1967-8 there were 889 general practitioner admissions to the hospital for intermediate surgical and medical care, the average length of stay being 6·3 days and the average cost per case £44·3. Of these patients 96 were transferred to other hospitals. The patients, doctors, and standard of medical care have benefited from this kind of service. A “satellite” hospital of this type therefore has an important role in the community for carefully selected types of cases. PMID:5429111

  2. Home versus hospital confinement

    PubMed Central

    Barry, C. N.

    1980-01-01

    The case for hospital rather than home delivery has been powerfully argued, especially in and since the Report of the Peel Committee. Nevertheless, evidence of comparison with other countries, notably the Netherlands, suggests the choice is not necessarily simple. Some general practitioner units are now reporting perinatal mortality rates which are consistently lower than those of specialist units, and recent statistical analyses suggest that the presence of more high risk cases in consultant units does not explain this. The only big controlled home-versus-hospital trial did not lead to a significantly lower perinatal mortality rate in the hospital group. The onus of proof now seems to lie with those who advocate 100 per cent hospital confinement. PMID:7373581

  3. Objections to hospital philosophers.

    PubMed Central

    Ruddick, W; Finn, W

    1985-01-01

    Like morally sensitive hospital staff, philosophers resist routine simplification of morally complex cases. Like hospital clergy, they favour reflective and principled decision-making. Like hospital lawyers, they refine and extend the language we use to formulate and defend our complex decisions. But hospital philosophers are not redundant: they have a wider range of principles and categories and a sharper eye for self-serving presuppositions and implicit contradictions within our practices. As semi-outsiders, they are often best able to take an 'external point of view,' unburdened by routine, details, and departmental loyalties. Their clarifications can temporarily disrupt routine, but can eventually improve staff morale, hence team practice and patient welfare. PMID:3981573

  4. Hospital-acquired thrombocytopenia.

    PubMed

    McMahon, Christine M; Cuker, Adam

    2014-10-01

    The development of thrombocytopenia is common in hospitalized patients and is associated with increased mortality. Frequent and important causes of thrombocytopenia in hospitalized patients include etiologies related to the underlying illness for which the patient is admitted, such as infection and disseminated intravascular coagulation, and iatrogenic etiologies such as drug-induced immune thrombocytopenia, heparin-induced thrombocytopenia, posttransfusion purpura, hemodilution, major surgery, and extracorporeal circuitry. This review presents a brief discussion of the pathophysiology, distinguishing clinical features, and management of these etiologies, and provides a diagnostic approach to hospital-acquired thrombocytopenia that considers the timing and severity of the platelet count fall, the presence of hemorrhage or thrombosis, the clinical context, and the peripheral blood smear. This approach may offer guidance to clinicians in distinguishing among the various causes of hospital-acquired thrombocytopenia and providing management appropriate to the etiology.

  5. Practice Hospital Bed Safety

    MedlinePlus

    ... 1, 1985 and January 1, 2013, FDA received reports of 901 incidents of patients caught, trapped, entangled, or strangled in ... Use Todd says there have been very few reports of safety incidents with hospital beds used in private residences. "This ...

  6. 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.

  7. Fast tracking hospital construction.

    PubMed

    Quirk, Andrew

    2013-03-01

    Hospital leaders should consider four factors in determining whether to fast track a hospital construction project: Expectations of project length, quality, and cost. Whether decisions can be made quickly as issues arise. Their own time commitment to the project, as well as that of architects, engineers, construction managers, and others. The extent to which they are willing to share with the design and construction teams how and why decisions are being made.

  8. Managing diversity in hospitals.

    PubMed

    Schwartz, R H; Sullivan, D B

    1993-01-01

    Hospital work force diversity, although potentially a source of creativity and improved problem solving, is often a source of political strife and the mistreatment of people based on their identification with one or another of the diverse groups that are employed in hospitals. Factors linked to these phenomena are discussed and are the basis for suggestions about how administrators can deal with the organizational pathologies that are often associated with unmanaged work force diversity.

  9. [Hospital organizational structure].

    PubMed

    Bittar, O J

    1994-01-01

    The basic point for an Institution to work is the existence of a definite organizational structure that puts together similar areas allowing decisions and the operationalization of different tasks. Knowledge and analysis of structures of private and public hospitals and a bibliography review about the issue is the purpose of this paper. Suggestions are given about the elaboration of small structures and the utilization of matrix management in order to accomplish the hospitals objectives.

  10. Salaries in psychiatric hospitals.

    PubMed

    Pope, D W

    1989-01-01

    The National Association of Private Psychiatric Hospitals has been surveying hospitals for the past several years. This paper focuses on the salary levels and average annual rates of increase for a few selected positions. Comparisons are made with data from surveys covering similar positions in other settings and with the Consumer Price Index. Annual rates of increase are reported for five- and ten-year periods.

  11. Preventing falls in hospital.

    PubMed

    Pearce, Lynne

    2017-02-27

    Essential facts Falls are the most frequent adverse event reported in hospitals, usually affecting older patients. Every year, more than 240,000 falls are reported in acute hospitals and mental health trusts in England and Wales, equivalent to more than 600 a day, according to the Royal College of Physicians (RCP). But research shows that when nurses, doctors and therapists work together, falls can be reduced by 20-30%.

  12. Recurrent psychiatric hospitalization.

    PubMed Central

    Voineskos, G.; Denault, S.

    1978-01-01

    Undue emphasis has been placed on rising rates of readmission to psychiatric facilities. After a decade of preoccupation with discharge rates, readmission statistics have been singled out in the last 15 years as the key factor for assessing hospital effectiveness. A study of a group of patients at high risk for recurrent hospitalization revealed that these patients were characterized more by features relating to environmental supports than by diagnosis. The operational definition for recurrent hospitalization (five or more admissions during the 2-year period preceding the latest admission) was effective in identifying this group; this is the first reported instance in which the definition has specified a certain number of admissions within a time-limited period. The findings of this study, as well as of an analysis of case histories and consumer opinion, led to the design of a pilot program for persons undergoing recurrent hospitalization. Readmission statistics are useless or misleading as measures of hospital effectiveness and efficiency; what matters is the way the former patients function in the community after discharge. Rather than simply trying to reduce the readmission rate psychiatric facilities should be examining the types of persons who are hospitalized recurrently to develop programs aimed at improving the functioning of these people in the community. PMID:630483

  13. Hospital Waste Management in Nonteaching Hospitals of Lucknow City, India

    PubMed Central

    Manar, Manish Kumar; Sahu, Krishna Kumar; Singh, Shivendra Kumar

    2014-01-01

    Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW) management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices. PMID:25657950

  14. 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.

  15. Immunization determinants in the eastern region of Ghana.

    PubMed

    Brugha, R; Kevany, J

    1995-09-01

    A study of the immunization determinants of children aged 12 to 18 months was conducted in 1991 in the Eastern Region of Ghana, using structured interviews of mothers and fathers. The completion of immunization schedules by one year, among the 294 children, was positively associated (P < 0.005) with the town of residence of the child and mother, the ability of the mother to speak English, the target child having been treated for illness at the local hospital, the child's mother having given birth to less than 5 children, the possession of a sewing machine by the mother, and the birth of the child in the current town of residence. Significantly higher immunization coverage levels were achieved where the Under Fives' Clinic was an affordable and acceptable service, integrating preventive and curative care, and where measures were implemented by the community to increase attendance levels at the Clinic. This was achieved among a target group who were otherwise at a relatively high risk of failing to complete immunization schedules on-time.

  16. 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.

  17. Incidence of mandibular fractures in Eastern part of Libya.

    PubMed

    Elgehani, Rafa-Abdelsalam; Orafi, Maraai-Idris

    2009-10-01

    The objective of this retrospective study is to evaluate the incidence of mandibular fractures in the eastern part of Libya and to present our experience in treating this type of facial fracture. We analyzed factors such as the incidence of age, sex, time distribution, cause and site of the fracture and the associated injuries in 493 patients presenting a total of 666 mandibular fractures. These patients were treated at Al-Jala Trauma Hospital, Benghazi-Libya between 2000 and 2006. The results were obtained from 432 males and 61 females, for which the ages ranged from 8 months to 72 years. The maximum number of the patients was recorded in 2004, and the busiest month was May. The most common cause of fracture was road traffic accidents and the most common site was the parasymphysis. Among those treated with closed reduction were 241 patients, whereas 201 patients were treated with open reduction. In conclusion, we found that the results were similar to most studies from developing countries and were in contrast to other studies. This may be due factors such as geography, socioeconomic trends, religion, road traffic legislation and seasons, which differ from one country to another. The period during which there was an embargo in Libya also appears to have affected the results.

  18. Quantifying the Anthropogenic Footprint in Eastern China

    PubMed Central

    Meng, Chunlei; Dou, Youjun

    2016-01-01

    Urban heat island (UHI) is one of the most focuses in urban climate study. The parameterization of the anthropogenic heat (AH) is crucial important in UHI study, but universal method to parameterize the spatial pattern of the AH is lacking now. This paper uses the NOAA DMSP/OLS nighttime light data to parameterize the spatial pattern of the AH. Two experiments were designed and performed to quantify the influences of the AH to land surface temperature (LST) in eastern China and 24 big cities. The annual mean heating caused by AH is up to 1 K in eastern China. This paper uses the relative LST differences rather than the absolute LST differences between the control run and contrast run of common land model (CoLM) to find the drivers. The heating effect of the anthropogenic footprint has less influence on relatively warm and wet cities. PMID:27067132

  19. Fuel shortage hits eastern Siberia region

    SciTech Connect

    Not Available

    1992-07-20

    Moscow's loss of absolute authority over the Russian economy has contributed to growing chaos in the supply of oil and gas to the former U.S.S.R.'s far eastern territories. This paper reports that Sakhalin Island, which has provided a substantial portion of the area's hydrocarbon fuels, has shown increasing reluctance to sell oil and gas for nearly worthless rubles to its eastern Siberian neighbors. Instead, it is bartering as much as possible of its surplus petroleum for foreign food and consumer goods. Moscow's Izvestia newspaper strongly criticized Sakhalin authorities for placing the island's interests ahead of the welfare of the Russian republic as a whole. It the Sakhalin's selfish attitude resulted in near disaster last winter for the economy and populace of neighboring Khabarovsk territory on the Siberian mainland. Only milder than normal winter weather prevented a catastrophe, Izvestia reported. Even so, some old people died from the cold in Khabarovsk, a city of 600,000 population.

  20. Quantifying the Anthropogenic Footprint in Eastern China.

    PubMed

    Meng, Chunlei; Dou, Youjun

    2016-04-12

    Urban heat island (UHI) is one of the most focuses in urban climate study. The parameterization of the anthropogenic heat (AH) is crucial important in UHI study, but universal method to parameterize the spatial pattern of the AH is lacking now. This paper uses the NOAA DMSP/OLS nighttime light data to parameterize the spatial pattern of the AH. Two experiments were designed and performed to quantify the influences of the AH to land surface temperature (LST) in eastern China and 24 big cities. The annual mean heating caused by AH is up to 1 K in eastern China. This paper uses the relative LST differences rather than the absolute LST differences between the control run and contrast run of common land model (CoLM) to find the drivers. The heating effect of the anthropogenic footprint has less influence on relatively warm and wet cities.

  1. Quantifying the Anthropogenic Footprint in Eastern China

    NASA Astrophysics Data System (ADS)

    Meng, Chunlei; Dou, Youjun

    2016-04-01

    Urban heat island (UHI) is one of the most focuses in urban climate study. The parameterization of the anthropogenic heat (AH) is crucial important in UHI study, but universal method to parameterize the spatial pattern of the AH is lacking now. This paper uses the NOAA DMSP/OLS nighttime light data to parameterize the spatial pattern of the AH. Two experiments were designed and performed to quantify the influences of the AH to land surface temperature (LST) in eastern China and 24 big cities. The annual mean heating caused by AH is up to 1 K in eastern China. This paper uses the relative LST differences rather than the absolute LST differences between the control run and contrast run of common land model (CoLM) to find the drivers. The heating effect of the anthropogenic footprint has less influence on relatively warm and wet cities.

  2. Science, Eastern Orthodoxy, and World Religions.

    PubMed

    Brooke, John Hedley; Numbers, Ronald L

    2016-09-01

    The history of Orthodoxy and science invites contrasts with other religious traditions. In contradistinction to the Latin West, for example, Eastern Orthodoxy throughout its history embraced the “pagan” scientific achievements of ancient Greece. Also unlike in the West, where ecclesiastical institutions often supported scientific activities, scholars in the East—in both the Byzantine and Ottoman periods— relied primarily on temporal sources to sustain their investigations of nature. Islam, with its strenuous resistance to any assimilation of the human to the divine, provides another contrasting example, as does the later Protestant justification for science grounded in the need to restore a fallen world through the application of experimental research. Not surprisingly, Eastern Orthodox believers seem to have paid little attention to non-Christian faiths, with the exception of Islam and Judaism, until well into the twentieth century.

  3. Paleoceanography of the tropical eastern pacific ocean.

    PubMed

    Grigg, R W; Hey, R

    1992-01-10

    The East Pacific Barrier (EPB) is the most effective marine barrier to dispersal of tropical shallow-water fauna in the world today. The fossil record of corals in the eastern Pacific suggests this has been true throughout the Cenozoic. In the Cretaceous, the EPB was apparently less effective in limiting dispersal. Equatorial circulation in the Pacific then appears to have been primarily east to west and the existence of oceanic atolls (now drowned guyots) in the eastern Pacific probably aided dispersal. Similarly, in the middle and early Mesozoic and late Paleozoic, terranes in the central tropical Pacific likely served as stepping stones to dispersal of tropical shelf faunas, reducing the isolating effect of an otherwise wider Pacific Ocean (Panthalassa).

