Science.gov

Sample records for national guard hospital

  1. The National Guard: State versus National Control.

    ERIC Educational Resources Information Center

    Newland, Samuel J.

    1989-01-01

    Provides historical perspectives on control of the National Guard by examining early writings to determine the original intent for what was the militia. Argues that it was established to defend the nation, but current governors are attempting to assert a stronger state role. Such actions could undermine national defense. (Author/CH)

  2. Successful Army National Guard units: A guard perspective

    SciTech Connect

    Wolfe, A.K.; Saulsbury, J.W.; Schexanayder, S.M.

    1991-10-01

    This project sought to identify factors contributing to a healthy Army National Guard (ARNG) unit. Its results were intended to contribute to a computerized forecasting model under development at Oak Ridge National Laboratory. The model, the ARNG Regional Recruiting Potential Model (RRPM), forecasts locations of successful new or modified Guard units. The study was expected to enhance the understanding of what constituents a healthy Guard unit. A Delphi approach was used to define criteria for healthy Guard units and to elicit rankings of those criteria. Two sets of telephone interviews were conducted with a sample of 102 individuals-two battalion-level administrative officers, or their equivalents, in each state in Washington, DC. During these telephone calls, the phrase ``unit supportability`` was used to express the notion of a healthy unit. The first set of interviews obtained background information and respondents` ideas of the criteria that lead to unit supportability and to a lack of supportability. The data were analyzed to develop a list of ten criteria for unit supportability. In the second interview, the same respondents were asked to rank those criteria in order of importance.

  3. Successful Army National Guard units: A guard perspective

    SciTech Connect

    Wolfe, A.K.; Saulsbury, J.W. ); Schexanayder, S.M. )

    1991-10-01

    This project sought to identify factors contributing to a healthy Army National Guard (ARNG) unit. Its results were intended to contribute to a computerized forecasting model under development at Oak Ridge National Laboratory. The model, the ARNG Regional Recruiting Potential Model (RRPM), forecasts locations of successful new or modified Guard units. The study was expected to enhance the understanding of what constituents a healthy Guard unit. A Delphi approach was used to define criteria for healthy Guard units and to elicit rankings of those criteria. Two sets of telephone interviews were conducted with a sample of 102 individuals-two battalion-level administrative officers, or their equivalents, in each state in Washington, DC. During these telephone calls, the phrase unit supportability'' was used to express the notion of a healthy unit. The first set of interviews obtained background information and respondents' ideas of the criteria that lead to unit supportability and to a lack of supportability. The data were analyzed to develop a list of ten criteria for unit supportability. In the second interview, the same respondents were asked to rank those criteria in order of importance.

  4. 78 FR 11676 - Notice of Inventory Completion: National Guard Bureau/A7AN, Air National Guard, Joint Base...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-19

    ... Base Andrews, MD AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The National Guard Bureau, Air National Guard, Joint Base Andrews, MD, has completed an inventory of human remains and... National Guard, Joint Base Andrews, MD. Repatriation of the human remains to the Indian tribes stated...

  5. 32 CFR 536.13 - Chief, National Guard Bureau.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Chief, National Guard Bureau. 536.13 Section 536.13 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.13 Chief, National Guard Bureau. The...

  6. 32 CFR 536.13 - Chief, National Guard Bureau.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CLAIMS AGAINST THE UNITED STATES The Army Claims System § 536.13 Chief, National Guard Bureau. The Chief, National Guard Bureau (NGB), shall: (a) Ensure the designation of a point of contact for claims matters in each State Adjutant General's office. (b) Provide the name, address, and telephone number of...

  7. Suicide in the Army National Guard: An Empirical Inquiry

    ERIC Educational Resources Information Center

    Griffith, James

    2012-01-01

    Since 2004, suicides in the U.S. military have risen, most notably in the Army National Guard (ARNG). Data used in this study were obtained for suicides occurring from 2007 to 2010 and for a random sample of nonsuicides from the general ARNG population. Of the military-related variables considered, a few showed relationships to suicide. Rather,…

  8. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force...

  9. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force...

  10. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force...

  11. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force...

  12. 32 CFR 728.25 - Army and Air Force National Guard personnel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Army and Air Force National Guard personnel. 728... Guard Personnel § 728.25 Army and Air Force National Guard personnel. (a) Medical and dental care. Upon... Care) and AFR 168-6 (Persons Authorized Medical Care) to members of the Army and Air Force...

  13. Geothermal Retrofit of Illinois National Guard's State headquarters Building

    SciTech Connect

    Lee, Mark

    2015-04-27

    The goal of this project was to assess the feasibility of utilizing mine water as a heat sink for a geothermal heat pump system to heat and cool the 74,000 sq. ft. Illinois National Guard State Headquarters’ building in Springfield Illinois. If successful, this type of system would be less expensive to install than a traditional closed loop geothermal (ground source) heat pump system by significantly reducing the size of the well field, thus shortening or eliminate the payback period compared to a conventional system. In the end, a conventional ground loop was used for the project.

  14. Preliminary assessment report for National Guard Training Center, Georgia Army National Guard, Fort Stewart, Georgia. Installation restoration program

    SciTech Connect

    Not Available

    1993-07-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Georgia Army National Guard (GAARNG) facility near Hinesville, Georgia, known as the National Guard Training Center (NGTC). Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a priority basis for completing corrective actions (where necessary) in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining previous site activities, types and quantities of hazardous substances utilized, and potential pathways by which contamination could affect public health and the environment. The scope of this assessment is limited to the facilities and past activities contained within the NGTC. Preliminary assessment site score sheet information is also provided for the NGTC. However, this assessment report is intended to be read in conjunction with a previous IRP assessment of Fort Stewart completed in 1992 (USATHAMA 1992) and to provide comprehensive information on the NGTC area for incorporation with information contained in that previous assessment for the entirety of Fort Stewart.

  15. 32 CFR 536.98 - Claims payable under the National Guard Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims payable under the National Guard Claims Act. 536.98 Section 536.98 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National Guard...

  16. 32 CFR 536.97 - Scope for claims under the National Guard Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Scope for claims under the National Guard Claims Act. 536.97 Section 536.97 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National Guard...

  17. 32 CFR 536.96 - Statutory authority for the National Guard Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Statutory authority for the National Guard Claims Act. 536.96 Section 536.96 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National Guard...

  18. 32 CFR 536.102 - Actions on appeal under the National Guard Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Actions on appeal under the National Guard Claims Act. 536.102 Section 536.102 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National Guard...

  19. Installation restoration program: Community relations plan. Minnesota Air National Guard 148th fighter wing

    SciTech Connect

    1996-05-01

    This Community Relations Plan has been developed as part of the Air National Guard`s Installation Restoration Program for the 148th Fighter Wing, Minnesota Air National Guard, Duluth, Minnesota. The Plan is part of the ongoing commitment by the Air National Guard to keep residents of the Duluth area informed about environmental restoration activities at the Duluth International Airport. The Plan describes the Installation Restoration Program and how it relates to the Minnesota Air National Guard, the environmental issues expressed by local residents, and the actions the Air National Guard will establish to maintain open and effective communications with its Duluth neighbors. The Air National Guard`s Installation Restoration Program is a nationwide effort to identify and resolve environmental problems that may have resulted from past practices or accidents on Air National Guard installations. These practices may have occurred years ago when the Air National Guard had limited knowledge of the environmental consequences associated with accidental spills or routine disposal of waste oils, cleaning solvents, fuels, and other substances.

  20. Bearing the burden: deployment stress among army national guard chaplains.

    PubMed

    Besterman-Dahan, Karen; Barnett, Scott; Hickling, Edward; Elnitsky, Christine; Lind, Jason; Skvoretz, John; Antinori, Nicole

    2012-01-01

    Military Chaplains are a critical component of behavioral health and spiritual support in combat operations. Support of combat operations has taken a toll on these caregivers. The purpose of this study was to explore the impact of deployment on the psychosocial and health characteristics and reintegration of Army National Guard (ARNG) chaplains. Seventy-four ARNG chaplains participated in an anonymous, online survey. Results were categorized into two mutually exclusive groups, combat deployed and non-combat deployed. Although both groups tended to present similar results, Combat deployed group chaplains were significantly more likely to be of higher rank, have served in a pastoral role in the ARNG longer, and present with higher scores for combat exposure, resilience, and alcohol use. Further, five and seven participants, respectively, the majority of whom were from the combat deployed group, endorsed "frequently" or "a great deal" to negative religious coping. These endorsements of abandonment may relate back to Reserve component specific deployment concerns.

  1. Prairie North: a joint civilian/military mass casualty exercise highlights the role of the National Guard in community disaster response.

    PubMed

    Vukotich, George; Bayram, Jamil D; Miller, Miriam I

    2012-01-01

    In a joint military/civilian exercise conducted in June 2010, military National Guard medical and decontamination response efforts proved to be paramount in supporting hospital resources to sustain an adequate response during a simulated terrorist event. Traditionally, hospitals include local responders in their disaster preparedness but overlook other available state and federal resources such as the National Guard. Lessons learned from the exercise included the value of regular joint disaster planning and training between the military and civilian medical sectors. Additionally, military communication and medical equipment compatibility with the civilian infrastructure was identified as one of the top areas for the improvement of this joint exercise. Involving the National Guard in community disaster planning provides a valuable medical support asset that can be critical in responding to multiple casualty events. National Guard response is inherently faster than its federal counterpart. Based on the findings from our joint exercise, states are encouraged to incorporate their corresponding National Guard in civilian critical medical infrastructure disaster preparedness activities, as the National Guard can be an integral part of the disaster response efforts in real multiple casualty events.

  2. Prairie North: a joint civilian/military mass casualty exercise highlights the role of the National Guard in community disaster response.

    PubMed

    Vukotich, George; Bayram, Jamil D; Miller, Miriam I

    2012-01-01

    In a joint military/civilian exercise conducted in June 2010, military National Guard medical and decontamination response efforts proved to be paramount in supporting hospital resources to sustain an adequate response during a simulated terrorist event. Traditionally, hospitals include local responders in their disaster preparedness but overlook other available state and federal resources such as the National Guard. Lessons learned from the exercise included the value of regular joint disaster planning and training between the military and civilian medical sectors. Additionally, military communication and medical equipment compatibility with the civilian infrastructure was identified as one of the top areas for the improvement of this joint exercise. Involving the National Guard in community disaster planning provides a valuable medical support asset that can be critical in responding to multiple casualty events. National Guard response is inherently faster than its federal counterpart. Based on the findings from our joint exercise, states are encouraged to incorporate their corresponding National Guard in civilian critical medical infrastructure disaster preparedness activities, as the National Guard can be an integral part of the disaster response efforts in real multiple casualty events. PMID:22649870

  3. Response capabilities of the National Guard: a focus on domestic disaster medical response.

    PubMed

    Bochicchio, Daniel

    2010-01-01

    The National Guard has a 373-year history of responding to the nation's call to duty for service both at home and abroad (The National Guard Bureau Web site: Available at http://www.ngb.army.mil/default. aspx.). The National Guard (NG) is a constitutionally unique organization (United States Constitution, US Government Printing Office Web site: Available at http://www.gpoaccess.gov/constitution/index.html.). Today's Guard conducts domestic disaster response and civilian assistance missions on a daily basis. Yet, the NG's role, mission, and capabilities are not well-known or understood. The National Response Framework (NRF) places significant responsibility on the local and state disaster planners (Department of Homeland Security: National Response Framework. US Department of Homeland Security, Washington, DC, January 2008). The public health professionals are an integral component of the disaster planning community. It is critical that the public health community be knowledgeable of types and capabilities of all the response assets at their disposal.

  4. Response capabilities of the National Guard: a focus on domestic disaster medical response.

    PubMed

    Bochicchio, Daniel

    2010-01-01

    The National Guard has a 373-year history of responding to the nation's call to duty for service both at home and abroad (The National Guard Bureau Web site: Available at http://www.ngb.army.mil/default. aspx.). The National Guard (NG) is a constitutionally unique organization (United States Constitution, US Government Printing Office Web site: Available at http://www.gpoaccess.gov/constitution/index.html.). Today's Guard conducts domestic disaster response and civilian assistance missions on a daily basis. Yet, the NG's role, mission, and capabilities are not well-known or understood. The National Response Framework (NRF) places significant responsibility on the local and state disaster planners (Department of Homeland Security: National Response Framework. US Department of Homeland Security, Washington, DC, January 2008). The public health professionals are an integral component of the disaster planning community. It is critical that the public health community be knowledgeable of types and capabilities of all the response assets at their disposal. PMID:20349703

  5. 75 FR 22829 - National Environmental Policy Act; Final Environmental Impact Statement on U.S. Coast Guard...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    .... The Coast Guard published a notice of intent to prepare an EIS in the Federal ] Register (71 FR 14233... SECURITY Coast Guard National Environmental Policy Act; Final Environmental Impact Statement on U.S. Coast Guard Pacific Area Operations: Districts 11 and 13 AGENCY: Coast Guard, DHS. ACTION: Notice...

  6. 32 CFR 536.99 - Claims not payable under the National Guard Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims not payable under the National Guard Claims Act. 536.99 Section 536.99 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National...

  7. Perceptions of Individual and Family Functioning Among Deployed Female National Guard Members.

    PubMed

    Kelly, Patricia J; Cheng, An-Lin; Berkel, LaVerne A; Nilsson, Johanna

    2016-08-01

    Females currently make up 15% of U.S. military service members. Minimal attention has been paid to families of female National Guard members who have been deployed and their subsequent reintegration challenges. This cross-sectional Internet-based survey of female members of four National Guard units compared those who were and were not deployed. Instruments, guided by the variables of the Family Resilience Model, measured individual, family, and deployment-related factors. Bivariate analysis and ordinal logistic regression were done to assess differences between the groups. Of the 239 National Guard members surveyed, deployed women (n = 164) had significantly higher levels of posttraumatic stress disorder (PTSD; p < .001) and lower coping skills (p = .003) than non-deployed women (n = 75). Perceptions of overall family functioning were higher among deployed when compared with never deployed women. Results indicate community interventions that focus on strengthening coping skills of female Guard members would be useful for this population. PMID:27076466

  8. 32 CFR 536.101 - Settlement authority for claims under the National Guard Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Settlement authority for claims under the National Guard Claims Act. 536.101 Section 536.101 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under...

  9. 32 CFR 536.100 - Applicable law for claims under the National Guard Claims Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Applicable law for claims under the National Guard Claims Act. 536.100 Section 536.100 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the...

  10. Task force St. Bernard: operational issues and medical management of a National Guard disaster response operation.

    PubMed

    Bonnett, Carl J; Schock, Tony R; McVaney, Kevin E; Colwell, Christopher B; Depass, Christopher

    2007-01-01

    After Hurricane Katrina struck the Gulf Coast of the United States on 29 August 2005, it became obvious that the country was facing an enormous national emergency. With local resources overwhelmed, governors across the US responded by deploying thousands of National Guard soldiers and airmen. The National Guard has responded to domestic disasters due to natural hazards since its inception, but an event with the magnitude of Hurricane Katrina was unprecedented. The deployment of >900 Army National Guard soldiers to St. Bernard Parish, Louisiana in the aftermath of the Hurricane was studied to present some of the operational issues involved with providing medical support for this type of operation. In doing so, the authors attempt to address some of the larger issues of how the National Guard can be incorporated into domestic disaster response efforts. A number of unforeseen issues with regards to medical operations, medical supply, communication, preventive medicine, legal issues, and interactions with civilians were encountered and are reviewed. A better understanding of the National Guard and how it can be utilized more effectively in future disaster response operations can be developed.

  11. Learning Without Boundaries: A NASA - National Guard Bureau Distance Learning Partnership

    NASA Technical Reports Server (NTRS)

    Anderson, Susan H.; Chilelli, Christopher J.; Picard, Stephan

    2003-01-01

    With a variety of high-quality live interactive educational programs originating at the Johnson Space Center in Houston, Texas and other space and research centers, the US space agency NASA (National Aeronautics and Space Administration) has a proud track record of connecting with students throughout the world and stimulating their creativity and collaborative skills by teaching them underlying scientific and technological underpinnings of space exploration. However, NASA desires to expand its outreach capability for this type of interactive instruction. In early 2002, NASA and the National Guard Bureau -- using the Guard's nationwide system of state-ofthe-art classrooms and high bandwidth network -- began a collaboration to extend the reach of NASA content and educational programs to more of America's young people. Already, hundreds of elementary, middle, and high school students have visited Guard e-Learning facilities and participated in interactive NASA learning events. Topics have included experimental flight, satellite imagery-interpretation, and Mars exploration. Through this partnership, NASA and the National Guard are enabling local school systems throughout the United States (and, increasingly, the world) to use the excitement of space flight to encourage their students to become passionate about the possibility of one day serving as scientists, mathematicians, technologists, and engineers. At the 54th International Astronautical Conference MAJ Stephan Picard, the guiding visionary behind the Guard's partnership with NASA, and Chris Chilelli, an educator and senior instructional designer at NASA, will share with attendees background on NASA's educational products and the National Guard's distributed learning network; will discuss the unique opportunity this partnership already has provided students and teachers throughout the United States; will offer insights into the formation by government entities of e-Learning partnerships with one another; and will

  12. Life goes on: the experiences of wives of multiply-deployed National Guard soldiers.

    PubMed

    Patzel, Brenda; McBride, Maryellen; Bunting, Judith; Anno, Tony

    2013-05-01

    Whether a service member is active duty or part of the National Guard, deployment of these service members is a major issue for most families. There is limited knowledge of the experience of multiple deployments on the family. The purpose of this study was to describe experiences of wives of National Guard soldiers that were deployed more than once. Nine wives were interviewed. An analysis of the interviews revealed four themes: (1) "Life Goes On" (i.e., despite the repeated deployments, life continues at home); (2) the "Guard is a Different Animal" (i.e., life as a National Guard spouse is different from that of an active duty spouse); (3) "It's a Mind-Set" (i.e., how wives cope their husband's deployment); and (4) "Going Back Again" (i.e., wives' experiences of multiple deployments). Exploring how multiple deployments affects wives of National Guard soldiers is helpful in understanding their experiences and the adjustments that must be made in family life. Knowledge of the experiences of these wives may help in formulating more effective interventions with families who have experienced multiple deployments.

  13. National Guard service members' perceptions of informal and formal supports: an exploratory study.

    PubMed

    Reedy, Amanda R; Kobayashi, Rie

    2015-01-01

    Much of the research on military families has focused on active duty service members. Little is known about informal and formal supports that National Guard service members use. Using an ecological systems perspective, this exploratory pilot study assessed awareness, access, use, satisfaction, and perceptions of effectiveness of informal and formal supports in a small group of National Guard service members. Results indicate that although service members are aware of many formal and informal supports, use of many of the supports is limited. Additionally, satisfaction and perceptions of effectiveness of many supports is neutral. The implications of these results are discussed.

  14. Joint civilian/national guard mass casualty exercise provides model for preparedness training.

    PubMed

    Grant, William D; Secreti, LaLainia

    2007-08-01

    After-action reports on the 2005 hurricane relief efforts pointed to the need for effective and efficient civilian/military operational cooperation. Cited for particular attention was the interface with National Guard units. This article describes an exercise conducted with National Guard units and members of the Central New York Medical Reserve Corps to educate all participants in effective interaction during disaster responses. Using a unique health care facility located at the New York State Fairgrounds, this 2-day operation demonstrated that jointly trained civilian and military units become well prepared for the conduct of joint relief and rescue operations.

  15. 77 FR 58295 - National Employer Support of the Guard and Reserve Week, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ...'s call, and their exceptional service in a post-9/11 world has secured their place alongside the..., which created new tax credits to encourage employers to hire veterans. And this July, we announced an... of the Guard and Reserve Week, let us pay tribute to the brave men and women who keep our Nation...

  16. 5 CFR 831.306 - Service as a National Guard technician before January 1, 1969.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Service as a National Guard technician before January 1, 1969. 831.306 Section 831.306 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) RETIREMENT Credit for Service § 831.306 Service as...

  17. Making the Transition: Interim Results of the National Guard Youth ChalleNGe Evaluation

    ERIC Educational Resources Information Center

    Millenky, Megan; Bloom, Dan; Dillon, Colleen

    2010-01-01

    Young people who drop out of high school face long odds of success in a labor market that increasingly values education and skills. This report presents interim results from a rigorous, ongoing evaluation of the National Guard Youth ChalleNGe Program, which aims to "reclaim the lives of at-risk youth" who have dropped out of high school. ChalleNGe…

  18. Making the Transition: Interim Results of the National Guard Youth ChalleNGe Evaluation. [Executive Summary

    ERIC Educational Resources Information Center

    Millenky, Megan; Bloom, Dan; Dillon, Colleen

    2010-01-01

    Young people who drop out of high school face long odds of success in a labor market that increasingly values education and skills. This report presents interim results from a rigorous, ongoing evaluation of the National Guard Youth ChalleNGe Program, which aims to "reclaim the lives of at-risk youth" who have dropped out of high school. ChalleNGe…

  19. Staying on Course: Three-Year Results of the National Guard Youth ChalleNGe Evaluation

    ERIC Educational Resources Information Center

    Millenky, Megan; Bloom, Dan; Muller-Ravett, Sara; Broadus, Joseph

    2011-01-01

    High school dropouts face an uphill battle in a labor market that increasingly rewards skills and postsecondary credentials: they are more likely than their peers to need public assistance, be arrested or incarcerated, and less likely to marry. This report presents results from a rigorous evaluation of the National Guard Youth ChalleNGe Program,…

  20. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  1. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  2. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  3. Children of National Guard Troops Deployed in the Global War on Terrorism

    ERIC Educational Resources Information Center

    Pfefferbaum, Betty; Houston, J. Brian; Sherman, Michelle D.; Melson, Ashley G.

    2011-01-01

    This study examined deployment effects in children and spouses of National Guard troops using a longitudinal design to assess 18 children (ages 6 to 17 years) and 13 nondeployed spouses before, during, and after deployment. Both self- and parent reports revealed that children of deployed service personnel experienced emotional and behavioral…

  4. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  5. 5 CFR 315.610 - Noncompetitive appointment of certain National Guard technicians.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Noncompetitive appointment of certain National Guard technicians. 315.610 Section 315.610 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CAREER AND CAREER-CONDITIONAL EMPLOYMENT Career or...

  6. 33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan... Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from...

  7. 33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan... Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from...

  8. 33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan... Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from...

  9. Preliminary assessment report for National Guard Facility, Installation 25255, Rehoboth, Massachusetts. Installation Restoration Program

    SciTech Connect

    Haffenden, R.; Flaim, S.; Krokosz, M.

    1993-08-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Massachusetts Army National Guard (MAARNG) property known as the Rehoboth National Guard Facility (RNGF) in Rehoboth, Massachusetts. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for ftirther action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the RNGF property, phase I of the Department of Defense Installation Restoration Program (IRP). The scope of this assessment is limited to the facilities under the control of the MAARNG and the past activities contained within that area.

  10. National hospital input price index.

    PubMed

    Freeland, M S; Anderson, G; Schendler, C E

    1979-01-01

    The national community hospital input price index presented here isolates the effects of prices of goods and services required to produce hospital care and measures the average percent change in prices for a fixed market basket of hospital inputs. Using the methodology described in this article, weights for various expenditure categories were estimated and proxy price variables associated with each were selected. The index is calculated for the historical period 1970 through 1978 and forecast for 1979 through 1981. During the historical period, the input price index increased an average of 8.0 percent a year, compared with an average rate of increase of 6.6 percent for overall consumer prices. For the period 1979 through 1981, the average annual increase is forecast at between 8.5 and 9.0 per cent. Using the index to deflate growth in expenses, the level of real growth in expenditures per inpatient day (net service intensity growth) averaged 4.5 percent per year with considerable annual variation related to government and hospital industry policies. PMID:10309052

  11. National hospital input price index.

    PubMed

    Freeland, M S; Anderson, G; Schendler, C E

    1979-01-01

    The national community hospital input price index presented here isolates the effects of prices of goods and services required to produce hospital care and measures the average percent change in prices for a fixed market basket of hospital inputs. Using the methodology described in this article, weights for various expenditure categories were estimated and proxy price variables associated with each were selected. The index is calculated for the historical period 1970 through 1978 and forecast for 1979 through 1981. During the historical period, the input price index increased an average of 8.0 percent a year, compared with an average rate of increase of 6.6 percent for overall consumer prices. For the period 1979 through 1981, the average annual increase is forecast at between 8.5 and 9.0 per cent. Using the index to deflate growth in expenses, the level of real growth in expenditures per inpatient day (net service intensity growth) averaged 4.5 percent per year with considerable annual variation related to government and hospital industry policies.

  12. Army National Guard (ARNG) Objective Supply Capability Adaptive Redesign (OSCAR) end-user manual

    SciTech Connect

    Pelath, R.P.; Rasch, K.A.

    1997-12-01

    The Objective Supply Capability Adaptive Redesign (OSCAR) project is designed to identify and develop programs which automate requirements not included in standard army systems. This includes providing automated interfaces between standard army systems at the National Guard Bureau (NGB) level and at the state/territory level. As part of the OSCAR project, custom software has been installed at NGB to streamline management of major end items. This software allows item managers to provide automated disposition on excess equipment to states operating the Standard Army Retail Supply System Objective (SARSS-O). It also accelerates movement of excess assets to improve the readiness of the Army National Guard (ARNG)--while reducing excess on hand. The purpose of the End-User Manual is to provide direction and guidance to the customer for implementing the ARNG Excess Management Program.

  13. Age moderates the association of depressive symptoms and unhealthy alcohol use in the National Guard.

    PubMed

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2016-12-01

    Unhealthy drinking is a significant problem contributing to poor health and performance of military personnel. The Iowa Army National Guard and the Iowa Department of Public Health have collaborated with the Substance Abuse and Mental Health Administration to better identify unhealthy substance use via Screening, Brief Intervention, and Referral to Treatment program (SBIRT). Yet, little research has been conducted on the Guard's use of SBIRT. This study examined depression, age, deployment status, and sex as factors contributing to unhealthy drinking. Of the Guardsmen who took part in SBIRT, 3.7% (n=75) met the criteria for unhealthy drinking and 3.9% (n=78) had some level of depression. The overall multivariate model significantly predicted unhealthy drinking (χ(2)(5)=41.41, p<0.001) with age moderating the association of depressive symptoms and unhealthy alcohol (Wald χ(2)(1)=7.16, p=0.007). These findings add to the existing understanding of factors contributing to unhealthy drinking suggesting the association between the presence of depression and unhealthy drinking depends on age of the Guradsman. This age and depression interaction may be an important diagnostic feature to consider for unhealthy drinking in the Guard. Furthermore, previous research on the general military population finds similar percentages, providing support for SBIRT as an effective screening tool in the Guard. PMID:27450908

  14. Age moderates the association of depressive symptoms and unhealthy alcohol use in the National Guard.

    PubMed

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2016-12-01

    Unhealthy drinking is a significant problem contributing to poor health and performance of military personnel. The Iowa Army National Guard and the Iowa Department of Public Health have collaborated with the Substance Abuse and Mental Health Administration to better identify unhealthy substance use via Screening, Brief Intervention, and Referral to Treatment program (SBIRT). Yet, little research has been conducted on the Guard's use of SBIRT. This study examined depression, age, deployment status, and sex as factors contributing to unhealthy drinking. Of the Guardsmen who took part in SBIRT, 3.7% (n=75) met the criteria for unhealthy drinking and 3.9% (n=78) had some level of depression. The overall multivariate model significantly predicted unhealthy drinking (χ(2)(5)=41.41, p<0.001) with age moderating the association of depressive symptoms and unhealthy alcohol (Wald χ(2)(1)=7.16, p=0.007). These findings add to the existing understanding of factors contributing to unhealthy drinking suggesting the association between the presence of depression and unhealthy drinking depends on age of the Guradsman. This age and depression interaction may be an important diagnostic feature to consider for unhealthy drinking in the Guard. Furthermore, previous research on the general military population finds similar percentages, providing support for SBIRT as an effective screening tool in the Guard.

  15. Assessment of a postdeployment Yellow Ribbon Reintegration Program for National Guard members and supporters.

    PubMed

    Scherrer, Jeffrey F; Widner, Greg; Shroff, Manan; Matthieu, Monica; Balan, Sundari; van den Berk-Clark, Carissa; Price, Rumi K

    2014-11-01

    The Yellow Ribbon Reintegration Program (YRRP) was created to meet the needs of National Guard members and their families throughout the deployment cycle. This study examined the perceived utility of the YRRP's delivery of information and assistance during the postdeployment reintegration period by National Guard members and accompanying supporters who were mostly spouses. Over 22 months, from 10 YRRP events, 683 service members and 411 supporters completed questionnaires immediately after the YRRP. We analyzed questions on information and avenues for help, timeliness and concerns related to education, employment, legal, family, and health. Service members and supporters most often endorsed information delivery on education being met (76.8% and 78.2%, respectively) and were least likely to endorse legal information delivery (63.5% and 60%, respectively). Significantly more supporters than service members (p < 0.0001) reported that the YRRP was the first time they learned of available services across all domains. Service members were significantly more likely than supporters to report concerns about education, employment, and health, while supporters were significantly more likely to report concerns about family. Results suggest the YRRP fills gaps in supporter knowledge and provides needed information and resources to most National Guard families 2 to 4 months after a deployment.

  16. Assessment of a Post-deployment Yellow Ribbon Reintegration Program for National Guard Members and Supporters

    PubMed Central

    Scherrer, Jeffrey F.; Widner, Greg; Shroff, Manan; Matthieu, Monica; Balan, Sundari; van den Berk-Clark, Carissa; Price, Rumi Kato

    2014-01-01

    The Yellow Ribbon Reintegration Program (YRRP) was created to meet the needs of National Guard members and their families throughout the deployment cycle. This study examined the perceived utility of the YRRP’s delivery of information and assistance during the post-deployment reintegration period by National Guard members and accompanying supporters who were mostly spouses. Over 22 months, from 10 YRRP events, 683 service members and 411 supporters completed questionnaires immediately after the YRRP. We analyzed questions on information and help provision, timeliness and concerns related to education, employment, legal, family, and health. Service members and supporters most often endorsed education needs being met (76.8% and 78.2% respectively) and were least likely to endorse legal needs being met (63.5% and 60% respectively). Significantly more supporters than service members (p < 0.0001) reported that the YRRP was the first time they learned of available services across all domains. Service members were significantly more likely than supporters to report concerns about education, employment, and health; while supporters were significantly more likely to report concerns about family. Results suggest the YRRP fills gaps in supporter knowledge and provides needed information and resources to most National Guard families 2-4 months after a deployment. PMID:25373071

  17. Preliminary assessment report for Kent National Guard Facility (Installation 53065), 24410 Military Road, Kent, Washington

    SciTech Connect

    Ketels, P.; Aggarwal, P.; Rose, C.M.

    1993-08-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Washington Army National Guard property in Kent, Washington. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment.

  18. Maternal and foetal outcome of 206 high risk pregnancy cases in border guard hospital, dhaka.

    PubMed

    Shapla, N R; Islam, M A; Shahida, S M; Parveen, Z; Lipe, Y S

    2015-04-01

    This observational study was carried out to identify the various types of high risk pregnancy and to determine the maternal and foetal outcome. The study was carried out on 206 pregnant high risk women in the Gynecology and Obstetrics department of Border Guard Hospital, Dhaka from January 2012 to December 2012. During mentioned period among 598 pregnant women 206 high risk pregnancy cases were randomly selected. Pregnant women (gestational age from 34 weeks upto 40 weeks) having medical condition and pregnancy related high risk factors were included and uncomplicated pregnancy, pregnancy before 37 weeks, post dated pregnancy were excluded from this study. Data was collected from semi structured history sheet and data analysis done by percentage. High risk pregnant women were grouped into three. Group A and Group B includes pregnant women having medical condition before and during pregnancy respectively. Group C consists of pregnant women had pregnancy related high risk issues. Among 206 high risk pregnancy cases majority 47.57% women had medical condition during pregnancy, 31.55% patient had medical condition before pregnancy. Among them majority 30.58% of the patient suffered from pregnancy induced hypertension, 15.04% patients suffered from gestational Diabetes Mellitus and premature rupture of membranes were 12.13%. In this study majority 43.68% of high risk pregnant patients were in age group of 30-35 years, 19.90% pregnant women were in age group of >35 years and 19.40% were in age group of upto 20 years. Among study groups maximum 65.04% of the patients were multiparous. Among 206 study population 60.19% high risk pregnant women were at term at the time of delivery and 39.8% women delivered their babies preterm. Caesarean section was done in 69.41% of high risk pregnant women. After delivery majority 77.66% women had no complication, only 10.19%, 8.25%, 2.91% and 0.97% high risk pregnant women suffered from fever, UTI, abdominal wound infection and post

  19. National machine guarding program: Part 1. Machine safeguarding practices in small metal fabrication businesses

    PubMed Central

    Yamin, Samuel C.; Brosseau, Lisa M.; Xi, Min; Gordon, Robert; Most, Ivan G.; Stanley, Rodney

    2015-01-01

    Background Metal fabrication workers experience high rates of traumatic occupational injuries. Machine operators in particular face high risks, often stemming from the absence or improper use of machine safeguarding or the failure to implement lockout procedures. Methods The National Machine Guarding Program (NMGP) was a translational research initiative implemented in conjunction with two workers' compensation insures. Insurance safety consultants trained in machine guarding used standardized checklists to conduct a baseline inspection of machine‐related hazards in 221 business. Results Safeguards at the point of operation were missing or inadequate on 33% of machines. Safeguards for other mechanical hazards were missing on 28% of machines. Older machines were both widely used and less likely than newer machines to be properly guarded. Lockout/tagout procedures were posted at only 9% of machine workstations. Conclusions The NMGP demonstrates a need for improvement in many aspects of machine safety and lockout in small metal fabrication businesses. Am. J. Ind. Med. 58:1174–1183, 2015. © 2015 The Authors. American Journal of Industrial Medicine published by Wiley Periodicals, Inc. PMID:26332060

  20. Health promotion practices as perceived by primary healthcare professionals at the Ministry of National Guard Health Affairs, Saudi Arabia

    PubMed Central

    Altamimi, Samar; Alshoshan, Feda; Al Shaman, Ghada; Tawfeeq, Nasser; Alasmary, May; Ahmed, Anwar E.

    2016-01-01

    Introduction: In recent years, several research studies have investigated health promotion practices in Saudi healthcare organizations, yet no published literature exists on health promotion practices of primary healthcare professionals working for the Ministry of National Guard Health Affairs (MNG-HA). Methods: A cross-sectional study was conducted in a convenience sample of 206 primary healthcare professionals at the MNG-HA. A self-reporting questionnaire was used to investigate the attitudes, awareness, satisfaction, and methods regarding health promotion practices of primary healthcare professionals. Results: Of the 206 primary healthcare professionals surveyed, 58.1% reported awareness of health promotion programs conducted in the hospitals and 64.6% reported that the health promotion system in the hospitals needs to be improved. Language barriers and cultural beliefs were viewed as obstacles to carrying out effective health promotion by 65% and 64.6% of primary healthcare professionals, respectively. The majority (79.9%) of the primary healthcare professionals perceived themselves as having the necessary skills to promote health and 80.6% believed that printed educational materials are the most prevalent method of health promotion/education, whereas 55.8% reported that counseling was the most preferred method of health promotion. Conclusion: The awareness level of health promotion policies, strategies, and programs conducted in the hospitals was not found to be satisfactory. Therefore, widespread training programs are recommended to improve the health promotion system in the hospitals. These programs include facilitating behavioral change, introducing health promotion policies and strategies in hospitals, mandatory workshops, and systematic reminders. PMID:27482512

  1. Superfund record of decision (EPA Region 1): Otis Air National Guard (USAF), Operable Unit 3, Falmouth, MA, September 30, 1998

    SciTech Connect

    1999-03-01

    The Massachusetts Military Reservation (MMR) on Cape Cod, Massachusetts, lies within the boundaries of the towns of Falmouth, Mashpee, Sandwich, and Bourne. The Area of Contamination (AOC) known as Chemical Spill 3 United States Coast Guard (CS-3 (USCG)) is located on Lee Road, in the south central portion of the MMR. The Air Force Center for Environmental Excellence (AFCEE) Installation Restoration Program Office at Otis Air National Guard (ANG) Base, Massachusetts.

  2. Coast Guard

    SciTech Connect

    Not Available

    1991-09-01

    The 11-million gallon Exxon Valdez oil spill highlighted deficiencies in the nation's ability to contain and recover spilled oil. The Oil Pollution Act of 1990 represents a major effort by Congress to address these deficiencies and to clarify the roles and responsibilities of the private sector and the federal government in preventing, preparing for, and responding to oil spills. This report examines the Coast Guard's efforts to avoid unnecessary and wasteful duplication by coordinating with the private sector and others, including federal and state agencies, its plans to buy oil spill response equipment and the new responsibilities the act places on the private sector and the Coast Guard and if these responsibilities call for a shift in emphasis in Coast Guard oil spill response activities.

  3. 3 CFR 8564 - Proclamation 8564 of September 17, 2010. National Employer Support of the Guard and Reserve Week...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... men and women in the National Guard and Reserve play a vital role in our national defense. Throughout... special tribute to the employers of our Guardsmen and Reservists, whose support and flexibility bolster the contributions of these brave men and women. Through accommodating personnel policies...

  4. Posttraumatic Stress Symptoms among National Guard Soldiers Deployed to Iraq: Associations with Parenting Behaviors and Couple Adjustment

    ERIC Educational Resources Information Center

    Gewirtz, Abigail H.; Polusny, Melissa A.; DeGarmo, David S.; Khaylis, Anna; Erbes, Christopher R.

    2010-01-01

    Objective: In this article, we report findings from a 1-year longitudinal study examining the impact of change in posttraumatic stress disorder (PTSD) symptoms following combat deployment on National Guard soldiers' perceived parenting and couple adjustment 1 year following return from Iraq. Method: Participants were 468 Army National Guard…

  5. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  6. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 4 2011-07-01 2011-07-01 false Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  7. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 4 2014-07-01 2013-07-01 true Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  8. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 4 2012-07-01 2011-07-01 true Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  9. 32 CFR 635.22 - Reserve component, U.S. Army Reserve, and Army National Guard personnel.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 4 2013-07-01 2013-07-01 false Reserve component, U.S. Army Reserve, and Army...) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Offense Reporting § 635.22 Reserve component, U.S. Army Reserve, and Army National Guard personnel....

  10. Stationwide environmental baseline survey and related environmental factors, Ontario Air National Guard Station, California

    SciTech Connect

    1996-11-26

    This Environmental Baseline Survey (EBS) has been prepared to document the environmental condition of real property at Ontario Air National Guard Station (ANGS), California, resulting from the storage, release, and disposal of hazardous substances and petroleum products and their derivatives over the installations history. This EBS is also used by the Air Force to meet its obligations under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), 42 United States Code Section 9620(h), as amended by the Community Environmental Response Facilitation Act (CERFA) (Public Law 102-426). Table ES-1 list all uncontaminated property based on information obtained through a records search, interviews, and visual site inspections at Ontario ANGS. Figure ES-1 depicts their respective locations.

