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Sample records for national hospital dar

  1. The burden of co-existing dermatological disorders and their tendency of being overlooked among patients admitted to muhimbili national hospital in Dar es Salaam, Tanzania

    PubMed Central

    2011-01-01

    Background Skin diseases are underestimated and overlooked by most clinicians despite being common in clinical practice. Many patients are hospitalized with co-existing dermatological conditions which may not be detected and managed by the attending physicians. The objective of this study was to determine the burden of co-existing and overlooked dermatological disorders among patients admitted to medical wards of Muhimbili National hospital in Dar es Salaam. Study design and settings A hospital-based descriptive cross-sectional study conducted at Muhimbili National hospital in Dar es Salaam, Tanzania. Methods Patients were consecutively recruited from the medical wards. Detailed interview to obtain clinico-demographic characteristics was followed by a complete physical examination. Dermatological diagnoses were made mainly clinically. Appropriate confirmatory laboratory investigations were performed where necessary. Data was analyzed using the 'Statistical Package for Social Sciences' (SPSS) program version 10.0. A p-value of < 0.5 was statistically significant. Results Three hundred and ninety patients admitted to medical wards were enrolled into the study of whom, 221(56.7%) were females. The mean age was 36.7 ± 17.9 (range 7-84 years). Overall, 232/390 patients (59.5%) had co-existing dermatological disorders with 49% (191/390) having one, 9% (36/390) two and 5 patients (1%) three. A wide range of co-existing skin diseases was encountered, the most diverse being non-infectious conditions which together accounted for 36.4% (142/390) while infectious dermatoses accounted for 31.5% (123/390). The leading infectious skin diseases were superficial fungal infections accounting for 18%. Pruritic papular eruption of HIV/AIDS (PPE) and seborrheic eczema were the most common non-infectious conditions, each accounting for 4.3%. Of the 232/390 patients with dermatological disorders, 191/232 (82.3%) and 154/232 (66.3%) had been overlooked by their referring and admitting

  2. Risk factors for anaemia among HIV infected children attending HIV care and treatment clinic at Muhimbili National Hospital in Dar es Salaam, Tanzania.

    PubMed

    Makubi, Abel N; Mugus, Ferdinand; Magesa, Pius M; Roberts, David; Quaresh, Amrana

    2012-01-01

    There is paucity of data describing the risk factors for anaemia among HIV infected children in Tanzania. This cross sectional study aimed at determining the contributing factors for anaemia among HIV-infected children attending Muhimbili National Hospital in Dar es Salaam. Both univariate and multivariate logistic regression analyses were performed to identify possible factors associated with anaemia in HIV-infected children. In this study a total of 75 (44%) patients among 167 recruited HIV children aged 6 months to 59 months were found to be anaemic (Hg<11 g/dl). Multivariate logistic regression demonstrated that not being on HAART (OR 3.40, 95%CI (1.20-9.60), having CD4% <25% (OR 2.30, 95%CI (1.20-34.60), having a history of tuberculosis (TB) (OR 3.23, 95%CI (1.10-9.70) and having hookworm infestation (OR 5.97, 95%CI (1.92-18.4) were independent risk factors for anaemia among HIV infected children. The analyses also showed that being HIV positive for ≥ 2.5 years resulted into a low risk of severe anaemia compared to being HIV positive for < 2.5 years. Taking multivitamins (OR 0.07, 95%, CI (0.020-0.30) and antihelminthics (OR 0.27, 95%CI (0.10-0.74) were also protective against anaemia in children. Similar factors (with exception of using antihelmintics) were associated with severe anaemia. In conclusion the factors associated with anaemia in HIV infected children were multifactorial in nature. Efforts to correct anaemia in HIV infected children should include use of HAART and treatment of infections such as TB and hookworms.

  3. Hyperspectral and LiDAR remote sensing of fire fuels in Hawaii Volcanoes National Park.

    PubMed

    Varga, Timothy A; Asner, Gregory P

    2008-04-01

    Alien invasive grasses threaten to transform Hawaiian ecosystems through the alteration of ecosystem dynamics, especially the creation or intensification of a fire cycle. Across sub-montane ecosystems of Hawaii Volcanoes National Park on Hawaii Island, we quantified fine fuels and fire spread potential of invasive grasses using a combination of airborne hyperspectral and light detection and ranging (LiDAR) measurements. Across a gradient from forest to savanna to shrubland, automated mixture analysis of hyperspectral data provided spatially explicit fractional cover estimates of photosynthetic vegetation, non-photosynthetic vegetation, and bare substrate and shade. Small-footprint LiDAR provided measurements of vegetation height along this gradient of ecosystems. Through the fusion of hyperspectral and LiDAR data, a new fire fuel index (FFI) was developed to model the three-dimensional volume of grass fuels. Regionally, savanna ecosystems had the highest volumes of fire fuels, averaging 20% across the ecosystem and frequently filling all of the three-dimensional space represented by each image pixel. The forest and shrubland ecosystems had lower FFI values, averaging 4.4% and 8.4%, respectively. The results indicate that the fusion of hyperspectral and LiDAR remote sensing can provide unique information on the three-dimensional properties of ecosystems, their flammability, and the potential for fire spread.

  4. Supporting Indonesia's National Forest Monitoring System with LiDAR Observations

    NASA Astrophysics Data System (ADS)

    Hagen, S. C.

    2015-12-01

    Scientists at Applied GeoSolutions, Jet Propulsion Laboratory, Winrock International, and the University of New Hampshire are working with the government of Indonesia to enhance the National Forest Monitoring System in Kalimantan, Indonesia. The establishment of a reliable, transparent, and comprehensive NFMS has been limited by a dearth of relevant data that are accurate, low-cost, and spatially resolved at subnational scales. In this NASA funded project, we are developing, evaluating, and validating several critical components of a NFMS in Kalimantan, Indonesia, focusing on the use of LiDAR and radar imagery for improved carbon stock and forest degradation information. Applied GeoSolutions and the University of New Hampshire have developed an Open Source Software package to process large amounts LiDAR data quickly, easily, and accurately. The Open Source project is called lidar2dems and includes the classification of raw LAS point clouds and the creation of Digital Terrain Models (DTMs), Digital Surface Models (DSMs), and Canopy Height Models (CHMs). Preliminary estimates of forest structure and forest damage from logging from these data sets support the idea that comprehensive, well documented, freely available software for processing LiDAR data can enable countries such as Indonesia to cost effectively monitor their forests with high precision.

  5. Mapping Vegetation Canopy Structure and Distribution for Great Smoky Mountains National Park Using LiDAR

    NASA Astrophysics Data System (ADS)

    Weiner, J.; Kumar, J.; Norman, S. P.

    2015-12-01

    A major challenge in forest management is the inaccessibility of large swaths of land, which makes accurate monitoring of forest change difficult. Remote sensing methods can help address this issue by allowing investigators to monitor remote or inaccessible regions using aerial or satellite-based platforms. However, most remote sensing methods do not provide a full three-dimensional (3D) description of the area. Rather, they return only a single elevation point or landcover description. Multiple-return LiDAR (Light Detection and Ranging) gathers data in a 3D point cloud, which allows forest managers to more accurately characterize and monitor changes in canopy structure and vegetation-type distribution. Our project used high-resolution aerial multiple-return LiDAR data to determine vegetation canopy structures and their spatial distribution in Great Smoky Mountains National Park. To ensure sufficient data density and to match LANDSAT resolution, we gridded the data into 30m x 30m cells. The LiDAR data points within each cell were then used to generate the vertical canopy structure for that cell. After vertical profiles had been created, we used a k-means cluster analysis algorithm to classify the landscape based on the canopy structure. The spatial distribution of distinct and unique canopy structures was mapped across the park and compared to a vegetation-type map to determine the correlation of canopy structure to vegetation types. Preliminary analysis conducted at a number of phenology sites maintained by the Great Smoky Mountains Institute at Tremont shows strong correspondence between canopy structure and vegetation type. However, more validation is needed in other regions of the park to establish this method as a reliable tool. LiDAR data has a unique ability to map full 3D structures of vegetation and the methods developed in this project offer an extensible tool for forest mapping and monitoring.

  6. 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.

  7. Metadata - National Hospital Discharge Survey (NHDS)

    EPA Pesticide Factsheets

    The National Hospital Discharge Survey (NHDS) is an annual probability survey that collects information on the characteristics of inpatients discharged from non-federal short-stay hospitals in the United States.

  8. National survey of hospital patients.

    PubMed Central

    Bruster, S.; Jarman, B.; Bosanquet, N.; Weston, D.; Erens, R.; Delbanco, T. L.

    1994-01-01

    OBJECTIVE--To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN--Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS--5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES--Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS--Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS--This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened

  9. Interpretations of GLAS LiDAR for the Tapajos National Forest, Brazil

    NASA Astrophysics Data System (ADS)

    Hunter, M. O.; Keller, M.; Lefsky, M.; Espà­Rito-Santo, F.

    2007-12-01

    LiDAR remote sensing has proven to be a valuable source of information for characterization of forest structure. We conducted a study at the Tapajós National Forest (TNF) in the state of Pará, Brazil (centered at 3.56S 55.06W) to understand how forest structural properties interpreted from GLAS derived forest heights compared to a more traditional forest classification. The vegetation classification map was based on forest surveys, topography, soils, and interpretation of Landsat data. The original map groups TNF into 16 vegetation classifications. Using approximately 1500 GLAS waveform height predictions (Lefsky, ICESat Vegetation Product, heights ver.0.2) we calculated the 10th and 90th percentile values of distributions. These were interpreted as signals of disturbance and potential forest stand height respectively. We found no clear agreement on an area by area basis though general coherent patterns were observed. Areas close to human populations and those with high water-table depths showed a lower 10th percentile signal indicative of frequent recent disturbance. High plateau areas on clay soils had the greatest 90th percentile values. Our data suggests that statistical interpretation of GLAS may be valuable for comprehensive analyses of forest structure.

  10. Characterization and classification of vegetation canopy structure and distribution within the Great Smoky Mountains National Park using LiDAR

    SciTech Connect

    Kumar, Jitendra; HargroveJr., William Walter; Norman, Steven P; Hoffman, Forrest M; Newcomb, Doug

    2015-01-01

    Vegetation canopy structure is a critically important habit characteristic for many threatened and endangered birds and other animal species, and it is key information needed by forest and wildlife managers for monitoring and managing forest resources, conservation planning and fostering biodiversity. Advances in Light Detection and Ranging (LiDAR) technologies have enabled remote sensing-based studies of vegetation canopies by capturing three-dimensional structures, yielding information not available in two-dimensional images of the landscape pro- vided by traditional multi-spectral remote sensing platforms. However, the large volume data sets produced by airborne LiDAR instruments pose a significant computational challenge, requiring algorithms to identify and analyze patterns of interest buried within LiDAR point clouds in a computationally efficient manner, utilizing state-of-art computing infrastructure. We developed and applied a computationally efficient approach to analyze a large volume of LiDAR data and to characterize and map the vegetation canopy structures for 139,859 hectares (540 sq. miles) in the Great Smoky Mountains National Park. This study helps improve our understanding of the distribution of vegetation and animal habitats in this extremely diverse ecosystem.

  11. [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.

  12. Metadata - National Hospital Ambulatory Medical Care Survey (NHAMCS)

    EPA Pesticide Factsheets

    The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect information on the services provided in hospital emergency and outpatient departments and in ambulatory surgery centers.

  13. Hospital bodies: the genesis of Italian National Health Service.

    PubMed

    Vannelli, Alberto; Buongiorno, Massimo; Battaglia, Luigi; Poiasina, Elia; Boati, Paolo; Rampa, Mario; Leo, Ermanno

    2010-01-01

    Hospital public bodies were instituted in Italy in 1968. Their creation represents a fundamental step forward in the evolution of the national healthcare system and has allowed improvements in social equity in hospitals. The lack of independent funding beyond the insurance-type healthcare system existing at the time, hindered its success. The hospital body has however left a trace in the modern national healthcare system with the introduction of the hospital corporation.

  14. The influence of accuracy, grid size, and interpolation method on the hydrological analysis of LiDAR derived dems: Seneca Nation of Indians, Irving NY

    NASA Astrophysics Data System (ADS)

    Clarkson, Brian W.

    Light Detection and Ranging (LiDAR) derived Digital Elevation Models (DEMs) provide accurate, high resolution digital surfaces for precise topographic analysis. The following study investigates the accuracy of LiDAR derived DEMs by calculating the Root Mean Square Error (RMSE) of multiple interpolation methods with grid cells ranging from 0.5 to 10-meters. A raster cell with smaller dimensions will drastically increase the amount of detail represented in the DEM by increasing the number of elevation values across the study area. Increased horizontal resolutions have raised the accuracy of the interpolated surfaces and the contours generated from the digitized landscapes. As the raster grid cells decrease in size, the level of detail of hydrological processes will significantly improve compared to coarser resolutions including the publicly available National Elevation Datasets (NEDs). Utilizing a LiDAR derived DEM with the lowest RMSE as the 'ground truth', watershed boundaries were delineated for a sub-basin of the Clear Creek Watershed within the territory of the Seneca Nation of Indians located in Southern Erie County, NY. An investigation of the watershed area and boundary location revealed considerable differences comparing the results of applying different interpretation methods on DEM datasets of different horizontal resolutions. Stream networks coupled with watersheds were used to calculate peak flow values for the 10-meter NEDs and LiDAR derived DEMs.

  15. Testicular cancer at Kenyatta National Hospital, Nairobi.

    PubMed

    Opot, E N; Magoha, G A

    2000-02-01

    This retrospective study was undertaken to determine the prevalence, clinical characteristics, management methods and prognosis of testicular cancer at Kenyatta National Hospital, Nairobi. All histologically confirmed testicular cancer patients recorded at the Histopathology Department between 1993 and 1997 were analyzed. The mean age was 34.8 years with a peak incidence in the 30-44 year age group. About 10.26% of patients had history of cryptochirdism. The clinical symptoms presented were painless testicular swelling (n = 31, 79.49%), testicular pain (n = 11, 28.08%), scrotal heaviness (n = 9, 23.08%), abdominal swelling (n = 6, 15.38%), gynecomastia (n = 1, 2.56%), and eye swelling (n = 1, 2.56%). On examination, 32 patients (82.05%) had testicular masses, 10 (25.64%) had abdominal masses, 7 (17.91%) had supraclavicular and cervical lymphadenopathy, 1 had gynecomastia, and 1 had an orbital mass. More than 89% of patients had germ cell cancers with seminoma accounting for 67.35%, teratoma for 12.24%, embryonal carcinoma for 8.16%, rhabdomyosarcoma for 6.12%, and malignant germ cell tumor, orchioblastoma, and dysgerminoma each accounting for 2.04%. The various methods of treatment include orchidectomy and radiotherapy and chemotherapy in 3 patients (7.7%), orchidectomy and radiotherapy in 16 patients (41.03%), orchidectomy and chemotherapy in 6 patients (15.38%), and radiotherapy and chemotherapy in 10 patients (25.64%). No cisplatin-based chemotherapy was used. 18 patients were followed up, of whom 7 were alive after 5 years. Prognosis with current regimens was poor, with a 38.89% survival ratio in 5 years. Hence, cisplatin-based chemotherapy with up to 90% cure rates should be included in the testicular cancer management in this hospital.

  16. 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

  17. National and Global: A History of Scholars' Experiences with Research at the University of Dar Es Salaam, Tanzania (1961-Present)

    ERIC Educational Resources Information Center

    Jamison, Amy J.

    2010-01-01

    In this dissertation, I draw on research carried out at the University of Dar es Salaam (UDSM), Tanzania in 2008 to examine Tanzanian academics' experience with research throughout the history of this institution. This dissertation is designed as an historical case study and investigates how economic and political changes in Tanzania's…

  18. Mapping tropical forest biomass with radar and spaceborne LiDAR in Lopé National Park, Gabon: overcoming problems of high biomass and persistent cloud

    NASA Astrophysics Data System (ADS)

    Mitchard, E. T. A.; Saatchi, S. S.; White, L. J. T.; Abernethy, K. A.; Jeffery, K. J.; Lewis, S. L.; Collins, M.; Lefsky, M. A.; Leal, M. E.; Woodhouse, I. H.; Meir, P.

    2012-01-01

    Spatially-explicit maps of aboveground biomass are essential for calculating the losses and gains in forest carbon at a regional to national level. The production of such maps across wide areas will become increasingly necessary as international efforts to protect primary forests, such as the REDD+ (Reducing Emissions from Deforestation and forest Degradation) mechanism, come into effect, alongside their use for management and research more generally. However, mapping biomass over high-biomass tropical forest is challenging as (1) direct regressions with optical and radar data saturate, (2) much of the tropics is persistently cloud-covered, reducing the availability of optical data, (3) many regions include steep topography, making the use of radar data complex, (5) while LiDAR data does not suffer from saturation, expensive aircraft-derived data are necessary for complete coverage. We present a solution to the problems, using a combination of terrain-corrected L-band radar data (ALOS PALSAR), spaceborne LiDAR data (ICESat GLAS) and ground-based data. We map Gabon's Lopé National Park (5000 km2) because it includes a range of vegetation types from savanna to closed-canopy tropical forest, is topographically complex, has no recent contiguous cloud-free high-resolution optical data, and the dense forest is above the saturation point for radar. Our 100 m resolution biomass map is derived from fusing spaceborne LiDAR (7142 ICESat GLAS footprints), 96 ground-based plots (average size 0.8 ha) and an unsupervised classification of terrain-corrected ALOS PALSAR radar data, from which we derive the aboveground biomass stocks of the park to be 78 Tg C (173 Mg C ha-1). This value is consistent with our field data average of 181 Mg C ha-1, from the field plots measured in 2009 covering a total of 78 ha, and which are independent as they were not used for the GLAS-biomass estimation. We estimate an uncertainty of ±25% on our carbon stock value for the park. This error term

  19. The problem of illegally induced abortion: results from a hospital-based study conducted at district level in Dar es Salaam.

    PubMed

    Rasch, V; Muhammad, H; Urassa, E; Bergström, S

    2000-07-01

    Illegal abortion is known to be a major contributor to maternal mortality. The objective of the study was firstly to identify women with illegally induced abortion, (IA) and to compare them with women admitted with a spontaneous abortion (SA) or receiving antenatal care (AC), and secondly to describe the circumstances which characterized the abortion. The population of this cross-sectional questionnaire study comprised patients from Temeke District Hospital, Dar es Salaam, Tanzania. After an in-depth confidential interview, 603 women with incomplete abortion were divided into two groups: 362 women with IA and 241 with SA. They were compared with 307 AC women. IA women were significantly younger, more often better educated, unmarried, nulliparous and students than AC women. Regarding civil-status, educational level, proportion of nullipara and proportion of students, SA patients were similar to AC women. These results lend support to the assumption that the in-depth confidential interview made it possible to distinguish IA women from SA women.

  20. Louse-borne relapsing fever profile at Felegehiwot referral hospital, Bahir Dar city, Ethiopia: a retrospective study

    PubMed Central

    2014-01-01

    Background Louse- borne relapsing fever is an acute febrile illness caused by Borrelia recurrentis and is transmitted by body lice, Pediculus humanus corporis. The disease has occurred as epidemic in different parts of the country.Therefore, the aim of this retrospective study was conducted to assess the LBRF profile for the last four years. Methods A retrospective study was conducted on patients with LBRF admitted from 2009–2012 at Felegehiwot referral hospital. The diagnosis was based on both clinical and laboratory methods. Patients with strong clinical suspicion of LBRF and positive for Borrelia species in their blood was diagnosed as LBRF cases. Data was collected from all patients with LBRF- like symptoms in their registration book. Data was checked for completeness, coded and analysed using SPSS version 16. P < 0.05 was considered significant for comparison. Results Of the 4559 patients admitted with LBRF- like symptoms, 4178 (91.6%) were males and 381 (8.4%) were females. Most of the patients (74.2%) were within age groups 11–20 years. The majority of patients (94.4%) were from urban residence. The overall prevalence of LBRF was 225 (4.9%) and the highest prevalence 171 (5.1%) was observed in age groups of 11–20 years. The association between seasonal variation and prevalence of LBRF showed that more patients with positive for Borrelia species were recorded in dry 27 (9.7%) than wet 198 (4.6%) seasons (P < 0.001). Finally, a trend in prevalence of LBRF for the last four years showed that the highest numbers of cases were documented in 2010. Conclusion The overall prevalence of LBRF was high and the highest prevalence was observed in young age groups. Moreover, most of the patients with LBRF were from urban dwellers. Therefore, health education should be delivered towards LBRF prevention in the city. PMID:24742342

  1. 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

  2. Human bite injuries in the oro-facial region at the Muhimbili National Hospital, Tanzania

    PubMed Central

    Shubi, Farrid M; Hamza, Omar JM; Kalyanyama, Boniphace M; Simon, Elison NM

    2008-01-01

    Background Human bites in the maxillofacial region compromise function and aesthetics, resulting in social and psychological effects. There is paucity of information regarding human bite injuries in Tanzania. The aim of the study was to assess the occurrence, treatment modalities and prognosis of human bite injuries in the oro-facial region at the Muhimbili National Hospital Dar es Salaam, Tanzania. Methods In a prospective study the details of patients with human bite injuries in the oro-facial region who attended at the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital between January 2001 and December 2005 were recorded. Data included information on age, sex, site, duration of the injury at the time of reporting to hospital, reasons, details of treatment offered and outcome after treatment. Results A total of 33 patients, 13 males and 20 females aged between 12 and 49 years with human bite injuries in the oro-facial region were treated. Thirty patients presented with clean uninfected wounds while 3 had infected wounds. The most (45.5%) frequently affected site was the lower lip. Treatment offered included thorough surgical cleansing with adequate surgical debridement and primary suturing. Tetanus prophylaxis and a course of broad-spectrum antibiotics were given to all the patients. In 90% of the 30 patients who were treated by suturing, the healing was uneventful with only 10% experiencing wound infection or necrosis. Three patients who presented with wounds that had signs of infection were treated by surgical cleansing with debridement, antibiotics and daily dressing followed by delayed primary suturing. Conclusion Most of the human bite injuries in the oro-facial region were due to social conflicts. Although generally considered to be dirty or contaminated they could be successfully treated by surgical cleansing and primary suture with a favourable outcome. Management of such injuries often need multidisciplinary approach. PMID

  3. 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

  4. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  5. Tuberculosis treatment outcomes among hospital workers at a public teaching and national referral hospital in Kenya

    PubMed Central

    Makori, L.; Gikera, M.; Wafula, J.; Chakaya, J.; Edginton, M. E.; Kumar, A. M. V.

    2013-01-01

    Setting: Kenyatta National Hospital (KNH), Nairobi, Ken-ya, a large referral and teaching hospital. Objective: 1) To document tuberculosis (TB) case notification rates and trends; 2) to describe demographic, clinical and workplace characteristics and treatment outcomes; and 3) to examine associations between demographic and clinical characteristics, HIV/AIDS (human immunodeficiency virus/acquired immune-deficiency syndrome) treatment and anti-tuberculosis treatment outcomes among hospital workers with TB at KNH during the period 2006–2011. Design: A retrospective cohort study involving a review of medical records. Results: The TB case notification rate among hospital staff ranged between 413 and 901 per 100 000 staff members per year; 51% of all cases were extra-pulmonary TB; 74% of all cases were among medical, paramedical and support staff. The TB-HIV coinfection rate was 60%. Only 75% had a successful treatment outcome. Patients in the retreatment category, those with unknown HIV status and those who were support staff had a higher risk of poor treatment outcomes. Conclusion: The TB case rate among hospital workers was unacceptably high compared to that of the general population, and treatment outcomes were poor. Infection control in the hospital and management of staff with TB requires urgent attention. PMID:26393055

  6. 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…

  7. High-resolution digital elevation dataset for Crater Lake National Park and vicinity, Oregon, based on LiDAR survey of August-September 2010 and bathymetric survey of July 2000

    USGS Publications Warehouse

    Robinson, Joel E.

    2012-01-01

    Crater Lake partially fills the caldera that formed approximately 7,700 years ago during the eruption of a 12,000-foot volcano known as Mount Mazama. The caldera-forming or climactic eruption of Mount Mazama devastated the surrounding landscape, left a thick deposit of pumice and ash in adjacent valleys, and spread a blanket of volcanic ash as far away as southern Canada. Because the Crater Lake region is potentially volcanically active, knowledge of past events is important to understanding hazards from future eruptions. Similarly, because the area is seismically active, documenting and evaluating geologic faults is critical to assessing hazards from earthquakes. As part of the American Recovery and Reinvestment Act (ARRA) of 2009, the U.S. Geological Survey was awarded funding for high-precision airborne LiDAR (Light Detection And Ranging) data collection at several volcanoes in the Cascade Range through the Oregon LiDAR Consortium, administered by the Oregon Department of Geology and Mineral Industries (DOGAMI). The Oregon LiDAR Consortium contracted with Watershed Sciences, Inc., to conduct the data collection surveys. Collaborating agencies participating with the Oregon LiDAR Consortium for data collection in the Crater Lake region include Crater Lake National Park (National Park Service) and the Federal Highway Administration. In the immediate vicinity of Crater Lake National Park, 798 square kilometers of LiDAR data were collected, providing a digital elevation dataset of the ground surface beneath forest cover with an average resolution of 1.6 laser returns/m2 and both vertical and horizontal accuracies of ±5 cm. The LiDAR data were mosaicked in this report with bathymetry of the lake floor of Crater Lake, collected in 2000 using high-resolution multibeam sonar in a collaborative effort between the U.S. Geological Survey, Crater Lake National Park, and the Center for Coastal and Ocean Mapping at the University of New Hampshire. The bathymetric survey

  8. Assessing fire effects on forest spatial structure using a fusion of Landsat and airborne LiDAR data in Yosemite National Park

    USGS Publications Warehouse

    Kane, Van R.; North, Malcolm P.; Lutz, James A.; Churchill, Derek J.; Roberts, Susan L.; Smith, Douglas F.; McGaughey, Robert J.; Kane, Jonathan T.; Brooks, Matthew L.

    2014-01-01

    Mosaics of tree clumps and openings are characteristic of forests dominated by frequent, low- and moderate-severity fires. When restoring these fire-suppressed forests, managers often try to reproduce these structures to increase ecosystem resilience. We examined unburned and burned forest structures for 1937 0.81 ha sample areas in Yosemite National Park, USA. We estimated severity for fires from 1984 to 2010 using the Landsat-derived Relativized differenced Normalized Burn Ratio (RdNBR) and measured openings and canopy clumps in five height strata using airborne LiDAR data. Because our study area lacked concurrent field data, we identified methods to allow structural analysis using LiDAR data alone. We found three spatial structures, canopy-gap, clump-open, and open, that differed in spatial arrangement and proportion of canopy and openings. As fire severity increased, the total area in canopy decreased while the number of clumps increased, creating a patchwork of openings and multistory tree clumps. The presence of openings > 0.3 ha, an approximate minimum gap size needed to favor shade-intolerant pine regeneration, increased rapidly with loss of canopy area. The range and variation of structures for a given fire severity were specific to each forest type. Low- to moderate-severity fires best replicated the historic clump-opening patterns that were common in forests with frequent fire regimes. Our results suggest that managers consider the following goals for their forest restoration: 1) reduce total canopy cover by breaking up large contiguous areas into variable-sized tree clumps and scattered large individual trees; 2) create a range of opening sizes and shapes, including ~ 50% of the open area in gaps > 0.3 ha; 3) create multistory clumps in addition to single story clumps; 4) retain historic densities of large trees; and 5) vary treatments to include canopy-gap, clump-open, and open mosaics across project areas to mimic the range of patterns found for each

  9. Hospital library service and the changes in national standards.

    PubMed Central

    Glitz, B; Flack, V; Lovas, I M; Newell, P

    1998-01-01

    Two important sets of standards affecting hospital libraries were significantly revised in 1994, those of the Medical Library Association (MLA) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). As part of its continuing efforts to monitor library services within its region, the University of California, Los Angeles Biomedical Library, Regional Medical Library for the Pacific Southwest Region of the National Network of Libraries of Medicine (NN/LM) conducted a survey in late 1994, in part to determine the effects of these revised standards on regional hospital libraries. Data from the survey were also used to provide a view of hospital libraries in the Pacific Southwest region, and to make comparisons with similar data collected in 1989. Results showed that while libraries remained stable in overall number, size, and staffing, services, especially those associated with end-user searching and interlibrary loan, increased enormously. With respect to the MLA standards, results show a high compliance level. Interesting differences were seen between the perceptions of library staff concerning their rate of compliance with the JCAHO standards and their actual compliance as measured by the MLA criteria. While some libraries appear to measure up better than their own perceptions would indicate, others may be fully aware of their actual compliance level. PMID:9549016

  10. Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

    PubMed Central

    Katalambula, Leonard K.; Ntwenya, Julius Edward; Ngoma, Twalib; Buza, Joram; Mpolya, Emmanuel

    2016-01-01

    Background. Colorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ2) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different (P = 0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age (P = 0.0183) and time (P = 0.004) but not gender (P = 0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P = 0.0405), age (P = 0.0015), and time (P = 0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate. PMID:27965709

  11. Estimation of Above Ground Biomass in the Everglades National Park using X-, C-, and L-band SAR data and Ground-based LiDAR

    NASA Astrophysics Data System (ADS)

    Feliciano, E. A.; Wdowinski, S.; Potts, M.; Kim, S.

    2011-12-01

    Anthropogenic activities are disrupting bio-diverse wetland ecosystems including the South Florida Everglades. To quantify these acute changes is difficult given its limited accessibility. Remote sensing is widely used for successful ecosystem monitoring. We use ground-based LiDAR a.k.a. Terrestrial Laser Scanning (TLS) and space-based Synthetic Aperture Radar (SAR) observations to estimate vegetation structure, above-ground biomass, and track their changes over time in the Everglades National Park. These surveys were conducted in six vegetation communities: short-mangrove, intermediate-mangrove, tall-mangrove, pine, dwarf cypress and hammock. The TLS surveys provided detailed 3-D estimates of the vegetation structure and above ground biomass. The upscaling approach started with the SAR acquisitions at the three different wavelengths, showing the interacted signal with different aspects of the vegetation. We use single- (HH and VV), dual- (HH/VV, HH/HV and VV/HV) and quad-polarization observations of the TerraSAR-X, RadarSAT-2, and ALOS satellites, acquired around same dates as the ground TLS surveys were conducted. The different polarization data reflect radar signal interaction with different sections of the vegetation due to different scattering mechanisms. The processing of the SAR included: Sigma Nought backscattering coefficient calibration, speckle noise suppression filtering and geocoding with the TLS data. A comparative analysis of the three bands of SAR to quantify above ground biomass in the different communities will be presented. We also plan to determine the essential bands needed to most efficiently estimate biomass. We expect to find that the performance of SAR upscaling differs by community types. We are optimistic that the integration of TLS and SAR could be applied to monitor different ecosystems around the world. This will increase the chance that the Reducing Emissions from Deforestation and Forest Degradation (REDD+), in which large

  12. Classification of savanna tree species, in the Greater Kruger National Park region, by integrating hyperspectral and LiDAR data in a Random Forest data mining environment

    NASA Astrophysics Data System (ADS)

    Naidoo, L.; Cho, M. A.; Mathieu, R.; Asner, G.

    2012-04-01

    The accurate classification and mapping of individual trees at species level in the savanna ecosystem can provide numerous benefits for the managerial authorities. Such benefits include the mapping of economically useful tree species, which are a key source of food production and fuel wood for the local communities, and of problematic alien invasive and bush encroaching species, which can threaten the integrity of the environment and livelihoods of the local communities. Species level mapping is particularly challenging in African savannas which are complex, heterogeneous, and open environments with high intra-species spectral variability due to differences in geology, topography, rainfall, herbivory and human impacts within relatively short distances. Savanna vegetation are also highly irregular in canopy and crown shape, height and other structural dimensions with a combination of open grassland patches and dense woody thicket - a stark contrast to the more homogeneous forest vegetation. This study classified eight common savanna tree species in the Greater Kruger National Park region, South Africa, using a combination of hyperspectral and Light Detection and Ranging (LiDAR)-derived structural parameters, in the form of seven predictor datasets, in an automated Random Forest modelling approach. The most important predictors, which were found to play an important role in the different classification models and contributed to the success of the hybrid dataset model when combined, were species tree height; NDVI; the chlorophyll b wavelength (466 nm) and a selection of raw, continuum removed and Spectral Angle Mapper (SAM) bands. It was also concluded that the hybrid predictor dataset Random Forest model yielded the highest classification accuracy and prediction success for the eight savanna tree species with an overall classification accuracy of 87.68% and KHAT value of 0.843.

  13. Management evaluation about introduction of electric medical record in the national hospital organization.

    PubMed

    Nakagawa, Yoshiaki; Tomita, Naoko; Irisa, Kaoru; Yoshihara, Hiroyuki; Nakagawa, Yoshinobu

    2013-01-01

    Introduction of Electronic Medical Record (EMR) into a hospital was started from 1999 in Japan. Then, most of all EMR company said that EMR improved efficacy of the management of the hospital. National Hospital Organization (NHO) has been promoting the project and introduced EMR since 2004. NHO has 143 hospitals, 51 hospitals offer acute-phase medical care services, the other 92 hospitals offer medical services mainly for chronic patients. We conducted three kinds of investigations, questionnaire survey, checking the homepage information of the hospitals and analyzing the financial statements of each NHO hospital. In this financial analysis, we applied new indicators which have been developed based on personnel costs. In 2011, there are 44 hospitals which have introduced EMR. In our result, the hospital with EMR performed more investment of equipment/capital than personnel expenses. So, there is no advantage of EMR on the financial efficacy.

  14. [Historical origins between National Medical Association of China and Boji Hospital in Guangzhou].

    PubMed

    Liu, Pinming

    2015-09-01

    In 2015, National Medical Association of China, now being called the Chinese Medical Association, celebrates its centennial and Boji Hospital in Guangzhou ( also known as Canton Hospital, or the Canton Pok Tsai Hospital, and now Sun Yat-sen Memorial Hospital of Sun Yat-sen University ) marks its 180th anniversary. Three major historical events establish the role of Boji Hospital in the founding and development of the National Medical Association of China during the last 100 years, viz.: ①hosting and participating in the establishment of the Medical Missionary Association of China and its official journal: the China Medical Missionary Journal; ②holding the 11th scientific sessions of the National Medical Association of China; ③nominating Dr. Wu Lien-teh as a candidate for the Nobel Prize in Physiology or Medicine in 1935 by William Warder Cadbury, the president of Boji Hospital.

  15. 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

  16. 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.

  17. 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

  18. National Trends in Hospitalizations of Adults with Tetralogy of Fallot

    PubMed Central

    Stefanescu Schmidt, Ada C.; Yeh, Doreen DeFaria; Tabtabai, Sara; Kennedy, Kevin F.; Yeh, Robert W.; Bhatt, Ami B.

    2017-01-01

    The population of adults with tetralogy of Fallot (TOF) is growing, and it is not known how the changes in age distribution, treatment strategies and prevalence of comorbidities impact their interaction with the healthcare system. We sought to analyze the frequency and reasons for hospital admissions over the past decade. We extracted serial cross-sectional data from the United States Nationwide Inpatient Sample on hospitalizations including the diagnostic code for TOF from 2000 to 2011. From 2000–2011, there were 20,545 admissions for individuals with TOF, with a steady increase in annual number. The most common primary admission diagnoses were heart failure (HF; 17%), arrhythmias (atrial 10%, ventricular 6%), pneumonia (9%) and device complications (7%). The rates of comorbidities increased significantly, particularly diabetes (4.5% to 8.1%), obesity (2.1% to 6.5%), hypertension and renal disease. The number of pulmonic valve replacements increased (6.8% to 11.3% of TOF admissions, p<0.001), with a rise in median age at surgery from 16 to 19 years old (p=0.036). The cost per TOF admission was more than double that of non-congenital HF admissions and rose significantly, reaching $21,800±46,000 in 2011. In conclusion, hospitalized patients with TOF have become significantly more medically complex and are growing in number. The rise in the prevalence of obesity, hypertension and diabetes in this young population supports the need for prevention efforts focused on modifiable risk factors, in addition to HF and arrhythmia treatment. The increase in cost of care calls for further analysis of areas in which efficiency can be increased to ensure high quality of care and lifelong follow-up of patients with TOF. PMID:27530825

  19. 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.

  20. [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.

  1. Surveillance of hospital-acquired infections in Australia--One Nation, Many States.

    PubMed

    Richards, Michael J; Russo, Phillip L

    2007-06-01

    Surveillance programmes for hospital-acquired infections differ amongst the Australian states. Victoria, New South Wales, Queensland and South Australia have recent substantial initiatives in development of statewide programmes. Whilst the definitions for surgical site infections (SSIs) and bloodstream infections (BSI) developed by the Australian Infection Control Association (AICA) do not differ from the US National Nosocomial Infection Surveillance (NNIS) programme definitions for SSI and intensive care unit (ICU) acquired central line-associated BSI, only two states use NNIS risk adjustment methods in reporting infection rates. Differences exist in the surgical procedures under surveillance, ICU surveillance, hospital-wide BSI surveillance, staff health immunization surveillance, process measures such us surgical antibiotic prophylaxis and small hospital programmes. Only in the area of antibiotic use surveillance has national consensus been reached. In Victoria, NNIS risk adjustment had limited usefulness in predicting SSIs, especially after coronary artery bypass graft (CABG) surgery. Ventilator-associated pneumonia (VAP) surveillance had limited acceptance, and is not undertaken in other states. Regular reporting of surgical antibiotic prophylaxis data has been followed by improvement in choice of antibiotic in some procedures. The South Australian programme for the surveillance of multiresistant organisms (MROs) has documented substantial improvement in meticillin-resistant Staphylococcus aureus (MRSA) morbidity over time coincident with the introduction of hand hygiene programmes and other measures. In Queensland, statewide monitoring of needlestick injuries is established. In Victoria, the small hospital programme concentrated on process measures, and in Queensland with a standardized investigation pathways for "signal" events. Data quality presented substantial challenges in small Victorian hospitals. Whilst state-based programmes have facilitated

  2. Factors associated with poor hospital mortality rates after the National Health Insurance program.

    PubMed

    Chang, Li

    2015-03-01

    The study examined whether hospital mortality rates have improved since National Health Insurance (NHI) in Taiwan and what factors affect the hospital mortality rates. The related hospital data were collected from databases belonging to the NHI Annual Statistics Information. In addition, panel data analysis and stepwise regression are used to indicate the determinants of hospital mortality rates from 1995 to 2008. The evidence shows that mortality rates have not improved since the NHI; competition, the elderly, family income, the poor, the number of clinical departments, length of stay, new technology, public hospitals and family medical expenses-all affect mortality rates. Moreover, longer length of stay, increase in the number of elderly and low-income families, and inequality of resource allocation have led to high mortality rates. Policy makers first have to realize what drives them to change and then set the benchmarks for their improvement.

  3. Hospital cardiac arrest resuscitation practice in the US: a nationally representative survey

    PubMed Central

    Edelson, Dana P.; Yuen, Trevor C; Mancini, Mary E; Davis, Daniel P; Hunt, Elizabeth A; Miller, Joseph A; Abella, Benjamin S

    2014-01-01

    Background In-hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in practice as a potential etiology. However, little is known about the standards of IHCA resuscitation practice among US hospitals. Objective To describe current US hospital practices with regard to resuscitation care. Design A nationally representative mail survey. Setting A random sample of 1,000 hospitals from the American Hospital Association database, stratified into nine categories by hospital volume tertile and teaching status (major teaching, minor teaching and non-teaching). Subjects Surveys were addressed to each hospital's CPR Committee Chair or Chief Medical/Quality Officer. Measurements A 27-item questionnaire. Results Responses were received from 439 hospitals with a similar distribution of admission volume and teaching status as the sample population (p=0.50). Of the 270 (66%) hospitals with a CPR committee, 23 (10%) were chaired by a Hospitalist. High frequency practices included having a Rapid Response Team (91%) and standardizing defibrillators (88%). Low frequency practices included therapeutic hypothermia and use of CPR assist technology. Other practices such as debriefing (34%) and simulation training (62%) were more variable and correlated with the presence of a CPR Committee and/or dedicated personnel for resuscitation quality improvement. The majority of hospitals (79%) reported at least one barrier to quality improvement, of which the lack of a resuscitation champion and inadequate training were the most common. Conclusions There is wide variability between hospitals and within practices for resuscitation care in the US with opportunities for improvement. PMID:24550202

  4. 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

  5. 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

  6. 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

    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.