  4. Damping modification factors for eastern Canada

    NASA Astrophysics Data System (ADS)

    Daneshvar, Poulad; Bouaanani, Najib

    2017-07-01

    This paper investigates damping modification factors in eastern Canada based on historical and simulated records compatible with seismic hazard in this region. Damping modification factors are characterized as a function of magnitude, distance, site condition, and damping ratio. Damping modification factors corresponding to historical and simulated ground motions on rock sites are shown to exhibit the same trends for all damping levels. In addition to period dependency of damping modification factors, we demonstrate their sensitivity to magnitude variations at longer periods. The effect of distance is shown to be less pronounced. It is also observed that soil conditions affect damping modification factors at short as well as longer periods. Period-dependent equations are proposed for practical assessment of damping modification factors corresponding to damping ratios between 1 and 40%, considering different magnitude-distance combinations and soil conditions representative of seismic hazard in eastern Canada.

  5. Why Telestroke networks? Rationale, implementation and results of the Stroke Eastern Saxony Network.

    PubMed

    Bodechtel, Ulf; Puetz, Volker

    2013-09-01

    Stroke is the third leading cause of death and the leading cause of acquired long-term disability in Europe and North America. Intravenous (IV) thrombolysis with alteplase and organized inpatient (stroke unit) care have been shown to improve stroke patients' functional outcomes. However, stroke unit care is not area-wide available and thrombolysis rates are low, partly due to limited stroke thrombolysis expertise in smaller community hospitals. Telemedical stroke networks (Telestroke network) with remote video assessment of patients and brain computed tomography (CT) scans by stroke neurologists have been shown to increase IV thrombolysis rates and functional outcomes of patients in smaller community hospitals. Our article summarizes the rationale, clinical, and currently published scientific results of Telestroke networks with special respect to the telemedical Stroke Eastern Saxony Network (SOS-NET), which has been established by the Dresden University Stroke Center (DUSC) in July 2007. From July 2007 to December 2012, 3416 teleconsultations have been performed within the SOS-NET.

  6. Timber Volume in Eastern South Dakota, 1980

    Treesearch

    Ronald L. Hackett

    1982-01-01

    Eastern South Dakota's 113,600 acres of commercial forest land supported 51.9 million cubic feet of growing stock in 1981. This is a decrease in timber volume of 24 percent since the last inventory in 1965. the decrease was entirely in hardwood species. Cottonwood is the most abundant tree species -- it accounts for 33 percent of the growing-stock volume and...

  7. box modeling of the eastern mediterranean sea

    NASA Astrophysics Data System (ADS)

    Ashkenazy, Y.; Stone, P. H.

    2003-04-01

    Recently (~1990) a new source of deep water formation in the Eastern Mediterranean was found in the southern part of the Aegean sea. Till then, the only source of deep water formation in the Eastern Mediterranean was in the Adriatic sea; the rate of the deep water formation of the new Aegean source is 1Sv=10^6m^3/s, three times larger then the Adriatic source. We develop a simple 3 box-model to study the stability of the thermohaline circulation of the Eastern Mediterranean sea. The 3 boxes represent the Adriatic sea, Aegean sea, and the Ionian sea. The boxes exchange heat and salinity and may be described by a set of nonlinear differential equations. We analytically analyze these equations and find that the system may have one, two, or four stable flux states. We consider two cases for which the temperatures of the boxes are (i) fixed or (ii) variable. After setting the parameters to correspond to the Eastern Mediterranean we find that the system has two stable states, one with (i) two thermally dominant sources of deep water formation in the Adriatic and Aegean and the other with (ii) a salinity dominant source of deep water formation in the Adriatic and a thermally dominant source in the Aegean. While the Adriatic thermally dominant source is comparable to the observed flux of 0.3Sv the Aegean source has much smaller flux than the observed value. This situation is analogous to the state of the thermohaline circulation pre 1990 where the only source of deep water formation was in the Adriatic. If we decrease the atmospheric temperature of the Aegean box by 2C in accordance with recent observations, we find that the deep water formation of the Aegean increases significantly to a value comparable to the recently observed flux.

  8. Phytoremediation of Excavation in Eastern Siberia

    NASA Astrophysics Data System (ADS)

    Timofeeva, S. S.; Zhmurova, T. M.

    2017-04-01

    The paper deals with prospects and applicability of phytoremediation technology in the conditions of Eastern Siberia as applied to gypsum stone extraction of Zalarinsky deposit in Irkutsk region. It analyses dust intensity for different technological processes of the deposit and evaluates the dust loading on the workers of the deposit. The selection of plantings that have potential to neutralize the dust loading produced by the plot “Severniy” is carried out.

  9. Hubble Space Telescope Deploy, Eastern Cuba, Haiti

    NASA Image and Video Library

    1990-04-29

    A close up deploy view of the Hubble Space Telescope on the end of the space shuttle remote manipulator system (RMS) with Eastern Cuba, (20.0N, 74.0W) seen on the left side of the telescope and northern Haiti seen on the right side of the telescope. The light colored blue feature in the water north of Haiti is the shallow waters of the Caicos Bank.

  10. Venus - Impact Crater in Eastern Navka Region

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This Magellan image, which is 50 kilometers (31 miles) in width and 80 kilometers (50 miles) in length, is centered at 11.9 degrees latitude, 352 degrees longitude in the eastern Navka Region of Venus. The crater, which is approximately 8 kilometers (5 miles) in diameter, displays a butterfly symmetry pattern. The ejecta pattern most likely results from an oblique impact, where the impactor came from the south and ejected material to the north.

  11. Venus - Impact Crater in Eastern Navka Region

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This Magellan image, which is 50 kilometers (31 miles) in width and 80 kilometers (50 miles) in length, is centered at 11.9 degrees latitude, 352 degrees longitude in the eastern Navka Region of Venus. The crater, which is approximately 8 kilometers (5 miles) in diameter, displays a butterfly symmetry pattern. The ejecta pattern most likely results from an oblique impact, where the impactor came from the south and ejected material to the north.

  12. Frost injury to bitterbrush in eastern California

    Treesearch

    R. S. Smith; R. F. Scharpf; E. R. Schneegas

    1965-01-01

    Widespread dieback of Purshia tridentata, on the Inyo National Forest in eastern California in the spring of 1964, was caused by a severe 3-day frost with daily minimums down to 13°F. An unusually warm 9-day period-with temperatures up to 70°F., which preceded the frost by a week, had induced the bitterbrush to break dormancy and start shoot elongation when the frost...

  13. Recent population trends of the eastern bluebird

    USGS Publications Warehouse

    Sauer, J.R.; Droege, S.

    1990-01-01

    North American Breeding Bird Survey data for the period 1966-1987 indicate that Eastern Bluebird (Sialia sialis) populations declined during the 1970s, primarily in association with either severe winters or severe spring storms. In recent years, bluebird populations have increased to levels similar to those observed during the first year (1966) of the survey. Survey results suggest that climate has an important role in affecting short-term population declines in bluebirds.

  14. Eastern Texas harvest and utilization study, 2003

    Treesearch

    James W. Bentley; Tony G. Johnson

    2004-01-01

    In 2003, a harvest and utilization study was conducted on 81 operations throughout eastern Texas. There were 2,072 total trees measured, 1,557 or 75 percent were softwood, while 515 or 25 percent were hardwood. Results from this study showed that 87 percent of the total softwood volume measured was utilized for a product, while the other 13 percent was left as logging...

  15. Temporal labyrinths of eastern Eurasian Pleistocene humans.

    PubMed

    Wu, Xiu-Jie; Crevecoeur, Isabelle; Liu, Wu; Xing, Song; Trinkaus, Erik

    2014-07-22

    One of the morphological features that has been identified as uniquely derived for the western Eurasian Neandertals concerns the relative sizes and positions of their semicircular canals. In particular, they exhibit a relatively small anterior canal, a relatively larger lateral one, and a more inferior position of the posterior one relative to the lateral one. These discussions have not included full paleontological data on eastern Eurasian Pleistocene human temporal labyrinths, which have the potential to provide a broader context for assessing Pleistocene Homo trait polarities. We present the temporal labyrinths of four eastern Eurasian Pleistocene Homo, one each of Early (Lantian 1), Middle (Hexian 1), and Late (Xujiayao 15) Pleistocene archaic humans and one early modern human (Liujiang 1). The labyrinths of the two earlier specimens and the most recent one conform to the proportions seen among western early and recent modern humans, reinforcing the modern human pattern as generally ancestral for the genus Homo. The labyrinth of Xujiayao 15 is in the middle of the Neandertal variation and separate from the other samples. This eastern Eurasian labyrinthine dichotomy occurs in the context of none of the distinctive Neandertal external temporal or other cranial features. As such, it raises questions regarding possible cranial and postcranial morphological correlates of Homo labyrinthine variation, the use of individual "Neandertal" features for documenting population affinities, and the nature of late archaic human variation across Eurasia.

  16. Late Quaternary mammalian zoogeography of eastern Washington

    NASA Astrophysics Data System (ADS)

    Lyman, R. Lee; Livingston, Stephanie D.

    1983-11-01

    The late Quaternary mammalian zoogeographic history of eastern Washington as revealed by archaeological and paleontological research conforms to a set of past environmental conditions inferred from botanical data. During the relatively cool and moist late Pleistocene and early Holocene, Cervus cf. elaphus, Ovis canadensis, Vulpes vulpes, Martes americana, Alopex lagopus, and perhaps Rangifer sp., taxa with ecological preferences for mesic steppe habitats, were present in the now xeric Columbia Basin. As the climate became progressively warmer and drier during the late Pleistocene and early Holocene, Antilocapra americana, Onychomys leucogaster, Spermophilus townsendii, and Neotoma cinerea, taxa with ecological preferences for xeric steppe habitats, appear in the Columbia Basin. Bison sp. and Taxidea taxus may have been present in eastern Washington for the last 20,000 yr. Middle and late Holocene records for Oreamnos americanus, Spermophilus columbianus, S. townsendii, Lagurus curtatus, and Urocyon cinereoargenteus in central eastern Washington suggest fluctuations in the ranges of these taxa that conform to a middle Holocene period of less effective precipitation and a ca. 3500-yr-old period of more effective precipitation before essentially modern environmental conditions prevailed.

  17. Temporal labyrinths of eastern Eurasian Pleistocene humans

    PubMed Central

    Wu, Xiu-Jie; Crevecoeur, Isabelle; Liu, Wu; Xing, Song; Trinkaus, Erik

    2014-01-01

    One of the morphological features that has been identified as uniquely derived for the western Eurasian Neandertals concerns the relative sizes and positions of their semicircular canals. In particular, they exhibit a relatively small anterior canal, a relatively larger lateral one, and a more inferior position of the posterior one relative to the lateral one. These discussions have not included full paleontological data on eastern Eurasian Pleistocene human temporal labyrinths, which have the potential to provide a broader context for assessing Pleistocene Homo trait polarities. We present the temporal labyrinths of four eastern Eurasian Pleistocene Homo, one each of Early (Lantian 1), Middle (Hexian 1), and Late (Xujiayao 15) Pleistocene archaic humans and one early modern human (Liujiang 1). The labyrinths of the two earlier specimens and the most recent one conform to the proportions seen among western early and recent modern humans, reinforcing the modern human pattern as generally ancestral for the genus Homo. The labyrinth of Xujiayao 15 is in the middle of the Neandertal variation and separate from the other samples. This eastern Eurasian labyrinthine dichotomy occurs in the context of none of the distinctive Neandertal external temporal or other cranial features. As such, it raises questions regarding possible cranial and postcranial morphological correlates of Homo labyrinthine variation, the use of individual “Neandertal” features for documenting population affinities, and the nature of late archaic human variation across Eurasia. PMID:25002467

  18. 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.

  19. Effect of Hospital Ownership on Outcomes of Heart Failure Hospitalization.

    PubMed

    Akintoye, Emmanuel; Briasoulis, Alexandros; Egbe, Alexander; Orhurhu, Vwaire; Ibrahim, Walid; Kumar, Kartik; Alliu, Samson; Nas, Hala; Levine, Diane; Weinberger, Jarrett

    2017-09-01

    This study aimed to evaluate the impact of hospital ownership on heart failure (HF) hospitalization outcomes in the United States using data from the National Inpatient Sample of the Agency for Healthcare Research and Quality. Hospital ownership was classified into three, namely, nonfederal government, not-for-profit, and for-profit hospitals. Participants were adults hospitalized with a primary diagnosis of HF (2013 to 2014). End points included inpatient mortality, length-of-stay, cost and charge of hospitalization, and disposition at discharge. Of the estimated 1.9 million HF hospitalizations in the United States between 2013 and 2014, 73% were in not-for-profit hospitals, 15% were in for-profit hospitals, and 12% were in nonfederal government hospitals. Overall, mortality rate was 3%, mean length of stay was 5.3 days, median cost of hospitalization was USD 7,248, and median charge was USD 25,229, and among those who survived to hospital discharge, 51% had routine home discharge. There was no significant difference in inpatient mortality between hospital ownership among male patients, but there was a significant difference for female patients. Compared with government hospitals, mortality in female patients was lower in not-for-profit (odds ratio: 0.85 [95% confidence interval: 0.77 to 0.94]) and for-profit hospitals (odds ratio: 0.77 [0.68 to 0.87]). In addition, mean length of stay was highest in not-for-profit hospitals (5.4 days) and lowest in for-profit hospitals (5 days). Although cost of hospitalization was highest in not-for-profit hospitals (USD 7462) and lowest in for-profit hospitals (USD 6,290), total charge billed was highest in for-profit hospitals (USD 35,576) and lowest in government hospitals (USD 19,652). The average charge-to-cost ratio was 3:1 for government hospitals, 3.5:1 for not-for-profit hospitals, and 5.9:1 for for-profit hospitals. In conclusion, there exist significant disparities in HF hospitalization outcomes between hospital

  20. 3. Hospital Point, general view toward Portsmouth Naval Hospital Building ...