  11. Children of National Guard troops: a pilot study of deployment, patriotism, and media coverage.

    PubMed

    Pfefferbaum, Betty; Jeon-Slaughter, Haekyung; Jacobs, Anne K; Houston, J Brian

    2013-01-01

    This exploratory pilot study examined the psychosocial effects of the war in Iraq, patriotism, and attention to war-related media coverage in the children of National Guard troops across phases of parental deployment--pre deployment, during deployment, and post deployment. Participants included 11 children, ages 8 to 18 years. Data collected in each deployment phase included demographics, the Behavior Assessment System for Children, (Second Edition, BASC-2), patriotism (national identity, uncritical patriotism, and constructive patriotism), and attention to war-related media coverage. School problems and emotional symptoms were significantly higher during deployment than post deployment. National identity and constructive patriotism increased and uncritical patriotism decreased post deployment from levels during deployment. Uncritical patriotism correlated positively with emotional symptoms and correlated negatively with personal adjustment. Constructive patriotism correlated positively with emotional symptoms and with internalizing problems. Greater attention to war-related media coverage correlated with uncritical patriotism, and attention to internet coverage correlated with constructive patriotism. Attention to media coverage was linked to greater emotional and behavioral problems and was negatively correlated with personal adjustment. The results of this pilot study identified relationships of both patriotism and attention to media coverage with children's emotional and behavioral status and personal adjustment suggesting areas for future investigation.

  12. Installation restoration program. Site investigation report, IRP sites No. 1, No. 2, and No. 3. 106th Civil Engineering Flight, New York Air National Guard, Roslyn Air National Guard Station, Roslyn, New York. Volume 3, Appendix H. Site Investigation report

    SciTech Connect

    1996-11-01

    This report is a continuation of the Installation Restoration Program site investigation report for IRP Sites No. 1, No. 2 and No. 3 at the Air National Guard, Rosyln, New York. The Sample Delivery Group (SDG) narratives and quality assurance/quality control analytical results of eighteen samples are reported.

  13. Anger problems and posttraumatic stress disorder in male and female National Guard and Reserve Service members.

    PubMed

    Worthen, Miranda; Rathod, Sujit D; Cohen, Gregory; Sampson, Laura; Ursano, Robert; Gifford, Robert; Fullerton, Carol; Galea, Sandro; Ahern, Jennifer

    2014-08-01

    Anger is a common problem among veterans and has been associated with posttraumatic stress disorder (PTSD). This study aimed to improve understanding of how anger and PTSD co-occur by examining gender differences and differences by whether the triggering traumatic event is deployment-related vs. civilian-related in current service members. A representative cohort of Reserve and National Guard service personnel (n = 1293) were interviewed to assess for deployment- or civilian-related traumas, PTSD, and anger. The prevalence of self-reported anger problems was estimated among male (n = 1036) and female (n = 257) service members. Log Poisson regression models with robust standard errors were used to estimate the associations of problems with anger with PTSD and PTSD symptom severity for men and women. Self-reported anger problems were common among male (53.0%) and female (51.3%) service members. Adjusted prevalence ratios (PR) showed associations between anger and PTSD connected to both civilian- and deployment-related traumas (PR were 1.77 (95% CI 1.52-2.05) and 1.85 (95% CI 1.62-2.12), respectively). PTSD symptom severity was also associated with anger. This study was cross-sectional and so a causal relationship between PTSD and anger cannot be established. Problems with anger are common among male and female current Guard and Reserve members. These findings suggest that anger treatment should be made available to current service members and that clinicians should assess anger problems irrespective of gender. Future research should examine the effectiveness of anger treatment protocols by gender.

  14. Preliminary assessment report for Redmond Army National Guard Facility, Installation 53120, Redmond, Washington. Installation Restoration Program

    SciTech Connect

    Ketels, P.; Aggarwal, P.

    1993-08-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Washington Army National Guard (WAARNG) property in Redmond, Washington. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Redmond ARNG property, Phase I of the Department of Defense Installation Restoration Program. The environmentally significant operations (ESOs) associated with the property are (1) supply/storage of hazardous materials, (2) weapons cleaning, (3) the underground storage tanks (USTs), and (4) the use of herbicides. These ESOs are no longer active because of the closure of OMS 10 activities in 1988.

  15. 33 CFR 334.845 - Wisconsin Air National Guard, Volk Field military exercise area located in Lake Michigan offshore...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., Volk Field military exercise area located in Lake Michigan offshore from Manitowoc and Sheboygan... Air National Guard, Volk Field military exercise area located in Lake Michigan offshore from Manitowoc.... (b) The regulation. (1) During specific, infrequent periods when Military exercises will be...

  16. A Study of the Physiological Factors Affecting the Nature of the Adult Learner in the Phoenix Air National Guard.

    ERIC Educational Resources Information Center

    Torbert, James Brison

    An investigation reviewed current literature in the field of physiological factors affecting the adult learning environment. These findings were compared to the academic learning environment at the Phoenix Air National Guard. The end product was a set of recommendations for management to implement in order to improve the learning climate for the…

  17. 3 CFR 9022 - Proclamation 9022 of September 20, 2013. National Employer Support of the Guard and Reserve Week...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... way to protect our freedoms, our lives, and our communities. We are grateful to the employers that... the world has ever known. This week, we honor members of the National Guard and Reserve who carry that legacy forward. We thank the employers who support them; and we reaffirm our promise to provide...

  18. The Predictive Validity of the PTSD Checklist in a Nonclinical Sample of Combat-Exposed National Guard Troops

    ERIC Educational Resources Information Center

    Arbisi, Paul A.; Kaler, Matthew E.; Kehle-Forbes, Shannon M.; Erbes, Christopher R.; Polusny, Melissa A.; Thuras, Paul

    2012-01-01

    After returning from an extended combat deployment to Iraq, 348 National Guard soldiers were administered the PTSD Checklist (PCL-M), and the Beck Depression Inventory II (BDI-II) followed, on average, 3 months later by structured diagnostic interviews including the Clinician-Administered PTSD Scale (CAPS) for the "Diagnostic and Statistical…

  19. [The national union for private hospital oncology].

    PubMed

    Parmentier, Gérard

    2013-06-01

    In the French health system, social security is the same for both public and private hospitals regardless of their status. In terms of number of patients screened, diagnosed, or treated, independant medicine is the most important sector in the French oncology. The multitude of organizations representing private hospitals or independant oncologists, physicians, radiologists or pathologists have a common organization, the National Union for Private Hospital Oncology (UNHPC). It bases its action on two founding postulates to ensure the quality of the oncology practice : the medical and managerial cultures are complementary and should be articulated ; the quality of organizations is as important as professional competence.

  20. National machine guarding program: Part 2. Safety management in small metal fabrication enterprises

    PubMed Central

    Yamin, Samuel C.; Brosseau, Lisa M.; Xi, Min; Gordon, Robert; Most, Ivan G.; Stanley, Rodney

    2015-01-01

    Background Small manufacturing businesses often lack important safety programs. Many reasons have been set forth on why this has remained a persistent problem. Methods The National Machine Guarding Program (NMGP) was a nationwide intervention conducted in partnership with two workers' compensation insurers. Insurance safety consultants collected baseline data in 221 business using a 33‐question safety management audit. Audits were completed during an interview with the business owner or manager. Results Most measures of safety management improved with an increasing number of employees. This trend was particularly strong for lockout/tagout. However, size was only significant for businesses without a safety committee. Establishments with a safety committee scored higher (55% vs. 36%) on the safety management audit compared with those lacking a committee (P < 0.0001). Conclusions Critical safety management programs were frequently absent. A safety committee appears to be a more important factor than business size in accounting for differences in outcome measures. Am. J. Ind. Med. 58:1184–1193, 2015. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:26345591

  1. A specific labor market comparison of male and female willingness to travel: The case of the Army National Guard

    SciTech Connect

    Daniell, A. ); Bell, S.E. ); Vogt, D.P. )

    1991-01-01

    This paper reports on an examination of gender differences in commuting behavior within the Army National Guard. This labor market provides a more level playing field than most for a direct comparison between male and female willingness to travel. In contrast to other studies, we find that women as a group are willing to travel greater distances, in this particular labor market. 9 refs., 1 fig., 10 tabs.

  2. Suicidal Ideation among Florida National Guard Members: Combat Deployment and Non-Deployment Risk and Protective Factors.

    PubMed

    Vanderploeg, Rodney D; Nazem, Sarra; Brenner, Lisa A; Belanger, Heather G; Donnell, Alison J; Scott, Steven G

    2015-01-01

    This study examined relationships among risk/protective factors and suicidal ideation (SI) in deployed and non-deployed National Guard members, particularly examining for possible differential effects of deployment on SI. A total of 3,098 Florida National Guard members completed an anonymous online survey that assessed variables associated with SI including demographics, current psychiatric diagnoses, and pre-, during, and post-deployment experiences. Those deployed had significantly higher rates of SI (5.5%) than those not deployed (3.0%; p < .001). In multivariate analyses, among those not deployed, SI was significantly associated with major depressive disorder (p < .001), posttraumatic stress disorder (PTSD) (p < .001), prior psychological trauma (p < .01), and heavy/hazardous alcohol consumption (p < .05). In contrast, in the deployed, only PTSD (p < .001) and deployment-related mild traumatic brain injury (p < .05) were independently associated with SI. Risk and protective factors differed by deployment status in National Guard members suggesting the possible need for cohort-specific treatment targets to minimize SI. PMID:25517207

  3. Longitudinal predictors of desire to re-enlist in the military among male and female national guard soldiers.

    PubMed

    Lancaster, Steven L; Erbes, Christopher R; Kumpula, Mandy J; Ferrier-Auerbach, Amanda; Arbisi, Paul A; Polusny, Melissa A

    2013-03-01

    Given the cost and burden associated with training and recruitment of military members, identifying predictors of military retention remains an important goal. The aim of the current study was to examine predictors of male and female service members' likelihood of remaining in the National Guard following combat deployment in support of Operation Iraqi Freedom. Using a prospective, longitudinal design, this study assessed a wide range of predictors including mental health functioning, personality variables, deployment stressors, and various domains of quality of life. Results indicated perceived unit support was the strongest predictor of intention to re-enlist for both male and female participants. However, significant gender differences emerged as predeployment depression and a trend toward perceived life threat during deployment were predictors of men's intention to re-enlist, whereas the predeployment personality dimension of introversion (low positive emotionality) and postdeployment life stressors were predictors of women's intention to re-enlist. Surprisingly, no postdeployment mental health variables predicted National Guard soldiers' intention to re-enlist. Findings from this study suggest factors associated with National Guard service members' retention or attrition from the military may be amenable to intervention.

  4. 78 FR 42452 - Safety Zone; Kentucky Air National Guard Vessel for Parachute Rescue Jumpmaster Training, Lake...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ..., and the use of distress signals of flares, smoke, and water dye during the training operations. DATES... Waterways Management, U.S. Coast Guard Sector Buffalo; telephone 716-843-9573, email SectorBuffaloMarine... of Homeland Security FR Federal Register NPRM Notice of Proposed Rulemaking TFR Temporary Final...

  5. Findings From the National Machine Guarding Program–A Small Business Intervention

    PubMed Central

    Parker, David L.; Yamin, Samuel C.; Xi, Min; Brosseau, Lisa M.; Gordon, Robert; Most, Ivan G.; Stanley, Rodney

    2016-01-01

    Objectives: The purpose of this nationwide intervention was to improve machine safety in small metal fabrication businesses (3 to 150 employees). The failure to implement machine safety programs related to guarding and lockout/tagout (LOTO) are frequent causes of Occupational Safety and Health Administration (OSHA) citations and may result in serious traumatic injury. Methods: Insurance safety consultants conducted a standardized evaluation of machine guarding, safety programs, and LOTO. Businesses received a baseline evaluation, two intervention visits, and a 12-month follow-up evaluation. Results: The intervention was completed by 160 businesses. Adding a safety committee was associated with a 10% point increase in business-level machine scores (P < 0.0001) and a 33% point increase in LOTO program scores (P < 0.0001). Conclusions: Insurance safety consultants proved effective at disseminating a machine safety and LOTO intervention via management-employee safety committees. PMID:27466709

  6. An initiative to retain reserve soldiers failing to meet weight and physical fitness standards: the Wisconsin Army National Guard experience.

    PubMed

    Lalich, R A

    2001-03-01

    This paper presents the Wisconsin Army National Guard's attempt to retain soldiers failing to meet weight and annual physical fitness test standards. Soldiers failing or at risk of failing weight and fitness standards attend a wellness program one weekend per month for three consecutive months. Instruction includes topics in exercise training, nutrition, general wellness, stress reduction, and motivational lectures. A total of 324 soldiers who completed the program were evaluated for retention rates. At 48 months, graduates of the program had a 55% retention rate. This program is cost effective and soldier caring.

  7. Peers and peer-based interventions in supporting reintegration and mental health among National Guard soldiers: a qualitative study.

    PubMed

    Pfeiffer, Paul N; Blow, Adrian J; Miller, Erin; Forman, Jane; Dalack, Gregory W; Valenstein, Marcia

    2012-12-01

    National Guard soldiers experience high levels of mental health symptoms following deployment to Iraq and Afghanistan, yet many do not seek treatment. We interviewed 30 National Guard soldiers with prior deployments to Iraq or Afghanistan to assess mental health treatment barriers and the role of peers in treatment engagement. Interview transcripts were analyzed by a multidisciplinary research team using techniques drawn from grounded theory. The following themes were identified: (1) personal acceptance of having a mental health problem rather than treatment access is the major barrier to treatment entry; (2) tightly connected, supportive peer networks can decrease stigma related to mental health problems and encourage treatment; however, soldiers in impoverished or conflicted peer networks are less likely to receive these benefits; and (3) soldiers are generally positive about the idea of peer-based programs to improve treatment engagement, although they note the importance of leadership support, peer assignment, and unit specialty in implementing these programs. We conclude that some, but not all, naturally occurring peer networks serve to overcome stigma and encourage mental health treatment seeking by soldiers. Formal peer-based programs may assist soldiers not sufficiently benefitting from natural peer networks, although there are barriers to implementation.

  8. Mortality of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Standley, W.G.; Berry, W.H.; O`Farrell, T.P.; Kato, T.T.

    1992-09-01

    Sources and rates of mortality of a San Joaquin kit fox population (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site, California, from November 1988 through September 1991. National Guard-authorized activities, including military training, caused the death of three of the 94 (3%) kit foxes radiocollared, and do not appear to jeopardize the continued existence of the population. Predation by larger carnivores, primarily coyotes (Canis latrans), caused the death of 75% of the 32 radiocollared kit foxes recovered dead for which a cause of death could be determined; vehicle impacts, disease (rabies), poisoning, and shooting were each responsible for the deaths of 6.3%. Adult annual mortality rate was 0.47 and the juvenile mortality rate was 0.80, and both rates are similar to rates reported for kit foxes in other locations. There was no significant difference between male and female mortality rates in either age class. The proportions of dead kit foxes recovered in different habitat types were similar to the availability of the habitat types within the distribution of kit fox on the installation.

  9. Bird guard

    DOEpatents

    Fairchild, Dana M.

    2010-03-02

    The bird guard provides a device to protect electrical insulators comprising a central shaft; a clamp attached to an end of the shaft to secure the device to a transmission tower; a top and bottom cover to shield transmission tower insulators; and bearings to allow the guard to rotate in order to frighten birds away from the insulators.

  10. Preliminary assessment report for Virginia Army National Guard Army Aviation Support Facility, Richmond International Airport, Installation 51230, Sandston, Virginia

    SciTech Connect

    Dennis, C.B.

    1993-09-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at the Virginia Army National Guard (VaARNG) property in Sandston, Virginia. The Army Aviation Support Facility (AASF) is contiguous with the Richmond International Airport. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The PA is designed to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. The AASF, originally constructed as an active Air Force interceptor base, provides maintenance support for VaARNG aircraft. Hazardous materials used and stored at the facility include JP-4 jet fuel, diesel fuel, gasoline, liquid propane gas, heating oil, and motor oil.

  11. Preliminary assessment report for Fort William Henry Harrison, Montana Army National Guard, Helena, Montana. Installation Restoration Program

    SciTech Connect

    DuWaldt, J.; Meyer, T.

    1993-07-01

    This report presents the results of the preliminary assessment (PA) conducted by Argonne National Laboratory at a Montana Army National Guard (MTARNG) property near Helena, Montana. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in response to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining site activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Fort William Henry Harrison property, requirements of the Department of Defense Installation Restoration Program.

  12. Optimization of a guard ring structure in Geiger-mode avalanche photodiodes fabricated at National NanoFab Center

    NASA Astrophysics Data System (ADS)

    Lim, K. T.; Kim, H.; Cho, M.; Kim, Y.; Kim, C.; Kim, M.; Lee, D.; Kang, D.; Yoo, H.; Park, K.; Sul, W. S.; Cho, G.

    2016-01-01

    A typical Geiger-mode avalanche photodiode (G-APD) contains a guard ring that protects the structure from having an edge breakdown due to the lowering of electric fields at junction curvatures. In this contribution, G-APDs with a virtual guard ring (vGR) merged with n-type diffused guard ring (nGR) in various sizes were studied to find the optimal design for G-APDs fabricated at National NanoFab Center (NNFC) . The sensors were fabricated via a customized CMOS process with a micro-cell size of 65× 65 μm2 on a 200 mm p-type epitaxial layer wafer. I-V characteristic curves for proposed structures were measured on a wafer-level with an auto probing system and plotted together to compare their performance. A vGR width of 1.5 μm and a nGR width of 1.5 μm with an overlapping between vGR and nGR of 1.5 μm showed the lowest leakage current before the breakdown voltage while suppressing the edge breakdown. Furthermore, the current level of the lowest-leakage-current structure was as low as that of only vGR with a width of 2.0 μm, indicating that the structure is also area efficient. Based on these results, the design with vGR, nGR, and OL with width of 1.5 μm is determined to be the optimal structure for G-APDs fabricated at NNFC.

  13. Increased risk of alcohol dependency in a cohort of National Guard troops with PTSD: a longitudinal study.

    PubMed

    Kline, Anna; Weiner, Marc D; Ciccone, Donald S; Interian, Alejandro; St Hill, Lauren; Losonczy, Miklos

    2014-03-01

    Studies show high rates of co-morbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) but there is no consensus on the causal direction of the relationship. Some theories suggest AUD develops as a coping mechanism to manage PTSD symptoms and others that AUD is a vulnerability factor for PTSD. A third hypothesis posits independent developmental pathways stemming from a shared etiology, such as the trauma exposure itself. We examined these hypotheses using longitudinal data on 922 National Guard soldiers, representing a subsample (56%) of a larger pre- and post-deployment cross-sectional study of New Jersey National Guard soldiers deployed to Iraq. Measures included the PTSD Checklist (PCL), DSM-IV-based measures of alcohol use/misuse from the National Household Survey of Drug Use and Health and other concurrent mental health, military and demographic measures. Results showed no effect of pre-deployment alcohol status on subsequent positive screens for new onset PTSD. However, in multivariate models, baseline PTSD symptoms significantly increased the risk of screening positive for new onset alcohol dependence (AD), which rose 5% with each unit increase in PCL score (AOR = 1.05; 95% CI = 1.02-1.07). Results also supported the shared etiology hypothesis, with the risk of a positive screen for AD increasing by 9% for every unit increase in combat exposure after controlling for baseline PTSD status (AOR = 1.09; 95% CI = 1.03-1.15) and, in a subsample with PCL scores <34, by 17% for each unit increase in exposure (AOR = 1.17; 95% CI = 1.05-1.31). These findings have implications for prevention, treatment and compensation policies governing co-morbidity in military veterans.

  14. Coast Guard

    SciTech Connect

    Meed, R.M.

    1991-10-01

    This paper testifies that water pollution by oil remains significant, and noncompliance with federal regulations to prevent oil pollution continues to be great in the four ports GAO visited. Additionally, the impact of the Coast Guard's efforts to reduce oil spill in unknown because the agency does not compile and analyze inspection and spill data needed to make this determination. Further, the Coast Guard has not been inspecting portions of pipes that transport oil between docks and storage tanks. Coast Guard officials now acknowledge this responsibility.

  15. Population trends of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Berry, W.H.; Standley, W.G.

    1992-10-01

    Population trends of a San Joaquin kit fox population (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site, California, from November 1989 through August 1991. Six semiannual livetrapping sessions and eight scent-station survey sessions were conducted. Livetrapping results and radiotelemetry data were used to calculate minimum population size, density, and distribution. A total of 175 individual foxes were trapped 463 times. The number of individuals trapped and minimum population size calculations showed a decline over time. The highest minimum population (109) was observed in winter 1988. Summer 1991 had the lowest minimum population size (45). No evidence was found to indicate that the apparent population decline was a result of military-authorized activities.

  16. 75 FR 58277 - National Employer Support of the Guard and Reserve Week, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-23

    ... civilian lives to wear the uniform of the United States, protect our freedoms around the world, and serve... play a vital role in our national defense. Throughout the year, they train and prepare for new... Guardsmen and Reservists, whose support and flexibility bolster the contributions of these brave men...

  17. 76 FR 58709 - National Employer Support of the Guard and Reserve Week, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-21

    ... opportunities they deserve, the First Lady and Dr. Jill Biden announced Joining Forces, a comprehensive national..., in the year of our Lord two thousand eleven, and of the Independence of the United States of America the two hundred and thirty-sixth. (Presidential Sig.) [FR Doc. 2011-24441 Filed 9-20-11; 11:15...

  18. Coast Guard

    SciTech Connect

    Not Available

    1990-02-01

    GAO found the situation in the Philadelphia and New York ports similar to that in Prince William Sound-neither industry nor the Coast Guard are prepared to respond to major oil spills. This report discusses how this unpreparedness is due to a lack of specificity in the industry and Coast Guard's plan on how to deal with spills of various sizes and Coast Guard authority to require ship owners and operators to have contingency plans or to require changes in existing plans. On the basic of recent experiences, GAO believes that prevention of oil spills rather than responding to them should be the main priority. Experiences in Price William Sound and in Philadelphia, however, show that much needs to be done to improve prevention measures like monitoring and guiding ship movements and using harbor pilots or vessel escorts.

  19. Sound Guard

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Lubrication technology originally developed for a series of NASA satellites has produced a commercial product for protecting the sound fidelity of phonograph records. Called Sound Guard, the preservative is a spray-on fluid that deposits a microscopically thin protective coating which reduces friction and prevents the hard diamond stylus from wearing away the softer vinyl material of the disc. It is marketed by the Consumer Products Division of Ball Corporation, Muncie, Indiana. The lubricant technology on which Sound Guard is based originated with NASA's Orbiting Solar Observatory (OSO), an Earth-orbiting satellite designed and built by Ball Brothers Research Corporation, Boulder, Colorado, also a division of Ball Corporation. Ball Brothers engineers found a problem early in the OSO program: known lubricants were unsuitable for use on satellite moving parts that would be exposed to the vacuum of space for several months. So the company conducted research on the properties of materials needed for long life in space and developed new lubricants. They worked successfully on seven OSO flights and attracted considerable attention among other aerospace contractors. Ball Brothers now supplies its "Vac Kote" lubricants and coatings to both aerospace and non-aerospace industries and the company has produced several hundred variations of the original technology. Ball Corporation expanded its product line to include consumer products, of which Sound Guard is one of the most recent. In addition to protecting record grooves, Sound Guard's anti-static quality also retards particle accumulation on the stylus. During comparison study by a leading U.S. electronic laboratory, a record not treated by Sound Guard had to be cleaned after 50 plays and the stylus had collected a considerable number of small vinyl particles. The Sound Guard-treated disc was still clean after 100 plays, as was its stylus.

  20. Critical Needs and Level of Support for the Military Spouse: A Comparative Study of the National Guard and Active Army during the Iraq War

    ERIC Educational Resources Information Center

    Vasilas, Cynthia Nikki

    2009-01-01

    National Guard units have been asked to serve in ways never before experienced since the beginning of the Iraq War and throughout the continued war on terror. Multiple deployments, frequent long-term separations from families, communities, and jobs may have far reaching implications. Family Readiness Groups and a climate of support shown by…

  1. The Minnesota Multiphasic Personality Inventory-2 Restructured Form in National Guard Soldiers Screening Positive for Posttraumatic Stress Disorder and Mild Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Arbisi, Paul A.; Polusny, Melissa A.; Erbes, Christopher R.; Thuras, Paul; Reddy, Madhavi K.

    2011-01-01

    The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2 RF) was administered to 251 National Guard soldiers who had recently returned from deployment to Iraq. Soldiers were also administered questionnaires to identify posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). On the basis of responses to the…

  2. Financial Analysis of National University Hospitals in Korea

    PubMed Central

    Lee, Munjae

    2015-01-01

    Objectives This paper provides information for decision making of the managers and the staff of national university hospitals. Methods In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. Results The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. Conclusion These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry. PMID:26730356

  3. Installation-Restoration Program. Phase 2. Confirmation/quantification. Stage 1. Problem confirmation study: Otis Air National Guard Base, Massachusetts, Air National Guard Support Center, Andrews Air Force Base, Maryland. Final technical report, November 1983-July 1985

    SciTech Connect

    Kraybill, R.L.; Smart, G.R.; Bopp, F.

    1985-09-04

    A Problem Confirmation Study was performed at seven sites on Otis Air National Guard Base: the Current and Former Training Areas, the Base Landfill, the Nondestructive Inspection Laboratory, the Fuel Test Dump Site, the Railyard Fuel Pumping Station, and the Petrol Fuel Storage Area. The field investigation was conducted in two stages, in November 1983 through January 1984, and in October through December 1984. Resampling was performed at selected locations in April and July 1985. A total of 11 monitor wells were installed and sampled and test-pit investigations were conducted at six sites. In addition, the contents of a sump tank, and two header pipes for fuel-transmission lines were sampled. Analytes included TOC, TOX, cyanide, phenols, Safe Drinking Water metals, pesticides and herbicides, and in the second round, priority-pollutant volatile organic compounds and a GC fingerprint scan for fuel products. On the basis of the field-work findings, it is concluded that, to date, water-quality impacts on ground water from past activities have been minimal.

  4. Blood characteristics of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Standley, W.G.; McCue, P.M.

    1992-09-01

    Hematology, serum chemistry, and prevalence of antibodies against selected, pathogens in a San Joaquin kit fox population (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site, California, in 1989 and 1990. Samples from 18 (10 female, 8 male) adult kit foxes were used to establish normal hematology and serum chemistry values for this population. Average values were all within the normal ranges reported for kit foxes in other locations. Three hematology parameters had significant differences between male and female values; males had higher total white blood cell and neutrophil counts, and lower lymphocyte counts. There were no significant differences between serum chemistry values from male and female foxes. Prevalence of antibodies was determined from serum samples from 47 (26 female, 21 male) adult kit foxes and eight (4 female, 4 male) juveniles. Antibodies were detected against five of the eight pathogens tested: canine parvovirus, Toxoplasma gondii Leptospira interrogans, canine distemper virus, and canine hepatitis virus. Antibodies were not detected against Brucella, canis, Coccidioides immitis, or Yersinia pestis.

  5. Fleas of the San Joaquin kit fox (Vulpes velox macrotis) on Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Spencer, K.A.; Egoscue, H.J.

    1992-09-01

    A total of 3,241 fleas, representing seven species, were identified from 398 samples collected from San Joaquin kit foxes (Vulpes velox macrotis), California ground squirrels (Spermophilus beecheyi), and deer mice (Peromyscus maniculatus) at Camp Roberts Army National Guard Training Site, California, from November 1988 through September 1991. Of 3,109 fleas collected from kit foxes 95.7% were Echidnophaga gallinacea, 4.0% Pulex irritans, 0.2% Hoplopsyllus anomolus, and 0.1% Odontopsyllus dentatus. One male Ctenocephalides fells was also collected from a kit fox. The 118 fleas collected from California ground squirrels consisted of Hoplopsyllus anomolus (55.9%), Echidnophaga gallinacea (37.3%), and Oropsylla montanus (6.8%). The 14 fleas collected from deer mice were Aetheca wagneri. Based on the distribution and abundance of flea species collected, and the vector efficiency of these fleas, it appears that kit foxes could play a role in the transfer of natural vectors of sylvatic plague between rodent populations, if the bacterium responsible for plague (Yersinia pestis) were present at Camp Roberts. Little information regarding kit fox food habits was evidenced by the distribution and abundance of small mammal flea species collected from kit foxes.

  6. Reproduction of the San Joaquin kit fox (Vulpes velox macrotis) on Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Spencer, K A; Berry, W H; Standley, W G; O`Farrell, T P

    1992-09-01

    The reproduction of a San Joaquin kit fox population (Vulpes velox macrotis) was investigated at Camp Roberts Army National Guard Training Site, California, from November 1988 through September 1991. Of 38 vixens radiocollared prior to parturition, 12 (32%) were successful in raising pups from conception to the point where pups were observed above ground. No yearling vixens were known tb be reproductively active. The mean litter size during 1989 - 1991 was 3.0 (n = 21, SE = 0.28) and ranged from one to six pups. Both the proportion of vixens successfully raising pups and the mean litter size observed at Camp Roberts during this study were lower than those reported at other locations. Sex ratios of kit fox pups were male biased two of the three years, but did not differ statistically from 1:1 throughout the study. Whelping was estimated to occur between February 15 and March 5. Results of this study support previous reports that kit foxes are primarily monogamous, although one case of polygamy may have occurred. Both the proportion of dispersing radiocollared juveniles (26%) and the mean dispersal distance (5.9 km) of juveniles at Camp Roberts appeared low compared to other locations.

  7. ICEPOD - Developing Ice Imaging Capabilities for the New York Air National Guard's LC-130 Aircraft

    NASA Astrophysics Data System (ADS)

    Detemple, J.; Frearson, N.; Zappa, C. J.; Turrin, M.; Bell, R. E.

    2010-12-01

    The ICEPOD program is a 5-year development effort to develop a polar instrumentation suite for the New York Air National Guard’s (NYANG) LC-130’s supported by the NSF American Reinvestment and Recovery Act (ARRA) Major Research Instrumentation program. The fundamental goal of the ICEPOD program is to develop an instrumentation package that can capture the dynamics of the changing polar regions, focusing on ice and ocean targets. The vision is for this instrumentation to be operated both on routine flights of the NYANG in the polar regions, such as missions between McMurdo and South Pole Station and on targeted science missions, such as mapping the sea ice and outlet glaciers surrounding Ross Island or the draining systems from large subglacial lakes in East Antarctica. We are in the process of finalizing the science requirements for the system. To provide support to the ICEPOD development, we are defining the goals for imaging the surface of the ice sheet with a scanning laser system and stereo-photogrammetry, the temperature of the ice surface using an IR camera and the internal structure of the ice sheet using a depth-sounding radar and an accumulation radar. The instrumentation will be positioned using an IMU and differential GPS. We also are working toward two operational modes - low-altitude flight operations to optimize the surface imaging systems, specifically the scanning laser, and a high-altitude flight operation to facilitate wide use of the instrumentation suite during a routine NYANG support mission flight envelope. The ICEPOD program is seeking input on the science goals of the instrumentation suite to ensure the system meets the community’s need for observations. The ultimate goal of the ICEPOD program is to provide the community with a facility for dedicated and routine measurements over the polar regions using the suite of instruments. The final ICEPOD system will also be capable of supporting instrumentation developed by other groups. The

  8. Coast Guard

    SciTech Connect

    Not Available

    1991-06-01

    This paper reports that about 16,000 oil spills involving the release of more than 46 million gallons of oil took place in U.S. navigable waters in 1988; spills at water-front facilities, where vessels load and unload oil, accounted for about half of the oil spilled. While the Coast Guard acknowledges its responsibility for regulating and inspecting waterfront facilities, it efforts in this area have fallen short because it has not been inspecting portions of intrafacility pipes that transport oil between docks and storage tanks. Water pollution and noncompliance with federal oil pollution prevention regulations continue to be high at waterfront facilities. Yet the Coast Guard cannot determine how effective its inspection program has been in reducing the risk of oil spills because information on program results, such as the types, severity, and frequency of deficiencies found by inspectors, is not compiled an linked with information on the causes of oil spills found by investigators. Until the Coast Guard collects this type of information, it will not be in a position to establish measurable goals.

  9. Preliminary assessment report for Wayland Army National Guard Armory (former Boston Defense Area Nike Battery 73), Installation 23295, Wayland, Massachusetts. Installation Restoration Program

    SciTech Connect

    Haffenden, R.; Flaim, S.; Krokosz, M.

    1993-08-01

    This report presents the results of preliminary assessment (PA) conducted by Argonne National Laboratory at the Massachusetts Army National Guard property near Wayland, Massachusetts. Preliminary assessments of federal facilities are being conducted to compile the information necessary for completing preremedial activities and to provide a basis for establishing corrective actions in respond to releases of hazardous substances. The principal objective of the PA is to characterize the site accurately and determine the need for further action by examining sites activities, quantities of hazardous substances present, and potential pathways by which contamination could affect public health and the environment. This PA satisfies, for the Wayland Army National Guard Army property, Phase I of the Department of Defense Installation Restoration Program.

  10. Predictors of Army National Guard and Reserve members' use of Veteran Health Administration health care after demobilizing from OEF/OIF deployment.

    PubMed

    Harris, Alex H S; Chen, Cheng; Mohr, Beth A; Adams, Rachel Sayko; Williams, Thomas V; Larson, Mary Jo

    2014-10-01

    This study described rates and predictors of Army National Guard and Army Reserve members' enrollment in and utilization of Veteran Health Administration (VHA) services in the 365 days following demobilization from an index deployment. We also explored regional and VHA facility variation in serving eligible members in their catchment areas. The sample included 125,434 Army National Guard and 48,423 Army Reserve members who demobilized after a deployment ending between FY 2008 and FY 2011. Demographic, geographic, deployment, and Military Health System eligibility were derived from Defense Enrollment Eligibility Reporting System and "Contingency Tracking System" data. The VHA National Patient Care Databases were used to ascertain VHA utilization and status (e.g., enrollee, TRICARE). Logistic regression models were used to evaluate predictors of VHA utilization as an enrollee in the year following demobilization. Of the study members demobilizing during the observation period, 56.9% of Army National Guard members and 45.7% of Army Reserve members utilized VHA as an enrollee within 12 months. Demographic, regional, health coverage, and deployment-related factors were associated with VHA enrollment and utilization, and significant variation by VHA facility was found. These findings can be useful in the design of specific outreach efforts to improve linkage from the Military Health System to the VHA.

  11. Support for hospital-based HIV testing and counseling: a national survey of hospital marketing executives.

    PubMed Central

    Boscarino, J A; Steiber, S R

    1995-01-01

    Today, hospitals are involved extensively in social marketing and promotional activities. Recently, investigators from the Centers for Disease Control and Prevention (CDC) estimated that routine testing of hospital patients for human immunodeficiency virus (HIV) could identify more than 100,000 patients with previously unrecognized HIV infections. Several issues are assessed in this paper. These include hospital support for voluntary HIV testing and AIDS education and the impact that treating AIDS patients has on the hospital's image. Also tested is the hypothesis that certain hospitals, such as for-profit institutions and those outside the AIDS epicenters, would be less supportive of hospital-based AIDS intervention strategies. To assess these issues, a national random sample of 193 executives in charge of hospital marketing and public relations were surveyed between December 1992 and January 1993. The survey was part of an ongoing annual survey of hospitals and included questions about AIDS, health education, marketing, patient satisfaction, and hospital planning. Altogether, 12.4 percent of executives indicated their hospital had a reputation for treating AIDS patients. Among hospitals without an AIDS reputation, 34.1 percent believed developing one would be harmful to the hospital's image, in contrast to none in hospitals that had such a reputation (chi 2 = 11.676, df = 1, P = .0006). Although 16.6 percent did not know if large-scale HIV testing should be implemented, a near majority (47.7 percent) expressed some support. In addition, 15 percent reported that HIV-positive physicians on the hospital's medical staff should not be allowed to practice medicine, but 32.1 percent indicated that they should.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7638335

  12. A national study of transitional hospital services in mental health.

    PubMed Central

    Dorwart, R A; Hoover, C W

    1994-01-01

    OBJECTIVES. Shifts in care for the seriously mentally ill from inpatient to community-based treatment have highlighted the importance of transitional care. Our objectives were to document the kinds and quantity of transitional services provided by psychiatric hospitals nationally and to assess the impact of hospital type (psychiatric vs general), ownership (public vs private), case mix, and revenue source on provision of these services. METHODS. A national sample of nonfederal inpatient mental health facilities (n = 915) was surveyed in 1988, and data were analyzed by using multiple regression. RESULTS. Half (46%) of the facilities surveyed provided patient follow-up of 1 week or less, and almost all (93%) conducted team review of discharge plans, but 74% provided no case management services. Hospital type was the most consistent predictor of transitional care, with psychiatric hospitals providing more of these services than general hospitals. Severity of illness, level of nonfederal funding, urbanicity, and teaching hospital affiliation were positively associated with provision of case management. CONCLUSIONS. Transitional care services for mentally ill patients leaving the hospital were found to be uneven and often inadequate. Reasons for broad variation in services are discussed. PMID:8059877

  13. Seoul National University Bundang Hospital's Electronic System for Total Care

    PubMed Central

    Yoo, Sooyoung; Lee, Kee Hyuck; Lee, Hak Jong; Ha, Kyooseob; Lim, Cheong; Chin, Ho Jun; Yun, Jonghoar; Cho, Eun-Young; Chung, Eunja; Baek, Rong-Min; Chung, Chin Youb; Wee, Won Ryang; Lee, Chul Hee; Lee, Hai-Seok; Byeon, Nam-Soo

    2012-01-01

    Objectives Seoul National University Bundang Hospital, which is the first Stage 7 hospital outside of North America, has adopted and utilized an innovative and emerging information technology system to improve the efficiency and quality of patient care. The objective of this paper is to briefly introduce the major components of the SNUBH information system and to describe our progress toward a next-generation hospital information system (HIS). Methods SNUBH opened in 2003 as a fully digital hospital by successfully launching a new HIS named BESTCare, "Bundang hospital Electronic System for Total Care". Subsequently, the system has been continuously improved with new applications, including close-loop medication administration (CLMA), clinical data warehouse (CDW), health information exchange (HIE), and disaster recovery (DR), which have resulted in the achievement of Stage 7 status. Results The BESTCare system is an integrated system for a university hospital setting. BESTCare is mainly composed of three application domains: the core applications, an information infrastructure, and channel domains. The most critical and unique applications of the system, such as the electronic medical record (EMR), computerized physician order entry (CPOE), clinical decision support system (CDSS), CLMA, CDW, HIE, and DR applications, are described in detail. Conclusions Beyond our achievement of Stage 7 hospital status, we are currently developing a next-generation HIS with new goals of implementing infrastructure that is flexible and innovative, implementing a patient-centered system, and strengthening the IT capability to maximize the hospital value. PMID:22844650

  14. Baseline water-quality characteristics of the Alaska Army National Guard Stewart River Training Area near Nome, Alaska

    USGS Publications Warehouse

    Eash, Josh D.