  7. 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.

  8. 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.

  9. Who decides which pharmacy services are provided in UK National Health Service hospitals?

    PubMed

    Cotter, S M; McKee, M; Strong, P M

    1997-02-01

    An interview survey of 129 UK National Health Service doctors, nurses, pharmacists and managers at eight acute care hospitals was conducted in 1994. The survey examined several topics including whether the introduction of the internal market had affected hospital pharmacy services and what those effects had been. An internal market has been introduced and it has had significant effects on the nature and structure of hospital pharmacy services. Directorate pharmacy services were available at six sites. Contracts for specific, usually novel, services had been implemented at one site and contracts had been introduced widely at another hospital. However, all the features of a market were not present at any site. Market orientation also has implications for the equity of service provision, primarily because decision-making regarding service provision is increasingly in the hands of the clinical directors, rather than pharmacy managers. The effects of this change are not yet clear.

  10. Use of a national collaborative to improve hospital quality in a low-income setting

    PubMed Central

    Linnander, Erika; McNatt, Zahirah; Sipsma, Heather; Tatek, Dawit; Abebe, Yigeremu; Endeshaw, Abraham; Bradley, Elizabeth H.

    2016-01-01

    Background Quality improvement collaboratives are a widely used mechanism to improve hospital performance in high-income settings, but we lack evidence about their effectiveness in low-income settings. Methods We conducted cross-sectional and longitudinal analysis of data from the Ethiopian Hospital Alliance for Quality, a national collaborative sponsored by Ethiopia's Federal Ministry of Health. We identified hospital strategies associated with more positive patient satisfaction using linear regression and assessed changes in patient experience over a 3-year period (2012–2014) using matched t-tests. Results A total of 68 hospitals (response rate 68/120, 56.7%) were included in cross-sectional analysis. Four practices were significantly associated with more positive patient satisfaction (p<0.05): posting a record of cleaning activity in toilets and in patient wards, distributing leaflets in the local language with each prescription, and sharing ideas about patient experience across the hospital. Among hospitals that had complete data for longitudinal analysis (44/68, 65%), we found a 10% improvement in a 10-point measure of patient satisfaction (7.7 vs 8.4, p<0.01) from the start to the end of the study period. Conclusions Quality improvement collaboratives can be useful at scale in low-income settings in sub-Saharan Africa, particularly for hospitals that adopt strategies associated with patient satisfaction. PMID:26796023

  11. 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

  12. National Trends in Incidence Rates of Hospitalization for Stroke in Children With Sickle Cell Disease

    PubMed Central

    McCavit, Timothy L.; Xuan, Lei; Zhang, Song; Flores, Glenn; Quinn, Charles T.

    2014-01-01

    Background The success of primary stroke prevention for children with sickle cell disease (SCD) throughout the United States is unknown. Therefore, we aimed to generate national incidence rates of hospitalization for stroke in children with sickle cell disease (SCD) before and after publication of the Stroke Prevention Trial in Sickle Cell Anemia (STOP trial) in 1998. Procedure We performed a retrospective trend analysis of the 1993–2009 Nationwide Inpatient Sample and Kids’ Inpatient Databases. Hospitalizations for SCD patients 0–18 years old with stroke were identified by ICD-9CM code. The primary outcome, the trend in annual incidence rate of hospitalization for stroke in children with SCD, was analyzed by linear regression. Incidence rates of hospitalization for stroke before and after 1998 were compared by the Wilcoxon rank-sum test. Results From 1993 to 2009, 2,024 hospitalizations were identified for stroke. Using the mean annual incidence rate of hospitalization for stroke from 1993 to 1998 as the baseline, the rate decreased from 1993 to 2009 (point estimate = −0.022/100 patient years [95% CI, −0.039, −0.005], P = 0.027). The mean annual incidence rate of hospitalization stroke decreased by 45% from 0.51 per 100 patient years in 1993–1998 to 0.28 per 100 patient years in 1999–2009 (P = 0.008). Total hospital days and charges attributed to stroke also decreased by 45% and 24%, respectively. Conclusions After publication of the STOP trial and hydroxyurea licensure in 1998, the incidence of hospitalization for stroke in children with SCD decreased across the United States, suggesting that primary stroke prevention has been effective nationwide, but opportunity for improvement remains. PMID:23151905

  13. 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.

  14. [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.

  15. 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.

  16. National In-Hospital Outcomes of Pregnancy in Women With Single Ventricle Congenital Heart Disease.

    PubMed

    Collins, R Thomas; Chang, Di; Sandlin, Adam; Goudie, Anthony; Robbins, James M

    2017-04-01

    Most patients with single ventricle (SV) congenital heart disease are expected to survive to adulthood. Women with SV are often counseled against pregnancy; however, data on pregnancies in these women are lacking. We sought to evaluate in-hospital outcomes of pregnancy in women with SV. We used nationally representative data from the 1998 to 2012 National Inpatient Sample to identify women ≥18 years of age admitted to the hospital with International Classification of Diseases-9th Revision codes for an intrauterine pregnancy and a diagnosis of hypoplastic left heart syndrome, tricuspid atresia, or common ventricle. A matched comparison group without a diagnosis of congenital heart disease or pulmonary hypertension was identified from the database. National estimates of hospitalizations were calculated. Length of stay, hospital charges, and complications were analyzed and compared between groups. Charge data were adjusted to 2012 dollars. There were 282 admissions of pregnant women with SV (69% with deliveries) and 1,405 admissions in the control group (88% with deliveries). Vaginal delivery was more common in SV (74% vs 71%, p <0.001). Length of stay (4.1 ± 0.91 vs 2.8 ± 0.18 days, p <0.001) and charges ($30,787 ± 8,109 vs $15,536 ± 1,006, p <0.0001) were higher in the SV group. Complications occurred in most SV admissions and were more common in the SV group than in the control group. No deaths occurred. Cardiovascular complications occurred in 25% of pregnancy-related hospitalizations, although in-hospital pregnancy-related death is rare. Vaginal delivery is common in these patients. These data suggest that pregnancy and vaginal delivery can be tolerated in women with SV, although the risk for a cardiovascular event is significantly higher than in the general population.

  17. National sex-specific trends in hospital-based stroke rates.

    PubMed

    Ovbiagele, Bruce

    2011-11-01

    Mounting regional and national evidence suggests a decline in primary in-hospital stroke diagnoses. However, these data do not include secondary diagnoses of stroke, and little is known about whether this decline varies significantly by sex. Compared with men, women are less likely to have optimal control of stroke risk factors, which may be leading to less impressive declines in stroke incidence in women. This study evaluated sex trends in hospital-based stroke diagnoses in the United States. The study was a time-trend analysis by sex of national age-adjusted rates of primary or secondary hospital-based stroke diagnosis per 100,000 persons (identified by ICD-9 procedure codes) among patients for 1997-2006 using data from all US states contributing to the Nationwide Inpatient Sample. Adjustments were made to correct for some inaccuracies in diagnostic codes. Between 1997 and 2006, total hospital-based stroke diagnoses decreased from 680,607 to 609,359. The age-adjusted hospital-based stroke diagnosis rate per 100,000 persons decreased in a roughly linear pattern from 282.7 to 210.4 in men (26%; P < .001) and from 240.5 to 184.7 in women (23%; P < .05). The average rate of decrease (slope) in hospital-based stroke diagnosis rates was greater in men than in women (-8.7 vs -7.5 per 100,000 persons; P = .003). Age-adjusted rates of hospital-based stroke diagnoses have decreased substantially in the United States during the last decade, but slightly less so in women. These results are generally encouraging, but nonetheless indicate that more intensive preventive efforts are warranted to completely eliminate sex disparities in stroke occurrence.

  18. 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.

  19. An international survey of physicians regarding clinical trials: a comparison between Kyoto University Hospital and Seoul National University Hospital

    PubMed Central

    2013-01-01

    Background International clinical trials are now rapidly expanding into Asia. However, the proportion of global trials is higher in South Korea compared to Japan despite implementation of similar governmental support in both countries. The difference in clinical trial environment might influence the respective physicians’ attitudes and experience towards clinical trials. Therefore, we designed a questionnaire to explore how physicians conceive the issues surrounding clinical trials in both countries. Methods A questionnaire survey was conducted at Kyoto University Hospital (KUHP) and Seoul National University Hospital (SNUH) in 2008. The questionnaire consisted of 15 questions and 2 open-ended questions on broad key issues relating to clinical trials. Results The number of responders was 301 at KUHP and 398 at SNUH. Doctors with trial experience were 196 at KUHP and 150 at SNUH. Among them, 12% (24/196) at KUHP and 41% (61/150) at SUNH had global trial experience. Most respondents at both institutions viewed clinical trials favorably and thought that conducting clinical trials contributed to medical advances, which would ultimately lead to new and better treatments. The main reason raised as a hindrance to conducting clinical trials was the lack of personnel support and time. Doctors at both university hospitals thought that more clinical research coordinators were required to conduct clinical trials more efficiently. KUHP doctors were driven mainly by pure academic interest or for their desire to find new treatments, while obtaining credits for board certification and co-authorship on manuscripts also served as motivation factors for doctors at SNUH. Conclusions Our results revealed that there might be two different approaches to increase clinical trial activity. One is a social level approach to establish clinical trial infrastructure providing sufficient clinical research professionals. The other is an individual level approach that would provide incentives to

  20. Modelling the standing timber volume of Baden-Württemberg-A large-scale approach using a fusion of Landsat, airborne LiDAR and National Forest Inventory data

    NASA Astrophysics Data System (ADS)

    Maack, Joachim; Lingenfelder, Marcus; Weinacker, Holger; Koch, Barbara

    2016-07-01

    Remote sensing-based timber volume estimation is key for modelling the regional potential, accessibility and price of lignocellulosic raw material for an emerging bioeconomy. We used a unique wall-to-wall airborne LiDAR dataset and Landsat 7 satellite images in combination with terrestrial inventory data derived from the National Forest Inventory (NFI), and applied generalized additive models (GAM) to estimate spatially explicit timber distribution and volume in forested areas. Since the NFI data showed an underlying structure regarding size and ownership, we additionally constructed a socio-economic predictor to enhance the accuracy of the analysis. Furthermore, we balanced the training dataset with a bootstrap method to achieve unbiased regression weights for interpolating timber volume. Finally, we compared and discussed the model performance of the original approach (r2 = 0.56, NRMSE = 9.65%), the approach with balanced training data (r2 = 0.69, NRMSE = 12.43%) and the final approach with balanced training data and the additional socio-economic predictor (r2 = 0.72, NRMSE = 12.17%). The results demonstrate the usefulness of remote sensing techniques for mapping timber volume for a future lignocellulose-based bioeconomy.

  1. National Rules for Drug–Drug Interactions: Are They Appropriate for Tertiary Hospitals?

    PubMed Central

    2016-01-01

    The application of appropriate rules for drug–drug interactions (DDIs) could substantially reduce the number of adverse drug events. However, current implementations of such rules in tertiary hospitals are problematic as physicians are receiving too many alerts, causing high override rates and alert fatigue. We investigated the potential impact of Korean national DDI rules in a drug utilization review program in terms of their severity coverage and the clinical efficiency of how physicians respond to them. Using lists of high-priority DDIs developed with the support of the U.S. government, we evaluated 706 contraindicated DDI pairs released in May 2015. We evaluated clinical log data from one tertiary hospital and prescription data from two other tertiary hospitals. The measured parameters were national DDI rule coverage for high-priority DDIs, alert override rate, and number of prescription pairs. The coverage rates of national DDI rules were 80% and 3.0% at the class and drug levels, respectively. The analysis of the system log data showed an overall override rate of 79.6%. Only 0.3% of all of the alerts (n = 66) were high-priority DDI rules. These showed a lower override rate of 51.5%, which was much lower than for the overall DDI rules. We also found 342 and 80 unmatched high-priority DDI pairs which were absent in national rules in inpatient orders from the other two hospitals. The national DDI rules are not complete in terms of their coverage of severe DDIs. They also lack clinical efficiency in tertiary settings, suggesting improved systematic approaches are needed. PMID:27822925

  2. A national survey of inpatient medication systems in English NHS hospitals

    PubMed Central

    2014-01-01

    Background Systems and processes for prescribing, supplying and administering inpatient medications can have substantial impact on medication administration errors (MAEs). However, little is known about the medication systems and processes currently used within the English National Health Service (NHS). This presents a challenge for developing NHS-wide interventions to increase medication safety. We therefore conducted a cross-sectional postal census of medication systems and processes in English NHS hospitals to address this knowledge gap. Methods The chief pharmacist at each of all 165 acute NHS trusts was invited to complete a questionnaire for medical and surgical wards in their main hospital (July 2011). We report here the findings relating to medication systems and processes, based on 18 closed questions plus one open question about local medication safety initiatives. Non-respondents were posted another questionnaire (August 2011), and then emailed (October 2011). Results One hundred (61% of NHS trusts) questionnaires were returned. Most hospitals used paper-based prescribing on the majority of medical and surgical inpatient wards (87% of hospitals), patient bedside medication lockers (92%), patients’ own drugs (89%) and ‘one-stop dispensing’ medication labelled with administration instructions for use at discharge as well as during the inpatient stay (85%). Less prevalent were the use of ward pharmacy technicians (62% of hospitals) or pharmacists (58%) to order medications on the majority of wards. Only 65% of hospitals used drug trolleys; 50% used patient-specific inpatient supplies on the majority of wards. Only one hospital had a pharmacy open 24 hours, but all had access to an on-call pharmacist. None reported use of unit-dose dispensing; 7% used an electronic drug cabinet in some ward areas. Overall, 85% of hospitals had a double-checking policy for intravenous medication and 58% for other specified drugs. “Do not disturb” tabards

  3. National Automated Surveillance of Hospital-Acquired Bacteremia in Denmark Using a Computer Algorithm.

    PubMed

    Gubbels, Sophie; Nielsen, Jens; Voldstedlund, Marianne; Kristensen, Brian; Schønheyder, Henrik C; Ellermann-Eriksen, Svend; Engberg, Jørgen H; Møller, Jens K; Østergaard, Christian; Mølbak, Kåre

    2017-03-09

    BACKGROUND In 2015, Denmark launched an automated surveillance system for hospital-acquired infections, the Hospital-Acquired Infections Database (HAIBA). OBJECTIVE To describe the algorithm used in HAIBA, to determine its concordance with point prevalence surveys (PPSs), and to present trends for hospital-acquired bacteremia SETTING Private and public hospitals in Denmark METHODS A hospital-acquired bacteremia case was defined as at least 1 positive blood culture with at least 1 pathogen (bacterium or fungus) taken between 48 hours after admission and 48 hours after discharge, using the Danish Microbiology Database and the Danish National Patient Registry. PPSs performed in 2012 and 2013 were used for comparison. RESULTS National trends showed an increase in HA bacteremia cases between 2010 and 2014. Incidence was higher for men than women (9.6 vs 5.4 per 10,000 risk days) and was highest for those aged 61-80 years (9.5 per 10,000 risk days). The median daily prevalence was 3.1% (range, 2.1%-4.7%). Regional incidence varied from 6.1 to 8.1 per 10,000 risk days. The microorganisms identified were typical for HA bacteremia. Comparison of HAIBA with PPS showed a sensitivity of 36% and a specificity of 99%. HAIBA was less sensitive for patients in hematology departments and intensive care units. Excluding these departments improved the sensitivity of HAIBA to 44%. CONCLUSIONS Although the estimated sensitivity of HAIBA compared with PPS is low, a PPS is not a gold standard. Given the many advantages of automated surveillance, HAIBA allows monitoring of HA bacteremia across the healthcare system, supports prioritizing preventive measures, and holds promise for evaluating interventions. Infect Control Hosp Epidemiol 2017;1-8.

  4. Length of hospital stay after craniotomy for tumor: a National Surgical Quality Improvement Program analysis.

    PubMed

    Dasenbrock, Hormuzdiyar H; Liu, Kevin X; Devine, Christopher A; Chavakula, Vamsidhar; Smith, Timothy R; Gormley, William B; Dunn, Ian F

    2015-12-01

    OBJECT Although the length of hospital stay is often used as a measure of quality of care, data evaluating the predictors of extended hospital stay after craniotomy for tumor are limited. The goals of this study were to use multivariate regression to examine which preoperative characteristics and postoperative complications predict a prolonged hospital stay and to assess the impact of length of stay on unplanned hospital readmission. METHODS Data were extracted from the National Surgical Quality Improvement Program (NSQIP) database from 2007 to 2013. Patients who underwent craniotomy for resection of a brain tumor were included. Stratification was based on length of hospital stay, which was dichotomized by the upper quartile of the interquartile range (IQR) for the entire population. Covariates included patient age, sex, race, tumor histology, comorbidities, American Society of Anesthesiologists (ASA) class, functional status, preoperative laboratory values, preoperative neurological deficits, operative time, and postoperative complications. Multivariate logistic regression with forward prediction was used to evaluate independent predictors of extended hospitalization. Thereafter, hierarchical multivariate logistic regression assessed the impact of length of stay on unplanned readmission. RESULTS The study included 11,510 patients. The median hospital stay was 4 days (IQR 3-8 days), and 27.7% (n = 3185) had a hospital stay of at least 8 days. Independent predictors of extended hospital stay included age greater than 70 years (OR 1.53, 95% CI 1.28%-1.83%, p < 0.001); African American (OR 1.75, 95% CI 1.44%-2.14%, p < 0.001) and Hispanic (OR 1.68, 95% CI 1.36%-2.08%) race or ethnicity; ASA class 3 (OR 1.52, 95% CI 1.34%-1.73%) or 4-5 (OR 2.18, 95% CI 1.82%-2.62%) designation; partially (OR 1.94, 95% CI 1.61%-2.35%) or totally dependent (OR 3.30, 95% CI 1.95%-5.55%) functional status; insulin-dependent diabetes mellitus (OR 1.46, 95% CI 1.16%-1.84%); hematological

  5. 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

  6. Evidence Points To 'Gaming' At Hospitals Subject To National Health Service Cleanliness Inspections.

    PubMed

    Toffolutti, Veronica; McKee, Martin; Stuckler, David

    2017-02-01

    Inspections are a key way to monitor and ensure quality of care and maintain high standards in the National Health Service (NHS) in England. Yet there is a perception that inspections can be gamed. This can happen, for example, when staff members know that an inspection will soon take place. Using data for 205 NHS hospitals for the period 2011-14, we tested whether patients' perceptions of cleanliness increased during periods when inspections occurred. Our results show that during the period within two months of an inspection, there was a significant elevation (2.5-11.0 percentage points) in the share of patients who reported "excellent" cleanliness. This association was consistent even after adjustment for secular time trends. The association was concentrated in hospitals that outsourced cleaning services and was not detected in those that used NHS cleaning services.

  7. National epidemiologic surveys of Enterobacter aerogenes in Belgian hospitals from 1996 to 1998.

    PubMed

    De Gheldre, Y; Struelens, M J; Glupczynski, Y; De Mol, P; Maes, N; Nonhoff, C; Chetoui, H; Sion, C; Ronveaux, O; Vaneechoutte, M

    2001-03-01

    Two national surveys were conducted to describe the incidence and prevalence of Enterobacter aerogenes in 21 Belgian hospitals in 1996 and 1997 and to characterize the genotypic diversity and the antimicrobial resistance profiles of clinical strains of E. aerogenes isolated from hospitalized patients in Belgium in 1997 and 1998. Twenty-nine hospitals collected 10 isolates of E. aerogenes, which were typed by arbitrarily primed PCR (AP-PCR) using two primers and pulsed-field gel electrophoresis. MICs of 10 antimicrobial agents were determined by the agar dilution method. Beta-lactamases were detected by the double-disk diffusion test and characterized by isoelectric point. The median incidence of E. aerogenes colonization or infection increased from 3.3 per 1,000 admissions in 1996 to 4.2 per 1000 admissions in the first half of 1997 (P < 0.01). E. aerogenes strains (n = 260) clustered in 25 AP-PCR types. Two major types, BE1 and BE2, included 36 and 38% of strains and were found in 21 and 25 hospitals, respectively. The BE1 type was indistinguishable from a previously described epidemic strain in France. Half of the strains produced an extended-spectrum beta-lactamase, either TEM-24 (in 86% of the strains) or TEM-3 (in 14% of the strains). Over 75% of the isolates were resistant to ceftazidime, piperacillin-tazobactam, and ciprofloxacin. Over 90% of the strains were susceptible to cefepime, carbapenems, and aminoglycosides. In conclusion, these data suggest a nationwide dissemination of two epidemic multiresistant E. aerogenes strains in Belgian hospitals. TEM-24 beta-lactamase was frequently harbored by one of these epidemic strains, which appeared to be genotypically related to a TEM-24-producing epidemic strain from France, suggesting international dissemination.

  8. 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

  9. Management of postoperative pain: experience of the Niamey National Hospital, Niger

    PubMed Central

    Chaibou, Maman Sani; Sanoussi, Samuila; Sani, Rachid; Toudou, Nouhou A; Daddy, Hadjara; Madougou, Moussa; Abdou, Idrissa; Abarchi, Habibou; Chobli, Martin

    2012-01-01

    Objective The aim of this study was to evaluate the management of postoperative pain at the Niamey National Hospital. Methods A prospective study was conducted in the Department of Anesthesiology and Intensive Care at the Niamey National Hospital from March to June, 2009. Data collected included age, sex, literacy, American Society of Anesthesiologists (ASA) physical status classification, type of anesthesia, type of surgery, postoperative analgesics used, and the cost of analgesics. Three types of pain assessment scale were used depending on the patient’s ability to describe his or her pain: the verbal rating scale (VRS), the numerical rating scale (NRS), or the visual analog scale (VAS). Patients were evaluated during the first 48 hours following surgery. Results The sample included 553 patients. The VRS was used for the evaluation of 72% of patients, the NRS for 14.4%, and the VAS for 13.6%. Of the VRS group, 33.9%, 8.3%, and 2.1% rated their pain as 3 or 4 out of 4 at 12, 24, and 48 hours postoperatively, respectively. For the NRS group, 33.8%, 8.8%, and 2.5% rated their pain as greater than 7 out of 10 at 12, 24, and 48 hours postoperatively, respectively. For the VAS group, 29.3%, 5.4%, and 0% rated their pain as greater than 7 out of 10 at 12, 24, and 48 hours postoperatively, respectively. Conclusion Postoperative pain assessment and management in developing countries has not been well described. Poverty, illiteracy, and inadequate training of physicians and other health personnel contribute to the underutilization of postoperative analgesia. Analysis of the results gathered at the Niamey National Hospital gives baseline data that can be the impetus to increase training in pain management and to establish standardized protocols. PMID:23271923

  10. 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.

  11. 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

  12. LiDAR: Providing structure

    USGS Publications Warehouse

    Vierling, Lee A.; Martinuzzi, Sebastián; Asner, Gregory P.; Stoker, Jason M.; Johnson, Brian R.

    2011-01-01

    Since the days of MacArthur, three-dimensional (3-D) structural information on the environment has fundamentally transformed scientific understanding of ecological phenomena (MacArthur and MacArthur 1961). Early data on ecosystem structure were painstakingly laborious to collect. However, as reviewed and reported in recent volumes of Frontiers(eg Vierling et al. 2008; Asner et al.2011), advances in light detection and ranging (LiDAR) remote-sensing technology provide quantitative and repeatable measurements of 3-D ecosystem structure that enable novel ecological insights at scales ranging from the plot, to the landscape, to the globe. Indeed, annual publication of studies using LiDAR to interpret ecological phenomena increased 17-fold during the past decade, with over 180 new studies appearing in 2010 (ISI Web of Science search conducted on 23 Mar 2011: [{lidar AND ecol*} OR {lidar AND fores*} OR {lidar AND plant*}]).

  13. 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.

  14. 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

  15. Vibrant Soundbridge middle ear implantations: experience at National University Hospital Singapore.

    PubMed

    Lim, Lynne Hsueh Yee; Del Prado, Jocelynne; Xiang, Ling; Yusof, Abdul Rahman Bin; Loo, Jenny Hooi Yin

    2012-09-01

    Vibrant Soundbridge (VSB) has been recommended for both adults and children with all types of hearing loss. The aim of this study was to evaluate the objective and subjective benefits with VSB and the difference in benefits for patients with different types of hearing loss. A retrospective case review was conducted on seven consecutive patients who had received VSB implantations at the National University Hospital of Singapore from March 2006 to November 2009. Patients were divided into the Sensorineural Hearing Loss (SNHL) Group and Conductive Hearing Loss (CHL)/Mixed Hearing Loss (MHL) Group. Surgical complications were evaluated, and objective and subjective results were compared between the two groups. No major complications were observed during the follow-up of up to 4 years. Greater objective and subjective benefits were observed in the CHL/MHL Group. Subjective benefits were consistent with objective improvements. Pre-operative counseling for realistic expectations is important, especially for patients with SNHL.

  16. 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

  17. 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.

  18. [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.

  19. 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

  20. Recovery rate and associated factors of children age 6 to 59 months admitted with severe acute malnutrition at inpatient unit of Bahir Dar Felege Hiwot Referral hospital therapeutic feeding unite, northwest Ethiopia

    PubMed Central

    Desyibelew, Hanna Demelash; Fekadu, Abel; Woldie, Haile

    2017-01-01

    Background Despite numerous advances made in improving child health and the clinical management protocols for treating severe acute malnutrition at treatment centers, evidences concerning the treatment outcomes are scarce. Therefore, this study was conducted to assess the recovery rate and associated factors of severely acute malnourished children of age 6 to 59 months admitted to inpatient therapeutic feeding unit at Felege Hiwot Referral Hospital. Methods We conducted a hospital-based cross-sectional study including 401 severely malnourished children who were admitted from September 2012 to January 2016. Bivariable and a Multivariable logistic regression model were fitted to identify factors associated with recovery rate. Adjusted Odds ratio with its 95% CI was reported and P-value less than 0.05 was considered as significant. Results Fifty eight percent (58.4%) (95%CI: 53.1–64.1) of admitted children were recovered with a mean recovery time of 18 (±6.3) days. Being female, children who were fully and partially vaccinated, who had better MUAC measurement, who stayed longer in the hospital, and children who took routine vitamin-A supplementation had better recovery rate. However, children who had co-morbidity at admission, had human immune virus (HIV) and Tuberculosis (TB) infection, and who had edema were less likely to recover. Interpretation Recovery rate was low as compared to international SPHERE cutoff points (> 75% recovery rate). Interventions that could address the outlined factors would be helpful to improve treatment recovery rate of admitted children. PMID:28166247

  1. 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

  2. Hospitalization for Invasive Pneumococcal Disease in a National Sample of Children with Sickle Cell Disease Before and After PCV7 Licensure

    PubMed Central

    McCavit, Timothy L.; Xuan, Lei; Zhang, Song; Flores, Glenn; Quinn, Charles T.

    2012-01-01

    Objective To estimate national hospitalization rates for invasive pneumococcal disease (IPD) in children with sickle cell disease (SCD) before and after the 2000 licensure of the heptavalent pneumococcal conjugate vaccine (PCV7). Procedure We performed a retrospective trend analysis of the 1994-2007 Nationwide Inpatient Sample databases. Hospitalizations involving children with SCD and IPD were identified by ICD-9CM code. The primary outcomes, the annual hospitalization rate for IPD in children with SCD and the proportion of hospitalizations for IPD per 100 total SCD hospitalizations, were analyzed using multivariable linear regression and contingency analysis, respectively. Results A total of 1,242 hospitalizations for IPD in SCD patients were identified from 1994-2007, with a mortality rate of 2.4%. The national mean annual rate of IPD hospitalization decreased by 65%, from 131.8 cases/year from 1994-2000 to 45.5 cases/year from 2001-2007 (p=0.001). The national proportion of hospitalizations for IPD per 100 total SCD hospitalizations decreased from 0.4 to 0.15 (p<0.0001) over the same interval. Following PCV7 licensure, the mean annual cumulative hospital days and cumulative hospital charges decreased nationally by 53% and 36%, respectively. Conclusion In a national sample, PCV7 licensure is temporally associated with a nearly three fold reduction in IPD hospitalizations in children with SCD. PMID:21793185

  3. 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,…

  4. 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…

  5. Alarm effectiveness no longer a national patient safety goal for hospitals: ECRI questions wisdom of JCAHO change.

    PubMed

    2004-11-01

    For 2005, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is no longer including alarm safety among its National Patient Safety Goals. JCAHO states that it has taken this action to keep the list of 2005 goals manageable. ECRI believes that removing the goal sends the wrong message to hospitals.

  6. Challenges in diagnosing paediatric malaria in Dar es Salaam, Tanzania

    PubMed Central

    2013-01-01

    Background Malaria is a major cause of paediatric morbidity and mortality. As no clinical features clearly differentiate malaria from other febrile illnesses, and malaria diagnosis is challenged by often lacking laboratory equipment and expertise, overdiagnosis and overtreatment is common. Methods Children admitted with fever at the general paediatric wards at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania from January to June 2009 were recruited consecutively and prospectively. Demographic and clinical features were registered. Routine thick blood smear microscopy at MNH was compared to results of subsequent thin blood smear microscopy, and rapid diagnostics tests (RDTs). Genus-specific PCR of Plasmodium mitochondrial DNA was performed on DNA extracted from whole blood and species-specific PCR was done on positive samples. Results Among 304 included children, 62.6% had received anti-malarials during the last four weeks prior to admission and 65.1% during the hospital stay. Routine thick blood smears, research blood smears, PCR and RDT detected malaria in 13.2%, 6.6%, 25.0% and 13.5%, respectively. Positive routine microscopy was confirmed in only 43% (17/40), 45% (18/40) and 53% (21/40), by research microscopy, RDTs and PCR, respectively. Eighteen percent (56/304) had positive PCR but negative research microscopy. Reported low parasitaemia on routine microscopy was associated with negative research blood slide and PCR. RDT-positive cases were associated with signs of severe malaria. Palmar pallor, low haemoglobin and low platelet count were significantly associated with positive PCR, research microscopy and RDT. Conclusions The true morbidity attributable to malaria in the study population remains uncertain due to the discrepancies in results among the diagnostic methods. The current routine microscopy appears to result in overdiagnosis of malaria and, consequently, overuse of anti-malarials. Conversely, children with a false positive malaria diagnosis

  7. [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.

  8. Security Personnel Practices and Policies in U.S. Hospitals: Findings From a National Survey.

    PubMed

    Schoenfisch, Ashley L; Pompeii, Lisa A

    2016-06-27

    Concerns of violence in hospitals warrant examination of current hospital security practices. Cross-sectional survey data were collected from members of a health care security and safety association to examine the type of personnel serving as security in hospitals, their policies and practices related to training and weapon/restraint tool carrying/use, and the broader context in which security personnel work to maintain staff and patient safety, with an emphasis on workplace violence prevention and mitigation. Data pertaining to 340 hospitals suggest security personnel were typically non-sworn officers directly employed (72%) by hospitals. Available tools included handcuffs (96%), batons (56%), oleoresin capsicum products (e.g., pepper spray; 52%), hand guns (52%), conducted electrical weapons (e.g., TASERs®; 47%), and K9 units (12%). Current workplace violence prevention policy components, as well as recommendations to improve hospital security practices, aligned with Occupational Safety and Health Administration guidelines. Comprehensive efforts to address the safety and effectiveness of hospital security personnel should consider security personnel's relationships with other hospital work groups and hospitals' focus on patients' safety and satisfaction.

  9. Assessment of Parents’ Perception of Quality of Pediatric Oncology Inpatient Care at Kenyatta National Hospital

    PubMed Central

    Keiza, Eunice Mmbone; Chege, Margaret Njambi; Omuga, Blasio Osogo

    2017-01-01

    Objective: Adequate knowledge of parents’ perception of quality of pediatric cancer care helps to identify the areas of care improvement which would contribute to disease outcome in regard to the quality of life and satisfaction with the care provided. The aim of the study was to assess the parents’ perception of the quality of Pediatric Oncology Inpatient Care at Kenyatta National Hospital. Methods: A cross-sectional descriptive quantitative and qualitative study was undertaken using a pretested semi-structured questionnaire and a focused group discussion guide. Assessment of parents’ perception of quality of care was done in relation to the institution's structures and care delivery processes. These included the ward environment, resources for cancer treatment, care processes, service providers, and parents’ knowledge empowerment. Participants were systematically selected. Parents’ perception was defined as satisfaction or dissatisfaction with the care provided. Data were analyzed using SPSS version 20.0 (Armonk, NY: IBM Corp.) and presented as frequencies and percentages. Chi-square was used to test the significant association between variables. Level of significance was set at a P ≤ 0.05. Results: A total of 107 respondents were interviewed and 57.9% were satisfied with the overall quality of care they received. The determinants of overall satisfaction in this study were found to be related to resources for cancer treatment (odds ratio [OR] =3.10; 95% confidence interval [CI] =1.39–6.90; P = 0.005), care delivery processes (OR = 2.87; 95% CI = 1.28–6.43; P = 0.009), and the ward environment (OR = 2.59; 95% CI = 1.17–5.74; P = 0.018). Conclusions: The parents were moderately satisfied with the oncology care services their children received. The gaps identified in service delivery included those related to the availability of the required resources for efficient care delivery and also educational as well as psychosocial needs of the parents

  10. Prevalence and Characterization of Carbapenem-Resistant Enterobacteriaceae Isolated from Mulago National Referral Hospital, Uganda

    PubMed Central

    Okoche, Deogratius; Asiimwe, Benon B.; Katabazi, Fred Ashaba; Kato, Laban; Najjuka, Christine F.

    2015-01-01

    Introduction Carbapenemases have increasingly been reported in enterobacteriaceae worldwide. Most carbapenemases are plasmid encoded hence resistance can easily spread. Carbapenem-resistant enterobacteriaceae are reported to cause mortality in up to 50% of patients who acquire bloodstream infections. We set out to determine the burden of carbapenem resistance as well as establish genes encoding for carbapenemases in enterobacteriaceae clinical isolates obtained from Mulago National Referral Hospital, Uganda. Methods This was a cross-sectional study with a total of 196 clinical isolates previously collected from pus swabs, urine, blood, sputum, tracheal aspirates, cervical swabs, endomentrial aspirates, rectal swabs, Vaginal swabs, ear swabs, products of conception, wound biopsy and amniotic fluid. All isolates were subjected to phenotypic carbapenemase screening using Boronic acid-based inhibition, Modified Hodge and EDTA double combined disk test. In addition, all the isolates were subjected to PCR assay to confirm presence of carbapenemase encoding genes. Results The study found carbapenemase prevalence of 22.4% (44/196) in the isolates using phenotypic tests, with the genotypic prevalence slightly higher at 28.6% (56/196). Over all, the most prevalent gene was blaVIM (21,10.7%), followed by blaOXA-48 (19, 9.7%), blaIMP (12, 6.1%), blaKPC (10, 5.1%) and blaNDM-1 (5, 2.6%). Among 56 isolates positive for 67 carbapenemase encoding genes, Klebsiella pneumonia was the species with the highest number (52.2%). Most 32/67(47.7%) of these resistance genes were in bacteria isolated from pus swabs. Conclusion There is a high prevalence of carbapenemases and carbapenem-resistance encoding genes among third generation cephalosporins resistant Enterobacteriaceae in Uganda, indicating a danger of limited treatment options in this setting in the near future. PMID:26284519

  11. Use of osteoporosis medications after hospitalization for hip fracture: a cross-national study

    PubMed Central

    Kim, Seoyoung C.; Kim, Mi-Sook; Sanfélix-Gimeno, Gabriel; Song, Hong Ji; Liu, Jun; Hurtado, Isabel; Peiró, Salvador; Lee, Joongyub; Choi, Nam-Kyong; Park, Byung-Joo; Avorn, Jerry

    2015-01-01

    Purpose While current osteoporosis management guidelines recommend use of pharmacologic treatment following hip fracture, the care of such patients has been suboptimal. The objective of this cross-national study is to quantify the use of and adherence to osteoporosis medication following hip fracture in three countries with different health care systems- the United States, Korea and Spain. Methods In three cohorts of patients aged ≥65 years hospitalized for hip fracture, we calculated the proportion receiving ≥1 osteoporosis drug after discharge. Adherence to osteoporosis treatment was measured as the proportion of days covered (PDC) during the first year following the hip fracture. Results We identified 86,202 patients with a hip fracture - 4,704 (U.S. Medicare), 6,700 (U.S. commercial), 57,631(Korea), and 17,167 (Spain). The mean age was 77–83 years and 74–78% were women. In the year prior to the index hip fracture, 16–18% were taking an osteoporosis medication. Within 3 months following the index hip fracture, 11% (U.S. Medicare), 13% (U.S. commercial), 39% (Korea), and 25% (Spain) of patients filled ≥1 prescription for osteoporosis medication. For those who filled one or more prescriptions for an osteoporosis medication, the mean PDC in the year following the fracture was 0.70 (U.S. Medicare), 0.67 (U.S. commercial), 0.43 (Korea) and 0.66 (Spain). Conclusions Regardless of differences in health care delivery systems and medication reimbursement plans, the use of osteoporosis medications for the secondary prevention of osteoporotic fracture was low. Adherence to osteoporosis treatment was also suboptimal with the PDC<0.70 in all three countries. PMID:25660252

  12. 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.

  13. Radial forearm flaps as durable soft tissue coverage for local nationals being treated in the field hospital setting.

    PubMed

    Hanna, Kh; Jeffery, Sla

    2013-03-01

    The current conflict in Afghanistan has seen the increasing use of Improvised Explosive Devices (IED) in insurgency attacks. In addition to the coalition forces killed and injured from these devices, local national civilians are also injured. Injuries often include amputations, open fractures and large areas of skin affected by fragmentation. Local national access to long-term care after an IED injury is limited, and often when the patient leaves a coalition hospital this concludes the care the patient will receive. Definitive, durable treatment options are needed for these patients. In the IED-injured patient with open extremity wounds and open metacarpal fractures, pedicled radial forearm flaps offer a suitable soft tissue coverage option. Four cases are reported on IED- injured Afghan patients treated at a Role 3 hospital facility.

  14. Change Detection from differential airborne LiDAR using a weighted Anisotropic Iterative Closest Point Algorithm

    NASA Astrophysics Data System (ADS)

    Zhang, X.; Kusari, A.; Glennie, C. L.; Oskin, M. E.; Hinojosa-Corona, A.; Borsa, A. A.; Arrowsmith, R.

    2013-12-01

    Differential LiDAR (Light Detection and Ranging) from repeated surveys has recently emerged as an effective tool to measure three-dimensional (3D) change for applications such as quantifying slip and spatially distributed warping associated with earthquake ruptures, and examining the spatial distribution of beach erosion after hurricane impact. Currently, the primary method for determining 3D change is through the use of the iterative closest point (ICP) algorithm and its variants. However, all current studies using ICP have assumed that all LiDAR points in the compared point clouds have uniform accuracy. This assumption is simplistic given that the error for each LiDAR point is variable, and dependent upon highly variable factors such as target range, angle of incidence, and aircraft trajectory accuracy. Therefore, to rigorously determine spatial change, it would be ideal to model the random error for every LiDAR observation in the differential point cloud, and use these error estimates as apriori weights in the ICP algorithm. To test this approach, we implemented a rigorous LiDAR observation error propagation method to generate estimated random error for each point in a LiDAR point cloud, and then determine 3D displacements between two point clouds using an anistropic weighted ICP algorithm. The algorithm was evaluated by qualitatively and quantitatively comparing post earthquake slip estimates from the 2010 El Mayor-Cucapah Earthquake between a uniform weight and anistropically weighted ICP algorithm, using pre-event LiDAR collected in 2006 by Instituto Nacional de Estadística y Geografía (INEGI), and post-event LiDAR collected by The National Center for Airborne Laser Mapping (NCALM).