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

    3. Hospital Point, general view toward Portsmouth Naval Hospital Building showing cannon (at left) and Saunders Monument (at right in distance), view to southwest - Portsmouth Naval Hospital, Bounded by Elizabeth River, Crawford Street, Portsmouth General Hospital, Parkview Avenue, & Scotts Creek, Portsmouth, Portsmouth, VA

  1. Hospitals look to hospitality service firms to meet TQM goals.

    PubMed

    Hard, R

    1992-05-20

    Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.

  2. Seismicity of the eastern Hellenic Subduction Zone

    NASA Astrophysics Data System (ADS)

    Bruestle, A.; Kueperkoch, L.; Rische, M.; Meier, T.; Friederich, W.; Egelados Working Group

    2012-04-01

    The Hellenic Subduction Zone (HSZ) is the seismically most active region of Europe. The African plate is subducting beneath the Aegean lithosphere with a relative velocity of 4 cm per year. A detailed picture of the microseismicity of the eastern HSZ was obtained by the recordings of the temporary networks CYCNET (September 2002 - September 2005) and EGELADOS (October 2005 - March 2007). In total, nearly 7000 earthquakes were located with a location uncertainty of less than 20 km. The SE Aegean is dominated by (1) shallow intraplate seismicity within the Aegean plate, by (2) interplate seismicity at the plate contact and by (3) intermediate deep seismicity along the subducting African slab. Strong shallow seismicity in the upper plate is observed along the Ptolemy graben south of Crete extending towards the Karpathos Basin, indicating intense recent deformation of the forearc. In contrary, low shallow seismicity around Rhodes indicates only minor seismic crustal deformation of the upper plate. An almost NS-striking zone of microseismicity has been located, running from the Karpathos basin via the Nisyros volcanic complex towards the EW striking Gökova graben. In the SE Aegean the geometry of the Wadati-Benioff-Zone (WBZ) within the subducting African plate is revealed in detail by the observed microseismicity. Between about 50 to 100 km depth a continuous band of intermediate deep seismicity describes the strongly curved geometry of the slab. From the central to the eastern margin of the HSZ, the dip direction of the WBZ changes from N to NW with a strong increase of the dip angle beneath the eastern Cretan Sea. The margin of the dipping African slab is marked by an abrupt end of the observed WBZ beneath SW Anatolia. Below 100 km depth, the WBZ of the eastern HSZ is dominated by an isolated cluster of intense intermediate deep seismicity (at 100-180 km depth) beneath the Nisyros volcanic complex. It has an extension of about 100x80 km and is build up of 3 parallel

  3. The impact of hospital discharge on inappropriate hospital stay.

    PubMed

    Panis, Lambert J G G; Verheggen, Frank W S M; Pop, Peter; Prins, Martin H

    2004-01-01

    Appropriate hospital stay should be effective, efficient and tailored to patient needs. Previous studies have found that on average 20 per cent of hospital stay is inappropriate. Within obstetrics, inappropriate hospital stay consists mostly of delays in hospital discharge. The specific goals of this study were to reduce inappropriate hospital stay by fine-tuning patient logistics, increasing efficiency and providing more comfortable surroundings. New policies using strict discharge criteria were implemented. Total inappropriate hospital stay decreased from 13.3 to 7.2 per cent. The delay in discharge procedures halved. P-charts showed a decrease in inappropriate hospital stay, indicating the current process to be stable. Concludes that a significant reduction in inappropriate hospital stay was found following the implementation of innovative hospital discharge policies, indicating greater efficiency and accessibility of hospital services.

  4. Interdepartmental Dermatology: Characteristics and Impact of Dermatology Inpatient Referrals at a Teaching Hospital in Eastern India

    PubMed Central

    Chowdhury, Satyendra Nath; Podder, Indrasish; Saha, Abanti; Bandyopadhyay, Debabrata

    2017-01-01

    Background: Dermatology is primarily considered to be an outpatient-centered specialty. However, several inpatient admissions to other specialties require dermatologic consultation for optimum management. Aims: To analyze the causes of inpatient dermatology referrals, departments sending referrals, and impact of dermatology consultation on patient management. Materials and Methods: We conducted a cross-sectional study by analyzing the records of 486 patient referrals over a 4-year period. The demographic details, specialties requesting consultation, cause of referral, and dermatological advice have been recorded and analyzed. Results: Dermatology consultation changed the dermatologic diagnosis and treatment of almost two-thirds of patients. General medicine requested the maximum number of referrals, “skin rash” being the most common cause for referral. Accurate diagnosis on referrals was provided by only 30.2% of nondermatologists. Common dermatological disorders were often misdiagnosed by these physicians, and dermatology referrals had significant impact on the diagnosis and subsequent management of these patients. Conclusion: While dermatologic referral leads to improved patient care, there is a need for better training of nondermatologists enabling them to recognize and treat common dermatoses. PMID:28216722

  5. Predictors of mortality in leptospirosis: an observational study from two hospitals in Kolkata, eastern India.

    PubMed

    Goswami, Rudra P; Goswami, Rama P; Basu, Ayan; Tripathi, Santanu Kumar; Chakrabarti, Sanghamitra; Chattopadhyay, Indrajit

    2014-12-01

    Leptospirosis has a mortality rate of 5-20%. Poor prognostic factors are older age; oliguria; elevated potassium, creatinine and/or bilirubin levels; and altered mental status. We conducted this retrospective study to analyse the predictors of mortality among Indian patients with leptospirosis. Clinical, biochemical, demographic and treatment related data (time between onset of symptoms and commencement of leptospira specific antibiotics) of 101 leptospirosis patients were reviewed. Predictors identified by univariate analysis were analysed by multivariable Cox regression for survival analysis. Prominent clinical features were: fever (101/101, 100%), jaundice (62, 62.4%), vomiting (42, 41.6%), oliguria (35, 34.7%), cough (18, 17.8%) and dyspnoea (10, 10.0%). Common complications were acute kidney injury (22, 21.8%), cardiovascular collapse (13, 12.9%), haemorrhages (10, 10.0%), meningitis (7, 6.9%), acute respiratory distress syndrome and pancreatitis (5, 5.0% each). Seventeen patients died (16.8%). Univariate predictors of mortality were older age, delayed antibiotic therapy, higher bilirubin, aspartate aminotransferase, alkaline phosphatase, leucocyte count and aspartate/alanine aminotransferase ratio (AAR). Only AAR (HR 1.208, 95% CI 1.051-1.388) and number of days the patient was symptomatic before access to specific antibiotic therapy (HR 1.304, 95% CI 1.081-1.574) remained significant predictors after Cox regression. Multivariate analysis showed high AAR and delayed antibiotic therapy might be associated with fatality. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. 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

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

    PubMed

    Li, Xiaohong; Shen, Jay J; Lu, Jun; Wang, Ying; Sun, Mei; Li, Chengyue; Chang, Fengshui; Hao, Mo

    2013-12-05

    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. 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. 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. 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.

  8. Yellow oleander poisoning in eastern province: an analysis of admission and outcome.

    PubMed

    Pirasath, Selladurai; Arulnithy, Kanagasingam

    2013-01-01

    Cardiac toxicity after self-poisoning from ingestion of yellow oleander seeds is common in Eastern Sri Lanka. To determine the clinical manifestations, cardiac arrhythmias, electrolytes abnormalities and outcome of management using currently available treatment, Poisoning Unit, Tertiary Care Hospital in Eastern Sri Lanka. We studied 65 patients [Mean age : 23(± 0.43)yrs], (Male: Female=27:38) with yellow oleander poisoning (YOP) admitted to a Poisoning Unit, Tertiary Care Hospital in Eastern Sri Lanka from January to December 2011. Most patients are symptomatic who presented with classical symptoms of vomiting, abdominal pain and diarrhea. Cardiac dysrhythmias such as bradycardia or an irregular pulse are the most common findings on examination. Most symptomatic patients had conduction defects affecting the sinus node, the atrioventricular (AV) node, or both. Patients showing cardiac arrhythmias that required transfer for specialised management had significantly higher serum potassium concentrations. Almost all patients were treated with multiple activated charcoal even late presentation. Patients with brad arrhythmias were treated with intravenous boluses of atropine and intravenous infusions of isoprenaline. Temporary cardiac pacing was done for those not responding to drug therapy. There were two deaths (3.07%), both had third-degree heart block. They died even definitive treatment could be instituted. Of the remaining 63 patients, 54 (83.1%) patients required treatment, and 29 were treated with only atropine and/or isoprenaline while one required cardiac pacing in addition. 12 (18.4%) patients had arrhythmias that were considered life threatening (second-degree heart block type II, third-degree heart block and nodal bradycardia). They had good recovery even though they had developed cardiac toxicity. YOP are common among young females. The cardiac toxicity develops within 24 hrs of ingestion of YO seeds. The risk of toxicity has negative correlation with

  9. [Marianne in hospital].

    PubMed

    Weium, Frode

    2003-12-23

    In 1948 Norwegian architect and author Odd Brochmann (1909-92) published his popular children's book Marianne in hospital (Marianne på sykehus). Two years later the book was filmed on the initiative of the Ministry of Social Affairs. This article considers the question of what were the purposes of the film. Officially, it was presented as an attempt to teach children not to be afraid of hospitals. However, in internal notes and letters the health authorities stressed that the film should be an educational film about the social benefits and health services of the welfare state. Furthermore, I will argue that the film was the result of a wish to present the nation's modern hospital care and, by way of conclusion, discuss the characterisation of the film as educational.

  10. [Stress management in hospitals].

    PubMed

    Miki, Akiko

    2002-11-01

    Job stress in employees in hospitals has been recognized as a key issue in the workplace. In this paper, characteristics of job stress in the medical profession, especially in doctors and nurses, and the effectiveness of stress management are overviewed. The important points in stress management in hospitals are summarized as follows: 1) improvement of work environment, 2) assurance of participation and autonomy, 3) education or training to reduce job stress (ex. coping behavior, self-care, relaxation), 4) career development, 5) total support among medical professions. Some reports have demonstrated that the establishment of constant meetings is an effective method of reducing job stress and improving mental health in the medical profession, but few prospective intervention studies have been carried out. Further research is necessary to evaluate the effectiveness of stress reduction and to develop effective intervention programs for medical professions in hospitals.

  11. [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.

  12. [Standardization of hospital feeding].

    PubMed

    Caracuel García, Ángel Manuel

    2015-05-07

    Normalization can be understood as the establishing measures against repetitive situations through the development, dissemination, and application of technical design documents called standards. In Andalusia there are 45 public hospitals with 14,606 beds, and in which 11,700 full pensions / day are served. The Working Group on Hospital Food Standardization of the Andalusian Society for Clinical Nutrition and Dietetics, started in 2010, working on the certification of suppliers, product specifications, and meals technical card. - Develop a specific tool to help improving food safety through the certification of their suppliers. - Develop a standardized technical specifications of foodstuffs necessary for the development of menus established codes diets Andalusian hospitals document. - Develop a catalog of data sheets plates of hospital meals, to homogenize menus, respecting local and unifying criteria for qualitative and quantitative ingredients. - Providing documentation and studying of several public hospitals in Andalusia: • Product specifications and certification of suppliers. • International standards certification and distribution companies. • Legislation. • Data sheets for the menu items. • Specifications of different product procurement procedures. - Development of the draft standard HOSPIFOOD®, and approval of the version “0.0”. - Training course for auditors to this standard. - Development of a raw materials catalog as technical cards. - Meals Technical cards review and election of the ones which will be part of the document. After nearly three years of work, we have achieved the following products: - Standardized database of technical specifications for the production of food dietary codes for: fish, seafood, meat and meat products, meats and pates, ready meals, bread and pastries, preserves, milk and dairy products, oils, cereals, legumes , vegetables, fruits, fresh and frozen vegetables, condiments and spices. - Standardized database of

  13. Tiered hospital networks.

    PubMed

    Yegian, Jill M

    2003-01-01

    As a result of rising health care costs, health plans are experimenting with insurance products that shift greater financial responsibility for medical care to consumers and create incentives for consumers to consider cost differences when choosing among providers. Based on an October 2002 roundtable discussion, this paper discusses insurance product trends, particularly tiered hospital networks. Issues addressed include these product features' potential to reduce system costs, the effect on the hospital-health plan relationship, consumers' ability to consider cost and quality in decision making, and financial barriers to care for the chronically ill.

  14. Marketing the hospital library.

    PubMed

    Bridges, Jane

    2005-01-01

    Many librarians do not see themselves as marketers, but marketing is an essential role for hospital librarians. Library work involves education, and there are parallels between marketing and education as described in this article. It is incumbent upon hospital librarians actively to pursue ways of reminding their customers about library services. This article reinforces the idea that marketing is an element in many of the things that librarians already do, and includes a list of suggested marketing strategies intended to remind administrators, physicians, and other customers that they have libraries in their organizations.

  15. Telecommunications and the hospital.

    PubMed

    Tobias, T; Levine, J

    1986-04-01

    Telecommunications is a rapidly changing industry which currently offers the hospital administrator an opportunity to cut costs in the short run while providing for future needs. Like any important resource, this technology must be managed by skilled personnel who can recommend solutions consistent with the hospital's business philosophy and strategic plan. Three specific actions were recommended: first, consider modernizing your PBX; second, train an inhouse person or hire a telecommunications analyst to conduct the review of available systems and options and to supervise installation and operation; and third, when replacing computer systems and PBXs, develop a plan which will provide for current needs and future growth.