    2005-01-01

    The Alaska Army National Guard Stewart River Training Area is approximately 23 miles north of Nome on the Seward Peninsula in northwest Alaska. The Stewart River Training Area encompasses much of the Stewart River Basin and a small part of the Snake River Basin. Hydrologic, water-quality, and physical-habitat data were collected at seven surface-water sites within the Stewart River Training Area during the summer runoff months (late-May to early-September) in 2004. Two of the sampling sites selected for this study were on the main stem Stewart River, one at the upstream boundary and one at the downstream boundary of the training area. Continuous hydrologic, precipitation, and water temperature data were collected at these two sites throughout the summer of 2004. Three pond sites, along the upper, middle, and lower reaches of the Stewart River within the training area, were each sampled twice during the summer of 2004 for analysis of water-quality constituents. Two tributaries to the Snake River Basin, Goldbottom Creek and North Fork Snake River, within the Stewart River Training Area boundary, also were sampled twice during the summer of 2004. Water-quality data collected from the Stewart River at the upstream and downstream study sites indicate similar constituent concentrations. Concentrations of most water-quality constituents collected during the summer of 2004 did not exceed standards for drinking water or recreational contact. Analysis of trace-element concentrations in bed sediment samples indicate the threshold effect concentration (below which no adverse effects on organisms is expected) was exceeded for arsenic, chromium, and nickel concentrations at all sample sites within the Stewart River Training Area and cadmium, copper, zinc, and lead concentrations were found to exceed the threshold effect concentration in varying degrees at the sample sites. The probable effect concentration (above which toxic effects on organisms is likely) was exceeded by

  15. Rural hospitals' experience with the National Practitioner Data Bank.

    PubMed Central

    Neighbor, W E; Baldwin, L M; West, P A; Hart, L G

    1997-01-01

    OBJECTIVES: This study examined hospital administrators' experiences with the National Practitioner Data Bank. METHODS: One hundred forty-nine rural hospital administrators completed questionnaires assessing their perceptions of the data bank. RESULTS: Nearly 90% of respondents rated the data bank as an important source of information for credentialing. Three percent indicated it had directly affected privileging decisions; 43% and 34%, respectively, believed the costs exceeded or equaled the benefits. Twenty percent reported changes that could decrease disciplinary action reports to the data bank. CONCLUSIONS: While the National Practitioner Data Bank is an important source of information to rural hospitals, it may, affect few credentialing decisions and motivate behavioral changes that could have a paradoxical effect on quality assurance. Images FIGURE 1 PMID:9146450

  16. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health care...

  17. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health care...

  18. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health care...

  19. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health care...

  20. Installation restoration program final remedial investigation report IRP sites 8 and 10. 151st air refueling group Utah Air National Guard, Salt Lake City, Utah. Final report

    SciTech Connect

    1996-06-01

    This report presents the results from a Remedial Investigation (RI) for two sites at the Utah Air National Guard (UANG) Base located in Salt Lake City, Utah. The two sites investigated are identified as Installation Restoration Program (IRP) Site 8, a former underground storage tank (UST) location, and IRP Site 10, an existing petroleum, oil, and lubricants (POL) yard. The RI was conducted as outlined in the Remedial Investigation/Feasibility Study (RI/FS) Work Plan prepared by Stone Webster and submitted to and approved by the ANG in May 1993. The field work associated with the RI was performed in June, July, and August 1995.

  1. ASHP national survey of pharmaceutical services in federal hospitals--1993.

    PubMed

    Crawford, S Y; Santell, J P

    1994-10-01

    The results of a national mail survey of pharmaceutical services in federal hospitals conducted by ASHP from May to July 1993 are reported. Mailing lists were compiled of all Air Force, Army, Navy, Public Health Service, and Department of Veterans Affairs (VA) hospitals, as well as some federal prison hospitals. Questionnaires were mailed to each chief of pharmacy. The adjusted gross population size was 326. The net response rate was 76%. Complete unit dose drug distribution was offered by 85% of respondents, and 83% offered complete, comprehensive i.v. admixture programs. About half of the pharmacies provided decentralized services. Over 99% provided services to ambulatory care patients. A computerized pharmacy system was present in 99% of the departments. More than 95% of hospitals participated in adverse drug reaction, medication error management, and drug-use-evaluation programs. A total of 93% provided drug therapy monitoring, and 89% provided patient education. About 70% provided written documentation of pharmacist interventions in the medical records, and 57% participated in drug research. A total of 42% provided pharmacist-managed drug clinics, 41% participated in drug management of medical emergencies, 30% provided written medication histories, and 30% provided drug therapy management planning. Pharmacokinetic consultations were provided by 64% of departments. About 90% had a well-controlled formulary system and prescribing restrictions. Therapeutic interchange was practiced by 64%. Diversified pharmaceutical services included telephone or mail-in refill services (80%), mail-out pharmaceutical services (58%), and services to long-term-care facilities (49%). A total of 70% of the hospitals were affiliated with a pharmacy school. The first ASHP national survey of pharmaceutical services in federal hospitals showed that comprehensive distributive and clinical services were offered by most of the facilities. PMID:7847403

  2. Cost of Hospitalization and Length of Stay in People with Down Syndrome: Evidence from a National Hospital Discharge Claims Database

    ERIC Educational Resources Information Center

    Hung, Wen-Jiu; Lin, Lan-Ping; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    The present paper aims to describe the hospitalization profiles which include medical expenses and length of stays, and to determine their possible influencing factors of hospital admission on persons with Down syndrome in Taiwan. We employed a population-based, retrospective analyses used national health insurance hospital discharge data of the…

  3. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  4. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  5. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  6. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  7. 49 CFR 850.30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Procedures for Coast Guard investigation. 850.30... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.30 Procedures for Coast Guard investigation. (a) The Coast Guard conducts an investigation...

  8. Final report on testing of ACONF technology for the US Coast Guard National Distress Systems : a study for the DOE Energy Storage Systems Program.

    SciTech Connect

    Storey, Leanne M.; Byrd, Thomas M., Jr.; Murray, Aaron T.; Ginn, Jerry W.; Symons, Philip C.; Corey, Garth P.

    2005-08-01

    This report documents the results of a six month test program of an Alternative Configuration (ACONF) power management system design for a typical United States Coast Guard (USCG) National Distress System (NDS) site. The USCG/USDOE funded work was performed at Sandia National Laboratories to evaluate the effect of a Sandia developed battery management technology known as ACONF on the performance of energy storage systems at NDS sites. This report demonstrates the savings of propane gas, and the improvement of battery performance when utilizing the new ACONF designs. The fuel savings and battery performance improvements resulting from ACONF use would be applicable to all current NDS sites in the field. The inherent savings realized when using the ACONF battery management design was found to be significant when compared to battery replacement and propane refueling at the remote NDS sites.

  9. Coast Guard

    SciTech Connect

    Not Available

    1991-08-01

    In the wake of the Exxon Valdez oil spill in Alaska's Prince William Sound, Congress passed the Oil Pollution Act of 1990, thereby activating the Oil Spill Liability Trust Fund. This fund had been set up four years earlier with the proviso that no money could be spent until the enactment of comprehensive oil spill legislation. Passage of the Oil Pollution Act, which significantly expanded the nation's oil spill prevention and response activities, meant that funds became available to federal agencies for the cost of oil spill prevention and response activities. This report provides information on the fund's receipts and disbursements as of March 31, 1991, and the status of activities under way to fully implement the provisions of the Act concerning the fund, including the development of regulations.

  10. Sexual abuse of children as seen at Kenyatta National Hospital.

    PubMed

    Nduati, R W; Muita, J W

    1992-07-01

    A retrospective study of 21 sexually abused children admitted to the Kenyatta National Hospital, Nairobi, Kenya, between January 1984 and December 1985 is presented. The peak incidence of sexual abuse was in the age group of 10-15 years (38.1%) followed by the 5-9 years age group (28.6%). Strangers and people familiar to the child were equally implicated as assailants. Fourteen out of the twenty one (66.7%) victims, presented with injuries ranging from perineal tears (19%), vaginal tears (19%), recto-vaginal fistulae (RVP) (4.8%) and vesico-vaginal-fistulae (VVF) and abdominal haematoma (4.8%). The victims presented to hospital within two days of the event usually accompanied by their mothers.

  11. New Integrated Information System for Pusan National University Hospital

    PubMed Central

    Kim, Hyung Hoi; Cho, Kyung-Won; Kim, Hye Sook; Kim, Ju-Sim; Kim, Jung Hyun; Han, Sang Pil; Park, Chun Bok; Kim, Seok

    2011-01-01

    Objectives This study presents the information system for Pusan National University Hospital (PNUH), evaluates its performance qualitatively, and conducts economic analysis. Methods Information system for PNUH was designed by component-based development and developed by internet technologies. Order Communication System, Electronic Medical Record, and Clinical Decision Support System were newly developed. The performance of the hospital information system was qualitatively evaluated based on the performance reference model in order to identify problem areas for the old system. The Information Economics approach was used to analyze the economic feasibility of hospital information system in order to account for the intangible benefits. Results Average performance scores were 3.16 for input layer, 3.35 for process layer, and 3.57 for business layer. In addition, the cumulative benefit to cost ratio was 0.50 in 2011, 1.73 in 2012, 1.76 in 2013, 1.71 in 2014, and 1.71 in 2015. The B/C ratios steadily increase as value items are added. Conclusions While overall performance scores were reasonably high, doctors were less satisfied with the system, perhaps due to the weak clinical function in the systems. The information economics analysis demonstrated the economic profitability of the information systems if all intangible benefits were included. The second qualitative evaluation survey and economic analysis were proposed to evaluate the changes in performance of the new system. PMID:21818459

  12. Few Hospital Palliative Care Programs Meet National Staffing Recommendations.

    PubMed

    Spetz, Joanne; Dudley, Nancy; Trupin, Laura; Rogers, Maggie; Meier, Diane E; Dumanovsky, Tamara

    2016-09-01

    The predominant model for palliative care delivery, outside of hospice care, is the hospital-based consultative team. Although a majority of US hospitals offer palliative care services, there has been little research on the staffing of their program teams and whether those teams meet national guidelines, such as the Joint Commission's standard of including at least one physician, an advanced practice or other registered nurse, a social worker, and a chaplain. Data from the 2012-13 annual surveys of the National Palliative Care Registry indicate that only 25 percent of participating programs met that standard based on funded positions, and even when unfunded positions were included, only 39 percent of programs met the standard. Larger palliative care programs were more likely than smaller ones to include a funded physician position, while smaller programs were more reliant upon advanced practice and registered nurses. To meet current and future palliative care needs, expanded and enhanced education, as well as supportive financing mechanisms for consultations, are needed. PMID:27605652

  13. Few Hospital Palliative Care Programs Meet National Staffing Recommendations.

    PubMed

    Spetz, Joanne; Dudley, Nancy; Trupin, Laura; Rogers, Maggie; Meier, Diane E; Dumanovsky, Tamara

    2016-09-01

    The predominant model for palliative care delivery, outside of hospice care, is the hospital-based consultative team. Although a majority of US hospitals offer palliative care services, there has been little research on the staffing of their program teams and whether those teams meet national guidelines, such as the Joint Commission's standard of including at least one physician, an advanced practice or other registered nurse, a social worker, and a chaplain. Data from the 2012-13 annual surveys of the National Palliative Care Registry indicate that only 25 percent of participating programs met that standard based on funded positions, and even when unfunded positions were included, only 39 percent of programs met the standard. Larger palliative care programs were more likely than smaller ones to include a funded physician position, while smaller programs were more reliant upon advanced practice and registered nurses. To meet current and future palliative care needs, expanded and enhanced education, as well as supportive financing mechanisms for consultations, are needed.

  14. Guard For Fuse Caps

    NASA Technical Reports Server (NTRS)

    Atwell, D. C.

    1985-01-01

    L-shaped guard attached to fuse holder. Guard prevents casual tampering with fuses in electrical junction box or fuse block. Protects fuses from being damaged by handling or by rope or string used to secure them. With fuse-cap guard, only responsible people have access to fuses.

  15. To direct the Mayor of the District of Columbia to establish a District of Columbia National Guard Educational Assistance Program to encourage the enlistment and retention of persons in the District of Columbia National Guard by providing financial assistance to enable members of the National Guard of the District of Columbia to attend undergraduate, vocational, or technical courses.

    THOMAS, 112th Congress

    Rep. Norton, Eleanor Holmes [D-DC-At Large

    2011-03-17

    04/01/2011 Referred to the Subcommittee on Health Care, District of Columbia, Census and the National Archives. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  16. Trends in Inpatient Hospital Deaths: National Hospital Discharge Survey, 2000-2010

    MedlinePlus

    ... Has the inpatient hospital death rate decreased for all patients and for those with selected first-listed ... 2010 differ from the length of stay for all hospitalizations? Inpatients who died in the hospital stayed ...

  17. A Comparison of the Human Characteristics of Curriculum Materials Used in an Air National Guard Leadership Development Program with the Characteristics of Students Encountering the Materials: A Study Using the Annehurst Curriculum Classification System.

    ERIC Educational Resources Information Center

    French, Russell L.; And Others

    The Annehurst Curriculum Classification System (ACCS), a tool for matching individual learners with appropriate curriculum materials, was used with a group of fifty-nine students (Air National Guard officer candidates) and their four instructor-advisors to examine two issues: (1) the applicability of the ACCS in a highly structured,…

  18. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false The Commandant of the Coast Guard. 700.602... States Coast Guard (When Operating as a Service in the Navy) § 700.602 The Commandant of the Coast Guard. (a) The Commandant of the Coast Guard is the senior officer of the United States Coast Guard....

  19. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false The Commandant of the Coast Guard. 700.602... States Coast Guard (When Operating as a Service in the Navy) § 700.602 The Commandant of the Coast Guard. (a) The Commandant of the Coast Guard is the senior officer of the United States Coast Guard....

  20. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false The Commandant of the Coast Guard. 700.602... States Coast Guard (When Operating as a Service in the Navy) § 700.602 The Commandant of the Coast Guard. (a) The Commandant of the Coast Guard is the senior officer of the United States Coast Guard....

  1. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false The Commandant of the Coast Guard. 700.602... States Coast Guard (When Operating as a Service in the Navy) § 700.602 The Commandant of the Coast Guard. (a) The Commandant of the Coast Guard is the senior officer of the United States Coast Guard....

  2. 32 CFR 700.602 - The Commandant of the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false The Commandant of the Coast Guard. 700.602... States Coast Guard (When Operating as a Service in the Navy) § 700.602 The Commandant of the Coast Guard. (a) The Commandant of the Coast Guard is the senior officer of the United States Coast Guard....

  3. Efficacy of a post-secondary environmental science education program on the attitude toward science of a group of Mississippi National Guard Youth ChalleNGe Program students

    NASA Astrophysics Data System (ADS)

    Smith, William Bradford, Jr.

    The National Guard Youth ChalleNGe Program (ChalleNGe) is a 17 month quasi-military training program authorized by Congress in the 1993 Defense Authorization Bill designed to improve life skills, education levels, and employment potential of 16--18 year old youth who drop out of high school. ChalleNGe is currently operational in 27 states/territories with the focus of this study on the Mississippi National Guard Program operated at Camp Shelby, Mississippi. During the five month residential portion of the program students are guided through an eight step process designed to meet the goals of improving life skills, education levels, and employment potential while ultimately leading to completion of high school equivalency credentials followed by a 12 month mentoring phase to encourage and track progress toward goals. The purpose of this study was to investigate the attitude toward science of a group of students enrolled in the ChalleNGe Program at Camp Shelby (ChalleNGe). The GED test is administered approximately two months into the residential phase of the program. While the program boasts an overall GED pass rate of nearly 80%, approximately 30--35% of students successfully complete the initial offering of the GED. As high school graduates, these students are offered college courses through William Carey College in Hattiesburg, Mississippi. Twenty four students elected to take the Introduction to Environmental Science course and formed the experimental group while 24 other students who passed the GED comprised the control group. Each group was administered the Scientific Attitude Inventory II, a 40 statement instrument with Likert Scale responses, as a pretest. Paired samples t-tests indicated no significant difference in attitude toward science between the experimental and control groups on the pretest. Following the two week Introduction to Environmental Science course for the experimental group, both groups were post tested. As predicted, the attitude toward

  4. The Coast Guard Comes to Class.

    ERIC Educational Resources Information Center

    Fawcett, Paul

    2002-01-01

    Focuses on Sea Partners, by the United States Coast Guard, that enables students to understand how pollution affects the marine environment. Correlates the activities with the National Science Education Standards. (DDR)

  5. Promoting reintegration of National Guard veterans and their partners using a self-directed program of integrative therapies: a pilot study.

    PubMed

    Collinge, William; Kahn, Janet; Soltysik, Robert

    2012-12-01

    This article reports pilot data from phase I of a project to develop and evaluate a self-directed program of integrative therapies for National Guard personnel and significant relationship partners to support reintegration and resilience after return from Iraq or Afghanistan. Data are reported on 43 dyads. Intervention was an integrated multimedia package of guided meditative, contemplative, and relaxation exercises (CD) and instruction in simple massage techniques (DVD) to promote stress reduction and interpersonal connectedness. A repeated measures design with standardized instruments was used to establish stability of baseline levels of relevant mental health domains (day 1, day 30), followed by the intervention and assessments 4 and 8 weeks later. Significant improvements in standardized measures for post-traumatic stress disorder, depression, and self-compassion were seen in both veterans and partners; and in stress for partners. Weekly online reporting tracked utilization of guided exercises and massage. Veterans reported significant reductions in ratings of physical pain, physical tension, irritability, anxiety/worry, and depression after massage, and longitudinal analysis suggested declining baseline levels of tension and irritability. Qualitative data from focus groups and implications for continued development and a phase II trial are discussed.

  6. Suicide and war: the mediating effects of negative mood, posttraumatic stress disorder symptoms, and social support among army National Guard soldiers.

    PubMed

    Griffith, James

    2012-08-01

    The mediating effects of posttraumatic stress disorder (PTSD) symptoms, negative mood, and social support on the relationship of war experiences to suicidality were examined. The research literature suggested a sequence among study scales representing these constructs, which was then tested on survey data obtained from a sample of National Guard soldiers (N=4,546). Results from structural equation modeling suggested that war experiences may precipitate a sequence of psychological consequences leading to suicidality. However, suicidality may be an enduring behavioral health condition. War experiences showed no direct effects on postdeployment suicidality, rather its effect was indirect through PTSD symptoms and negative mood. War experiences were, however, predictive of PTSD symptoms, as would be expected. PSTD symptoms showed no direct effect on postdeployment suicidality, but showed indirect effects through negative mood. Results also suggested that suicidality is relatively persistent, at least during deployment and postdeployment. The percentage of those at risk for suicide was low both during and after deployment, with little association between suicidality and time since returning from deployment. Additionally, few soldiers were initially nonsuicidal and then reported such symptoms at postdeployment. Implications of relationships of both negative mood and combat trauma to suicidality are discussed, as well as possible mediating effects of both personal dispositions and social support on relationships of war experiences to PTSD, negative mood, and suicidality.

  7. Homecoming of soldiers who are citizens: Re-employment and financial status of returning Army National Guard soldiers from Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF).

    PubMed

    Griffith, James

    2015-01-01

    This study examined civilian employment among Army National Guard soldiers who had recently returned from Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF). Of specific interest were relationships of re-employment and financial difficulties to several conditions, such as amount of social support during and after deployment, combat exposure, negative feelings during and after deployment, and postdeployment adjustment symptoms. Survey data from the Army's Reintegration Unit Risk Inventory were used (4,546 soldiers in 50 units who were deployed during 2010). Few soldiers reported financial difficulties during deployment (7.1% of the sample) and after having returned (11.8%). Of those who reported postdeployment financial difficulties, nearly one-half had reported such difficulties during deployment, and not having resumed the predeployment job was associated with more postdeployment financial difficulties. Logistic regression analyses showed the relative contribution of the study variables to changed financial status, from deployment to postdeployment. Reported deployment support (e.g., trust in the unit chain-of-command and available support) was associated with decreased financial difficulties. In contrast, increased financial difficulties were associated with having seen others wounded or killed in combat. Other postdeployment experiences, such as feelings of anger and frustration and available support, were associated with increased financial difficulties, in addition to alcohol use, trouble sleeping and suicidal thoughts. Implications of results for policy and practice to lessen financial hardships and job loss associated with deployment are discussed.

  8. Effects of military-authorized activities on the San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training Site, California

    SciTech Connect

    Berry, W.H.; Standley, W.G.; O`Farrell, T.P.; Kato, T.T.

    1992-10-01

    The effects of military-authorized activities on San Joaquin kit fox (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training Site from 1988 to 1991. Military-authorized activities included military training exercises, facilities maintenance, new construction, controlled burning, livestock grazing, and public-access hunting. Positive effects of the military included habitat preservation, preactivity surveys, and natural resources management practices designed to conserve kit foxes and their habitat. Perceived negative effects such as entrapment in dens, shootings during military exercises, and accidental poisoning were not observed. Foxes were observed in areas being used simultaneously by military units. Authorized activities were known to have caused the deaths of three of 52 radiocollared foxes recovered dead: one became entangled in concertina wire, one was believed shot by a hunter, and one was struck by a vehicle. Entanglement in communication wire may have contributed to the death of another radiocollared fox that was killed by a predator. Approximately 10% of kit fox dens encountered showed evidence of vehicle traffic, but denning sites did not appear to be a limiting factor for kit foxes.

  9. Prey abundance and food habits of San Joaquin kit fox (Vulpes velox macrotis) at Camp Roberts Army National Guard Training site, California

    SciTech Connect

    Logan, C.G.; Berry, W.H.; Standley, W.G.; Kato, T.T.

    1992-09-01

    Prey abundance and food habits of the San Joaquin kit fox (Vulpes velox macrotis) were investigated at Camp Roberts Army National Guard Training site, California, from November 1988 through September 1991. The sampling methods initially used to assess abundance of prey species resulted in indices too low to be of value. Because of this, the relationship between relative abundance and frequency of occurrence of prey species could not be examined. Six hundred forty-nine fecal samples (scats) were analyzed to determine the frequency of occurrence of prey items. California ground squirrels (Spermophilus beecheyi) and lagomorphs primarily desert cottontails (Sylvilagus audubonii) and black-tailed jackrabbits (Lepus californicus) were the most frequently occurring mammalian prey items found in scats (35.0% and 12.2%, respectively). The frequency of occurrence of ground squirrel (but not lagomorph) remains in scats collected from juveniles was significantly higher than in scats collected from adults. The frequency of occurrence of ground squirrel and lagomorph remains in scats collected from males was not significant different than in scats collected from females. There were significant variations in the frequency of ground squirrel remains among the years 1989--1991 and during the June--November periods between 1989 and 1990 and between 1990 and 1991. The frequency of lagomorph remains collected during the June--November period differed significantly among the years 1989--1991 and between 1990 and 1991.

  10. Guarded Motion for Mobile Robots

    SciTech Connect

    2005-03-30

    The Idaho National Laboratory (INL) has created codes that ensure that a robot will come to a stop at a precise, specified distance from any obstacle regardless of the robot's initial speed, its physical characteristics, and the responsiveness of the low-level motor control schema. This Guarded Motion for Mobile Robots system iteratively adjusts the robot's action in response to information about the robot's environment.

  11. Performance Analysis of Hospital Information System of the National Health Insurance Corporation Ilsan Hospital

    PubMed Central

    Han, Jung Mi; Boo, Eun Hee; Kim, Jung A; Yoon, Soo Jin; Kim, Seong Woo

    2012-01-01

    Objectives This study evaluated the qualitative and quantitative performances of the newly developed information system which was implemented on November 4, 2011 at the National Health Insurance Corporation Ilsan Hospital. Methods Registration waiting time and changes in the satisfaction scores for the key performance indicators (KPI) before and after the introduction of the system were compared; and the economic effects of the system were analyzed by using the information economics approach. Results After the introduction of the system, the waiting time for registration was reduced by 20%, and the waiting time at the internal medicine department was reduced by 15%. The benefit-to-cost ratio was increased to 1.34 when all intangible benefits were included in the economic analysis. Conclusions The economic impact and target satisfaction rates increased due to the introduction of the new system. The results were proven by the quantitative and qualitative analyses carried out in this study. This study was conducted only seven months after the introduction of the system. As such, a follow-up study should be carried out in the future when the system stabilizes. PMID:23115744

  12. Utah National Guard Readiness Act

    THOMAS, 112th Congress

    Rep. Bishop, Rob [R-UT-1

    2011-02-14

    10/04/2011 Received in the Senate and Read twice and referred to the Committee on Energy and Natural Resources. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

  13. National Guard Technician Equity Act

    THOMAS, 112th Congress

    Rep. Andrews, Robert E. [D-NJ-1

    2011-03-17

    04/01/2011 Referred to the Subcommittee on Federal Workforce, U.S. Postal Service, and Labor Policy. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  14. National Guard Technician Equity Act

    THOMAS, 112th Congress

    Sen. Reed, Jack [D-RI

    2011-11-17

    11/17/2011 Read twice and referred to the Committee on Armed Services. (text of measure as introduced: CR S7709-7710) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  15. Hospital-Sponsored Child Care: A 1988 National Survey.

    ERIC Educational Resources Information Center

    American Coll. of Healthcare Executives, Chicago, IL.

    A representative sample of 965 U.S. hospitals was surveyed for the purpose of obtaining information about: (1) current and projected involvement in provision of child care services to employees and their communities; and (2) hospitals' views of the costs and benefits of offering child care services, and of appropriate governmental policies.…

  16. Assessment of soil and water contaminants from selected locations in and near the Idaho Army National Guard Orchard Training Area, Ada County, Idaho, 2001-2003

    USGS Publications Warehouse

    Parliman, D.J.

    2004-01-01

    In 2001, the National Guard Bureau and the U.S. Geological Survey began a project to compile hydrogeologic data and determine presence or absence of soil, surface-water, and ground-water contamination at the Idaho Army National Guard Orchard Training Area in southwestern Idaho. Between June 2002 and April 2003, a total of 114 soil, surface-water, ground-water, precipitation, or dust samples were collected from 68 sample sites (65 different locations) in the Orchard Training Area (OTA) or along the vehicle corridor to the OTA. Soil and water samples were analyzed for concentrations of selected total trace metals, major ions, nutrients, explosive compounds, semivolatile organics, and petroleum hydrocarbons. Water samples also were analyzed for concentrations of selected dissolved trace metals and major ions. Distinguishing naturally occurring large concentrations of trace metals, major ions, and nutrients from contamination related to land and water uses at the OTA was difficult. There were no historical analyses for this area to compare with modern data, and although samples were collected from 65 locations in and near the OTA, sampled areas represented only a small part of the complex OTA land-use areas and soil types. For naturally occurring compounds, several assumptions were made?anomalously large concentrations, when tied to known land uses, may indicate presence of contamination; naturally occurring concentrations cannot be separated from contamination concentrations in mid- and lower ranges of data; and smallest concentrations may represent the lowest naturally occurring range of concentrations and (or) the absence of contaminants related to land and water uses. Presence of explosive, semivolatile organic (SVOC), and petroleum hydrocarbon compounds in samples indicates contamination from land and water uses. In areas along the vehicle corridor and major access roads within the OTA, most trace metal, major ion, and nutrient concentrations in soil samples were

  17. Safety net hospital performance on national quality of care process measures.

    PubMed

    Marshall, Lindsey; Harbin, Vanessa; Hooker, Jane; Oswald, John; Cummings, Linda

    2012-01-01

    Several studies have found poor or mixed performance by safety net hospitals on national measures of quality. The study's purposes were to determine whether safety net hospital performance is similar to the average U.S. hospital, both currently and during earlier reporting periods, and to summarize features commonly used to assess performance, including definition of safety net and patient characteristics. This study reviewed quality performance data for the Joint Commission's accountability measures for hospitals that are members of the National Association of Public Hospitals and Health Systems (NAPH)-safety net hospitals that serve a large proportion of Medicaid and uninsured patients. Analyses of quality performance on the earliest data show that on average there was no statistically significant difference in performance between NAPH members and other hospitals on 6 of 15 measures. According to the most recent data, NAPH hospitals on average had no statistically significant differences as other hospitals on 13 of 18 measures and had statistically significantly better scores on two measures. These results are an important addition to the literature regarding safety net hospitals that serve a high proportion of Medicaid, low income, and uninsured patients, and support the case that quality of care at safety net hospitals is equivalent to that of non-safety net hospitals.

  18. Current problems in national hospitals of Phnom Penh: finance and health care.

    PubMed

    Uy, Sophoat; Akashi, Hidechika; Taki, Kazumi; Ito, Katsuki

    2007-01-01

    The current problems in Cambodia's national hospitals subsist in a geographic imbalance in the location of staff and health facilities, and low staff motivation largely due to inadequate payment. This paper aims to investigate the associations among hospital performance, hospital finances, and other related issues in five national hospitals in Phnom Penh, using annual reports of the five hospitals and annual statistics of the Ministry of Health, from 2000 to 2004. The bed occupancy rates (BOR), average lengths of stay (ALS), hospital mortality rates (HMR), maternal and neonatal mortality rates, numbers of patients, main health problems of inpatients, numbers of health personnel, staff incentives, and annual hospital income were used in this study as indicators of five hospitals in Phnom Penh city. The ALS varied from 3.8 to 9 days. The numbers of health personnel (physician, medical assistant, secondary nurses, primary nurses, secondary midwives, and primary midwives) per 100 beds were from 114 to 282. Supplemental salary per staff also differed greatly among these hospitals; the salaries were the highest at Calmette hospital (US$ 212.8) and the lowest at Preah Kossamak (US$ 12.4). In the five hospitals, the average BOR was 58.8%, and the mean of total annual income was US$ 1,427,852 per year. Although not significant, there was a tendency for higher supplemental salaries to be associated with higher BOR (Spearman rank correlation coefficient 0.70, p = 0.188). This study showed the differences in the hospital indicators among five national hospitals in Phnom Penh city, and the tendency of higher BOR in the hospitals paying higher supplemental salaries to the staff. Higher supplemental salary to the staff seemed to contribute the better hospital performance. PMID:17378183

  19. Is anybody managing the store? National trends in hospital performance.

    PubMed

    Griffith, John R; Pattullo, Andrew; Alexander, Jeffrey A; Jelinek, Richard C; Foster, David A

    2006-01-01

    Nine standardized measures compiled from Medicare data show trends in the safety, quality, financial management, and efficiency for more than 2,500 community hospitals over five years ending in 2003. Although much public attention has been given to hospital performance, along with exhortations to improve, few measures show substantial positive trends, either in variance reduction or overall improvement. The authors conclude that environmental forces are not stimulating improvement and that the overall picture is one of randomness rather than management. PMID:17184003

  20. Abortion a business hurdle for nation's Catholic hospitals.

    PubMed

    Burda, D

    1989-08-25

    Abortion is the foremost moral issue for 626 Catholic hospitals nationwide since church teachings prohibit the performance of elective abortions. This and the fact that Catholic hospitals can not do voluntary sterilizations can hinder their ability to get managed care contracts. In some cases a hospital will not join a network because abortions and sterilizations are done in other hospitals in the network. In other cases they have been in plans where abortions are performed in other contract facilities; this does not violate the Catholic church policy since the abortions are not performed in their facility. When a Catholic and secular hospital plan a merger, Catholic ideals seem to take precedence. A Catholic hospital that went bankrupt in Philadelphia, was turned over to investors, and was under no obligation to follow the Catholic church's directives, but did not perform abortions anyway. In Washington state there are merger talks going on between a secular facility and the Franciscan Health System. The cessation of abortion and sterilization services appear to be outweighed by the financial benefits. Besides, these procedures can be performed through other providers in the area. In Michigan similar merger talks may fail because of the abortion issue. The government justice system is investigating and is likely to challenge any merger there.

  1. Human mate guarding.

    PubMed

    Buss, David M

    2002-12-01

    Long-term committed mating is a fundamental strategy in the human repertoire. Successful enactment of this strategy requires solving two related adaptive problems--fending off potential mate poachers and preventing a mates from defecting. Mate guarding adaptations evolved to solve these persistent problems. Those who failed in mate guarding risked suffering substantial reproductive costs ranging from genetic cuckoldry to reputational damage to the entire loss of a mate. Because the precise nature of the adaptive problems confronted differed historically for the sexes, men and women evolved corresponding differences in the underlying psychology of mate guarding. Men's mate guarding, relative to that of women's, is strongly triggered as a consequence of being mated to young and physically attractive women, being confronted by interested rivals who have superior economic resources or prospects, and having a mate who displays signs of sexual involvement with a rival. Women's mate guarding, relative to that of men's, is triggered as a consequence of being mated to men high in income and status striving, rivals who are more physically attractive, and having a partner who shows signs of emotional involvement with another woman. Behavioral output of mate guarding adaptations range from vigilance to violence. PMID:12496732

  2. 45 CFR 60.12 - Information which hospitals must request from the National Practitioner Data Bank.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS Disclosure of Information by the National Practitioner Data Bank § 60.12 Information which hospitals must request from the National Practitioner Data Bank. (a) When information...

  3. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    PubMed

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods. PMID:27601396

  4. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    PubMed

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods.

  5. Surface-water quantity and quality, aquatic biology, stream geomorphology, and groundwater-flow simulation for National Guard Training Center at Fort Indiantown Gap, Pennsylvania, 2002-05

    USGS Publications Warehouse

    Langland, Michael J.; Cinotto, Peter J.; Chichester, Douglas C.; Bilger, Michael D.; Brightbill, Robin A.

    2010-01-01

    Base-line and long-term monitoring of water resources of the National Guard Training Center at Fort Indiantown Gap in south-central Pennsylvania began in 2002. Results of continuous monitoring of streamflow and turbidity and monthly and stormflow water-quality samples from two continuous-record long-term stream sites, periodic collection of water-quality samples from five miscellaneous stream sites, and annual collection of biological data from 2002 to 2005 at 27 sites are discussed. In addition, results from a stream-geomorphic analysis and classification and a regional groundwater-flow model are included. Streamflow at the facility was above normal for the 2003 through 2005 water years and extremely high-flow events occurred in 2003 and in 2004. Water-quality samples were analyzed for nutrients, sediments, metals, major ions, pesticides, volatile and semi-volatile organic compounds, and explosives. Results indicated no exceedances for any constituent (except iron) above the primary and secondary drinking-water standards or health-advisory levels set by the U.S. Environmental Protection Agency. Iron concentrations were naturally elevated in the groundwater within the watershed because of bedrock lithology. The majority of the constituents were at or below the method detection limit. Sediment loads were dominated by precipitation due to the remnants of Hurricane Ivan in September 2004. More than 60 percent of the sediment load measured during the entire study was transported past the streamgage in just 2 days during that event. Habitat and aquatic-invertebrate data were collected in the summers of 2002-05, and fish data were collected in 2004. Although 2002 was a drought year, 2003-05 were above-normal flow years. Results indicated a wide diversity in invertebrates, good numbers of taxa (distinct organisms), and on the basis of a combination of metrics, the majority of the 27 sites indicated no or slight impairment. Fish-metric data from 25 sites indicated results

  6. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

    PubMed

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

  7. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital

    PubMed Central

    Yoo, Sooyoung; Hwang, Hee

    2016-01-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience. PMID:27651940

  8. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital.

    PubMed

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience. PMID:27651940

  9. Hospital information systems: experience at the fully digitized Seoul National University Bundang Hospital

    PubMed Central

    Yoo, Sooyoung; Hwang, Hee

    2016-01-01

    The different levels of health information technology (IT) adoption and its integration into hospital workflow can affect the maximization of the benefits of using of health IT. We aimed at sharing our experiences and the journey to the successful adoption of health IT over 13 years at a tertiary university hospital in South Korea. The integrated system of comprehensive applications for direct care, support care, and smart care has been implemented with the latest IT and a rich user information platform, achieving the fully digitized hospital. The users experience design methodology, barcode and radio-frequency identification (RFID) technologies, smartphone and mobile technologies, and data analytics were integrated into hospital workflow. Applications for user-centered electronic medical record (EMR) and clinical decision support (CDS), closed loop medication administration (CLMA), mobile EMR and dashboard system for care coordination, clinical data warehouse (CDW) system, and patient engagement solutions were designed and developed to improve quality of care, work efficiency, and patient safety. We believe that comprehensive electronic health record systems and patient-centered smart hospital applications will go a long way in ensuring seamless patient care and experience.

  10. Study rates U.S. hospitals vs. other nations, industries.

    PubMed

    Burda, D

    1991-10-01

    American hospitals generally are further along with their total quality management programs than their Canadian counterparts but lag behind companies in other U.S. industries, according to a comprehensive international study that examined four industries--healthcare, automotive, banking and computer--in four countries--the United States, Canada, Germany and Japan. PMID:10114178

  11. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  12. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  13. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  14. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  15. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  16. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  17. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  18. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  19. 49 CFR 850.10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Preliminary investigation by the Coast Guard. 850... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.10 Preliminary investigation by the Coast Guard. (a) The Coast Guard conducts the...

  20. 49 CFR 850.35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Records of the Coast Guard and the Board. 850.35... TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.35 Records of the Coast Guard and the Board. (a) Records of the Coast Guard made under § 850.30...

  1. National hospital survey of anaerobic culture and susceptibility methods: III.

    PubMed

    Goldstein, Ellie J C; Citron, Diane M; Goldman, Pamela J; Goldman, Ronald J

    2008-04-01

    To assess the current status of anaerobic bacteriology in the United States, we surveyed, by means of a questionnaire, 150 hospitals selected at random with bed capacities of 200-1000 and we received responses from 98 (65%). Ninety-eight percent processed anaerobic culture specimens with 21% sending them to reference laboratories. Almost all these hospitals processed blood and wound cultures for anaerobes and all used selective media for identification, including BBE (52%), LKV (77%), and PEA (53%) agars. All hospital laboratories attempted identification of blood culture isolates including 80% that attempted speciation. Wound cultures for anaerobic bacteria and sterile site cultures were also processed for anaerobes by almost all labs. Identification of B. fragilis group species to species level was performed only in 56% of labs always and 37% sometimes. Preformed enzyme kits were used by 66% of labs and 30% used special potency disks for identification. Susceptibility testing was performed in-house by 21% of hospital labs and sent out to reference labs an additional 20%. Susceptibility testing was attempted for all blood culture isolates by both hospital (21% of total labs) and reference laboratories, but only performed by 17% for sterile body site and 14% of the time for wound isolates. Etest was used most often followed by broth microdilution. No labs used the agar dilution or disk elution methods. The antimicrobials most often tested in hospital labs, predicated on the commercial panel used, were penicillin/ampicillin and clindamycin (15/18; 83%; 15% of total labs), metronidazole (16/18; 89%; 16% of total labs) and cefotetan and ampicillin/sulbactam (12/18; 67%; 12% of total labs), piperacillin/tazobactam (7/18; 39%; 7% of total labs), cefoxitin (9/18; 50%), imipenem (8/18; 44%), and chloramphenicol (6/18; 33%). Our current survey suggests that while many labs are processing anaerobic cultures, especially blood cultures, the identification of isolates and the

  2. GUARD RING SEMICONDUCTOR JUNCTION

    DOEpatents

    Goulding, F.S.; Hansen, W.L.

    1963-12-01

    A semiconductor diode having a very low noise characteristic when used under reverse bias is described. Surface leakage currents, which in conventional diodes greatly contribute to noise, are prevented from mixing with the desired signal currents. A p-n junction is formed with a thin layer of heavily doped semiconductor material disposed on a lightly doped, physically thick base material. An annular groove cuts through the thin layer and into the base for a short distance, dividing the thin layer into a peripheral guard ring that encircles the central region. Noise signal currents are shunted through the guard ring, leaving the central region free from such currents. (AEC)

  3. National Survey of Children's Hospitals on Legacy-Making Activities

    PubMed Central

    Dietrich, Mary S.; Friedman, Debra L.; Gordon, Jessie E.; Gilmer, Mary J.