  15. Survey of incapacity associated with mental handicap at Rampton and Moss Side Special Hospitals: a comparison with the 1970 National Survey.

    PubMed

    Parker, E

    1975-08-01

    The results of a survey carried out at Rampton and Moss Side Special Hospitals into physical and behavioural incapacity associated with mental handicap are described and compared with the findings of the 1970 National Survey. The Special Hospital patients were found to be less mentally handicapped than similar patients in subnormality hospitals in the National Health Service. The prevalence of physical incapacity associated with mental handicap was also lower in the Special Hospitals but the Special Hospital patients were assessed as more behaviourally disordered. In both surveys the incapacities present were concentrated in the severely mentally handicapped patients. In the Special Hospitals survey the women, when compared with the men, were found to be more behaviourally disordered and to suffer from a greater degree of multiple severe incapacity. All the differences found between the two surveys are consistent with the statutory criteria for admission to a Special Hospital.

  16. National survey of pediatric hospitalizations due to Kawasaki disease and coronary artery aneurysms in the USA.

    PubMed

    Okubo, Yusuke; Nochioka, Kotaro; Sakakibara, Hiroshi; Testa, Marcia; Sundel, Robert P

    2017-02-01

    Several studies revealed the epidemiology of Kawasaki disease-related hospitalizations among children in the USA and other countries. However, disparities of developing coronary artery aneurysms by race/ethnicity, patient socioeconomic status, and geographic locations remain unknown in the USA. Hospital discharge record data of patients with Kawasaki disease aged 19 years or younger were obtained from the 2003, 2006, 2009, and 2012 Kid's Inpatient Database. The data were weighted to estimate the annual hospitalization rates with respect to age, gender, and race/ethnicity in the USA. Multivariable logistic regression was conducted to ascertain the factors associated with the development of coronary artery aneurysms. Total annual hospitalization rates of Kawasaki disease showed a decreasing trend, ranging from 6.54 per 100,000 children in 2003 to 6.11 per 100,000 children in 2012 (p < 0.001). The proportions of coronary artery aneurysms among patients with Kawasaki disease ranged from 2.25 to 3.20%. Factor associated with the development of coronary artery aneurysms was hospitals in West (OR 2.15, 95% CI 1.42-3.26). Race/ethnicity, health insurance status, and household income were not associated with the development of coronary artery aneurysms. Total hospitalization rates of Kawasaki disease showed a decreasing trend. Children admitted to hospitals in West region were more likely to develop coronary artery aneurysms.

  17. LiDAR Applications in Resource Geology and Benefits for Land Management

    NASA Astrophysics Data System (ADS)

    Mikulovsky, R. P.; De La Fuente, J. A.

    2013-12-01

    The US Forest Service (US Department of Agriculture) manages a broad range of geologic resources and hazards on National Forests and Grass Lands throughout the United States. Resources include rock and earth materials, groundwater, caves and paleontological resources, minerals, energy resources, and unique geologic areas. Hazards include landslides, floods, earthquakes, volcanic eruptions, and naturally hazardous materials (e.g., asbestos, radon). Forest Service Geologists who address these issues are Resource Geologists. They have been exploring LiDAR as a revolutionary tool to efficiently manage all of these hazards and resources. However, most LiDAR applications for management have focused on timber and fuels management, rather than landforms. This study shows the applications and preliminary results of using LiDAR for managing geologic resources and hazards on public lands. Applications shown include calculating sediment budgets, mapping and monitoring landslides, mapping and characterizing borrow pits or mines, determining landslide potential, mapping faults, and characterizing groundwater dependent ecosystems. LiDAR can be used to model potential locations of groundwater dependent ecosystems with threatened or endangered plant species such as Howellia aquatilis. This difficult to locate species typically exists on the Mendocino National Forest within sag ponds on landslide benches. LiDAR metrics of known sites are used to model potential habitat. Thus LiDAR can link the disciplines of geology, hydrology, botany, archaeology and others for enhanced land management. As LiDAR acquisition costs decrease and it becomes more accessible, land management organizations will find a wealth of applications with potential far-reaching benefits for managing geologic resources and hazards.

  18. National audit of acute severe asthma in adults admitted to hospital. Standards of Care Committee, British Thoracic Society.

    PubMed Central

    Pearson, M G; Ryland, I; Harrison, B D

    1995-01-01

    OBJECTIVE--To ascertain the standard of care for hospital management of acute severe asthma in adults. DESIGN--Questionnaire based retrospective multicentre survey of case records. SETTING--36 hospitals (12 teaching and 24 district general hospitals) across England, Wales, and Scotland. PATIENTS--All patients admitted with acute severe asthma between 1 August and 30 September 1990 immediately before publication of national guidelines for asthma management. MAIN MEASURES--Main recommendations of guidelines for hospital management of acute severe asthma as performed by respiratory and non-respiratory physicians. RESULTS--766 patients (median age 41 (range 16-94) years) were studied; 465 (63%) were female and 448 (61%) had had previous admissions for asthma. Deficiencies were evident for each aspect of care studied, and respiratory physicians performed better than non-respiratory physicians. 429 (56%) patients had had their treatment increased in the two weeks preceding the admission but only 237 (31%) were prescribed oral steroids. Initially 661/766 (86%) patients had peak expiratory flow measured and recorded but only 534 (70%) ever had arterial blood gas tensions assessed. 65 (8%) patients received no steroid treatment in the first 24 hours after admission. Variability of peak expiratory flow was measured before discharge in 597/759 (78%) patients, of whom 334 (56%) achieved good control (variability < 25%). 47 (6%) patients were discharged without oral or inhaled steroids; 182/743 (24%) had no planned outpatient follow up and 114 failed to attend, leaving 447 (60%) seen in clinic within two months. Only 57/629 (8%) patients were recorded as having a written management plan. CONCLUSIONS--The hospital management of a significant minority of patients deviates from recommended national standards and some deviations are potentially serious. Overall, respiratory physicians provide significantly better care than non-respiratory physicians. PMID:10142032

  19. Hospital-based pulmonary rehabilitation in patients with COPD in Sweden--a national survey.

    PubMed

    Wadell, K; Janaudis Ferreira, T; Arne, M; Lisspers, K; Ställberg, B; Emtner, M

    2013-08-01

    Pulmonary rehabilitation (PR) is an evidence-based, multidisciplinary and cost-effective intervention that leads to improved health in patients with chronic obstructive pulmonary disease, COPD. However, the availability of PR programs varies between and within different countries. The aim of this study was to investigate the availability and content of hospital-based PR programs in patients with COPD in Sweden. A cross-sectional descriptive design was applied using a web-based questionnaire which was sent out to all hospitals in Sweden. The questionnaire consisted of 32 questions that concerned availability and content of PR in patients with COPD during 2011. Seventy out of 71 hospitals responded the electronic survey. Forty-six (66%) hospitals offered PR for patients with COPD. Around 75% of the hospitals in southern and middle parts of Sweden and 33% of the hospitals in the northern part offered PR. Thirty-four percent of the patients declined participation. A total number of 1355 patients participated in PR which represents 0.2% of the COPD population in Sweden. All hospitals had exercise training as major component and 76% offered an educational program. Not even half a percent of the patients with COPD in Sweden took part in a hospital-based PR program during 2011. There was a considerable geographic discrepancy in availability over the country. To enable a greater part of the increasing number of patients with COPD to take part in this evidence-based treatment, there is a need of evaluating other settings of PR programs; in primary care, at home and/or over the internet.

  20. Third-party reimbursement of therapeutic recreation services within a national sample of United States hospitals.

    PubMed

    Teaff, J D; Van Hyning, T E

    1988-01-01

    The purpose of this study was to determine the status of third-party reimbursement for therapeutic recreation services within three types of hospital classifications: Government, nonfederal (GNF); non-government, not-for-profit (NFP); and investor-owned (IO). A sample of 580 hospitals was drawn by the American Hospital Association through a randomly selected, proportionate sample from the universe of 5,799 GNF, NFP, and IO hospitals. Three hundred-twenty hospitals (55.2 percent) returned usable instruments. Based upon the analysis of 33 therapeutic recreation services approved for third-party reimbursement, it was found that: Significantly more therapeutic recreation directors who gave financing a higher priority tended to direct programs whose services were approved for third-party reimbursement; significantly more therapeutic recreation services were successful in their efforts to obtain third-party reimbursement even though they were denied approval in their initial efforts and approaches to obtain third-party reimbursement; and significantly more IO hospitals with therapeutic recreation services were approved for third-party reimbursement than either GNF or NFP therapeutic recreation services.

  1. 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

  2. Are Tuberculosis Patients in a Tertiary Care Hospital in Hyderabad, India Being Managed According to National Guidelines?

    PubMed Central

    Kondapaka, Kiran Kumar; Prasad, Surapaneni Venkateswara; Satyanarayana, Srinath; Kandi, Subhakar; Zachariah, Rony; Harries, Anthony David; Nagaraja, Sharath Burugina; Tetali, Shailaja; Anchala, Raghupathy; Kannuri, Nanda Kishore; Murthy, Krishna; Koppu, Dhanamurthy; Vangari, Latha; Rao, Sreenivas

    2012-01-01

    Setting A tertiary health care facility (Government General and Chest hospital) in Hyderabad, India. Objectives To assess a) the extent of compliance of specialists to standardized national (RNTCP) tuberculosis management guidelines and b) if patients on discharge from hospital were being appropriately linked up with peripheral health facilities for continuation of anti-Tuberculosis (TB) treatment. Methods A descriptive study using routine programme data and involving all TB patients admitted to inpatient care from 1st January to 30th June, 2010. Results and Conclusions There were a total of 3120 patients admitted of whom, 1218 (39%) required anti-TB treatment. Of these 1104 (98%) were treated with one of the RNTCP recommended regimens, while 28 (2%) were treated with non-RNTCP regimens. The latter included individually tailored MDR-TB treatment regimens for 19 patients and adhoc regimens for nine patients. A total of 957 (86%) patients were eventually discharged from the hospital of whom 921 (96%) had a referral form filled for continuing treatment at a peripheral health facility. Formal feedback from peripheral health facilities on continuation of TB treatment was received for 682 (74%) patients. In a tertiary health facility with specialists the great majority of TB patients are managed in line with national guidelines. However a number of short-comings were revealed and measures to rectify these are discussed. PMID:22272323

  3. Hemovigilance in Massachusetts and the adoption of statewide hospital blood bank reporting using the National Healthcare Safety Network.

    PubMed

    Cumming, Melissa; Osinski, Anthony; O'Hearn, Lynne; Waksmonski, Pamela; Herman, Michele; Gordon, Deborah; Griffiths, Elzbieta; Knox, Kim; McHale, Eileen; Quillen, Karen; Rios, Jorge; Pisciotto, Patricia; Uhl, Lynne; DeMaria, Alfred; Andrzejewski, Chester

    2017-02-01

    A collaboration that grew over time between local hemovigilance stakeholders and the Massachusetts Department of Public Health (MDPH) resulted in the change from a paper-based method of reporting adverse reactions and monthly transfusion activity for regulatory compliance purposes to statewide adoption of electronic reporting via the National Healthcare Safety Network (NHSN). The NHSN is a web-based surveillance system that offers the capacity to capture transfusion-related adverse events, incidents, and monthly transfusion statistics from participating facilities. Massachusetts' hospital blood banks share the data they enter into NHSN with the MDPH to satisfy reporting requirements. Users of the NHSN Hemovigilance Module adhere to specified data entry guidelines, resulting in data that are comparable and standardized. Keys to successful statewide adoption of this reporting method include the fostering of strong partnerships with local hemovigilance champions and experts, engagement of regulatory and epidemiology divisions at the state health department, the leveraging of existing relationships with hospital NHSN administrators, and the existence of a regulatory deadline for implementation. Although limitations exist, successful implementation of statewide use of the NHSN Hemovigilance Module for hospital blood bank reporting is possible. The result is standardized, actionable data at both the hospital and state level that can facilitate interfacility comparisons, benchmarking, and opportunities for practice improvement.

  4. Final report of the National Health and Hospitals Reform Commission: will we get the health care governance reform we need?

    PubMed

    Stoelwinder, Johannes U

    2009-10-05

    The National Health and Hospitals Reform Commission (NHHRC) has recommended that Australia develop a "single health system", governed by the federal government. Steps to achieving this include: a "Healthy Australia Accord" to agree on the reform framework; the progressive takeover of funding of public hospitals by the federal government; and the possible implementation of a consumer-choice health funding model, called "Medicare Select". These proposals face significant implementation issues, and the final solution needs to deal with both financial and political sustainability. If the federal and state governments cannot agree on a reform plan, the Prime Minister may need to go to the electorate for a mandate, which may be shaped by other economic issues such as tax reform and intergenerational challenges.

  5. 10 years of Vertigo Clinic at National Hospital Abuja, Nigeria: what have we learned?

    PubMed

    Olusesi, Abiodun D; Abubakar, J

    2016-11-01

    The clinician's major role in management of the dizzy patient involves determining what dizziness is vertigo, and what vertigo is of central or peripheral origin. These demand attention to details of history, otolaryngological workup including vestibular assessment, and often use of diagnostic and management algorithms. There is paucity of published reports of the management outcomes of peripheral vestibular diseases from Africa. Two tertiary care otologist-led dedicated vertigo clinics are located in Abuja, Nigeria. A prospective, non-randomized study of patients presenting with features of peripheral vestibular diseases attending the National Hospital Abuja Nigeria (between May 2005 and April 2014) and CSR Otologics Specialist Clinics (May 2010 to April 2014) was carried out. Both institutions adopted the same diagnostic and management protocols. Data extracted from anonymized databases created for this study include age, sex, vertigo duration (acute <12 weeks, chronic >12 weeks), dizziness handicap inventory score at presentation and at subsequent visits, otological and vestibular findings, ice-water caloric testing results, other investigation outcomes, treatments offered and outcomes. 561/575 (97.5 %) of the cases recorded had peripheral vestibular disease. The male-to-female ratio was 290:271. The mean age of the subjects was 44.7 years. Duration of vertigo at presentation was acute in 278 subjects and chronic in 283 subjects. Identifiable clinical diagnostic groups include BPPV (n = 200), Meniere's disease (n = 189), cervicogenic vertigo (n = 35), labyrinthitis (n = 32), Migraine-associated vertigo (MAV) (n = 32), cholesteatoma/perilymph Fistula (n = 10), climacteric vertigo (n = 8) and unclassified vertigo (n = 55). Migraine-associated vertigo recorded the highest DHI score (95 % CI 75 ± 4.3), followed by cholesteatoma/perilymph fistula (95 % CI 72 ± 6.1) and labyrinthitis (95 % CI 62 ± 1.9). Pure tone audiometry (95 % CI 67

  6. Terrain Referenced Navigation Using SIFT Features in LiDAR Range-Based Data

    DTIC Science & Technology

    2014-12-26

    Geomorphology , 182:147– 156, 2013. [39] Jiaping Zhao, Suya You. “Road Network Extraction from Airbone LiDAR Data using Scene Context”. International...New Opportunities from High Resolution DTMs”. Geomorphology , 113(1):47–56, 2009. [106] The National Coordination Office. “GPS Applications”, September

  7. 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…

  8. 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…

  9. 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…

  10. Melanoma in the Italian Population and Regional Environmental Influences: A National Retrospective Survey on 2001–2008 Hospitalization Records

    PubMed Central

    Piscitelli, Prisco; Neglia, Cosimo; Falco, Andrea; Rivezzi, Matteo; Agnello, Nadia; Argentiero, Alberto; Chitano, Giovanna; Distante, Chiara; Della Rosa, Giulia; Vinci, Giorgia; De Donno, Antonella; Distante, Alessandro; Romanini, Antonella

    2015-01-01

    Objective: To assess the burden of regional environmental factors influencing the incidence of Melanoma in the Italian population and overcome the problem of partial population coverage by local cancer registries and thematic archives. Methods: We analyzed the Italian national hospitalization records from 2001 to 2008 provided by the Ministry of Health, excluding hospital re-admissions of the same patients, in order to assess the occurrence of Melanoma over a 8-year period. Data were presented by age groups (absolute number of cases from 20 to ≥80 years old) and per Region (rates per 100,000 inhabitants) for each year. Results: The overall number of new hospitalizations due to malignant Melanoma increased by 16.8% from 2001 (n = 4846) to 2008 (n = 5823), with the rate per 100,000 inhabitants passing from 10.5 to almost 12.0 at a national level. The majority of new diagnoses of malignant Melanoma was observed in two age groups: 61–70 years old (from 979 in 2001 up to 1209 in 2008, corresponding to 15.1 and 18.1 new cases per 100,000 inhabitants, respectively) and 71–80 years old (from 954 in 2001 up to 1141 in 2008, corresponding to 19.5 and 21.8 new cases per 100,000 inhabitants, respectively). The number of hospitalizations due to Melanoma increased in all age groups with the only exception of the youngest patients aged 20–30 years old. The highest increases over the 8-year period were observed in people aged ≥81 years old (+34%), 61–70 years old (+20%) and surprisingly in the age group 31–40 years old (+17%). Southern Regions showed lower hospitalization rates compared to Northern Italy and Region Lazio. The highest increases between 2001 and 2008 were observed in Trentino/Alto Adige, Friuli Venezia Giulia, Valla d’Aosta and Veneto Region. Conclusions: Hospitalizations due to malignant Melanoma in Italy seem to be influenced by environmental or population-related factors showing a decreasing incidence rate from the Northern to Southern Regions

  11. 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.

  12. 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

  13. 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

  14. National hospital quality measures data: supporting nurses' key roles in organizational performance improvement.

    PubMed

    Matthes, Nikolas; Cheng, Jacob; Ogunbo, Sam; Reilly, Corey; Wilbon, Ashlie; Wood, Nell

    2010-01-01

    With the emergence of so many methodologies for generating comparison data and with the growing accountability demands from so many sectors (each, seemingly, with its own preferred comparative methodology), nurses and quality improvement professionals may feel as if they have many masters to serve. This article outlines the Maryland Hospital Association's Quality Indicator Project's approach to working with quality improvement professionals to build their understanding of comparative data and help them determine which data analysis tools best fit their reporting needs.

  15. A 1911 postcard of the National Hospital for the Paralysed and Epileptic highlighting European medical specialty training

    PubMed Central

    Zubair, Adeel

    2017-01-01

    The purpose of this study was to describe the historical importance of a 1911 European hospital postcard sent from one American physician to another. In the late 19th and early 20th centuries, very few formal residency programs existed in America for training physicians. Most authors rightfully emphasize Johns Hopkins Hospital, founded in 1889, as the site of origin of the American medical residency, but these positions were for a chosen few. Many young physicians would go abroad to study medicine after completing medical school, a decision with many benefits and few drawbacks. At least 15,000 Americans took some kind of medical training in Austria-Hungary, Germany, and Switzerland between 1870 and 1914. Dr. Frank F. Hutchins took such a trip to Europe. On March 12, 1911, Dr. Hutchins wrote a postcard from Queen Square, London, to Dr. Allison Maxwell admiring the positive attributes of The National Hospital for the Paralysed and Epileptic. This trip would serve to shape Dr. Hutchins' subsequent career and would influence the future of the Indiana University School of Medicine, neuropsychiatry in the US military, and the care of veterans. PMID:28127153

  16. [The Hospital Information System of the Brazilian Unified National Health System: a performance evaluation for auditing maternal near miss].

    PubMed

    Nakamura-Pereira, Marcos; Mendes-Silva, Wallace; Dias, Marcos Augusto Bastos; Reichenheim, Michael E; Lobato, Gustavo

    2013-07-01

    This study aimed to investigate the performance of the Hospital Information System of the Brazilian Unified National Health System (SIH-SUS) in identifying cases of maternal near miss in a hospital in Rio de Janeiro, Brazil, in 2008. Cases were identified by reviewing medical records of pregnant and postpartum women admitted to the hospital. The search for potential near miss events in the SIH-SUS database relied on a list of procedures and codes from the International Classification of Diseases, 10th revision (ICD-10) that were consistent with this diagnosis. The patient chart review identified 27 cases, while 70 potential occurrences of near miss were detected in the SIH-SUS database. However, only 5 of 70 were "true cases" of near miss according to the chart review, which corresponds to a sensitivity of 18.5% (95%CI: 6.3-38.1), specificity of 94.3% (95%CI: 92.8-95.6), area under the ROC of 0.56 (95%CI: 0.48-0.63), and positive predictive value of 10.1% (IC95%: 4.7-20.3). These findings suggest that SIH-SUS does not appear appropriate for monitoring maternal near miss.

  17. 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

  18. 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.

  19. A healthier future for all Australians: an overview of the final report of the National Health and Hospitals Reform Commission.

    PubMed

    Bennett, Christine C

    2009-10-05

    After extensive community and health industry consultation, the final report of the National Health and Hospitals Reform Commission, A healthier future for all Australians, was presented to the Australian Government on 30 June 2009. The reform agenda aims to tackle major access and equity issues that affect health outcomes for people now; redesign our health system so that it is better positioned to respond to emerging challenges; and create an agile, responsive and self-improving health system for long-term sustainability. The 123 recommendations are grouped in four themes: Taking responsibility: supporting greater individual and collective action to build good health and wellbeing. Connecting care: delivering comprehensive care for people over their lifetime, by strengthening primary health care, reshaping hospitals, improving subacute care, and opening up greater consumer choice and competition in aged care services. Facing inequities: taking action to tackle the causes and impact of health inequities, focusing on Aboriginal and Torres Strait Islander people, people in rural and remote areas, and access to mental health and dental services. Driving quality performance: having leadership and systems to achieve the best use of people, resources and knowledge, including "one health system" with national leadership and local delivery, revised funding arrangements, and changes to health workforce education, training and practice.

  20. ‘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

  1. Haunted by Enron's ghost. National Century Financial Enterprises files for Chapter 11, leaving a string of broken healthcare chains and hospitals.

    PubMed

    Taylor, Mark

    2002-11-25

    Some are calling it the Enron of the healthcare industry. Ryder trucks hauled possible evidence from embattled financier National Century Financial Enterprises during an FBI raid. NCFE filed for Chapter 11 bankruptcy protection last week, sending ripples through the industry and contributing to the bankruptcies of a string of national healthcare chains and at least six hospitals.

  2. Trends in the incidence and treatment of necrotizing soft tissue infections: an analysis of the National Hospital Discharge Survey.

    PubMed

    Soltani, Ali M; Best, Matthew J; Francis, Cameron S; Allan, Bassan J; Askari, Morad; Panthaki, Zubin J

    2014-01-01

    Necrotizing soft tissue infections are a rare but potentially fatal condition of the soft tissues caused by virulent, toxin-producing bacteria. In the United States, there is an estimated annual incidence of 0.04 cases per 1000 annually, but previous estimates of the Centers for Disease Control and Prevention had the incidence at 500 to 1500 cases yearly. Early reports of mortality were variable with rates ranging from 46 to 76% but outcomes have been improving over time. The National Hospital Discharge Survey was analyzed to study current trends in the demographics, incidence, use, and mortality of patients diagnosed with necrotizing soft tissue infections. The authors analyzed the 1999, 2002, and 2007 National Hospital Discharge Survey by using a sampling weighting method. A total of 13,648 cases of necrotizing soft tissue infections were identified in 2007. This represents an increase from 12,153 cases in 2002 and 6612 cases in 1999. In the 9 years from 1999 to 2007 the gross incidence of necrotizing soft tissue infections more than doubled. Hospital stay was essentially unchanged within study years, at 16 days. Mean age increased from approximately 50 years in 1999 to 54 years in 2007. Further, mortality went from 10.45% in 1999 to 9.75% in the 2007 survey. The population-adjusted incidence rate increased 91% in the studied years. Rising use of immunosupression, exponential growth in the incidence of obesity, and type 2 diabetes could be a major contributing factor. The mortality rate is far below the rate in reports published from as early as 20 years ago, and at 9.75% compares with modern case series, but is a more accurate measure of mortality in this condition.

  3. Hospital Admission and Criminality Associated with Substance Misuse in Young Refugees – A Swedish National Cohort Study

    PubMed Central

    Manhica, Hélio; Gauffin, Karl; Almqvist, Ylva B.; Rostila, Mikael; Hjern, Anders

    2016-01-01

    Background High rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers. Methods Gender stratified Cox regression models were used to estimate the risks of criminal convictions and hospital care associated with substance misuse from national Swedish data for 2005–2012. We focused on 22,992 accompanied and 5,686 unaccompanied refugees who were aged 13–19 years when they settled in Sweden and compared them with 1 million native Swedish youths from the same birth cohort. Results The risks of criminal conviction associated with substance misuse increased with the length of residency in male refugees, after adjustment for age and domicile. The hazard ratios (HRs) were 5.21 (4.39–6.19) for unaccompanied and 3.85 (3.42–4.18) for accompanied refugees after more than 10 years of residency, compared with the native population. The risks were slightly lower for hospital care, at 2.88 (2.18–3.79) and 2.52(2.01–3.01) respectively. Risks were particularly pronounced for male refugees from the Horn of Africa and Iran. The risks for all male refugees decreased substantially when income was adjusted for. Young female refugees had similar risks to the general population. Conclusion The risks of criminality and hospital care associated with substance misuse in young male refugees increased with time of residency in Sweden and were associated with a low level of income compared with the native Swedish population. Risks were similar in accompanied and unaccompanied refugees. PMID:27902694

  4. Adverse drug reactions to anticoagulants in Spain: analysis of the Spanish National Hospital Discharge Data (2010–2013)

    PubMed Central

    Carrasco-Garrido, P; Hernández-Barrera, V; Esteban-Hernández, J; Jiménez-Trujillo, I; Álvaro-Meca, A; López de Andrés, A; de Miguel Diez, J; Rodríguez Barrios, J M; Muñoz Robles, J A; Jiménez-García, R

    2017-01-01

    Objective To describe and analyse hospitalisations for adverse drug reactions (ADRs) involving anticoagulants. We also analysed the progress of the reactions over time, the factors related with ADRs. Design A retrospective, descriptive, epidemiological study. Setting This study used the Spanish National Hospital Discharge Database (Conjunto Mínimo Básico de Datos, CMBD), over a 4-year period. Participants We selected CMBD data corresponding to hospital discharges with a diagnosis of ADRs to anticoagulants (International Classification of Diseases-Ninth Revision, Clinical Modification (ICD-9-CM) code E934.2) in any diagnostic field during the study period. Main outcome measures We calculated the annual incidence of ADRs to anticoagulants according to sex and age groups. The median lengths of hospital stay and in-hospital mortality (IHM) were also estimated for each year studied. Bivariate analyses of the changes in variables according to year were based on Poisson regression. IHM was analysed using logistic regression models. The estimates were expressed as ORs and their 95% CI. Results During the study period, 50 042 patients were hospitalised because of ADRs to anticoagulants (6.38% of all ADR-related admissions). The number of cases increased from 10 415 in 2010 to 13 891 in 2013. Cumulative incidence of ADRs to anticoagulants was significantly higher for men than women and in all age groups. An adjusted multivariate analysis revealed that IHM did not change significantly over time. We observed a statistically significant association between IHM and age, with the highest risk for the ≥85 age group (OR 2.67; 95% CI 2.44 to 2.93). Conclusions The incidence of ADRs to anticoagulants in Spain increased from 2010 to 2013, and was significantly higher for men than women and in all age groups. Older patients were particularly susceptible to being hospitalised with an adverse reaction to an anticoagulant. PMID:28073793

  5. Spinning a laser web: predicting spider distributions using LiDAR.

    PubMed

    Vierling, K T; Bässler, C; Brandl, R; Vierling, L A; Weiss, I; Müller, J

    2011-03-01

    LiDAR remote sensing has been used to examine relationships between vertebrate diversity and environmental characteristics, but its application to invertebrates has been limited. Our objectives were to determine whether LiDAR-derived variables could be used to accurately describe single-species distributions and community characteristics of spiders in remote forested and mountainous terrain. We collected over 5300 spiders across multiple transects in the Bavarian National Park (Germany) using pitfall traps. We examined spider community characteristics (species richness, the Shannon index, the Simpson index, community composition, mean body size, and abundance) and single-species distribution and abundance with LiDAR variables and ground-based measurements. We used the R2 and partial R2 provided by variance partitioning to evaluate the predictive power of LiDAR-derived variables compared to ground measurements for each of the community characteristics. The total adjusted R2 for species richness, the Shannon index, community species composition, and body size had a range of 25-57%. LiDAR variables and ground measurements both contributed >80% to the total predictive power. For species composition, the explained variance was approximately 32%, which was significantly greater than expected by chance. The predictive power of LiDAR-derived variables was comparable or superior to that of the ground-based variables for examinations of single-species distributions, and it explained up to 55% of the variance. The predictability of species distributions was higher for species that had strong associations with shade in open-forest habitats, and this niche position has been well documented across the European continent for spider species. The similar statistical performance between LiDAR and ground-based measures at our field sites indicated that deriving spider community and species distribution information using LiDAR data can provide not only high predictive power at

  6. Social inequalities and women's satisfaction with childbirth care in Brazil: a national hospital-based survey.

    PubMed

    d'Orsi, Eleonora; Brüggemann, Odaléa Maria; Diniz, Carmen Simone Grilo; Aguiar, Janaina Marques de; Gusman, Christine Ranier; Torres, Jacqueline Alves; Angulo-Tuesta, Antonia; Rattner, Daphne; Domingues, Rosa Maria Soares Madeira

    2014-08-01

    The objective is to identify factors associated with women's satisfaction towards the care provided by the health professionals during hospital assisted delivery and identify how those factors influence their general levels of satisfaction. The cohort hospital based study was carried out in connection with the Birth in Brazil research. 15,688 women were included, interviewed at home, through the phone, from March 2011 to February 2012. All the variables that compose the professional/pregnant woman relationship (waiting time, respect, privacy, clarity of explanations, possibility of asking questions and participating in the decisions) and schooling remained independently associated with general satisfaction towards delivery care, in the adjusted model. The white women assisted in the southeastern and southern regions of the country, by the private sector and with a companion present gave a better evaluation of the care provided. Women value the way in which they are assisted by the health professionals, and there are inequalities in the way they are treated based on skin color, geographic region and financial situation.

  7. [Influenza: a four-year evolution of the pandemic. Prof. Alejandro Posadas National Hospital, Argentina].

    PubMed

    Siciliani, Daniel D; Cabral, Graciela; Pingray, Verónica; Borda, María E; Aranaz, Alicia; Miceli, Isabel N P

    2014-01-01

    As from January to August 2013, epidemiological weeks 1-35 (EW), Influenza incidence, case characteristics, types and subtypes of circulating influenza virus in the Nacional Profesor Alejandro Posadas Hospital were studied, and were compared to incidences during 2009-2012. From late May to the end of August 2013 (EW18-35), an increase was observed in the proportion of patients' visits for respiratory disease, influenza-like illness and hospitalizations due to pneumonia; of 207 cases diagnosed with influenza A virus, 153 were infected by H1N1pdm09, 46 by H3, and eight without subtype. The highest proportion of cases was found in children under five years of age, followed by the group 60-64. The chances of having the illness were three times greater among the group 40-64 years old compared to 15-39 or those older than 64. Mortality, which increased with age, was 7.2%, and the odds of death were six times higher among those older than 64. Vaccination rate among the cases was 11.6%. None of the fatal cases had received the vaccine. After the 2009 pandemic, the proportions of annual patients' visits decreased until 2012; in 2013, an increase of 52.0% during the winter period compared to 2012. The viral circulation started earlier in 2013 compared to previous years. FLU-A(H1N1pdm) was the predominant circulating virus in 2009 and 2013, FLU-A(H3) in 2011, FLU-A(H3) and FLU-B in both 2010 and 2012.

  8. Help prevent hospital errors

    MedlinePlus

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

  9. 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.

  10. Intertwined epidemics: national demographic trends in hospitalizations for heroin- and opioid-related overdoses, 1993-2009.

    PubMed

    Unick, George Jay; Rosenblum, Daniel; Mars, Sarah; Ciccarone, Daniel

    2013-01-01

    The historical patterns of opiate use show that sources and methods of access greatly influence who is at risk. Today, there is evidence that an enormous increase in the availability of prescription opiates is fuelling a rise in addiction nationally, drawing in new initiates to these drugs and changing the geography of opiate overdoses. Recent efforts at supply-based reductions in prescription opiates may reduce harm, but addicted individuals may switch to other opiates such as heroin. In this analysis, we test the hypothesis that changes in the rates of Prescription Opiate Overdoses (POD) are correlated with changes in the rate of heroin overdoses (HOD). ICD9 codes from the Nationwide Inpatient Sample and population data from the Census were used to estimate overall and demographic specific rates of POD and HOD hospital admissions between 1993 and 2009. Regression models were used to test for linear trends and lagged negative binomial regression models were used to model the interrelationship between POD and HOD hospital admissions. Findings show that whites, women, and middle-aged individuals had the largest increase in POD and HOD rates over the study period and that HOD rates have increased in since 2007. The lagged models show that increases in a hospitals POD predict an increase in the subsequent years HOD admissions by a factor of 1.26 (p<0.001) and that each increase in HOD admissions increase the subsequent years POD by a factor of 1.57 (p<0.001). Our hypothesis of fungibility between prescription opiates and heroin was supported by these analyses. These findings suggest that focusing on supply-based interventions may simply lead to a shift in use to heroin rather minimizing the reduction in harm. The alternative approach of using drug abuse prevention resources on treatment and demand-side reduction is likely to be more productive at reducing opiate abuse related harm.

  11. 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.

  12. Spinal fusion for pediatric neuromuscular scoliosis: national trends, complications, and in-hospital outcomes.

    PubMed

    Rumalla, Kavelin; Yarbrough, Chester K; Pugely, Andrew J; Koester, Linda; Dorward, Ian G

    2016-10-01

    OBJECTIVE The objective of this study was to determine if the recent changes in technology, surgical techniques, and surgical literature have influenced practice trends in spinal fusion surgery for pediatric neuromuscular scoliosis (NMS). In this study the authors analyzed recent trends in the surgical management of NMS and investigated the effect of various patient and surgical factors on in-hospital complications, outcomes, and costs, using the Nationwide Inpatient Sample (NIS) database. METHODS The NIS was queried from 2002 to 2011 using International Classification of Diseases, Ninth Edition, Clinical Modification codes to identify pediatric cases (age < 18 years) of spinal fusion for NMS. Several patient, surgical, and short-term outcome factors were included in the analyses. Trend analyses of these factors were conducted. Both univariate and multivariable analyses were used to determine the effect of the various patient and surgical factors on short-term outcomes. RESULTS Between 2002 and 2011, a total of 2154 NMS fusion cases were identified, and the volume of spinal fusion procedures increased 93% from 148 in 2002 to 286 in 2011 (p < 0.0001). The mean patient age was 12.8 ± 3.10 years, and 45.6% of the study population was female. The overall complication rate was 40.1% and the respiratory complication rate was 28.2%. From 2002 to 2011, upward trends (p < 0.0001) were demonstrated in Medicaid insurance status (36.5% to 52.8%), presence of ≥ 1 comorbidity (40.2% to 52.1%), and blood transfusions (25.2% to 57.3%). Utilization of posterior-only fusions (PSFs) increased from 66.2% to 90.2% (p < 0.0001) while combined anterior release/fusions and PSF (AR/PSF) decreased from 33.8% to 9.8% (< 0.0001). Intraoperative neurophysiological monitoring (IONM) underwent increasing utilization from 2009 to 2011 (15.5% to 20.3%, p < 0.0001). The use/harvest of autograft underwent a significant upward trend between 2002 and 2011 (31.3% to 59.8%, p < 0.0001). In univariate

  13. 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

  14. 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

  15. Peer mentors, mobile phone and pills: collective monitoring and adherence in Kenyatta National Hospital's HIV treatment programme.

    PubMed

    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.

  16. Characterizing Lava Flows With LiDAR

    NASA Astrophysics Data System (ADS)

    Deligne, N. I.; Cashman, K. V.; Deardorff, N.; Dietterich, H. R.; House, P. K.; Soule, S.

    2009-12-01

    Digital elevation models (DEMs) have been used in volcanology in predictive modeling of lava flow paths, both for assessment of potential hazards and specific predictions of lava flow paths. Topographic analysis of a lava flow is potentially useful for mapping and quantifying flow surface morphologies, which in turn can be used to determine flow emplacement conditions, such as effusion rate, steadiness of flow, and interactions with pre-existing topography and surface water. However, this has been limited in application because of the coarse resolution of most DEMs. In recent years, use of Light Detection and Ranging (LiDAR) airborne laser altimetry, capable of producing high resolution (≤ 1 meter) DEMs, has become increasingly common in the geomorphic and mapping community. However, volcanologists have made little use of airborne LiDAR. Here we compare information obtained using field observations and standard (10 meter) DEMs against LiDAR high resolution DEMs to assess the usefulness, capabilities, and limitations of LiDAR as applicable to lava flows. We compare morphologic characteristics of five lava flows of different compositions, tectonic settings, flow extents, slopes, and eruption duration: (1) 1984 Mauna Loa lava flow, Hawaii; (2) December 1974 Kilauea lava flow, Hawaii; (3) c. 1600 ybp Collier Cone lava flow, central Oregon Cascades; (4) Holocene lava flows from the Sand Mountain volcanic chain, central Oregon Cascades; and (5) Pleistocene lava flows along the Owyhee River, eastern Oregon basin and range. These lava flows range in composition from basalt to andesite, and have eruption durations ranging from 6 hours (observed) to years (inferred). We measure channel width, levee and flow front heights, compression ridge amplitude, wavelength and tumuli dimensions, and surface roughness. For all but the smallest scale features, LiDAR is easily used to quantify these features, which often is impossible or technically challenging to do in the field, while

  17. Using National Inpatient Death Rates as a Benchmark to Identify Hospitals with Inaccurate Cause of Death Reporting - Missouri, 2009-2012.

    PubMed

    Lloyd, Jennifer; Jahanpour, Ehsan; Angell, Brian; Ward, Craig; Hunter, Andy; Baysinger, Cherri; Turabelidze, George

    2017-01-13

    Reporting causes of death accurately is essential to public health and hospital-based programs; however, some U.S. studies have identified substantial inaccuracies in cause of death reporting. Using CDC's national inpatient hospital death rates as a benchmark, the Missouri Department of Health and Senior Services (DHSS) analyzed inpatient death rates reported by hospitals with high inpatient death rates in St. Louis and Kansas City metro areas. Among the selected hospitals with high inpatient death rates, 45.8% of death certificates indicated an underlying cause of death that was inconsistent with CDC's Guidelines for Death Certificate completion. Selected hospitals with high inpatient death rates were more likely to overreport heart disease and renal disease, and underreport cancer as an underlying cause of death. Based on these findings, the Missouri DHSS initiated a new web-based training module for death certificate completion based on the CDC guidelines in an effort to improve accuracy in cause of death reporting.

  18. [Harmonization procedures directed toward clinical trials in laboratory medicine at the National Cancer Center Hospital].

    PubMed

    Ozeki, Mitsuru; Shioya, Kana; Furuta, Koh

    2009-09-01

    Recent advances in pharmacology and molecular sciences made it possible to develop drugs for patients with various maladies. Frustration has existed concerning the delayed provision of these drugs for routine practices in the clinical field. To correct this problem, the importance of clinical trials is increasing. Although there exists a strong demand for participation of clinical laboratories in clinical trials, an awkward attitude in clinical laboratories frustrates those performing clinical trials. We are attempting to correct this problem by introducing our experience with harmonization procedures directed toward clinical trials in laboratory medicine in general. First we described the current status of clinical trials in our hospital. Then we will show personnel in need for clinical trials. Finally we describe in detail our clinical trial procedures. We focus particularly on three aspects of participation in clinical trials: pre-analytical, analytical, and post analytical. Additionally we describe the problems and perspectives in clinical trials by giving special reference to the clinical laboratories in general through discussion with various personnel and specialists. Our goal in the field of laboratory medicine is to benefit patients through the establishment of a harmony between clinical trials and clinical laboratories.