  16. Toward healthier hospitals.

    PubMed

    Mintzberg, H

    1997-01-01

    This article builds around a framework of cure, care, control, and community, with collaboration at the center, to consider 12 issues common to many hospitals. These include, among others, the fragmentation of efforts, confusion in mission (and in mission statements), the problems of bundling research with clinical work, selectivity in informing board members, the dangers of professional management, and the difficulties of combining external advocacy with internal reconciliation in the senior manager's job. The article concludes that hospitals could better learn how to solve systemic problems systemically, and that to do so will require not the wish lists of strategic planning and structural reorganizing, but tangible changes in their collective behavior.

  17. 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.

  18. 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

  19. 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.

  20. Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems.

    PubMed

    Melnick, Glenn A; Fonkych, Katya

    2016-01-01

    A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission) across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113%) than prices paid to all other California hospitals (70%). Prices were similar in both groups at the start of the period (approximately $9200 per admission). By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country. © The Author(s) 2016.

  1. 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.

  2. Episodic growth of topography in eastern Tibet

    NASA Astrophysics Data System (ADS)

    Kirby, E.; Furlong, K.; Wang, E.; Shi, X.; van Soest, M.; Xu, G.; Kamp, P.; Hodges, K.

    2012-04-01

    High topography associated with the eastern portions of the Tibetan Plateau is thought to have developed as eastward flow of deep crust from beneath central Tibet drove crustal thickening and attendant surface uplift along the periphery of the plateau. The onset of rapid Late Miocene exhumation (ca. 10-15 Ma) in deep canyons of eastern Tibet is inferred to herald surface uplift which enabled rapid fluvial incision and the development of high topographic relief. Although consistent with geophysical data, this model struggles to explain the timing and amount of Cenozoic shortening adjacent to the Sichuan Basin. Here we report cooling histories of rocks currently exposed along a ~3 km vertical section adjacent to the Sichuan Basin derived from multiple low-temperature thermochronologic systems including apatite and zircon fission-track and (U-Th)/He. Our results reveal that this margin of the plateau was subject to slow, steady exhumation during early Cenozoic time, requiring that limited topographic relief (<1000m) was present prior to initial collision of India and Asia. Moreover, thermal models of exhumation-driven cooling demonstrate that subsequent exhumation of >10 km occurred in two temporally-distinct episodes, during Oligocene (~30-25 Ma) and Late Miocene (~10-15 Ma) time, separated by a hiatus of at least 10 Ma. These results challenge the notion that the plateau in eastern Tibet developed as a singular consequence of lower crustal flow. Rather, our findings require a punctuated history of mountain building that potentially reconciles conflicting models for relative roles of upper crustal shortening and lower crustal flow in the development of topography adjacent to the Sichuan Basin.

  3. Modelling the shelf circulation off eastern Tasmania

    NASA Astrophysics Data System (ADS)

    Oliver, Eric C. J.; Herzfeld, Mike; Holbrook, Neil J.

    2016-11-01

    The marine waters across Tasmanian's eastern continental shelf are biologically productive and home to economically important fisheries and aquaculture industries. However, the marine climate there is poorly understood. We use a high-resolution (∼2 km in the horizontal), three-dimensional ocean model for eastern Tasmania (ETAS) to examine the simulated mean state and seasonal cycle of temperature, salinity and three-dimensional flow field, and the evaluation of daily model outputs against in situ and remote observations for the 1993-2014 period. We also use the model to examine the roles of river input and tidal forcing. The model is evaluated against remotely-sensed sea surface temperature and in-situ observations of sea level and subsurface temperature, salinity, and currents. The mean state demonstrates the influence of two well-known boundary currents (the East Australian Current, EAC, and the Zeehan Current, ZC) as well as the effects of local freshwater input from river runoff. The EAC is dominant in summer and the ZC in winter; the influence of the EAC also increases northwards and in the offshore direction. In addition, the model indicates the presence of a semi-permanent subsurface (50-100 m depth) northward flow trapped near the coast. Cool freshwater runoff from the Derwent and Huon Rivers directly impacts the temperature and salinity in their estuaries but has little influence further across the shelf. Tidal forcing impacts the mean state through tide-river interactions which flush Frederick Henry Bay and Norfolk Bay with freshwater. Tidal forcing also impacts the variability of temperature all along the coastline, most likely due to changes in the turbulent mixing near to the coast. The ETAS model output data are available as a high-resolution representation of the mean state, seasonal variations, and interannual variability of Tasmania's eastern continental shelf marine climate.

  4. ALPASS: Teleseismic Tomography of the Eastern Alps

    NASA Astrophysics Data System (ADS)

    Brueckl, E.; Mitterbauer, U.; Lippitsch, R.; Behm, M.; ALPASS Working Group

    2007-12-01

    The Eastern Alps were formed by the north-south directed collision of the Adriatic (African) and European plates and a subsequent tectonic escape of crustal fragments to the unconstrained margin in the east, represented by the Pannonian Basin. Recent controlled source seismic experiments (TRANSALP, CELEBRATION 2000, and ALP 2002) revealed significant internal structures of the crust and the Moho topography. However, deeper plate tectonic structures (e.g. subducting slab) are still under debate. ALPASS is a passive seismic monitoring project aiming to reveal lower lithosphere and upper mantle beneath the wider Eastern Alpine region, and to contribute to a better understanding of the geodynamic processes at work. By cooperation of Austria, Croatia, Finland, Hungary, Poland, and USA 57 temporary seismic recording stations were deployed from May 2005 until May 2006. The layout was designed to extend the efforts of earlier experiments (e.g. TRANSALP) and to support two other passive seismic experiments (BOHEMA, Carpathian Basin Project), which are overlapping in the investigation area. Additionally, data from permanent networks was collected to improve coverage of the investigation area. 144 events (50% with M > 5.6) from epicentre distances between 30° and 100° were selected for teleseismic inversion. Travel time picking of P-wave arrivals has been done by a semi-automatic correlation technique. Crustal corrections benefit from the high resolution velocity model of the crust and the new Moho map derived from CELEBRATION 2000 and ALP 2002 data. First results of teleseismic inversion will be presented and discussed with respect to crustal structures revealed by the controlled source experiments, tomographic models generated during earlier studies, and their consequences for the conception of plate tectonics in the Eastern Alps.

  5. Emigration dynamics of eastern African countries.

    PubMed

    Oucho, J O

    1995-01-01

    This examination of emigration dynamics focuses on 13 countries extending from Eritrea to Zimbabwe and Mozambique on the eastern African mainland and on 5 Indian Ocean island nations. The first part of the study looks at the temporal, spatial, and structural perspectives of emigration dynamics. Part 2 considers international migration in the region according to Appleyard's typology (permanent settlers, labor migration, refugees, and illegal migrants) with the additional category of return migration. Measurement issues in emigration dynamics are discussed in part 3, and the demographic/economic setting is the topic of part 4. The demographic factors emphasized include spatial distribution, population density, population structure, population dynamics, demographic transition, and the relationship between internal and international migration. Other major topics of this section of the study are the economic base, the human resource base, population and natural resources, the sociocultural context (emigration, chain migration, return migration, and migration linkages and networks), political factors (including human rights, minority rights and security, regional integration and economic cooperation, and the impact of structural adjustment programs), and a prediction of future emigration dynamics. It is concluded that refugee flows remain a major factor in eastern African countries but the development of human resources in the northern portion of the region indicates development of potential labor migration from this area. Data constraints have limited measurement of emigration in this region and may contribute to the seeming indifference of most eastern African countries to emigration policies. Emigration in this region has been triggered by deteriorating economic and political conditions and is expected to increase.

  6. Environmental Regulation Impacts on Eastern Interconnection Performance

    SciTech Connect

    Markham, Penn N; Liu, Yilu; Young II, Marcus Aaron

    2013-07-01

    In the United States, recent environmental regulations will likely result in the removal of nearly 30 GW of oil and coal-fired generation from the power grid, mostly in the Eastern Interconnection (EI). The effects of this transition on voltage stability and transmission line flows have previously not been studied from a system-wide perspective. This report discusses the results of power flow studies designed to simulate the evolution of the EI over the next few years as traditional generation sources are replaced with environmentally friendlier ones such as natural gas and wind.

  7. Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016

    PubMed Central

    Bossé, D.; Ng, T.; Ahmad, C.; Alfakeeh, A.; Alruzug, I.; Biagi, J.; Brierley, J.; Chaudhury, P.; Cleary, S.; Colwell, B.; Cripps, C.; Dawson, L.A.; Dorreen, M.; Ferland, E.; Galiatsatos, P.; Girard, S.; Gray, S.; Halwani, F.; Kopek, N.; Mahmud, A.; Martel, G.; Robillard, L.; Samson, B.; Seal, M.; Siddiqui, J.; Sideris, L.; Snow, S.; Thirwell, M.; Vickers, M.; Goodwin, R.; Goel, R.; Hsu, T.; Tsvetkova, E.; Ward, B.; Asmis, T.

    2016-01-01

    The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5–7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics: ■ Follow-up and survivorship of patients with resected colorectal cancer■ Indications for liver metastasectomy■ Treatment of oligometastases by stereotactic body radiation therapy■ Treatment of borderline resectable and unresectable pancreatic cancer■ Transarterial chemoembolization in hepatocellular carcinoma■ Infectious complications of antineoplastic agents PMID:28050151

  8. Eastern hemlock found in Macon County, Alabama

    Treesearch

    David B. South; Brian Via; Henri D. Grissino-Mayer; Richard Martin; Richard Shelby; Sandie McCall

    2016-01-01

    Alabama is currently the southern limit of the range of eastern hemlock [Tsuga canadensis (L.) Carriere]. In 2012, several well preserved stumps were excavated from a farm located in Notasulga, Alabama (32 º 33” 6’ N; 85º 40” 22’ W). Even though they were buried in a saturated soil for approximately 1,500 years, the stumps were remarkably well preserved. The low-...

  9. Venus - Impact Crater in Eastern Navka Region

    NASA Image and Video Library

    1996-11-20

    This Magellan image, which is 50 kilometers (31 miles) in width and 80 kilometers (50 miles) in length, is centered at 11.9 degrees latitude, 352 degrees longitude in the eastern Navka Region of Venus. The crater, which is approximately 8 kilometers (5 miles) in diameter, displays a butterfly symmetry pattern. The ejecta pattern most likely results from an oblique impact, where the impactor came from the south and ejected material to the north. http://photojournal.jpl.nasa.gov/catalog/PIA00474

  10. Hurricane Ileana in the Eastern Pacific

    NASA Image and Video Library

    2006-08-22

    This is an infrared image of Hurricane Ileana in the Eastern Pacific, from the Atmospheric Infrared Sounder (AIRS) on NASA's Aqua satellite on August 22, 2006. This AIRS image shows the temperature of the cloud tops or the surface of the Earth in cloud-free regions. The lowest temperatures (in purple) are associated with high, cold cloud tops that make up the top of the storm. The infrared signal does not penetrate through clouds. Where there are no clouds the AIRS instrument reads the infrared signal from the surface of the Earth, revealing warmer temperatures (red). http://photojournal.jpl.nasa.gov/catalog/PIA00509

  11. Crustal Structure in Central-Eastern Greenland

    NASA Astrophysics Data System (ADS)

    Shulgin, A.; Thybo, H.

    2013-12-01

    We present the seismic structure in the interior of Greenland based on the first measurements by the seismic refraction/wide angle reflection method. Previous seismic surveys have only been carried out offshore and near the coast of Greenland, where the crustal structure is affected by oceanic break-up and may not be representative of the interior of the island. Acquisition of geophysical data onshore Greenland is logistically complicated by the presence of an up to 3.4 km thick ice sheet, permanently covering most of the land mass. The seismic data was acquired by a team of six people during a two-month long experiment in summer of 2011 on the ice cap in the interior of central-eastern Greenland. The EW-trending profile extends 310 km inland from the approximate edge of the stable ice cap near Scoresby Sund across the centre of the ice cap. The planned extension of the profile by use of OBSs and air gun shooting in Scoresbysund Fjord to the east coast of Greenland was unfortunately cancelled, because navigation was prevented by ice drift. 350 Reftek Texan receivers recorded high-quality seismic data from 8 equidistant shots along the profile. Explosive charge sizes were 1 ton at the ends and ca. 500 kg along the profile, loaded with about 100 kg at 35-85 m depth in individual boreholes. Two-dimensional velocity model based on forward ray tracing and tomography modelling shows a decrease of crustal thickness from 47 km below the centre of Greenland in the western part to 40 km in the eastern part of the profile. Earlier studies show that crustal thickness further decreases eastward to ca. 30 km below the fjord system, but details of the changes are unknown. Relatively high lower crustal velocities (Vp 6.8 - 7.3) in the western part of the TopoGreenland profile may indicate past collision tectonics or may be related or to the passage of the Iceland mantle plume. The origin of the pronounced circum-Atlantic mountain ranges in Norway and eastern Greenland, which have

  12. Implementing safe obstetric anesthesia in Eastern Europe.

    PubMed

    Kuczkowski, Krzysztof M; Kuczkowski, Krzysztof M

    2009-08-01

    The position of woman in any civilization is an index of the advancement of that civilization; the position of woman is gauged best by the care given her at the birth of her child. Obstetric anesthesia, by definition, is a subspecialty of anesthesia devoted to peripartum, perioperative, pain and anesthetic management of women during pregnancy and the puerperium. Today, obstetric anesthesia has become a recognized subspecialty of anesthesiology and an integral part of practice of most anesthesiologists. Perhaps, no other subspecialty of anesthesiology provides more personal gratification than the practice of obstetric anesthesia. This article reviews the challenges associated with implementing safe obstetric anesthesia practice in Eastern Europe.