    2012-01-01

    Abstract Objective Many hospitals offer legacy-building activities for children with serious illnesses or their family members, yet legacy-making has received little empirical attention. This descriptive cross-sectional study examined healthcare provider perceptions of legacy-making activities (e.g., memory books) currently offered by hospitals to pediatric patients and their families. Methods Healthcare providers in seventy-seven (100%) teaching children's hospitals across the United States completed an electronic survey. Results Nearly all providers surveyed reported offering legacy-making activities to ill children and their families, with patients and families usually completing the activity together. Most activities were offered before a patient died and when cure is no longer being sought. Perceived outcomes included benefit to bereaved families and a tangible memento of their deceased child. Conclusion Legacy-making may enhance life and decrease suffering for dying children and their families. Healthcare professionals can facilitate opportunities for children and their families to build legacies. Additional research is needed to examine activities across different age groups and conditions, the best time to offer such activities, and associations with positive and negative outcomes for ill children, their family members, and the bereaved. PMID:22577785

  4. Hospital liability and AIDS treatment: the need for a national standard of care.

    PubMed

    Hermann, D H; Gorman, R D

    1989-08-01

    This Article examines the current rules governing hospital liability in relation to the potential liability arising from Acquired Immunodeficiency Syndrome (AIDS). Traditional limitations on hospital liability have eroded while doctrines of corporate negligence and apparent agency have increased the basis for hospital liability. At the same time, the use of the locality rule, which established a standard of care based on community practice, increasingly has been replaced by the adoption of a national standard of care. With no existing precedent concerning the standard of care in AIDS treatment, both hospitals and courts require an authoritative basis for establishing the appropriate national standard of care. The authors contend that the guidelines established by the Centers for Disease Control (CDC) provide the most appropriate basis for establishing a national standard of care for AIDS treatment. PMID:10314361

  5. Organizational and market factors associated with leadership development programs in hospitals: a national study.

    PubMed

    Kim, Tae Hyun; Thompson, Jon M

    2012-01-01

    Effective leadership in hospitals is widely recognized as the key to organizational performance. Clinical, financial, and operational performance is increasingly being linked to the leadership practices of hospital managers. Moreover, effective leadership has been described as a means to achieve competitive advantage. Recent environmental forces, including reimbursement changes and increased competition, have prompted many hospitals to focus on building leadership competencies to successfully address these challenges. Using the resource dependence theory as our conceptual framework, we present results from a national study of hospitals examining the association of organizational and market factors with the provision of leadership development program activities, including the presence of a leadership development program, a diversity plan, a program for succession planning, and career development resources. The data are taken from the American Hospital Association's (AHA) 2008 Survey of Hospitals, the Area Resource File, and the Centers for Medicare & Medicaid Services. The results of multilevel logistic regressions of each leadership development program activity on organizational and market factors indicate that hospital size, system and network affiliation, and accreditation are significantly and positively associated with all leadership development program activities. The market factors significantly associated with all leadership development activities include a positive odds ratio for metropolitan statistical area location and a negative odds ratio for the percentage of the hospital's service area population that is female and minority. For-profit hospitals are less likely to provide leadership development program activities. Additional findings are presented, and the implications for hospital management are discussed.

  6. The incomplete circle of the National Disaster Medical System: what Arkansas hospitals learned from hurricane Gustav.

    PubMed

    Mason, William L

    2010-06-01

    On August 31, 2008, during Hurricane Gustav, 225 patients from Louisiana hospitals were evacuated to 12 hospitals in the central region of Arkansas. The evacuation was a success for the National Disaster Medical System (NDMS) but left Arkansas NDMS hospitals on their own to repatriate patients and negotiate payments for care. This article examines repatriation and reimbursement issues of Arkansas hospitals that provided care for these NDMS patients. Consensus statements were obtained from key organization stakeholders focused on repatriation of NDMS patients and reimbursement to Arkansas NDMS hospitals. The stakeholders concurred with recommendations addressing changes in both federal and state agreements related to repatriation of NDMS patients and reimbursement for care. Surveys from 10 of 12 participating hospitals showed Medicare was the primary payer for 57% of NDMS patients, higher than the usual community average of 43%. Length of stay was 3 days longer for NDMS patients than for the patients usually served by the hospital. Thirty percent of hospitals reported that they would be unlikely to take NDMS patients in the future. Private sector hospitals were adversely affected by system difficulties in repatriation and reimbursement. The federal government should consider a new paradigm for reimbursement of hospitals and develop a single payer for all NDMS patients.

  7. Happy crisis tests hospitals' PR plan. Septuplets' arrival swamps Iowa hospitals with national, international media. Blank Children's Hospital, Iowa Methodist Medical Center, Des Moines.

    PubMed

    1998-01-01

    The public relations staff believed the birth of healthy septuplets would become a human interest story for local media. But the staff was stunned at the outpouring of international and national media knocking at their front doors. The staff of both Iowa Methodist Medical Center and Blank Children's Hospital in Des Moines, Iowa, organized a communications plan for 14 official press conferences, constant updates to the media and a website to handle ongoing inquiries from the public. As a result, the story of the McCaughey septuplets was shown in more than 10,000 television stories around the world. The hospitals received more than 36,000 magazine and newspaper articles. The public relations staff not only fielded more than 2,000 phone calls in the days following the Nov. 19 birth, but more than 15 major networks parked their vehicles and satellite dishes in front of the hospital.

  8. Coast Guard Firefighting Module

    NASA Technical Reports Server (NTRS)

    1977-01-01

    NASA and the U.S. Coast Guard are jointly developing a lightweight, helicopter-transportable, completely self-contained firefighting module for combating shipboard and dockside fires. The project draws upon NASA technology in high-capacity rocket engine pumps, lightweight materials and compact packaging.

  9. The Nanaimo and Charles Camsell Indian Hospitals: First Nations' narratives of health care, 1945 to 1965.

    PubMed

    Drees, Laurie Meijer

    2010-01-01

    First Nations' perspectives on health and health care as delivered by doctors, nurses, and Canada's former Indian hospital system form a significant part of Canada's medical history, as well as a part of First Nations people's personal histories. Oral histories collected in Alberta and British Columbia suggest that First Nations people who experienced the Nanaimo and Charles Camsell Indian hospitals between 1945 and 1965 perceive the value of their experiences to be reflected in their survivance, a concept recalled through narratives emphasizing both humour and pain, as well as past and present personal resilience.

  10. Hydrogeologic framework and water quality of the Vermont Army National Guard Ethan Allen Firing Range, northern Vermont, October 2002 through December 2003

    USGS Publications Warehouse

    Clark, Stewart F.; Chalmers, Ann; Mack, Thomas J.; Denner, Jon C.

    2005-01-01

    The Ethan Allen Firing Range of the Vermont Army National Guard is a weapons-testing and training facility in a mountainous region of Vermont that has been in operation for about 80 years. The hydrologic framework and water quality of the facility were assessed between October 2002 and December 2003. As part of the study, streamflow was continuously measured in the Lee River and 24 observation wells were installed at 19 locations in the stratified drift and bedrock aquifers to examine the hydrogeology. Chemical analyses of surface water, ground water, streambed sediment, and fish tissue were collected to assess major ions, trace elements, nutrients, and volatile and semivolatile compounds. Sampling included 5 surface-water sites sampled during moderate and low-flow conditions; streambed-sediment samples collected at the 5 surface-water sites; fish-tissue samples collected at 3 of the 5 surface-water sites; macroinvertebrates collected at 4 of the 5 surface-water sites; and ground-water samples collected from 10 observation wells, and samples collected at all surface- and ground-water sites. The hydrogeologic framework at the Ethan Allen Firing Range is dominated by the upland mountain and valley setting of the site. Bedrock wells yield low to moderate amounts of water (0 to 23 liters per minute). In the narrow river valleys, layered stratified-drift deposits of sand and gravel of up to 18 meters thick fill the Lee River and Mill Brook Valleys. In these deposits, the water table is generally within 3 meters below the land surface and overall ground-water flow is from east to west. Streamflow in the Lee River averaged 0.72 cubic meters per second (25.4 cubic feet per second) between December 2002 and December 2003. Streams are highly responsive to precipitation events in this mountainous environment and a comparison with other nearby watersheds shows that Lee River maintains relatively high streamflow during dry periods. Concentrations of trace elements and nutrients

  11. Organizational and environmental determinants of hospital EMR adoption: a national study.

    PubMed

    Kazley, Abby Swanson; Ozcan, Yasar A

    2007-10-01

    The recent focus on health care quality improvement and cost containment has led some policymakers and practitioners to advocate the adoption of health information technology. One such technology is the Electronic Medical Record (EMR), which is predicted to change and improve health care in the USA. Little is known about factors that influence hospital adoption of this relatively new technology. The purpose of this paper is to determine the national prevalence of EMR adoption in acute care hospitals while examining the organizational and environmental correlates using a Resource Dependence Theoretical Perspective. Significant predictors of hospital EMR use may indicate barriers to use for some hospitals and can be used to guide policy. This study uses a non-experimental cross sectional design to examine hospital EMR use in 2004. A logistic regression approach is used to determine the correlations between hospital EMR use and organizational and environmental characteristics. Hospital EMR use was identified using the HIMSS Analytics data. Organizational and environmental variables were measured using data from the AHA, CMS (financial and case mix) and ARF. Hospital EMR adoption is significantly associated with environmental uncertainty, type of system affiliation, size, and urbanness. The effects of competition, munificence, ownership, teaching status, public payer mix, and operating margin were not statistically significant. Significant predictors of hospital EMR adoption represent barriers that may prevent certain hospitals from obtaining and using EMRs. These hospitals include those that are smaller, more rural, non-system affiliated, and in areas of low environmental uncertainty. Since EMR adoption may be an organizational survival strategy for hospitals to improve quality and efficiency, hospitals that are at risk of missing the wave of implementation should be offered services and incentives to enable them to implement and maintain EMR systems.

  12. [Fates at the psychiatric hospital of Klagenfurt during National Socialism].

    PubMed

    Oberlerchner, Herwig; Stromberger, Helge

    2013-01-01

    In this article the fate of Mr. B. is described as an example for the fate of hundreds of mentally ill patients of the "Landes-Irrenanstalt of Klagenfurt", murdered during the era of National Socialism. This extraordinary fate marks two outstanding aspects of history of medicine, the treatment of syphilis with malaria and the organised mass murder of mentally ill people during the cynic era of National Socialism. Beyond this historical perspective reconstructive biographical work together with relatives is presented as a proactive duty of psychiatric institutions.

  13. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  14. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  15. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  16. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  17. 49 CFR 213.355 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Frog guard rails and guard faces; gage. 213.355... Higher § 213.355 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs... distance between the gage line of a frog to the guard line 1 of its guard rail or guarding face,...

  18. National Lupus Hospitalization Trends Reveal Rising Rates of Herpes Zoster and Declines in Pneumocystis Pneumonia

    PubMed Central

    Murray, Sara G.; Schmajuk, Gabriela; Trupin, Laura; Gensler, Lianne; Katz, Patricia P.; Yelin, Edward H.; Gansky, Stuart A.; Yazdany, Jinoos

    2016-01-01

    Objective Infection is a leading cause of morbidity and mortality in systemic lupus erythematosus (SLE). Therapeutic practices have evolved over the past 15 years, but effects on infectious complications of SLE are unknown. We evaluated trends in hospitalizations for severe and opportunistic infections in a population-based SLE study. Methods Data derive from the 2000 to 2011 United States National Inpatient Sample, including individuals who met a validated administrative definition of SLE. Primary outcomes were diagnoses of bacteremia, pneumonia, opportunistic fungal infection, herpes zoster, cytomegalovirus, or pneumocystis pneumonia (PCP). We used Poisson regression to determine whether infection rates were changing in SLE hospitalizations and used predictive marginals to generate annual adjusted rates of specific infections. Results We identified 361,337 SLE hospitalizations from 2000 to 2011 meeting study inclusion criteria. Compared to non-SLE hospitalizations, SLE patients were younger (51 vs. 62 years), predominantly female (89% vs. 54%), and more likely to be racial/ethnic minorities. SLE diagnosis was significantly associated with all measured severe and opportunistic infections. From 2000 to 2011, adjusted SLE hospitalization rates for herpes zoster increased more than non-SLE rates: 54 to 79 per 10,000 SLE hospitalizations compared with 24 to 29 per 10,000 non-SLE hospitalizations. Conversely, SLE hospitalizations for PCP disproportionately decreased: 5.1 to 2.5 per 10,000 SLE hospitalizations compared with 0.9 to 1.3 per 10,000 non-SLE hospitalizations. Conclusions Among patients with SLE, herpes zoster hospitalizations are rising while PCP hospitalizations are declining. These trends likely reflect evolving SLE treatment strategies. Further research is needed to identify patients at greatest risk for infectious complications. PMID:26731012

  19. Access to primary care and the route of emergency admission to hospital: retrospective analysis of national hospital administrative data

    PubMed Central

    Cowling, Thomas E; Harris, Matthew; Watt, Hilary; Soljak, Michael; Richards, Emma; Gunning, Elinor; Bottle, Alex; Macinko, James; Majeed, Azeem

    2016-01-01

    Background The UK government is pursuing policies to improve primary care access, as many patients visit accident and emergency (A and E) departments after being unable to get suitable general practice appointments. Direct admission to hospital via a general practitioner (GP) averts A and E use, and may reduce total hospital costs. It could also enhance the continuity of information between GPs and hospital doctors, possibly improving healthcare outcomes. Objective To determine whether primary care access is associated with the route of emergency admission—via a GP versus via an A and E department. Methods Retrospective analysis of national administrative data from English hospitals for 2011–2012. Adults admitted in an emergency (unscheduled) for ≥1 night via a GP or an A and E department formed the study population. The measure of primary care access—the percentage of patients able to get a general practice appointment on their last attempt—was derived from a large, nationally representative patient survey. Multilevel logistic regression was used to estimate associations, adjusting for patient and admission characteristics. Results The analysis included 2 322 112 emergency admissions (81.9% via an A and E department). With a 5 unit increase in the percentage of patients able to get a general practice appointment on their last attempt, the adjusted odds of GP admission (vs A and E admission) was estimated to increase by 15% (OR 1.15, 95% CI 1.12 to 1.17). The probability of GP admission if ≥95% of appointment attempts were successful in each general practice was estimated to be 19.6%. This probability reduced to 13.6% when <80% of appointment attempts were successful. This equates to 139 673 fewer GP admissions (456 232 vs 316 559) assuming no change in the total number of admissions. Associations were consistent in direction across geographical regions of England. Conclusions Among hospital inpatients admitted as an emergency, patients

  20. The Impact of National Cultural Differences on Nurses' Acceptance of Hospital Information Systems.

    PubMed

    Lin, Hsien-Cheng

    2015-06-01

    This study aims to explore the influence of national cultural differences on nurses' perceptions of their acceptance of hospital information systems. This study uses the perspective of Technology Acceptance Model; national cultural differences in terms of masculinity/femininity, individualism/collectivism, power distance, and uncertainty avoidance are incorporated into the Technology Acceptance Model as moderators, whereas time orientation is a control variable on hospital information system acceptance. A quantitative research design was used in this study; 261 participants, US and Taiwan RNs, all had hospital information system experience. Data were collected from November 2013 to February 2014 and analyzed using a t test to compare the coefficients for each moderator. The results show that individualism/collectivism, power distance, and uncertainty avoidance all exhibit significant difference on hospital information system acceptance; however, both masculinity/femininity and time orientation factors did not show significance. This study verifies that national cultural differences have significant influence on nurses' behavioral intention to use hospital information systems. Therefore, hospital information system providers should emphasize the way in which to integrate different technological functions to meet the needs of nurses from various cultural backgrounds. PMID:25899441

  1. A national system for monitoring the performance of hospitals in Ethiopia

    PubMed Central

    McNatt, Zahirah; Linnander, Erika; Endeshaw, Abraham; Tatek, Dawit; Conteh, David

    2015-01-01

    Abstract Many countries struggle to develop and implement strategies to monitor hospitals nationally. The challenge is particularly acute in low-income countries where resources for measurement and reporting are scarce. We examined the experience of developing and implementing a national system for monitoring the performance of 130 government hospitals in Ethiopia. Using participatory observation, we found that the monitoring system resulted in more consistent hospital reporting of performance data to regional health bureaus and the federal government, increased transparency about hospital performance and the development of multiple quality-improvement projects. The development and implementation of the system, which required technical and political investment and support, would not have been possible without strong hospital-level management capacity. Thorough assessment of the health sector’s readiness to change and desire to prioritize hospital quality can be helpful in the early stages of design and implementation. This assessment may include interviews with key informants, collection of data about health facilities and human resources and discussion with academic partners. Aligning partners and donors with the government’s vision for quality improvement can enhance acceptability and political support. Such alignment can enable resources to be focused strategically towards one national effort – rather than be diluted across dozens of potentially competing projects. Initial stages benefit from having modest goals and the flexibility for continuous modification and improvement, through active engagement with all stakeholders. PMID:26600614

  2. The Impact of National Cultural Differences on Nurses' Acceptance of Hospital Information Systems.

    PubMed

    Lin, Hsien-Cheng

    2015-06-01

    This study aims to explore the influence of national cultural differences on nurses' perceptions of their acceptance of hospital information systems. This study uses the perspective of Technology Acceptance Model; national cultural differences in terms of masculinity/femininity, individualism/collectivism, power distance, and uncertainty avoidance are incorporated into the Technology Acceptance Model as moderators, whereas time orientation is a control variable on hospital information system acceptance. A quantitative research design was used in this study; 261 participants, US and Taiwan RNs, all had hospital information system experience. Data were collected from November 2013 to February 2014 and analyzed using a t test to compare the coefficients for each moderator. The results show that individualism/collectivism, power distance, and uncertainty avoidance all exhibit significant difference on hospital information system acceptance; however, both masculinity/femininity and time orientation factors did not show significance. This study verifies that national cultural differences have significant influence on nurses' behavioral intention to use hospital information systems. Therefore, hospital information system providers should emphasize the way in which to integrate different technological functions to meet the needs of nurses from various cultural backgrounds.

  3. Laser beam guard clamps

    DOEpatents

    Dickson, Richard K.

    2010-09-07

    A quick insert and release laser beam guard panel clamping apparatus having a base plate mountable on an optical table, a first jaw affixed to the base plate, and a spring-loaded second jaw slidably carried by the base plate to exert a clamping force. The first and second jaws each having a face acutely angled relative to the other face to form a V-shaped, open channel mouth, which enables wedge-action jaw separation by and subsequent clamping of a laser beam guard panel inserted through the open channel mouth. Preferably, the clamping apparatus also includes a support structure having an open slot aperture which is positioned over and parallel with the open channel mouth.

  4. Battered baby syndrome at Kenyatta National Hospital, Nairobi.

    PubMed

    Muita, J W; Nduati, R W

    1990-12-01

    Thirty children presenting with Battered Baby Syndrome over a five year period were studied retrospectively. The male:female ratio was 1:1.1. The majority (60%) were aged 0-11 months. 14 children (46%) were abandoned while six (20%) had multiple fractures, six (20%) multiple bruises and bites, and four (13.3%) had other forms of abuse. Twelve (40%) children were malnourished while eight of the babies (26.6%) were small for gestational age. Children were most frequently brought to hospital by the police or their mothers. The children were most frequently abused by their mothers either through abandonment or through physical battering. Details of mothers of the 14 abandoned children were unknown. Among the mothers of the other children, nine mothers were single, seven married and living with spouses and one stepmother. Two children (6.6%) died while the fate of two others was not known. Three children were sent home without intervention of the social worker, while twenty three children were discharged following intervention of the social worker; fourteen sent home, nine to a childrens' home and one through the juvenile court.

  5. Building an FTP guard

    SciTech Connect

    Sands, P.D.

    1998-08-01

    Classified designs usually include lesser classified (including unclassified) components. An engineer working on such a design needs access to the various sub-designs at lower classification levels. For simplicity, the problem is presented with only two levels: high and low. If the low-classification component designs are stored in the high network, they become inaccessible to persons working on a low network. In order to keep the networks separate, the component designs may be duplicated in all networks, resulting in a synchronization problem. Alternatively, they may be stored in the low network and brought into the high network when needed. The latter solution results in the use of sneaker-net (copying the files from the low system to a tape and carrying the tape to a high system) or a file transfer guard. This paper shows how an FTP Guard was constructed and implemented without degrading the security of the underlying B3 platform. The paper then shows how the guard can be extended to an FTP proxy server or an HTTP proxy server. The extension is accomplished by allowing the high-side user to select among items that already exist on the low-side. No high-side data can be directly compromised by the extension, but a mechanism must be developed to handle the low-bandwidth covert channel that would be introduced by the application.

  6. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  7. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  8. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  9. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  10. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  11. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  12. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  13. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  14. 49 CFR 850.3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 false Relationship to Coast Guard marine investigation... (Continued) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.3 Relationship to Coast Guard marine investigation regulations and...

  15. 49 CFR 850.25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 false Coast Guard marine casualty investigation for the...) NATIONAL TRANSPORTATION SAFETY BOARD COAST GUARD-NATIONAL TRANSPORTATION SAFETY BOARD MARINE CASUALTY INVESTIGATIONS § 850.25 Coast Guard marine casualty investigation for the Board. (a) If the Board does...

  16. Biological assessment of the effects of activities conducted at Camp Roberts Army National Guard training site, Monterey and San Luis Obispo Counties, California, on the endangered san joaquin kit fox, Vulpes macrotis mutica

    SciTech Connect

    Not Available

    1989-12-01

    Section 7 of the Endangered Species Act of 1973 imposes several requirements on federal agencies concerning listed threatened and endangered species and their designated critical habitat. Camp Roberts is operated by the California Army National Guard (CA ARNG) with funding from the National Guard Bureau (NGB). Its primary mission to provide a site where military training requirements of the western United States can be met. The presence of the endangered San Joaquin kit fox (Vulpes macrotis mutica) was confirmed in 1960 and the distribution and abundance of the species increased over the next two decades. The Secretary of Interior has not designated any critical habitat for San Joaquin kit fox. The major objective of this Biological Assessment is to provide FWS with sufficient information concerning the possible impacts that routine military training, maintenance and repair activities, and proposed construction projects may have on the San Joaquin kit fox and its essential habitat at Camp Roberts so that formal consultation with NGB and CA ARNG can begin. FWS will use this information as part of the basis for issuing a Biological Opinion which will include an incidental take provision. 45 refs., 8 figs., 1 tab.

  17. Nosocomial Cholera Outbreak in a Mental Hospital: Challenges and Lessons Learnt from Butabika National Referral Mental Hospital, Uganda.

    PubMed

    Bwire, Godfrey; Malimbo, Mugagga; Kagirita, Atek; Makumbi, Issa; Mintz, Eric; Mengel, Martin A; Orach, Christopher Garimoi

    2015-09-01

    During the last four decades, Uganda has experienced repeated cholera outbreaks in communities; no cholera outbreaks have been reported in Ugandan health facilities. In October 2008, a unique cholera outbreak was confirmed in Butabika National Mental Referral Hospital (BNMRH), Uganda. This article describes actions taken to control the outbreak, challenges, and lessons learnt. We reviewed patient and hospital reports for clinical symptoms and signs, treatment and outcome, patient mental diagnosis, and challenges noted during management of patients and contacts. Out of 114 BNMRH patients on two affected wards, 18 cholera cases and five deaths were documented for an attack rate of 15.8% and a case fatality rate of 28%. Wards and surroundings were intensively disinfected and 96 contacts (psychiatric patients) in the affected wards received chemoprophylaxis with oral ciprofloxacin 500 mg twice daily until November 5, 2008. We documented a nosocomial cholera outbreak in BNMRH with a high case fatality of 28% compared with the national average of 2.4% for cholera outbreaks in communities. To avoid cholera outbreaks and potentially high mortality among patients in mental institutions, procedures for prompt diagnosis, treatment, disinfection, and prophylaxis are needed and preemptive use of oral cholera vaccines should be considered.

  18. Nosocomial Cholera Outbreak in a Mental Hospital: Challenges and Lessons Learnt from Butabika National Referral Mental Hospital, Uganda

    PubMed Central

    Bwire, Godfrey; Malimbo, Mugagga; Kagirita, Atek; Makumbi, Issa; Mintz, Eric; Mengel, Martin A.; Orach, Christopher Garimoi

    2015-01-01

    During the last four decades, Uganda has experienced repeated cholera outbreaks in communities; no cholera outbreaks have been reported in Ugandan health facilities. In October 2008, a unique cholera outbreak was confirmed in Butabika National Mental Referral Hospital (BNMRH), Uganda. This article describes actions taken to control the outbreak, challenges, and lessons learnt. We reviewed patient and hospital reports for clinical symptoms and signs, treatment and outcome, patient mental diagnosis, and challenges noted during management of patients and contacts. Out of 114 BNMRH patients on two affected wards, 18 cholera cases and five deaths were documented for an attack rate of 15.8% and a case fatality rate of 28%. Wards and surroundings were intensively disinfected and 96 contacts (psychiatric patients) in the affected wards received chemoprophylaxis with oral ciprofloxacin 500 mg twice daily until November 5, 2008. We documented a nosocomial cholera outbreak in BNMRH with a high case fatality of 28% compared with the national average of 2.4% for cholera outbreaks in communities. To avoid cholera outbreaks and potentially high mortality among patients in mental institutions, procedures for prompt diagnosis, treatment, disinfection, and prophylaxis are needed and preemptive use of oral cholera vaccines should be considered. PMID:26195468

  19. Transforming safety and effectiveness in pediatric hospital care locally and nationally.

    PubMed

    Mandel, Keith E; Muething, Stephen E; Schoettker, Pamela J; Kotagal, Uma R

    2009-08-01

    Achieving dramatic, sustainable improvements in the safety and effectiveness of care for children requires a transformational approach to how hospitals individually focus on improvement and learn from each other to achieve national goals. The authors describe a theoretic framework for transformation that includes setting system-level priorities, aligning measures with each priority, identifying breakthrough targets, testing interventions to get results, and spreading successful interventions throughout the organization. Essential key drivers of transformation include leadership, building will, transparency, a business case for quality, patient and family engagement, improvement infrastructure, improvement capability, and reliability and standardization. Improving national system-level measures requires each hospital to pursue its own transformation journey while collaborating with hospitals and other organizations. PMID:19660634

  20. Improving Service Quality in Long-term Care Hospitals: National Evaluation on Long-term Care Hospitals and Employees Perception of Quality Dimensions

    PubMed Central

    Kim, Jinkyung; Han, Woosok

    2012-01-01

    Objectives To investigate predictors for specific dimensions of service quality perceived by hospital employees in long-term care hospitals. Methods Data collected from a survey of 298 hospital employees in 18 long-term care hospitals were analysed. Multivariate ordinary least squares regression analysis with hospital fixed effects was used to determine the predictors of service quality using respondents’ and organizational characteristics. Results The most significant predictors of employee-perceived service quality were job satisfaction and degree of consent on national evaluation criteria. National evaluation results on long-term care hospitals and work environment also had positive effects on service quality. Conclusion The findings of the study show that organizational characteristics are significant determinants of service quality in long-term care hospitals. Assessment of the extent to which hospitals address factors related to employeeperceived quality of services could be the first step in quality improvement activities. Results have implications for efforts to improve service quality in longterm care hospitals and designing more comprehensive national evaluation criteria. PMID:24159497

  1. 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

  2. Incidence Rate of Needlestick and Sharps Injuries in 67 Japanese Hospitals: A National Surveillance Study

    PubMed Central

    Yoshikawa, Toru; Wada, Koji; Lee, Jong Ja; Mitsuda, Toshihiro; Kidouchi, Kiyoshi; Kurosu, Hitomi; Morisawa, Yuji; Aminaka, Mayumi; Okubo, Takashi; Kimura, Satoshi; Moriya, Kyoji

    2013-01-01

    Background Determining incidence rates of needlestick and sharps injuries (NSIs) using data from multiple hospitals may help hospitals to compare their in-house data with national averages and thereby institute relevant measures to minimize NSIs. We aimed to determine the incidence rate of NSIs using the nationwide EPINet surveillance system. Methodology/Principal Findings Data were analyzed from 5,463 cases collected between April 2009 and March 2011 from 67 Japanese HIV/AIDS referral hospitals that participated in EPINet-Japan. The NSI incidence rate was calculated as the annual number of cases with NSIs per 100 occupied beds, according to the demographic characteristics of the injured person, place, timing, device, and the patients’ infectious status. The NSI incidence rates according to hospital size were analyzed by a non-parametric test of trend. The mean number of cases with NSIs per 100 occupied beds per year was 4.8 (95% confidence interval, 4.1–5.6) for 25 hospitals with 399 or fewer beds, 6.7 (5.9–7.4) for 24 hospitals with 400–799 beds, and 7.6 (6.7–8.5) for 18 hospitals with 800 or more beds (p-trend<0.01). NSIs frequently occurred in health care workers in their 20 s; the NSI incidence rate for this age group was 2.1 (1.6–2.5) for hospitals having 399 or fewer beds, 3.5 (3.0–4.1) for hospitals with 400–799 beds, and 4.5 (3.9–5.0) for hospitals with 800 or more beds (p-trend<0.01). Conclusions/Significance The incidence rate of NSIs tended to be higher for larger hospitals and in workers aged less than 40 years; injury occurrence was more likely to occur in places such as patient rooms and operating rooms. Application of the NSI incidence rates by hospital size, as a benchmark, could allow individual hospitals to compare their NSI incidence rates with those of other institutions, which could facilitate the development of adequate control strategies. PMID:24204856

  3. A comparison of hospital administrative costs in eight nations: US costs exceed all others by far.

    PubMed

    Himmelstein, David U; Jun, Miraya; Busse, Reinhard; Chevreul, Karine; Geissler, Alexander; Jeurissen, Patrick; Thomson, Sarah; Vinet, Marie-Amelie; Woolhandler, Steffie

    2014-09-01

    A few studies have noted the outsize administrative costs of US hospitals, but no research has compared these costs across multiple nations with various types of health care systems. We assembled a team of international health policy experts to conduct just such a challenging analysis of hospital administrative costs across eight nations: Canada, England, Scotland, Wales, France, Germany, the Netherlands, and the United States. We found that administrative costs accounted for 25.3 percent of total US hospital expenditures--a percentage that is increasing. Next highest were the Netherlands (19.8 percent) and England (15.5 percent), both of which are transitioning to market-oriented payment systems. Scotland and Canada, whose single-payer systems pay hospitals global operating budgets, with separate grants for capital, had the lowest administrative costs. Costs were intermediate in France and Germany (which bill per patient but pay separately for capital projects) and in Wales. Reducing US per capita spending for hospital administration to Scottish or Canadian levels would have saved more than $150 billion in 2011. This study suggests that the reduction of US administrative costs would best be accomplished through the use of a simpler and less market-oriented payment scheme.

  4. [Problems in career planning for novice medical technologists in Japanese national hospitals].

    PubMed

    Ogasawara, Shu; Tsutaya, Shoji; Akimoto, Hiroyuki; Kojima, Keiya; Yabaka, Hiroyuki

    2012-12-01

    Skills and knowledge regarding many different types of test are required for medical technologists (MTs) to provide accurate information to help doctors and other medical specialists. In order to become an efficient MT, specialized training programs are required. Certification in specialized areas of clinical laboratory sciences or a doctoral degree in medical sciences may help MTs to realize career advancement, a higher earning potential, and expand the options in their career. However, most young MTs in national university hospitals are employed as part-time workers on a three-year contract, which is too short to obtain certifications or a doctoral degree. We have to leave the hospital without expanding our future. We need to take control of our own development in order to enhance our employability within the period. As teaching and training hospitals, national university hospitals in Japan are facing a difficult dilemma in nurturing MTs. I hope, as a novice medical technologist, that at least university hospitals in Japan create an appropriate workplace environment for novice MTs.

  5. National Hospital Management Portal (NHMP): a framework for e-health implementation.

    PubMed

    Adetiba, E; Eleanya, M; Fatumo, S A; Matthews, V O

    2009-01-01

    Health information represents the main basis for health decision-making process and there have been some efforts to increase access to health information in developing countries. However, most of these efforts are based on the internet which has minimal penetration especially in the rural and sub-urban part of developing countries. In this work, a platform for medical record acquisition via the ubiquitous 2.5G/3G wireless communications technologies is presented. The National Hospital Management Portal (NHMP) platform has a central database at each specific country's national hospital which could be updated/accessed from hosts at health centres, clinics, medical laboratories, teaching hospitals, private hospitals and specialist hospitals across the country. With this, doctors can have access to patients' medical records more easily, get immediate access to test results from laboratories, deliver prescription directly to pharmacists. If a particular treatment can be provided to a patient more effectively in another country, NHMP makes it simpler to organise and carry out such treatment abroad.

  6. [Problems in career planning for novice medical technologists in Japanese national hospitals].

    PubMed

    Ogasawara, Shu; Tsutaya, Shoji; Akimoto, Hiroyuki; Kojima, Keiya; Yabaka, Hiroyuki

    2012-12-01

    Skills and knowledge regarding many different types of test are required for medical technologists (MTs) to provide accurate information to help doctors and other medical specialists. In order to become an efficient MT, specialized training programs are required. Certification in specialized areas of clinical laboratory sciences or a doctoral degree in medical sciences may help MTs to realize career advancement, a higher earning potential, and expand the options in their career. However, most young MTs in national university hospitals are employed as part-time workers on a three-year contract, which is too short to obtain certifications or a doctoral degree. We have to leave the hospital without expanding our future. We need to take control of our own development in order to enhance our employability within the period. As teaching and training hospitals, national university hospitals in Japan are facing a difficult dilemma in nurturing MTs. I hope, as a novice medical technologist, that at least university hospitals in Japan create an appropriate workplace environment for novice MTs. PMID:23427696

  7. The impact of ongoing national terror on the community of hospital nurses in Israel.

    PubMed

    Ron, Pnina; Shamai, Michal

    2014-04-01

    The main goal of this study was to explore the connections between the exposure of nurses in Israel to national terror and the levels of distress experienced due to ongoing terror attacks. The data were collected from 214 nurses from various parts of Israel who work in three types of heath services (mainly hospital departments) and provide help to victims of terror. The nurses reported very high levels of burnout, high levels of stress and medium-to high levels of intrusive memories. Levels of exposure were associated with burnout, intrusive memories and level of stress. More professional attention should be given to hospital nurses who provide care for trauma patients.

  8. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  9. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National...

  10. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  11. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  12. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  13. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  14. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National...

  15. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  16. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  17. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Powers with respect to the Coast Guard. 700.307... of the Navy The Secretary of the Navy § 700.307 Powers with respect to the Coast Guard. Whenever the Coast Guard operates as a service in the Navy under Section 3 of Title 14, United States Code,...

  18. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Powers with respect to the Coast Guard. 700.307... of the Navy The Secretary of the Navy § 700.307 Powers with respect to the Coast Guard. Whenever the Coast Guard operates as a service in the Navy under Section 3 of Title 14, United States Code,...

  19. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  20. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety...

  1. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National...

  2. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety...

  3. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety...

  4. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National...

  5. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  6. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety...

  7. 46 CFR 4.40-30 - Procedures for Coast Guard investigation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Procedures for Coast Guard investigation. 4.40-30 Section 4.40-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  8. 46 CFR 4.40-3 - Relationship to Coast Guard marine investigation regulations and procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Relationship to Coast Guard marine investigation regulations and procedures. 4.40-3 Section 4.40-3 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National...

  9. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  10. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  11. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Powers with respect to the Coast Guard. 700.307... of the Navy The Secretary of the Navy § 700.307 Powers with respect to the Coast Guard. Whenever the Coast Guard operates as a service in the Navy under Section 3 of Title 14, United States Code,...

  12. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Powers with respect to the Coast Guard. 700.307... of the Navy The Secretary of the Navy § 700.307 Powers with respect to the Coast Guard. Whenever the Coast Guard operates as a service in the Navy under Section 3 of Title 14, United States Code,...

  13. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  14. 46 CFR 4.40-25 - Coast Guard marine casualty investigation for the Board.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Coast Guard marine casualty investigation for the Board. 4.40-25 Section 4.40-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety...

  15. 32 CFR 700.307 - Powers with respect to the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Powers with respect to the Coast Guard. 700.307... of the Navy The Secretary of the Navy § 700.307 Powers with respect to the Coast Guard. Whenever the Coast Guard operates as a service in the Navy under Section 3 of Title 14, United States Code,...

  16. 46 CFR 4.40-10 - Preliminary investigation by the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Preliminary investigation by the Coast Guard. 4.40-10 Section 4.40-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  17. 46 CFR 4.40-35 - Records of the Coast Guard and the Board.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Records of the Coast Guard and the Board. 4.40-35 Section 4.40-35 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Coast Guard-National Transportation Safety Board Marine...

  18. The Payment by Results (PbR) national tariff severely penalises efficiency and early hospital discharge.

    PubMed

    Alam, Syed Munawer; Brown, Alex; Moreea, Sulleman

    2009-01-01

    The system of Payment by Results (PbR) was instituted in 2005 to reimburse secondary care for its activity. One of the features of PbR is the short stay tariff (SST), in which only 20-50% of the national tariff is paid if patients have a length of stay (LoS) of less than 2 days in hospital for certain Healthcare Resource Groups (HRGs) - or conditions. We analysed the admissions under Acute Medicine at Bradford Teaching Hospitals over a period of one year and identified the HRGs to which the SST applied. We used the 2007 PbR national tariff to calculate the additional income that would have been generated if these patients were kept in hospital for at least 2 days in order to avoid SST. We calculated an extra theoretical income of approximately £5 million if all these patients had a length of stay (LoS) more than 2 days to avoid the SST. Sixteen additional beds (assuming 85% occupancy) would have been required at a cost of around £1million per year to accommodate these patients. We show that the current PbR system is flawed and penalises hospitals with a higher turnover of patients.

  19. Has cost containment after the National Health Insurance system been successful? Determinants of Taiwan hospital costs.

    PubMed

    Hung, Jung-Hua; Chang, Li

    2008-03-01

    Taiwan implemented the National Health Insurance system (NHI) in 1995. After the NHI, the insurance coverage expanded and the quality of healthcare improved, however, the healthcare costs significantly escalated. The objective of this study is to determine what factors have direct impact on the increased costs after the NHI. Panel data analysis is used to investigate changes and factors affecting cost containment at Taipei municipal hospitals from 1990 to 2001. The results show that the expansion of insured healthcare coverage (especially to the elderly and the treatment of more complicated types of diseases), and the increased competition (requiring the growth of new technology and the longer average length of stay) are important driving forces behind the increase of hospital costs, directly influenced by the advent of the NHI. Therefore, policymakers should emphasize health prevention activities and disease management programs for the elderly to improve cost containment. In addition, hospital managers should find ways to improve the hospital efficiency (shorten the LOS) to reduce excess services and medical waste. They also need to better understand their market position and acquire suitable new-tech equipment earlier, to be a leader, not a follower. Finally, policymakers should establish related benchmark indices for what drivers up hospital costs (micro-aspect) and to control healthcare expenditures (macro-level).