  19. 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

  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. 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…

  2. A comparison of the surgical mortality due to colorectal perforation at different hospitals with data from 10,090 cases in the Japanese National Clinical Database

    PubMed Central

    Ohki, Takeshi; Yamamoto, Masakazu; Miyata, Hiroaki; Sato, Yasuto; Saida, Yoshihisa; Morimoto, Tsuyoshi; Konno, Hiroyuki; Seto, Yasuyuki; Hirata, Koichi

    2017-01-01

    Abstract Colorectal perforation has a high rate of mortality. We compared the incidence and fatality rates of colorectal perforation among different hospitals in Japan using data from the nationwide surgical database. Patients were registered in the National Clinical Database (NCD) between January 1st, 2011 and December 31st, 2013. Patients with colorectal perforation were identified from surgery records by examining if acute diffuse peritonitis (ADP) and diseases associated with a high probability of colorectal perforation were noted. The primary outcome measures included the 30-day postsurgery mortality and surgical mortality of colorectal perforation. We analyzed differences in the observed-to-expected mortality (O/E) ratio between the two groups of hospitals, that is, specialized and non-specialized, using the logistic regression analysis forward selection method. There were 10,090 cases of disease-induced colorectal perforation during the study period. The annual average postoperative fatality rate was 11.36%. There were 3884 patients in the specialized hospital group and 6206 in the non-specialized hospital group. The O/E ratio (0.9106) was significantly lower in the specialized hospital group than in the non-specialized hospital group (1.0704). The experience level of hospitals in treating cases of colorectal perforation negatively correlated with the O/E ratio. We conducted the first study investigating differences among hospitals with respect to their fatality rate of colorectal perforation on the basis of data from a nationwide database. Our data suggest that patients with colorectal perforation should choose to be treated at a specialized hospital or a hospital that treats five or more cases of colorectal perforation per year. The results of this study indicate that specialized hospitals may provide higher quality medical care, which in turn proves that government policy on healthcare is effective at improving the medical system in Japan. PMID:28079809

  3. Adherence to medication: A nation-wide study from the Children’s Cancer Hospital, Egypt

    PubMed Central

    El Malla, Hanan; Ylitalo Helm, Nathalie; Wilderäng, Ulrica; El Sayed Elborai, Yasser; Steineck, Gunnar; Kreicbergs, Ulrika

    2013-01-01

    AIM: To investigate adherence to medical regimen and predictors for non-adherence among children with cancer in Egypt. METHODS: We administered two study specific questionnaires to 304 parents of children diagnosed with cancer at the Children’s Cancer Hospital in Cairo, Egypt, one before the first chemotherapy treatment and the other before the third. The questionnaires were translated to colloquial Egyptian Arabic, and due, to the high illiteracy level in Egypt an interviewer read the questions in Arabic to each parent and registered the answers. Both questionnaires consisted of almost 90 questions each. In addition, a Case Report Form was filled in from the child’s medical journal. The study period consisted of 7 mo (February until September 2008) and we had a participation rate of 97%. Descriptive statistics are presented and Fisher’s exact test was used to check for possible differences between the adherent and non-adherent groups. A P-value below 0.05 was considered significant. Software used was SAS version 9.3 for Windows (SAS Institute Inc., Cary, NC, United States). RESULTS: Two hundred and eighty-one (90%) parents answered the second questionnaire, regarding their child’s adherence behaviour. Approximately two thirds of the children admitted to their third chemotherapy treatment had received medical recommendations upon discharge from the first or second chemotherapy treatment (181/281, 64%). Sixty-eight percent (123/181) of the parents who were given medical recommendations reported that their child did not follow the recommendations. Two main predictors were found for non-adherence: child resistance (111/123, 90%) and inadequate information (100/123, 81%). In the adherent group, 20% of the parents (n = 12/58) reported trust in their child’s doctor while 14 percent 8/58 reported trust in the other health-care professionals. Corresponding numbers for the non-adherent group are 8/123 (7%) for both their child’s doctor and other health

  4. 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

  5. DoD Architecture Registry System (DARS)

    DTIC Science & Technology

    2012-04-30

    Communications-Electronics Research, Development and Engineering Center (CERDEC), S ft E i i Di t t (SED) UNCLASSIFIED 5 o ware ng neer ng rec ora e...Army 1245 (1183, 5 %)  Air Force 960 (889, 8%)  OSD 358 (346, 3%) M i 223 ( %) ar nes 209, 7  Combatant Command 156 (155, 1%)  Joint Staff...Program • Deployed DARS Release 5 6 in April 29 2011 This releaseCompleted Support . . included: • Migrate Community Management and

  6. The evaluation of hospital laboratory information management systems based on the standards of the American National Standard Institute

    PubMed Central

    Isfahani, Sakineh Saghaeiannejad; Khajouei, Reza; Jahanbakhsh, Maryan; Mirmohamadi, Mahboubeh

    2014-01-01

    Introduction: Nowadays, modern laboratories are faced with a huge volume of information. One of the goals of the Laboratory Information Management System (LIMS) is to assist in the management of the information generated in the laboratory. This study intends to evaluate the LIMS based on the standards of the American National Standard Institute (ANSI). Materials and Methods: This research is a descriptive–analytical study, which had been conducted in 2011, on the LIMSs in use, in the teaching and private hospitals in Isfahan. The data collecting instrument was a checklist, which was made by evaluating three groups of information components namely: ‘System capabilities’, ‘work list functions,’ and ‘reporting’ based on LIS8-A. Data were analyzed using the SPSS 20. Data were analyzed using (relative) frequency, percentage. To compare the data the following statistical tests were used: Leven test, t-test, and Analysis of Variance (ANOVA). Results: The results of the study indicated that the LIMS had a low conformity (30%) with LIS8-A (P = 0.001), with no difference between teaching and private hospitals (P = 0.806). The ANOVA revealed that in terms of conformity with the LIS8-A standard, there was a significant difference between the systems produced by different vendors (P = 0.023). According to the results, a Kowsar system with more than %57 conformity in the three groups of information components had a better conformity to the standard, compared to the other systems. Conclusions: This study indicated that none of the LIMSs had a good conformity to the standard. It seems that system providers did not pay sufficient attention to many of the information components required by the standards when designing and developing their systems. It was suggested that standards from certified organizations and institutions be followed in the design and development process of health information systems. PMID:25077154

  7. Interpreting the National Hospital Ambulatory Medical Care Survey: United States Emergency Department Opioid Prescribing, 2006–2010

    PubMed Central

    Kea, Bory; Fu, Rochelle; Lowe, Robert A.; Sun, Benjamin C.

    2016-01-01

    Objective Prescription opioid overdoses are a leading cause of death in the United States. Emergency departments (EDs) are potentially high risk environments for doctor shopping and diversion. We hypothesized that opioid prescribing rates from the ED have increased over time. Methods We analyzed data on ED discharges from the 2006–2010 NHAMCS, a probability sample of all United States EDs. The outcome was documentation of an opioid prescription on discharge. The primary independent predictor was time. Covariates included severity of pain, a pain-related discharge diagnosis, age, gender, race, payer, hospital ownership, and geographic location of hospital. Up to three discharge diagnoses were available in NHAMCS to identify ‘pain-related’ (e.g. back pain, fracture, dental/jaw pain, nephrolithiasis) ED visits. We performed multivariate logistic regression to assess the independent associations between opioid prescribing and predictors. All analyses incorporated NHAMCS survey weights, and all results are presented as national estimates. Results Opioids were prescribed for 18.7% (95% CI: 17.7–19.7%) of all ED discharges, representing 18.8 million prescriptions per year. There were no significant temporal trends in opioid prescribing overall (adjusted p=0.93). Painful discharge diagnoses that received the top 3 highest proportion of opioids prescriptions included: nephrolithiasis (62.1%), neck pain (51.6%), and dental/jaw pain (49.7%). A pain-related discharge diagnosis, non-Hispanic white race, older age, male gender, uninsured status and Western region were associated with opioid prescribing (p<0.05). Conclusions We found with no temporal trend towards increased prescribing from 2006–2012. Our results suggest that problems with opioid over-prescribing are multifactorial and not solely rooted in the ED. PMID:26802501

  8. Patient-Safety-Related Hospital Deaths in England: Thematic Analysis of Incidents Reported to a National Database, 2010–2012

    PubMed Central

    Donaldson, Liam J.; Panesar, Sukhmeet S.; Darzi, Ara

    2014-01-01

    Background Hospital mortality is increasingly being regarded as a key indicator of patient safety, yet methodologies for assessing mortality are frequently contested and seldom point directly to areas of risk and solutions. The aim of our study was to classify reports of deaths due to unsafe care into broad areas of systemic failure capable of being addressed by stronger policies, procedures, and practices. The deaths were reported to a patient safety incident reporting system after mandatory reporting of such incidents was introduced. Methods and Findings The UK National Health Service database was searched for incidents resulting in a reported death of an adult over the period of the study. The study population comprised 2,010 incidents involving patients aged 16 y and over in acute hospital settings. Each incident report was reviewed by two of the authors, and, by scrutinising the structured information together with the free text, a main reason for the harm was identified and recorded as one of 18 incident types. These incident types were then aggregated into six areas of apparent systemic failure: mismanagement of deterioration (35%), failure of prevention (26%), deficient checking and oversight (11%), dysfunctional patient flow (10%), equipment-related errors (6%), and other (12%). The most common incident types were failure to act on or recognise deterioration (23%), inpatient falls (10%), healthcare-associated infections (10%), unexpected per-operative death (6%), and poor or inadequate handover (5%). Analysis of these 2,010 fatal incidents reveals patterns of issues that point to actionable areas for improvement. Conclusions Our approach demonstrates the potential utility of patient safety incident reports in identifying areas of service failure and highlights opportunities for corrective action to save lives. Please see later in the article for the Editors' Summary PMID:24959751

  9. Visualization of High-Resolution LiDAR Topography in Google Earth

    NASA Astrophysics Data System (ADS)

    Crosby, C. J.; Nandigam, V.; Arrowsmith, R.; Blair, J. L.

    2009-12-01

    The growing availability of high-resolution LiDAR (Light Detection And Ranging) topographic data has proven to be revolutionary for Earth science research. These data allow scientists to study the processes acting on the Earth’s surfaces at resolutions not previously possible yet essential for their appropriate representation. In addition to their utility for research, the data have also been recognized as powerful tools for communicating earth science concepts for education and outreach purposes. Unfortunately, the massive volume of data produced by LiDAR mapping technology can be a barrier to their use. To facilitate access to these powerful data for research and educational purposes, we have been exploring the use of Keyhole Markup Language (KML) and Google Earth to deliver LiDAR-derived visualizations. The OpenTopography Portal (http://www.opentopography.org/) is a National Science Foundation-funded facility designed to provide access to Earth science-oriented LiDAR data. OpenTopography hosts a growing collection of LiDAR data for a variety of geologic domains, including many of the active faults in the western United States. We have found that the wide spectrum of LiDAR users have variable scientific applications, computing resources, and technical experience and thus require a data distribution system that provides various levels of access to the data. For users seeking a synoptic view of the data, and for education and outreach purposes, delivering full-resolution images derived from LiDAR topography into the Google Earth virtual globe is powerful. The virtual globe environment provides a freely available and easily navigated viewer and enables quick integration of the LiDAR visualizations with imagery, geographic layers, and other relevant data available in KML format. Through region-dependant network linked KML, OpenTopography currently delivers over 20 GB of LiDAR-derived imagery to users via simple, easily downloaded KMZ files hosted at the Portal

  10. 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

  11. Causality analysis on health care evaluation criteria for state-operated mental hospitals in Korea using Malcolm Baldrige National Quality Award model.

    PubMed

    Kim, Yang-Kyun; Oh, Hyun-Jong

    2012-10-01

    Hospitals today are pressured to move away from the conventional health services management techniques and provide higher-quality health care to survive in intense competition. In our study, we aimed to develop health care evaluation criteria for the mental health care sector based on the existing Malcolm Baldrige National Quality Award model, and verify the causality of the evaluation model to lay groundwork for future research on the outcomes of national quality awards for mental health care. We focused on comparison groups comprising five state-operated mental hospitals in Korea using 92 survey questions derived from the MBNQA criteria for health care through structural equation modeling techniques. We verified that Leadership drives Foundation and Direction, which affect System that creates Results with 15 hypotheses supported out of 18 hypotheses established. We believe our findings will provide valuable implications to the top management of mental hospitals for self-examining quality management and promoting competitiveness.

  12. Assessment and provision of rehabilitation among patients hospitalized with acute ischemic stroke in China: Findings from the China National Stroke Registry II.

    PubMed

    Bettger, Janet Prvu; Li, Zixiao; Xian, Ying; Liu, Liping; Zhao, Xingquan; Li, Hao; Wang, Chunxue; Wang, Chunjuan; Meng, Xia; Wang, Anxin; Pan, Yuesong; Peterson, Eric D; Wang, Yilong; Wang, Yongjun

    2017-04-01

    Background Stroke rehabilitation improves functional recovery among stroke patients. However, little is known about clinical practice in China regarding the assessment and provision of rehabilitation among patients with acute ischemic stroke. Aims We examined the frequency and determinants of an assessment for rehabilitation among acute ischemic stroke patients from the China National Stroke Registry II. Methods Data for 19,294 acute ischemic stroke patients admitted to 219 hospitals from June 2012 to January 2013 were analyzed. The multivariable logistic regression model with the generalized estimating equation method accounting for in-hospital clustering was used to identify patient and hospital factors associated with having a rehabilitation assessment during the acute hospitalization. Results Among 19,294 acute ischemic stroke patients, 11,451 (59.4%) were assessed for rehabilitation. Rates of rehabilitation assessment varied among 219 hospitals (IQR 41.4% vs 81.5%). In the multivariable analysis, factors associated with increased likelihood of a rehabilitation assessment ( p < 0.05) included disability prior to stroke, higher NIHSS on admission, receipt of a dysphagia screen, deep venous thrombosis prophylaxis, carotid vessel imaging, longer length of stay, and treatment at a hospital with a higher number of hospital beds (per 100 units). In contrast, patients with a history of atrial fibrillation and hospitals with higher number of annual stroke discharges (per 100 patients) were less likely to receive rehabilitation assessment during the acute stroke hospitalization. Conclusions Rehabilitation assessment among acute ischemic stroke patients was suboptimal in China. Rates varied considerably among hospitals and support the need to improve adherence to recommended care for stroke survivors.

  13. [Kingella kingae ostemyelitis and septic arthritis in paediatric patients. Six cases from the Department of Pediatrics, National University Hospital of Iceland.].

    PubMed

    Birgisson, H; Steingrímsson, O; Guðnason, T

    2000-01-01

    Kingella kingae (K. kingae) is a gram negative rod most often associated with septic arthritis and osteomyelitis in children. Infections caused by K. kingae had not been reported in Iceland when six cases were diagnosed at the Pediatric Department at the National University Hospital of Iceland. In this report we describe those cases and review the literature.

  14. Envisioning electronic health record systems as change management: the experience of an English hospital joining the National Programme for Information Technology.

    PubMed

    Takian, Amirhossein

    2012-01-01

    The historical National Programme for Information Technology (NPfIT) in England was the most expensive (~$20billion) and ambitious politically-driven IT-based transformations of public services ever undertaken. Nation-wide implementation of integrated electronic health record (EHR) systems in hospitals was at the heart of the NPfIT (~$10billion). We conducted the first longitudinal, prospective, and sociotechnical case study implementation and adoption of national EHRs implementations in 12 'early adopter' hospitals across England. This paper reports the arrival, implementation process, and stakeholders' experiences of one EHR software (Millennium) at a National Health Service's (NHS) general hospital participating in NPfIT, hereafter called Alpha. From the outset, Alpha envisioned the implementation of EHR as a practice of change management to improve its performance. This vision attributed to the establishment of a 'design authority' at Alpha, including users from various capacities and levels. The 'design authority' was perceived a key contributor to appropriate (compared to other hospitals we studied) clinical engagement and bottom-up approach to deploying EHR. Through conducting several hundreds of group and individual workflow familiarization, Alpha adopted a novel approach to training staff on EHR software. This led to greater local configuration and high sense of ownership among users, which transformed work practices towards overall better performance of the hospital. Contrary to painful and turbulent experiences of EHR implementation via NPfIT route in the English hospitals, this in-depth case study revealed the importance of vision (change management) and insightful leadership in 'working out' EHR. We advocate envisioning EHRs as change management endeavors to enhance their complex, multi-dimensional, and sociotechnical adoption in healthcare settings.

  15. 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

  16. 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

  17. Bigger is not always better: what the National Health and Hospitals Reform Commission report means for general practice.

    PubMed

    Kidd, Michael R

    2009-10-19

    The National Health and Hospitals Reform Commission report has a focus on building on "the vital role of general practice", to strengthen primary health care as the "cornerstone of our future health system". The report proposes Comprehensive Primary Health Care Centres and Services that will deliver "one-stop" primary health care; but in health care, bigger is not always better. The biggest challenge for the reform process may well be bringing together the different cultures of the largely private primary health care services, funded by the federal government, and the public, primary and community health services, funded by the states and territories. The report pays little real attention to the reforms needed to address the social determinants of health. There is a clear need for action now on the report's most urgent recommendations for Aboriginal and Torres Strait Islander health, mental health, dental health and services for rural and remote communities. Diversity is a great strength of Australian general practice, and we must not lose it in the rush to reform.

  18. Provision of Vocational Skills Education to Orphans: Lessons from Orphanage Centres in Dar es Salaam City, Tanzania

    ERIC Educational Resources Information Center

    Meli, Benjamin Mbeba

    2015-01-01

    This paper utilises data from a study that investigated the efficacy of vocational skills training provided to orphans from three orphanages in Temeke District, Dar es Salaam. The three orphanage centres that were studied are Kurasini National Children Home, Saudia and Don Bosco Vocational Centre. The sample comprised of 45 orphans, an official…

  19. Quantifying soil carbon loss and uncertainty from a peatland wildfire using multi-temporal LiDAR

    USGS Publications Warehouse

    Reddy, Ashwan D.; Hawbaker, Todd J.; Wurster, F.; Zhu, Zhiliang; Ward, S.; Newcomb, Doug; Murray, R.

    2015-01-01

    Peatlands are a major reservoir of global soil carbon, yet account for just 3% of global land cover. Human impacts like draining can hinder the ability of peatlands to sequester carbon and expose their soils to fire under dry conditions. Estimating soil carbon loss from peat fires can be challenging due to uncertainty about pre-fire surface elevations. This study uses multi-temporal LiDAR to obtain pre- and post-fire elevations and estimate soil carbon loss caused by the 2011 Lateral West fire in the Great Dismal Swamp National Wildlife Refuge, VA, USA. We also determine how LiDAR elevation error affects uncertainty in our carbon loss estimate by randomly perturbing the LiDAR point elevations and recalculating elevation change and carbon loss, iterating this process 1000 times. We calculated a total loss using LiDAR of 1.10 Tg C across the 25 km2 burned area. The fire burned an average of 47 cm deep, equivalent to 44 kg C/m2, a value larger than the 1997 Indonesian peat fires (29 kg C/m2). Carbon loss via the First-Order Fire Effects Model (FOFEM) was estimated to be 0.06 Tg C. Propagating the LiDAR elevation error to the carbon loss estimates, we calculated a standard deviation of 0.00009 Tg C, equivalent to 0.008% of total carbon loss. We conclude that LiDAR elevation error is not a significant contributor to uncertainty in soil carbon loss under severe fire conditions with substantial peat consumption. However, uncertainties may be more substantial when soil elevation loss is of a similar or smaller magnitude than the reported LiDAR error.

  20. Recent development of hyperspectral LiDAR using supercontinuum laser

    NASA Astrophysics Data System (ADS)

    Wang, Zhen; Li, Chuanrong; Zhou, Mei; Zhang, Huijing; He, Wenjing; Li, Wei; Qiu, Yuanyuan

    2016-10-01

    Hyperspectral Light Detection And Ranging (Hyperspectral LiDAR), a recently developed technique, combines the advantages of the LiDAR and hyperspectral imaging and has been attractive for many applications. Supercontinuum laser (SC laser), a rapidly developing technique offers hyperspectral LiDAR a suitable broadband laser source and makes hyperspectral Lidar become an installation from a theory. In this paper, the recent research and progressing of the hyperspectral LiDAR are reviewed. The hyperspectral LiDAR has been researched in theory, prototype system, instrument, and application experiment. However, the pulse energy of the SC laser is low so that the range of the hyperspectral LiDAR is limited. Moreover, considering the characteristics of sensors and A/D converter, in order to obtain the full waveform of the echo, the repetition rate and the pulse width of the SC laser needs to be limited. Recently, improving the detection ability of hyperspectral LiDAR, especially improving the detection range, is a main research area. A higher energy pulse SC laser, a more sensitive sensor, or some algorithms are applied in hyperspectral LiDAR to improve the detection distance from 12 m to 1.5 km. At present, a lot of research has been focused on this novel technology which would be applied in more applications.

  1. LiDAR - An emerging tool for geological applications

    USGS Publications Warehouse

    Stoker, Jason M.

    2012-01-01

    Over the past five to ten years the use and applicability of light detection and ranging (LiDAR) technology has increased dramatically. As a result, more and more LiDAR data now are being collected across the country for a wide range of applications, and LiDAR currently is the technology of choice for high resolution terrain model creation, 3-D city and infrastructure modeling, forestry, and a wide range of scientific applications. LiDAR is a key technology for geological applications both within and outside the U.S. Geological Survey, and efforts are underway to try to collect high resolution LiDAR data for the entire United States (https://pubs.usgs.gov/fs/2012/3089/pdf/fs2012-3089.pdf).

  2. Distinguishing grass from ground using LiDAR: Techniques and applications

    NASA Astrophysics Data System (ADS)

    Pelletier, J. D.; Swetnam, T.; Papuga, S. A.; Nelson, K.; Brooks, P. D.; Harpold, A. A.; Chorover, J.

    2011-12-01

    Standard protocols exist for extracting bare-earth Digital Elevation Models (DEMs) from LiDAR point clouds that include trees and other large woody vegetation. Grasses and other herbaceous plants can also obscure the ground surface, yet methods for optimally distinguishing grass from ground to generate accurate LiDAR-based raster products for geomorphic and ecological applications are still under development. Developing such methods is important because LiDAR-based difference products (e.g. snow thickness) require accurate representations of the ground surface and because raster data for grass height and density have important applications in ecology. In this study, we developed and tested methods for constructing optimal bare-earth and grass height raster layers from LiDAR point clouds and compared the results to high-quality field-based measurements of grass height, density, and species type for nearly 1000 precisely geo-referenced locations collected during the acquisition of a >200 km^2 airborne LiDAR flight of the Valles Caldera National Preserve (New Mexico). In cases of partially bare ground (where the skewness of return heights above a plane fit to the lowest first returns is sufficiently large), a planar fit to the lowest first returns provides a good method of producing an accurate bare-earth DEM and the statistics of the first returns above that planar fit provide good estimates of the mean and variance of grass height. In areas of relatively thick grass cover, however, a fit to the lowest first returns yields a bare-earth DEM that may be a meter or more above the actual ground surface. Here we propose a method to solve this problem using field-measured correlations among the mean, variance, and skewness of grass heights. In this method, the variance and skewness of the differences between LiDAR first returns and a 10m^2 planar fit to the lowest first returns is used, together with field-based correlations of grass height statistics, to estimate the mean

  3. [Unified National Health System costs in São José dos Campos, São Paulo State, Brazil, for hospital admissions due to external causes].

    PubMed

    Melione, Luís Paulo Rodrigues; Mello-Jorge, Maria Helena Prado de

    2008-08-01

    The objective of this study was to identify direct expenditures for hospitalizations due to external causes in the Unified National Health System (SUS) in the city of São José dos Campos, São Paulo State, Brazil. Admissions to the Dr. José de Carvalho Florence Municipal Hospital resulting from external causes or injuries - ICD-10, chapters XIX and XX respectively - were analyzed for the first semester of 2003. 976 patient admission forms were analyzed, after data evaluation. Admissions with the highest total cost were those resulting from motor vehicle accidents and falls. The highest mean cost for hospitalization for injury was due to motor vehicle accidents (BRL 614.63), followed by assault (BRL 594.90). The highest mean cost for hospitalization due to injury was for cervical fractures (BRL 1,191.42) and head injuries (BRL 1,000.44). Hospitalizations with the highest daily cost were skull and facial fractures (BRL 166.72) and abdominal trauma (BRL 148.26). The study confirmed that motor vehicle accidents, falls, and assault are an important source of costs due to hospitalization for injuries.

  4. Do acute myocardial infarction and stroke mortality vary by distance to hospitals in Switzerland? Results from the Swiss National Cohort Study

    PubMed Central

    Zwahlen, Marcel

    2016-01-01

    Objective Switzerland has mountains and valleys complicating the access to a hospital and critical care in case of emergencies. Treatment success for acute myocardial infarction (AMI) or stroke depends on timely treatment. We examined the relationship between distance to different hospital types and mortality from AMI or stroke in the Swiss National Cohort (SNC) Study. Design and setting The SNC is a longitudinal mortality study of the census 2000 population of Switzerland. For 4.5 million Swiss residents not living in a nursing home and older than 30 years in the year 2000, we calculated driving time and straight-line distance from their home to the nearest acute, acute with emergency room, central and university hospital (in total 173 hospitals). On the basis of quintiles, we used multivariable Cox proportional hazard models to estimate HRs of AMI and stroke mortality for driving time distance groups compared to the closest distance group. Results Over 8 years, 19 301 AMI and 21 931 stroke deaths occurred. Mean driving time to the nearest acute hospital was 6.5 min (29.7 min to a university hospital). For AMI mortality, driving time to a university hospital showed the strongest association among the four types of hospitals with a hazard ratio (HR) of 1.19 (95% CI 1.10 to 1.30) and 1.10 (95% CI 1.01 to 1.20) for men and women aged 65+ years when comparing the highest quintile with the lowest quintile of driving time. For stroke mortality, the association with university hospital driving time was less pronounced than for AMI mortality and did not show a clear incremental pattern with increasing driving time. There was no association with driving time to the nearest hospital. Conclusions The increasing AMI mortality with increasing driving time to the nearest university hospital but not to any nearest hospital reflects a complex interplay of many factors along the care pathway. PMID:27803109

  5. Association between Socioeconomic and Psychological Experiences of Parents with Children on Leukemia Treatment in Kenyatta National Hospital, Kenya

    PubMed Central

    Okumu, Roselyne Anyango; Muiva, Margret; Wagoro, Miriam; Abdallah, Fatmah; Oweya, Erick

    2017-01-01

    Objective: The survival rate for children with leukemia has increased dramatically since the late 1990s; treatment effects of the disease can be extremely stressful for families. Research on psychological and socioeconomic effects of leukemia treatment had been conducted in Western countries, but little is known within Africa including Kenya. Methods: This was a cross-sectional study with a sample of 62 out of 72 parents of children undergoing leukemia treatment at Kenyatta National Hospital. Data were collected between May and August 2015 using structured questionnaires while qualitative data were collected using focus group discussions. This manuscript is based on quantitative data which were entered into EpiData version 3.1 and analyzed using SPSS version 20. Psychological distress index was created by counting the number of psychological experiences reported by respondents. Kendall's tau-b was used to test the association between the psychological distress index and socioeconomic characteristics; P ≤ 0.05 was considered statistically significant. Results: The respondents experienced anxiety, shock, and fatigue. Spending a higher proportion of family's income was associated with higher psychological distress index (P = 0.009). The economic challenge led to significantly heightened tension in the family (P = 0.021). Conclusions: Financial challenge is a major cause of psychological distress thus needs for financial support through collaboration with government institutions, for example, NHIF, development agencies, and nongovernment organization who can contribute toward the treatment cost. Need to decentralize effective leukemia treatment centers. Psychological support and counseling should be done to alleviate tension. The nurse needs to be empathetic when caring for the child and family as well as to apply the ethical principles of justice and beneficence so that the child gets the best care despite the financial challenge. PMID:28217728

  6. Prevalence of microalbuminuria and its correlates among diabetic patients attending diabetic clinic at National Guard Hospital in Alhasa

    PubMed Central

    AlFehaid, Aneesah A.

    2017-01-01

    INTRODUCTION: Diabetes mellitus is one of the most common diseases encountered in clinical practice. Diabetic nephropathy is a common consequence of long-standing diabetes mellitus; microalbuminuria (MA) is considered an early stage of diabetic nephropathy. OBJECTIVES: To determine the prevalence of miciroalbuminuria in diabetic patients and factors associated with MA. MATERIALS AND METHODS: This cross-sectional study was conducted in the diabetic clinic of the primary health center of the National Guard Hospital. Diabetes type 2 patients between the ages of 20–60 years who attended the clinic in 2012 were included in this study. Data were collected by reviewing medical records for demographic and disease-related variables. MA was detected by measuring the albumin to creatinine ratio, and MA was diagnosed if this ratio was between 30 and 300 mg/g on two occasions. RESULTS: MA was found in 37.4% of the sample and the rate was significantly higher among females (P < 0.027). MA was positively related to body mass index (BMI) (P < 0.002), the presence of hypertension (P < 0.000), duration of diabetes (P < 0.000), glycated hemoglobin (P < 0.000), fasting plasma glucose (P < 0.000), and low-density lipoprotein (LDL) (P < 0.043). No statistically significant correlation was found between MA and age, creatinine level, high-density lipoprotein, and triglyceride. CONCLUSION: The prevalence of MA in patients with diabetes in this study was high. The study suggests the need to screen for MA early, and the active management of modifiable risk factors, in particular, hyperglycemia, hypertension, LDL, and BMI, to reduce the burden of future end-stage renal disease. PMID:28163568

  7. Bacterial isolates and drug susceptibility patterns of urinary tract infection among pregnant women at Muhimbili National Hospital in Tanzania.

    PubMed

    Moyo, Sabrina J; Aboud, Said; Kasubi, Mabula; Maselle, Samuel Y

    2010-10-01

    Urinary tract infection (UTI) during pregnancy may cause complications such as pyelonephritis, hypertensive disease of pregnancy, anaemia, chronic renal failure, premature delivery and foetal mortality. This study aimed to identify the etiologic agents of UTI and to determine the patterns of antimicrobial drug susceptibility among pregnant women at Muhimbili National Hospital in Tanzania. Retrospective analysis of 200 mid-stream urine specimens processed for culture and antimicrobial drug susceptibility testing between January 2007 and December 2009 was carried out. Significant bacteriuria (> 105 colony forming units/mL of urine) was found in 42/200 (21%) specimens. Of the 42 isolates, the most commonly isolated bacteria were Escherichia coli 14 (33.3%), Klebsiella spp 9 (21.4%) coagulase negative Staphylococcus 7 (16.7%), Staphylococcus aureus 6 (14.3%), Proteus species 3 (7.1%) and Enterococcus species 3 (7.1%). Low rate to moderately high rate of antimicrobial drug resistance was observed against first line drugs namely, nitrofurantoin 18.7 % (n=16), co-trimoxazole 38.5 % (n=13) and ampicillin 57.7% (n=26). Relatively low rate of resistance was seen against second line drugs: ciprofloxacin 13.6 % (n=22) and amikacin 5 % (n=20). High rate of resistance was observed in third generation cephalosporin cefotaxime 31.2 % (n=16). Of the Gram-positive organisms tested against vancomicin and methicilin, resistance was found in 25 % (n=13) and 25 % (n=4), respectively. In conclusion, E coli was found to be the common cause of UTI among the pregnant women. Low to moderately high level of resistance was found in first line drugs while high level of resistance was found in third generation cephalosporin. It is recommended to monitor the levels of resistance for nitrofurantoin, fluoroquinolone and cefotaxime and to screen for Extended Spectrum Beta Lactamase production among cefotaxime resistant E. coli and Klebsiella spp.

  8. Ambulatory care for cancer in the United States: results from two national surveys comparing visits to physicians' offices and hospital outpatient departments.

    PubMed Central

    Richardson, Lisa C.; Tangka, Florence K.

    2007-01-01

    BACKGROUND: Among the general population, type of health insurance has been reported to affect the location of ambulatory visits and the content of those visits. We examined where cancer patient visits occurred (physicians' offices or hospital clinics), and whether anticancer therapy is administered or prescribed. METHODS: Cross-sectional study using National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey (NAMCS/NHAMCS) data to characterize ambulatory cancer patient visits from 2001-2003. Multivariable logistic regression analyses were performed to identify factors associated with where a cancer patient went for care (office practice versus hospital clinic) and anticancer therapy received. RESULTS: Thirteen percent of patients visited hospital clinics, with the remainder visiting office-based settings. Younger cancer patients and those with Medicaid were more likely to visit hospital clinics compared to older and privately insured cancer patients. Cancer patients with <6 visits in the last year were less likely to be seen in the office setting. Patients with lung cancer, lymphoma/leukemia and melanoma were less likely to have anticancer therapy administered or prescribed compared to breast cancer patients. The uninsured were less likely to have anticancer administered or prescribed compared with the privately insured. CONCLUSIONS: Cancer patients with Medicaid were more likely to visit hospital clinics than privately insured patients. Treatment was associated with cancer type, not where care occurred and health insurance type, though there was a trend for the uninsured and those insured by Medicaid to be less likely to be administered or be prescribed anticancer therapy. PMID:18229771

  9. Processing LiDAR Data to Predict Natural Hazards

    NASA Technical Reports Server (NTRS)

    Fairweather, Ian; Crabtree, Robert; Hager, Stacey

    2008-01-01

    ELF-Base and ELF-Hazards (wherein 'ELF' signifies 'Extract LiDAR Features' and 'LiDAR' signifies 'light detection and ranging') are developmental software modules for processing remote-sensing LiDAR data to identify past natural hazards (principally, landslides) and predict future ones. ELF-Base processes raw LiDAR data, including LiDAR intensity data that are often ignored in other software, to create digital terrain models (DTMs) and digital feature models (DFMs) with sub-meter accuracy. ELF-Hazards fuses raw LiDAR data, data from multispectral and hyperspectral optical images, and DTMs and DFMs generated by ELF-Base to generate hazard risk maps. Advanced algorithms in these software modules include line-enhancement and edge-detection algorithms, surface-characterization algorithms, and algorithms that implement innovative data-fusion techniques. The line-extraction and edge-detection algorithms enable users to locate such features as faults and landslide headwall scarps. Also implemented in this software are improved methodologies for identification and mapping of past landslide events by use of (1) accurate, ELF-derived surface characterizations and (2) three LiDAR/optical-data-fusion techniques: post-classification data fusion, maximum-likelihood estimation modeling, and hierarchical within-class discrimination. This software is expected to enable faster, more accurate forecasting of natural hazards than has previously been possible.

  10. Diagnostic virology practices for respiratory syncytial virus and influenza virus among children in the hospital setting: a national survey.

    PubMed

    Jafri, Hasan S; Ramilo, Octavio; Makari, Doris; Charsha-May, Deborah; Romero, José R

    2007-10-01

    A survey was sent to the emergency room and laboratory directors of 400 randomly selected US hospitals to assess the diagnostic testing practices for respiratory syncytial virus and influenza virus in children. The results demonstrate that the majority of hospitals routinely perform viral testing for both viruses and use virology testing practices appropriate for the reasons reported for testing.

  11. Understanding the Determinants of Australian Hospital Nurses' Hand Hygiene Decisions Following the Implementation of a National Hand Hygiene Initiative

    ERIC Educational Resources Information Center

    White, Katherine M.; Starfelt, Louise C.; Jimmieson, Nerina L.; Campbell, Megan; Graves, Nicholas; Barnett, Adrian G.; Cockshaw, Wendell; Gee, Phillip; Page, Katie; Martin, Elizabeth; Brain, David; Paterson, David

    2015-01-01

    Hand hygiene is the primary measure in hospitals to reduce the spread of infections, with nurses experiencing the greatest frequency of patient contact. The "5 critical moments" of hand hygiene initiative has been implemented in hospitals across Australia, accompanied by awareness-raising, staff training and auditing. The aim of this…

  12. Record linkage between hospital discharges and mortality registries for motor neuron disease case ascertainment for the Spanish National Rare Diseases Registry.

    PubMed

    Ruiz, Elena; Ramalle-Gómara, Enrique; Quiñones, Carmen

    2014-06-01

    Our objective was to analyse the coverage of hospital discharge data and the mortality registry (MR) of La Rioja to ascertain motor neuron disease (MND) cases to be included in the Spanish National Rare Diseases Registry. MND cases that occurred in La Rioja during the period 1996-2011 were selected from hospital discharge data and the MR by means of the International Classification of Diseases. Review of the medical histories was carried out to confirm the causes of death reported. Characteristics of the population with MND were analysed. A total of 133 patients with MND were detected in La Rioja during the period 1996-2011; 30.1% were only recorded in the hospital discharges data, 12.0% only in the MR, and 57.9% were recorded by both databases. Medical records revealed a miscoding of patients who had been diagnosed with progressive supranuclear palsy but were recorded in the MR with an MND code. In conclusion, the hospital discharges data and the MR appear to be complementary and are valuable databases for the Spanish National Rare Diseases Registry when MNDs are properly codified. Nevertheless, it would be advisable to corroborate the validity of the MR as data source since the miscoding of progressive supranuclear palsy has been corrected.

  13. Northern Latitude but Not Season Is Associated with Increased Rates of Hospitalizations Related to Inflammatory Bowel Disease: Results of a Multi-Year Analysis of a National Cohort

    PubMed Central

    Stein, Adam C.; Gaetano, John Nick; Jacobs, Jeffrey; Kunnavakkam, Rangesh; Bissonnette, Marc; Pekow, Joel

    2016-01-01

    Background and Aims There is growing evidence that the incidence and severity of inflammatory bowel disease (IBD) may be geographically and seasonally related. Why these associations are observed remains unclear. We assessed the impact of geographic location, season, and exposure to ultraviolet light on disease severity by measuring national hospital IBD-related discharge rates. Methods Utilizing the Nationwide Inpatient Sample (NIS), we identified all patients with IBD-related discharges from 2001–2007. Patients were included if they were discharged from states above the 40th parallel (north) or at or below the 35th parallel (south); and their discharge fell within the winter (January, February, and March) or summer (July, August, and September). Groups of patients were assessed comparing north to south within each season, and summer to winter within each region. UV index was recorded from the National Weather Service data and compared to monthly discharge rates. Results There was a consistent pattern of increased IBD-related hospitalization rates in northern states compared to southern states for both ulcerative colitis and Crohn’s disease. Differences in IBD-related hospitalization rates by season, however, were not uniform across the years studied. UV index was significantly inversely associated although not proportional to discharge rates for both Crohn’s disease and ulcerative colitis. Conclusions In the US, there is a significant increased rate of IBD-related hospitalizations in the northern compared to southern states, which not fully explained by differences in UV exposure. PMID:27579718

  14. Tensor Modeling Based for Airborne LiDAR Data Classification

    NASA Astrophysics Data System (ADS)

    Li, N.; Liu, C.; Pfeifer, N.; Yin, J. F.; Liao, Z. Y.; Zhou, Y.

    2016-06-01

    Feature selection and description is a key factor in classification of Earth observation data. In this paper a classification method based on tensor decomposition is proposed. First, multiple features are extracted from raw LiDAR point cloud, and raster LiDAR images are derived by accumulating features or the "raw" data attributes. Then, the feature rasters of LiDAR data are stored as a tensor, and tensor decomposition is used to select component features. This tensor representation could keep the initial spatial structure and insure the consideration of the neighborhood. Based on a small number of component features a k nearest neighborhood classification is applied.