  13. Groundwater resources development in the eastern Sahara

    NASA Astrophysics Data System (ADS)

    Lloyd, John William

    1990-11-01

    Aspects of the regional hydrogeology of the Nubian Sandstone aquifer system in the Sudan, Egypt and eastern Libya and the associated Tertiary aquifers of the Sirte Basin, Libya are described. It is concluded that major groundwater resources are present that can be developed by abstraction adjacent to the River Nile, by groundwater mining or by abstraction from throughflow. Examples of aquifer control parameters and potential resources development are given. The problems of in situ groundwater development in the harsh desert environment are discussed and it is indicated that such development is not constrained by groundwater resources potential but by socioeconomic factors. The solution of groundwater conveyance adopted in Libya is detailed.

  14. Wooden Calendar Sticks in Eastern Europe

    NASA Astrophysics Data System (ADS)

    Koleva, Vesselina; Koleva, Svetlana

    Wooden calendar sticks have preserved an archaic time-keeping tradition, which, during the Middle Ages, was one of the tools for establishing and disseminating Christian chronology and the liturgical calendars of the Western and Eastern Churches. The calendars vary in size and shape, type of signs, and structure of the record. Christian symbols interwoven with signs and pictograms mark days of importance in the ritual and economic year cycle. The wooden calendars are considered one of the proofs of the syncretism between the pagan tradition and Christian rites in folk cultures.

  15. PATHWAY ALIGNED WITH PICNIC PAVILION LOOKING SOUTHWEST FROM THE EASTERN ...

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

    PATHWAY ALIGNED WITH PICNIC PAVILION LOOKING SOUTHWEST FROM THE EASTERN EDGE OF THE BOTANIC GARDEN - John Bartram House & Garden, 54th Street & Lindbergh Boulevard, Philadelphia, Philadelphia County, PA

  16. 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.

  17. Naval Computer & Telecommunications Area Master Station, Eastern Pacific, Radio ...

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

    Naval Computer & Telecommunications Area Master Station, Eastern Pacific, Radio Transmitter Facility Lualualei, Marine Barracks, Intersection of Tower Drive & Morse Street, Makaha, Honolulu County, HI

  18. 7. DETAIL, NORTH FRONT, EASTERN PORTION OF MAIN BLOCK, WINDOWS ...

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

    7. DETAIL, NORTH FRONT, EASTERN PORTION OF MAIN BLOCK, WINDOWS - Smithsonian Institution Building, 1000 Jefferson Drive, between Ninth & Twelfth Streets, Southwest, Washington, District of Columbia, DC

  19. Cost characteristics of hospitals.

    PubMed

    Smet, Mike

    2002-09-01

    Modern hospitals are complex multi-product organisations. The analysis of a hospital's production and/or cost structure should therefore use the appropriate techniques. Flexible functional forms based on the neo-classical theory of the firm seem to be most suitable. Using neo-classical cost functions implicitly assumes minimisation of (variable) costs given that input prices and outputs are exogenous. Local and global properties of flexible functional forms and short-run versus long-run equilibrium are further issues that require thorough investigation. In order to put the results based on econometric estimations of cost functions in the right perspective, it is important to keep these considerations in mind when using flexible functional forms. The more recent studies seem to agree that hospitals generally do not operate in their long-run equilibrium (they tend to over-invest in capital (capacity and equipment)) and that it is therefore appropriate to estimate a short-run variable cost function. However, few studies explicitly take into account the implicit assumptions and restrictions embedded in the models they use. An alternative method to explain differences in costs uses management accounting techniques to identify the cost drivers of overhead costs. Related issues such as cost-shifting and cost-adjusting behaviour of hospitals and the influence of market structure on competition, prices and costs are also discussed shortly.

  20. Hospital restructuring and burnout.

    PubMed

    Greenglass, Esther R; Burke, Ronald J

    2002-01-01

    Increasingly, organizations are experiencing changes as a result of extensive downsizing, restructuring, and merging. In Canada, government-sponsored medicine has been affected as hospitals have merged or closed, reducing essential medical services and resulting in extensive job loss for hospital workers, particularly nurses. Hospital restructuring has also resulted in greater stress and job insecurity in nurses. The escalation of stressors has created burnout in nurses. This study examines predictors of burnout in nurses experiencing hospital restructuring using the MBI-General Survey which yields scores on three scales: Emotional exhaustion, Cynicism, and Professional efficacy. Multiple regressions were conducted where each burnout scale was the criterion and stressors (e.g., amount of work, use of generic workers to do nurses' work), restructuring effects, social support, and individual resources (e.g., control coping, self-efficacy, prior organizational commitment) were predictors. There were differences in the amount of variance accounted for in the burnout components by stressors and resources. Stressors contributed most to emotional exhaustion and least to professional efficacy. Individual resources were more likely to contribute to professional efficacy and least to emotional exhaustion. Stressors and resources accounted for approximately equal amounts of variance in cynicism. Three conclusions were drawn. First, present findings parallel others by showing that individual coping patterns contribute to professional efficacy. Second, emotional exhaustion was found to be the prototype of stress. Third, prior organizational commitment, self-efficacy, and control coping resulted in lower burnout.

  1. Innovations in Hospitality Industry

    ERIC Educational Resources Information Center

    Dzhandzhugazova, Elena A.; Blinova, Ekaterina A.; Orlova, Liubov N.; Romanova, Marianna M.

    2016-01-01

    The article focuses on the study of the role and importance of innovation, its classification, the problems of its application in the hotel industry with emphasis on the application of sensory marketing tools in the development of the innovative marketing mix within the hospitality industry. The article provides an analysis of the "seven…

  2. In-hospital resuscitation.

    PubMed

    Mason, Christine

    2016-09-21

    What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The CPD article outlined the response sequence required for cardiac arrest in an in-hospital environment and discussed effective cardiopulmonary resuscitation (CPR) and defibrillation.

  3. Hospital perceived value.

    PubMed

    Moliner, Miguel A

    2006-01-01

    The creation, distribution and communication of value have been considered to be the key element of marketing (American Marketing Association, 2004, www.marketingpower.com). The aim of this article is to identify the indicators of perceived value in a hospital context. The results show that perceived quality and emotions are key dimensions of perceived value.

  4. Responsible Hospitality. Prevention Updates

    ERIC Educational Resources Information Center

    Colthurst, Tom

    2004-01-01

    Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…

  5. Speech intelligibility in hospitals.

    PubMed

    Ryherd, Erica E; Moeller, Michael; Hsu, Timothy

    2013-07-01

    Effective communication between staff members is key to patient safety in hospitals. A variety of patient care activities including admittance, evaluation, and treatment rely on oral communication. Surprisingly, published information on speech intelligibility in hospitals is extremely limited. In this study, speech intelligibility measurements and occupant evaluations were conducted in 20 units of five different U.S. hospitals. A variety of unit types and locations were studied. Results show that overall, no unit had "good" intelligibility based on the speech intelligibility index (SII > 0.75) and several locations found to have "poor" intelligibility (SII < 0.45). Further, occupied spaces were found to have 10%-15% lower SII than unoccupied spaces on average. Additionally, staff perception of communication problems at nurse stations was significantly correlated with SII ratings. In a targeted second phase, a unit treated with sound absorption had higher SII ratings for a larger percentage of time as compared to an identical untreated unit. Taken as a whole, the study provides an extensive baseline evaluation of speech intelligibility across a variety of hospitals and unit types, offers some evidence of the positive impact of absorption on intelligibility, and identifies areas for future research.

  6. Toilet privacy in hospital.

    PubMed

    Logan, Karen

    Good practice in toilet management and continence promotion can help hospital patients to maintain their dignity. This article reports on an audit that highlighted the issues important to patients and nurses in terms of improving privacy and dignity for inpatients using the toilet.

  7. Drama Therapies in Hospitals

    ERIC Educational Resources Information Center

    Goodman, Judith; Prosperi, Mario

    1976-01-01

    Explores the use of drama as a therapeutic tool at various hospitals and records specific therapy groups dialogues. Available from: The Drama Review, 51 West 4th Street, Room 300, New York, N.Y. 10012. Subscription Rates: $12.50 per year. (MH)

  8. Dying in hospital.

    PubMed

    Pearce, Lynne

    2016-06-22

    While surveys consistently show that about two thirds of people want to die at home, more than half of all deaths happen in hospitals. And in their last days, many people are cared for by generalist nursing staff who may be reticent, or even afraid, to talk about what is happening.

  9. Reengineering hospital materiel management.

    PubMed

    Giunipero, L C

    1995-08-01

    Reengineering involves significant change and dramatic rethinking of the business process. The expected result of these changed processes is dramatic improvement. Hospital cost pressures and technological change necessitate review or reengineering the process to enhance customer service at a lower cost. Three areas that yield significant results include reducing the cost of purchasing, implementing new technologies, and empowering teams to accomplish customer driven goals.

  10. Mechanical engineering in hospitals.

    PubMed

    Wallington, J W

    1980-10-01

    The design of a modern hospital owes more to engineering than the layman may realize. In this context, many engineers are in the position of laymen, being unfamiliar with the multitude of services that lies behind the impressive facade of a modern hospital. In recent years medicine and surgery themselves have taken on many of the characteristics of a technology. This has required a matching development of the services both mechanical and electrical that are required in modern health care buildings. In medical terms, if the architectural features provide the 'skin' of the hospital, the mechanical and electrical engineering services provide the nerves and sinews. If we take as an example the recently completed Freeman Hospital, Newcastle upon Tyne, (Fig. 1), which cost 10 million pounds at current cost, the service network was responsible for about half the total cost. About 400 miles (643 km) of electrical wiring and more than 40 mile (64.5 km) of copper and steel piping were used to service 3000 separate rooms. This compares with percentages of between 18 and 25 per cent for other large buildings such as office blocks, hotels and sports complexes.

  11. Measuring hospital input price increases: The rebased hospital market basket

    PubMed Central

    Freeland, Mark S.; Chulis, George S.; Brown, Aaron P.; Skellan, David; Maple, Brenda T.; Singer, Naphtale; Lemieux, Jeffrey; Arnett, Ross H.

    1991-01-01

    The input prices indexes used in part to set payment rates for Medicare inpatient hospital services in both prospective payment system (PPS) and PPS-excluded hospitals were rebased from 1982 to 1987 beginning with payments for fiscal year 1991. In this article, the issues and evidence used to determine the composition of the revised hospital input price indexes are discussed. One issue is the need for a separate market basket for PPS-excluded hospitals. Also, the payment implications of using hospital-industry versus economywide measures of wage rates as price proxies for the growth in hospital wage rates are addressed. PMID:10113610

  12. The ice storm in eastern Canada 1998 KAMEDO-Report No. 74.

    PubMed

    Riddex, L; Dellgar, U

    2001-01-01

    This is a report of the impact of the ice storm that struck eastern Canada on 04-09 January 1998. The storm deposited ice some 100 mm thick on the ground and on the electric power lines and eventually left 1.4 million households and much of the infrastructure without electrical power. Data were obtained through non-structured interviews of those involved. Most of the larger hospitals were equipped with emergency generating equipment and were able to provide most essential services. For most hospitals, non-emergency services were compromised. Many other medical facilities, including clinics had to be shut down, and smaller hospitals were forced to transfer some patients to larger institutions. In addition, hospitals experienced a marked increase in the number of emergency department visits including an increase in the number of persons with injuries, respiratory tract infections, or heart problems. A marked increase in carbon-monoxide intoxication was observed: 50 persons required the use of hyperbaric oxygen and six persons died of CO poisoning. Prehospital services not only experienced a marked increase in the number of emergency responses, but also were utilized to provide transportation of non-ill or injured persons, equipment, and supplies. Home care was interrupted and many patients dependent upon power had to be transported to hospitals. Many hospitals opened their buildings to provide shelter to the families of many of their employees and medical staff. This helped to keep staffing at a better level than if they had to find shelter and essential services elsewhere. The transmission and sharing of information was severely limited due in part to the loss of power and inability to access television. This led to the distribution of misleading or incorrect information. This storm was exemplary of our dependence upon electrical power and that we are not prepared to cope with the loss of electricity.

  13. Factors associated with breastfeeding cessation in nursing mothers in a peer support programme in Eastern Lancashire

    PubMed Central

    2010-01-01

    Background The UK has one of the lowest breastfeeding rates worldwide and in recent years the Government has made breastfeeding promotion one of its priorities. The UNICEF UK Baby Friendly Initiative is likely to increase breastfeeding initiation but not duration. Other strategies which involve provision of support for breastfeeding mothers in the early weeks after birth are therefore required to encourage UK mothers to breastfeed for the recommended duration. This paper examines the effects of maternal socio-demographic factors, maternal obstetric factors, and in-hospital infant feeding practices on breastfeeding cessation in a peer support setting. Methods Data on mothers from Blackburn with Darwen (BwD) and Hyndburn in Eastern Lancashire who gave birth at the Royal Blackburn Hospital and initiated breastfeeding while in hospital were linked to the Index of Multiple Deprivation (IMD). The data were analysed to describe infant feeding methods up to 6 months and the association between breastfeeding cessation, and maternal factors and in-hospital infant feeding practices. Results The mean breastfeeding duration was 21.6 weeks (95% CI 20.86 to 22.37 weeks) and the median duration was 27 weeks (95% CI 25.6 to 28.30 weeks). White mothers were 69% more likely to stop breastfeeding compared with non-White mothers (HR: 0.59; 95% CI, 0.52 to 0.67 [White mothers were the reference group]). Breastfeeding cessation was also independently associated with parity and infant feeding practices in hospital. There were no significant associations between breastfeeding cessation and marital status, mode of delivery, timing of breastfeeding initiation and socio-economic deprivation. Conclusion In this study ethnicity, parity and in-hospital infant feeding practices remained independent predictors of breastfeeding cessation in this peer support setting. However other recognised predictors such as marital status, mode of delivery, timing of breastfeeding initiation and socio

  14. Factors associated with breastfeeding cessation in nursing mothers in a peer support programme in Eastern Lancashire.