  20. Suicide and War: The Mediating Effects of Negative Mood, Posttraumatic Stress Disorder Symptoms, and Social Support among Army National Guard Soldiers

    ERIC Educational Resources Information Center

    Griffith, James

    2012-01-01

    The mediating effects of posttraumatic stress disorder (PTSD) symptoms, negative mood, and social support on the relationship of war experiences to suicidality were examined. The research literature suggested a sequence among study scales representing these constructs, which was then tested on survey data obtained from a sample of National Guard…

  1. Tobacco control policies in hospitals before and after the implementation of a national smoking ban in Catalonia, Spain

    PubMed Central

    Martínez, Cristina; Fu, Marcela; Martínez-Sánchez, Jose M; Ballbè, Montse; Puig, Montse; García, Montse; Carabasa, Esther; Saltó, Esteve; Fernández, Esteve

    2009-01-01

    Background Diverse projects and guidelines to assist hospitals towards the attainment of comprehensive smoke-free policies have been developed. In 2006, Spain government passed a new smoking ban that reinforce tobacco control policies and banned completely smoking in hospitals. This study assesses the progression of tobacco control policies in the Catalan Network of Smoke-free Hospitals before and after a comprehensive national smoking ban. Methods We used the Self-Audit Questionnaire of the European Network for Smoke-free Hospitals to score the compliance of 9 policy standards (global score = 102). We used two cross-sectional surveys to evaluate tobacco control policies before (2005) and after the implementation of a national smoking ban (2007) in 32 hospitals of Catalonia, Spain. We compared the means of the overall score in 2005 and 2007 according to the type of hospital, the number of beds, the prevalence of tobacco consumption, and the number of years as a smoke-free hospital. Results The mean of the implementation score of tobacco control policies was 52.4 (95% CI: 45.4–59.5) in 2005 and 71.6 (95% CI: 67.0–76.2) in 2007 with an increase of 36.7% (p < 0.01). The hospitals with greater improvement were general hospitals (48% increase; p < 0.01), hospitals with > 300 beds (41.1% increase; p < 0.01), hospitals with employees' tobacco consumption prevalence 35–39% (72.2% increase; p < 0.05) and hospitals that had recently implemented smoke-free policies (74.2% increase; p < 0.01). Conclusion The national smoking ban appears to increase tobacco control activities in hospitals combined with other non-bylaw initiatives such as the Smoke-free Hospital Network. PMID:19473549

  2. A national, cross-sectional survey of children's hospital-based safety resource centres

    PubMed Central

    Kendi, Sadiqa; Zonfrillo, Mark R; Seaver Hill, Karen; Arbogast, Kristy B; Gittelman, Michael A

    2014-01-01

    Objective To describe the location, staffing, clientele, safety product disbursement patterns, education provided and sustainability of safety resource centres (SRCs) in US children's hospitals. Methods A cross-sectional survey was distributed to children's hospital-based SRC directors. Survey categories included: funding sources, customer base, items sold, items given free of charge, education provided and directors’ needs. Results 32/38 (84.2%) SRC sites (affiliated with 30 hospitals) completed the survey. SRCs were in many hospital locations including lobby (28.1%), family resource centres (12.5%), gift shop/retail space (18.8%), mobile units (18.8%) and patient clinics (12.5%). 19% of respondents reported that their SRC was financially self-sustainable. Sales to patients predominated (mean of 44%); however, hospital employees made up a mean of 20% (range 0–60%) of sales. 78.1% of SRCs had products for children with special healthcare needs. Documentation kept at SRC sites included items purchased (96.9%), items given free of charge (65.6%) and customer demographics (50%). 56.3% of SRCs provided formal injury prevention education classes. The SRCs’ directors’ most important needs were finances (46.9%), staffing (50%) and space (46.9%). All of the directors were ‘somewhat interested’ or ‘very interested’ in each of the following: creation of a common SRC listserv, national SRC data bank and multisite SRC research platform. Conclusions SRCs are located in many US children's hospitals, and can be characterised as heterogeneous in location, products sold, data kept and ability to be financially sustained. Further research is needed to determine best practices for SRCs to maximise their impact on injury prevention. PMID:24667383

  3. Longitudinal Association of Registered Nurse National Nursing Specialty Certification and Patient Falls in Acute Care Hospitals

    PubMed Central

    Boyle, Diane K.; Cramer, Emily; Potter, Catima; Staggs, Vincent S.

    2015-01-01

    Background Researchers have studied inpatient falls in relation to aspects of nurse staffing, focusing primarily on staffing levels and proportion of nursing care hours provided by registered nurses (RNs). Less attention has been paid to other nursing characteristics, such as RN national nursing specialty certification. Objective The aim of the study was to examine the relationship over time between changes in RN national nursing specialty certification rates and changes in total patient fall rates at the patient care unit level. Methods We used longitudinal data with standardized variable definitions across sites from the National Database of Nursing Quality Indicators. The sample consisted of 7,583 units in 903 hospitals. Relationships over time were examined using multilevel (units nested in hospitals) latent growth curve modeling. Results The model indices indicated a good fit of the data to the model. At the unit level, there was a small statistically significant inverse relationship (r = −.08, p = .04) between RN national nursing specialty certification rates and total fall rates; increases in specialty certification rates over time tended to be associated with improvements in total fall rates over time. Discussion Our findings may be supportive of promoting national nursing specialty certification as a means of improving patient safety. Future study recommendations are (a) modeling organizational leadership, culture, and climate as mediating variables between national specialty certification rates and patient outcomes and (b) investigating the association of patient safety and specific national nursing specialty certifications which test plans include patient safety, quality improvement, and diffusion of innovation methods in their certifying examinations. PMID:26049719

  4. Well christmas tree guard apparatus

    SciTech Connect

    Camos, W.M.; Doize, W.L.

    1981-11-17

    An oil or gas well christmas tree guard apparatus provides an annular guard body which is protectively secured about a bolted flanged connection of the well christmas tree, the guard so placed forming an envelope about the flanged connection and preventing access by a thief to the bolts and thus discouraging removal of the bolts from the bolted connection. The protective guard body thus prevents removal of the christmas tree from its location at the well head by theft denying access to the bolted connection which flanges the christmas tree to the remainder of the well. In the preferred embodiment the guard body provides a pair of annular shroud halves which are hingedly connected allowing them to be pivotally moved from an outer position allowing removal from the flanged connection to an inner closed operative position providing an overall annular guard body which is latched into position about the desired bolted connection. The guard body hinge as well as the latch structure can be protectively covered by a connected shroud or housing about the latch structure, or the hinge respectively.

  5. National Audit of Seizure management in Hospitals (NASH): results of the national audit of adult epilepsy in the UK

    PubMed Central

    Dixon, Peter A; Kirkham, Jamie J; Marson, Anthony G; Pearson, Mike G

    2015-01-01

    Objectives About 100 000 people present to hospitals each year in England with an epileptic seizure. How they are managed is unknown; thus, the National Audit of Seizure management in Hospitals (NASH) set out to assess prior care, management of the acute event and follow-up of these patients. This paper describes the data from the second audit conducted in 2013. Setting 154 emergency departments (EDs) across the UK. Participants Data from 4544 attendances (median age of 45 years, 57% men) showed that 61% had a prior diagnosis of epilepsy, 12% other neurological problems and 22% were first seizure cases. Each ED identified 30 consecutive adult cases presenting due to a seizure. Primary and secondary outcome measures Details were recorded of the patient's prior care, management at hospital and onward referral to neurological specialists onto an online database. Descriptive results are reported at national level. Results Of those with epilepsy, 498 (18%) were on no antiepileptic drug therapy and 1330 (48%) were on monotherapy. Assessments were often incomplete and witness histories were sought in only 759 (75%) of first seizure patients, 58% were seen by a senior doctor and 57% were admitted. For first seizure patients, advice on further seizure management was given to 264 (27%) and only 55% were referred to a neurologist or epilepsy specialist. For each variable, there was wide variability among sites that was not explicable. For the sites who partook in both audits, there was a trend towards better care in 2013, but this was small and dwarfed by the intersite variability. Conclusions These results have parallels with the Sentinel Audit of Stroke performed a decade earlier. There is wide intersite variability in care covering the entire care pathway, and a need for better organised and accessible care for these patients. PMID:25829372

  6. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Frog guard rails and guard faces; gage. 213.143... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  7. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Frog guard rails and guard faces; gage. 213.143... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  8. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Frog guard rails and guard faces; gage. 213.143... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  9. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Frog guard rails and guard faces; gage. 213.143... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  10. 49 CFR 213.143 - Frog guard rails and guard faces; gage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Frog guard rails and guard faces; gage. 213.143... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.143 Frog guard rails and guard faces; gage. The guard check and guard face gages in frogs shall be within the...

  11. Activity-based funding for National Health Service hospitals in England: managers' experience and expectations.

    PubMed

    Sussex, Jonathan; Farrar, Shelley

    2009-05-01

    Activity-based funding of hospital services has been introduced progressively since 2003 in the National Health Service (NHS) in England, under the name 'Payment by Results' (PbR). It represents a major change from previous funding arrangements based on annual "block" payments for large bundles of services. We interviewed senior local NHS managers about their experience and expectations of the impact of PbR. A high degree of 'NHS solidarity' was apparent, and competition between NHS hospitals was muted. PbR has been introduced against a background of numerous other efficiency incentives, and managers did not detect a further PbR-specific boost to efficiency. No impact on care quality, either positive or negative, is yet evident.

  12. Dutch Hospital Drug Formularies: pharmacotherapeutic variation and conservatism, but concurrence with national pharmacotherapeutic guidelines

    PubMed Central

    Fijn, R; Engels, S A G; Brouwers, J R B J; Knaap, R J; De Jong-Van den Berg, L T W

    2000-01-01

    Aims This research examines current hospital drug formularies (HDFs) of all Dutch general hospitals. It assesses the extent to which they recommend the same drugs, the breadth of their coverage in terms of therapeutic areas, drug groups incorporated and individuals drugs included, and their extent of conservatism by considering the year of introduction of the drugs included within groups. Furthermore, it considers the extent to which their recommendations concur and comply with those of national pharmacotherapeutic guidelines and the WHO Essential Drugs List (EDL). Methods Seventy-eight (81%) out of all 96 current Dutch HDFs were received of which 62 were suitable for study. Differences between HDFs and eventual associations with hospital characteristics were researched by statistical testing and case-control studies. To evaluate HDFs' concurrence with national guidelines and compliance with the WHO EDL, nine drug groups were studied in detail: benzodiazepines, calcium channel blockers, β-adrenoceptor blocking agents, ACE-inhibitors, angiotensin-II inhibitors, NSAIDs, H2-receptor antagonists, 5HT3-antagonists, and H+-pump inhibitors. Concurrence and compliance with national guidelines and the WHO EDL was defined as inclusion of recommended drugs. Non-concurrence was defined as inclusion of nonrecommended drugs. Results The total number of indications addressed and drug groups incorporated within HDFs varied from 28 to 72 (median 56) and from 30 to 123 (median 97), respectively. The total number of individual drug entities (pharmacological substances) included ranged from 239 to 658 (median 430) and the total number of drug products, including all different dosage forms, from 412 to 1121 (median 655). Within drug groups, drug entities first marketed were most frequently included. Teaching hospitals were most likely to include recently marketed drugs. Depending on the drug group, HDFs' concurrence and compliance with national guidelines and the WHO EDL ranged from

  13. Predictive Factors of Hospital Mortality Due to Myocardial Infarction: A Multilevel Analysis of Iran's National Data

    PubMed Central

    Ahmadi, Ali; Soori, Hamid; Mehrabi, Yadollah; Etemad, Koorosh; Sajjadi, Homeira; Sadeghi, Mehraban

    2015-01-01

    Background: Regarding failure to establish the statistical presuppositions for analysis of the data by conventional approaches, hierarchical structure of the data as well as the effect of higher-level variables, this study was conducted to determine the factors independently associated with hospital mortality due to myocardial infarction (MI) in Iran using a multilevel analysis. Methods: This study was a national, hospital-based, and cross-sectional study. In this study, the data of 20750 new MI patients between April, 2012 and March, 2013 in Iran were used. The hospital mortality due to MI was considered as the dependent variable. The demographic data, clinical and behavioral risk factors at the individual level and environmental data were gathered. Multilevel logistic regression models with Stata software were used to analyze the data. Results: Within 1-year of study, the frequency (%) of hospital mortality within 30 days of admission was derived 2511 (12.1%) patients. The adjusted odds ratio (OR) of mortality with (95% confidence interval [CI]) was derived 2.07 (95% CI: 1.5–2.8) for right bundle branch block, 1.5 (95% CI: 1.3–1.7) for ST-segment elevation MI, 1.3 (95% CI: 1.1–1.4) for female gender, and 1.2 (95% CI: 1.1–1.3) for humidity, all of which were considered as risk factors of mortality. But, OR of mortality was 0.7 for precipitation (95% CI: 0.7–0.8) and 0.5 for angioplasty (95% CI: 0.4–0.6) were considered as protective factors of mortality. Conclusions: Individual risk factors had independent effects on the hospital mortality due to MI. Variables in the province level had no significant effect on the outcome of MI. Increasing access and quality to treatment could reduce the mortality due to MI. PMID:26730342

  14. Installation restoration program: Closure investigation report. Site 1: Former base landfill; Stewart Air National Guard Base, Newburgh, New York. Volume II. Final report

    SciTech Connect

    1997-04-01

    The magnetic method is a versatile, relatively inexpensive, geophysical exploration technique. Magnetic data can be acquired on land or water, or in the air. Aeromagnetic surveys and deep water marine studies are commonly used as a reconnaissance tool for evaluating hydrocarbon prospects. Land-based or coastal water marine magnetic surveys are usually done for evaluating shallow geologic structures (e.g., shallow mineral deposits) in detail. More recently, the focus of national attention on the hazardous waste problem has prompted routine use of magnetometers for locating repositories of buried (drummed) wastes. Locating and quantifying these materials is essential to any remediation effort, and magnetometer surveys can provide an extra measure of safety to those personnel involved in the clean-up activities.

  15. Translational research in thoracic surgery—the National Taiwan University Hospital experience

    PubMed Central

    Lin, Mong-Wei; Yang, Pei-Wen

    2016-01-01

    Thoracic surgeons should be more aware of the latest information about histopathological, genetic and epigenetic alterations that may influence treatment policy and patient outcome in the biomolecular era. Translational research studies often produce a promising diagnostic tool or new treatment that can be used clinically. The results of these translational studies may even change the practical guidelines and current staging system in thoracic malignancies. The following article summarizes the experiences of translational research in esophageal cancer and non-small cell lung cancer (NSCLC) at National Taiwan University Hospital in Taiwan.

  16. Translational research in thoracic surgery—the National Taiwan University Hospital experience

    PubMed Central

    Lin, Mong-Wei; Yang, Pei-Wen

    2016-01-01

    Thoracic surgeons should be more aware of the latest information about histopathological, genetic and epigenetic alterations that may influence treatment policy and patient outcome in the biomolecular era. Translational research studies often produce a promising diagnostic tool or new treatment that can be used clinically. The results of these translational studies may even change the practical guidelines and current staging system in thoracic malignancies. The following article summarizes the experiences of translational research in esophageal cancer and non-small cell lung cancer (NSCLC) at National Taiwan University Hospital in Taiwan. PMID:27651941

  17. Translational research in thoracic surgery-the National Taiwan University Hospital experience.

    PubMed

    Lin, Mong-Wei; Yang, Pei-Wen; Lee, Jang-Ming

    2016-08-01

    Thoracic surgeons should be more aware of the latest information about histopathological, genetic and epigenetic alterations that may influence treatment policy and patient outcome in the biomolecular era. Translational research studies often produce a promising diagnostic tool or new treatment that can be used clinically. The results of these translational studies may even change the practical guidelines and current staging system in thoracic malignancies. The following article summarizes the experiences of translational research in esophageal cancer and non-small cell lung cancer (NSCLC) at National Taiwan University Hospital in Taiwan.

  18. Translational research in thoracic surgery-the National Taiwan University Hospital experience.

    PubMed

    Lin, Mong-Wei; Yang, Pei-Wen; Lee, Jang-Ming

    2016-08-01

    Thoracic surgeons should be more aware of the latest information about histopathological, genetic and epigenetic alterations that may influence treatment policy and patient outcome in the biomolecular era. Translational research studies often produce a promising diagnostic tool or new treatment that can be used clinically. The results of these translational studies may even change the practical guidelines and current staging system in thoracic malignancies. The following article summarizes the experiences of translational research in esophageal cancer and non-small cell lung cancer (NSCLC) at National Taiwan University Hospital in Taiwan. PMID:27651941

  19. [Does the National HIV /AIDS Control programme provide support for district hospitals in Cameroon?].

    PubMed

    Keugoung, Basile; Fotsing, Richard; Macq, Jean; Buve, Anne; Marchal, Bruno; Meli, Jean; Criel, Bart

    2015-01-01

    The aim of this study was to investigate the effects of the national HIV/AIDS control programme on district hospitals in Cameroon. A multiple case study was conducted in two district hospitals- one public and one faith-based. Data were collected by document review, semi-structured interviews and observation of managerial processes and health care delivery. Programme interventions result in a series of positive and negative effects on the functioning of district hospitals and local health systems. High input and support of staff skills were observed for antiretroviral therapy and the management of opportunistic infections. However, the impact of the programme on the stewardship function is problematic. The low implication of district management teams in the implementation of HIV /AIDS activities reduces their structural capacity to run the local health systems. Programme and health system managers failed to take advantage of opportunities to develop synergies between the HIV/AIDS programme and local health systems. The HIV/AIDS programme weakens the systemic and structural capacity of local health systems. Managers of both programmes and general health systems should analyse and adapt their interventions in order to effective' strengthen health systems. One of the research questions is to understand why health system stakeholders do not seize opportunities to develop synergies between programmes and the general system and to strengthen health systems.

  20. Biological aging and social characteristics: gerontology, the Baltimore city hospitals, and the National Institutes of Health.

    PubMed

    Park, Hyung Wook

    2013-01-01

    The intramural gerontological research program in the National Institutes of Health underwent a substantial growth after its creation within the precincts of the Baltimore City Hospitals in 1940. This paper analyzes its development and the associated problems of its early years. Gerontologists aimed at improving the social and economic life of the elderly through scientific research. With this aim in mind, they conducted various investigations using the indigent aged patients of the Baltimore City Hospitals. Yet the scientists of aging, who hoped to eliminate negative social factors that might bias their research and heighten the confusion between pathology and aging per se, eventually stopped using these patients in the hospital as human subjects. Instead they sought educated affluent subjects in order to eliminate the impact of poverty. By doing so, however, they introduced a new source of social bias to their work, especially within the novel project begun in 1958, the Baltimore Longitudinal Study of Aging. This article thus examines the context of the development of gerontologists' research by analyzing their agenda, institutional environment, and research subjects in the 1940s and the 1950s.

  1. Establishment of national laboratory standards in public and private hospital laboratories.

    PubMed

    Anjarani, Soghra; Safadel, Nooshafarin; Dahim, Parisa; Amini, Rana; Mahdavi, Saeed; Mirab Samiee, Siamak

    2013-01-01

    In September 2007 national standard manual was finalized and officially announced as the minimal quality requirements for all medical laboratories in the country. Apart from auditing laboratories, Reference Health Laboratory has performed benchmarking auditing of medical laboratory network (surveys) in provinces. 12(th) benchmarks performed in Tehran and Alborz provinces, Iran in 2010 in three stages. We tried to compare different processes, their quality and accordance with national standard measures between public and private hospital laboratories. The assessment tool was a standardized checklist consists of 164 questions. Analyzing process show although in most cases implementing the standard requirements are more prominent in private laboratories, there is still a long way to complete fulfillment of requirements, and it takes a lot of effort. Differences between laboratories in public and private sectors especially in laboratory personnel and management process are significant. Probably lack of motivation, plays a key role in obtaining less desirable results in laboratories in public sectors.

  2. Hospital costs of out-of-hospital cardiac arrest patients treated in intensive care; a single centre evaluation using the national tariff-based system

    PubMed Central

    Petrie, J; Easton, S; Naik, V; Lockie, C; Brett, S J; Stümpfle, R

    2015-01-01

    Objectives There is a scarcity of literature reporting hospital costs for treating out of hospital cardiac arrest (OOHCA) survivors, especially within the UK. This is essential for assessment of cost-effectiveness of interventions necessary to allow just allocation of resources within the National Health Service. We set out primarily to calculate costs stratified against hospital survival and neurological outcomes. Secondarily, we estimated cost effectiveness based on estimates of survival and utility from previous studies to calculate costs per quality adjusted life year (QALY). Setting We performed a single centre (London) retrospective review of in-hospital costs of patients admitted to the intensive care unit (ICU) following return of spontaneous circulation (ROSC) after OOHCA over 18 months from January 2011 (following widespread introduction of targeted temperature management and primary percutaneous intervention). Participants Of 69 successive patients admitted over an 18-month period, survival and cerebral performance category (CPC) outcomes were obtained from review of databases and clinical notes. The Trust finance department supplied ICU and hospital costs using the Payment by Results UK system. Results Of those patients with ROSC admitted to ICU, survival to hospital discharge (any CPC) was 33/69 (48%) with 26/33 survivors in CPC 1–2 at hospital discharge. Cost per survivor to hospital discharge (including total cost of survivors and non-survivors) was £50 000, cost per CPC 1–2 survivor was £65 000. Cost and length of stay of CPC 1–2 patients was considerably lower than CPC 3–4 patients. The majority of the costs (69%) related to intensive care. Estimated cost per CPC 1–2 survivor per QALY was £16 000. Conclusions The costs of in-hospital patient care for ICU admissions following ROSC after OOHCA are considerable but within a reasonable threshold when assessed from a QALY perspective. PMID:25838503

  3. 'Shell shock' revisited: an examination of the case records of the National Hospital in London.

    PubMed

    Linden, Stefanie Caroline; Jones, Edgar

    2014-10-01

    During the First World War the National Hospital for the Paralysed and Epileptic, in Queen Square, London, then Britain's leading centre for neurology, took a key role in the treatment and understanding of shell shock. This paper explores the case notes of all 462 servicemen who were admitted with functional neurological disorders between 1914 and 1919. Many of these were severe or chronic cases referred to the National Hospital because of its acknowledged expertise and the resources it could call upon. Biographical data was collected together with accounts of the patient's military experience, his symptoms, diagnostic interpretations and treatment outcomes. Analysis of the notes showed that motor syndromes (loss of function or hyperkinesias), often combined with somato-sensory loss, were common presentations. Anxiety and depression as well as vegetative symptoms such as sweating, dizziness and palpitations were also prevalent among this patient population. Conversely, psychogenic seizures were reported much less frequently than in comparable accounts from German tertiary referral centres. As the war unfolded the number of physicians who believed that shell shock was primarily an organic disorder fell as research failed to find a pathological basis for its symptoms. However, little agreement existed among the Queen Square doctors about the fundamental nature of the disorder and it was increasingly categorised as functional disorder or hysteria.

  4. Nation-wide prospective surveillance of Clostridium difficile infections in hospitals in Belgium, July 2007-June 2008.

    PubMed

    Lambert, M L; Mertens, K; Ramboer, I; Delmée, M; Suetens, C

    2009-01-01

    We report here baseline data from the first year of compulsory surveillance of Clostridium difficile infections (CDI) in hospitals in Belgium. Between 1 July 2007 and 30 June 2008, 2,704 CDI were reported: 12% were recurrent and 66% were hospital-associated (half of which occurred 15 days or more after admission). CDI was considered the cause of death (direct or indirect) for 10% of the episodes. The median incidence of CDI was 1.5 per 1,000 admissions and 1.9 per 10,000 hospital-days for all cases, and 0.9 per 1,000 admissions, and 1.1 per 10,000 hospital-days for hospital-associated cases. Further investigation of risk stratification by average length of stay in the reporting hospitals is warranted as a way to improve the comparability of indicators across hospitals and surveillance systems. In spite of methodological issues, the surveillance of CDI in Belgian hospitals has been able to produce robust baseline data that should allow monitoring of trends at hospital and national level, and provide a basis for international comparisons. Remaining challenges are to define and monitor targets for the control of CDI, and to improve the individual feed-back of data at hospital level. PMID:19371509

  5. Incidence of “never events” among weekend admissions versus weekday admissions to US hospitals: national analysis

    PubMed Central

    Attenello, Frank J; Cen, Steven Y; Ng, Alvin; Kim-Tenser, May; Sanossian, Nerses; Amar, Arun P; Mack, William J

    2015-01-01

    Objective To evaluate the association between weekend admission to hospital and 11 hospital acquired conditions recently considered by the Centers for Medicare and Medicaid as “never events” for which resulting healthcare costs are not reimbursed. Design National analysis. Setting US Nationwide Inpatient Sample discharge database. Participants 351 million patients discharged from US hospitals, 2002-10. Main outcome measures Univariate rates and multivariable likelihood of hospital acquired conditions among patients admitted on weekdays versus weekends, as well as the impacts of these events on prolonged length of stay and total inpatient charges. Results From 2002 to 2010, 351 170 803 patients were admitted to hospital, with 19% admitted on a weekend. Hospital acquired conditions occurred at an overall frequency of 4.1% (5.7% among weekend admissions versus 3.7% among weekday admissions). Adjusting for patient and hospital cofactors the probability of having one or more hospital acquired conditions was more than 20% higher in weekend admissions compared with weekday admissions (odds ratio 1.25, 95% confidence interval 1.24 to 1.26, P<0.01). Hospital acquired conditions have a negative impact on both hospital charges and length of stay. At least one hospital acquired condition was associated with an 83% (1.83, 1.77 to 1.90, P<0.01) likelihood of increased charges and 38% likelihood of prolonged length of stay (1.38, 1.36 to 1.41, P<0.01). Conclusion Weekend admission to hospital is associated with an increased likelihood of hospital acquired condition, cost, and length of stay. Future protocols and staffing regulations must be tailored to the requirements of this high risk subgroup. PMID:25876878

  6. Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

    PubMed

    Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

    2013-01-01

    The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease.

  7. Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

    PubMed

    Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

    2013-01-01

    The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease. PMID:24443075

  8. Awareness of, responsiveness to and practice of patients’ rights at Uganda's national referral hospital

    PubMed Central

    Kibuule, Dan; Mitonga-Kabwebwe, Honoré; Ekirapa-Kiracho, Elizabeth; Ssempebwa, John C.

    2013-01-01

    Abstract Background The realisation of patients’ rights in resource-constrained and patient-burdened public health care settings in Uganda remains an obstacle towards quality health care delivery, health care-seeking behaviour and health outcomes. Although the Uganda Patients’ Charter of 2009 empowers patients to demand quality care, inequitable access and abuse remain common. Aim The study aimed to assess level of awareness of, responsiveness to and practice of patients’ rights amongst patients and health workers (HWs) at Uganda's national referral hospital, Mulago Hospital in Kampala. Methods A three-phase cross-sectional questionnaire-based descriptive survey was conducted amongst 211 patients, 98 HWs and 16 key informants using qualitative and quantitative data collection methods. The study was conducted in May–June 2012, 2.5 years after the launch of the Uganda Patients’ Charter. Results At least 36.5% of patients faced a challenge regarding their rights whilst seeking health care. Most of the patients (79%) who met a challenge never attempted to demand their rights. Most patients (81.5%) and HWs (69.4%) had never heard of the Uganda Patients’ Charter. Awareness of patients’ rights was significantly higher amongst HWs (70%) than patients (40%) (p < 0.01). Patients’ awareness was associated with education level (χ2 = 42.4, p < 0.001), employment status (χ2 = 33.6, p < 0.001) and hospital visits (χ2 = 3.9, p = 0.048). For HWs it was associated with education level (χ2 = 155.6, p < 0.001) and length of service (χ2 = 154.5, p <0.001). Patients feel powerless to negotiate for their rights and fear being discriminated against based on their ability to bribe HWs with money to access care, and political, socio-economic and tribal status. Conclusion and recommendations Awareness of, responsiveness to and practice of patients’ rights remains limited at Mulago Hospital. There is a need for urgent implementation of an integrated multilevel

  9. Health-promoting organization and organizational effectiveness of health promotion in hospitals: a national cross-sectional survey in Taiwan.

    PubMed

    Lin, Yea-Wen; Lin, Yueh-Ysen

    2011-09-01

    To assess the organizational health-promotion (HP) status and its effect on the organizational effectiveness of HP in a national cross-sectional survey of all hospitals above the local community hospital level in Taiwan's hospitals, questionnaires were sent to 474 hospitals, of which 162 (34.18%) hospitals returned them and were rendered valid. The results of the organizational HP status reveal that the standardized overall score achieved is 76.26, suggesting that there is considerable room for improvement. The results of correlation analysis partially support the proposition of this study, suggesting that the higher the organizational HP status, the better the self-evaluated overall organizational and administrative effectiveness of its HP. When hierarchical multiple regression was performed, support for ownership (private hospitals), hospital accreditation grades (academic medical centers) and overall score of the Organizational Health of Hospital Assessment Scale were significant predicators of self-evaluated overall organizational effectiveness (F = 11.097, p < 0.01, R(2) = 0.369). Moreover, drafted annually, HP policies and plans and the number of staff HP training activities were found to partially mediate the relation between the organizational HP status, hospital characteristics and self-evaluated overall organizational effectiveness. The results contribute to clarify the conception of health-promoting hospital organizations and to identify a number of dimensions of health-promoting organizations related to the organizational effectiveness of HP in hospitals, which could allow hospitals to establish a healthier organization and more effective HP programs. This study also supplies the research field with important data and insights that can be used in future research.

  10. Public hospital quality report awareness: evidence from National and Californian Internet searches and social media mentions, 2012

    PubMed Central

    Huesch, Marco D; Currid-Halkett, Elizabeth; Doctor, Jason N

    2014-01-01

    Objectives Publicly available hospital quality reports seek to inform consumers of important healthcare quality and affordability attributes, and may inform consumer decision-making. To understand how much consumers search for such information online on one Internet search engine, whether they mention such information in social media and how positively they view this information. Setting and design A leading Internet search engine (Google) was the main focus of the study. Google Trends and Google Adwords keyword analyses were performed for national and Californian searches between 1 August 2012 and 31 July 2013 for keywords related to ‘top hospital’, best hospital’, and ‘hospital quality’, as well as for six specific hospital quality reports. Separately, a proprietary social media monitoring tool was used to investigate blog, forum, social media and traditional media mentions of, and sentiment towards, major public reports of hospital quality in California in 2012. Primary outcome measures (1) Counts of searches for keywords performed on Google; (2) counts of and (3) sentiment of mentions of public reports on social media. Results National Google search volume for 75 hospital quality-related terms averaged 610 700 searches per month with strong variation by keyword and by state. A commercial report (Healthgrades) was more commonly searched for nationally on Google than the federal government's Hospital Compare, which otherwise dominated quality-related search terms. Social media references in California to quality reports were generally few, and commercially produced hospital quality reports were more widely mentioned than state (Office of Statewide Healthcare Planning and Development (OSHPD)), or non-profit (CalHospitalCompare) reports. Conclusions Consumers are somewhat aware of hospital quality based on Internet search activity and social media disclosures. Public stakeholders may be able to broaden their quality dissemination initiatives by

  11. National Veterans Health Administration inpatient risk stratification models for hospital-acquired acute kidney injury

    PubMed Central

    Cronin, Robert M; VanHouten, Jacob P; Siew, Edward D; Eden, Svetlana K; Fihn, Stephan D; Nielson, Christopher D; Peterson, Josh F; Baker, Clifton R; Ikizler, T Alp; Speroff, Theodore

    2015-01-01

    Objective Hospital-acquired acute kidney injury (HA-AKI) is a potentially preventable cause of morbidity and mortality. Identifying high-risk patients prior to the onset of kidney injury is a key step towards AKI prevention. Materials and Methods A national retrospective cohort of 1,620,898 patient hospitalizations from 116 Veterans Affairs hospitals was assembled from electronic health record (EHR) data collected from 2003 to 2012. HA-AKI was defined at stage 1+, stage 2+, and dialysis. EHR-based predictors were identified through logistic regression, least absolute shrinkage and selection operator (lasso) regression, and random forests, and pair-wise comparisons between each were made. Calibration and discrimination metrics were calculated using 50 bootstrap iterations. In the final models, we report odds ratios, 95% confidence intervals, and importance rankings for predictor variables to evaluate their significance. Results The area under the receiver operating characteristic curve (AUC) for the different model outcomes ranged from 0.746 to 0.758 in stage 1+, 0.714 to 0.720 in stage 2+, and 0.823 to 0.825 in dialysis. Logistic regression had the best AUC in stage 1+ and dialysis. Random forests had the best AUC in stage 2+ but the least favorable calibration plots. Multiple risk factors were significant in our models, including some nonsteroidal anti-inflammatory drugs, blood pressure medications, antibiotics, and intravenous fluids given during the first 48 h of admission. Conclusions This study demonstrated that, although all the models tested had good discrimination, performance characteristics varied between methods, and the random forests models did not calibrate as well as the lasso or logistic regression models. In addition, novel modifiable risk factors were explored and found to be significant. PMID:26104740

  12. Biomaterials use in Mulago National Referral Hospital in Kampala, Uganda: Access and affordability.

    PubMed

    Bakwatanisa, Bosco; Enywaku, Alfred; Kiwanuka, Martin; Lamunu, Claire; Mbowa, Nicholas; Mukiibi, Denis; Namayega, Catherine; Ngabirano, Beryl; Ntambi, Henry; Reichert, William

    2016-01-01

    Students in Biomaterials BBE3102 at Makerere University in Kampala, Uganda were assigned semester long group projects in the first semester of the 2014-15 academic year to determine the biomaterials type and usage in Mulago National Referral Hospital, which is emblematic of large public hospitals across East Africa. Information gathering was conducted through student interviews with Mulago physicians because there were no archival records. The students divided themselves into seven project groups covering biomaterials use in the areas of wound closure, dental and oral surgery, cardiology, burn care, bone repair, ophthalmology and total joint replacement. As in the developed world, the majority of biomaterials used in Mulago are basic wound closure materials, dental materials, and bone fixation materials, all of which are comparatively inexpensive, easy to store, and readily available from either the government or local suppliers; however, there were significant issues with the implant supply chain, affordability, and patient compliance and follow-up in cases where specialty expertise and expensive implants were employed. PMID:26190587

  13. [From the medieval hospitals hospices to modern National public Health Institutes].

    PubMed

    de Micheli, Alfredo

    2016-01-01

    Since the most ancient times, hospital constructions and progresses in the clinical practice advanced pari passu. We can find exampless of this statement in Greek regions as well as in Greek citie overseas. Thus, during the renaissance, great figures ot that time converged in Italy: The genius Leonardo da Vinci (1452-1519) and Leon Battista Alberti (1404-1472), a humanist and innovator of architecture. Michelangelo Buonarroti (1475-1564) and his contemporany artists performed anatomical dissection to perfect their art by studying the human body. Anatomical studies flourished at the University of Padua, driven by the Flemish Master. Based on the rigorous study of the anatomical substrate, the studies on the function of the already known organic structures excelled in the xvii century. That century started with the revelation of the major blood circulation by the British physician William Harvey, alumni of the University of Padua, and continued with the description of the minior or pulmonary circulation by ancient or contemporany authors and of the peripheral connections between the arterial and the venous system (Marcelo Malpighi, 1661). All these researchers, and others, were membres of the University of Padua, were the beneficial influence of the teachings of Galileo persisted. In the following centuries, together with the embryological and normal anatomy, the pathological anatomy, systematized by G.B. Morgani, became the cornerstone of the clinical practice. The model of the ancient hospitals evolved to ward the National Institutes of Health in Mexico fostered by Dr. Ignacio Chávez. PMID:25862293

  14. [From the medieval hospitals hospices to modern National public Health Institutes].

    PubMed

    de Micheli, Alfredo

    2016-01-01

    Since the most ancient times, hospital constructions and progresses in the clinical practice advanced pari passu. We can find exampless of this statement in Greek regions as well as in Greek citie overseas. Thus, during the renaissance, great figures ot that time converged in Italy: The genius Leonardo da Vinci (1452-1519) and Leon Battista Alberti (1404-1472), a humanist and innovator of architecture. Michelangelo Buonarroti (1475-1564) and his contemporany artists performed anatomical dissection to perfect their art by studying the human body. Anatomical studies flourished at the University of Padua, driven by the Flemish Master. Based on the rigorous study of the anatomical substrate, the studies on the function of the already known organic structures excelled in the xvii century. That century started with the revelation of the major blood circulation by the British physician William Harvey, alumni of the University of Padua, and continued with the description of the minior or pulmonary circulation by ancient or contemporany authors and of the peripheral connections between the arterial and the venous system (Marcelo Malpighi, 1661). All these researchers, and others, were membres of the University of Padua, were the beneficial influence of the teachings of Galileo persisted. In the following centuries, together with the embryological and normal anatomy, the pathological anatomy, systematized by G.B. Morgani, became the cornerstone of the clinical practice. The model of the ancient hospitals evolved to ward the National Institutes of Health in Mexico fostered by Dr. Ignacio Chávez.

  15. High Survival Rates and Associated Factors Among Ebola Virus Disease Patients Hospitalized at Donka National Hospital, Conakry, Guinea

    PubMed Central

    Qureshi, Adnan I.; Chughtai, Morad; Bah, Elhadj Ibrahima; Barry, Moumié; Béavogui, Kézély; Loua, Tokpagnan Oscar; Malik, Ahmed A.

    2015-01-01

    Background Anecdotal reports suggesting that survival rates among hospitalized patients with Ebola virus disease in Guinea are higher than the 29.2% rate observed in the current epidemic in West Africa. Methods Survival after symptom onset was determined using Kaplan Meier survival methods among patients with confirmed Ebola virus disease treated in Conakry, Guinea from March 25, 2014, to August 5, 2014. We analyzed the relationship between survival and patient factors, including demographics and clinical features. Results Of the 70 patients analyzed [mean age ± standard deviation (SD), 34 ± 14.1; 44 were men], 42 were discharged alive with a survival rate among hospitalized patients of 60% (95% confidence interval, 41.5–78.5%). The survival rate was 28 (71.8%) among 39 patients under 34 years of age, and 14 (46.7%) among 30 patients aged 35 years or greater (p = 0.034). The rates of myalgia (3 of 42 versus 7 of 28, p = 0.036) and hiccups (1 of 42 versus 5 of 28, p = 0.023) were significantly lower among patients who survived. Conclusions Our results provide insights into a cohort of hospitalized patients with Ebola virus disease in whom survival is prominently higher than seen in other cohorts of hospitalized patients. PMID:25992182

  16. [Complicated chickenpox in a national pediatric Peruvian hospital, 2001-2011].

    PubMed

    Miranda-Choque, Edwin; Candela-Herrera, Jorge; Díaz-Pera, Javier; Farfán-Ramos, Sonia; Muñoz-Junes, Edith María; Escalante-Santivañez, Imelda Rita

    2013-03-01

    The objective of the study was to describe the clinical and epidemiological characteristics of complicated chickenpox cases seen at the National Institute of Children's Health (INSN, Spanish acronym) of Peru from 2001 to 2011. A case series was collected, including a total of 1,073 children with complicated chickenpox. The median age was 2.5 years (IQR 1.1-4.8 years), of which 578 (54%) were male. The most frequent complications were secondary skin and soft tissue infections with 768 cases (72%). 13 deaths (1.4%) were recorded. In conclusion, the hospitalizations due to complicated chickenpox in the INSN included mostly children under five, with a short stay and a low proportion of deaths most complications being related to secondary skin and soft tissue infections.