  15. Timing of surgery for hip fracture and in-hospital mortality: a retrospective population-based cohort study in the Spanish National Health System

    PubMed Central

    2012-01-01

    Background While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture repair and in-hospital mortality in elderly people attending public hospitals in the Spanish National Health System and, additionally, to explore factors associated with the decision to perform early hip fracture repair. Methods A cohort of 56,500 patients of 60-years-old and over, hospitalized for hip fracture during the period 2002 to 2005 in all the public hospitals in 8 Spanish regions, were followed up using administrative databases to identify the time to surgical repair and in-hospital mortality. We used a multivariate logistic regression model to analyze the relationship between the timing of surgery (< 2 days from admission) and in-hospital mortality, controlling for several confounding factors. Results Early surgery was performed on 25% of the patients. In the unadjusted analysis early surgery showed an absolute difference in risk of mortality of 0.57 (from 4.42% to 3.85%). However, patients undergoing delayed surgery were older and had higher comorbidity and severity of illness. Timeliness for surgery was not found to be related to in-hospital mortality once confounding factors such as age, sex, chronic comorbidities as well as the severity of illness were controlled for in the multivariate analysis. Conclusions Older age, male gender, higher chronic comorbidity and higher severity measured by the Risk Mortality Index were associated with higher mortality, but the time to surgery was not. PMID:22257790

  16. National Bloodstream Infection Surveillance in Switzerland 2008-2014: Different Patterns and Trends for University and Community Hospitals.

    PubMed

    Buetti, Niccolò; Marschall, Jonas; Atkinson, Andrew; Kronenberg, Andreas

    2016-09-01

    OBJECTIVE To characterize the epidemiology of bloodstream infections in Switzerland, comparing selected pathogens in community and university hospitals. DESIGN Observational, retrospective, multicenter laboratory surveillance study. METHODS Data on bloodstream infections from 2008 through 2014 were obtained from the Swiss infection surveillance system, which is part of the Swiss Centre for Antibiotic Resistance (ANRESIS). We compared pathogen prevalences across 26 acute care hospitals. A subanalysis for community-acquired and hospital-acquired bloodstream infections in community and university hospitals was performed. RESULTS A total of 42,802 bloodstream infection episodes were analyzed. The most common etiologies were Escherichia coli (28.3%), Staphylococcus aureus (12.4%), and polymicrobial bloodstream infections (11.4%). The proportion of E. coli increased from 27.5% in 2008 to 29.6% in 2014 (P = .04). E. coli and S. aureus were more commonly reported in community than university hospitals (34.3% vs 22.7%, P<.001 and 13.9% vs 11.1%, P<.001, respectively). Fifty percent of episodes were community-acquired, with E. coli again being more common in community hospitals (41.0% vs 32.4%, P<.001). The proportion of E. coli in community-acquired bloodstream infections increased in community hospitals only. Community-acquired polymicrobial infections (9.9% vs 5.6%, P<.001) and community-acquired coagulase-negative staphylococci (6.7% vs 3.4%, P<0.001) were more prevalent in university hospitals. CONCLUSIONS The role of E. coli as predominant pathogen in bloodstream infections has become more pronounced. There are distinct patterns in community and university hospitals, potentially influencing empirical antibiotic treatment. Infect Control Hosp Epidemiol 2016;37:1060-1067.

  17. Influential Factors for and Outcomes of Hospitalized Patients with Suicide-Related Behaviors: A National Record Study in Taiwan from 1997–2010

    PubMed Central

    Lin, Yu-Wen; Huang, Hui-Chuan; Lin, Mei-Feng; Shyu, Meei-Ling; Tsai, Po-Li; Chang, Hsiu-Ju

    2016-01-01

    Background Investigating the factors related to suicide is crucial for suicide prevention. Psychiatric disorders, gender, socioeconomic status, and catastrophic illnesses are associated with increased risk of suicide. Most studies have typically focused on the separate influences of physiological or psychological factors on suicide-related behaviors, and have rarely used national data records to examine and compare the effects of major physical illnesses, psychiatric disorders, and socioeconomic status on the risk of suicide-related behaviors. Objectives To identify the characteristics of people who exhibited suicide-related behaviors and the multiple factors associated with repeated suicide-related behaviors and deaths by suicide by examining national data records. Design This is a cohort study of Taiwan’s national data records of hospitalized patients with suicide-related behaviors from January 1, 1997, to December 31, 2010. Participants The study population included all people in Taiwan who were hospitalized with a code indicating suicide or self-inflicted injury (E950–E959) according to the International Classification of Disease, Ninth Revision, Clinical Modification. Results Self-poisoning was the most common method of self-inflicted injury among hospitalized patients with suicide-related behaviors who used a single method. Those who were female, had been hospitalized for suicide-related behaviors at a younger age, had a low income, had a psychiatric disorder (i.e., personality disorder, major depressive disorder, bipolar disorder, schizophrenia, alcohol-related disorder, or adjustment disorder), had a catastrophic illness, or had been hospitalized for suicide-related behaviors that involved two methods of self-inflicted injury had a higher risk of hospitalization for repeated suicide-related behaviors. Those who were male, had been hospitalized for suicide-related behaviors at an older age, had low income, had schizophrenia, showed repeated suicide

  18. Can Patient Safety Incident Reports Be Used to Compare Hospital Safety? Results from a Quantitative Analysis of the English National Reporting and Learning System Data

    PubMed Central

    2015-01-01

    Background The National Reporting and Learning System (NRLS) collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals. Finally, it assesses which health-care professionals report more incidents of patient harm, which report more near miss incidents and what hospital factors encourage reporting. These findings may suggest methods for increasing the utility of reporting systems. Methods This study used a mix methods approach for assessing NRLS data. The data were investigated using Pareto analysis and regression models to establish which patients are most vulnerable to reported harm. Hospital factors were correlated with institutional reporting rates over one year to examine what factors influenced reporting. Staff survey findings regarding hospital safety culture were correlated with reported rates of incidents causing harm; no harm and death to understand what barriers influence error disclosure. Findings 5,879,954 incident reports were collected from acute hospitals over the decade. 70.3% of incidents produced no harm to the patient and 0.9% were judged by the reporter to have caused severe harm or death. Obstetrics and Gynaecology reported the most no harm events [OR 1.61(95%CI: 1.12 to 2.27), p<0.01] and pharmacy was the hospital location where most near-misses were captured [OR 3.03(95%CI: 2.04 to 4.55), p<0.01]. Clinicians were significantly more likely to report death than other staff [OR 3.04(95%CI: 2.43 to 3.80) p<0.01]. A higher ratio of clinicians to beds correlated with reduced rate of harm reported [RR = -1.78(95%Cl: -3.33 to -0.23), p = 0.03]. Litigation

  19. National survey on cholecystectomy related bile duct injury--public health and financial aspects in Belgian hospitals--1997.

    PubMed

    Van de Sande, St; Bossens, M; Parmentier, Y; Gigot, J F

    2003-04-01

    Public health and financial aspects of cholecystectomy related bile duct injury (BDI) are highlighted in a National Cholecystectomy Survey carried out through 'datamining' the Federal State Medical Records Summaries and Financial Summaries of all Belgian hospitals in 1997. All cancer diagnoses, children < or = 10 years, cholecystectomies performed as an abdominal co-procedure or patients having undergone other non-related surgery were excluded from the study. 10.595 laparoscopic (LC) and 1.033 open cholecystectomies (OC) as well as 137 secondary BDI treatments (LC/OC) were included in the survey (total 11.765). Both LC and OC groups turned out to be significantly different as to distribution of patient's age and APR-DRG severity classes. Composite criteria in terms of ICD-9-CM and billing codes were elaborated to classify: 1) primary, intra-operatively detected and treated BDI (N = 30), 2) primary delayed BDI treatments (N = 38), 3) secondary BDI treatments (N = 137), 4) non-BDI abdomino-surgical complications (N = 119), 4) uneventful laparoscopic (N = 7.476) and 5) uneventful open cholecystectomy (N = 681). Complication rates, community costs of LC and OC groups, incidence of preoperative ERCP and/or intra-operative cholangiography as well as interventions for complications were studied. Incidence of cholecystectomy related BDI was 0.37% in LC, 2.81% in OC and 0.58% overall. Average costs amounted to [symbol: see text] 1.721 for uneventful LC, [symbol: see text] 2.924 for uneventful OC, [symbol: see text] 7.250 for primary, intra-operatively detected and immediately treated BDI [symbol: see text] 9.258 for primary delayed BDI treatments, [symbol: see text] 6.076 for secondary BDI treatments and [symbol: see text] 10.363 for non-BDI abdomino-surgical complications. In conclusion BDI with cholecystectomy reveals to be a serious complication increasing the overall average cost factor ninefold if not detected intra-operatively, in which case the raise is only fourfold

  20. Analyzing Hydro-Geomorphic Responses in Post-Fire Stream Channels with Terrestrial LiDAR

    NASA Astrophysics Data System (ADS)

    Nourbakhshbeidokhti, S.; Kinoshita, A. M.; Chin, A.

    2015-12-01

    Wildfires have potential to significantly alter soil properties and vegetation within watersheds. These alterations often contribute to accelerated erosion, runoff, and sediment transport in stream channels and hillslopes. This research applies repeated Terrestrial Laser Scanning (TLS) Light Detection and Ranging (LiDAR) to stream reaches within the Pike National Forest in Colorado following the 2012 Waldo Canyon Fire. These scans allow investigation of the relationship between sediment delivery and environmental characteristics such as precipitation, soil burn severity, and vegetation. Post-fire LiDAR images provide high resolution information of stream channel changes in eight reaches for three years (2012-2014). All images are processed with RiSCAN PRO to remove vegetation and triangulated and smoothed to create a Digital Elevation Model (DEM) with 0.1 m resolution. Study reaches with two or more successive DEM images are compared using a differencing method to estimate the volume of sediment erosion and deposition. Preliminary analysis of four channel reaches within Williams Canyon and Camp Creek yielded erosion estimates between 0.035 and 0.618 m3 per unit area. Deposition was estimated as 0.365 to 1.67 m3 per unit area. Reaches that experienced higher soil burn severity or larger rainfall events produced the greatest geomorphic changes. Results from LiDAR analyses can be incorporated into post-fire hydrologic models to improve estimates of runoff and sediment yield. These models will, in turn, provide guidance for water resources management and downstream hazards mitigation.

  1. Automatic registration method for mobile LiDAR data

    NASA Astrophysics Data System (ADS)

    Wang, Ruisheng; Ferrie, Frank P.

    2015-01-01

    We present an automatic mutual information (MI) registration method for mobile LiDAR and panoramas collected from a driving vehicle. The suitability of MI for registration of aerial LiDAR and aerial oblique images has been demonstrated under an assumption that minimization of joint entropy (JE) is a sufficient approximation of maximization of MI. We show that this assumption is invalid for the ground-level data. The entropy of a LiDAR image cannot be regarded as approximately constant for small perturbations. Instead of minimizing the JE, we directly maximize MI to estimate corrections of camera poses. Our method automatically registers mobile LiDAR with spherical panoramas over an approximate 4-km drive, and is the first example we are aware of that tests MI registration in a large-scale context.

  2. Creating a “culture of research” in a community hospital: Strategies and tools from the National Cancer Institute Community Cancer Centers Program

    PubMed Central

    St. Germain, Diane; Nacpil, Lianne M; Zaren, Howard A; Swanson, Sandra M; Minnick, Christopher; Carrigan, Angela; Denicoff, Andrea M; Igo, Kathleen E; Acoba, Jared D; Gonzalez, Maria M; McCaskill-Stevens, Worta

    2015-01-01

    Background The value of community-based cancer research has long been recognized. In addition to the National Cancer Institute’s Community Clinical and Minority-Based Oncology Programs established in 1983, and 1991 respectively, the National Cancer Institute established the National Cancer Institute Community Cancer Centers Program in 2007 with an aim of enhancing access to high-quality cancer care and clinical research in the community setting where most cancer patients receive their treatment. This article discusses strategies utilized by the National Cancer Institute Community Cancer Centers Program to build research capacity and create a more entrenched culture of research at the community hospitals participating in the program over a 7-year period. Methods To facilitate development of a research culture at the community hospitals, the National Cancer Institute Community Cancer Centers Program required leadership or chief executive officer engagement; utilized a collaborative learning structure where best practices, successes, and challenges could be shared; promoted site-to-site mentoring to foster faster learning within and between sites; required research program assessments that spanned clinical trial portfolio, accrual barriers, and outreach; increased identification and use of metrics; and, finally, encouraged research team engagement across hospital departments (navigation, multidisciplinary care, pathology, and disparities) to replace the traditionally siloed approach to clinical trials. Limitations The health-care environment is rapidly changing while complexity in research increases. Successful research efforts are impacted by numerous factors (e.g. institutional review board reviews, physician interest, and trial availability). The National Cancer Institute Community Cancer Centers Program sites, as program participants, had access to the required resources and support to develop and implement the strategies described. Metrics are an important

  3. National trends in inpatient admissions following stereotactic radiosurgery and the in-hospital patient outcomes in the United States from 1998 to 2011

    PubMed Central

    Ho, Allen L.; Li, Alexander Y.; Sussman, Eric S.; Pendharkar, Arjun V.; Iyer, Aditya; Thompson, Patricia A.; Tayag, Armine T.; Chang, Steven D.

    2016-01-01

    Purpose This study sought to examine trends in stereotactic radiosurgery (SRS) and in-hospital patient outcomes on a national level by utilizing national administrative data from the Nationwide Inpatient Sample (NIS) database. Methods and materials Using the NIS database, all discharges where patients underwent inpatient SRS were included in our study from 1998 – 2011 as designated by the ICD9-CM procedural codes. Trends in the utilization of primary and adjuvant SRS, in-hospital complications and mortality, and resource utilization were identified and analyzed. Results Our study included over 11,000 hospital discharges following admission for primary SRS or for adjuvant SRS following admission for surgery or other indication. The most popular indication for SRS continues to be treatment of intracranial metastatic disease (36.7%), but expansion to primary CNS lesions and other non-malignant pathology beyond trigeminal neuralgia has occurred over the past decade. Second, inpatient admissions for primary SRS have declined by 65.9% over this same period of time. Finally, as inpatient admissions for SRS become less frequent, the complexity and severity of illness seen in admitted patients has increased over time with an increase in the average comorbidity score from 1.25 in the year 2002 to 2.29 in 2011, and an increase in over-all in-hospital complication rate of 2.8 times over the entire study period. Conclusions As the practice of SRS continues to evolve, we have seen several trends in associated hospital admissions. Overall, the number of inpatient admissions for primary SRS has declined while adjuvant applications have remained stable. Over the same period, there has been associated increase in complication rate, length of stay, and mortality in inpatients. These associations may be explained by an increase in the comorbidity-load of admitted patients as more high-risk patients are selected for admission at inpatient centers while more stable patients are

  4. Establishing an Anaesthesia and Intensive Care partnership and aiming for national impact in Tanzania.

    PubMed

    Ulisubisya, Mpoki; Jörnvall, Henrik; Irestedt, Lars; Baker, Tim

    2016-03-18

    Anaesthesia and Intensive Care is a neglected specialty in low-income countries. There is an acute shortage of health workers - several low-income countries have less than 1 anaesthesia provider per 100,000 population. Only 1.5% of hospitals in Africa have the intensive care resources needed for managing patients with sepsis. Health partnerships between institutions in high and low-income countries have been proposed as an effective way to strengthen health systems. The aim of this article is to describe the origin and conduct of a health partnership in Anaesthesia and Intensive Care between institutions in Tanzania and Sweden and how the partnership has expanded to have an impact at regional and national levels.The Muhimbili-Karolinska Anaesthesia and Intensive Care Collaboration was initiated in 2008 on the request of the Executive Director of Muhimbili National Hospital in Dar es Salaam. The partnership has conducted training courses, exchanges, research projects and introduced new equipment, routines and guidelines. The partnership has expanded to include all hospitals in Dar es Salaam. Through the newly formed Life Support Foundation, the partnership has had a national impact assisting the reanimation of the Society of Anaesthesiologists of Tanzania and has seen a marked increase of the number of young doctors choosing a residency in Anaesthesia and Intensive Care.

  5. Shipborne LiDAR system for coastal change monitoring

    NASA Astrophysics Data System (ADS)

    Kim, chang hwan; Park, chang hong; Kim, hyun wook; hyuck Kim, won; Lee, myoung hoon; Park, hyeon yeong

    2016-04-01

    Coastal areas, used as human utilization areas like leisure space, medical care, ports and power plants, etc., are regions that are continuously changing and interconnected with oceans and land and the sea level has risen by about 8cm (1.9mm / yr) due to global warming from 1964 year to 2006 year in Korea. Coastal erosion due to sea-level rise has caused the problem of marine ecosystems and loss of tourism resources, etc. Regular monitoring of coastal erosion is essential at key locations with such volatility. But the survey method of land mobile LiDAR (light detection and ranging) system has much time consuming and many restrictions. For effective monitoring beach erosion, KIOST (Korea Institute of Ocean Science & Technology) has constructed a shipborne mobile LiDAR system. The shipborne mobile LiDAR system comprised a land mobile LiDAR (RIEGL LMS-420i), an INS (inertial navigation system, MAGUS Inertial+), a RTKGPS (LEICA GS15 GS25), and a fixed platform. The shipborne mobile LiDAR system is much more effective than a land mobile LiDAR system in the measuring of fore shore areas without shadow zone. Because the vessel with the shipborne mobile LiDAR system is continuously moved along the shoreline, it is possible to efficiently survey a large area in a relatively short time. Effective monitoring of the changes using the constructed shipborne mobile LiDAR system for seriously eroded coastal areas will be able to contribute to coastal erosion management and response.

  6. Modelling rating curves using remotely sensed LiDAR data

    USGS Publications Warehouse

    Nathanson, Marcus; Kean, Jason W.; Grabs, Thomas J.; Seibert, Jan; Laudon, Hjalmar; Lyon, Steve W.

    2012-01-01

    Accurate stream discharge measurements are important for many hydrological studies. In remote locations, however, it is often difficult to obtain stream flow information because of the difficulty in making the discharge measurements necessary to define stage-discharge relationships (rating curves). This study investigates the feasibility of defining rating curves by using a fluid mechanics-based model constrained with topographic data from an airborne LiDAR scanning. The study was carried out for an 8m-wide channel in the boreal landscape of northern Sweden. LiDAR data were used to define channel geometry above a low flow water surface along the 90-m surveyed reach. The channel topography below the water surface was estimated using the simple assumption of a flat streambed. The roughness for the modelled reach was back calculated from a single measurment of discharge. The topographic and roughness information was then used to model a rating curve. To isolate the potential influence of the flat bed assumption, a 'hybrid model' rating curve was developed on the basis of data combined from the LiDAR scan and a detailed ground survey. Whereas this hybrid model rating curve was in agreement with the direct measurements of discharge, the LiDAR model rating curve was equally in agreement with the medium and high flow measurements based on confidence intervals calculated from the direct measurements. The discrepancy between the LiDAR model rating curve and the low flow measurements was likely due to reduced roughness associated with unresolved submerged bed topography. Scanning during periods of low flow can help minimize this deficiency. These results suggest that combined ground surveys and LiDAR scans or multifrequency LiDAR scans that see 'below' the water surface (bathymetric LiDAR) could be useful in generating data needed to run such a fluid mechanics-based model. This opens a realm of possibility to remotely sense and monitor stream flows in channels in remote

  7. Georeferenced LiDAR 3D Vine Plantation Map Generation

    PubMed Central

    Llorens, Jordi; Gil, Emilio; Llop, Jordi; Queraltó, Meritxell

    2011-01-01

    The use of electronic devices for canopy characterization has recently been widely discussed. Among such devices, LiDAR sensors appear to be the most accurate and precise. Information obtained with LiDAR sensors during reading while driving a tractor along a crop row can be managed and transformed into canopy density maps by evaluating the frequency of LiDAR returns. This paper describes a proposed methodology to obtain a georeferenced canopy map by combining the information obtained with LiDAR with that generated using a GPS receiver installed on top of a tractor. Data regarding the velocity of LiDAR measurements and UTM coordinates of each measured point on the canopy were obtained by applying the proposed transformation process. The process allows overlap of the canopy density map generated with the image of the intended measured area using Google Earth®, providing accurate information about the canopy distribution and/or location of damage along the rows. This methodology was applied and tested on different vine varieties and crop stages in two important vine production areas in Spain. The results indicate that the georeferenced information obtained with LiDAR sensors appears to be an interesting tool with the potential to improve crop management processes. PMID:22163952

  8. Georeferenced LiDAR 3D vine plantation map generation.

    PubMed

    Llorens, Jordi; Gil, Emilio; Llop, Jordi; Queraltó, Meritxell

    2011-01-01

    The use of electronic devices for canopy characterization has recently been widely discussed. Among such devices, LiDAR sensors appear to be the most accurate and precise. Information obtained with LiDAR sensors during reading while driving a tractor along a crop row can be managed and transformed into canopy density maps by evaluating the frequency of LiDAR returns. This paper describes a proposed methodology to obtain a georeferenced canopy map by combining the information obtained with LiDAR with that generated using a GPS receiver installed on top of a tractor. Data regarding the velocity of LiDAR measurements and UTM coordinates of each measured point on the canopy were obtained by applying the proposed transformation process. The process allows overlap of the canopy density map generated with the image of the intended measured area using Google Earth(®), providing accurate information about the canopy distribution and/or location of damage along the rows. This methodology was applied and tested on different vine varieties and crop stages in two important vine production areas in Spain. The results indicate that the georeferenced information obtained with LiDAR sensors appears to be an interesting tool with the potential to improve crop management processes.

  9. Implementation and adoption of nationwide electronic health records in secondary care in England: final qualitative results from prospective national evaluation in “early adopter” hospitals

    PubMed Central

    Cornford, Tony; Barber, Nicholas; Avery, Anthony; Takian, Amirhossein; Lichtner, Valentina; Petrakaki, Dimitra; Crowe, Sarah; Marsden, Kate; Robertson, Ann; Morrison, Zoe; Klecun, Ela; Prescott, Robin; Quinn, Casey; Jani, Yogini; Ficociello, Maryam; Voutsina, Katerina; Paton, James; Fernando, Bernard; Jacklin, Ann; Cresswell, Kathrin

    2011-01-01

    Objectives To evaluate the implementation and adoption of the NHS detailed care records service in “early adopter” hospitals in England. Design Theoretically informed, longitudinal qualitative evaluation based on case studies. Setting 12 “early adopter” NHS acute hospitals and specialist care settings studied over two and a half years. Data sources Data were collected through in depth interviews, observations, and relevant documents relating directly to case study sites and to wider national developments that were perceived to impact on the implementation strategy. Data were thematically analysed, initially within and then across cases. The dataset consisted of 431 semistructured interviews with key stakeholders, including hospital staff, developers, and governmental stakeholders; 590 hours of observations of strategic meetings and use of the software in context; 334 sets of notes from observations, researchers’ field notes, and notes from national conferences; 809 NHS documents; and 58 regional and national documents. Results Implementation has proceeded more slowly, with a narrower scope and substantially less clinical functionality than was originally planned. The national strategy had considerable local consequences (summarised under five key themes), and wider national developments impacted heavily on implementation and adoption. More specifically, delays related to unrealistic expectations about the capabilities of systems; the time needed to build, configure, and customise the software; the work needed to ensure that systems were supporting provision of care; and the needs of end users for training and support. Other factors hampering progress included the changing milieu of NHS policy and priorities; repeatedly renegotiated national contracts; different stages of development of diverse NHS care records service systems; and a complex communication process between different stakeholders, along with contractual arrangements that largely excluded NHS

  10. Impact of tobacco control policies in hospitals: Evaluation of a national smoke-free campus ban in Spain

    PubMed Central

    Sureda, Xisca; Ballbè, Montse; Martínez, Cristina; Fu, Marcela; Carabasa, Esther; Saltó, Esteve; Martínez-Sánchez, Jose M.; Fernández, Esteve

    2014-01-01

    Introduction On January 2, 2011, the Spanish government passed a new smoking law that banned smoking in hospital campuses. The objective of this study was to evaluate the implementation of smoke-free campuses in the hospitals of Catalonia based on both airborne particulate matter and observational data. Methods This cross-sectional study included the hospitals registered in the Catalan Network of Smoke-free Hospitals. We measured the concentration of particulate matter < 2.5 µm in μg/m3 at different locations, both indoors and outdoors before (2009) and after (2011) the implementation of the tobacco law. During 2011, we also assessed smoke-free zone signage and indications of smoking in the outdoor areas of hospital campuses. Results The overall median particulate matter < 2.5 µm concentration fell from 12.22 μg/m3 (7.80–19.76 μg/m3) in 2009 to 7.80 μg/m3 (4.68–11.96 μg/m3) in 2011. The smoke-free zone signage within the campus was moderately implemented after the legislation in most hospitals, and 55% of hospitals exhibited no indications of tobacco consumption around the grounds. Conclusions After the law, particulate matter < 2.5 µm concentrations were much below the values obtained before the law and below the annual guideline value recommended by the World Health Organization for outdoor settings (10 μg/m3). Our data showed the feasibility of implementing a smoke-free campus ban and its positive effects. PMID:26844041

  11. Non-invasive ventilation (NIV) in the clinical management of acute COPD in 233 UK hospitals: results from the RCP/BTS 2003 National COPD Audit.

    PubMed

    Kaul, Sundeep; Pearson, Michael; Coutts, Ian; Lowe, Derek; Roberts, Michael

    2009-06-01

    Non-invasive ventilation (NIV) is a clinically proven, cost-effective intervention for acidotic exacerbations of COPD that is recommended by UK national guidelines. This study examines the extent to which these recommendations are being followed in the UK. Between August and October 2003 a national audit of COPD exacerbations was conducted by the Royal College of Physicians and the British Thoracic Society. 233 (94%) UK hospitals submitted data for 7,529 prospectively recruited acute COPD admissions, documenting process of care and outcomes from a retrospective case note audit. They also completed a resources and organisation of care proforma. Nineteen hospitals (8%) reported they did not offer NIV. There was no access to NIV in 92 (39%) intensive care units in 88 (36%), high-dependency units or on general wards of 85 (34%) hospitals. In 74 (30%) NIV was available on all 3 sites. A low pH (<7.35) was noted at some time during admission for 26% (1714/6544) of patients and NIV was administered to 31%. Patients receiving NIV were more often admitted under a respiratory physician, or seen at some stage by a respiratory specialist and had more severe disease (higher PaCO2 (median 9.8 v 7.8 kPa), lower oxygen tension (median 8.8 v 9.8 kPa), higher incidence of peripheral oedema (48% v 39%), of pneumonia (27% v 16%), higher in-hospital mortality (26% v 14%) and at 90 days (37% v 24%) and longer hospital stays (median 9 v 7 days) than those not receiving NIV. Hospitals with least usage of NIV had similar mortality rates to those using NIV more often. A comprehensive NIV service is not available in many hospitals admitting patients with acute respiratory failure secondary to COPD. Access to acute NIV is inadequate and does not conform with NICE and BTS guidelines. These observational audit data do not demonstrate benefits of NIV on survival when compared to conventional management, contrary to results from randomised trials. Reasons for this are unclear but unmeasured

  12. The changing status of hospital libraries 1984 to 1989: characteristics and services in Region 7 of the National Network of Libraries of Medicine.

    PubMed Central

    Glitz, B; Lovas, I; Flack, V

    1992-01-01

    Economic and political factors have had far-reaching effects on hospital libraries in the last decade, but quantitative evidence of these changes is not readily available. Through periodic evaluation surveys within its multistate region, the Pacific Southwest Regional Medical Library Service, the Regional Medical Library for Region 7 of the National Network of Libraries of Medicine (formerly the Regional Medical Library Network) has monitored hospital library changes over the years. This paper compares data from a 1989 survey with similar information gathered in 1984. Longitudinal analysis was performed on responses from 188 hospitals that responded to both the 1984 and the 1989 survey, as was cross-sectional analysis of all responses from both surveys. Results showed a small decrease in the number of hospitals with separate library collections. Staffing patterns had changed considerably, with a drop of approximately one entire full-time salaried equivalent per library and a decrease in libraries managed by a librarian with an M.L.S. The libraries that provide all of a set of predefined core services and resources decreased from 61% in 1984 to 44% in 1989. Libraries with M.L.S. staff were more likely to have core services than those without professional staff. PMID:1600427

  13. Hospitals, finance, and health system reform in Britain and the United States, c. 1910-1950: historical revisionism and cross-national comparison.

    PubMed

    Gorsky, Martin

    2012-06-01

    Comparative histories of health system development have been variously influenced by the theoretical approaches of historical institutionalism, political pluralism, and labor mobilization. Britain and the United States have figured significantly in this literature because of their very different trajectories. This article explores the implications of recent research on hospital history in the two countries for existing historiographies, particularly the coming of the National Health Service in Britain. It argues that the two hospital systems initially developed in broadly similar ways, despite the very different outcomes in the 1940s. Thus, applying the conceptual tools used to explain the U.S. trajectory can deepen appreciation of events in Britain. Attention focuses particularly on working-class hospital contributory schemes and their implications for finance, governance, and participation; these are then compared with Blue Cross and U.S. hospital prepayment. While acknowledging the importance of path dependence in shaping attitudes of British bureaucrats toward these schemes, analysis emphasizes their failure in pressure group politics, in contrast to the United States. In both countries labor was also crucial, in the United States sustaining employment-based prepayment and in Britain broadly supporting system reform.

  14. LiDAR Vegetation Investigation and Signature Analysis System (LVISA)

    NASA Astrophysics Data System (ADS)

    Höfle, Bernhard; Koenig, Kristina; Griesbaum, Luisa; Kiefer, Andreas; Hämmerle, Martin; Eitel, Jan; Koma, Zsófia

    2015-04-01

    Our physical environment undergoes constant changes in space and time with strongly varying triggers, frequencies, and magnitudes. Monitoring these environmental changes is crucial to improve our scientific understanding of complex human-environmental interactions and helps us to respond to environmental change by adaptation or mitigation. The three-dimensional (3D) description of the Earth surface features and the detailed monitoring of surface processes using 3D spatial data have gained increasing attention within the last decades, such as in climate change research (e.g., glacier retreat), carbon sequestration (e.g., forest biomass monitoring), precision agriculture and natural hazard management. In all those areas, 3D data have helped to improve our process understanding by allowing quantifying the structural properties of earth surface features and their changes over time. This advancement has been fostered by technological developments and increased availability of 3D sensing systems. In particular, LiDAR (light detection and ranging) technology, also referred to as laser scanning, has made significant progress and has evolved into an operational tool in environmental research and geosciences. The main result of LiDAR measurements is a highly spatially resolved 3D point cloud. Each point within the LiDAR point cloud has a XYZ coordinate associated with it and often additional information such as the strength of the returned backscatter. The point cloud provided by LiDAR contains rich geospatial, structural, and potentially biochemical information about the surveyed objects. To deal with the inherently unorganized datasets and the large data volume (frequently millions of XYZ coordinates) of LiDAR datasets, a multitude of algorithms for automatic 3D object detection (e.g., of single trees) and physical surface description (e.g., biomass) have been developed. However, so far the exchange of datasets and approaches (i.e., extraction algorithms) among LiDAR users

  15. Pre-hospital midazolam for benzodiazepine-treated seizures before and after the Rapid Anticonvulsant Medication Prior to Arrival Trial: A national observational cohort study

    PubMed Central

    Silbergleit, Robert

    2017-01-01

    Background Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. Methods and findings This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014. We compared the rates and odds of midazolam use as first-line treatment among all adult and pediatric benzodiazepine-treated seizures before and after RAMPART publication (February 2012). Secondary analyses were conducted for rates of airway interventions and rescue therapy, as proxies for safety and efficacy of seizure termination. 156,539 benzodiazepine-treated seizures were identified. Midazolam use increased from 26.1% in January 2010 to 61.7% in December 2014 (difference +35.6%, 95% CI, 32.7%-38.4%). The annual rate of midazolam adoption increased significantly from 5.9% per year to 8.9% per year after the publication of RAMPART (difference +3.0% per year; 95%CI, 1.6%-4.5% per year; adjusted OR 1.24; 95%CI, 1.17–1.32). Overall frequency of rescue therapy and airway interventions changed little after the publication of RAMPART. Conclusions These data are consistent with effective, ongoing, but incomplete clinical translation of the RAMPART results. The effects of the trial, however, cannot be isolated. The study was limited by broad inclusion of all benzodiazepine-treated seizures as well as a lack of information on route of drug of administration. The safety and effectiveness of midazolam for benzodiazepine-treated seizures in prehospital clinical practice appear consistent

  16. Uas Topographic Mapping with Velodyne LiDAR Sensor

    NASA Astrophysics Data System (ADS)

    Jozkow, G.; Toth, C.; Grejner-Brzezinska, D.

    2016-06-01

    Unmanned Aerial System (UAS) technology is nowadays willingly used in small area topographic mapping due to low costs and good quality of derived products. Since cameras typically used with UAS have some limitations, e.g. cannot penetrate the vegetation, LiDAR sensors are increasingly getting attention in UAS mapping. Sensor developments reached the point when their costs and size suit the UAS platform, though, LiDAR UAS is still an emerging technology. One issue related to using LiDAR sensors on UAS is the limited performance of the navigation sensors used on UAS platforms. Therefore, various hardware and software solutions are investigated to increase the quality of UAS LiDAR point clouds. This work analyses several aspects of the UAS LiDAR point cloud generation performance based on UAS flights conducted with the Velodyne laser scanner and cameras. The attention was primarily paid to the trajectory reconstruction performance that is essential for accurate point cloud georeferencing. Since the navigation sensors, especially Inertial Measurement Units (IMUs), may not be of sufficient performance, the estimated camera poses could allow to increase the robustness of the estimated trajectory, and subsequently, the accuracy of the point cloud. The accuracy of the final UAS LiDAR point cloud was evaluated on the basis of the generated DSM, including comparison with point clouds obtained from dense image matching. The results showed the need for more investigation on MEMS IMU sensors used for UAS trajectory reconstruction. The accuracy of the UAS LiDAR point cloud, though lower than for point cloud obtained from images, may be still sufficient for certain mapping applications where the optical imagery is not useful.

  17. Harnessing a Nation's Linguistic Competence: Identifying and Addressing Needs for LOTE in the Tourism and Hospitality Industry.

    ERIC Educational Resources Information Center

    O'Neill, Shirley; Hatoss, Aniko

    2003-01-01

    Reports research that aimed to identify the foreign language and cross-cultural skill needs of workers in the tourism and hospitality industry in Australia and to develop foreign language competencies for use in industry training packages. Provides evidence for the need for foreign language skills in the industry and gives an account of the…

  18. Utilization and Expenditure of Hospital Admission in Patients with Autism Spectrum Disorder: National Health Insurance Claims Database Analysis

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Hung, Wen-Jiu; Lin, Lan-Ping; Lai, Chia-Im

    2011-01-01

    There were not many studies to provide information on health access and health utilization of people with autism spectrum disorders (ASD). The present study describes a general profile of hospital admission and the medical cost among people with ASD, and to analyze the determinants of medical cost. A retrospective study was employed to analyze…

  19. Comparison of Evidence-Based Practice between Physicians and Nurses: A National Survey of Regional Hospitals in Taiwan

    ERIC Educational Resources Information Center

    Chiu, Ya-Wen; Weng, Yi-Hao; Lo, Heng-Lien; Hsu, Chih-Cheng; Shih, Ya-Hui; Kuo, Ken N.

    2010-01-01

    Introduction: Although evidence-based practice (EBP) has been widely investigated, few studies compare physicians and nurses on performance. Methods: A structured questionnaire survey was used to investigate EBP among physicians and nurses in 61 regional hospitals of Taiwan. Valid postal questionnaires were collected from 605 physicians and 551…

  20. Organizational barriers associated with the implementation of national essential medicines policy: A cross-sectional study of township hospitals in China.

    PubMed

    Yang, Lianping; Liu, Chaojie; Ferrier, J Adamm; Zhang, Xinping

    2015-11-01

    This study identifies potential organizational barriers associated with the implementation of the Chinese National Essential Medicines Policy (NEMP) in rural primary health care institutions. We used a multistage sampling strategy to select 90 township hospitals from six provinces, two from each of eastern, middle, and western China. Data relating to eight core NEMP indicators and institutional characteristics were collected from January to September 2011, using a questionnaire. Prescription-associated indicators were calculated from 9000 outpatient prescriptions selected at random. We categorized the eight NEMP indicators using an exploratory factor analysis, and performed linear regressions to determine the association between the factor scores and institution-level characteristics. The results identified three main factors. Overall, low levels of expenditure of medicines (F1) and poor performance in rational use of medicines (F2) were evident. The availability of medicines (F3) varied significantly across both hospitals and regions. Factor scores had no significant relationship with hospital size (in terms of number of beds and health workers); however, they were associated with revenue and structure of the hospital, patient service load, and support for health workers. Regression analyses showed that public finance per health worker was negatively associated with the availability of medicines (p < 0.05), remuneration of prescribers was positively associated with higher performance in the rational use of medicines (p < 0.05), and drug sales were negatively associated with higher levels of drug expenditure (p < 0.01). In conclusion, irrational use of medicines remains a serious issue, although the financial barriers for gaining access to essential medicines may be less for prescribers and consumers. Limited public finance from local governments may reduce medicine stock lines of township hospitals and lead them to seek alternative sources of income

  1. Seagrass Identification Using High-Resolution 532nm Bathymetric LiDAR and Hyperspectral Imagery

    NASA Astrophysics Data System (ADS)

    Pan, Z.; Prasad, S.; Starek, M. J.; Fernandez Diaz, J. C.; Glennie, C. L.; Carter, W. E.; Shrestha, R. L.; Singhania, A.; Gibeaut, J. C.

    2013-12-01

    Seagrass provides vital habitat for marine fisheries and is a key indicator species of coastal ecosystem vitality. Monitoring seagrass is therefore an important environmental initiative, but measuring details of seagrass distribution over large areas via remote sensing has proved challenging. Developments in airborne bathymetric light detection and ranging (LiDAR) provide great potential in this regard. Traditional bathymetric LiDAR systems have been limited in their ability to map within the shallow water zone (< 1 m) where seagrass is typically present due to limitations in receiver response and laser pulse length. Emergent short-pulse width bathymetric LiDAR sensors and waveform processing algorithms enable depth measurements in shallow water environments previously inaccessible. This 3D information of the benthic layer can be applied to detect seagrass and characterize its distribution. Researchers with the National Center for Airborne Laser Mapping (NCALM) at the University of Houston (UH) and the Coastal and Marine Geospatial Sciences Lab (CMGL) of the Harte Research Institute at Texas A&M University-Corpus Christi conducted a coordinated airborne and boat-based survey of the Redfish Bay State Scientific Area as part of a collaborative study to investigate the capabilities of bathymetric LiDAR and hyperspectral imaging for seagrass mapping. Redfish Bay, located along the middle Texas coast of the Gulf of Mexico, is a state scientific area designated for the purpose of protecting and studying native seagrasses. Redfish Bay is part of the broader Coastal Bend Bays estuary system recognized by the US Environmental Protection Agency (EPA) as a national estuary of significance. For this survey, UH acquired high-resolution discrete-return and full-waveform bathymetric data using their Optech Aquarius 532 nm green LiDAR. In a separate flight, UH collected 2 sets of hyperspectral imaging data (1.2-m pixel resolution and 72 bands, and 0.6m pixel resolution and 36

  2. Automated Probabilistic LiDAR Swath Registration

    NASA Astrophysics Data System (ADS)

    Jalobeanu, A.; Gonçalves, G. R.