    PubMed

    Agboado, Gabriel; Michel, Elaine; Jackson, Elaine; Verma, Arpana

    2010-01-27

    The UK has one of the lowest breastfeeding rates worldwide and in recent years the Government has made breastfeeding promotion one of its priorities. The UNICEF UK Baby Friendly Initiative is likely to increase breastfeeding initiation but not duration. Other strategies which involve provision of support for breastfeeding mothers in the early weeks after birth are therefore required to encourage UK mothers to breastfeed for the recommended duration. This paper examines the effects of maternal socio-demographic factors, maternal obstetric factors, and in-hospital infant feeding practices on breastfeeding cessation in a peer support setting. Data on mothers from Blackburn with Darwen (BwD) and Hyndburn in Eastern Lancashire who gave birth at the Royal Blackburn Hospital and initiated breastfeeding while in hospital were linked to the Index of Multiple Deprivation (IMD). The data were analysed to describe infant feeding methods up to 6 months and the association between breastfeeding cessation, and maternal factors and in-hospital infant feeding practices. The mean breastfeeding duration was 21.6 weeks (95% CI 20.86 to 22.37 weeks) and the median duration was 27 weeks (95% CI 25.6 to 28.30 weeks). White mothers were 69% more likely to stop breastfeeding compared with non-White mothers (HR: 0.59; 95% CI, 0.52 to 0.67 [White mothers were the reference group]). Breastfeeding cessation was also independently associated with parity and infant feeding practices in hospital. There were no significant associations between breastfeeding cessation and marital status, mode of delivery, timing of breastfeeding initiation and socio-economic deprivation. In this study ethnicity, parity and in-hospital infant feeding practices remained independent predictors of breastfeeding cessation in this peer support setting. However other recognised predictors such as marital status, mode of delivery, timing of breastfeeding initiation and socio-economic deprivation were not found to be

  15. 78 FR 30911 - Texas Eastern Transmission, LP; Prior Notice Activity Under Blanket Certificate

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-23

    ... Energy Regulatory Commission Texas Eastern Transmission, LP; Prior Notice Activity Under Blanket Certificate On May 8, 2013, Texas Eastern Transmission, LP (Texas Eastern), filed a prior notice request... Act, and Texas Eastern's blanket certificate issued in Docket No. CP82-535-000. Texas Eastern seeks...

  16. [Leadership in the hospital].

    PubMed

    Schrappe, Matthias

    2009-01-01

    Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments.

  17. The frontline hospital.

    PubMed

    Mein, P

    1983-01-01

    This brief description of the planning process for a frontline hospital is intended as a guide only: there will be a variety of approaches depending on local conditions. However, certain of the principles raised have universal relevance for the construction of health facilities where resources are limited. In brief, these: - The changing role of the frontline hospital should not be allowed to obscure the fact that the small hospital still has a significant role to play and that future, as yet undefined, functional changes will take place necessitating generalized designs that can accommodate those changes. - The erection of new buildings is not always the appropriate solution to apparent problems with facilities. Often a more relevant course is to adapt existing buildings or to provide community-level primary health care services not based on facilities. - The development of standardized, though flexible, briefs for hospitals of different sizes is essential, since ther will, for some years to come, be a shortage of the professional manpower needed to enable completely individual designs to be produced for each facility. Standardized briefs are infinitely preferable to standard or type plans, which tend to be inflexible and lead to overbuilding. - Local involvement in the planning process is essential, not only because it provides useful knowledge but primarily because local commitment is the only way of avoiding the construction of inappropriate facilities. - Architectural expertise must be available within the health system, since very often outside consultants are unable or unwilling, because of the system of payment, to design suitable hospital buildings. - The type of construction used should be the simplest and most economical that will provide an effective environment for the health tasks to be carried out so that the limited resources available can be stretched to serve as many people as possible. - Local building materials should always be preferred- to

  18. Improving Hospital Discharge Time

    PubMed Central

    El-Eid, Ghada R.; Kaddoum, Roland; Tamim, Hani; Hitti, Eveline A.

    2015-01-01

    Abstract Delays in discharging patients can impact hospital and emergency department (ED) throughput. The discharge process is complex and involves setting specific challenges that limit generalizability of solutions. The aim of this study was to assess the effectiveness of using Six Sigma methods to improve the patient discharge process. This is a quantitative pre and post-intervention study. Three hundred and eighty-six bed tertiary care hospital. A series of Six Sigma driven interventions over a 10-month period. The primary outcome was discharge time (time from discharge order to patient leaving the room). Secondary outcome measures included percent of patients whose discharge order was written before noon, percent of patients leaving the room by noon, hospital length of stay (LOS), and LOS of admitted ED patients. Discharge time decreased by 22.7% from 2.2 hours during the preintervention period to 1.7 hours post-intervention (P < 0.001). A greater proportion of patients left their room before noon in the postintervention period (P < 0.001), though there was no statistical difference in before noon discharge. Hospital LOS dropped from 3.4 to 3.1 days postintervention (P < 0.001). ED mean LOS of patients admitted to the hospital was significantly lower in the postintervention period (6.9 ± 7.8 vs 5.9 ± 7.7 hours; P < 0.001). Six Sigma methodology can be an effective change management tool to improve discharge time. The focus of institutions aspiring to tackle delays in the discharge process should be on adopting the core principles of Six Sigma rather than specific interventions that may be institution-specific. PMID:25816029

  19. [The founding of Zemun Hospital].

    PubMed

    Milanović, Jasmina; Milenković, Sanja; Pavlović, Momcilo; Stojanović, Dragos

    2014-01-01

    This year Zemun Hospital--Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia.The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the"Kontumac"--a quarantine established in 1730. Soon after, two more confessional hospitals were opened.The Serbian (Orthodox) Hospital was founded before 1769, whereas the German (Catholic) Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall--the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time.The final, physical merging of these hospitals was completed in 1795.

  20. 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

    2017-07-23

    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

  1. Hospital malnutrition: a 33-hospital screening study.

    PubMed

    Kamath, S K; Lawler, M; Smith, A E; Kalat, T; Olson, R

    1986-02-01

    A collaborative study involving nutrition screening of 3,047 patients (excluding 125 pregnant women) at admission to 33 hospitals in and around the greater Chicago area was carried out to identify patients at nutritional risk. Information on sex, age, admitting diagnosis, serum albumin, hemoglobin, total lymphocyte count, and height and weight was collected from the medical chart within 48 hours of admission. Nutrition screening could not be completed for a larger number of patients (60%) because data at admission were not available. Of the remaining 40% of patients, more than 50% had below normal values for one or more of the variables studied: serum albumin, hemoglobin, and total lymphocyte count. A large number of the patients (40%) also were considered at nutritional risk as judged by the criteria of weight/height (measured only). Early nutrition intervention for high-risk patients cannot be implemented, nor can the efficacy of nutrition services be evaluated, unless nutrition screening is carried out on patients at admission.

  2. Cenozoic diapiric traps in eastern China

    SciTech Connect

    Xie-Pei, W.; Qi, F.; Jia-Hua, Z.

    1985-12-01

    Diapiric traps, including diapirs of salt and mud or igneous intrusives, have recently been found in many places in the Cenozoic petroliferous basins in eastern China, and most of them produce oil and gas. During the Eocene-early Oligocene, salt-lake basins evolved extensively. Plastic source materials for diapirism were deposited in the basins in great thickness. We have found that the diapiric traps of salt and mud in eastern China are unpierced or slightly pierced structures. The diapiric materials are a mixture of salt, gypsum, and mudstone, but mudstone is the main component of the plastic bodies. Based on an analysis of the structural features of the diapirs and the regional tectonic setting, we believe that the diapiric traps are caused by a combination of horizontal stress due to regional tectonic movement and vertical stress due to gravitational instability. Some diabase diapirs are arranged in a series of small anticlinal traps along the regional faults in the Subei basin of Jiangsu province. Oil and gas have been found in certain of these diapirs. 16 figures.

  3. Eastern Europe and Community of Independent States.

    PubMed

    Axmann, A

    1998-01-01

    This article reviews the literature on migration, HIV/AIDS, and sexually transmitted diseases in Eastern Europe and the Community of Independent States (CIS): Bulgaria, Czechoslovakia, Hungary, Poland, Romania, and the former Yugoslavian countries; and Armenia, Azerbaijan, Belarus, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Russian Federation, Tajikistan, Turkmenistan, Ukraine, and Uzbekistan. There is little in-depth research on the prevalence of HIV/AIDS. After the collapse of the USSR, the opening up of borders presented greater options for the spread of HIV. During 1991-1996, HIV-infected persons increased from 0.3/100,000 to 7.8/100,000. Syphilis and gonorrhea also spread in the 1990s. The increased prevalence is attributed to changes in sexual behavior due to increased travel and migration, disruption among families, and changes in sexual mores; and changes in the structure, availability, and effectiveness of health services. Many migrants in the CIS are young people. Mobile populations in the CIS include labor migrants, refugees, persons displaced by armed conflicts, repatriates, forced migrants, resettlement of formerly deported persons, and ecological migrants. It is general knowledge that migrants are poorly informed about HIV/AIDS. Condoms are not readily available in the CIS. Eastern Europe has high rates of HIV among migrant sex workers.

  4. Acid rain reduced in Eastern United States

    SciTech Connect

    Lynch, J.A.; Bowersox, V.C.; Grimm, J.W.

    2000-03-15

    Concentrations of sulfate (SO{sub 4}{sup 2{minus}}) and free hydrogen ions (H{sup +}) in precipitation decreased from 10% to 25% over a large area of the Eastern US from 1995 through 1997 as compared to the previous 12-year (1983--1994) reference period. These decreases were unprecedented in magnitude and spatial extent. In contrast, nitrate (NO{sub 3}{sup {minus}}) concentrations generally did not change over this period. The largest decreases in both H{sup +} and SO{sub 4}{sup 2{minus}} concentrations, which nearly mimicked one another, occurred in and downwind of the Ohio River Valley, the same area where Title 4 of the 1990 Clean Air Act Amendments (CAAA) set limitations on sulfur dioxide (SO{sub 2}) emissions from a large number of utility-owned coal-fired sources. Phase 1 of the CAAA required that these limitations be met by January 1, 1995. On the basis of their analysis of precipitation chemistry and emissions data, the authors conclude that significant declines in acid rain occurred in many parts of the Eastern US from 1995 through 1997 because of large reductions in SO{sub 2} emissions in this region and a corresponding reduction in SO{sub 4}{sup 2{minus}} concentrations in precipitation.

  5. The Altai Mountains environmental disaster (Eastern Kazakhstan)

    NASA Astrophysics Data System (ADS)

    Akhmadiyeva, Z. K.

    2009-12-01

    The space centre "Baikoniyr" (Kazakhstan) has had substantial affects on the environment. During the past several decades as a result of the launching of carrier rockets, such as "Proton" that use as fuel the asymmetrical dimethylhydrazine (ASDH), more well-known as "heptyl", the unique mountain landscapes in Eastern Kazakhstan have been subjected to pollution. In 2004, RSE "Kazakh research Institute of Ecology and Climate" carried out the complex geochemical and radiation researches in East Kazakhstan that is an impact area of second stages of carrier rockets. Such detailed examinations of this area were conducted for the first time because the Eastern Kazakhstan Mountains are difficult for human access. The landscape-geochemical research over the natural landscapes covered the ridge, low, and middle mountains with fir forests. The research results have shown the presence of heptyl in the samples of the soil, plants, and rivers’ bottom sediments. The findings of the influence of space activity on environment of the Kazakhstan part of the Altai Mountains confirm and complement the Russian scientific research results over the territory of the neighbouring Altai Krai. Though the heptyl pollution in the investigated region is of a local nature and highly spatially inhomogeneous, nevertheless, this anthropogenic effect intensifying from year to year increases the load on the natural ecosystems. In particular, it strengthens the desertification process of mountain regions of East Kazakhstan.

  6. Tropical Storm Sam, Eastern Indian Ocean

    NASA Image and Video Library

    1990-01-20

    STS032-80-036 (9-20 Jan. 1990) --- This oblique view of Tropical Storm Sam in the eastern Indian Ocean off the western coast of Australia was photographed with a 70mm camera by the astronauts. Tropical Storm Sam (known as Willy-Willy in Australia) was born in the eastern Indian Ocean near the islands of Timor and Sumba in Indonesia. The storm tracked southwestward attaining sustained winds in excess of 60 knots (70 miles per hour). Other than on Christmas Island and the Cocos (Keeling) Islands south of Java, and for strong swells along the western Australia coast, the storm had little impact on land areas. At the time this photograph was taken, the storm was beginning to dissipate in the south Indian Ocean. The eye of the storm is still visible near center, with the swirling bands of the storm propagating in a clockwise direction toward the center. Winds aloft have begun to shear the tops of thunderstorms associated with the storm, forming a high cirrus cloud cover over the center portions of the storm. This picture was used by the crew at their January 30, 1990 Post-Flight Press Conference (PFPC).

  7. Energy conservation opportunities in Eastern Europe

    SciTech Connect

    Zellhoeffer, J.W.

    1996-05-01

    Today, Eastern Europe and the member countries of the NIS are facing energy shortages and cost increases of a scale never experienced in America. Even during the energy crisis of the 70`s, when oil prices tripled over a two year period. our economy was not exposed to the problems now facing this region of the world. This paper covers the challenges and opportunities facing those individuals and companies involved in energy efficiency and other technologies that benefit the environment. Unfortunately, the social and economic stress caused by, the five fold average increases in energy costs since 1990 in most Eastern European countries has not been offset by improved living standards, the increased availability of quality goods, or even the ability of citizens to travel freely, In reality, food and raw material costs have gone up so dramatically that most individuals are worse off today than they were six years ago. Compounding this situation is the fact that most school age children have little ambition to continue with their education as a result of the general collapse of most of the more prestigious large industrial and commercial enterprises.