  17. Multiple sclerosis in Mexico: hospital cases at the National Institute of Neurology and Neurosurgery, Mexico City.

    PubMed

    Corona, T; Rodrigues, J L; Otero, E; Stopp, L

    1996-05-01

    The frequency and clinical features of multiple sclerosis (MS) at the National Institute of Neurology and Neurosurgery in Mexico City for the period spanning 1984-1993 is presented. Hospital records of patients with clinically diagnosed MS were selected, the frequency and cumulative frequency of this diagnosis were determined and demographic information and clinical features were recorded. It was found that 70% of the patients were women, 25% were professionals, and 95% were of mixed race. The clinical features of our patients and their neuroimages were consistent with those of MS patients in other populations. Importantly, we found that the frequency of MS has almost doubled over the last 10 years. The reason for this phenomenon is discussed as resulting from better health screening, the availability of nuclear magnetic resonance imaging, and the cultural, demographic and dietary changes that have occurred due to the rapid urbanization of our country.

  18. The Dutch Hospital Standardised Mortality Ratio (HSMR) method and cardiac surgery: benchmarking in a national cohort using hospital administration data versus a clinical database

    PubMed Central

    Siregar, S; Pouw, M E; Moons, K G M; Versteegh, M I M; Bots, M L; van der Graaf, Y; Kalkman, C J; van Herwerden, L A; Groenwold, R H H

    2014-01-01

    Objective To compare the accuracy of data from hospital administration databases and a national clinical cardiac surgery database and to compare the performance of the Dutch hospital standardised mortality ratio (HSMR) method and the logistic European System for Cardiac Operative Risk Evaluation, for the purpose of benchmarking of mortality across hospitals. Methods Information on all patients undergoing cardiac surgery between 1 January 2007 and 31 December 2010 in 10 centres was extracted from The Netherlands Association for Cardio-Thoracic Surgery database and the Hospital Discharge Registry. The number of cardiac surgery interventions was compared between both databases. The European System for Cardiac Operative Risk Evaluation and hospital standardised mortality ratio models were updated in the study population and compared using the C-statistic, calibration plots and the Brier-score. Results The number of cardiac surgery interventions performed could not be assessed using the administrative database as the intervention code was incorrect in 1.4–26.3%, depending on the type of intervention. In 7.3% no intervention code was registered. The updated administrative model was inferior to the updated clinical model with respect to discrimination (c-statistic of 0.77 vs 0.85, p<0.001) and calibration (Brier Score of 2.8% vs 2.6%, p<0.001, maximum score 3.0%). Two average performing hospitals according to the clinical model became outliers when benchmarking was performed using the administrative model. Conclusions In cardiac surgery, administrative data are less suitable than clinical data for the purpose of benchmarking. The use of either administrative or clinical risk-adjustment models can affect the outlier status of hospitals. Risk-adjustment models including procedure-specific clinical risk factors are recommended. PMID:24334377

  19. Time Trends in Hospital Admissions for Bronchiectasis: Analysis of the Spanish National Hospital Discharge Data (2004 to 2013)

    PubMed Central

    Sánchez-Muñoz, Gema; López de Andrés, Ana; Jiménez-García, Rodrigo; Carrasco-Garrido, Pilar; Hernández-Barrera, Valentín; Pedraza-Serrano, Fernando; Puente-Maestu, Luis; de Miguel-Díez, Javier

    2016-01-01

    Objective To analyze changes in the incidence, diagnostic procedures, comorbidity, length of hospital stay (LOHS), costs and in-hospital mortality (IHM) for patients with bronchiectasis who were hospitalized in Spain over a 10-year period. Methods We included all admissions for patients diagnosed with bronchiectasis as primary or secondary diagnosis during 2004–2013. Results 282,207 patients were admitted to the study. After controlling for possible confounders, we observed a significant increase in the incidence of hospitalizations over the study period when bronchiectasis was a secondary diagnosis. When bronchiectasis was the primary diagnosis we observed a significant decline in the incidence. In all cases, this pathology was more frequent in males, and the average age and comorbidity increased significantly during the study period (p<0.001). When bronchiectasis was the primary diagnosis, the most frequent secondary diagnosis was Pseudomonas aeruginosa infection. When bronchiectasis was the secondary diagnosis, the most frequent primary diagnosis was COPD. IHM was low, tending to decrease from 2004 to 2013 (p<0.05). The average LOHS decreased significantly during the study period in both cases (p<0.001). The mean cost per patient decreased in patients with bronchiectasis as primary diagnosis, but it increased for cases of bronchiectasis as secondary diagnosis (p<0.001). Conclusions Our results reveal an increase in the incidence of hospital admissions for patients with bronchiectasis as a secondary diagnosis from 2004 to 2013, as opposed to cases of bronchiectasis as the primary diagnosis. Although the average age and comorbidity significantly increased over time, both IHM and average LOHS significantly decreased. PMID:27622273

  20. 45 CFR 60.12 - Information which hospitals must request from the National Practitioner Data Bank.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... be requested. Each hospital, either directly or through an authorized agent, must request information... (courtesy or otherwise), or for clinical privileges at the hospital; and (2) Every 2 years concerning any...), or has clinical privileges at the hospital. (b) Failure to request information. Any hospital...

  1. 76 FR 11503 - National Offshore Safety Advisory Committee; Vacancies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-02

    ... environmental interests; and, (e) One person representing enterprises specializing in offshore drilling. To be... SECURITY Coast Guard National Offshore Safety Advisory Committee; Vacancies AGENCY: Coast Guard, DHS... National Offshore Safety Advisory Committee. This Committee advises the Coast Guard on matters...

  2. The relationship between healthy lifestyle and hospital utilization among adults with diabetes: results from a national cohort in Taiwan.

    PubMed

    Li, Chia-Lin; Sheu, Ji-Tian; Wang, Ting-Ann; Wen, Yu-Ping; Chao, Minston; Chang, Hsing-Yi

    2015-04-01

    The aim of this study was to investigate whether adopting healthy lifestyle habits, such as engaging in leisure time physical activity (LTPA), adopting recommended dietary patterns, and not smoking, are associated with reduced hospitalizations over 1 year among adults with diabetes. We analyzed data from a national sample of people aged 18 years and above with self-reported physician-diagnosed diabetes (n = 664) through linkage to the 2001 National Health Interview Survey in Taiwan and the 2002 National Health Insurance claims data. Multivariate analysis showed that participants reporting greater than 150 min/wk of moderate-intensity activity had a significantly lower chance for hospitalization (odds ratio = 0.52; 95% confidence interval [CI] = 0.27-0.98), fewer admissions (incidence rate ratio [IRR] = 0.58; 95% CI = 0.33-1.00), and fewer hospital bed days (IRR = 0.42; 95% CI = 0.20-0.92) compared with inactive individuals. Diet control and smoking status did not significantly predict hospital use after controlling for other factors. Our findings indicate that increased LTPA results in reduced hospitalization among adults with diabetes.

  3. 38 CFR 3.1605 - Death while traveling under prior authorization or while hospitalized by the Department of...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...; or (2) Members of the National Guard who reported to camp in answer to the President's call for World War I, World War II, or Korean service, but who when medically examined were not finally accepted for... hospitalized under section 5 of Executive Order 10122 (15 FR 2173; 3 CFR 1950 Supp.) issued pursuant to Pub....

  4. Acute pain services in Europe: a 17-nation survey of 105 hospitals. The EuroPain Acute Pain Working Party.

    PubMed

    Rawal, N; Allvin, R

    1998-05-01

    A 17-nation survey was undertaken with the aim of studying the availability of acute pain services (APS) and the use of newer analgesic techniques, such as epidural and patient-controlled analgesia (PCA). A questionnaire was mailed to selected anaesthesiologists in 105 European hospitals from 17 countries. Depending on the population, between five and ten representative hospitals from each country were selected by a country coordinator. A total of 101 (96.2%) completed questionnaires were returned. A majority of respondents were dissatisfied with pain management on surgical wards. Pain management was better in post-anaesthesia care units (PACUs); however, 27% of participating hospitals did not have PACUs. There were no organized APS in 64% of hospitals, although anaesthesiologists from chronic pain centres were available for consultation. In the hospitals that had APS, the responsible person for the APS was either: (1) a junior anaesthesiologist (senior anaesthesiologist available for consultation); or (2) a specially trained nurse (supervised by consultant anaesthesiologists). Many anaesthesiologists were unable to introduce techniques such as PCA on wards because of the high equipment costs. Although 40% of hospitals used a visual analogue scale (VAS) or other methods for assessment of pain intensity, routine pain assessment and documenting on a vital sign chart was rarely practised. There was a great variation in routines for opioid prescription and documentation procedures. Nursing regulations regarding injection of drugs into epidural and intrathecal catheters also varied considerably between countries. This survey of 105 hospitals from 17 European countries showed that over 50% of anaesthesiologists were dissatisfied with post-operative pain management on surgical wards. Only 34% of hospitals had an organized APS, and very few hospitals used quality assurance measures such as frequent pain assessment and documentation. There is a need to establish organized

  5. Hospital work and pregnancy outcomes: a study in the Danish National Birth Cohort.

    PubMed

    Suárez-Varela, María M Morales; Kaerlev, Linda; Zhu, Jin Liang; Bonde, Jens Peter; Nøhr, Ellen-Aagaard; Llopis-González, Agustín; Olsen, Jørn

    2009-01-01

    In hospitals, women of reproductive age do a range of work tasks, some of which are known to carry potential risks. Tasks such as working with radiation, chemicals, and infectious agents, as well as performing heavy lifting or tasks requiring erratic sleep patterns have been reported to increase the risk of reproductive failures. Our aim was to study pregnancy outcomes in female hospital workers in Denmark. We performed a cohort study of 5976 female hospital workers and used as a reference group 60,890 women employed outside of hospitals. The reproductive health of hospital workers working during pregnancy is comparable to those of non-hospital workers for the majority of reproductive failures studied. However, an increased prevalence of congenital abnormalities was noted in some subgroups of hospital workers, which may indicate that some hospital work still entails fetotoxic hazards. PMID:19886351

  6. Disability and Hospital Care Expenses among National Health Insurance Beneficiaries: Analyses of Population-Based Data in Taiwan

    ERIC Educational Resources Information Center

    Lin, Lan-Ping; Lee, Jiunn-Tay; Lin, Fu-Gong; Lin, Pei-Ying; Tang, Chi-Chieh; Chu, Cordia M.; Wu, Chia-Ling; Lin, Jin-Ding

    2011-01-01

    Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N = 937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM…

  7. The Implications of the National Minimum Wage for Training Practices and Skill Utilisation in the United Kingdom Hospitality Industry

    ERIC Educational Resources Information Center

    Norris, Gill; Williams, Steve; Adam-Smith, Derek

    2003-01-01

    Two key issues thrown up by the 1999 introduction of the National Minimum Wage (NMW) in the United Kingdom are its likely impact on employers' training practices in low paying sectors of the economy and the implications for skills. Based on a study of the hospitality industry, this article assesses the limited significance of the differential,…

  8. National Trends in Foot and Ankle Arthrodesis: 17-Year Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey.

    PubMed

    Best, Matthew J; Buller, Leonard T; Miranda, Alejandro

    2015-01-01

    Foot and ankle arthrodesis reliably reduces pain and functional disability among patients with arthritis and deformity. Since its introduction in 1953, improvements in surgical technique have enhanced the outcomes and reduced complications. However, little is known regarding US national trends of foot and ankle arthrodesis. The present study sought to use the most recently available Centers for Disease Control and Prevention data to investigate changes in the usage of inpatient and ambulatory foot and ankle arthrodesis. Cases of foot and ankle arthrodesis were identified using the National Hospital Discharge Survey and National Survey of Ambulatory Surgery, and the data were analyzed for trends in demographics, treatment, and usage. From 1994 to 2006, the population-adjusted rates of foot and ankle arthrodeses increased by 146% (8.2/100,000 capita to 20.2/100,000 capita). The number of outpatient arthrodeses performed with arthroscopic assistance increased by 858%. The population-adjusted rate of outpatient and inpatient procedures increased by 415% and 17%, respectively. The gender-adjusted rates increased by 59% for males and 209% for females. The age-adjusted rates increased among patients >35 years old in both settings. The use of peripheral nerve blocks during ambulatory procedures increased from 3.3% to 10.1%. Private insurance was the largest compensator. In conclusion, the rate of foot and ankle arthrodesis increased dramatically from 1990 to 2007 using the most up-to-date publicly available data. Knowledge of these national practice patterns could aid policy-makers and surgeons in appropriately allocating healthcare resources to ensure quality patient care. PMID:26213159

  9. National Trends in Foot and Ankle Arthrodesis: 17-Year Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey.

    PubMed

    Best, Matthew J; Buller, Leonard T; Miranda, Alejandro

    2015-01-01

    Foot and ankle arthrodesis reliably reduces pain and functional disability among patients with arthritis and deformity. Since its introduction in 1953, improvements in surgical technique have enhanced the outcomes and reduced complications. However, little is known regarding US national trends of foot and ankle arthrodesis. The present study sought to use the most recently available Centers for Disease Control and Prevention data to investigate changes in the usage of inpatient and ambulatory foot and ankle arthrodesis. Cases of foot and ankle arthrodesis were identified using the National Hospital Discharge Survey and National Survey of Ambulatory Surgery, and the data were analyzed for trends in demographics, treatment, and usage. From 1994 to 2006, the population-adjusted rates of foot and ankle arthrodeses increased by 146% (8.2/100,000 capita to 20.2/100,000 capita). The number of outpatient arthrodeses performed with arthroscopic assistance increased by 858%. The population-adjusted rate of outpatient and inpatient procedures increased by 415% and 17%, respectively. The gender-adjusted rates increased by 59% for males and 209% for females. The age-adjusted rates increased among patients >35 years old in both settings. The use of peripheral nerve blocks during ambulatory procedures increased from 3.3% to 10.1%. Private insurance was the largest compensator. In conclusion, the rate of foot and ankle arthrodesis increased dramatically from 1990 to 2007 using the most up-to-date publicly available data. Knowledge of these national practice patterns could aid policy-makers and surgeons in appropriately allocating healthcare resources to ensure quality patient care.

  10. A&M. Guard house (TAN638), contextual view. Built in 1968. Camera ...

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

    A&M. Guard house (TAN-638), contextual view. Built in 1968. Camera faces south. Guard house controlled access to radioactive waste storage tanks beyond and to left of view. Date: February 4, 2003. INEEL negative no. HD-33-4-1 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  11. Indications for percutaneous coronary interventions performed in U.S. Hospitals: a report from the National Cardiovascular Data Registry

    PubMed Central

    Cram, Peter; House, John A.; Messenger, John; Piana, Robert N.; Horwitz, Phillip A; Spertus, John A.

    2011-01-01

    Background There are many factors hypothesized as contributing to overuse of percutaneous coronary intervention (PCI) in the United States (U.S.), including financial ties between physicians and hospitals, but empirical data are lacking. We examined PCI indications in not-for-profit (NFP), major teaching, for-profit (FP) and physician-owned specialty hospitals. Methods A retrospective cohort study of 1,113,554 patients who underwent PCI in 694 hospitals (NFP=471, teaching=131, FP=79, specialty=13) participating in the National Cardiovascular Data Registry® (NCDR®) CathPCI Registry® between January 1, 2004 and December 31, 2007. PCI indications derived from American College of Cardiology (ACC) Guidelines were classified as: survival benefit (patients with primary reperfusion for STEMI); potential quality of life (QOL) benefit (patients with NSTEMI, ACS, positive stress test, or chest pain); or unclear indications (patients receiving PCI without an obvious potential survival or QOL benefit). Results The percentage of PCI performed for unclear indications was somewhat higher for specialty hospitals (5.1% of all procedures) as compared with other hospital categories (FP 4.7%, NFP 4.2%, teaching 4.5%; P<0.001). Overall, 17% of hospitals had 20% or more of their total PCI procedures performed for unclear indications but the proportion of FP, NFP, teaching, and specialty hospitals reaching this threshold was not statistically different (20%, 16%, 17% and 15% respectively; P=.84). Conclusions A small proportion of PCI procedures were performed in patients with unclear indications, but there was wide variation across hospitals. On average, specialty hospitals performed more PCIs for unclear indications. Efforts to reduce variability should be pursued. PMID:22305839

  12. Implementation Issues of Virtual Desktop Infrastructure and Its Case Study for a Physician's Round at Seoul National University Bundang Hospital

    PubMed Central

    Yoo, Sooyoung; Kim, Seok; Kim, Taegi; Kim, Jon Soo; Baek, Rong-Min; Suh, Chang Suk; Chung, Chin Youb

    2012-01-01

    Objectives The cloud computing-based virtual desktop infrastructure (VDI) allows access to computing environments with no limitations in terms of time or place such that it can permit the rapid establishment of a mobile hospital environment. The objective of this study was to investigate the empirical issues to be considered when establishing a virtual mobile environment using VDI technology in a hospital setting and to examine the utility of the technology with an Apple iPad during a physician's rounds as a case study. Methods Empirical implementation issues were derived from a 910-bed tertiary national university hospital that recently launched a VDI system. During the physicians' rounds, we surveyed patient satisfaction levels with the VDI-based mobile consultation service with the iPad and the relationship between these levels of satisfaction and hospital revisits, hospital recommendations, and the hospital brand image. Thirty-five inpatients (including their next-of-kin) and seven physicians participated in the survey. Results Implementation issues pertaining to the VDI system arose with regard to the highly availability system architecture, wireless network infrastructure, and screen resolution of the system. Other issues were related to privacy and security, mobile device management, and user education. When the system was used in rounds, patients and their next-of-kin expressed high satisfaction levels, and a positive relationship was noted as regards patients' decisions to revisit the hospital and whether the use of the VDI system improved the brand image of the hospital. Conclusions Mobile hospital environments have the potential to benefit both physicians and patients. The issues related to the implementation of VDI system discussed here should be examined in advance for its successful adoption and implementation. PMID:23346476

  13. A national study of the efficiency of hospitals in urban markets.

    PubMed Central

    Ozcan, Y A; Luke, R D

    1993-01-01

    Using a sample of 3,000 urban hospitals, this article examines the contributions of selected hospital characteristics to variations in hospital technical efficiencies, while it accounts for multiple products and inputs, and controls for local environmental variations. Four hospital characteristics are examined: hospital size, membership in a multihospital system, ownership, and payer mix (managed care contracts, percent Medicare, and percent Medicaid). Ownership and percent Medicare are consistently found to be related significantly to hospital efficiency. Within the ownership variable, government hospitals tend to be more efficient and for-profit hospitals less efficient than other hospitals. Higher percentages of Medicare payment are negatively related to efficiency. While not consistently significant across all five of the MSA size categories in which the analyses are conducted, possession of managed care contracts, membership in a multihospital system, and size all are consistently related positively to hospital technical efficiency. These variables are also all significant when the hospitals are examined in a combined analysis. Percent Medicaid was not significant in any of the analyses. Implications for policy and the need for methodological work are discussed. PMID:8428810

  14. [Scorpion envenomation treated in the Infectious and Tropical Diseases at the Donka National Hospital, Guinea].

    PubMed

    Sako, F B; Bangoura, E F; Traoré, F A; Soumah, M M; Tounkara, T M; Djessanglar, R; Baldé, H; Baldé, O

    2014-12-01

    A retrospective descriptive study was conducted from 1(st) October 2010 to 30 November 2012 on the records of patients admitted for scorpion envenomation in the Department of Infectious and Tropical Diseases at the Donka National Hospital. The objective of this study is to describe the epidemiological profile and clinical characteristics of scorpion envenomation in Maritime Guinea, from scorpion stings recently covered in this service. We collected 75 cases of scorpion envenomation. The median age was 21.5 with interquartile 8 and 20 and sex ratio was 1.29. The upper limbs were involved in 55% of cases, followed by the lower limbs (35%), trunk (6%), head and neck (4%). We observed 63% of patients with local signs, 30% mild and general clinical signs of 7% severe systemic symptoms. All patients received an analgesic and a heterologous antitoxin, associated with an antibiotic (87% of patients), a corticosteroid (72%), diazepam (13%) and furosemide (34.6%). The incidence of scorpion envenomation is not negligible despite underreporting of cases, most often treated in traditional medicine.

  15. [Scorpion envenomation treated in the Infectious and Tropical Diseases at the Donka National Hospital, Guinea].

    PubMed

    Sako, F B; Bangoura, E F; Traoré, F A; Soumah, M M; Tounkara, T M; Djessanglar, R; Baldé, H; Baldé, O

    2014-12-01

    A retrospective descriptive study was conducted from 1(st) October 2010 to 30 November 2012 on the records of patients admitted for scorpion envenomation in the Department of Infectious and Tropical Diseases at the Donka National Hospital. The objective of this study is to describe the epidemiological profile and clinical characteristics of scorpion envenomation in Maritime Guinea, from scorpion stings recently covered in this service. We collected 75 cases of scorpion envenomation. The median age was 21.5 with interquartile 8 and 20 and sex ratio was 1.29. The upper limbs were involved in 55% of cases, followed by the lower limbs (35%), trunk (6%), head and neck (4%). We observed 63% of patients with local signs, 30% mild and general clinical signs of 7% severe systemic symptoms. All patients received an analgesic and a heterologous antitoxin, associated with an antibiotic (87% of patients), a corticosteroid (72%), diazepam (13%) and furosemide (34.6%). The incidence of scorpion envenomation is not negligible despite underreporting of cases, most often treated in traditional medicine. PMID:25158841

  16. Posttransfusion Haematocrit Equilibration: Timing Posttransfusion Haematocrit Check in Neonates at the National Hospital, Abuja, Nigeria

    PubMed Central

    Audu, L. I.; Otuneye, A. T.; Mairami, A. B.; Mshelia, L. J.; Nwatah, V. E.

    2015-01-01

    Anaemia is a common morbidity in the NICU and often requires transfusion of packed red blood cells. Haematocrit equilibration following red cell transfusion occurs over time ultimately resulting in a stable packed cell volume (PCV). Knowledge of this equilibration process is pertinent in the accurate timing of posttransfusion (PT) PCV. We conducted a prospective study to determine an appropriate timing for PT PCV estimation on 47 stable anaemic babies at the Neonatal Unit of National Hospital, Abuja. Values of PCV were determined before transfusion and at 1, 6, 12, 24, and 48 hours posttransfusion. Forty of the recruited neonates and young infants were analyzed. Their gestational age range was 26 to 40 weeks. 1-hour PT PCV (48.5% ± 5.5%) was similar to the 6-hour PT PCV (47.8% ± 5.6%) P = 0.516, but both were significantly different from the 12-hour (46.8% ± 5.9%), 24-hour (45.9 ± 5.8%), and 48-hour (45.4% ± 6.2%) PT PCVs. The 12-hour PT PCV was similar to the 24-hour and 48-hour PT PCVs (P = 0.237 and 0.063, resp.). We concluded that, in stable nonhaemorrhaging and nonhaemolysing young infants, the estimated timing of haematocrit equilibration and, consequently, posttransfusion PCV is 12 hours after red blood cell transfusion. PMID:25861284

  17. 1. General view of guard house and entrance to Coast ...

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

    1. General view of guard house and entrance to Coast Guard Base from La Putilla Street, looking southwest - U.S. Coast Guard Base, San Juan, Guard House, La Puntilla Finalle, San Juan, San Juan Municipio, PR

  18. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...; screening mammography services; critical access hospitals; or clinic, rehabilitation agency, or public health agency providers of outpatient physical therapy, occupational therapy or speech pathology...

  19. Best practices of hospital security planning for patient surge--a comparative analysis of three national systems.

    PubMed

    Downey, Erin; Hebert, Anjanette

    2010-01-01

    This paper examines three international healthcare security systems as they relate to patient surge in Canada, Israel, and the United States. Its purpose is to compare the systems, to highlight unique characteristics that define those systems, and to initiate the development of best practices that transcend national boundaries. Several significant national characteristics of demographics, healthcare systems, and political climate, among others, present challenges to translating best practices among these three countries. However, we have found that best practice strategies exist in areas of communications, coordination, building design, space adaptability, and patient routing (both from the community to the hospital, as well as within the hospital) that can be shared and incorporated into the healthcare preparedness efforts in all three countries. PMID:20873500

  20. US Coast Guard organization for response to oil and hazardous chemical discharges

    SciTech Connect

    Yaroch, G.N.

    1980-01-01

    The authority, organization, responsibilities and marine pollution prevention and control activities of the US Coast Guard and its National Response Team, Regional Response Teams, and Emergency Port Task Forces are discussed.

  1. IET. Exclusion guard house, 71.8% complete. Camera facing northerly. Pumice ...

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

    IET. Exclusion guard house, 71.8% complete. Camera facing northerly. Pumice block walls, canopy over concrete slabs. Date: October 20, 1954. INEEL negative no. 12541 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  2. Horizontal and vertical integration-diversification in rural hospitals: a national study of strategic activity, 1983-1988.

    PubMed

    Mick, S S; Morlock, L L; Salkever, D; de Lissovoy, G; Malitz, F E; Wise, C G; Jones, A S

    1993-01-01

    This study examines both the magnitude of and factors influencing the adoption of 13 horizontal and vertical integration and diversification strategies in a national sample of 797 U.S. rural hospitals during the period 1983-1988. Using organization theory, hypotheses were posed relating environmental and market factors, geographic location, and hospital characteristics to the adoption of horizontal and vertical integration and diversification. Results indicate that only one of 13 strategies was adopted by more than 50 percent of all rural hospitals during the study period, and that most of the directional hypotheses were not confirmed using Cox's proportional hazards models. In particular, environmental and market factors were unrelated to the strategies studied. Issues of methodology and theory are discussed; however, during an historically turbulent period, both relatively low levels of rural hospital strategic activities and lack of predictive power of the theory suggest caution in relying heavily on a policy for rural hospital survival that is dependent on individual market-oriented strategic behavior.

  3. Framing in policy processes: a case study from hospital planning in the National Health Service in England.

    PubMed

    Jones, Lorelei; Exworthy, Mark

    2015-01-01

    This paper reports from an ethnographic study of hospital planning in England undertaken between 2006 and 2009. We explored how a policy to centralise hospital services was espoused in national policy documents, how this shifted over time and how it was translated in practice. We found that policy texts defined hospital planning as a clinical issue and framed decisions to close hospitals or hospital departments as based on the evidence and necessary to ensure safety. We interpreted this framing as a rhetorical strategy for implementing organisational change in the context of community resistance to service closure and a concomitant policy emphasising the importance of public and patient involvement in planning. Although the persuasive power of the framing was limited, a more insidious form of power was identified in the way the framing disguised the political nature of the issue by defining it as a clinical problem. We conclude by discussing how the clinical rationale constrains public participation in decisions about the delivery and organisation of healthcare and restricts the extent to which alternative courses of action can be considered.

  4. Framing in policy processes: a case study from hospital planning in the National Health Service in England.

    PubMed

    Jones, Lorelei; Exworthy, Mark

    2015-01-01

    This paper reports from an ethnographic study of hospital planning in England undertaken between 2006 and 2009. We explored how a policy to centralise hospital services was espoused in national policy documents, how this shifted over time and how it was translated in practice. We found that policy texts defined hospital planning as a clinical issue and framed decisions to close hospitals or hospital departments as based on the evidence and necessary to ensure safety. We interpreted this framing as a rhetorical strategy for implementing organisational change in the context of community resistance to service closure and a concomitant policy emphasising the importance of public and patient involvement in planning. Although the persuasive power of the framing was limited, a more insidious form of power was identified in the way the framing disguised the political nature of the issue by defining it as a clinical problem. We conclude by discussing how the clinical rationale constrains public participation in decisions about the delivery and organisation of healthcare and restricts the extent to which alternative courses of action can be considered. PMID:25461877

  5. Treatment concepts of day hospitals for general psychiatric patients. Findings from a national survey in Germany.

    PubMed

    Seidler, Klaus-Peter; Garlipp, Petra; Machleidt, Wielant; Haltenhof, Horst

    2006-03-01

    Psychiatric day hospital treatment concepts have to deal with a wide spectrum of mental disorders. We raised the question, if day hospitals can be differentiated concerning their treatment concepts and if so how much this is reflected in their structural and procedural features. In 1999 a survey was initiated concerning structure, concept and method of treatment in psychiatric day hospitals for adults in Germany. Furthermore data concerning rate of utilization, patients' characteristics and aspects of referral and further treatment were ascertained. One hundred and seventy-three (63.4%) of 273-day hospitals contacted took part in the inquiry. The data were interpreted using multivariate as well as non-parametric procedures. The results show that treatment concepts of day hospitals can be specified as three main areas of function (psychotherapy, crisis intervention orientated treatment alternative, rehabilitation) and four therapeutic orientations (psychodynamic social psychiatric, behavioral social psychiatric, psychodynamic, sociotherapeutic). Structural features are predominantly comparable and the differences found concerning the treatment concepts are especially related to patients' characteristics and some procedural features. The conclusion is that the differentiation of day hospital treatment concepts should be taken into consideration in planning psychosocial treatment services as well as in day hospital evaluation research.

  6. Athletic mouth guards--one town's approach.

    PubMed

    Johnson, D W; Parker, B J

    1993-04-01

    A program to produce inexpensive, custom mouth guards for high school basketball players was implemented by teams of dentists who took impressions, fabricated and then delivered the mouth guards. This community service involved three hours of donated time; the player or school was charged $7.50 for materials per mouth guard. The potential reduction of dental related injuries is immeasurable, and it is hoped that other cities will adopt a similar program.

  7. Roles of sucrose in guard cell regulation.

    PubMed

    Daloso, Danilo M; Dos Anjos, Leticia; Fernie, Alisdair R

    2016-08-01

    The control of stomatal aperture involves reversible changes in the concentration of osmolytes in guard cells. Sucrose has long been proposed to have an osmolytic role in guard cells. However, direct evidence for such a role is lacking. Furthermore, recent evidence suggests that sucrose may perform additional roles in guard cells. Here, we provide an update covering the multiple roles of sucrose in guard cell regulation, highlighting the knowledge accumulated regarding spatiotemporal differences in the synthesis, accumulation, and degradation of sucrose as well as reviewing the role of sucrose as a metabolic connector between mesophyll and guard cells. Analysis of transcriptomic data from previous studies reveals that several genes encoding sucrose and hexose transporters and genes involved in gluconeogenesis, sucrose and trehalose metabolism are highly expressed in guard cells compared with mesophyll cells. Interestingly, this analysis also showed that guard cells have considerably higher expression of C4 -marker genes than mesophyll cells. We discuss the possible roles of these genes in guard cell function and the role of sucrose in stomatal opening and closure. Finally, we provide a perspective for future experiments which are required to fill gaps in our understanding of both guard cell metabolism and stomatal regulation.

  8. Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals

    PubMed Central

    Griffiths, Peter; Sloane, Douglas M; Rafferty, Anne Marie; Ball, Jane E; Aiken, Linda H

    2015-01-01

    Objectives To examine whether patient satisfaction with nursing care in National Health Service (NHS) hospitals in England is associated with the proportion of non-UK educated nurses providing care. Design Cross-sectional analysis using data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. Logistic regression models with corrections for clustering were used to determine whether the proportions of non-UK educated nurses were significantly related to patient satisfaction before and after taking account of other hospital, nursing and patient characteristics. Setting 31 English NHS trusts. Participants 12 506 patients 16 years of age and older with at least one overnight stay that completed a satisfaction survey; 2962 bedside care nurses who completed a nurse survey; and 31 NHS trusts. Main outcome measure Patient satisfaction. Results The percentage of non-UK educated nurses providing bedside hospital care, which ranged from 1% to 52% of nurses, was significantly associated with patient satisfaction. After controlling for potential confounding factors, each 10-point increase in the percentage of non-UK educated nurses diminished the odds of patients reporting good or excellent care by 12% (OR=0.88), and decreased the odds of patients agreeing that they always had confidence and trust in nurses by 13% (OR=0.87). Other indicators of patient satisfaction also revealed lower satisfaction in hospitals with higher percentages of non-UK educated nurses. Conclusions Use of non-UK educated nurses in English NHS hospitals is associated with lower patient satisfaction. Importing nurses from abroad to substitute for domestically educated nurses may negatively impact quality of care. PMID:26634400

  9. Systems Engineering of Coast Guard Aviator Training.

    ERIC Educational Resources Information Center

    Hall, Eugene R.; Caro, Paul W.

    This paper describes a total-program application of the systems engineering concept of the U.S. Coast Guard aviation training programs. The systems approach used treats all aspects of the training to produce the most cost-effective integration of academic, synthetic, and flight training for the production of graduate Coast Guard aviators. The…

  10. 30 CFR 57.10006 - Tower guards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tower guards. 57.10006 Section 57.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Aerial Tramways § 57.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  11. 30 CFR 56.10006 - Tower guards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tower guards. 56.10006 Section 56.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Aerial Tramways § 56.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  12. 30 CFR 56.10006 - Tower guards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tower guards. 56.10006 Section 56.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Aerial Tramways § 56.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  13. 30 CFR 57.10006 - Tower guards.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Tower guards. 57.10006 Section 57.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Aerial Tramways § 57.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  14. 30 CFR 57.10006 - Tower guards.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Tower guards. 57.10006 Section 57.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Aerial Tramways § 57.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  15. 30 CFR 56.10006 - Tower guards.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Tower guards. 56.10006 Section 56.10006 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Aerial Tramways § 56.10006 Tower guards. Towers shall be suitably protected from swaying buckets....

  16. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... lower guard may be removed only when the saw is used for bevel cuts; (2) Radial saws used for ripping... be used. (h) Rotating parts, drives and connections. (1) Rotating parts, such as gears and pulleys... coming into contact with moving parts. (3) Gears, sprockets and chains shall be guarded to...

  17. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... lower guard may be removed only when the saw is used for bevel cuts; (2) Radial saws used for ripping... be used. (h) Rotating parts, drives and connections. (1) Rotating parts, such as gears and pulleys... coming into contact with moving parts. (3) Gears, sprockets and chains shall be guarded to...

  18. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... lower guard may be removed only when the saw is used for bevel cuts; (2) Radial saws used for ripping... be used. (h) Rotating parts, drives and connections. (1) Rotating parts, such as gears and pulleys... coming into contact with moving parts. (3) Gears, sprockets and chains shall be guarded to...

  19. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... lower guard may be removed only when the saw is used for bevel cuts; (2) Radial saws used for ripping... be used. (h) Rotating parts, drives and connections. (1) Rotating parts, such as gears and pulleys... coming into contact with moving parts. (3) Gears, sprockets and chains shall be guarded to...

  20. 29 CFR 1917.151 - Machine guarding.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... lower guard may be removed only when the saw is used for bevel cuts; (2) Radial saws used for ripping... be used. (h) Rotating parts, drives and connections. (1) Rotating parts, such as gears and pulleys... coming into contact with moving parts. (3) Gears, sprockets and chains shall be guarded to...

  1. Epidemiology of Endometriosis in France: A Large, Nation-Wide Study Based on Hospital Discharge Data.

    PubMed

    von Theobald, Peter; Cottenet, Jonathan; Iacobelli, Silvia; Quantin, Catherine

    2016-01-01

    We aimed to assess the prevalence of hospitalization for endometriosis in the general population in France and in each French region and to describe temporal trends, rehospitalization rates, and prevalence of the different types of endometriosis. The analyses were carried out on French hospital discharge data and covered the period 2008-2012 and a population of 14,239,197 women of childbearing age. In this population, the prevalence of hospitalization for endometriosis was 0.9%, ranging from 0.4% to 1.6% between regions. Endometriosis affected 1.5% of hospitalized women of childbearing age, ranging from 1.0% to 2.4% between regions. The number of patients hospitalized for endometriosis significantly increased over the study period (p < 0.01). Of these, 4.2% were rehospitalized at least once at one year: ranging from 2.7% to 6.3% between regions. The cumulative rehospitalization rate at 3 years was 6.9%. The types of endometriosis according to the procedures performed were as follows: ovarian (40-50%), peritoneal (20-30%), intestinal (10-20%), and ureteral or bladder (<10%), with significant differences between regions. This is the first detailed epidemiological study of endometriosis in France. Further studies are needed to assess the reasons for the increasing prevalence of endometriosis and for the significant differences in regional prevalence of this disease.

  2. Epidemiology of Endometriosis in France: A Large, Nation-Wide Study Based on Hospital Discharge Data

    PubMed Central

    von Theobald, Peter; Cottenet, Jonathan; Iacobelli, Silvia; Quantin, Catherine

    2016-01-01

    We aimed to assess the prevalence of hospitalization for endometriosis in the general population in France and in each French region and to describe temporal trends, rehospitalization rates, and prevalence of the different types of endometriosis. The analyses were carried out on French hospital discharge data and covered the period 2008–2012 and a population of 14,239,197 women of childbearing age. In this population, the prevalence of hospitalization for endometriosis was 0.9%, ranging from 0.4% to 1.6% between regions. Endometriosis affected 1.5% of hospitalized women of childbearing age, ranging from 1.0% to 2.4% between regions. The number of patients hospitalized for endometriosis significantly increased over the study period (p < 0.01). Of these, 4.2% were rehospitalized at least once at one year: ranging from 2.7% to 6.3% between regions. The cumulative rehospitalization rate at 3 years was 6.9%. The types of endometriosis according to the procedures performed were as follows: ovarian (40–50%), peritoneal (20–30%), intestinal (10–20%), and ureteral or bladder (<10%), with significant differences between regions. This is the first detailed epidemiological study of endometriosis in France. Further studies are needed to assess the reasons for the increasing prevalence of endometriosis and for the significant differences in regional prevalence of this disease. PMID:27148550

  3. Life of a partnership: the process of collaboration between the National Tuberculosis Program and the hospitals in Yogyakarta, Indonesia.

    PubMed

    Probandari, Ari; Utarini, Adi; Lindholm, Lars; Hurtig, Anna-Karin

    2011-11-01

    Public-private partnerships (PPP) for improving the health of populations are currently attracting attention in many countries with limited resources. The Public-Private Mix for Tuberculosis Control is an example of an internationally supported PPP that aims to engage all providers, including hospitals, to implement standardized diagnosis and treatment. This paper explores mainly the local actors' views and experiences of the process of PPP in delivering TB care in hospitals in Yogyakarta Province, Indonesia. The study used a qualitative research design. By maximum variation sampling, 33 informants were purposefully selected. The informants were involved in the Public-Private Mix for Tuberculosis Control in Yogyakarta Province. Data were collected during 2008-2009 by in-depth interview and analyzed using content analysis techniques. Triangulation, reference group checking and peer debriefing were conducted to improve the trustworthiness of the data. This analysis showed that the process of partnership was dynamic. In the early phase of partnership, the National Tuberculosis Program and hospital actors perceived barriers to interaction such as low enthusiasm, lack of confidence, mistrust and inequality of relationships. The existence of an intermediary actor was important for approaching the National Tuberculosis Program and hospitals. After intensive interactions, compromises and acceptance were reached among the actors and even enabled the growth of mutual respect and feelings of programme ownership. However, the partnership faced declining interactions when faced with scarce resources and weak governance. The strategies, power and interactions between actors are important aspects of the process of collaboration. We conclude that good partnership governance is needed for the partnership to be effective and sustainable. PMID:21940084

  4. The development of a national surveillance system for monitoring blood use and inventory levels at sentinel hospitals in South Korea.