    2014-12-01

    We recently developed a new point cloud registration algorithm. Compared to Iterated Closest Point (ICP) techniques, it is robust to noise and outliers, and easier to use, as it is less sensitive to initial conditions. It minimizes the entropy of the joint point cloud (including intensity attributes to help register areas with poor relief), uses a voxel space and B-Spline interpolation to accelerate computation. A natural application of registration is swath alignment in airborne light detection and ranging (LiDAR). Indeed, due to uncertainty in the inertial navigation system (INS), attitude angles are subject to time-dependent errors. Such errors can be understood as a sum of three terms: 1) a global term, or boresight error, which can be addressed using several existing techniques; 2) a low-frequency term, which is modeled as a constant attitude error for regions several hundred meters along-track; 3) a high-frequency term, responsible for corduroy artifacts (not addressed here). We propose to use the new registration algorithm to correct the low-frequency attitude variations. Relative geometric errors are significantly reduced, as pairs of swaths are registered onto each other local corrections. Absolute geometric errors are reduced during a second step, by applying all the corrections together to the entire dataset. We used a test area of 200 km2 in Portugal, with a density of 3-4 pts/m2. The point clouds were derived from waveform data, and include predictive range uncertainties estimated within a Bayesian framework. The data collection was supported by FCT and FEDER as part of the AutoProbaDTM research project (2009-2012). Modeling and reducing geometric error helps build consistent uncertainty maps. After correction, residual errors are taken into account in the final 3D error budget. For gridded elevation models a vertical uncertainty map is computed. Finally, it is possible to use the inter-swath registration parameters to estimate the distribution of

  3. Wet Channel Network Extraction based on LiDAR Data

    NASA Astrophysics Data System (ADS)

    Hooshyar, M.; Kim, S.; Wang, D.; Medeiros, S. C.

    2015-12-01

    The temporal dynamics of stream network is vitally important for understanding hydrologic processes including groundwater interactions and hydrograph recessions. However, observations are limited on flowing channel heads, which are usually located in headwater catchments and under canopy. Near infrared LiDAR data provides an opportunity to map the flowing channel network owing to the fine spatial resolution, canopy penetration, and strong absorption of the light energy by the water surface. A systematic method is developed herein to map flowing channel networks based on the signal intensity of ground LiDAR return, which is lower on water surfaces than on dry surfaces. Based on the selected sample sites where the wetness conditions are known, the signal intensities of ground returns are extracted from the LiDAR point data. The frequency distributions of wet surface and dry surface returns are constructed. With the aid of LiDAR-based ground elevation, the signal intensity thresholds are identified for mapping flowing channels. The developed method is applied to Lake Tahoe area based on eight LiDAR snapshots during recession periods in five watersheds. A power-law relationship between streamflow and flowing channel length during the recession period is derived based on the result.

  4. Waveform LiDAR across forest biomass gradients

    NASA Astrophysics Data System (ADS)

    Montesano, P. M.; Nelson, R. F.; Dubayah, R.; Sun, G.; Ranson, J.

    2011-12-01

    Detailed information on the quantity and distribution of aboveground biomass (AGB) is needed to understand how it varies across space and changes over time. Waveform LiDAR data is routinely used to derive the heights of scattering elements in each illuminated footprint, and the vertical structure of vegetation is related to AGB. Changes in LiDAR waveforms across vegetation structure gradients can demonstrate instrument sensitivity to land cover transitions. A close examination of LiDAR waveforms in footprints across a forest gradient can provide new insight into the relationship of vegetation structure and forest AGB. In this study we use field measurements of individual trees within Laser Vegetation Imaging Sensor (LVIS) footprints along transects crossing forest to non-forest gradients to examine changes in LVIS waveform characteristics at sites with low (< 50Mg/ha) AGB. We relate field AGB measurements to original and adjusted LVIS waveforms to detect the forest AGB interval along a forest - non-forest transition in which the LVIS waveform lose the ability to discern differences in AGB. Our results help identify the lower end the forest biomass range that a ~20m footprint waveform LiDAR can detect, which can help infer accumulation of biomass after disturbances and during forest expansion, and which can guide the use of LiDAR within a multi-sensor fusion biomass mapping approach.

  5. Using LiDAR technology in forestry activities.

    PubMed

    Akay, Abdullah Emin; Oğuz, Hakan; Karas, Ismail Rakip; Aruga, Kazuhiro

    2009-04-01

    Managing natural resources in wide-scale areas can be highly time and resource consuming task which requires significant amount of data collection in the field and reduction of the data in the office to provide the necessary information. High performance LiDAR remote sensing technology has recently become an effective tool for use in applications of natural resources. In the field of forestry, the LiDAR measurements of the forested areas can provide high-quality data on three-dimensional characterizations of forest structures. Besides, LiDAR data can be used to provide very high quality and accurate Digital Elevation Model (DEM) for the forested areas. This study presents the progress and opportunities of using LiDAR remote sensing technology in various forestry applications. The results indicate that LiDAR based forest structure data and high-resolution DEMs can be used in wide-scale forestry activities such as stand characterizations, forest inventory and management, fire behaviour modeling, and forest operations.

  6. Time Trends in Ischemic Stroke among Type 2 Diabetic and Non-Diabetic Patients: Analysis of the Spanish National Hospital Discharge Data (2003-2012)

    PubMed Central

    de Miguel-Yanes, José Ma; Esteban-Hernández, Jesús; Jiménez-Trujillo, Isabel; Alvaro-Meca, Alejandro; Carrasco-Garrido, Pilar; de Miguel-Díez, Javier

    2015-01-01

    Background Type 2 Diabetes (T2DM) is the most rapidly increasing risk factor for ischemic stroke. We aimed to compare trends in outcomes for ischemic stroke in people with or without diabetes in Spain between 2003 and 2012. Methods We selected all patients hospitalized for ischemic stroke using national hospital discharge data. We evaluated annual incident rates stratified by T2DM status. We analyzed trends in the use of diagnostic and therapeutic procedures, patient comorbidities, and in-hospital outcomes. We calculated in-hospital mortality (IHM), length of hospital stay (LOHS) and readmission rate in one month after discharge. Time trend on the incidence of hospitalization was estimated fitting Poisson regression models by sex and diabetes variables. In-hospital mortality was analyzed using logistic regression models separate for men and women. LOHS were compared with ANOVA or Kruskal-Wallis when necessary. Results We identified a total of 423,475 discharges of patients (221,418 men and 202,057 women) admitted with ischemic stroke as primary diagnosis. Patients with T2DM accounted for 30.9% of total. The estimated incidence rates of discharges increased significantly in all groups. The incidence of hospitalization due to stroke (with ICD9 codes for stroke as main diagnosis at discharge) was higher among those with than those without diabetes in all the years studied. T2DM was positively associated with ischemic stroke with an adjusted incidence rate ratio (IRR) of 2.27 (95% CI 2.24–2.29) for men and 2.15 (95%CI 2.13–2.17) for women. Over the 10 year period LOHS decreased significantly in men and women with and without diabetes. Readmission rate remained stable in diabetic and non diabetic men (around 5%) while slightly increased in women with and without diabetes. We observed a significant increase in the use of fibrinolysis from 2002–2013. IHM was positively associated with older age in all groups, with Charlson Comorbidity Index > 3 and atrial

  7. LiDAR Individual Tree Detection for Assessing Structurally Diverse Forest Landscapes

    NASA Astrophysics Data System (ADS)

    Jeronimo, Sean

    Contemporary forest management on public land incorporates a focus on restoration and maintenance of ecological functions through silvicultural manipulation of forest structure on a landscape scale. Incorporating reference conditions into restoration treatment planning and monitoring can improve treatment efficacy, but the typical ground-based methods of quantifying reference condition data---and comparing it to pre- and post-treatment stands---are expensive, time-consuming, and limited in scale. Airborne LiDAR may be part of the solution to this problem, since LiDAR acquisitions have both broad coverage and high resolution. I evaluated the ability of LiDAR Individual Tree Detection (ITD) to describe forest structure across a structurally variable landscape in support of large-scale forest restoration. I installed nineteen 0.25 ha stem map plots across a range of structural conditions in potential reference areas (Yosemite National Park) and potential restoration treatment areas (Sierra National Forest) in the Sierra Nevada of California. I used the plots to evaluate a common ITD algorithm, the watershed transform, compare it to past uses of ITD, and determine which aspects of forest structure contributed to errors in ITD. I found that ITD across this structurally diverse landscape was generally less accurate than across the smaller and less diverse areas over which it has previously been studied. However, the pattern of tree recognition is consistent: regardless of forest structure, canopy dominants are almost always detected and relatively shorter trees are almost never detected. Correspondingly, metrics dominated by large trees, such as biomass, basal area, and spatial heterogeneity, can be measured using ITD, while metrics dominated by smaller trees, such as stand density, cannot. Bearing these limitations in mind, ITD can be a powerful tool for describing forest structure across heterogeneous landscape restoration project areas.

  8. Age differences in alcohol drinking patterns among Norwegian and German hospital doctors – a study based on national samples

    PubMed Central

    Rosta, Judith; Aasland, Olaf G.

    2010-01-01

    Aims: To describe and discuss the alcohol drinking patterns of the younger generation of hospital doctors in Norway and Germany – respectively the abstainers, frequent drinkers, episodic heavy drinkers and hazardous drinkers. Methods: Data were collected in nationwide postal surveys among doctors in Norway (2000) and Germany (2006). A representative sample of 1898 German and 602 Norwegian hospital doctors aged 27–65 years were included in the analyses (N=2500). Alcohol drinking patterns were measured using the first three items of AUDIT in Norway and the AUDIT-C in Germany, scores of ≥5 (ranking from 0 to 12) indicating hazardous drinking. Episodic heavy drinking was defined by the intake of ≥60g of ethanol, on one occasion, at least once a week. Frequent drinkers were who drank alcoholic beverages at least twice a week. Abstainers were persons who drank no alcohol. The analyses were performed separately for age groups (27–44 years versus 45–65 years) and genders. Results: Compared to the age groups 45 to 65 years in the Norwegian and German samples, the younger age groups (27–44 years) tend to have higher rates of abstainers, higher rates of infrequent drinking of moderate amount of alcoholic drinks, lower rates of episodic heavy drinking and lower rates of hazardous drinking. Conclusion: The younger generation of hospital doctors in Norway and Germany showed tendencies to healthier drinking habits. Changes in professional life, and in the attitude towards alcohol consumption, may go some way towards explaining these findings. PMID:20200658

  9. [Longer working hours of pharmacists in the ward resulted in lower medication-related errors--survey of national university hospitals in Japan].

    PubMed

    Matsubara, Kazuo; Toyama, Akira; Satoh, Hiroshi; Suzuki, Hiroshi; Awaya, Toshio; Tasaki, Yoshikazu; Yasuoka, Toshiaki; Horiuchi, Ryuya

    2011-04-01

    It is obvious that pharmacists play a critical role as risk managers in the healthcare system, especially in medication treatment. Hitherto, there is not a single multicenter-survey report describing the effectiveness of clinical pharmacists in preventing medical errors from occurring in the wards in Japan. Thus, we conducted a 1-month survey to elucidate the relationship between the number of errors and working hours of pharmacists in the ward, and verified whether the assignment of clinical pharmacists to the ward would prevent medical errors between October 1-31, 2009. Questionnaire items for the pharmacists at 42 national university hospitals and a medical institute included the total and the respective numbers of medication-related errors, beds and working hours of pharmacist in 2 internal medicine and 2 surgical departments in each hospital. Regardless of severity, errors were consecutively reported to the Medical Security and Safety Management Section in each hospital. The analysis of errors revealed that longer working hours of pharmacists in the ward resulted in less medication-related errors; this was especially significant in the internal medicine ward (where a variety of drugs were used) compared with the surgical ward. However, the nurse assignment mode (nurse/inpatients ratio: 1 : 7-10) did not influence the error frequency. The results of this survey strongly indicate that assignment of clinical pharmacists to the ward is critically essential in promoting medication safety and efficacy.

  10. Application of LiDAR's multiple attributes for wetland classification

    NASA Astrophysics Data System (ADS)

    Ding, Qiong; Ji, Shengyue; Chen, Wu

    2016-03-01

    Wetlands have received intensive interdisciplinary attention as a unique ecosystem and valuable resources. As a new technology, the airborne LiDAR system has been applied in wetland research these years. However, most of the studies used only one or two LiDAR observations to extract either terrain or vegetation in wetlands. This research aims at integrating LiDAR's multiple attributes (DSM, DTM, off-ground features, Slop map, multiple pulse returns, and normalized intensity) to improve mapping and classification of wetlands based on a multi-level object-oriented classification method. By using this method, we are able to classify the Yellow River Delta wetland into eight classes with overall classification accuracy of 92.5%

  11. Business Plan for the Creation of a National Center of Excellence for Alcohol Septal Ablation at Ben Taub General Hospital

    DTIC Science & Technology

    2003-04-23

    obstructive cardiomyopathy. Some possibilities include beta - blockers , calcium channel blockers, antiarrhythmic medications, and diuretics (National Heart...Lung, & and Blood Institute, 1997). Beta - blockers can ease symptoms by slowing the pumping action of the heart muscle. Calcium channel blockers relax

  12. A Geoinformatics Approach to LiDAR / ALSM Data Distribution, Interpolation, and Analysis

    NASA Astrophysics Data System (ADS)

    Crosby, C. J.; Conner, J.; Frank, E.; Arrowsmith, J. R.; Memon, A.; Nandigam, V.; Wurman, G.; Baru, C.

    2005-12-01

    choose to download their results in ESRI or ascii grid formats as well as geo tiff. Additionally, our workflow feeds into GEON web services in development that will allow visualization of Lservice outputs in either a web browser window or in 3D through Fledermaus' free viewer iView3D (or our own OpenGL-based tools). This geoinformatics-based system will allow GEON to host LiDAR point cloud data for the greater geoscience community, including data collected by the National Center for Airborne Laser Mapping (NCALM). In addition, most of the functions within this workflow are not limited to LiDAR data and may be used for distributing, interpolating and visualizing any computationally intensive point dataset (such as gravity). By utilizing the computational infrastructure developed by GEON, this system can democratize LiDAR data access for the geoscience community.

  13. Comparison of Precision of Biomass Estimates in Regional Field Sample Surveys and Airborne LiDAR-Assisted Surveys in Hedmark County, Norway

    NASA Technical Reports Server (NTRS)

    Naesset, Erik; Gobakken, Terje; Bollandsas, Ole Martin; Gregoire, Timothy G.; Nelson, Ross; Stahl, Goeran

    2013-01-01

    Airborne scanning LiDAR (Light Detection and Ranging) has emerged as a promising tool to provide auxiliary data for sample surveys aiming at estimation of above-ground tree biomass (AGB), with potential applications in REDD forest monitoring. For larger geographical regions such as counties, states or nations, it is not feasible to collect airborne LiDAR data continuously ("wall-to-wall") over the entire area of interest. Two-stage cluster survey designs have therefore been demonstrated by which LiDAR data are collected along selected individual flight-lines treated as clusters and with ground plots sampled along these LiDAR swaths. Recently, analytical AGB estimators and associated variance estimators that quantify the sampling variability have been proposed. Empirical studies employing these estimators have shown a seemingly equal or even larger uncertainty of the AGB estimates obtained with extensive use of LiDAR data to support the estimation as compared to pure field-based estimates employing estimators appropriate under simple random sampling (SRS). However, comparison of uncertainty estimates under SRS and sophisticated two-stage designs is complicated by large differences in the designs and assumptions. In this study, probability-based principles to estimation and inference were followed. We assumed designs of a field sample and a LiDAR-assisted survey of Hedmark County (HC) (27,390 km2), Norway, considered to be more comparable than those assumed in previous studies. The field sample consisted of 659 systematically distributed National Forest Inventory (NFI) plots and the airborne scanning LiDAR data were collected along 53 parallel flight-lines flown over the NFI plots. We compared AGB estimates based on the field survey only assuming SRS against corresponding estimates assuming two-phase (double) sampling with LiDAR and employing model-assisted estimators. We also compared AGB estimates based on the field survey only assuming two-stage sampling (the NFI

  14. Incidence and costs of hip fractures vs strokes and acute myocardial infarction in Italy: comparative analysis based on national hospitalization records

    PubMed Central

    Piscitelli, Prisco; Iolascon, Giovanni; Argentiero, Alberto; Chitano, Giovanna; Neglia, Cosimo; Marcucci, Gemma; Pulimeno, Manuela; Benvenuto, Marco; Mundi, Santa; Marzo, Valentina; Donati, Daniela; Baggiani, Angelo; Migliore, Alberto; Granata, Mauro; Gimigliano, Francesca; Di Blasio, Raffaele; Gimigliano, Alessandra; Renzulli, Lorenzo; Brandi, Maria Luisa; Distante, Alessandro; Gimigliano, Raffaele

    2012-01-01

    Objectives As osteoporotic fractures are becoming a major health care problem in countries characterized by an increasing number of older adults, in this study we aimed to compare the incidence and costs of hip fragility fractures in Italian elderly people versus those of major cardiovascular diseases (strokes and acute myocardial infarctions [AMI]) occurring in the whole adult population. Methods We analyzed hospitalization records maintained at the national level by the Italian Ministry of Health for the diagnosis of hip fractures (ICD-9-CM codes 820–821), AMI (code 410), hemorrhagic (codes 430, 431, 432) and ischemic strokes (codes 433–434), and TIA (code 435) between 2001–2005. Cost analyses were based on diagnosis-related groups. Results The incidence of hip fractures in elderly people has increased (+12.9% between 2001 and 2005), as well as that of AMI (+20.2%) and strokes (hemorrhagic: +9.6%; ischemic: +14.7) occurring in the whole adult population; conversely, hospitalization due to TIA decreased by a rate of 13.6% between 2001 and 2005. In 2005, the hospital costs across the national health care system that were associated with hip fragility fractures in the elderly were comparable to those of strokes (both hemorrhagic and ischemic), which occurred in the whole Italian adult population. Moreover, these costs were higher than those generated by AMI and TIA. Rehabilitation costs following strokes reached about 3 billion Euros in 2005, but rehabilitative costs of hip fractures and AMI were comparable (about 530 million Euros in 2005). Conclusion The burden of hip fragility fractures in Italy is comparable to that of AMI and strokes. PMID:23269863

  15. Raster Vs. Point Cloud LiDAR Data Classification

    NASA Astrophysics Data System (ADS)

    El-Ashmawy, N.; Shaker, A.

    2014-09-01

    Airborne Laser Scanning systems with light detection and ranging (LiDAR) technology is one of the fast and accurate 3D point data acquisition techniques. Generating accurate digital terrain and/or surface models (DTM/DSM) is the main application of collecting LiDAR range data. Recently, LiDAR range and intensity data have been used for land cover classification applications. Data range and Intensity, (strength of the backscattered signals measured by the LiDAR systems), are affected by the flying height, the ground elevation, scanning angle and the physical characteristics of the objects surface. These effects may lead to uneven distribution of point cloud or some gaps that may affect the classification process. Researchers have investigated the conversion of LiDAR range point data to raster image for terrain modelling. Interpolation techniques have been used to achieve the best representation of surfaces, and to fill the gaps between the LiDAR footprints. Interpolation methods are also investigated to generate LiDAR range and intensity image data for land cover classification applications. In this paper, different approach has been followed to classifying the LiDAR data (range and intensity) for land cover mapping. The methodology relies on the classification of the point cloud data based on their range and intensity and then converted the classified points into raster image. The gaps in the data are filled based on the classes of the nearest neighbour. Land cover maps are produced using two approaches using: (a) the conventional raster image data based on point interpolation; and (b) the proposed point data classification. A study area covering an urban district in Burnaby, British Colombia, Canada, is selected to compare the results of the two approaches. Five different land cover classes can be distinguished in that area: buildings, roads and parking areas, trees, low vegetation (grass), and bare soil. The results show that an improvement of around 10 % in the

  16. Time trends in coronary revascularization procedures among people with COPD: analysis of the Spanish national hospital discharge data (2001–2011)

    PubMed Central

    de Miguel-Díez, Javier; Jiménez-García, Rodrigo; Hernández-Barrera, Valentín; Carrasco-Garrido, Pilar; Bueno, Héctor; Puente-Maestu, Luis; Jimenez-Trujillo, Isabel; Alvaro-Meca, Alejandro; Esteban-Hernandez, Jesús; de Andrés, Ana López

    2015-01-01

    Background People with COPD suffering from coronary artery disease are frequently treated with revascularization procedures. We aim to compare trends in the use and outcomes of these procedures in COPD and non-COPD patients in Spain between 2001 and 2011. Methods We identified all patients who had undergone percutaneous coronary interventions (PCIs) and coronary artery bypass graft (CABG) surgeries, using national hospital discharge data. Discharges were grouped into: COPD and no COPD. Results From 2001 to 2011, 428,516 PCIs and 79,619 CABGs were performed. The sex and age-adjusted use of PCI increased by 21.27% per year from 2001 to 2004 and by 5.47% per year from 2004 to 2011 in patients with COPD. In-hospital mortality (IHM) among patients with COPD who underwent a PCI increased significantly from 2001 to 2011 (odds ratio 1.11; 95% confidence interval 1.03–1.20). Among patients with COPD who underwent a CABG, the sex and age-adjusted CABG incidence rate increased by 9.77% per year from 2001 to 2003, and then decreased by 3.15% through 2011. The probability of dying during hospitalization in patients who underwent a CABG did not change significantly in patients with and without COPD (odds ratio, 1.06; 95% confidence interval 0.96–1.17). Conclusion The annual percent change in PCI procedures increased in COPD and non-COPD patients. We found a decrease in the use of CABG procedures in both groups. IHM was higher in patients with COPD who underwent a PCI than in those without COPD. However, COPD did not increase the probability of dying during hospitalization in patients who underwent a CABG. PMID:26543361

  17. Emerging Infectious Diseases in Free-Ranging Wildlife–Australian Zoo Based Wildlife Hospitals Contribute to National Surveillance

    PubMed Central

    Cox-Witton, Keren; Reiss, Andrea; Woods, Rupert; Grillo, Victoria; Baker, Rupert T.; Blyde, David J.; Boardman, Wayne; Cutter, Stephen; Lacasse, Claude; McCracken, Helen; Pyne, Michael; Smith, Ian; Vitali, Simone; Vogelnest, Larry; Wedd, Dion; Phillips, Martin; Bunn, Chris; Post, Lyndel

    2014-01-01

    Emerging infectious diseases are increasingly originating from wildlife. Many of these diseases have significant impacts on human health, domestic animal health, and biodiversity. Surveillance is the key to early detection of emerging diseases. A zoo based wildlife disease surveillance program developed in Australia incorporates disease information from free-ranging wildlife into the existing national wildlife health information system. This program uses a collaborative approach and provides a strong model for a disease surveillance program for free-ranging wildlife that enhances the national capacity for early detection of emerging diseases. PMID:24787430

  18. Retrivability in The Danish National Hospital Registry of HIV and hepatitis B and C coinfection diagnoses of patients managed in HIV centers 1995–2004

    PubMed Central

    Obel, Niels; Reinholdt, Hanne; Omland, Lars H; Engsig, Frederik; Sørensen, Henrik T; Hansen, Ann-Brit E

    2008-01-01

    Background Hospital-based discharge registries are used increasingly for longitudinal epidemiological studies of HIV. We examined completeness of registration of HIV infections and of chronic hepatitis B (HBV) and hepatitis C (HCV) coinfections in the Danish National Hospital Registry (DNHR) covering all Danish hospitals. Methods The Danish HIV Cohort Study (DHCS) encompasses all HIV-infected patients treated in Danish HIV clinics since 1 January 1995. All 2,033 Danish patients in DHCS diagnosed with HIV-1 during the 10-year period from 1 January 1995 to 31 December 2004 were included in the current analysis. We used the DHCS as a reference to examine the completeness of HIV and of HBV and HCV coinfections recorded in DNHR. Cox regression analysis was used to estimate hazard ratios of time to diagnosis of HIV in DNHR compared to DHCS. Results Of the 2,033 HIV patients in DHCS, a total of 2,006 (99%) were registered with HIV in DNHR. Of these, 1,888 (93%) were registered in DNHR within one year of their first positive HIV test. A CD4 < 200 cells/μl, a viral load >= 100,000 copies/ml and being diagnosed after 1 January 2000, were associated with earlier registration in DNHR, both in crude and adjusted analyses. Thirty (23%) HIV patients registered with chronic HBV (n = 129) in DHCS and 126 (48%) of HIV patients with HCV (n = 264) in DHCS were registered with these diagnoses in the DNHR. Further 17 and 8 patients were registered with HBV and HCV respectively in DNHR, but not in DHCS. The positive predictive values of being registered with HBV and HCV in DHCS were thereby estimated to 0.88 and 0.97 and in DNHR to 0.32 and 0.54. Conclusion The study demonstrates that secondary data from national hospital databases may be reliable for identification of patients diagnosed with HIV infection. However, the predictive value of co-morbidity data may be low. PMID:18439245

  19. Fusing Hyperspectral and LiDAR data from CAO-VSWIR for Increased Data Dimensionality

    NASA Astrophysics Data System (ADS)

    Knapp, D. E.; Asner, G. P.; Boardman, J. W.; Kennedy-Bowdoin, T.; Eastwood, M.; Anderson, C.; Martin, R. E.; Green, R. O.

    2012-12-01

    The use of multi-sensor platforms for scientific data collection requires precise co-location in order to gain maximum data dimensionality for Earth system research. The different types of collection mechanisms of the sensors (e.g., scanning and pushbroom) can make it difficult to precisely match data from multiple sensors, even when the sensors are flown on the same aircraft at the same time. To overcome these problems, the Carnegie Airborne Observatory (CAO) AToMS sensor suite uses a method that maximizes the match between the Light Detection and Ranging (LiDAR), Visible-to-Near Infrared (VNIR), and Visible-to-Shortwave Infrared (VSWIR) sensors. This is done by generating an intensity image from the LiDAR data that serves as a base on which the spectrometers (VNIR and VSWIR) are matched using ground control points (GCPs). To do so, we employ the use of automated tie point matching in the overlap regions of the spectrometers to improve the co-location between flightlines. The combination of the GCPs and tie points produce data that is used to build camera models for the VNIR and VSWIR spectrometers such that they will match the LiDAR data. The result produces a matched hyper-dimensional data set with great scientific information content. We compare the data dimensionality of two contrasting scenes - a built environment at Stanford University and a lowland tropical forest in Amazonia. Principal components analysis revealed 336 dimensions (degrees of freedom) in the Stanford case, and 218 dimensions in the Amazon. The Amazon case presents what could be the highest level of remotely sensed data dimensionality ever reported for a forested ecosystem. Simulated misalignment of data streams reduced the effective information content by up to 48%, highlighting the critical role of achieving high precision when undertaking multi-sensor fusion. The instrumentation and methods described here are a pathfinder for future airborne applications undertaken by the National

  20. Modeling low-height vegetation with airborne LiDAR

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Low-height vegetation, common in semiarid regions, is difficult to characterize with LiDAR (Light Detection and Ranging) due to similarities, in time and space, of the point returns of vegetation and ground. Other complications may occur due to the low-height vegetation structural characteristics a...

  1. Nurses and opioids: results of a bi-national survey on mental models regarding opioid administration in hospitals

    PubMed Central

    Guest, Charlotte; Sobotka, Fabian; Karavasopoulou, Athina; Ward, Stephen; Bantel, Carsten

    2017-01-01

    Objective Pain remains insufficiently treated in hospitals. Increasing evidence suggests human factors contribute to this, due to nurses failing to administer opioids. This behavior might be the consequence of nurses’ mental models about opioids. As personal experience and conceptions shape these models, the aim of this prospective survey was to identify model-influencing factors. Material and methods A questionnaire was developed comprising of 14 statements concerning ideations about opioids and seven questions concerning demographics, indicators of adult learning, and strength of religious beliefs. Latent variables that may underlie nurses’ mental models were identified using undirected graphical dependence models. Representative items of latent variables were employed for ordinal regression analysis. Questionnaires were distributed to 1,379 nurses in two London, UK, hospitals (n=580) and one German (n=799) hospital between September 2014 and February 2015. Results A total of 511 (37.1%) questionnaires were returned. Mean (standard deviation) age of participants were 37 (11) years; 83.5% participants were female; 45.2% worked in critical care; and 51.5% had more than 10 years experience. Of the nurses, 84% were not scared of opioids, 87% did not regard opioids as drugs to help patients die, and 72% did not view them as drugs of abuse. More English (41%) than German (28%) nurses were afraid of criminal investigations and were constantly aware of side effects (UK, 94%; Germany, 38%) when using opioids. Four latent variables were identified which likely influence nurses’ mental models: “conscious decision-making”; “medication-related fears”; “practice-based observations”; and “risk assessment”. They were predicted by strength of religious beliefs and indicators of informal learning such as experience but not by indicators of formal learning such as conference attendance. Conclusion Nurses in both countries employ analytical and affective mental

  2. Airborne LiDAR based Mapping of Alpine Permafrost Distribution

    NASA Astrophysics Data System (ADS)

    Sailer, Rudolf; Bollmann, Erik; Briese, Christian; Fischer, Andrea; Krainer, Karl; Pfeifer, Norbert; Rieg, Lorenzo; Stötter, Johann

    2010-05-01

    Recent global climate change findings show an acceleration of melting of glaciers, ice-sheets and ice caps. Extended remote sensing and in-situ measurements demonstrate that glaciers are losing mass at an increasing rate. In contrast to glaciers with large mass losses (about 5 m per year at the lower parts of the glacier tongue of Hintereisferner, Ötztal Alps, Tyrol, Austria), moderate to small changing rates (centimetres to decimetres per year) characterize the surface variations caused by permafrost degradation in high mountain areas. For a reliable mapping of the spatial permafrost distribution advanced remote sensing techniques with a high degree of vertical accuracy have to be applied. Recent studies have shown that airborne LiDAR survey in mountainous regions provide high-resolution spatial data with a vertical accuracy range of centimetre to decimetre. This prediction is based on a world wide unique dataset of 18 airborne LiDAR campaigns covering the Hintereisferner region . Furthermore, the according multi-temporal dataset offers the opportunity to identify surface changes (altitudinal changes) outside glaciated areas, which have not been observed until now. Excluding gravitational induced processes these altitudinal changes have to be assigned to alpine permafrost degradations, although detailed information from prominent permafrost features like rock glaciers are missing. Beyond the detection of the climate induced permafrost degradation, based on the multi-temporal LiDAR data set, the method (point based and avoiding point to raster conversions) will be applied to identify altitudinal changes and displacement rates of prominent rock glaciers in the Stubai and Ötztal Alps (Tyrol, Austria). In contrast to the multi-temporal approach, with at least one LiDAR terrain model per ablation period (June to September), the analysis of the rock glacier features is based on a data set of only two LiDAR campaigns, which were carried out with a time shift of four

  3. The interface between the national tuberculosis control programme and district hospitals in Cameroon: missed opportunities for strengthening the local health system –a multiple case study

    PubMed Central

    2013-01-01

    Background Tuberculosis remains a major public health problem in sub-Saharan Africa. District hospitals (DHs) play a central role in district-based health systems, and their relation with vertical programmes is very important. Studies on the impact of vertical programmes on DHs are rare. This study aims to fill this gap. Its purpose is to analyse the interaction between the National Tuberculosis Control Programme (NTCP) and DHs in Cameroon, especially its effects on the human resources, routine health information system (HIS) and technical capacity at the hospital level. Methods We used a multiple case study methodology. From the Adamaoua Region, we selected two DHs, one public and one faith-based. We collected qualitative and quantitative data through document reviews, semi-structured interviews with district and regional staff, and observations in the two DHs. Results The NTCP trained and supervised staff, designed and provided tuberculosis data collection and reporting tools, and provided anti-tuberculosis drugs, reagents and microscopes to DHs. However, these interventions were limited to the hospital units designated as Tuberculosis Diagnostic and Treatment Centres and to staff dedicated to tuberculosis control activities. The NTCP installed a parallel HIS that bypassed the District Health Services. The DH that performs well in terms of general hospital care and that is well managed was successful in tuberculosis control. Based on the available resources, the two hospitals adapt the organisation of tuberculosis control to their settings. The management teams in charge of the District Health Services are not involved in tuberculosis control. In our study, we identified several opportunities to strengthen the local health system that have been missed by the NTCP and the health system managers. Conclusion Well-managed DHs perform better in terms of tuberculosis control than DHs that are not well managed. The analysis of the effects of the NTCP on the human

  4. An in-depth, exploratory assessment of the implementation of the National Health Information System at a district level hospital in Tanzania

    PubMed Central

    2014-01-01

    Background A well functioning Health Information System (HIS) is crucial for effective and efficient health service delivery. In Tanzania there is a national HIS called Mfumo wa Taarifa za Uendeshaji Huduma za Afya (MTUHA). It comprises a guideline/manual, a series of registers for primary data collection and secondary data books where information from the registers is totalled or used for calculations. Methods A mix of qualitative methods were used. These included key informant interviews; staff interviews; participant observations; and a retrospective analysis of the hospital’s 2010 MTUHA reporting documents and the hospital’s development plan. Results All staff members acknowledged data collection as part of their job responsibilities. However, all had concerns about the accuracy of MTUHA data. Access to training was limited, mathematical capabilities often low, dissemination of MTUHA knowledge within the hospital poor, and a broad understanding of the HIS’s full capabilities lacking. Whilst data collection for routine services functioned reasonably well, filling of the secondary data tools was unsatisfactory. Internal inconsistencies between the different types of data tools were found. These included duplications, and the collection of data that was not further used. Sixteen of the total 72 forms (22.2%) that make up one of the key secondary data books (Hospital data/MTUHA book 2) could not be completed with the information collected in the primary data books. Moreover, the hospital made no use of any of the secondary data. The hospital’s main planning document was its development plan. Only 3 of the 22 indicators in this plan were the same as indicators in MTUHA, the information for 9 more was collected by the MTUHA system but figures had to be extracted and recalculated to fit, while for the remaining 10 indicators no use could be made of MTUHA at all. Conclusion The HIS in Tanzania is very extensive and it could be advisable to simplify it to the

  5. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  6. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 2 2012-10-01 2012-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  7. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 2 2014-10-01 2014-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  8. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 2 2013-10-01 2013-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  9. 47 CFR 25.401 - Satellite DARS applications subject to competitive bidding.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Satellite DARS applications subject to...) COMMON CARRIER SERVICES SATELLITE COMMUNICATIONS Competitive Bidding Procedures for DARS § 25.401 Satellite DARS applications subject to competitive bidding. Mutually exclusive initial applications for...

  10. The virgin land of quality management: a first measure of patient safety climate at the National Hospital of the Faroe Islands

    PubMed Central

    Kristensen, Solvejg; Túgvustein, Naina; Zachariassen, Hjørdis; Sabroe, Svend; Bartels, Paul; Mainz, Jan

    2016-01-01

    Purpose The Faroe Islands are formally part of the Kingdom of Denmark, but the islands enjoy extensive autonomy as home ruled. In Denmark, extensive quality management initiatives have been implemented throughout hospitals, this was not the case in the Faroese Islands in 2013. The purpose of this study is to investigate the patient safety culture in the National Hospital of the Faroe Islands prior to implementation of quality management initiatives. Methods The Danish version of the Safety Attitudes Questionnaire (SAQ-DK) was distributed electronically to 557 staff members from five medical centers of the hospital, and one administrative unit. SAQ-DK has six cultural dimensions. The proportion of respondents with positive attitudes and mean scale scores were described, and comparison between medical specialties, and between clinical leaders and frontline staff was made using analysis of variance and chi-square test, respectively. Results The response rate was 65.8% (N=367). Job satisfaction was rated most favorable, and the perceived culture of the top management least favorable. Safety climate was the dimension with the greatest variability across the 28 units. The diagnostic center had the most favorable culture of all centers. More leaders than frontline staff had positive attitudes toward teamwork and safety climate, and working conditions, respectively. Also, the leaders perceived these dimensions more positive than the frontline staff, P<0.05. Among three management levels, the unit management was perceived most favorable and the top management least favorable. Conclusion The management group is recommended to raise awareness of their role in supporting a safe and caring environment for patients and staff, moreover the leaders should ensure that every day work achieves its objectives; keeping the patients safe. Furthermore, following the development in patient safety culture over time is recommended. PMID:27217800

  11. National Trends over One Decade in Hospitalization for Acute Myocardial Infarction among Spanish Adults with Type 2 Diabetes: Cumulative Incidence, Outcomes and Use of Percutaneous Coronary Intervention

    PubMed Central

    Lopez-de-Andres, Ana; Jimenez-Garcia, Rodrigo; Hernandez-Barrera, Valentin; Jimenez-Trujillo, Isabel; Gallardo-Pino, Carmen; de Miguel, Angel Gil; Carrasco-Garrido, Pilar

    2014-01-01

    Background This study aims to describe trends in the rate of acute myocardial infarction (AMI) and use of percutaneous coronary interventions (PCI) in patients with and without type 2 diabetes in Spain, 2001–2010. Methods We selected all patients with a discharge of AMI using national hospital discharge data. Discharges were grouped by diabetes status: type 2 diabetes and no diabetes. In both groups PCIs were identified. The cumulative incidence of discharges attributed to AMI were calculated overall and stratified by diabetes status and year. We calculated length of stay and in-hospital mortality (IHM). Use of PCI was calculated stratified by diabetes status. Multivariate analysis was adjusted by age, sex, year and comorbidity. Results: From 2001 to 2010, 513,517 discharges with AMI were identified (30.3% with type 2 diabetes). The cumulative incidence of discharges due to AMI in diabetics patients increased (56.3 in 2001 to 71 cases per 100,000 in 2004), then decreased to 61.9 in 2010. Diabetic patients had significantly higher IHM (OR, 1.14; 95%CI, 1.05–1.17). The proportion of diabetic patients that underwent PCI increased from 11.9% in 2001 to 41.6% in 2010. Adjusted incidence of discharge in patients with diabetes who underwent PCI increased significantly (IRR, 3.49; 95%CI, 3.30–3.69). The IHM among diabetics patients who underwent a PCI did not change significantly over time. Conclusions AMI hospitalization rates increased initially but declining slowly. From 2001 to 2010 the proportion of diabetic patients who undergo a PCI increased almost four-fold. Older age and more comorbidity may explain why IHM did not improve after a PCI. PMID:24454920

  12. [Use and perceptions of information and communication technologies in patients with hypertension, dyslipidemia or diabetes in a national hospital in Lima, Peru].

    PubMed

    Rivas-Nieto, Andrea C; Málaga, Germán; Ruiz-Grosso, Paulo; Huayanay-Espinoza, Carlos A; Curioso, Walter H

    2015-01-01

    This study aimed to determine the use and perceptions towards information and communication technologies (ICT) in 206 patients with arterial hypertension, dyslipidemia and diabetes, recruited from the outpatient clinic in a national hospital in Lima, Peru. 54.4% were older adults and 70.4% were women. The use of daily phone calls was 44.7%. Most had never used a computer (78.2%), email (84%) or the Internet (84%). Many have never sent (80.6%) or received (69.9%) a text message. 70% had at some time forgotten to take their medicine. 72.8% would like to be reminded to take their medication and 67.9% had a family member who could help them with access to ICT. Despite the low use of ICT in this population, there is willingness and expectation from the patients to participate in programs that implement them.

  13. [The seroprevalence of human immunodeficiency virus infection (HIV) in patients with tuberculosis at the National Hospital of Niamey, Niger (1990-1991)].

    PubMed

    Ousseini, H; Kim, D S; Adamou, A

    1995-01-01

    This study has been planned in order to determinate the frequency of the infection by VIH among the 394 new tuberculous, for a period extended from July 1990 to July 1991 at the section of pneumophtisiology in the National Hospital of Niamey. The number of seropositives is 7.6%. The two types of viruses, i.e. VIH1 and VIH2, and the double infection by VIH1 + VIH2 types exist in the tuberculous patients. The VIH1 is most frequently found in the subjects of age group 20-39 years, who are almost emigrants. Inspite of the actual weak sero-prevalency among the tuberculous patients, the authors claim that a sero-epidemiological sequential survey of tuberculosis in Niamey can be a relatively easy method for measuring the variations of sero-prevalency of AIDS in Niger.

  14. The evolution of epilepsy theory and practice at the National Hospital for the Relief and Cure of Epilepsy, Queen Square between 1860 and 1910.