  8. Late Cenozoic intraplate faulting in eastern Australia

    NASA Astrophysics Data System (ADS)

    Babaahmadi, Abbas; Rosenbaum, Gideon

    2014-12-01

    The intensity and tectonic origin of late Cenozoic intraplate deformation in eastern Australia is relatively poorly understood. Here we show that Cenozoic volcanic rocks in southeast Queensland have been deformed by numerous faults. Using gridded aeromagnetic data and field observations, structural investigations were conducted on these faults. Results show that faults have mainly undergone strike-slip movement with a reverse component, displacing Cenozoic volcanic rocks ranging in ages from ˜31 to ˜21 Ma. These ages imply that faulting must have occurred after the late Oligocene. Late Cenozoic deformation has mostly occurred due to the reactivation of major faults, which were active during episodes of basin formation in the Jurassic-Early Cretaceous and later during the opening of the Tasman and Coral Seas from the Late Cretaceous to the early Eocene. The wrench reactivation of major faults in the late Cenozoic also gave rise to the occurrence of brittle subsidiary reverse strike-slip faults that affected Cenozoic volcanic rocks. Intraplate transpressional deformation possibly resulted from far-field stresses transmitted from the collisional zones at the northeast and southeast boundaries of the Australian plate during the late Oligocene-early Miocene and from the late Miocene to the Pliocene. These events have resulted in the hitherto unrecognized reactivation of faults in eastern Australia.

  9. Extensive Quaternary glaciations in eastern Turkey

    NASA Astrophysics Data System (ADS)

    Yeşilyurt, Serdar; Akçar, Naki; Doǧan, Uǧur; Yavuz, Vural; Ivy-Ochs, Susan; Vockenhuber, Christof; Schlunegger, Fritz; Schlüchter, Christian

    2016-04-01

    During cold periods in the Quaternary, global ice volume increased and as a result valley glaciers advanced and the vice versa occurred during the warm periods. Quaternary glacier fluctuations had been also recorded in the Turkish mountains. Recently, the chronology of Late Quaternary advances in the northern and western Turkish mountains was reconstructed by surface exposure dating. However, these advances in the eastern Turkey are not dated yet. In this study, we investigated paleoglaciations in Kavuşşahap Mountains, which is located to the south of Lake Van in eastern Turkey. These mountains are one of the extensively glaciated areas in Turkey. Glacial activity is evidenced by more than 20 U-shaped valleys. For instance, one of the prominent and well-preserved glacial landscapes of Turkey is situated in the Narlıca valley system. Lateral and terminal moraines in the valley system indicate more than 10 glacial advances. To build their chronology, 39 erratic carbonaceous boulders were sampled for surface exposure dating with cosmogenic 36Cl. We also reconstructed the ice margin reconstruction of the Narlıca paleoglacier using the accumulation area ratio and area-altitude balance ratio approaches. We estimated an equilibrium line altitude (ELA) of ca. 2900 m above sea level based on the maximum ice extend, which implied ca. 800 m decrease in the ELA during the Late Quaternary in comparison to the lower bound of the modern ELA estimate. The first results of the surface exposure dating will be presented.

  10. Tsunami Catalogues for the Eastern Mediterranean - Revisited.

    NASA Astrophysics Data System (ADS)

    Ambraseys, N.; Synolakis, C. E.

    2008-12-01

    We critically examine examine tsunami catalogues of tsunamis in the Eastern Mediterranean published in the last decade, by reference to the original sources, see Ambraseys (2008). Such catalogues have been widely used in the aftermath of the 2004 Boxing Day tsunami for probabilistic hazard analysis, even to make projections for a ten year time frame. On occasion, such predictions have caused panic and have reduced the credibility of the scientific community in making hazard assessments. We correct classification and other spurious errors in earlier catalogues and posit a new list. We conclude that for some historic events, any assignment of magnitude, even on a six point intensity scale is inappropriate due to lack of information. Further we assert that any tsunami catalogue, including ours, can only be used in conjunction with sedimentologic evidence to quantitatively infer the return period of larger events. Statistical analyses correlating numbers of tsunami events derived solely from catalogues with their inferred or imagined intensities are meaningless, at least when focusing on specific locales where only a handful of tsunamis are known to have been historically reported. Quantitative hazard assessments based on scenario events of historic tsunamis for which -at best- only the size and approximate location of the parent earthquake is known should be undertaken with extreme caution and only with benefit of geologic studies to enhance the understanding of the local tectonics. Ambraseys N. (2008) Earthquakes in the Eastern Mediterranean and the Middle East: multidisciplinary study of 2000 years of seimicity, Cambridge Univ. Press, Cambridge (ISBN 9780521872928).

  11. Alphaviral equine encephalomyelitis (Eastern, Western and Venezuelan).

    PubMed

    Aréchiga-Ceballos, N; Aguilar-Setién, A

    2015-08-01

    Summary Alphaviral equine encephalomyelitis is a mosquito-borne infection that causes severe neurological disease and fatalities in horses and humans in the Americas. Consequently, the equine alphaviruses (Eastern, Western and Venezuelan) are of considerable concern worldwide and are notifiable to the World Organisation for Animal Health. In addition, these diseases are considered a potent potential biological weapon, emphasising the need to develop an effective vaccine. Alphaviral equine encephalomyelitis is caused by Eastern equine encephalomyelitis virus (EEEV), Western equine encephalomyelitis virus (WEEV) or Venezuelan equine encephalomyelitis virus (VEEV), which are related members of the Alphavirus genus in the Togaviridae family. Although related, the three viruses are genetically and antigenically distinct. The disease is characterised by fever, anorexia, depression and clinical signs of encephalomyelitis, and may be fatal in up to 90% of cases, for both humans and horses, particularly in the case of EEE. Surviving horses develop lifelong immunity but may have permanent neuropathology. The aim of this paper is to analyse the scientific information available on the evolution of EEE, WEE and VEE, and any potential vaccines.

  12. The politics of hospital payment.

    PubMed

    Feder, J; Spitz, B

    1979-01-01

    This paper analyzes the politics of hospital payment over the last decade. The authors explain how provider interests and judgments became a standard for appropriate hospital payment: the impact of that standard on hospital costs; and the political obstacles to imposing an alternative standard and controlling hospital costs. The authors draw lessons from this experience, here and in other countries, to propose an alternative approach to hospital payment that would allow policymakers, accountable to the public, to make explicit choices about the level and nature of hospital expenditures.

  13. How consumers view hospital advertising.

    PubMed

    Johns, H E; Moser, H R

    1988-01-01

    The purposes of this study were to determine: (a) consumers' attitudes toward advertising by hospitals; (b) which media consumers feel are appropriate for hospital advertising; and (c) whether consumers are seeing hospital advertisements, and if so, through which media. It was found that consumers indeed have a favorable attitude toward hospitals that advertise. It was also found that consumers feel that most media are appropriate for hospital advertising. Finally, it was found that most consumers have seen hospitals advertise their services, especially on television and radio and in the newspaper.

  14. Epidemiologic characteristics of 10 years hospitalized patients with glaucoma at shanghai eye and ear, nose, and throat hospital.

    PubMed

    Zheng, Yingying; Zhang, Yuqiu; Sun, Xinghuai

    2016-07-01

    To analyze the epidemiologic characteristics of hospitalized patients with glaucoma at Shanghai Eye and Ear, Nose, and Throat Hospital in the relative well economic condition area Eastern China.Researchers reviewed the 10 years charts of patients with a discharge diagnosis of glaucoma at this hospital from January 2004 to December 2013. With the criteria used for diagnoses of different types of glaucoma, the constitution of this disease between the first and last 5 years was compared and analyzed.A total of 11,864 cases were enrolled according to the criteria of diagnoses for 10 years. Primary angle-closure glaucoma (PACG) was the main type (51.69%) followed by secondary glaucoma (SG, 28.14%), primary open-angle glaucoma (POAG) (10.41%), and congenital glaucoma (7.16%). Other glaucoma types were less prevalent (2.61%). PACG has seen a declining trend (from 57.75% to 48.41%), while the proportion of SG has increased (from 23.68% to 34.21%). For the POAG group, there is no increasing trend and the same is true of CG. The mean age of PACG patients was 62.28 year-old, while it was 46 year-old for the POAG and SG groups. The patients of PACG had more women than men (M/F ratio: 1:1.92). The reverse was the case with regard to POAG (M/F ratio: 1.97:1).In Eastern China, although PACG has some decreased, but still is the most commonly encountered type of glaucoma, while SG has significantly increased, and POAG has slightly decreased in hospitalized patients during recent 10 years.

  15. Accuracy of the Charlson Index Comorbidities Derived from a Hospital Electronic Database in a Teaching Hospital in Saudi Arabia

    PubMed Central

    Youssef, Adel; Alharthi, Hana

    2013-01-01

    Hospital management and researchers are increasingly using electronic databases to study utilization, effectiveness, and outcomes of healthcare provision. Although several studies have examined the accuracy of electronic databases developed for general administrative purposes, few studies have examined electronic databases created to document the care provided by individual hospitals. In this study, we assessed the accuracy of an electronic database in a major teaching hospital in Eastern Province, Saudi Arabia, in documenting the 17 comorbidities constituting the Charlson index as recorded in paper charts by care providers. Using the hospital electronic database, the researchers randomly selected the data for 1,019 patients admitted to the hospital and compared the data for accuracy with the corresponding paper charts. Compared with the paper charts, the hospital electronic database did not differ significantly in prevalence for 9 conditions but differed from the paper charts for 8 conditions. The kappa (K) values of agreement ranged from a high of 0.91 to a low of 0.09. Of the 17 comorbidities, the electronic database had substantial or excellent agreement for 10 comorbidities relative to paper chart data, and only one showed poor agreement. Sensitivity ranged from a high of 100.0 percent to a low of 6.0 percent. Specificity for all comorbidities was greater than 93 percent. The results suggest that the hospital electronic database reasonably agrees with patient chart data and can have a role in healthcare planning and research. The analysis conducted in this study could be performed in individual institutions to assess the accuracy of an electronic database before deciding on its utility in planning or research. PMID:23861671

  16. [Hospital clinical ethics committees].

    PubMed

    Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor

    2007-01-01

    The scientific and technological advances have been surprising, more in the two last decades, but they don't go united with to the ethical values of the medical professional practice, it has been totally escaped, specially when the biological subsistence, the maintenance of the life through apparatuses and the mechanisms that prolong the existence are who undergoes an alteration that until recently time was mortal shortly lapse. It is common listening that exist a crisis in the medical profession, but what really is it of human values, which as soon and taken into nowadays, actually professional account, which gives rise to a dehumanization towards the life, the health, the disease, the suffering and the death. The ideal of the doctor to give to service to the man in its life and health, as well to be conscious that the last biological process that must fulfill is the death, and when it appears, does not have considered as a actually professional failure. It has protect to the patient as the extreme cruelty therapeutic, that it has right a worthy death. It's taking to the birth of the hospital ethics committees, they have like function to analyze, to advise and to think about the ethical dilemmas that appear actually clinical or in the biomedical investigation. In 1982 in the UEA only 1% of its hospitals had a ethics committees; by 1988, it was 67% and the 100% in 2000. In Mexico the process of the formation by these committees begins, only in the Military Central Hospital, to count the ethics committee on 1983, also the Hospital no. 14 of the IMSS in Guadalajara, it works with regularity from 1995, with internal teaching of bioethic. The Secretariat of Health has asked the formation of the bioethical committees in each hospital, and order the it was be coordinated by the National Committee of Bioética. The integration of these committees is indispensable that their members have the knowledge necessary of bioética. The Mexican Society of Ortopedia, conscious of

  17. Symptoms and occurrences of narcolepsy: a retrospective study of 162 patients during a 10-year period in eastern China.

    PubMed

    Wu, Huijuan; Zhuang, Jianhua; Stone, William S; Zhang, Lin; Zhao, Zhengqing; Wang, Zongwen; Yang, Yang; Li, Xiang; Zhao, Xiangxiang; Zhao, Zhongxin

    2014-06-01

    Our study was designed to assess symptomatology and occurrences of narcolepsy in eastern China between 2003 and 2012. Herein we report the substantial changes in the occurrence and clinical features of narcolepsy over the last decade in China. We performed a retrospective analysis of 162 Han Chinese patients with narcolepsy at Changzheng Hospital, Shanghai, China. Clinical histories and precipitating factors were recorded, in addition to narcolepsy and H1N1 winter flu pandemic (pH1N1) occurrences at Changzheng Hospital. The occurrences also were compared between the Changzheng Hospital and the People's Hospital, Beijing, China. In our sample, narcolepsy occurred 1.73 times more frequently in men than in women. Most of the participants were children, which peaked to 91% in 2010. Excessive daytime sleepiness (EDS), disrupted nocturnal sleep, cataplexy, and weight gain were the four major symptoms. We found that 40% of patients had identifiable precipitating factors. The occurrence of narcolepsy in 2010 showed an approximate three-fold difference from the baseline levels at the Changzheng Hospital, which showed positive relationships with occurrences of pH1N1 in Shanghai and the occurrence of narcolepsy at the People's Hospital. Our findings show the interactive effects of geography and H1N1 disease in relation to narcolepsy in Han Chinese populations, and strengthen the theoretic hypothesis that immune and mental factors facilitate the onset of narcolepsy. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Pattern of motor neurone disease in eastern India.