    PubMed

    Lim, Y A; Kim, H H; Joung, U S; Kim, C Y; Shin, Y H; Lee, S W; Kim, H J

    2010-04-01

    We developed a web-based program for a national surveillance system to determine baseline data regarding the supply and demand of blood products at sentinel hospitals in South Korea. Sentinel hospitals were invited to participate in a 1-month pilot-test. The data for receipts and exports of blood from each hospital information system were converted into comma-separated value files according to a specific conversion rule. The daily data from the sites could be transferred to the web-based program server using a semi-automated submission procedure: pressing a key allowed the program to automatically compute the blood inventory level as well as other indices including the minimal inventory ratio (MIR), ideal inventory ratio (IIR), supply index (SI) and utilisation index (UI). The national surveillance system was referred to as the Korean Blood Inventory Monitoring System (KBIMS) and the web-based program for KBIMS was referred to as the Blood Inventory Monitoring System (BMS). A total of 30 256 red blood cell (RBC) units were submitted as receipt data, however, only 83% of the receipt data were submitted to the BMS server as export data (25 093 RBC units). Median values were 2.67 for MIR, 1.08 for IIR, 1.00 for SI, 0.88 for UI and 5.33 for the ideal inventory day. The BMS program was easy to use and is expected to provide a useful tool for monitoring hospital inventory levels. This information will provide baseline data regarding the supply and demand of blood products in South Korea. PMID:20015060

  5. Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); establishment of national differentials for children's hospitals--DoD. Notice.

    PubMed

    1995-04-28

    The Office of the Civilian Health and Medical Program of the Uniformed Services (OCHAMPUS) is announcing the national differential rates for children's hospitals which go into effect April 1, 1995. This notice is issued as required in 32 CFR 199.14 in which OCHAMPUS announced that a notice would be published setting forth the national differential and eliminating the hospital-specific differentials. PMID:10142479

  6. 76 FR 30575 - Eleventh Coast Guard District Annual Marine Events

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ... SECURITY Coast Guard 33 CFR Part 100 RIN 1625-AA08 Eleventh Coast Guard District Annual Marine Events AGENCY: Coast Guard, DHS. ACTION: Supplemental notice of proposed rulemaking. SUMMARY: The Coast Guard... regulated area. DATES: Comments and related material must be received by the Coast Guard on or before...

  7. 76 FR 53329 - Eleventh Coast Guard District Annual Marine Events

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ... SECURITY Coast Guard 33 CFR Part 100 RIN 1625-AA08 Eleventh Coast Guard District Annual Marine Events AGENCY: Coast Guard, DHS. ACTION: Final rule. SUMMARY: The Coast Guard is updating and consolidating the list of marine events occurring annually within the Eleventh Coast Guard District. These...

  8. 33 CFR 23.15 - Coast Guard ensign.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Coast Guard ensign. 23.15 Section 23.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.15 Coast Guard ensign. The Coast Guard...

  9. 75 FR 79956 - Protection for Whistleblowers in the Coast Guard

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-21

    ... SECURITY Coast Guard 33 CFR Part 53 RIN 1625-AB33 Protection for Whistleblowers in the Coast Guard AGENCY: Coast Guard, DHS. ACTION: Direct final rule; request for comments. SUMMARY: By this direct final rule, the Coast Guard is amending its ``Coast Guard Whistleblower Protection'' regulations to conform...

  10. 33 CFR 23.15 - Coast Guard ensign.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Coast Guard ensign. 23.15 Section 23.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.15 Coast Guard ensign. The Coast Guard...

  11. 78 FR 74048 - Eleventh Coast Guard District Annual Fireworks Events

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-10

    ... SECURITY Coast Guard 33 CFR Part 165 RIN 1625-AA00 Eleventh Coast Guard District Annual Fireworks Events AGENCY: Coast Guard, DHS. ACTION: Notice of proposed rulemaking. SUMMARY: The Coast Guard proposes to amend several permanent safety zones located in the Eleventh Coast Guard District that are...

  12. 33 CFR 23.15 - Coast Guard ensign.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Coast Guard ensign. 23.15 Section 23.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.15 Coast Guard ensign. The Coast Guard...

  13. 33 CFR 23.15 - Coast Guard ensign.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Coast Guard ensign. 23.15 Section 23.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.15 Coast Guard ensign. The Coast Guard...

  14. 33 CFR 23.15 - Coast Guard ensign.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Coast Guard ensign. 23.15 Section 23.15 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.15 Coast Guard ensign. The Coast Guard...

  15. Hospital contacts with infection and risk of schizophrenia: a population-based cohort study with linkage of Danish national registers.

    PubMed

    Nielsen, Philip R; Benros, Michael E; Mortensen, Preben B

    2014-11-01

    Infections and immune responses have been suggested to play an important role in the etiology of schizophrenia. Several studies have reported associations between maternal infections during pregnancy and the child's risk of schizophrenia; however, infection during childhood and adolescence unrelated to maternal infection during pregnancy has not been studied to nearly the same extent and the results are far from conclusive. Data were drawn from 2 population-based registers, the Danish Psychiatric Central Register and the Danish National Hospital Register. We used a historical population-based cohort design and selected all individuals born in Denmark between 1981 and 1996 (n = 843 390). We identified all individuals with a first-time hospital contact with schizophrenia from 1991 through 2010. Out of the 3409 individuals diagnosed with schizophrenia, a total of 1549 individuals had had a hospital contact with infection before their schizophrenia diagnosis (45%). Our results indicate that individuals who have had a hospital contact with infection are more likely to develop schizophrenia (relative risk [RR] = 1.41; 95% CI: 1.32-1.51) than individuals who had not had such a hospital contact. Bacterial infection was the type of infection that was associated with the highest risk of schizophrenia (RR = 1.63; 95% CI: 1.47-1.82). Our study does not exclude that a certain type of infection may have a specific effect; yet, it does suggest that schizophrenia is associated with a wide range of infections. This association may be due to inflammatory responses affecting the brain or genetic and environmental risk factors aggregating in families.

  16. Education Program Cost Reimbursement in University Hospitals. Is There a Coherent National Policy?

    ERIC Educational Resources Information Center

    Jeddeloh, Norman P.

    1981-01-01

    Medicare reimbursement for educational program costs is a quagmire of conflicting rules, regulations, laws, procedures, and precedents. The reimbursement principles in force fail to recognize the special value to patient care provided by the integration of the university hospital with an academic health sciences center and are illogical and…

  17. Risk Factors for Violent Offending in Autism Spectrum Disorder: A National Study of Hospitalized Individuals

    ERIC Educational Resources Information Center

    Langstrom, Niklas; Grann, Martin; Ruchkin, Vladislav; Sjostedt, Gabrielle; Fazel, Seena

    2009-01-01

    Little is known about risk factors for violence among individuals with autism spectrum disorder (ASD). This study uses data from Swedish longitudinal registers for all 422 individuals hospitalized with autistic disorder or Asperger syndrome during 1988-2000 and compares those committing violent or sexual offenses with those who did not. Thirty-one…

  18. Language, Literacy and Numeracy in National Training Packages: Case Studies in Aged Care and Hospitality.

    ERIC Educational Resources Information Center

    Haines, Christine; Brand, Jennie Bickmore

    The implementation and effectiveness of the inclusion of literacy and numeracy in industry training packages was examined in case studies of three programs in Western Australia. Two were certificate programs in cooking and food and beverage as specified in the hospitality training package, and the third was an aged care program based on the…

  19. Audit of clinical-laboratory practices in haematology and blood transfusion at Muhimbili National Hospital in Tanzania.

    PubMed

    Makubi, Abel N; Meda, Collins; Magesa, Alex; Minja, Peter; Mlalasi, Juliana; Salum, Zubeda; Kweka, Rumisha E; Rwehabura, James; Quaresh, Amrana; Magesa, Pius M; Robert, David; Makani, Julie; Kaaya, Ephata

    2012-10-01

    In Tanzania, there is paucity of data for monitoring laboratory medicine including haematology. This therefore calls for audits of practices in haematology and blood transfusion in order to provide appraise practice and devise strategies that would result in improved quality of health care services. This descriptive cross-sectional study which audited laboratory practice in haematology and blood transfusion at Muhimbili National Hospital (MNH) aimed at assessing the pre-analytical stage of laboratory investigations including laboratory request forms and handling specimen processing in the haematology laboratory and assessing the chain from donor selection, blood component processing to administration of blood during transfusion. A national standard checklist was used to audit the laboratory request forms (LRF), phlebotomists' practices on handling and assessing the from donor selection to administration 6f blood during transfusion. Both interview and observations were used. A total of 195 LRF were audited and 100% of had incomplete information such as patients' identification numbers, time sample ordered, reason for request, summary of clinical assessment and differential diagnoses. The labelling of specimens was poorly done by phlebotomists/clinicians in 82% of the specimens. Also 65% (132/202) of the blood samples delivered in the haematology laboratory did not contain the recommended volume of blood. There was no laboratory request form specific for ordering blood and there were no guidelines for indication of blood transfusion in the wards/ clinics. The blood transfusion laboratory section was not participating in external quality assessment and the hospital transfusion committee was not in operation. It is recommended that a referral hospital like MNH should have a transfusion committee to provide an active forum to facilitate communication between those involved with transfusion, monitor, coordinate and audit blood transfusion practices as per national

  20. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England.

    PubMed

    Loveday, H P; Wilson, J A; Pratt, R J; Golsorkhi, M; Tingle, A; Bak, A; Browne, J; Prieto, J; Wilcox, M; UK Department of Health

    2014-01-01

    National evidence-based guidelines for preventing healthcare-associated infections (HCAI) in National Health Service (NHS) hospitals in England were originally commissioned by the Department of Health and developed during 1998-2000 by a nurse-led multi-professional team of researchers and specialist clinicians. Following extensive consultation, they were first published in January 2001(1) and updated in 2007.(2) A cardinal feature of evidence-based guidelines is that they are subject to timely review in order that new research evidence and technological advances can be identified, appraised and, if shown to be effective for the prevention of HCAI, incorporated into amended guidelines. Periodically updating the evidence base and guideline recommendations is essential in order to maintain their validity and authority. The Department of Health commissioned a review of new evidence and we have updated the evidence base for making infection prevention and control recommendations. A critical assessment of the updated evidence indicated that the epic2 guidelines published in 2007 remain robust, relevant and appropriate, but some guideline recommendations required adjustments to enhance clarity and a number of new recommendations were required. These have been clearly identified in the text. In addition, the synopses of evidence underpinning the guideline recommendations have been updated. These guidelines (epic3) provide comprehensive recommendations for preventing HCAI in hospital and other acute care settings based on the best currently available evidence. National evidence-based guidelines are broad principles of best practice that need to be integrated into local practice guidelines and audited to reduce variation in practice and maintain patient safety. Clinically effective infection prevention and control practice is an essential feature of patient protection. By incorporating these guidelines into routine daily clinical practice, patient safety can be enhanced and

  1. National Estimates of Noncanine Bite and Sting Injuries Treated in US Hospital Emergency Departments, 2001–2010

    PubMed Central

    Langley, Ricky; Mack, Karin; Haileyesus, Tadesse; Proescholdbell, Scott; Annest, Joseph L.

    2015-01-01

    Objective Injuries resulting from contact with animals and insects are a significant public health concern. This study quantifies nonfatal bite and sting injuries by noncanine sources using data from the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP). Methods The NEISS-AIP is an ongoing nationally representative surveillance system used to monitor all types and causes of injuries treated in US hospital emergency departments (EDs). Cases were coded by trained hospital coders using information from medical records on animal and insect sources of bite and sting injuries being treated. Data were weighted to produce national annualized estimates, percentages, and rates based on the US population. Results From 2001 to 2010 an estimated 10.1 million people visited EDs for noncanine bite and sting injuries, based on an unweighted case count of 169,010. This translates to a rate of 340.1 per 100,000 people (95% CI, 232.9–447.3). Insects accounted for 67.5% (95% CI, 45.8–89.2) of bite and sting injuries, followed by arachnids 20.8% (95% CI, 13.8–27.9). The estimated number of ED visits for bedbug bite injuries increased more than 7-fold—from 2156 visits in 2007 to 15,945 visits in 2010. Conclusions This study provides an update of national estimates of noncanine bite and sting injuries and describes the diversity of animal exposures based on a national sample of EDs. Treatment of nonfatal bite and sting injuries are costly to society. Direct medical and work time lost translates to an estimated $7.5 billion annually. PMID:24433776

  2. Variations in Implementation of Acute Care Surgery: Results from a national survey of university-affiliated hospitals

    PubMed Central

    Santry, Heena P.; Madore, John C.; Collins, Courtney E.; Ayturk, M. Didem; Velmahos, George C.; Britt, LD; Kiefe, Catarina I.

    2015-01-01

    BACKGROUND To date, no studies have reported nationwide adoption of Acute Care Surgery (ACS) or identified structural and/or process variations for the care of emergency general surgery (EGS) patients within such models. METHODS We surveyed surgeons responsible for EGS coverage at University HealthSystems Consortium hospitals using an 8-page postal/email questionnaire querying respondents on hospital and EGS structure/process measures. Survey responses were analyzed using descriptive statistics, univariate comparisons, and multivariable regression models. RESULTS 258 of 319 (81%) potential respondents completed surveys. 81 hospitals (31%) had implemented ACS while 134 (52%) had a traditional general surgeon on-call model (GSOC). 38 (15%) hospitals had another model (HYBRID). Larger bed, university-based, teaching hospitals with Level 1 trauma center verification status located in urban areas were more likely to have adopted ACS. In multivariable modeling, hospital type, setting, and trauma center verification predicted ACS implementation. EGS processes of care varied with 28% GSOC having block time vs 67% ACS (p<0.0001); 45% GSOC providing ICU care to EGS patients in a surgical/trauma ICU vs 93% ACS (p<0.0001); GSOC sharing call among 5.7 (+/− 3.2) surgeons vs 7.9 (+/−2.3) ACS surgeons (p<0.0001); and 13% GSOC taking in-house EGS call vs 75% ACS (p<0.0001). Among ACS hospitals there were variations in patient cohorting (25% EGS patients alone; 21% EGS+trauma; 17% EGS+elective; 30% EGS+trauma+elective), data collection (26% had prospective EGS registries), and patient handoffs (56% had attending surgeon presence), call responsibilities (averaging 4.8 (+/− 1.3) calls per month with 60% providing extra call stipend and 40% with no post-call clinical duties). CONCLUSION The potential of the ACS on the national crisis in access to EGS care is not fully met. Variations in EGS processes of care among adopters of ACS suggest that standardized criteria for ACS

  3. National Trends in Main Causes of Hospitalization: A Multi-Cohort Register Study of the Finnish Working-Age Population, 1976–2010

    PubMed Central

    Kouvonen, Anne; Koskinen, Aki; Varje, Pekka; Kokkinen, Lauri; De Vogli, Roberto; Väänänen, Ari

    2014-01-01

    Background The health transition theory argues that societal changes produce proportional changes in causes of disability and death. The aim of this study was to identify long-term changes in main causes of hospitalization in working-age population within a nation that has experienced considerable societal change. Methodology National trends in all-cause hospitalization and hospitalizations for the five main diagnostic categories were investigated in the data obtained from the Finnish Hospital Discharge Register. The seven-cohort sample covered the period from 1976 to 2010 and consisted of 3,769,356 randomly selected Finnish residents, each cohort representing 25% sample of population aged 18 to 64 years. Principal Findings Over the period of 35 years, the risk of hospitalization for cardiovascular diseases and respiratory diseases decreased. Hospitalization for musculoskeletal diseases increased whereas mental and behavioral hospitalizations slightly decreased. The risk of cancer hospitalization decreased marginally in men, whereas in women an upward trend was observed. Conclusions/Significance A considerable health transition related to hospitalizations and a shift in the utilization of health care services of working-age men and women took place in Finland between 1976 and 2010. PMID:25379723

  4. The evolution of methicillin-resistant Staphylococcus aureus in Canadian hospitals: 5 years of national surveillance

    PubMed Central

    Simor, Andrew E.; Ofner-Agostini, Marianna; Bryce, Elizabeth; Green, Karen; McGeer, Allison; Mulvey, Michael; Paton, Shirley

    2001-01-01

    Background To better understand the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Canadian hospitals, surveillance has been conducted in sentinel hospitals across the country since 1995. We report the results of the first 5 years of the program. Methods For each newly identified inpatient with MRSA, medical records were reviewed for demographic and clinical data. Isolates were subjected to susceptibility testing and molecular typing by pulsed-field gel electrophoresis. Results A total of 4507 patients infected or colonized with MRSA were identified between January 1995 and December 1999. The rate of MRSA increased each year from a mean of 0.95 per 100 S. aureus isolates in 1995 to 5.97 per 100 isolates in 1999 (0.46 per 1000 admissions in 1995 to 4.12 per 1000 admissions in 1999) (p < 0.05). Most of the increase in MRSA occurred in Ontario, Quebec and the western provinces. Of the 3009 cases for which the site of MRSA acquisition could be determined, 86% were acquired in a hospital, 8% were acquired in a long-term care facility and 6% were acquired in the community. A total of 1603 patients (36%) were infected with MRSA. The most common sites of infection were skin or soft tissue (25% of MRSA infections), pulmonary tissues (24%) and surgical sites (23%); 13% of the patients were bacteremic. An epidemiologic link with a previously identified MRSA patient was suspected in 53% of the cases. Molecular typing indicated that most (81%) of the isolates could be classified as related to 1 of the 4 Canadian epidemic strains of MRSA. Interpretation There has been a significant increase in the rate of isolating MRSA in many Canadian hospitals, related to the transmission of a relatively small number of MRSA strains. PMID:11468949

  5. Interim Results of a National Test of the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD)

    PubMed Central

    Traino, H. M.; Alolod, G. P.; Shafer, T.; Siminoff, L. A.

    2012-01-01

    Organ donation remains a major public health challenge with over 114 000 people on the waitlist in the United States. Among other factors, extant research highlights the need to improve the identification and timely referral of potential donors by hospital health-care providers (HCPs) to organ procurement organizations (OPOs). We implemented a national test of the Rapid Assessment of hospital Procurement barriers in Donation (RAPiD) to identify assets and barriers to the organ donation and patient referral processes; assess hospital–OPO relationships and offer tailored recommendations for improving these processes. Having partnered with seven OPOs, data were collected at 70 hospitals with high donor potential in the form of direct observations and interviews with 2358 HCPs. We found that donation attitudes and knowledge among HCPs were high, but use of standard referral criteria was lacking. Significant differences were found in the donation-related attitudes, knowledge and behaviors of physicians and emergency department staff as compared to other staff in intensive care units with high organ donor potential. Also, while OPO staff were generally viewed positively, they were often perceived as outsiders rather than members of healthcare teams. Recommendations for improving the referral and donation processes are discussed. PMID:22900761

  6. Security: Detection, Emergency System, Guard Services

    ERIC Educational Resources Information Center

    Nation's Schools and Colleges, 1974

    1974-01-01

    Three short articles describe (respectively) a student security advisory council at one high school that involves students in security work, emergency telephone systems on two university campuses, and tips for hiring security guards for colleges. (Author/DN)

  7. ‘Shell shock’ Revisited: An Examination of the Case Records of the National Hospital in London

    PubMed Central

    Linden, Stefanie Caroline; Jones, Edgar

    2014-01-01

    During the First World War the National Hospital for the Paralysed and Epileptic, in Queen Square, London, then Britain’s leading centre for neurology, took a key role in the treatment and understanding of shell shock. This paper explores the case notes of all 462 servicemen who were admitted with functional neurological disorders between 1914 and 1919. Many of these were severe or chronic cases referred to the National Hospital because of its acknowledged expertise and the resources it could call upon. Biographical data was collected together with accounts of the patient’s military experience, his symptoms, diagnostic interpretations and treatment outcomes. Analysis of the notes showed that motor syndromes (loss of function or hyperkinesias), often combined with somato-sensory loss, were common presentations. Anxiety and depression as well as vegetative symptoms such as sweating, dizziness and palpitations were also prevalent among this patient population. Conversely, psychogenic seizures were reported much less frequently than in comparable accounts from German tertiary referral centres. As the war unfolded the number of physicians who believed that shell shock was primarily an organic disorder fell as research failed to find a pathological basis for its symptoms. However, little agreement existed among the Queen Square doctors about the fundamental nature of the disorder and it was increasingly categorised as functional disorder or hysteria. PMID:25284893

  8. A Retrospective Case Series of Surgical Implant Generation Network (SIGN) Placement at the Afghan National Police Hospital, Kabul, Afghanistan.

    PubMed

    Ertl, Christian W; Royal, David; Arzoiey, Humayoon Abdul; Shefa, Azizullah; Sultani, Salim; Mosafa, Mohammed Omar; Sadat, Safiullah; Zirkle, Lewis

    2016-01-01

    In Afghanistan, adequate and cost-effective medical care for even routine conditions is lacking; especially for complex injuries like long-bone fractures. The Surgical Implant Generation Network (SIGN) intramedullary nail is used for treatment of long-bone fractures from blunt injuries and does not require imaging. We are reporting for the first time results of the SIGN intramedullary nail at the Afghan National Police Hospital, a tertiary care facility in Kabul. 71 records from the SIGN Online Surgical Database were reviewed for gender, age, date of injury, implant date, patient's home of record, and type/ mechanism of injury. Mean age was 26.7 years, all but one being male; time from injury to implant ranged 1 to 401 days, with mean of 40.6 days. Long-bone fractures from motor vehicle accidents remained constant, and war injuries peaked in summer. Follow-up is limited because of security and financial burdens of travel. However, personal communication with Afghan National Police Hospital surgeons suggests that patients included in the current study have not experienced any adverse outcomes. While it remains to be seen if the SIGN Online Surgical Database will facilitate more comprehensive outcome studies, our results provide support for the efficacy of SIGN nails in treating long-bone fractures from war injuries. PMID:26741473

  9. Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

    PubMed Central

    2011-01-01

    Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH) in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment) study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572) received an intravenous haemodiluting agent such as mannitol (96%) or a neuroprotectant (72%), and there was high use of intravenous traditional Chinese medicine (TCM) (42%). Neurosurgery was undertaken in 137 (9%) patients; being overweight, having a low Glasgow Coma Scale (GCS) score on admission, and Total Anterior Circulation Syndrome (TACS) clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p < 0.001). Continuation of antihypertensives in-hospital and at 3 and 12 months post-stroke was reported in 732/935 (78%), 775/935 (83%), and 752/935 (80%) living patients with hypertension, respectively. Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH. PMID:21276264

  10. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  11. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  12. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  13. 33 CFR 5.59 - Medical treatment and hospitalization.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Medical treatment and hospitalization. 5.59 Section 5.59 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL COAST GUARD AUXILIARY § 5.59 Medical treatment and hospitalization. When any member of...

  14. Motor vehicle related injuries among American Indian and Alaskan Native youth, 1981–92: analysis of a national hospital discharge database

    PubMed Central

    Quinlan, K.; Wallace, L; Furner, S.; Brewer, R.; Bolen, J.; Schieber, R.

    1998-01-01

    Objective—To describe national trends in hospitalizations for motor vehicle related injuries among children and youth (0–24 years) of the United States Indian Health Service (IHS) from 1981–92. Design—Descriptive epidemiologic study of the E coded national hospital discharge database of the IHS. Results—From 1981 to 1992, the age standardized annual incidence of motor vehicle related injury hospitalizations (per 100 000 population) among American Indian and Alaskan Native (AI/AN) youth decreased more than 65% from 269 to 93. Substantial declines in hospitalization rates for all age and sex groups, all IHS areas, and most injury types were seen over this time. Injuries to vehicle occupants accounted for 78% of all motor vehicle related injury hospitalizations. The annual incidence of hospitalization (per 100 000 population) ranged from 291 in the Billings (Wyoming/Montana) and Aberdeen (the Dakotas) areas to 38 in the Portland area (Pacific Northwest). Conclusions—National motor vehicle related injury hospitalization rates of AI/AN children and youth decreased significantly from 1981–92. This may be due to a reduction in the incidence of severe motor vehicle related trauma, changing patterns of medical practice, and changes in the use of services. Additional measures, such as passage and enforcement of tribal laws requiring the use of occupant restraints and stronger laws to prevent alcohol impaired driving, might further reduce the incidence of serious motor vehicle related injuries in this high risk population. PMID:9887418

  15. An Assessment of the Application of Pharma Cloud System to the National Health Insurance Program of Taiwan and the Result in Hospitals.

    PubMed

    Yan, Yu-Hua; Lu, Chen-Luan

    2016-01-01

    National Health Insurance Administration established Pharma Cloud System in July 2014. The purpose is to decrease therapeutic duplications and enhance public medication safety. Comparison will be made among individual hospitals and the administering branches of National Health Insurance Bureau (NHIB) on the statistical data on the inquiry of the cloud medication history record system to understand the result of the installation and advocacy of this system. The results show (1) there were 2,329,846 entries of data collected from the branches of the NHIB from 2015 on cloud medication history record and 50,224 entries of data from individual hospitals. (2) The inquiry rate at the branches of the NHIB was 43.2% from January to April, 2015 and at individual hospitals was 18.8%. (3) The improvement rate at the branches of the NHIB was 32.5% and at the individual hospitals was 47.0% from January to April, 2015.

  16. [Cardiovascular emergencies and their morbimortality at the hospital. Report of 733 cases at the CHU campus in Lome (national reference hospital in Togo)].

    PubMed

    Damorou, F; Pessinaba, S; Lawson, B; Abdoulaye, S; Soussou, B; Grunitzky, K

    2008-01-01

    Due to the recent establishment of the emergencies Units in Black Africa, their epidemiological aspects are not well known. Our aims was to describe the epidemiology of this desease in Togo. Through a retrospective analysis we study over a period of 42 mouths. From January first, 2001 to June 30th, 2004. It was carried out exclusively at CHU-Campus, the hospital of Lomé Campus, the second national medical center of reference. Included were all the patients with cardio-vascular emergency cases. We have studied the epidemilogical aspects according to the age, sex, profession, morbidity, and mortality. The treatment of results have been done by Computer. The registered emergency cases were 733 il all with is a frequency of the patients admitted at CHU-CAMPUS. The average age is 56 +/- 13 years with extreme ages from 20 to 97 years. The age group most affected is between 30 and 69 years--The ratio according to the sex is 1.09 in favour of men. Housewives are the professional category most affected (42.3%). Constitute the essential of the cardiovascular emergency cases with a ratio of the 78.3%. The mortality is 17.1% which in most registered between 30 and 69 years. The morbidity ratio is 64.1% We have to keep in mind that cardio-vascular emergency cases are very frequent in Togo. A very active population of young people is concerned. The poor are the most threatened. Henceforth the establishment and equipment of cardiological units are absolutely necessary, for they constitute the only solution by which the level of morbi-mortality can be reduced. PMID:19434971

  17. Factors associated with hospital retention of RNs in the New York City Metropolitan Area: an analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses.

    PubMed

    Rosenfeld, Peri; Adams, Richard E

    2008-08-01

    The nursing shortage is well documented, and government estimates indicate that shortfalls will worsen in the future. As the largest employer of registered nurses (RNs), hospitals are the most seriously affected by shortages, as they compete with other employment settings for limited nursing resources. Recruitment remains the primary avenue for ensuring staffing levels, but retention is increasingly important as applicant pools shrink because of demographic and employment trends. Effective retention strategies must address the factors that contribute to exodus of RNs from hospitals, as well as isolating the factors that enable RNs to remain in hospital employment. This secondary analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses examines the demographic, employment, and educational factors associated with working in hospitals, having full-time status, and holding patient care positions. The findings suggest that hospitals must address nonwork issues to retain nursing personnel. Relevant policy issues are examined and strategies for effective retention are offered. PMID:18509198

  18. In-Hospital Economic Burden of Metastatic Renal Cell Carcinoma in France in the Era of Targeted Therapies: Analysis of the French National Hospital Database from 2008 to 2013

    PubMed Central

    2016-01-01

    Background & Objectives The aim of this study was to assess the economic burden of hospitalisations for metastatic renal cell carcinoma (mRCC), to describe the patterns of prescribing expensive drugs and to explore the impact of geographic and socio-demographic factors on the use of these drugs. Methods We performed a retrospective analysis from the French national hospitals database. Hospital stays for mRCC between 2008 and 2013 were identified by combining the 10th revision of the International Classification of Diseases (ICD-10) codes for renal cell carcinoma (C64) and codes for metastases (C77 to C79). Incident cases were identified out of all hospital stays and followed till December 2013. Descriptive analyses were performed with a focus on hospital stays and patient characteristics. Costs were assessed from the perspective of the French National Health Insurance and were obtained from official diagnosis-related group tariffs for public and private hospitals. Results A total of 15,752 adult patients were hospitalised for mRCC, corresponding to 102,613 hospital stays. Of those patients, 68% were men and the median age at first hospitalisation was 69 years [Min-Max: 18–102]. Over the study period, the hospital mortality rate reached 37%. The annual cost of managing mRCC at hospital varied between 28M€ in 2008 and 42M€ in 2012 and was mainly driven by inpatient costs. The mean annual per capita cost of hospital management of mRCC varied across the study period from 8,993€ (SD: €8,906) in 2008 to 10,216€ (SD: €10,527) in 2012. Analysis of the determinants of prescribing expensive drugs at hospital did not show social or territorial differences in the use of these drugs. Conclusion This study is the first to investigate the in-hospital economic burden of mRCC in France. Results showed that in-hospital costs of managing mRCC are mainly driven by expensive drugs and inpatient costs. PMID:27649305

  19. The national database of hospital-based cancer registries: a nationwide infrastructure to support evidence-based cancer care and cancer control policy in Japan.

    PubMed

    Higashi, Takahiro; Nakamura, Fumiaki; Shibata, Akiko; Emori, Yoshiko; Nishimoto, Hiroshi

    2014-01-01

    Monitoring the current status of cancer care is essential for effective cancer control and high-quality cancer care. To address the information needs of patients and physicians in Japan, hospital-based cancer registries are operated in 397 hospitals designated as cancer care hospitals by the national government. These hospitals collect information on all cancer cases encountered in each hospital according to precisely defined coding rules. The Center for Cancer Control and Information Services at the National Cancer Center supports the management of the hospital-based cancer registry by providing training for tumor registrars and by developing and maintaining the standard software and continuing communication, which includes mailing lists, a customizable web site and site visits. Data from the cancer care hospitals are submitted annually to the Center, compiled, and distributed as the National Cancer Statistics Report. The report reveals the national profiles of patient characteristics, route to discovery, stage distribution, and first-course treatments of the five major cancers in Japan. A system designed to follow up on patient survival will soon be established. Findings from the analyses will reveal characteristics of designated cancer care hospitals nationwide and will show how characteristics of patients with cancer in Japan differ from those of patients with cancer in other countries. The database will provide an infrastructure for future clinical and health services research and will support quality measurement and improvement of cancer care. Researchers and policy-makers in Japan are encouraged to take advantage of this powerful tool to enhance cancer control and their clinical practice.

  20. Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania

    PubMed Central

    Nyongole, Obadia; Akoko, Larry; Mwanga, Ally; Mchembe, Mabula; Kamala, Benjamin; Mbembati, Naboth

    2015-01-01

    Introduction Antimicrobial prophylaxis for urologic procedures is a major issue, as potential advantages of antibiotic administration should be carefully weighed against potential side effects, microbial resistance, and health care costs. This study aimed to review a six years trend of antibiotic use in urological surgeries at Muhimbili National Hospital (MNH) being an experience in a typical third world environment. Methods This was a six years hospital based descriptive, retrospective study conducted of which all case notes of urological patients operated on in between January 2007 to December, 2012 were reviewed by using a structured data collecting tool. The data were analyzed using SPSS software. Results Male patients were the majority at 62% (450). The age range was 0 - 90 years, with a mean of 30 ± 22.09. Among the urological surgeries done at MNH 86.5% (628) received prophylactic antibiotics regardless of the type surgery done. Majority 63.7% (463) received antibiotics during induction. Ceftriaxone was the commonly given antibiotic regardless of the type of urological surgery done. Most of patients (86.4%) were given antibiotics for five days regardless whether it was for prophylactic or treatment intention. Conclusion Antibiotic use is still a challenge at our hospital with over use of prophylactic antibiotics without obvious indications. Prolonged use of prophylactic antibiotics beyond five days was the main finding. Ceftriaxone was the most given antibiotic regardless of the urological surgery done and its level of contamination. Antibiotic stewardship needs to be addressed urgently to avoid serious drug resistances leaving alone the cost implication. PMID:26952184

  1. Sex and Occupational Socialization among Prison Guards: A Longitudinal Study.

    ERIC Educational Resources Information Center

    Crouch, Ben M.; Alpert, Geoffrey P.

    1982-01-01

    Reports changes in attitudes of male and female prison guards over the first six months on the job. Found male guards became more, and female guards became less, punitive and aggressive. Results appear to derive from differences in the work milieu of male and female guards. (Author/JAC)

  2. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed...

  3. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed...

  4. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed...

  5. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed...

  6. 46 CFR 169.331 - Guards in hazardous locations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Guards in hazardous locations. 169.331 Section 169.331 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) NAUTICAL SCHOOLS SAILING SCHOOL VESSELS Construction and Arrangement Rails and Guards § 169.331 Guards in hazardous locations. Each exposed...

  7. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  8. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  9. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  10. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  11. 49 CFR 213.141 - Self-guarded frogs.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Self-guarded frogs. 213.141 Section 213.141..., DEPARTMENT OF TRANSPORTATION TRACK SAFETY STANDARDS Track Structure § 213.141 Self-guarded frogs. (a) The raised guard on a self-guarded frog shall not be worn more than three-eighths of an inch. (b) If...

  12. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 1 2011-10-01 2011-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the...

  13. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Coast Guard commission pennant. 23.20 Section 23.20 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.20 Coast Guard commission...

  14. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 1 2013-10-01 2013-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the...

  15. 76 FR 17782 - Protection for Whistleblowers in the Coast Guard

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... the Coast Guard'' in the Federal Register. (75 FR 79956). That rule broadens the whistleblower... SECURITY Coast Guard 33 CFR Part 53 RIN 1625-AB33 Protection for Whistleblowers in the Coast Guard AGENCY: Coast Guard, DHS. ACTION: Direct final rule; confirmation of effective date. SUMMARY: On December...

  16. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other...

  17. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  18. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Coast Guard emblem. 23.10 Section 23.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.10 Coast Guard emblem. (a) The...

  19. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  20. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Availability of Coast Guard forms. 173.83 Section 173.83 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Number § 173.83 Availability of Coast Guard forms. In a State where the Coast Guard is the...

  1. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  2. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying...

  3. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other...

  4. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Coast Guard commission pennant. 23.20 Section 23.20 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.20 Coast Guard commission...

  5. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other...

  6. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the...

  7. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Availability of Coast Guard forms. 173.83 Section 173.83 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Number § 173.83 Availability of Coast Guard forms. In a State where the Coast Guard is the...

  8. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Coast Guard commission pennant. 23.20 Section 23.20 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.20 Coast Guard commission...

  9. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying...

  10. 5. AERIAL VIEW TO NORTHEAST OF ENTIRE COAST GUARD AIR ...

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

    5. AERIAL VIEW TO NORTHEAST OF ENTIRE COAST GUARD AIR STATION SAN FRANCISCO. 8X10 black and white silver gelatin print. United States Coast Guard Official Photograph, 12th Coast Guard District, San Francisco. 1960. - U.S. Coast Guard Air Station San Francisco, 1020 North Access Road, San Francisco, San Francisco County, CA

  11. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 1 2014-10-01 2014-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the...

  12. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  13. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Coast Guard commission pennant. 23.20 Section 23.20 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.20 Coast Guard commission...

  14. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  15. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Availability of Coast Guard forms. 173.83 Section 173.83 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Number § 173.83 Availability of Coast Guard forms. In a State where the Coast Guard is the...

  16. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  17. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  18. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Coast Guard emblem. 23.10 Section 23.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.10 Coast Guard emblem. (a) The...

  19. 2. General view of guard house and entrance to Coast ...

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

    2. General view of guard house and entrance to Coast Guard Base from La Putilla Street, with view of Motor Pool (Building 122) on right side looking west - U.S. Coast Guard Base, San Juan, Guard House, La Puntilla Finalle, San Juan, San Juan Municipio, PR

  20. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying...

  1. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  2. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Coast Guard emblem. 23.10 Section 23.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.10 Coast Guard emblem. (a) The...

  3. 46 CFR 4.03-20 - Coast Guard district.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 1 2012-10-01 2012-10-01 false Coast Guard district. 4.03-20 Section 4.03-20 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE CASUALTIES AND INVESTIGATIONS Definitions § 4.03-20 Coast Guard district. A Coast Guard district is one of the...

  4. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Availability of Coast Guard forms. 173.83 Section 173.83 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Number § 173.83 Availability of Coast Guard forms. In a State where the Coast Guard is the...

  5. 46 CFR 50.10-25 - Coast Guard Symbol.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Coast Guard Symbol. 50.10-25 Section 50.10-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-25 Coast Guard Symbol. (a) The term Coast Guard...

  6. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying...

  7. 76 FR 7123 - Eleventh Coast Guard District Annual Marine Events

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-09

    ... SECURITY Coast Guard 33 CFR Part 100 RIN 1625-AA08 Eleventh Coast Guard District Annual Marine Events AGENCY: Coast Guard, DHS. ACTION: Notice of proposed rulemaking. SUMMARY: The Coast Guard proposes to update and consolidate the list of marine events occurring annually within the Eleventh Coast...

  8. 46 CFR 50.10-30 - Coast Guard number.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Coast Guard number. 50.10-30 Section 50.10-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING GENERAL PROVISIONS Definition of Terms Used in This Subchapter § 50.10-30 Coast Guard number. (a) The Coast Guard number...

  9. The U.S. Coast Guard Academy Curricula; An Evaluation.

    ERIC Educational Resources Information Center

    Powers, Theodore R.; And Others

    This report presents the results of research that had as its objective the evaluation of the curricula of the U.S. Coast Guard Academy. Over 125 Coast Guard officers and men were interviewed to gather detailed background information about the Coast Guard, the Coast Guard Academy, and job requirements of Academy graduates. These data were developed…

  10. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other...

  11. 33 CFR 23.20 - Coast Guard commission pennant.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Coast Guard commission pennant. 23.20 Section 23.20 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.20 Coast Guard commission...

  12. 33 CFR 173.83 - Availability of Coast Guard forms.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Availability of Coast Guard forms. 173.83 Section 173.83 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY... Number § 173.83 Availability of Coast Guard forms. In a State where the Coast Guard is the...

  13. 33 CFR 23.12 - Coast Guard identifying insignia.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Coast Guard identifying insignia. 23.12 Section 23.12 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.12 Coast Guard identifying...

  14. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Coast Guard emblem. 23.10 Section 23.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.10 Coast Guard emblem. (a) The...

  15. 33 CFR 23.10 - Coast Guard emblem.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Coast Guard emblem. 23.10 Section 23.10 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY GENERAL DISTINCTIVE MARKINGS FOR COAST GUARD VESSELS AND AIRCRAFT § 23.10 Coast Guard emblem. (a) The...