    PubMed

    Shorvon, Simon

    2014-02-01

    In the years between 1860 and 1910, a revolution in epilepsy theory and practice occurred. The National Hospital for the Relief and Cure of the Paralysed and the Epileptic at Queen Square in London was at the center of this revolution. A series of remarkable physicians and surgeons were appointed to the staff. The four greatest were John Hughlings Jackson, Sir David Ferrier, Sir Victor Horsley, and Sir William Gowers. Their lasting contribution to epilepsy is discussed. Other physicians who made notable contributions to epilepsy were Jabez Spence Ramskill, Charles Eduard Brown-Séquard, Charles Bland Radcliffe, Sir John Russell Reynolds, Sir Edward Henry Sieveking, Walter Stacy Colman, and William Aldren Turner. At the hospital in this period, amongst the lasting contributions to epilepsy were the following: the development of a new conceptual basis of epilepsy, the development of a theory of the physiological structure of the nervous system in relation to epilepsy, the demonstration and investigation of cortical localization of epileptic activity, the establishment of the principle of focal epilepsy and the description of focal seizure types, the discovery of the first effective drug treatment for epilepsy (bromide therapy, indeed one of the first effective drug treatments in the whole of neurology), and the performance of the first surgical operation for epilepsy. This paper is based on the 2013 Gowers Memorial Lecture, delivered in May 2013.

  15. Is Sexual Abuse a Part of War? A 4-Year Retrospective Study on Cases of Sexual Abuse at the Kenyatta National Hospital, Kenya

    PubMed Central

    Omondi, Lilian; Olando, Yvonne; Makenyengo, Margaret; Bukusi, David

    2013-01-01

    The harmful effects of sexual abuse are long lasting. Sexual abuse when associated with violence is likely to impact negatively on the life of the victim. Anecdotal reports indicate that there was an increase in the number of cases of sexual violence following the 2007 post election conflict and violence in Kenya. Although such increases in sexual abuse are common during war or conflict periods the above reports have not been confirmed through research evidence. The purpose of the current study is to establish the trend in numbers of reported cases of sexual abuse at Kenyatta National Hospital over a 4-year period (2006-2009). Data on sexually abused persons for the year 2006-2009 was retrieved from the hospitals record. A researcher designed questionnaire was used to collect relevant data from the completed Post Rape Care (PRC) form. The PRC-Ministry of Health no. 363 (MOH363) form is mandatorily completed by the physician attending the sexually abused patient. There was an increase in the number of cases of sexual abuse reported in 2007 election year in Kenya, with a statistically significant increase in the sexually abused male cases. Sexual crime is more prevalent when there is war or conflict. PMID:28299094

  16. Role of National Accreditation Board of Hospitals and Healthcare Providers (NABH) core indicators monitoring in quality and safety of blood transfusion

    PubMed Central

    Gupta, Anshu; Gupta, Chhavi

    2016-01-01

    Context: Certain quality indicators are mandatory in the maintenance and improvement of quality in blood transfusion. Monitoring of such indicators should be done regularly and deficiencies are to be corrected for effective blood transfusion services. Aims: To study the usefulness of monitoring of the National Accreditation Board for Hospitals and Healthcare Providers (NABH) core indicators in blood transfusion and in the maintenance of hemovigilance. Settings and Design: Hemovigilance is a quality process to improve quality and increase the safety of blood transfusion. It covers and surveys all activities of the blood transfusion chain from donors to recipients. Core indicators’ monitoring is a part of the hemovigilance process. Materials and Methods: A 2-year retrospective study was conducted in a blood storage unit of a NABH accredited tertiary care hospital of a metropolitan city. Four NABH core indicators in blood transfusion were observed and monitored by the clinical and blood storage unit staff of different levels. Results: It was observed that there was an improvement in quality by core indicators monitoring with decreased wastage of blood and blood components, decreased average turnaround time for issue of blood and blood components, and lesser number of transfusion reactions. Conclusion: This study demonstrated that monitoring of NABH core indicators results in the enhancement of quality and safety in blood transfusion services, reducing the incidence of transfusion reactions. PMID:27011668

  17. Interoperable Data Systems for Satellite, Airborne, and Terrestrial LiDAR Data

    NASA Astrophysics Data System (ADS)

    Meertens, C. M.; Baru, C.; Blair, B.; Crosby, C. J.; Haran, T. M.; Harding, D. J.; Hofton, M. A.; Khalsa, S. S.; McWhirter, J.

    2010-12-01

    LiDAR (Light Detection and Ranging) technology is being widely applied to scientific problems on global to local scales using a range of laser technologies mounted on satellite, low- and high-altitude airborne and terrestrial platforms. Modern laser ranging instruments are increasingly capable of providing full waveform data, multiple detectors, higher sample rates and longer ranges. Accompanying these improvements, however, are rapidly growing data volumes and ever more complex data formats and processing algorithms. This presents significant challenges for existing Earth science data systems serving these data and creates barriers to the efficient use of these data by a growing and diverse community of scientific and other users who are studying deformation of the solid Earth, the cryosphere, vegetation structure, and land form evolution. To address these challenges, a group of data centers is collaborating under a project funded by the NASA ROSES ACCESS Program to develop interoperable LiDAR data access systems to provide integrated access to data and derived products in common data formats via simple-to-navigate web interfaces. The web service-based systems created by this project, called NLAS, will enhance access to existing laser data sources hosted at the National Snow and Ice Data Center DAAC, Goddard Space Flight Center LVIS Data Center, UNAVCO, and the OpenTopography Facility at the San Diego Supercomputer Center (SDSC). Through the OpenTopography portal, NLAS systems will provide access to satellite laser altimetry data from ICESat and high altitude airborne laser scanning data from LVIS, as well as low altitude airborne LiDAR and terrestrial laser scanning data hosted at OpenTopography and UNAVCO. NLAS will develop new web service interfaces for NASA data archives at GSFC/LVIS and NSIDC in an effort to improve and streamline access to these data archives. The OpenTopography portal will act as a client to the NLAS services and will provide integrated

  18. National Institute of Allergy and Infectious Disease (NIAID) Funding for Studies of Hospital-Associated Bacterial Pathogens: Are Funds Proportionate to Burden of Disease?

    PubMed Central

    2012-01-01

    Background Hospital-associated infections (HAIs) are associated with a considerable burden of disease and direct costs greater than $17 billion. The pathogens that cause the majority of serious HAIs are Enterococcus faecium, Staphylococcus aureus, Clostridium difficile, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species, referred as ESCKAPE. We aimed to determine the amount of funding the National Institute of Health (NIH) National Institute of Allergy and Infectious Diseases (NIAID) allocates to research on antimicrobial resistant pathogens, particularly ESCKAPE pathogens. Methods The NIH Research Portfolio Online Reporting Tools (RePORT) database was used to identify NIAID antimicrobial resistance research grants funded in 2007-2009 using the terms "antibiotic resistance," "antimicrobial resistance," and "hospital-associated infection." Results Funding for antimicrobial resistance grants has increased from 2007-2009. Antimicrobial resistance funding for bacterial pathogens has seen a smaller increase than non-bacterial pathogens. The total funding for all ESKCAPE pathogens was $ 22,005,943 in 2007, $ 30,810,153 in 2008 and $ 49,801,227 in 2009. S. aureus grants received $ 29,193,264 in FY2009, the highest funding amount of all the ESCKAPE pathogens. Based on 2009 funding data, approximately $1,565 of research money was spent per S. aureus related death and $750 of was spent per C. difficile related death. Conclusions Although the funding for ESCKAPE pathogens has increased from 2007 to 2009, funding levels for antimicrobial resistant bacteria-related grants is still lower than funding for antimicrobial resistant non-bacterial pathogens. Efforts may be needed to improve research funding for resistant-bacterial pathogens, particularly as their clinical burden increases. PMID:22958856

  19. Is Survival After Out-of-Hospital Cardiac Arrests Worse During Days of National Academic Meetings in Japan? A Population-Based Study

    PubMed Central

    Kitamura, Tetsuhisa; Kiyohara, Kosuke; Matsuyama, Tasuku; Hatakeyama, Toshihiro; Shimamoto, Tomonari; Izawa, Junichi; Nishiyama, Chika; Iwami, Taku

    2016-01-01

    Background Outcomes after out-of-hospital cardiac arrests (OHCAs) might be worse during academic meetings because many medical professionals attend them. Methods This nationwide population-based observation of all consecutively enrolled Japanese adult OHCA patients with resuscitation attempts from 2005 to 2012. The primary outcome was 1-month survival with a neurologically favorable outcome. Calendar days at three national meetings (Japanese Society of Intensive Care Medicine, Japanese Association for Acute Medicine, and Japanese Circulation Society) were obtained for each year during the study period, because medical professionals who belong to these academic societies play an important role in treating OHCA patients after hospital admission, and we identified two groups: the exposure group included OHCAs that occurred on meeting days, and the control group included OHCAs that occurred on the same days of the week 1 week before and after meetings. Multiple logistic regression analysis was used to adjust for confounding variables. Results A total of 20 143 OHCAs that occurred during meeting days and 38 860 OHCAs that occurred during non-meeting days were eligible for our analyses. The proportion of patients with favorable neurologic outcomes after whole arrests did not differ during meeting and non-meeting days (1.6% [324/20 143] vs 1.5% [596/38 855]; adjusted odds ratio 1.02; 95% confidence interval, 0.88–1.19). Regarding bystander-witnessed ventricular fibrillation arrests of cardiac origin, the proportion of patients with favorable neurologic outcomes also did not differ between the groups. Conclusions In this population, there were no significant differences in outcomes after OHCAs that occurred during national meetings of professional organizations related to OHCA care and those that occurred during non-meeting days. PMID:26639754

  20. Irrigation network extraction methodology from LiDAR DTM using Whitebox and ArcGIS

    NASA Astrophysics Data System (ADS)

    Mahor, M. A. P.; De La Cruz, R. M.; Olfindo, N. T.; Perez, A. M. C.

    2016-10-01

    Irrigation networks are important in distributing water resources to areas where rainfall is not enough to sustain agriculture. They are also crucial when it comes to being able to redirect vast amounts of water to decrease the risks of flooding in flat areas, especially near sources of water. With the lack of studies about irrigation feature extraction, which range from wide canals to small ditches, this study aims to present a method of extracting these features from LiDAR-derived digital terrain models (DTMs) using Geographic Information Systems (GIS) tools such as ArcGIS and Whitebox Geospatial Analysis Tools (Whitebox GAT). High-resolution LiDAR DTMs with 1-meter horizontal and 0.25-meter vertical accuracies were processed to generate the gully depth map. This map was then reclassified, converted to vector, and filtered according to segment length, and sinuosity to be able to isolate these irrigation features. Initial results in the test area show that the extraction completeness is greater than 80% when compared with data obtained from the National Irrigation Administration (NIA).

  1. Modeling of in hospital mortality determinants in myocardial infarction patients, with and without stroke: A national study in Iran

    PubMed Central

    Ahmadi, Ali; Khaledifar, Arsalan; Etemad, Koorosh

    2016-01-01

    Background: The data and determinants of mortality due to stroke in myocardial infarction (MI) patients are unknown. This study was conducted to evaluate the differences in risk factors for hospital mortality among MI patients with and without stroke history. Materials and Methods: This study was a retrospective, cohort study; 20,750 new patients with MI from April, 2012 to March, 2013 were followed up and their data were analyzed according to having or not having the stroke history. Stroke and MI were defined based on the World Health Organization's definition. The data were analyzed by logistic regression in STATA software. Results: Of the 20,750 studied patients, 4293 had stroke history. The prevalence of stroke in the studied population was derived 20.96% (confidence interval [CI] 95%: 20.13–21.24). Of the patients, 2537 (59.1%) had ST-elevation MI (STEMI). Mortality ratio in patients with and without stroke was obtained 18.8% and 10.3%, respectively. The prevalence of risk factors in MI patients with and without a stroke is various. The adjusted odds ratio of mortality in patients with stroke history was derived 7.02 (95% CI: 5.42–9) for chest pain resistant to treatment, 2.39 (95% CI: 1.97–2.9) for STEMI, 3.02 (95% CI: 2.5–3.64) for lack of thrombolytic therapy, 2.2 (95% CI: 1.66–2.91) for heart failure, and 2.17 (95% CI: 1.6–2.9) for ventricular tachycardia. Conclusion: With regards to the factors associated with mortality in this study, it is particularly necessary to control the mortality in MI patients with stroke history. More emphasis should be placed on the MI patients with the previous stroke over those without in the interventions developed for prevention and treatment, and for the prevention of avoidable mortalities. PMID:27904619

  2. Contrasting Patterns of Damage and Recovery in Logged Amazon Forests From Small Footprint LiDAR Data

    NASA Technical Reports Server (NTRS)

    Morton, D. C.; Keller, M.; Cook, B. D.; Hunter, Maria; Sales, Marcio; Spinelli, L.; Victoria, D.; Andersen, H.-E.; Saleska, S.

    2012-01-01

    Tropical forests ecosystems respond dynamically to climate variability and disturbances on time scales of minutes to millennia. To date, our knowledge of disturbance and recovery processes in tropical forests is derived almost exclusively from networks of forest inventory plots. These plots typically sample small areas (less than or equal to 1 ha) in conservation units that are protected from logging and fire. Amazon forests with frequent disturbances from human activity remain under-studied. Ongoing negotiations on REDD+ (Reducing Emissions from Deforestation and Forest Degradation plus enhancing forest carbon stocks) have placed additional emphasis on identifying degraded forests and quantifying changing carbon stocks in both degraded and intact tropical forests. We evaluated patterns of forest disturbance and recovery at four -1000 ha sites in the Brazilian Amazon using small footprint LiDAR data and coincident field measurements. Large area coverage with airborne LiDAR data in 2011-2012 included logged and unmanaged areas in Cotriguacu (Mato Grosso), Fiona do Jamari (Rondonia), and Floresta Estadual do Antimary (Acre), and unmanaged forest within Reserva Ducke (Amazonas). Logging infrastructure (skid trails, log decks, and roads) was identified using LiDAR returns from understory vegetation and validated based on field data. At each logged site, canopy gaps from logging activity and LiDAR metrics of canopy heights were used to quantify differences in forest structure between logged and unlogged areas. Contrasting patterns of harvesting operations and canopy damages at the three logged sites reflect different levels of pre-harvest planning (i.e., informal logging compared to state or national logging concessions), harvest intensity, and site conditions. Finally, we used multi-temporal LiDAR data from two sites, Reserva Ducke (2009, 2012) and Antimary (2010, 2011), to evaluate gap phase dynamics in unmanaged forest areas. The rates and patterns of canopy gap

  3. Quantifying Soil Carbon Change from Wildfires in Peatland Ecosystems of the Eastern United States Using Repeat LiDAR

    NASA Astrophysics Data System (ADS)

    Reddy, A.; Hawbaker, T. J.; Zhu, Z.; Ward, S.; Wurster, F.; Newcomb, D.

    2013-12-01

    Wildfires are an increasing concern in peatland ecosystems along the coastal plains of the Eastern US. Human- and climate-induced changes to the ecosystems' hydrology can leave the soils, heavy with organic matter, susceptible to combustion in wildfires. This results in large losses of carbon that took many years to accumulate. However, accurately quantifying carbon losses in peatlands from wildfires is challenging because field data collection over extensive areas is difficult. For this study, our first objective was to evaluate the use of pre- and post-fire LiDAR data to quantify changes in surface elevations and soil carbon stocks for the 2011 Lateral West fire, which occurred in the Great Dismal Swamp National Wildlife Refuge (GDSNWR), Virginia, USA. Our second objective was to use a Monte Carlo approach to estimate how the vertical error in LiDAR points affected our calculation of soil carbon emissions. Bare-earth LiDAR points from 2010 and 2012 were obtained for GDSNWR with densities of 2 pulses/m2 and vertical elevation RMSE of 9 and 7 cm, respectively. Monte Carlo replicates were used to perturb individual bare-earth LiDAR points and generate probability distributions of elevation change within 10 m grid cells. Change in soil carbon were calculated within the Monte Carlo replicates by multiplying the LiDAR-derived volume of soil loss by depth-specific published values of soil bulk density, organic matter content, and carbon content. The 5th, 50th and 95th percentiles of the elevation and carbon change distributions were outputted as raster layers. Loss in soil volume ranged from 10,820,000 to 13,190,000 m3 based on vertical error. Carbon loss within the entire area burned by the Lateral West fire perimeter (32.1 km2), based on the 5th, 50th and 95th percentiles was 0.64, 0.96, and 1.33 Tg C, respectively. Our study demonstrated a method to use LiDAR data to quantify carbon loss following fires in peatland ecosystems and incorporate elevation errors to

  4. Self-reported use of internet by cervical cancer clients in two National Referral Hospitals in Kenya

    PubMed Central

    2012-01-01

    Background Cervical cancer remains a devastating disease in Kenya accounting for more than 2000 deaths each year. Lack of information on cervical cancer prevention and management has been attributed to the apathy among women in seeking health interventions. Use of internet-based and mobile e-health tools could increase information access among cervical cancer patients. The objective of the study was; to establish the extent of use of mobile phones and internet by cervical cancer patients in accessing information related to cancer treatment and management.; find out the characteristics of patients associated with internet use and identify barriers faced by the patients in internet use. A cross sectional descriptive survey of 199 cervical patients visiting the two main referral hospitals in Kenya was done. A structured questionnaire was used to collect data. Findings The average length of illness was 2.43 years (SD ± 3.0). Only 7.5 %( n=15) reported to having used the internet as a source of information. 92.5 %( n=184) did not use internet. With Multiple options, 70.9% did not know how to use a computer, 29.2% did not have access to a computer, 14.6% lacked the money to use computers at the local cyber cafe while other barriers identified accounted for 11.1%. Patients reported that the internet had an important role in the management of cancer of the cervix in health education (17.6%), online consultation (14.6%), booking of patients (13.6%), referrals (8.5%) and collecting data (7%). The 96.5% of the respondents who had access to a mobile phone, recommended mobile phones for health education messages (31.7%), reminder alerts for medication (29.7%) and booking appointments (21.6%). There was a statistically significant association between income of the patients and internet use (p = 0.026) in this study. Conclusions There is low level use of the internet by cervical cancer clients attended in Public referral facilities in Kenya. This was attributed to; lack of

  5. Volume component analysis for classification of LiDAR data

    NASA Astrophysics Data System (ADS)

    Varney, Nina M.; Asari, Vijayan K.

    2015-03-01

    One of the most difficult challenges of working with LiDAR data is the large amount of data points that are produced. Analysing these large data sets is an extremely time consuming process. For this reason, automatic perception of LiDAR scenes is a growing area of research. Currently, most LiDAR feature extraction relies on geometrical features specific to the point cloud of interest. These geometrical features are scene-specific, and often rely on the scale and orientation of the object for classification. This paper proposes a robust method for reduced dimensionality feature extraction of 3D objects using a volume component analysis (VCA) approach.1 This VCA approach is based on principal component analysis (PCA). PCA is a method of reduced feature extraction that computes a covariance matrix from the original input vector. The eigenvectors corresponding to the largest eigenvalues of the covariance matrix are used to describe an image. Block-based PCA is an adapted method for feature extraction in facial images because PCA, when performed in local areas of the image, can extract more significant features than can be extracted when the entire image is considered. The image space is split into several of these blocks, and PCA is computed individually for each block. This VCA proposes that a LiDAR point cloud can be represented as a series of voxels whose values correspond to the point density within that relative location. From this voxelized space, block-based PCA is used to analyze sections of the space where the sections, when combined, will represent features of the entire 3-D object. These features are then used as the input to a support vector machine which is trained to identify four classes of objects, vegetation, vehicles, buildings and barriers with an overall accuracy of 93.8%

  6. Hydrography change detection: the usefulness of surface channels derived From LiDAR DEMs for updating mapped hydrography

    USGS Publications Warehouse

    Poppenga, Sandra K.; Gesch, Dean B.; Worstell, Bruce B.

    2013-01-01

    The 1:24,000-scale high-resolution National Hydrography Dataset (NHD) mapped hydrography flow lines require regular updating because land surface conditions that affect surface channel drainage change over time. Historically, NHD flow lines were created by digitizing surface water information from aerial photography and paper maps. Using these same methods to update nationwide NHD flow lines is costly and inefficient; furthermore, these methods result in hydrography that lacks the horizontal and vertical accuracy needed for fully integrated datasets useful for mapping and scientific investigations. Effective methods for improving mapped hydrography employ change detection analysis of surface channels derived from light detection and ranging (LiDAR) digital elevation models (DEMs) and NHD flow lines. In this article, we describe the usefulness of surface channels derived from LiDAR DEMs for hydrography change detection to derive spatially accurate and time-relevant mapped hydrography. The methods employ analyses of horizontal and vertical differences between LiDAR-derived surface channels and NHD flow lines to define candidate locations of hydrography change. These methods alleviate the need to analyze and update the nationwide NHD for time relevant hydrography, and provide an avenue for updating the dataset where change has occurred.

  7. Intergration of LiDAR Data with Aerial Imagery for Estimating Rooftop Solar Photovoltaic Potentials in City of Cape Town

    NASA Astrophysics Data System (ADS)

    Adeleke, A. K.; Smit, J. L.

    2016-06-01

    Apart from the drive to reduce carbon dioxide emissions by carbon-intensive economies like South Africa, the recent spate of electricity load shedding across most part of the country, including Cape Town has left electricity consumers scampering for alternatives, so as to rely less on the national grid. Solar energy, which is adequately available in most part of Africa and regarded as a clean and renewable source of energy, makes it possible to generate electricity by using photovoltaics technology. However, before time and financial resources are invested into rooftop solar photovoltaic systems in urban areas, it is important to evaluate the potential of the building rooftop, intended to be used in harvesting the solar energy. This paper presents methodologies making use of LiDAR data and other ancillary data, such as high-resolution aerial imagery, to automatically extract building rooftops in City of Cape Town and evaluate their potentials for solar photovoltaics systems. Two main processes were involved: (1) automatic extraction of building roofs using the integration of LiDAR data and aerial imagery in order to derive its' outline and areal coverage; and (2) estimating the global solar radiation incidence on each roof surface using an elevation model derived from the LiDAR data, in order to evaluate its solar photovoltaic potential. This resulted in a geodatabase, which can be queried to retrieve salient information about the viability of a particular building roof for solar photovoltaic installation.

  8. LiDAR observation of the flow structure in typhoons

    NASA Astrophysics Data System (ADS)

    Wu, Yu-Ting; Hsuan, Chung-Yao; Lin, Ta-Hui

    2015-04-01

    Taiwan is subject to 3.4 landfall typhoons each year in average, generally occurring in the third quarter of every year (July-September). Understanding of boundary-layer turbulence characteristics of a typhoon is needed to ensure the safety of both onshore and offshore wind turbines used for power generation. In this study, a floating LiDAR (Light Detection and Ranging) was deployed in a harbor to collect data of wind turbulence, atmospheric pressure, and temperature in three typhoon events (Matmo typhoon, Soulik typhoon, Trami typhoon). Data collected from the floating LiDAR and from meteorological stations located at Taipei, Taichung and Kaohsiung are adopted to analyse the wind turbulence characteristics in the three typhoon events. The measurement results show that the maximum 10-min average wind speed measured with the floating LiDAR is up to 24 m/s at a height of 200 m. Compared with other normal days, the turbulence intensity is lower in the three typhoon events where the wind speed has a rapid increase. Changes of wind direction take place clearly as the typhoons cross Taiwan from East to West. Within the crossing intervals, the vertical momentum flux is observed to have a significant pattern with both upward and downward propagating waves which are relevant to the flow structure of the typhoons.

  9. Road Curb Extraction From Mobile LiDAR Point Clouds

    NASA Astrophysics Data System (ADS)

    Xu, Sheng; Wang, Ruisheng; Zheng, Han

    2017-02-01

    Automatic extraction of road curbs from uneven, unorganized, noisy and massive 3D point clouds is a challenging task. Existing methods often project 3D point clouds onto 2D planes to extract curbs. However, the projection causes loss of 3D information which degrades the performance of the detection. This paper presents a robust, accurate and efficient method to extract road curbs from 3D mobile LiDAR point clouds. Our method consists of two steps: 1) extracting the candidate points of curbs based on the proposed novel energy function and 2) refining the candidate points using the proposed least cost path model. We evaluated our method on a large-scale of residential area (16.7GB, 300 million points) and an urban area (1.07GB, 20 million points) mobile LiDAR point clouds. Results indicate that the proposed method is superior to the state-of-the-art methods in terms of robustness, accuracy and efficiency. The proposed curb extraction method achieved a completeness of 78.62% and a correctness of 83.29%. These experiments demonstrate that the proposed method is a promising solution to extract road curbs from mobile LiDAR point clouds.

  10. Rockfall hazard analysis using LiDAR and spatial modeling

    NASA Astrophysics Data System (ADS)

    Lan, Hengxing; Martin, C. Derek; Zhou, Chenghu; Lim, Chang Ho

    2010-05-01

    Rockfalls have been significant geohazards along the Canadian Class 1 Railways (CN Rail and CP Rail) since their construction in the late 1800s. These rockfalls cause damage to infrastructure, interruption of business, and environmental impacts, and their occurrence varies both spatially and temporally. The proactive management of these rockfall hazards requires enabling technologies. This paper discusses a hazard assessment strategy for rockfalls along a section of a Canadian railway using LiDAR and spatial modeling. LiDAR provides accurate topographical information of the source area of rockfalls and along their paths. Spatial modeling was conducted using Rockfall Analyst, a three dimensional extension to GIS, to determine the characteristics of the rockfalls in terms of travel distance, velocity and energy. Historical rockfall records were used to calibrate the physical characteristics of the rockfall processes. The results based on a high-resolution digital elevation model from a LiDAR dataset were compared with those based on a coarse digital elevation model. A comprehensive methodology for rockfall hazard assessment is proposed which takes into account the characteristics of source areas, the physical processes of rockfalls and the spatial attribution of their frequency and energy.

  11. National Assessment of Statin Therapy in Patients Hospitalized with Acute Myocardial Infarction: Insight from China PEACE-Retrospective AMI Study, 2001, 2006, 2011

    PubMed Central

    Zhang, Lihua; Li, Jing; Li, Xi; Nasir, Khurram; Zhang, Haibo; Wu, Yongjian; Hu, Shuang; Wang, Qing; Downing, Nicholas S.; Desai, Nihar R.; Masoudi, Frederick A.; Spertus, John A.; Krumholz, Harlan M.; Jiang, Lixin

    2016-01-01

    Background Statin therapy is among the most effective treatments to improve short- and long-term mortality after acute myocardial infarction. The use of statin, and the intensity of their use, has not been described in acute myocardial infarction patients in China, a country with a rapidly growing burden of cardiovascular disease. Methods and Results Using a nationally representative sample of patients with acute myocardial infarction admitted to 162 Chinese hospitals in 2001, 2006 and 2011, we identified 14,958 patients eligible for statin therapy to determine rates of statin use and the intensity of statin therapy, defined as those statin regimens with expected low-density lipoprotein cholesterol lowering of at least 40%, to identify factors associated with the use of statin therapy. Statin use among hospitalized patients with acute myocardial infarction increased from 27.9% in 2001 to 72.5% in 2006, and 88.8% in 2011 (P<0.001 for trend). Regional variation in statin use correspondingly decreased over time. Among treated patients, those receiving intensive statin therapy increased from 1.0% in 2001 to 24.2% in 2006 to 57.2% in 2011(P<0.001 for trend). Patients without low-density lipoprotein cholesterol measured were less likely to be treated with statin or to receive intensive therapy. Conclusions The use of statin therapy has dramatically increased over the past decade in Chinese patients with acute myocardial infarction. However, half of patients still did not receive intensive statin therapy in 2011.Given that guidelines strongly endorse intensive statin therapy for acute myocardial infarction patients, initiatives promoting the use of statin therapy, with attention to treatment intensity, would support further improvements in practice. PMID:27058862

  12. In-Hospital and 4-Year Clinical Outcomes Following Transcatheter Versus Surgical Closure for Secundum Atrial Septal Defect in Adults: A National Cohort Propensity Score Analysis.

    PubMed

    Chen, Tien-Hsing; Hsiao, Yuan-Chuan; Cheng, Chia-Chi; Mao, Chun-Tai; Chen, Dong-Yi; Tsai, Ming-Lung; Yang, Teng-Yao; Lin, Yu-Sheng

    2015-09-01

    Atrial septal defect (ASD) closure is major therapy for patients with secundum ASD. Although surgical closure (SC) and transcatheter closure (TC) are usually performed in such patients, data on the long-term outcomes comparing TC and SC in adults are limited. Data on the participants of this cohort study were retrieved from Taiwan's National Health Insurance Research Database from 2004 to 2011. Secundum ASD patients > 18 years of age who underwent TC or SC were initially enrolled, and those with associated comorbidities were excluded. After propensity score matching, the clinical outcomes between the TC and SC groups were analyzed. There were 595 patients recruited in the TC group and 308 patients in the SC group. The SC group had a higher incidence of systemic thromboembolism (P < 0.001), ischemic stroke (P = 0.002), and all-cause mortality (P = 0.013) when compared with those of the TC group at the index hospitalization, and similar phenomena could also be seen in a around 4-year follow-up period after the procedures (systemic thromboembolism (P < 0.001, HR = 11.48, 95% CI: 3.29-40.05), ischemic stroke (P = 0.005, HR = 9.28, 95% CI: 1.94-44.39), and all-cause mortality (P = 0.035, HR = 2.28, 95% CI: 1.06-4.89). In addition, atrial fibrillation (P = 0.005) and atrial flutter (P = 0.049) more frequently developed in the SC group than in the TC group at the index hospitalization. The adult secundum ASD patients had lower incidence rates of systemic thromboembolism, ischemic stroke, and all-cause mortality after TC than those after SC in the 4-year follow-up after procedures. Transcatheter ASD closure should therefore be given priority.

  13. Tropical Airborne LiDAR for Landslide Assessment in Malaysia: a technical perspective

    NASA Astrophysics Data System (ADS)

    Abd Manap, Mohamad; Azhari Razak, Khamarrul; Mohamad, Zakaria; Ahmad, Azhari; Ahmad, Ferdaus; Mohamad Zin, Mazlan; A'zad Rosle, Qalam

    2015-04-01

    Malaysia has faced a substantial number of landslide events every year. Cameron Highlands, Pahang is one of the badly areas affected by slope failures characterized by extreme climate, rugged topographic and weathered geological structures in a tropical environment. A high frequency of landslide occurrence in the hilly areas is predominantly due to the geological materials, tropical monsoon seasons and uncontrolled agricultural activities. Therefore the Government of Malaysia through the Prime Minister Department has allocated a special budget to conduct national level hazard and risk mapping project through Minerals and Geoscience Department Malaysia, the Ministry of Natural Resources and Environment. The primary aim of this project is to provide slope hazard risk information for a better slope management in Malaysia. In addition this project will establish national infrastructure for geospatial information on the geological terrain and slope by emphasizing the disaster risk throughout the country. The areas of interest are located in the three different selected areas i.e. Cameron Highlands (275 square kilometers), Ipoh (200 square kilometers) and Cheras Kajang -- Batang kali (650 square kilometers). These areas are selected based on National Slope Master Plan (2009 -- 2023) that endorsed by Malaysia Government Cabinet. The national hazard and risk mapping project includes six parts of major tasks: (1) desk study and mobilization, (2) airborne LiDAR data acquisition and analysis, (3) field data acquisition and verification, (4) hazard and risk for natural terrain, (5) hazard and risk analysis for man-made slope and (6) Man-made slope mitigation/preventive measures. The project was authorized in September, 2014 and will be ended in March, 2016. In this paper, the main focus is to evaluate the suitability of integrated capability of airborne- and terrestrial LiDAR data acquisition and analysis, and also digital photography for regional landslide assessment. The

  14. Increasing the Efficiency of LiDAR Based Forest Inventories: A Novel Approach for Integrating Variable Radius Inventory Plots with LiDAR Data.

    NASA Astrophysics Data System (ADS)

    Falkowski, M. J.; Fekety, P.; Silva, C. A.; Hudak, A. T.

    2015-12-01

    LiDAR data are increasingly applied to support forest inventory and assessment across a variety of spatial scales. Typically this is achieved by integrating LiDAR data with forest inventory collected at fixed radius forest inventory plots. A well-designed forest inventory, one that covers the full range of structural and compositional variation across the forest of interest, is costly especially when collecting fixed radius plot data. Variable radius plots offer an alternative inventory protocol that is more efficient in terms of both time and money. However, integrating variable radius plot data with LiDAR data is problematic because the plots have unknown sizes that vary with variation in tree size. This leads to a spatial mismatch between LiDAR metrics (e.g., mean height, canopy cover, density, etc.) and plot data, which ultimately translates into errors in LiDAR derived forest inventory predictions. We propose and evaluate and novel approach for integrating variable radius plot data into a LiDAR based forest inventories in two different forest systems, one in the inland northwest and another in the northern lakes states of the USA. The novel approach calculates LiDAR metrics by weighting the point cloud proportional to return height, mimicking the way in which variable radius plot data weights tree measurements by tree size. This could increase inventory sampling efficiency, allowing for the collection of a greater number of inventory plots, and ultimately improve the performance of LiDAR based inventories.

  15. Mapping tropical forest biomass with radar and spaceborne LiDAR: overcoming problems of high biomass and persistent cloud

    NASA Astrophysics Data System (ADS)

    Mitchard, E. T. A.; Saatchi, S. S.; White, L. J. T.; Abernethy, K. A.; Jeffery, K. J.; Lewis, S. L.; Collins, M.; Lefsky, M. A.; Leal, M. E.; Woodhouse, I. H.; Meir, P.

    2011-08-01

    Spatially-explicit maps of aboveground biomass are essential for calculating the losses and gains in forest carbon at a regional to national level. The production of such maps across wide areas will become increasingly necessary as international efforts to protect primary forests, such as the REDD+ (Reducing Emissions from Deforestation and forest Degradation) mechanism, come into effect, alongside their use for management and research more generally. However, mapping biomass over high-biomass tropical forest is challenging as (1) direct regressions with optical and radar data saturate, (2) much of the tropics is persistently cloud-covered, reducing the availability of optical data, (3) many regions include steep topography, making the use of radar data complex, (4) while LiDAR data does not suffer from saturation, expensive aircraft-derived data are necessary for complete coverage. We present a solution to the problems, using a combination of terrain-corrected L-band radar data (ALOS PALSAR), spaceborne LiDAR data (ICESat GLAS) and ground-based data. We map Gabon's Lopé National Park (5000 km2) because it includes a range of vegetation types from savanna to closed-canopy tropical forest, is topographically complex, has no recent cloud-free high-resolution optical data, and the dense forest is above the saturation point for radar. Our 100 m resolution biomass map is derived from fusing spaceborne LiDAR (7142 ICESat GLAS footprints), 96 ground-based plots (average size 0.8 ha) and an unsupervised classification of terrain-corrected ALOS PALSAR radar data, from which we derive the aboveground biomass stocks of the park to be 78 Tg C (173 Mg C ha-1). This value is consistent with our field data average of 181 Mg C ha-1, from the field plots measured in 2009 covering a total of 78 ha, and which are independent as they were not used for the GLAS-biomass estimation. We estimate an uncertainty of ± 25 % on our carbon stock value for the park. This error term includes

  16. Immunogenicity and Protective Efficacy of the DAR-901 Booster Vaccine in a Murine Model of Tuberculosis

    PubMed Central

    Lahey, Timothy; Laddy, Dominick; Hill, Krystal; Schaeffer, Jacqueline; Hogg, Alison; Keeble, James; Dagg, Belinda; Ho, Mei Mei; Arbeit, Robert D.; von Reyn, C. Fordham

    2016-01-01

    Background The development of a novel tuberculosis vaccine is a leading global health priority. SRL172, an inactivated, whole-cell mycobacterial vaccine, was safe, immunogenic and reduced the incidence of culture-confirmed tuberculosis in a phase III trial in HIV-infected and BCG immunized adults in Tanzania. Here we describe the immunogenicity and protective efficacy of DAR-901, a booster vaccine against tuberculosis manufactured from the same seed strain using a new scalable method. Methods We evaluated IFN-γ responses by ELISpot and antibody responses by enzyme linked immunosorbent assay in C57BL/6 and BALB/c mice after three doses of DAR-901. In an aerosol challenge model, we evaluated the protective efficacy of the DAR-901 booster in C57BL/6 mice primed with BCG and boosted with two doses of DAR-901 at 4 dosage levels in comparison with homologous BCG boost. Results DAR-901 vaccination elicited IFN-γ responses to mycobacterial antigen preparations derived from both DAR-901 and Mycobacterium tuberculosis. DAR-901 immunization enhanced antibody responses to DAR-901 but not Mycobacterium tuberculosis lysate or purified protein derivative. Among animals primed with BCG, boosting with DAR-901 at 1 mg provided greater protection against aerosol challenge than a homologous BCG boost (lungs P = 0.036, spleen P = 0.028). Conclusions DAR-901 induces cellular and humoral immunity and boosts protection from M. tuberculosis compared to a homologous BCG boost. PMID:27997597

  17. Coastal and tidal landform detection from high resolution topobathymetric LiDAR data

    NASA Astrophysics Data System (ADS)

    Skovgaard Andersen, Mikkel; Al-Hamdani, Zyad; Steinbacher, Frank; Rolighed Larsen, Laurids; Brandbyge Ernstsen, Verner

    2016-04-01

    Coastal and tidal environments are valuable ecosystems, which, however, are under pressure in many areas around the world due to globalisation and/or climate change. Detailed mapping of these environments is required in order to manage the coastal zone in a sustainable way. However, historically these transition zones between land and water are difficult or even impossible to map and investigate in high spatial resolution due to the challenging environmental conditions. The new generation of airborne topobathymetric light detection and ranging (LiDAR) potentially enables full-coverage and high-resolution mapping of these land-water transition zones. We have carried out topobathymetric LiDAR surveys in the Knudedyb tidal inlet system, a coastal environment in the Danish Wadden Sea which is part of the Wadden Sea National Park and UNESCO World Heritage. Detailed digital elevation models (DEMs) with a grid cell size of 0.5 m x 0.5 m were generated from the LiDAR point cloud with a mean point density in the order of 20 points/m2. The DEM was analysed morphometrically using a modification of the tool Benthic Terrain Modeler (BTM) developed by Wright et al. (2005). Initially, stage (the elevation in relation to tidal range) was used to divide the area of investigation into the different tidal zones, i.e. subtidal, intertidal and supratidal. Subsequently, morphometric units were identified and characterised by a combination of statistical neighbourhood analysis with varying window sizes (using the Bathymetric Positioning Index (BPI) from the BTM, moving average and standard deviation), slope parameters and area/perimeter ratios. Finally, these morphometric units were classified into six different types of landforms based on their stage and morphometric characteristics, i.e. either subtidal channel, intertidal flat, intertidal creek, linear bar, swash bar or beach dune. We hereby demonstrate the potential of using airborne topobathymetric LiDAR for seamless mapping of land

  18. [Evaluation of the colonic endoscopic polypectomy in patients of the National Carlos Alberto Seguín Escobedo Hospital ESSALUD of Arequipa (1999-2004)].

    PubMed

    Suárez Cueva, Yanyne; Campos Nizama, Juan

    2006-01-01

    The investigation was performed in the Carlos Alberto Seguín Escobedo National Hospital of Essalud-Arequipa, in 194 patients that were submitted to Colonic Endoscopic Polypectomy from January of 1999 to December of 2004. This study is observational, retrospective and transverse. The clinical histories, endoscopies reports and pathological anatomy reports were reviewed, taking the personal data, clinical symptoms, endoscopic and pathologic characteristics of the polyps; colonoscopies associate findings; surgical technique of polypectomies, complications and complementary treatment of post-polypectomy. The colonic endoscopic polypectomy was performed in 194 patients from 1380 colonoscopies (14.05 %), with more frequency in the sixth decade of life, and corresponding most to the masculine sex. Most of the patients did not have previous symptoms, and of those who had clinical manifestations the more frequent were the bleeding lost and changes in the intestinal rhythm. The polyps endoscopic characteristics found that the sessile were the more frequent and were located in rectum--sigmoid zone. The preponderant size was from 5 to 10mm, and mostly unique. The histopathology type of the polyps was adenoma, frequently with some grade of dysplasia. The surgical techniques for the colonic endoscopy polypectomy were with cold pincer and electric cut. The complications were rare. The complementary treatment after polypectomy was injectotherapy and surgery. Finally, our results were discussed and compared with other similar studies, and then we elaborated the conclusions and recommendations, with whom we expect to contribute to a better knowledge of the Colonic Endoscopy Polypectomy in our country.