    PubMed

    Saha, S P; Das, S K; Gangopadhyay, P K; Roy, T N; Maiti, B

    1997-07-01

    A clinical study about the pattern of motor neurone disease in eastern India was carried out from July 1993 to June 1995 at Bangur Institute of Neurology, Calcutta and SSKM Hospital, Calcutta. A total of 110 cases were studied and they constituted 0.11% of all neurological cases seen in the general OPD. Of 110 cases, amyotropic lateral sclerosis (ALS) constituted 43.6%, progressive muscular atrophy (PMA) 10.9%, post-polio progressive muscular atrophy (PPMA) 1.8%, spinal muscular atrophy (SMA) 20%, atypical form Madras pattern of MND (MMND) 0.9% and monomelic amyotrophy (MMA) 22.7% of cases. Disease is more common in males than females and average duration of symptoms before presentation varied from 1 to 12 months. Most of the patients were either agricultural labourers or manual workers in ALS variety whereas MMA variety was evenly distributed in both hard labourers and sedentary workers. Most of the patients in MMA and SMA groups presented before 30 years of age whereas ALS and PMA group presented after 30 years. Trauma was the commonest antecedent event in ALS and MMA followed by electrocution in the same two groups. Family history was found to be absent in SMA group though the disease is considered as a hereditary one. Weakness of the limbs and wasting of the muscles were common presenting symptoms and signs. Bulbar symptoms and signs were found only in the ALS group. EMG showed neurogenic pattern and mixed pattern in most of the patients in all groups. Only a few patients showed myopathic pattern. Neuroimaging study helped in exclusion of compressive lesion excepting two cases of MMA where facetal hypertrophy was present. Monomelic amyotrophy, a special variety of motor neurone disease, is not rare in this part as compared to other parts of India and Asia.

  19. Occupation and renal cell cancer in Central and Eastern Europe

    PubMed Central

    Heck, Julia E; Charbotel, Barbara; Moore, Lee E; Karami, Sara; Zaridze, David G; Matveev, Vsevolod; Janout, Vladimir; Kollárová, Helena; Foretova, Lenka; Bencko, Vladimir; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Mates, Dana; Ferro, Gilles; Chow, Wong-Ho; Rothman, Nathaniel; Stewart, Patricia; Brennan, Paul; Boffetta, Paolo

    2010-01-01

    Objective Central and Eastern Europe has among the highest rates of renal cell cancer worldwide. Few studies have been conducted in these areas to investigate the possible role of occupational exposures in renal cell cancer etiology. The purpose of this study was to examine the association of renal cell cancer with employment in specific occupations and industries. Methods From 1999–2003, we conducted a hospital-based case-control study in seven areas of the Czech Republic, Poland, Romania and Russia. A detailed occupational history was collected from renal cell cancer cases and controls, together with information on potential confounders. Odds ratios (OR) and 95% confidence intervals (CI) of cancer risk were calculated for having ever been employed in selected jobs and industries, with follow-up analyses examining duration of employment. Results A total of 992 histologically confirmed incident renal cell cancer cases and 1,465 controls were included in the analysis. An increased risk of renal cell cancer was observed for workers in agricultural labor and animal husbandry (OR=1.43, 95% CI 1.05, 1.93), particularly among women employed as general farm workers (OR=2.73, 95% CI 1.05, 7.13). Risk gradients for agricultural work increased with longer employment. An overall increased risk of renal cell cancer was seen among architects and engineers (OR=1.89, 95% CI 1.35, 2.65), and mechanical engineers (OR=1.71, 95% CI 1.03, 2.84). Conclusions Our data suggest an association between renal cell cancer and agricultural work, particularly among female workers. PMID:19737732

  20. Urinary calculous disease in south-eastern Nigeria.

    PubMed

    Ekwere, P D

    1995-09-01

    Prospective observations are reported on 96 South Eastern Nigerians with urinary calculi, during a five year period. An overall hospital incidence of 19.1 per 100,000, and male: female ratio of 2.7:1, were obtained. There were 79% upper-urinary tract stones and 21% lower-tract stones. Thirty-two per cent of the patients were idiopathic stone formers. Other associated aetiologic factors include obstructive uropathy (29%), UTI (30%) prolonged catheterisation (9%), hyperuricaemia (6%), foreign body in the bladder (3.8%) and hyperparathyroidism (2.5%). The lower socio-economic group accounted for 55% of the patients. Fifty three (55%) stones were removed surgically whilst 38% (45%) were passed spontaneously. Mean size of the latter was 6.3 mm +/- 1.6 mm, and of the former 17.7 mm +/- 9.5 mm. Five patients did not know when they passed the stones. Clinical features were similar to other reported series but six females had pyonephrosis, one with nephrocutaneous fistula. One urethral stone was recovered from a periurethral abscess. Infection and dietary intake appear to be important aetiologic agents. Ninety-eight per cent of stones contained calcium. Other components were similar to other reported series, but it was not possible to detect any case of cystinuria. The relatively high incidence in contrast to most other Nigerian centres may be due to high consumption of calcium/magnesium-rich sea foods and vegetables, as well as the soft water of the South-East. Endemic bladder stones were absent in the series. The close similarity with caucasian stone patterns is a curiosity and of particular interest, deserving further elucidation.

  1. Hospital Library Development. Hospital Library Handbooks No. 2.

    ERIC Educational Resources Information Center

    Cramer, Anne

    Addressed to the administrator of the hospital as well as the librarian, this handbook covers aspects of library service policy and long-range planning. While hospitals of all sizes are discussed, a special effort is made to cover problems of small hospitals (17 to 100 beds) in sparsely-settled regions. Contents: The library as a clinical service,…

  2. Hospital Preparedness and SARS

    PubMed Central

    Wallington, Tamara; Rutledge, Tim; Mederski, Barbara; Rose, Keith; Kwolek, Sue; McRitchie, Donna; Ali, Azra; Wolff, Bryan; White, Diane; Glassman, Edward; Ofner, Marianna; Low, Don E.; Berger, Lisa; McGeer, Allison; Wong, Tom; Baron, David; Berall, Glenn

    2004-01-01

    On May 23, 2003, Toronto experienced the second phase of a severe acute respiratory syndrome (SARS) outbreak. Ninety cases were confirmed, and >620 potential cases were managed. More than 9,000 persons had contact with confirmed or potential case-patients; many required quarantine. The main hospital involved during the second outbreak was North York General Hospital. We review this hospital’s response to, and management of, this outbreak, including such factors as building preparation and engineering, personnel, departmental workload, policies and documentation, infection control, personal protective equipment, training and education, public health, management and administration, follow-up of SARS patients, and psychological and psychosocial management and research. We also make recommendations for other institutions to prepare for future outbreaks, regardless of their origin. PMID:15200807

  3. Dementia for hospital physicians.

    PubMed

    Harwood, Rowan H

    2012-02-01

    Many people with dementia are admitted to general hospitals, yet doctors feel ill-prepared to manage them. Problems are often multiple and complex. In many cases, dementia is complicated by delirium. Medical assessment must be meticulous and requires collateral history taking, mental state examination and cognitive function testing. Hospital environments can be provocative, and the way staff interact with people with dementia can increase distress. Difficult behaviours usually represent unmet needs. The right approach by (all) staff can reduce this, including special efforts to establish reassuring, comforting relationships with patients. Try to see situations from the perspective of the person with dementia. Skilled communication is vital and family carers should be kept informed and involved. People with dementia are prone to side effects of prescribed drugs. Antipsychotic drugs are rarely the answer to difficult behaviours, but may be used in cases of psychosis or severe distress.

  4. 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

  5. Quebec's ice storm '98: "all cards wild, all rules broken" in Quebec's shell-shocked hospitals.

    PubMed

    Hamilton, J

    1998-02-24

    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.

  6. [Homicide crimes in hospitals].

    PubMed

    Dürwald, W

    1993-02-01

    Report of some cases of willful homicide in hospitals of the former GDR. In no case the patient has wished his death. Besides compassion the cause of the homicide was a large carefully expense and in two cases the attempt to prove the incapability of the competent doctor. The patients were only means to an end. All the cases are discovered by the great number of obscure death.

  7. Children's Hospital visit

    NASA Image and Video Library

    2011-02-04

    NASA senior staff members from John C. Stennis Space Center traveled to Children's Hospital in New Orleans on Feb. 4 for a morning of educational outreach, offering interactive demonstrations and activities for children. Staff members offered cryogenic demonstrations, informative and interactive exhibits and a chance for children to take photos 'wearing' a space suit. Children also had a chance to interact with Stennis' astronaut mascot.

  8. Hospital nurses' work motivation.

    PubMed

    Toode, Kristi; Routasalo, Pirkko; Helminen, Mika; Suominen, Tarja

    2015-06-01

    The knowledge surrounding nurses' work motivation is currently insufficient, and previous studies have rarely taken into account the role of many influential background factors. This study investigates the motivation of Estonian nurses in hospitals, and how individual and organisational background factors influence their motivation to work. The study is quantitative and cross-sectional. An electronically self-reported questionnaire was used for data collection. The sample comprised of 201 Registered Nurses working in various hospital settings in Estonia. Data were analysed using descriptive statistics, two-sample Wilcoxon rank-sum (Mann-Whitney) test, Kruskal-Wallis equality-of-populations rank test and Spearman's correlation. Both extrinsic and intrinsic motivations were noted among hospital nurses. Nurses were moderately externally motivated (M = 3.63, SD = 0.89) and intrinsically strongly motivated (M = 4.98, SD = 1.03). A nurses' age and the duration of service were positively correlated with one particular area of extrinsic work motivation, namely introjected regulation (p < 0.001). Nurses who had professional training over 7 days per year had both a higher extrinsic motivation (p = 0.016) and intrinsic work motivation (p = 0.004). The findings expand current knowledge of nurses' work motivation by describing the amount and orientation of work motivation among hospital nurses and highlighting background factors which should be taken into account in order to sustain and increase their intrinsic work motivation. The instrument used in the study can be an effective tool for nurse managers to determine a nurse's reasons to work and to choose a proper motivational strategy. Further research and testing of the instrument in different countries and in different contexts of nursing is however required. © 2014 Nordic College of Caring Science.

  9. Community Hospital Telehealth Consortium

    DTIC Science & Technology

    2007-04-01

    project involving the purchase of a neonatal retinal camera . This clinic transmits images from Lake Charles Memorial Hospital to a neonatal...ophthalmologist in New Orleans and assists in diagnosing Retinopathy of prematurity ( ROP ), a potentially blinding eye disorder that primarily affects...weeks). The smaller a baby is at birth, the more likely that baby is to develop ROP . This disorder—which usually develops in both eyes—is one of

  10. 33 CFR 167.153 - Off New York: Eastern approach.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Off New York: Eastern approach. 167.153 Section 167.153 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Schemes and Precautionary Areas Atlantic East Coast § 167.153 Off New York: Eastern approach. (a)...

  11. 76 FR 41755 - Eastern Arizona Counties Resource Advisory; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... Forest Service Eastern Arizona Counties Resource Advisory; Meeting AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eastern Arizona Counties Resource Advisory Committee will meet in Springerville, Arizona. The committee is authorized under the Secure Rural Schools and Community Self...

  12. 77 FR 51966 - Eastern Arizona Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... Forest Service Eastern Arizona Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eastern Arizona Resource Advisory Committee will meet in Springerville, Arizona. The committee is authorized under the Secure Rural Schools and Community Self-Determination Act...

  13. 75 FR 18145 - Eastern Arizona Counties Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-09

    ... Forest Service Eastern Arizona Counties Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eastern Arizona Counties Resource Advisory Committee will meet in Pinetop, Arizona. The purpose of the meeting is to review and recommend funding of project proposals in accordance...

  14. The Soviet Union and Eastern Europe. Teachers' Guide.

    ERIC Educational Resources Information Center

    Indiana Univ., Bloomington. Russian and East European Inst.

    Basic material on the Soviet Union and Eastern Europe is presented in this teachers' guide in such a way that teachers can incorporate it into the daily curriculum or utilize it through special units or projects. The guide is divided into two sections, one covering the Soviet Union, the other Eastern Europe. The Soviet Union section discusses…

  15. 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...

  16. A Comparative Study of Defense Reforms in Eastern European Nations

    DTIC Science & Technology

    2010-12-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT A Comparative Study of Defense Reforms in Eastern...2010 3. REPORT TYPE AND DATES COVERED MBA Professional Report 4. TITLE AND SUBTITLE A Comparative Study of Defense Reforms in Eastern European...to Comparative Public Administration (Aldershot: Edward Elgar, 1995), ix. 7. John Clarke and Janet Newman, The Managerial State (Oxford: Sage, 1997

  17. The Artist Residency Program in Eastern Oregon: Emphasizing the Rural.

    ERIC Educational Resources Information Center

    Davis, Doug

    During a 1979-1980 pilot project, 13 nine-week residencies by professional artists were sponsored in 10 eastern Oregon school districts with Eastern Oregon State College serving as liaison, the Northwest Area Foundation of St. Paul (Minnesota) contributing $33,500, and participating school districts adding a total of $8,000 in funding. This low…

  18. Tectonic Evolution of the Eastern Hemisphere of Mars

    NASA Technical Reports Server (NTRS)

    Pounders, E.; Anderson, R. C.; Dohm, J. M.; Haldemann, A. F. C.; Golombek, M. P.

    2002-01-01

    The magmatic-tectonic history of Mars is largely dominated by the Tharsis magmatic complex of the western hemisphere and the Elysium rise of the eastern hemisphere. In order to address the history of Mars, the tectonic history of the eastern hemisphere must also be unraveled. Additional information is contained in the original extended abstract.

  19. 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...

  20. 14 CFR 95.13 - Eastern United States Mountainous Area.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 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...