  16. 33 CFR 52.42 - Views of the Coast Guard.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Views of the Coast Guard. 52.42 Section 52.42 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PERSONNEL BOARD FOR CORRECTION OF MILITARY RECORDS OF THE COAST GUARD Submissions by the Coast Guard and Other...

  17. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 4 2011-10-01 2011-10-01 false Guards in vehicle spaces. 116.940 Section 116.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.940 Guards in vehicle spaces. On a vessel authorized to carry one or...

  18. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Guards in vehicle spaces. 177.940 Section 177.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.940 Guards in vehicle spaces. On a...

  19. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Guards in vehicle spaces. 116.940 Section 116.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.940 Guards in vehicle spaces. On a vessel authorized to carry one or...

  20. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Guards in vehicle spaces. 177.940 Section 177.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.940 Guards in vehicle spaces. On a...

  1. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 4 2012-10-01 2012-10-01 false Guards in vehicle spaces. 116.940 Section 116.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.940 Guards in vehicle spaces. On a vessel authorized to carry one or...

  2. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 4 2014-10-01 2014-10-01 false Guards in vehicle spaces. 116.940 Section 116.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.940 Guards in vehicle spaces. On a vessel authorized to carry one or...

  3. 46 CFR 116.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 4 2013-10-01 2013-10-01 false Guards in vehicle spaces. 116.940 Section 116.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE... ARRANGEMENT Rails and Guards § 116.940 Guards in vehicle spaces. On a vessel authorized to carry one or...

  4. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Guards in vehicle spaces. 177.940 Section 177.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.940 Guards in vehicle spaces. On a...

  5. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Guards in vehicle spaces. 177.940 Section 177.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.940 Guards in vehicle spaces. On a...

  6. 46 CFR 177.940 - Guards in vehicle spaces.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Guards in vehicle spaces. 177.940 Section 177.940 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) CONSTRUCTION AND ARRANGEMENT Rails and Guards § 177.940 Guards in vehicle spaces. On a...

  7. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27175280

  8. Peer mentors, mobile phone and pills: collective monitoring and adherence in Kenyatta National Hospital's HIV treatment programme

    PubMed Central

    Moyer, Eileen

    2014-01-01

    In 2006, the Kenyan state joined the international commitment to make antiretroviral treatment free in public health institutions to people infected with HIV. Less than a decade later, treatment has reached over 60% of those who need it in Kenya. This paper, which is based on an in-depth ethnographic case study of the HIV treatment programme at Kenyatta National Hospital, conducted intermittently between 2008 and 2014, examines how HIV-positive peer mentors encourage and track adherence to treatment regimens within and beyond the clinic walls using mobile phones and computer technology. This research into the everyday practices of patient monitoring demonstrates that both surveillance and adherence are collective activities. Peer mentors provide counselling services, follow up people who stray from treatment regimens, and perform a range of other tasks related to patient management and treatment adherence. Despite peer mentors’ involvement in many tasks key to encouraging optimal adherence, their role is rarely acknowledged by co-workers, hospital administrators, or public health officials. Following a biomedical paradigm, adherence at Kenyatta and in Kenya is framed by programme administrators as something individual clients must do and for which they must be held accountable. This framing simultaneously conceals the sociality of adherence and undervalues the work of peer mentors in treatment programmes. PMID:25175291

  9. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27648258

  10. Understanding the recruitment and retention of overseas nurses: realist case study research in National Health Service Hospitals in the UK.

    PubMed

    O'Brien, Terri; Ackroyd, Stephen

    2012-03-01

    This paper illustrates one of the possible applications of critical realist ideas to the analysis of health services, in the use of comparative case study research design, to elucidate the causal social processes underlying events. In the research reported here, a comparative research design was used as a basis for improving our understanding of the processes involved in the assimilation of overseas nurses (OSN) into the salient long-term workforce of the National Health Service (NHS) hospitals in the UK. The work brought to light the salient experiences of overseas nurses during their initial work in the NHS hospitals, and these were used as a basis for developing an account of the general mechanisms typically underlying the recruitment and assimilation at work. The authors conclude that successful assimilation is often hindered by the presence of occupational closure mechanisms, by which home nurses effectively excluded recruits from participation and promotion; these mechanisms, which articulate with everyday racism, threaten successful assimilation for obvious reasons. If the treatment recruits receive does not lead to withdrawal, it is because they typically have very strong economic motives to continue despite unfavourable and sometimes inhumane treatment. Thus, the research offered substantial reasons why recruitment policies should be reviewed by policy-makers.

  11. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions.

  12. Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

    PubMed Central

    Langan Martin, Julie; McLean, Gary; Cantwell, Roch; Smith, Daniel J

    2016-01-01

    Objective To describe weekly admission rates for affective and non-affective psychosis, major depression and other psychiatric disorders in the early and late postpartum periods. To assess the impact of socioeconomic status, age and parity on admission rates. Methods Scottish maternity records were linked to psychiatric hospital admissions. 3290 pregnancy-related psychiatric admissions were assessed. Weekly admission rates were calculated for the pregnancy period, early postpartum period (6 weeks after birth) and late postpartum period (up to 2 years after birth), and compared with pre-pregnancy rates (up to 2 years before pregnancy). Admission rates were generated by calculating the total number of admissions for each time period divided by the number of weeks in the period. Incidence rate ratios (IRRs) were generated for each time period, using deprivation, age, parity and record of previous psychiatric hospital care-adjusted Poisson regression models. Results Women from more deprived social quintiles accounted for the largest proportion of admissions across all time periods. Compared with pre-pregnancy period, admission rates fell during pregnancy, increased markedly during the early postpartum period, and remained elevated for 2 years after childbirth. Within the most affluent quintile, admission IRRs were higher in the early postpartum period (IRR=1.29, 95% CI 1.02 to 1.59) than in the late postpartum period (IRR=0.87, 95% CI 0.74 to 0.98). For the late postpartum period, there was a positive association between higher maternal age and admission IRRs (ages 20–35 years, IRR=1.35, 95% CI 1.16 to 1.54 and age>40 years IRR=1.72, 95% CI 1.41 to 2.09). Conclusions Rates of psychiatric admission fell during pregnancy and increased in the early postpartum period (particularly during the first 2 weeks after birth), and remained elevated above baseline during the 2-year late postpartum period. An understanding of how social deprivation, age and parity

  13. The impact of new national HIV testing guidelines at a district general hospital in an area of high HIV seroprevalence.

    PubMed

    Page, I; Phillips, M; Flegg, P; Palmer, R

    2011-03-01

    The latest UK national human immunodeficiency virus (HIV) testing guidelines, released in September 2008, state that HIV testing should be offered to all patients with indicator conditions and considered in all general medical admissions in high-prevalence areas. We audited testing rates at Blackpool Victoria Hospital, a high-prevalence area, one year before and one year after the publication of the new guidelines. In the year after publication the rate of HIV testing in patients with indicator diseases was as follows: hepatitis B 6%, hepatitis C 28%, tuberculosis 9% and lymphoma 14%. The overall rate of HIV testing in acute medical admissions was 0.5%. Our results demonstrate that traditional methods of guideline dissemination did not lead to implementation. We are now assessing alternative methods such as marking all positive laboratory results for indicator diseases with the phrase 'HIV testing should be considered' and implementing universal opt-out screening in our Clinical Decisions Unit.

  14. GUARD/WATCH TOWER #S84 Naval Magazine Lualualei, Waikele Branch, GuardWatch ...

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

    GUARD/WATCH TOWER #S84 - Naval Magazine Lualualei, Waikele Branch, Guard-Watch Tower Type, On ridge above Tunnel CE-1, on Prime Road on ridge above Tunnel B-11, & on ridge above Tunnel C-17, Pearl City, Honolulu County, HI

  15. GUARD/WATCH TOWER #S82 Naval Magazine Lualualei, Waikele Branch, GuardWatch ...

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

    GUARD/WATCH TOWER #S82 - Naval Magazine Lualualei, Waikele Branch, Guard-Watch Tower Type, On ridge above Tunnel CE-1, on Prime Road on ridge above Tunnel B-11, & on ridge above Tunnel C-17, Pearl City, Honolulu County, HI

  16. GUARD/WATCH TOWER #S68 Naval Magazine Lualualei, Waikele Branch, GuardWatch ...

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

    GUARD/WATCH TOWER #S68 - Naval Magazine Lualualei, Waikele Branch, Guard-Watch Tower Type, On ridge above Tunnel C-11, on Prime Road on ridge above Tunnel B-5, & on ridge above Tunnel D-14, Pearl City, Honolulu County, HI

  17. The EASTR Study: indications for transfusion and estimates of transfusion recipient numbers in hospitals supplied by the National Blood Service.

    PubMed

    Wells, A W; Llewelyn, C A; Casbard, A; Johnson, A J; Amin, M; Ballard, S; Buck, J; Malfroy, M; Murphy, M F; Williamson, L M

    2009-12-01

    This study provides data on National Blood Service (NBS) red blood cell (RBC, n = 9142), platelet (PLT, n = 4232) and fresh frozen plasma (FFP, n = 3584) recipients independently sampled by monthly quota from 29 representative hospitals over 12 months in 2001-2002. Hospitals were stratified by size according to total yearly RBC issues. Transfusion indications were chosen from diagnostic and procedural codes, and recipients grouped into Epidemiology and Survival of Transfusion Recipients Case-mix Groups (E-CMGs). The main E-CMGs were digestive [19% of RBC recipients; including 5% gastrointestinal (GI) bleeds and 3% colorectal surgery], musculoskeletal (15%; 12% hip and knee replacement), haematology (13%) and obstetrics and gynaecology (10%). Renal failure, fractured neck of femur, cardiac artery by-pass grafting (CABG) and paediatrics, each accounted for 3-4% recipients. FFP recipients: the main E-CMGs were digestive (21% of FFP recipients; including 7% GI bleeds and 3% colorectal surgery), hepatobiliary (15%; 7% liver disease and 2% liver transplant), cardiac (12%) and paediatrics (9%) The renal, paediatrics, vascular and haematology E-CMGs each had 6-7% of recipients. PLT recipients: the main E-CMGs were haematology (27% of PLT recipients; including 9% lymphoma and 8% acute leukaemia), cardiac (17%), paediatrics (13%), hepatobiliary (10%) and digestive (9%). Back-weighting gave national estimates of 433 000 RBC, 57 500 FFP and 41 500 PLT recipients/year in England and North Wales, median age 69, 64 and 59 years, respectively. Digestive and hepatobiliary indications emerged as the top reason for transfusion in RBC and FFP recipients, and was also a frequent indication in PLT recipients.

  18. Reliability and validity of the American Hospital Association's national longitudinal survey of health information technology adoption

    PubMed Central

    Everson, Jordan; Lee, Shoou-Yih D; Friedman, Charles P

    2014-01-01

    Objective To evaluate the internal consistency, construct validity, and criterion validity of a battery of items measuring information technology (IT) adoption, included in the American Hospital Association (AHA) IT Supplement Survey. Methods We analyzed the 2012 release of the AHA IT Supplement Survey. We performed reliability analysis using Cronbach's α and part-whole correlations, construct validity analysis using principal component analysis (PCA), and criterion validity analysis by assessing the items’ sensitivity and specificity of predicting attestation to Medicare Meaningful Use (MU). Results Twenty-eight items of the 31-item instrument and five of six functionality subcategories defined by the AHA all produced reliable scales (α’s between 0.833 and 0.958). PCA mostly confirmed the AHA's categorization of functionalities; however, some items loaded only weakly onto the factor most associated with their survey category, and one category loaded onto two separate factors. The battery of items was a valid predictor of attestation to MU, producing a sensitivity of 0.82 and a specificity of 0.72. Discussion The battery of items performed well on most indices of reliability and validity. However, they lack some components of ideal survey design, leaving open the possibility that respondents are not responding independently to each item in the survey. Despite measuring only a portion of the objectives required for attestation to MU, the items are a moderately sensitive and specific predictor of attestation. Conclusions The analyzed instrument exhibits satisfactory reliability and validity. PMID:24623194

  19. Catering & Hospitality, Serving Food & Drink, Levels 1-3. 2nd Edition. Catering & Hospitality, Reception & Housekeeping, Levels 1-3. Catering & Hospitality, Supervisory Management, Level 3. Catering & Hospitality Management, Level 4. 2nd Edition. National Vocational Qualifications.

    ERIC Educational Resources Information Center

    Business and Technology Education Council, London (England).

    Britain's National Vocational Qualifications (NVQs) are work qualifications that measure what an employee or potential employee can do as well as how much he or she knows and understands about a particular job. Used as written proof of usable workplace skills that can be put to profitable use by an employer, NVQs range from basic Level 1, for…

  20. Executive Function, Survival, and Hospitalization in Chronic Obstructive Pulmonary Disease. A Longitudinal Analysis of the National Emphysema Treatment Trial (NETT)

    PubMed Central

    Dodd, James W.; Novotny, Paul; Sciurba, Frank C.

    2015-01-01

    Rationale: Cognitive dysfunction has been demonstrated in chronic obstructive pulmonary disease (COPD), but studies are limited to cross-sectional analyses or incompletely characterized populations. Objectives: We examined longitudinal changes in sensitive measures of executive function in a well-characterized population of patients with severe COPD. Methods: This study was performed on patients enrolled in the National Emphysema Treatment Trial. To assess executive function, we analyzed trail making (TM) A and B times at enrollment in the trial (2,128 patients), and at 12 (731 patients) and 24 months (593 patients) after enrollment, adjusted for surgery, marriage status, age, education, income, depression, PaO2, PaCO2, and smoking. Associations with survival and hospitalizations were examined using Cox regression and linear regression models. Measurements and Main Results: The average age of the patients was 66.4 years, and the average FEV1 was 23.9% predicted. At the time of enrolment, 38% had executive dysfunction. Compared with those who did not, these patients were older, less educated, had higher oxygen use, higher PaCO2, worse quality of life as measured by the St. George’s Respiratory Quotient, reduced well-being, and lower social function. There was no significant change over 2 years in TM A or B times after adjustment for covariables. Changes in TM B times were modestly associated with survival, but changes in TM B − A times were not. Changes in TM scores were not associated with frequency of hospitalization. Lung function, PaO2, smoking, survival, and hospitalizations were not significantly different in those with executive dysfunction. Conclusions: In this large population of patients with severe emphysema and heavy cigarette smoking exposure, there was no significant decline over 2 years in cognitive executive function as measured by TM tests. There was no association between executive function impairment and frequency of hospitalization, and

  1. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area. 334.783 Section 334.783 Navigation and... RESTRICTED AREA REGULATIONS § 334.783 Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast.... Government vessels include U.S. Coast Guard vessels, Department of Defense vessels, state and local...

  2. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area. 334.783 Section 334.783 Navigation and... RESTRICTED AREA REGULATIONS § 334.783 Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast.... Government vessels include U.S. Coast Guard vessels, Department of Defense vessels, state and local...

  3. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area. 334.783 Section 334.783 Navigation and... RESTRICTED AREA REGULATIONS § 334.783 Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast.... Government vessels include U.S. Coast Guard vessels, Department of Defense vessels, state and local...

  4. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area. 334.783 Section 334.783 Navigation and... RESTRICTED AREA REGULATIONS § 334.783 Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast.... Government vessels include U.S. Coast Guard vessels, Department of Defense vessels, state and local...

  5. 33 CFR 334.783 - Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Guard Base Mobile, Mobile, Alabama, Coast Guard restricted area. 334.783 Section 334.783 Navigation and... RESTRICTED AREA REGULATIONS § 334.783 Arlington Channel, U.S. Coast Guard Base Mobile, Mobile, Alabama, Coast.... Government vessels include U.S. Coast Guard vessels, Department of Defense vessels, state and local...

  6. Variations in U.S. pediatric burn injury hospitalizations using the national burn repository data.

    PubMed

    Kramer, C Bradley; Rivara, Frederick P; Klein, Matthew B

    2010-01-01

    An understanding of population-specific variation in pediatric burn injuries is essential to the development of effective prevention strategies. The purpose of this study was to examine the etiology of pediatric burn injury considering age and race categories using the National Burn Repository. The authors reviewed the records of all pediatric patients (age <18 years) in the American Burn Association's National Burn Registry injured between 1995 and 2007. The authors compared patient and injury characteristics across race, age, etiology, and payor status. A total of 46,582 patients were included in this study. The etiology of burn injury varied by both age and race. Populations of color were younger, constituting 53.8% of patients younger than 5 years, whereas 53.9% of the total study population identified as Caucasian. Scald etiology was disproportionately less common in patients identifying as Caucasian (39.9 vs 61.4%, P < .001), and scald was a common etiology in older children identifying as African American, Asian, and Hispanic. Inhalation injuries were also higher in patients identifying as Native American (5.4%), Hispanic (4.2%), and African American (3.7%). Pediatric burn injury etiology varies with age and race. These data should encourage careful consideration of race, age, and other differences in formulating the most effective, population-specific prevention and outreach strategies.

  7. Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: A cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban

    PubMed Central

    2011-01-01

    Background Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC) attitudes before the national ban came into force in January 2008. Methods Questionnaire-based cross-sectional study, including all eligible staff. Sample: 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR) was performed to identify factors associated with smoking status and TC attitudes. Results Smoking prevalence was 40.5% (95% CI: 33.6-47.4) in males, 23.5% (95% CI: 19.2-27.8) in females (p < 0.001); 43.2% in auxiliaries, 26.1% in nurses, 18.9% among physicians, and 34.7% among other non-health professionals (p = 0.024). The findings showed a very high level of agreement with smoking bans, even among smokers, despite the fact that 70.3% of the smokers smoked on the premises and 76% of staff reported being frequently exposed to second-hand smoke (SHS). In addition 42.8% reported that SHS was unpleasant and 28.3% admitted complaining. MLR showed that smoking behaviour was the most important predictor of TC attitudes. Conclusions Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low

  8. [Optimalisation of the antibiotic policy in The Netherlands. XI. The national electronic antibiotic guide'SWAB-ID' for use in hospitals].

    PubMed

    van Vonderen, M G A; Gyssens, I C; Hartwig, N G; Kullberg, B J; Leverstein-van Hall, M A; Natsch, S; Prins, J M

    2006-11-18

    The 'Stichting Werkgroep Antibioticabeleid' (Dutch Working Party on Antibiotic Policy) has developed an electronic national antibiotic guide for the antibiotic treatment and prophylaxis of common infectious diseases in hospitals. This guide also contains information on the most important characteristics of antimicrobial drugs. Advice on antibiotic treatment is based on existing national evidence-based guidelines, where available. Where no guideline is available, the advice is based on an inventory of the antibiotic policies of the 12 Dutch centres with an infectious disease or medical microbiology training programme. The national antibiotic guide can be accessed through the SWAB website (www.swab.nl) and can also be downloaded on PDA/PocketPC, free of charge. Every hospital antibiotic formulary committee in the Netherlands will be offered the opportunity to edit The national version for local use.

  9. The Mechanism of Guard Cell Movement

    ERIC Educational Resources Information Center

    Marques, M.; Arrabaca, J.; Chagas, I.

    2005-01-01

    Leaves of higher terrestrial plants have small pores--stomata--responsible for gas exchange. The opening of each stoma results from the osmotic uptake of water by two specialised cells--the guard cells. Because of the involvement in this mechanism of ATPase-proton pumps and active transport of ions across membranes, we have designed an Exploring…

  10. General Education at the Coast Guard Academy.

    ERIC Educational Resources Information Center

    Sanders, William A.

    In seeking the most effective presentation of the liberal arts in curricula such as the heavily technical and professional curricula at the U.S. Coast Guard Academy, which leave little room for general education, general education course design must capture the imagination of students and motivate them for continuing self-education. Development of…

  11. Coast Guard's Response to Spilled Oil

    ERIC Educational Resources Information Center

    Ard, R. W., Jr.

    1976-01-01

    The Coast Guard utilizes a number of monitoring detectors, sensors, and techniques to find, recover and identify oil spills. Discussed in this article are in-situ and airborne sensors, systems developed to provide clean-up capability such as air deployable anti-pollution transfer system (ADAPTS), and techniques which will determine the source of a…

  12. 76 FR 39410 - National Offshore Safety Advisory Committee; Vacancies

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

    ... specializing in offshore drilling; and, (e) One member representing companies engaged in production of... SECURITY Coast Guard National Offshore Safety Advisory Committee; Vacancies AGENCY: Coast Guard, DHS... National Offshore Safety Advisory Committee. This Committee advises the Secretary of Department of...

  13. A national system for monitoring the performance of hospitals in Ethiopia.

    PubMed

    McNatt, Zahirah; Linnander, Erika; Endeshaw, Abraham; Tatek, Dawit; Conteh, David; Bradley, Elizabeth H

    2015-10-01

    De nombreux pays s'efforcent d'élaborer et de mettre en œuvre des stratégies pour contrôler les hôpitaux à l'échelle nationale. C'est un défi de taille, en particulier pour les pays à faible revenu, qui disposent de peu de ressources pour effectuer des mesures et des comptes-rendus. Nous avons analysé l'expérience qui a consisté à élaborer et mettre en œuvre un système national de contrôle des performances de 130 hôpitaux publics en Éthiopie. Des observations participatives ont révélé que ce système de contrôle a entraîné une communication plus systématique des données sur les performances aux bureaux régionaux de la santé et au gouvernement fédéral de la part des hôpitaux, a amélioré la transparence concernant les performances de ces derniers et a permis d'élaborer plusieurs projets d'amélioration de la qualité. L'élaboration et la mise en œuvre de ce système, qui ont nécessité des investissements et des soutiens techniques et politiques, n'auraient pas été possibles sans d'importantes capacités de gestion dans les hôpitaux. Il peut être utile, aux premiers stades de la conception et de la mise en œuvre, d'évaluer de manière approfondie l'ouverture au changement du secteur de la santé ainsi que son souhait de placer au premier plan la qualité des services hospitaliers. Cette évaluation peut s'appuyer sur des entretiens avec des informateurs clés, sur la collecte de données au sujet des établissements de santé et des ressources humaines, ou encore sur une discussion avec des partenaires universitaires. Le fait d'associer des partenaires et des donateurs à l'objectif d'amélioration de la qualité visé par le gouvernement peut permettre de renforcer son acceptabilité ainsi que le soutien politique en la matière. Cela peut permettre de faire converger les ressources de façon stratégique vers un même effort national, plutôt que de les éparpiller dans des dizaines de projets potentiellement concurrents

  14. Efficacy of hand rubs with a low alcohol concentration listed as effective by a national hospital hygiene society in Europe

    PubMed Central

    2013-01-01

    Background Some national hospital hygiene societies in Europe such as the French society for hospital hygiene (SFHH) have positive lists of disinfectants. Few hand disinfectants with a rather low concentration of ethanol are listed by one society as effective for hygienic hand disinfection with 3 mL in 30 s including a virucidal activity in 30 s or 60 s, but published data allow having doubts. We have therefore evaluated the efficacy of three commonly used hand disinfectants according to EN 1500 and EN 14476. Methods Products 1 (Aniosgel 85 NPC) and 2 (Aniosrub 85 NPC) were based on 70% ethanol, product 3 (ClinoGel derma+) on 60% ethanol and 15% isopropanol (all w/w). They were tested in 3 laboratories according to EN 1500. Three mL were applied for 30 s and compared to the reference treatment of 2 × 3 mL applications of isopropanol 60% (v/v), on hands artificially contaminated with Escherichia coli. Each laboratory used a cross-over design against the reference alcohol with 15 or 20 volunteers. The virucidal activity of the products was evaluated (EN 14476) in one laboratory against adenovirus and poliovirus in different concentrations (80%, 90%, 97%), with different organic loads (none; clean conditions; phosphate-buffered saline) for up to 3 min. Results Product 1 revealed a mean log10-reduction of 3.87 ± 0.79 (laboratory 1) and 4.38 ± 0.87 (laboratory 2) which was significantly lower compared to the reference procedure (4.62 ± 0.89 and 5.00 ± 0.87). In laboratory 3 product 1 was inferior to the reference disinfection (4.06 ± 0.86 versus 4.99 ± 0.90). Product 2 revealed similar results. Product 3 fulfilled the requirements in one laboratory but failed in the two other. None of the three products was able to reduce viral infectivity of both adenovirus and poliovirus by 4 log10 steps in 3 min according to EN 14476. Conclusions Efficacy data mentioned in a positive list published by a society for hospital hygiene should still be regarded with caution

  15. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

    PubMed Central

    2011-01-01

    Background Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills

  16. Relationship between mean daily ambient temperature range and hospital admissions for schizophrenia: Results from a national cohort of psychiatric inpatients.

    PubMed

    Sung, Tzu-I; Chen, Mu-Jean; Lin, Chuan-Yao; Lung, Shih-Chun; Su, Huey-Jen

    2011-12-01

    Environmental temperature is known to correlate with schizophrenia, but little is known about the association with changes in temperature. This 12-year study aimed to evaluate the relationship between the mean daily range of ambient temperature and schizophrenia admissions in a national cohort of psychiatric inpatients in Taiwan. Meteorological data provided by the Central Weather Bureau of Taiwan were interpolated to create representative estimates. Psychiatric inpatient admissions in all hospitals with medical services enrolled in the current health care insurance system were retrieved from the 1996-2007 Psychiatric Inpatient Medical Claim dataset of the National Health Insurance Research Database. Generalized linear models with Poisson distributions were used to analyze the impact of mean diurnal change of temperature on schizophrenia admissions, controlling for internal correlations and demographic covariates. The daily temperature range varied between 1.7°C and 12.1°C (1st to 99th percentile). The relative risk of schizophrenia admission was significantly increased at a temperature range of 3.2°C (10th percentile), and the maximum was at 12.1°C (99th percentile); however, no such association was found with schizoaffective disorder. When restricted to the capital and largest city, the effects of temperature range were prominent and may correlate with temperature itself. The joint effect of temperature and temperature range was associated with elevated risk, particularly at cooler temperatures. A positive correlation was found between increasing temperature range and schizophrenia admissions. The increase in morbidity at high percentiles suggests that the increasing dynamics of temperature range are a valid reflection of risk, highlighting the need for precautionary action. PMID:22018962

  17. Task-Shifting and Quality of HIV Testing Services: Experiences from a National Reference Hospital in Zambia

    PubMed Central

    Mwangala, Sheila; Moland, Karen M.; Nkamba, Hope C.; Musonda, Kunda G.; Monze, Mwaka; Musukwa, Katoba K.; Fylkesnes, Knut

    2015-01-01

    Background With new testing technologies, task-shifting and rapid scale-up of HIV testing services in high HIV prevalence countries, assuring quality of HIV testing is paramount. This study aimed to explore various cadres of providers’ experiences in providing HIV testing services and their understanding of elements that impact on quality of service in Zambia. Methods Sixteen in-depth interviews and two focus group discussions were conducted with HIV testing service providers including lay counselors, nurses and laboratory personnel at purposively selected HIV testing sites at a national reference hospital in Lusaka. Qualitative content analysis was adopted for data analysis. Results Lay counselors and nurses reported confidentiality and privacy to be greatly compromised due to limited space in both in- and out-patient settings. Difficulties in upholding consent were reported in provider-initiated testing in in-patient settings. The providers identified non-adherence to testing procedures, high workload and inadequate training and supervision as key elements impacting on quality of testing. Difficulties related to testing varied by sub-groups of providers: lay counselors, in finger pricking and obtaining adequate volumes of specimen; non-laboratory providers in general, in interpreting invalid, false-negative and false-positive results. The providers had been participating in a recently established national HIV quality assurance program, i.e. proficiency testing, but rarely received site supervisory visits. Conclusion Task-shifting coupled with policy shifts in service provision has seriously challenged HIV testing quality, protection of confidentiality and the process of informed consent. Ways to better protect confidentiality and informed consent need careful attention. Training, supervision and quality assurance need strengthening tailored to the needs of the different cadres of providers. PMID:26605800

  18. [Noma and HIV infection: apropos of a case at the National Hospital Center in Bobo-Dioulasso (Burkina Faso)].

    PubMed

    Ki-Zerbo, G A; Guigma, Y

    2001-12-01

    Noma (Cancrum oris) is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles. Recently, cases have been reported in adults especially elderly patients or during immunodeficiency states. Reconstructive surgery is often necessary to deal with destruction and sequel but is rarely accessible in developing countries. We report one case of noma (cancrum oris) in an HIV seropositive patient at the National Hospital in Bobo-Dioulasso. The noma was inaugural of AIDS in a 40 years old labourer coming back from Ivory Coast and no major opportunistic infection was associated. The course was fulminant leading to extensive facial gangrene with recurrent bacterial infections. The disease was fatal in this depressive, malnourished and diarrhoeic patient despite local surgical treatment, prolonged antibiotherapy and supportive care. Pathogenic mechanisms, management and preventive issues are discussed. PMID:11887587

  19. [Noma and HIV infection: apropos of a case at the National Hospital Center in Bobo-Dioulasso (Burkina Faso)].

    PubMed

    Ki-Zerbo, G A; Guigma, Y

    2001-12-01

    Noma (Cancrum oris) is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles. Recently, cases have been reported in adults especially elderly patients or during immunodeficiency states. Reconstructive surgery is often necessary to deal with destruction and sequel but is rarely accessible in developing countries. We report one case of noma (cancrum oris) in an HIV seropositive patient at the National Hospital in Bobo-Dioulasso. The noma was inaugural of AIDS in a 40 years old labourer coming back from Ivory Coast and no major opportunistic infection was associated. The course was fulminant leading to extensive facial gangrene with recurrent bacterial infections. The disease was fatal in this depressive, malnourished and diarrhoeic patient despite local surgical treatment, prolonged antibiotherapy and supportive care. Pathogenic mechanisms, management and preventive issues are discussed.

  20. Parallel Quality Assessment of Emergency Departments by European Foundation for Quality Management Model and Iranian National Program for Hospital Evaluation

    PubMed Central

    IMANI NASAB, Mohammad Hasan; MOHAGHEGH, Bahram; KHALESI, Nader; JAAFARIPOOYAN, Ebrahim

    2013-01-01

    Background European Foundation for Quality Management (EFQM) model is a widely used quality management system (QMS) worldwide, including Iran. Current study aims to verify the quality assessment results of Iranian National Program for Hospital Evaluation (INPHE) based on those of EFQM. Methods: This cross-sectional study was conducted in 2012 on a sample of emergency departments (EDs) affiliated with Tehran University of Medical Sciences (TUMS), Iran. The standard questionnaire of EFQM (V-2010) was used to gather appropriate data. The results were compared with those of INPHE. MS Excel was used to classify and display the findings. Results: The average assessment score of the EDs based on the INPHE and EFQM model were largely different (i.e. 86.4% and 31%, respectively). In addition, the variation range among five EDs’ scores according to each model was also considerable (22% for EFQM against 7% of INPHE), especially in the EDs with and without prior record of applying QMSs. Conclusion: The INPHE’s assessment results were not confirmed by EFQM model. Moreover, the higher variation range among EDs’ scores using EFQM model could allude to its more differentiation power in assessing the performance comparing with INPHE. Therefore, a need for improvement in the latter drawing on other QMSs’ (such as EFQM) strengths, given the results emanated from its comparison with EFQM seems indispensable. PMID:23967429

  1. 29 CFR 1910.243 - Guarding of portable powered tools.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... shall be guarded in accordance with the machine guarding requirements in 29 CFR 1910.212, General... limited to, cast iron, glazed tile, surface-hardened steel, glass block, live rock, face brick, or...

  2. 29 CFR 1910.243 - Guarding of portable powered tools.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... shall be guarded in accordance with the machine guarding requirements in 29 CFR 1910.212, General... limited to, cast iron, glazed tile, surface-hardened steel, glass block, live rock, face brick, or...

  3. 29 CFR 1910.243 - Guarding of portable powered tools.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... shall be guarded in accordance with the machine guarding requirements in 29 CFR 1910.212, General... limited to, cast iron, glazed tile, surface-hardened steel, glass block, live rock, face brick, or...

  4. 29 CFR 1910.243 - Guarding of portable powered tools.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... shall be guarded in accordance with the machine guarding requirements in 29 CFR 1910.212, General... limited to, cast iron, glazed tile, surface-hardened steel, glass block, live rock, face brick, or...

  5. 29 CFR 1910.243 - Guarding of portable powered tools.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... shall be guarded in accordance with the machine guarding requirements in 29 CFR 1910.212, General... limited to, cast iron, glazed tile, surface-hardened steel, glass block, live rock, face brick, or...

  6. Cell block one and southeast guard tower, looking from the ...

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

    Cell block one and southeast guard tower, looking from the central guard tower, facing southeast (note view also includes cell block ten (left) and cell block nine (right)) - Eastern State Penitentiary, 2125 Fairmount Avenue, Philadelphia, Philadelphia County, PA

  7. 30 CFR 75.816 - Guarding of cables.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Underground High-Voltage Distribution High-Voltage Longwalls § 75.816 Guarding of cables. (a) High-voltage cables must be guarded at the following...

  8. 30 CFR 75.827 - Guarding of trailing cables.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... HEALTH MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Underground High-Voltage Distribution High-Voltage Longwalls § 75.827 Guarding of trailing cables. (a) Guarding. (1) The high-voltage cable must...

  9. S316, GUARD TOWER INTERIOR. Naval Magazine Lualualei, Headquarters Branch, ...

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

    S316, GUARD TOWER INTERIOR. - Naval Magazine Lualualei, Headquarters Branch, Guard-Watch Tower Type, Off Dent Road & on Kolekole Road near north boundary of installation, Pearl City, Honolulu County, HI

  10. S316, GUARD TOWER ON KOLEKOLE PASS RD. Naval Magazine ...

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

    S316, GUARD TOWER ON KOLEKOLE PASS RD. - Naval Magazine Lualualei, Headquarters Branch, Guard-Watch Tower Type, Off Dent Road & on Kolekole Road near north boundary of installation, Pearl City, Honolulu County, HI

  11. 30 CFR 75.816 - Guarding of cables.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Underground High-Voltage Distribution High-Voltage Longwalls § 75.816 Guarding of cables. (a) High-voltage cables must be guarded at the following...

  12. 30 CFR 75.816 - Guarding of cables.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Underground High-Voltage Distribution High-Voltage Longwalls § 75.816 Guarding of cables. (a) High-voltage cables must be guarded at the following...

  13. 30 CFR 75.816 - Guarding of cables.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... MANDATORY SAFETY STANDARDS-UNDERGROUND COAL MINES Underground High-Voltage Distribution High-Voltage Longwalls § 75.816 Guarding of cables. (a) High-voltage cables must be guarded at the following...

  14. US Coast Guard collision at sea.

    PubMed

    McCaughey, B G

    1985-01-01

    The collision between the USCGC Cuyahoga and the motor vessel Santa Cruz II resulted in psychological distress among the Coast Guard crewmen. The US Navy Special Psychiatric Rapid Intervention Team (SPRINT) was activated to provide mental health services to the Coast Guard survivors and others who had been affected by the disaster. The psychiatric records of the 18 survivors were examined and summarized, and combined with anecdotal comments made by SPRINT members. The most prominent psychological reactions among the survivors were shock, anger, sadness, and guilt. Spouses of the survivors dealt with bereavement and strove to understand their husbands' reactions. Variables identified by the SPRINT as being important to their success were communication with and support from the training center command, assurances of confidentiality to the survivors, and commencement of their work almost immediately following the collision.

  15. MAPK Cascades in Guard Cell Signal Transduction

    PubMed Central

    Lee, Yuree; Kim, Yun Ju; Kim, Myung-Hee; Kwak, June M.

    2016-01-01

    Guard cells form stomata on the epidermis and continuously respond to endogenous and environmental stimuli to fine-tune the gas exchange and transpirational water loss, processes which involve mitogen-activated protein kinase (MAPK) cascades. MAPKs form three-tiered kinase cascades with MAPK kinases and MAPK kinase kinases, by which signals are transduced to the target proteins. MAPK cascade genes are highly conserved in all eukaryotes, and they play crucial roles in myriad developmental and physiological processes. MAPK cascades function during biotic and abiotic stress responses by linking extracellular signals received by receptors to cytosolic events and gene expression. In this review, we highlight recent findings and insights into MAPK-mediated guard cell signaling, including the specificity of MAPK cascades and the remaining questions. PMID:26904052

  16. MAPK Cascades in Guard Cell Signal Transduction.

    PubMed

    Lee, Yuree; Kim, Yun Ju; Kim, Myung-Hee; Kwak, June M

    2016-01-01

    Guard cells form stomata on the epidermis and continuously respond to endogenous and environmental stimuli to fine-tune the gas exchange and transpirational water loss, processes which involve mitogen-activated protein kinase (MAPK) cascades. MAPKs form three-tiered kinase cascades with MAPK kinases and MAPK kinase kinases, by which signals are transduced to the target proteins. MAPK cascade genes are highly conserved in all eukaryotes, and they play crucial roles in myriad developmental and physiological processes. MAPK cascades function during biotic and abiotic stress responses by linking extracellular signals received by receptors to cytosolic events and gene expression. In this review, we highlight recent findings and insights into MAPK-mediated guard cell signaling, including the specificity of MAPK cascades and the remaining questions.

  17. MAPK Cascades in Guard Cell Signal Transduction.

    PubMed

    Lee, Yuree; Kim, Yun Ju; Kim, Myung-Hee; Kwak, June M

    2016-01-01

    Guard cells form stomata on the epidermis and continuously respond to endogenous and environmental stimuli to fine-tune the gas exchange and transpirational water loss, processes which involve mitogen-activated protein kinase (MAPK) cascades. MAPKs form three-tiered kinase cascades with MAPK kinases and MAPK kinase kinases, by which signals are transduced to the target proteins. MAPK cascade genes are highly conserved in all eukaryotes, and they play crucial roles in myriad developmental and physiological processes. MAPK cascades function during biotic and abiotic stress responses by linking extracellular signals received by receptors to cytosolic events and gene expression. In this review, we highlight recent findings and insights into MAPK-mediated guard cell signaling, including the specificity of MAPK cascades and the remaining questions. PMID:26904052

  18. LPT. Guard House (TAN642). Elevations, floor plan, sections, details. Ralph ...

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

    LPT. Guard House (TAN-642). Elevations, floor plan, sections, details. Ralph M. Parsons 1229-12 ANP/GE-7-642-A-S-H7V-1. November 1956. Approved by INEEL Classification Office for public release. INEEL index code no. 038-0642-00-693-107306 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  19. 121. ARAI Guard house (ARA628). Drawing shows north, south, east, ...

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

    121. ARA-I Guard house (ARA-628). Drawing shows north, south, east, and west elevations, floor plan, counter details, and roof plan. Norman Engineering Corporation 961-area/SF-628-A-1. Date: January 1959. Ineel index code no. 063-0628-00-613-102772. - Idaho National Engineering Laboratory, Army Reactors Experimental Area, Scoville, Butte County, ID

  20. U.S. Coast Guard and Florida Power & Light Successfully Implement a Multi-Site UESC Project

    SciTech Connect

    2013-05-01

    As the largest component of the Department of Homeland Security (DHS), more than 42,000 active-duty members of the U.S. Coast Guard safeguard the nation’s maritime interests. Consequently, Coast Guard facilities represent about 60 percent of the DHS shore energy use portfolio. Under the National Energy Conservation Policy Act (NECPA) and Executive Order 13423, the Coast Guard has reduced its facility energy intensity year-on-year, achieving a fiscal year (FY) 2012 reduction of 28.6 percent from a FY 2003 baseline.