  19. Norovirus - hospital

    MedlinePlus

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

  20. Development of DArT Marker Platforms and Genetic Diversity Assessment of the U.S. Collection of the New Oilseed Crop Lesquerella and Related Species

    PubMed Central

    Cruz, Von Mark V.; Kilian, Andrzej; Dierig, David A.

    2013-01-01

    The advantages of using molecular markers in modern genebanks are well documented. They are commonly used to understand the distribution of genetic diversity in populations and among species which is crucial for efficient management and effective utilization of germplasm collections. We describe the development of two types of DArT molecular marker platforms for the new oilseed crop lesquerella (Physaria spp.), a member of the Brassicaceae family, to characterize a collection in the National Plant Germplasm System (NPGS) with relatively little known in regards to the genetic diversity and traits. The two types of platforms were developed using a subset of the germplasm conserved ex situ consisting of 87 Physaria and 2 Paysonia accessions. The microarray DArT revealed a total of 2,833 polymorphic markers with an average genotype call rate of 98.4% and a scoring reproducibility of 99.7%. On the other hand, the DArTseq platform developed for SNP and DArT markers from short sequence reads showed a total of 27,748 high quality markers. Cluster analysis and principal coordinate analysis indicated that the different accessions were successfully classified by both systems based on species, by geographical source, and breeding status. In the germplasm set analyzed, which represented more than 80% of the P. fendleri collection, we observed that a substantial amount of variation exists in the species collection. These markers will be valuable in germplasm management studies and lesquerella breeding, and augment the microsatellite markers previously developed on the taxa. PMID:23724020

  1. Segmenting tree crowns from terrestrial and mobile LiDAR data by exploring ecological theories

    NASA Astrophysics Data System (ADS)

    Tao, Shengli; Wu, Fangfang; Guo, Qinghua; Wang, Yongcai; Li, Wenkai; Xue, Baolin; Hu, Xueyang; Li, Peng; Tian, Di; Li, Chao; Yao, Hui; Li, Yumei; Xu, Guangcai; Fang, Jingyun

    2015-12-01

    The rapid development of light detection and ranging (LiDAR) techniques is advancing ecological and forest research. During the last decade, numerous single tree segmentation techniques have been developed using airborne LiDAR data. However, accurate crown segmentation using terrestrial or mobile LiDAR data, which is an essential prerequisite for extracting branch level forest characteristics, is still challenging mainly because of the difficulties posed by tree crown intersection and irregular crown shape. In the current work, we developed a comparative shortest-path algorithm (CSP) for segmenting tree crowns scanned using terrestrial (T)-LiDAR and mobile LiDAR. The algorithm consists of two steps, namely trunk detection and subsequent crown segmentation, with the latter inspired by the well-proved metabolic ecology theory and the ecological fact that vascular plants tend to minimize the transferring distance to the root. We tested the algorithm on mobile-LiDAR-scanned roadside trees and T-LiDAR-scanned broadleaved and coniferous forests in China. Point-level quantitative assessments of the segmentation results showed that for mobile-LiDAR-scanned roadside trees, all the points were classified to their corresponding trees correctly, and for T-LiDAR-scanned broadleaved and coniferous forests, kappa coefficients ranging from 0.83 to 0.93 were obtained. We believe that our algorithm will make a contribution to solving the problem of crown segmentation in T-LiDAR scanned-forests, and might be of interest to researchers in LiDAR data processing and to forest ecologists. In addition, our research highlights the advantages of using ecological theories as guidelines for processing LiDAR data.

  2. Using LiDAR to Estimate Surface Erosion Volumes within the Post-storm 2012 Bagley Fire

    NASA Astrophysics Data System (ADS)

    Mikulovsky, R. P.; De La Fuente, J. A.; Mondry, Z. J.

    2014-12-01

    The total post-storm 2012 Bagley fire sediment budget of the Squaw Creek watershed in the Shasta-Trinity National Forest was estimated using many methods. A portion of the budget was quantitatively estimated using LiDAR. Simple workflows were designed to estimate the eroded volume's of debris slides, fill failures, gullies, altered channels and streams. LiDAR was also used to estimate depositional volumes. Thorough manual mapping of large erosional features using the ArcGIS 10.1 Geographic Information System was required as these mapped features determined the eroded volume boundaries in 3D space. The 3D pre-erosional surface for each mapped feature was interpolated based on the boundary elevations. A surface difference calculation was run using the estimated pre-erosional surfaces and LiDAR surfaces to determine volume of sediment potentially delivered into the stream system. In addition, cross sections of altered channels and streams were taken using stratified random selection based on channel gradient and stream order respectively. The original pre-storm surfaces of channel features were estimated using the cross sections and erosion depth criteria. Open source software Inkscape was used to estimate cross sectional areas for randomly selected channel features and then averaged for each channel gradient and stream order classes. The average areas were then multiplied by the length of each class to estimate total eroded altered channel and stream volume. Finally, reservoir and in-channel depositional volumes were estimated by mapping channel forms and generating specific reservoir elevation zones associated with depositional events. The in-channel areas and zones within the reservoir were multiplied by estimated and field observed sediment thicknesses to attain a best guess sediment volume. In channel estimates included re-occupying stream channel cross sections established before the fire. Once volumes were calculated, other erosion processes of the Bagley

  3. Data management based on geocoding index and adaptive visualization for airborne LiDAR

    NASA Astrophysics Data System (ADS)

    Zhi, Xiaodong

    2008-10-01

    With more surveying practice and deeper application, data post-process for airborne LiDAR system has been extracted lots of attention in data accuracy, post-process, fusion, modeling, automation and visualization. However, post-process and flexible visualization were found to be the bottle-neck which limits the LiDAR data usage for industrial applications. The cause of above bottle-neck problems is great capacity for LiDAR system. Thus in article a geocoding index based multivariate data management and adaptive visualization will be studied for based on the feature of airborne LiDAR's data to improve automatization of post-process and surveying efficiency.

  4. Can we estimate precipitation rate during snowfall using a scanning terrestrial LiDAR?

    NASA Astrophysics Data System (ADS)

    LeWinter, A. L.; Bair, E. H.; Davis, R. E.; Finnegan, D. C.; Gutmann, E. D.; Dozier, J.

    2012-12-01

    Accurate snowfall measurements in windy areas have proven difficult. To examine a new approach, we have installed an automatic scanning terrestrial LiDAR at Mammoth Mountain, CA. With this LiDAR, we have demonstrated effective snow depth mapping over a small study area of several hundred m2. The LiDAR also produces dense point clouds by detecting falling and blowing hydrometeors during storms. Daily counts of airborne detections from the LiDAR show excellent agreement with automated and manual snow water equivalent measurements, suggesting that LiDAR observations have the potential to directly estimate precipitation rate. Thus, we suggest LiDAR scanners offer advantages over precipitation radars, which could lead to more accurate precipitation rate estimates. For instance, uncertainties in mass-diameter and mass-fall speed relationships used in precipitation radar, combined with low reflectivity of snow in the microwave spectrum, produce errors of up to 3X in snowfall rates measured by radar. Since snow has more backscatter in the near-infrared wavelengths used by LiDAR compared to the wavelengths used by radar, and the LiDAR detects individual hydrometeors, our approach has more potential for directly estimating precipitation rate. A key uncertainty is hydrometeor mass. At our study site, we have also installed a Multi Angle Snowflake Camera (MASC) to measure size, fallspeed, and mass of individual hydrometeors. By combining simultaneous MASC and LiDAR measurements, we can estimate precipitation density and rate.

  5. Weibull approximation of LiDAR waveforms for estimating the beam attenuation coefficient.

    PubMed

    Montes-Hugo, Martin A; Vuorenkoski, Anni K; Dalgleish, Fraser R; Ouyang, Bing

    2016-10-03

    Tank experiments were performed at different water turbidities to examine relationships between the beam attenuation coefficient (c) and Weibull shape parameters derived from LiDAR waveforms measured with the Fine Structure Underwater LiDAR (FSUIL). Optical inversions were made at 532 nm, within a c range of 0.045-1.52 m-1, and based on a LiDAR system having two field-of-view (15 and 75.7 mrad) and two linear polarizations. Consistently, the Weibull scale parameter or P2 showed the strongest covariation with c and was a more accurate proxy with respect to the LiDAR attenuation coefficient.

  6. How integrating 3D LiDAR data in the dike surveillance protocol: The French case

    NASA Astrophysics Data System (ADS)

    Bretar, F.; Mériaux, P.; Fauchard, C.

    2012-04-01

    carried out. A LiDAR system is able to acquire data on a dike structure of up to 80 km per day, which makes the use of this technique also valuable in case of emergency situations. It provides additional valuable products like precious information on dike slopes and crest or their near environment (river banks, etc.). Moreover, in case of vegetation, LiDAR data makes possible to study hidden structures or defaults from images like the erosion of riverbanks under forestry vegetation. The possibility of studying the vegetation is also of high importance: the development of woody vegetation near or onto the dike is a major risk factor. Surface singularities are often signs of disorder or suspected disorder in the dike itself: for example a subsidence or a sinkhole on a ridge may result from internal erosion collapse. Finally, high resolution topographic data contribute to build specific geomechanical model of the dike that, after incorporating data provided by geophysical and geotechnical surveys, are integrated in the calculations of the structure stability. Integrating the regular use of LiDAR data in the dike surveillance protocol is not yet operational in France. However, the high number of French stakeholders at the national level (on average, there is one stakeholder for only 8-9km of dike !) and the real added value of LiDAR data makes a spatial data infrastructure valuable (webservices for processing the data, consulting and filling the database on the field when performing the local diagnosis)

  7. Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals

    PubMed Central

    2012-01-01

    Background Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. Method A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. Result A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the

  8. Data Archiving and Distribution of LiDAR and Derived Datasets in the Philippines

    NASA Astrophysics Data System (ADS)

    Tupas, M. E. A.; Lat, S. C.; Magturo, R. A.

    2016-06-01

    LiDAR programs in the Philippines have been generating valuable resource and hazard information for most of the country at a substantial rate since 2012. Significant progress have been made due to the programs design of engaging 16 Universities and research institutions spatially distributed across the country. Because of this, data has been accumulating at a brisk rate which poses significant technical and logistic issues. While a central node, the University of the Philippines, Diliman, handles data acquisition, pre-processing, and quality checking, processing and ground validation are devolved to the various nodes. For this setup to be successful, an efficient data access and distribution system should be in place. In this paper, we discuss the spatial data infrastructure and data access protocols implemented by the program. At the center of the data access and distribution operations is LiPAD or our LiDAR portal for archiving and distribution. LiPAD is built on open source technologies, established web standards, and protocols. At its back-end a central data archive has been established using state of the art Object Storage technology to store both raw, processed Lidar and derived data sets. Catalog of available data sets ranging from data acquisition foot prints, to DEM coverages, to derived products such as flood hazard, and crop suitability are viewable and accessible on the main site based on the popular GeoNode application. Data exchange is performed using varying protocols to address various logistical problems. Given the various challenges the program is successful in distributing data sets not just to partner processing nodes but to other stakeholders where main requesters include national agencies and general research and academic institutions.

  9. Using LiDAR, RADAR, and Optical data to improve a NFMS in Kalimantan, Indonesia

    NASA Astrophysics Data System (ADS)

    Hagen, S. C.; Saatchi, S. S.; Braswell, B. H., Jr.; Palace, M. W.; Salas, W.; Walker, S.; Hoekman, D.; Ipsan, C.; Brown, S.; Sullivan, F.

    2014-12-01

    Around the world, governments are establishing national forest monitoring systems (NFMS) that use a combination of remote sensing and ground-based forest carbon inventory approaches to estimate anthropogenic forest-related greenhouse gas emissions and removals. The NFMS forms the link between historical assessments and current/future assessments of forests, enabling consistency in the data and information to support the implementation of REDD+ activities. The creation of a reliable, transparent, and comprehensive NFMS is currently limited by a dearth of relevant data that are accurate, low-cost, and spatially resolved at subnational scales. With funding from a 3-year NASA Carbon Monitoring System project beginning in September 2013, we are developing, evaluating, and validating several critical components of an NFMS in Kalimantan, Indonesia, focusing on the use of LiDAR and radar imagery for improved carbon stock and forest degradation information. Here, we present results from an initial analysis of a spatially extensive set of LiDAR data collected across the Indonesian provinces on the island of Borneo together with RADAR and optical data. Our objectives are to evaluate sensor and platform tradeoffs systematically against in situ investments, as well as provide detailed tracking and characterization of uncertainty in a cost-benefit framework. Kalimantan is an ideal area to evaluate the use of remote sensing methods because measuring forest carbon stocks and their human caused changes with a high degree of certainty on the ground can be difficult. While our work focuses at the subnational scale for Kalimantan, we are targeting these methods for applicability across broader geographies and for implementation at various scales.

  10. Characterization of an alpine tree line using airborne LiDAR data and physiological modeling.

    PubMed

    Coops, Nicholas C; Morsdorf, Felix; Schaepman, Michael E; Zimmermann, Niklaus E

    2013-12-01

    Understanding what environmental drivers control the position of the alpine tree line is important for refining our understanding of plant stress and tree development, as well as for climate change studies. However, monitoring the location of the tree line position and potential movement is difficult due to cost and technical challenges, as well as a lack of a clear boundary. Advanced remote sensing technologies such as Light Detection and Ranging (LiDAR) offer significant potential to map short individual tree crowns within the transition zone despite the lack of predictive capacity. Process-based forest growth models offer a complementary approach by quantifying the environmental stresses trees experience at the tree line, allowing transition zones to be defined and ultimately mapped. In this study, we investigate the role remote sensing and physiological, ecosystem-based modeling can play in the delineation of the alpine tree line. To do so, we utilize airborne LiDAR data to map tree height and stand density across a series of altitudinal gradients from below to above the tree line within the Swiss National Park (SNP), Switzerland. We then utilize a simple process-based model to assess the importance of seasonal variations on four climatically related variables that impose non-linear constraints on photosynthesis. Our results indicate that all methods predict the tree line to within a 50 m altitudinal zone and indicate that aspect is not a driver of significant variations in tree line position in the region. Tree cover, rather than tree height is the main discriminator of the tree line at higher elevations. Temperatures in fall and spring are responsible for the major differences along altitudinal zones, however, changes in evaporative demand also control plant growth at lower altitudes. Our results indicate that the two methods provide complementary information on tree line location and, when combined, provide additional insights into potentially endangered

  11. Performance testing of LiDAR exploitation software

    NASA Astrophysics Data System (ADS)

    Varela-González, M.; González-Jorge, H.; Riveiro, B.; Arias, P.

    2013-04-01

    Mobile LiDAR systems are being used widely in recent years for many applications in the field of geoscience. One of most important limitations of this technology is the large computational requirements involved in data processing. Several software solutions for data processing are available in the market, but users are often unknown about the methodologies to verify their performance accurately. In this work a methodology for LiDAR software performance testing is presented and six different suites are studied: QT Modeler, AutoCAD Civil 3D, Mars 7, Fledermaus, Carlson and TopoDOT (all of them in x64). Results depict as QTModeler, TopoDOT and AutoCAD Civil 3D allow the loading of large datasets, while Fledermaus, Mars7 and Carlson do not achieve these powerful performance. AutoCAD Civil 3D needs large loading time in comparison with the most powerful softwares such as QTModeler and TopoDOT. Carlson suite depicts the poorest results among all the softwares under study, where point clouds larger than 5 million points cannot be loaded and loading time is very large in comparison with the other suites even for the smaller datasets. AutoCAD Civil 3D, Carlson and TopoDOT show more threads than other softwares like QTModeler, Mars7 and Fledermaus.

  12. Applying the Moment Distance Framework to LiDAR Waveforms

    NASA Astrophysics Data System (ADS)

    Salas, E. L.; Aguilar-Amuchastegui, N.; Henebry, G. M.

    2010-12-01

    In the past decade or so, there have only been limited approaches formulated for the analysis of waveform LiDAR data. We illustrate how the Moment Distance (MD) framework can characterize the shape of the LiDAR waveforms using simple, computationally fast, geometric operations. We assess the relationship of the MD metrics to some key waveform landmarks - such as locations of peaks, power of returns, and pseudo-heights - using LVIS datasets acquired over a tropical forest in La Selva, Costa Rica in 1998 and 2005. We also apply the MD framework to 2003 LVIS data from Howland Forest, Maine. We also explore the effects of noise on the MD Index (MDI). Our results reveal that the MDI can capture important dynamics in canopy structure. Movement in the location of the peaks is detected by shifts in the MDI. Because this new approach responds to waveform shape, it is more sensitive to changes of location of peak returns than to the power of the return. Results also suggest a positive relationship between the MDI and the canopy pseudo-height.

  13. Identifying Colluvial Slopes by Airborne LiDAR Analysis

    NASA Astrophysics Data System (ADS)

    Kasai, M.; Marutani, T.; Yoshida, H.

    2015-12-01

    Colluvial slopes are one of major sources of landslides. Identifying the locations of the slopes will help reduce the risk of disasters, by avoiding building infrastructure and properties nearby, or if they are already there, by applying appropriate counter measures before it suddenly moves. In this study, airborne LiDAR data was analyzed to find their geomorphic characteristics to use for extracting their locations. The study site was set in the suburb of Sapporo City, Hokkaido in Japan. The area is underlain by Andesite and Tuff and prone to landslides. Slope angle and surface roughness were calculated from 5 m resolution DEM. These filters were chosen because colluvial materials deposit at around the angle of repose and accumulation of loose materials was considered to form a peculiar surface texture differentiable from other slope types. Field survey conducted together suggested that colluvial slopes could be identified by the filters with a probability of 80 percent. Repeat LiDAR monitoring of the site by an unmanned helicopter indicated that those slopes detected as colluviums appeared to be moving at a slow rate. In comparison with a similar study from the crushed zone in Japan, the range of slope angle indicative of colluviums agreed with the Sapporo site, while the texture was rougher due to larger debris composing the slopes.

  14. Relying on the National Mobile Disaster Hospital as a business continuity strategy in the aftermath of a tornado: The Louisville experience.

    PubMed

    Kearns, Randy D; Stringer, Lew; Craig, James; Godette-Crawford, Regina; Black, Paul S; Andra, David L; Winslow, James

    2017-01-01

    On 28th April, 2014, a tornado left much of Louisville, MS and the local hospital, Winston Medical Center, in ruin. In the USA, temporary hospital solutions have been used to augment the mainstream healthcare system since the American Civil War. As memories fade, however, the necessary readiness for a temporary hospital also fades, at times leaving a patchwork of resources either underfunded or abandoned. With the creation of the Hospital Preparedness Program, several temporary hospital solutions were created in various states across the USA. In the present case, Mississippi and North Carolina resources were used in Louisville in the aftermath of a direct impact that destroyed the hospital and nursing home. In the hours that followed, after lives were saved and patients safely relocated, a frank assessment confirmed the structural loss of the hospital. Local emergency responders, hospital staff, state and federal representatives all rallied with the aim of saving the community's only hospital. The steps taken in Louisville and the deliberate restoration of these essential services offer a learning opportunity for all involved in healthcare disaster preparedness, response and recovery.

  15. “Can’t you initiate me here?”: Challenges to timely initiation on antiretroviral therapy among methadone clients in Dar es Salaam, Tanzania

    PubMed Central

    Saleem, Haneefa T.; Mushi, Dorothy; Hassan, Saria; Bruce, R. Douglas; Cooke, Alexis; Mbwambo, Jessie; Lambdin, Barrot H.

    2016-01-01

    Background Despite dramatic improvement in antiretroviral therapy (ART) access globally, people living with HIV who inject drugs continue to face barriers that limit their access to treatment. This paper explores barriers and facilitators to ART initiation among clients attending a methadone clinic in Dar es Salaam, Tanzania. Methods We interviewed 12 providers and 20 clients living with HIV at the Muhimbili National Hospital methadone clinic between January and February 2015. We purposively sampled clients based on sex and ART status and providers based on job function. To analyze interview transcripts, we adopted a content analysis approach. Results Participants identified several factors that hindered timely ART initiation for clients at the methadone clinic. These included delays in CD4 testing and receiving CD4 test results; off-site HIV clinics; stigma operating at the individual, social and institutional levels; insufficient knowledge of the benefits of early ART initiation among clients; treatment breakdown at the clinic level possibly due to limited staff; and initiating ART only once one feels physically ill. Participants perceived social support as a buffer against stigma and facilitator of HIV treatment. Some clients also reported that persistent monitoring and follow-up on their HIV care and treatment by methadone clinic providers led them to initiate ART. Conclusion Health system factors, stigma and limited social support pose challenges for methadone clients living with HIV to initiate ART. Our findings suggest that on-site point-of-care CD4 testing, a peer support system, and trained HIV treatment specialists who are able to counsel HIV-positive clients and initiate them on ART at the methadone clinic could help reduce barriers to timely ART initiation for methadone clients. PMID:26831364

  16. Demographics and Clinical Features of Postresuscitation Comorbidities in Long-Term Survivors of Out-of-Hospital Cardiac Arrest: A National Follow-Up Study

    PubMed Central

    Su, Chih-Pei; Wu, Jr-Hau; Yang, Mei-Chueh; Liao, Ching-Hui; Hsu, Hsiu-Ying; Chang, Chin-Fu

    2017-01-01

    The outcome of patients suffering from out-of-hospital cardiac arrest (OHCA) is very poor, and postresuscitation comorbidities increase long-term mortality. This study aims to analyze new-onset postresuscitation comorbidities in patients who survived from OHCA for over one year. The Taiwan National Health Insurance (NHI) Database was used in this study. Study and comparison groups were created to analyze the risk of suffering from new-onset postresuscitation comorbidities from 2011 to 2012 (until December 31, 2013). The study group included 1,346 long-term OHCA survivors; the comparison group consisted of 4,038 matched non-OHCA patients. Demographics, patient characteristics, and risk of suffering comorbidities (using Cox proportional hazards models) were analyzed. We found that urinary tract infections (n = 225, 16.72%), pneumonia (n = 206, 15.30%), septicemia (n = 184, 13.67%), heart failure (n = 111, 8.25%) gastrointestinal hemorrhage (n = 108, 8.02%), epilepsy or recurrent seizures (n = 98, 7.28%), and chronic kidney disease (n = 62, 4.61%) were the most common comorbidities. Furthermore, OHCA survivors were at much higher risk (than comparison patients) of experiencing epilepsy or recurrent seizures (HR = 20.83; 95% CI: 12.24–35.43), septicemia (HR = 8.98; 95% CI: 6.84–11.79), pneumonia (HR = 5.82; 95% CI: 4.66–7.26), and heart failure (HR = 4.88; 95% CI: 3.65–6.53). Most importantly, most comorbidities occurred within the first half year after OHCA. PMID:28286775

  17. Clinical study on psoriasis patients for past 30 years (1982-2012) in Seoul National University Hospital Psoriasis Clinic.

    PubMed

    Na, Sun Jae; Jo, Seong Jin; Youn, Jai Il

    2013-09-01

    Psoriasis is a chronic relapsing disorder which shows variable clinical features. The long-term clinical study with many patients is important to elucidate the epidemiologic characteristics and clinical features of psoriasis. The purpose of this study was to analyze the epidemiologic characteristics and clinical features of psoriasis in Korean patients. Epidemiologic and clinic data and assessments for severity of extent and activity of psoriasis were collected from the medical records of 5084 patients, who had been newly diagnosed with psoriasis in the Psoriasis Clinic of Seoul National University Hospital between 1982 and 2012. The sex ratio of the psoriasis patients was 1.2:1 (male 54.6%, female 45.4%). The peak age of onset in males was 20s, while it was the teenage years in females. A total of 63.5% of patients developed psoriasis before 30 years of age. Family history of psoriasis was observed in 26.0% of patients. Moderate to severe extent of involvement were more frequently observed in male patients and patients under 30 years of onset age than in females and patients 30 years or over of onset age, respectively. Moderate to severe disease activity were also more frequently presented in male patients, but not in patients under 30 years of onset age. The most common morphological type was nummular (56.7%), followed by large plaque (28.5%) and guttate (8.5%). Nail involvement accompanied in 26.4% of patients. We demonstrated the epidemiologic and clinical characteristics of psoriasis in Korean patients.

  18. [The cat cry (cri du chat) syndrome: report of a case with review of 10 cases at the National Taiwan University Hospital].

    PubMed

    Chuang, S M; Wang, T R; Jean, H H; Lee, F Y

    1989-06-01

    The cat cry (cri du chat) syndrome is a rare congenital anomaly due to partial deletion of the short arm of the No. 5 chromosome. Since the first report of Lejeune et al, in 1963, nearly 400 cases have been reported. However, the syndrome with a ring chromosome is still very rare and only 10 cases were reported up to 1988, since the first report of Rohde and Tompkins in 1965. To investigate the chromosomal changes in the patients of cat cry syndrome, a chromosomal study was carried out on 10 cases of cat cry syndrome from 5,870 cases submitted to the Laboratory of Cytogenetics, National Taiwan University Hospital from Nov. 1968 through Apr. 1988. These ten cases included 3 males and 7 females (M:F = 1:2.3) aged 2 days to 18 months with an average of 5.5 months. The most common clinical features are: cat-like cry, growth failure, microcephaly with mental retardation, round face with facial abnormalities including hypertelorism, downward slanting palpebral fissures, micrognathia and low-set ears, and simian crease. Laryngomalacia or underdevelopment of the larynx may be a factor causing the cat-like cry. On chromosome analysis, 8 out of these 10 cases showed the usual simple deletion of the short arm of the no. 5 chromosome, and the other 2 cases revealed ring chromosome including a case of pure ring chromosome([(4, XY, r (5)] and a case of mosaicism with one ring chromosome, 2 ring chromosomes and simple deletion of the short arm of the No. 5 chromosome.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. A nationwide study of patients hospitalised for poisoning in Korea based on Korea National Hospital Discharge In-Depth Injury Survey data from 2005 to 2009

    PubMed Central

    Kim, Kyunghee; Choi, Jae Wook; Park, Miso; Kim, Min Soo; Lee, Eun Sun

    2015-01-01

    Objectives In light of the need to develop an integrated database on poisoning incidents in Korea, this study seeks to determine the characteristics of poisoning incidents in Korea by age, gender, location of incident, causative substance and patient prognosis. Data sources The Korea National Hospital Discharge In-Depth Injury Survey results (2005–2009) from the Korea Centers for Disease Control and Prevention were used. Participants 3826 participants in the survey who had been hospitalised for poisoning incidents. Results The poisoning hospitalisation rate per 100 000 population was higher in women (1.735) than in men (1.372) and increased with age: the rate was 0.458 among individuals aged ≤9 years, 0.481 among those aged 10–19 years, 1.584 among those aged 20–64 years and 4.053 among those aged ≥65 years. The intentional poisoning hospitalisation rate differed by gender and age group. Women aged ≤19 years and 20–64 years showed a higher hospitalisation rate than men, while men aged ≥65 years showed a higher hospitalisation rate than women in the same age group. The most common poisoning substance was pesticides (33.6%), while antiepileptic, sedative-hypnotic and antiparkinsonism drugs and psychotropic drugs, not elsewhere classified were also very common. Poisoning in those aged ≤9 years usually involved other drugs, while pesticides were the most common substances in those aged 20–64 years and ≥65 years. Conclusions This study analysed poisoning incidents in Korea from 2005 to 2009, by age and gender, causative substance, and characteristics. The results of this study may serve as evidence for new strategies in Korea to prevent poisoning. PMID:26553832

  20. Risk factors for postpartum depression in women living with HIV attending prevention of mother-to-child transmission clinic at Kenyatta National Hospital, Nairobi.

    PubMed

    Yator, Obadia; Mathai, Muthoni; Vander Stoep, Ann; Rao, Deepa; Kumar, Manasi

    2016-07-01

    Mothers with HIV are at high risk of a range of psychosocial issues that may impact HIV disease progression for themselves and their children. Stigma has also become a substantial barrier to accessing HIV/AIDS care and prevention services. The study objective was to determine the prevalence and severity of postpartum depression (PPD) among women living with HIV and to further understand the impact of stigma and other psychosocial factors in 123 women living with HIV attending prevention of mother-to-child transmission (PMTCT) clinic at Kenyatta National Hospital located in Nairobi, Kenya. We used the Edinburgh Postnatal Depression Scale and HIV/AIDS Stigma Instrument - PLWHA (HASI - P). Forty-eight percent (N = 59) of women screened positive for elevated depressive symptoms. Eleven (9%) of the participants reported high levels of stigma. Multivariate analyses showed that lower education (OR = 0.14, 95% CI [0.04-0.46], p = .001) and lack of family support (OR = 2.49, 95% CI [1.14-5.42], p = .02) were associated with the presence of elevated depressive symptoms. The presence of stigma implied more than ninefold risk of development of PPD (OR = 9.44, 95% CI [1.132-78.79], p = .04). Stigma was positively correlated with an increase in PPD. PMTCT is an ideal context to reach out to women to address mental health problems especially depression screening and offering psychosocial treatments bolstering quality of life of the mother-baby dyad.

  1. Motivation and values of hospital consultants in south-east England who work in the national health service and do private practice.

    PubMed

    Humphrey, Charlotte; Russell, Jill

    2004-09-01

    In the UK, a small private health care sector has always existed alongside the national health service (NHS). The conventional assumption is that doctors who work as salaried employees of the NHS are guided in their clinical practice by professional values which encourage them to put their patients' interests first. A common suspicion is that doctors undertaking fee-for-service practice in the private sector are motivated by self-interest, with commitment to their patients compromised by consideration for their purse. The great majority of hospital consultants are salaried employees of the NHS, but most also undertake some private practice. This paper uses findings from an interview study of 60 surgeons and physicians engaged in dual practice of this kind to investigate their reasons for working in this way and look at how they reconcile their personal, professional and public sector values and responsibilities with the temptations of the market. The existence of the private sector and their own engagement in it was regarded by almost all respondents as a net benefit, not only to themselves and their private patients, but also to the NHS, so long as they handled it properly. The interviews revealed a complex range of beliefs and assumptions through which these doctors justify their activities and a variety of informal principles for dealing with such conflicts of interest as they acknowledge. Neither their values nor their actions can be adequately explained using generic concepts of professional self-interest or public service values without consideration of what such concepts represented in the specific social, economic, professional and policy context of health care in south-east England at the time of the study.

  2. Nontraumatic dental condition-related visits to emergency departments on weekdays, weekends and night hours: findings from the National Hospital Ambulatory Medical Care survey

    PubMed Central

    Okunseri, Christopher; Okunseri, Elaye; Fischer, Melissa Christine; Sadeghi, Saba Noori; Xiang, Qun; Szabo, Aniko

    2013-01-01

    Objective To determine whether the rates of nontraumatic dental condition (NTDC)-related emergency department (ED) visits are higher during the typical working hours of dental offices and lower during night hours, as well as the associated factors. Methods We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997 through 2007 using multivariate binary and polytomous logistic regression adjusted for survey design to determine the effect of predictors on specified outcome variables. Results Overall, 4,726 observations representing 16.4 million NTDC-related ED visits were identified. Significant differences in rates of NTDC-related ED visits were observed with 40%–50% higher rates during nonworking hours and 20% higher rates on weekends than the overall average rate of 170 visits per hour. Compared with 19–33 year olds, subjects < 18 years old had significantly higher relative rates of NTDC-related ED visits during nonworking hours [relative rate ratio (RRR) = 1.6 to 1.8], whereas those aged 73 and older had lower relative rates during nonworking hours (RRR = 0.4; overall P = 0.0005). Compared with those having private insurance, Medicaid and self-pay patients had significantly lower relative rates of NTDC visits during nonworking and night hours (RRR = 0.6 to 0.7, overall P < 0.0003). Patients with a dental reason for visit were overrepresented during the night hours (RRR = 1.3; overall P = 0.04). Conclusion NTDC-related visits to ED occurred at a higher rate during nonworking hours and on weekends and were significantly associated with age, patient-stated reason for visit and payer type. PMID:24039453

  3. The Daily Activity Report (DAR) a Novel Measure of Functional Outcome for Serious Mental Illness

    PubMed Central

    Velligan, Dawn I.; Mintz, Jim; Sierra, Cynthia; Martin, Mona L.; Fredrick, Megan; Maglinte, Gregory A.; Corey-Lisle, Patricia K.

    2016-01-01

    The assessment of real-world functional outcomes in clinical trials for medications targeting negative symptoms and cognitive impairment is extremely important. We tested the psychometric properties of the Daily Activity Report (DAR), a novel assessment of productive daily activity. We administered the DAR and additional assessments of functional outcome, functional capacity, cognition and symptomatology to 50 individuals with schizophrenia at 2 time points, 1 month apart and to 25 healthy controls. The DAR records a person’s daily activity for 7 consecutive days based upon phone calls made 3 times a day. A total score and scores in 3 domains; instrumental activities (ie, independent living), social and work or school related activities are generated for the DAR. Inter-item consistency was high 0.89–0.94 for each domain and 0.88 overall. Test–retest reliability across 1 month for the total DAR score was 0.67, P < .0001. The total DAR score as well as scores for social activity and nondomestic work/school differed significantly between control and patient participants (P < .0001). DAR domain scores were associated with negative symptoms and functional outcomes, but the primary score related to these measures was the work/school dimension of the DAR. DAR scores were only weakly and nonsignificantly related to positive symptoms. This study provides preliminary support for the reliability and validity of the DAR using interviewer administration. The development of a patient reported version of the DAR using smart phone technology with automatic scoring is the next step. PMID:26712856

  4. Assessment of drainage network extractions in a low-relief area of the Cuvelai Basin (Namibia) from multiple sources: LiDAR, topographic maps, and digital aerial orthophotographs

    NASA Astrophysics Data System (ADS)

    Persendt, F. C.; Gomez, C.

    2016-05-01

    Accurate delineation of drainage networks (DNs) is crucial for hydrological or hydraulic modelling, and the comprehension of fluvial processes. This task presents challenging aspects in complex lowland terrains with subtle relief and particularly for data poor-areas like the Cuvelai river basin (CRB), Namibia, where the present study takes place. In the CRB standard methods of drainage network extraction from low resolution gridded digital elevation models (DEMs) are unsuitable, hence airborne Light Detection and Ranging (LiDAR) solutions have been utilized. However, LiDAR also presents challenges to large areal applications, especially with a surface roughness exceeding the capacity of numerous algorithms. Indeed, LiDAR-based DEMs (2 and 50 m resolutions) need to be hydrologically corrected and smoothed to enable the extraction of scale-relevant geomorphologic features such as DNs. In the present contribution, channels from topographic maps (blue lines) were compared to those from hydrologically corrected and uncorrected LiDAR DEMs, heads-up digitized channels from high-resolution digital aerial orthophotographs, field-mapped channels and auxiliary data. The 'maximum gradient deterministic eight (D8)' GIS algorithm was applied to the corrected and uncorrected LiDAR DEMs using two network extraction methods: area threshold support and curvature/drop analysis. Different progressive flow accumulation threshold values (12) were used to delineate channels with these methods. Validation was performed between the field-mapped channels, the modelled channels and those derived from multiple sources. Additionally, spatial and quantitative analyses were performed on geomorphologic parameters and indices. The results have shown that hydrologically corrected LiDAR DEMs offer useful details for identifying low order stream segments in headwaters, while blue lines derived from the national hydrography datasets for watersheds, located in elevated and low-lying areas of the study

  5. Mapping Forest Carbon by Fusing Terrestrial and Airborne LiDAR Datasets

    NASA Astrophysics Data System (ADS)

    Stovall, A. E.

    2015-12-01

    The storage and flux of terrestrial carbon (C) is one of the largest and most uncertain components of the global C budget, the vast majority of which is held within the biomass of the world's forests. However, the spatial distribution and quantification of forest C remains difficult to measure on a large scale. Remote sensing of forests with airborne LiDAR has proven to be an extremely effective method of bridging the gap between data from plot-level forestry mensuration and landscape-scale C storage estimates, but the standard method of assessing forest C is typically based on national or regional-scale allometric equations that are often not representative on the local-scale. Improvement of these measurements is necessary in order for collaborative multi-national carbon monitoring programs such as REDD implemented by the UNFCCC to be successful in areas, such as tropical forests, with tree species that have insufficiently documented allometric relationships. The primary goal of this study is to set forth a pipeline for precise non-destructive monitoring of C storage by: 1) determining C storage on 15 1/10th ha plots in a 25.6 ha Virginia temperate forest using the recently updated national allometric equations from Chojnacky et. al 2014, 2) comparing these estimates to non-destructively determined individual tree biomass using several semi-automated approaches of three-dimensionally analyzing the point cloud from a high-precision Terrestrial Laser Scanner (TLS), and 3) creating a predictive model of forest C storage by fusing airborne LiDAR data to the plot-level TLS measurements. Our findings align with several other studies, indicating a strong relationship between allometrically-derived C estimates and TLS-derived C measurements (R2=0.93, n=30) using relatively few individuals, suggesting the potential application of these methods to species that are understudied or are without allometric relationships. Voxel based C storage was estimated on the plot level and

  6. Fine-scale ignimbrite morphology revealed in LiDAR at Crater Lake, OR

    NASA Astrophysics Data System (ADS)

    Robinson, J. E.; Bacon, C. R.; Wright, H. M.

    2011-12-01

    Mount Mazama erupted ~7,700 years ago resulting in the collapse of Crater Lake caldera, ash fall across the Pacific Northwest, and emplacement of compositionally zoned ignimbrite. Early climactic ignimbrite contains uniform rhyodacitic pumice and traveled far from the vent, whereas late, less mobile ignimbrite is dominated by crystal-rich andesitic scoria and mafic crystal mush. Funded by the USGS, NPS, and FHWA, the DOGAMI-led Oregon LiDAR Consortium contracted with Watershed Services to collect ~800 km2 of LiDAR over Crater Lake National Park from Aug 2010 to Sept 2010. Ground laser returns have an average density of 1.63 returns/m2 over the heavily forested area of interest. The data have a lateral RMSE and vertical accuracy of 0.05 m. A bare earth terrain model allows a virtual removal of the forest, revealing fine-scale surface morphology, notably in the climactic ignimbrite. Secondary pyroclastic flows, explosion craters, erosion by water, and compaction-related deformation modified the originally smooth ignimbrite surface. Distinct pyroclastic flow fronts are evident in the LiDAR in Annie Creek valley. Leveed flows stand approximately 5 m above the lower ignimbrite surface, and individual toes are about 1-2 m high. Preliminary field checking indicates that rhyodacitic pumice dominates the lower ignimbrite surface, but the leveed flows are a subequal mix of locally oxidized rhyodacitic pumice and andesitic scoria. We hypothesize that these deposits were secondary pyroclastic flows formed by gravitational failure of late ignimbrite. In the Castle Creek valley, is a 2-meter collapse scarp that may have spawned a small secondary pyroclastic flow; several such headwall scarps are present in Sand Creek valley. Differential compaction features are common in many thick ignimbrites. We suggest this caused the deformation of the ignimbrite apparent in the LiDAR. In Annie Creek valley are a series of flow parallel asymmetric ridges, with shallower slopes toward the

  7. Factors affecting the quality of hospital hotel services from the patients and their companions’ point of view: A national study in Iran

    PubMed Central

    Shirzadi, Seyed Majid; Raeissi, Pouran; Nasiripour, Amir Ashkan; Tabibi, Seyed Jamaleddin

    2016-01-01

    Background: The hospitality design of a hospital is a complex process that depends on careful planning, systematic thinking, and consideration of various factors. This study aimed to determine the viewpoints of patients and their relatives on factors affecting hospital hotel services in Iran in 2015. The results of this study can be used to design a suitable model for the assessment and improvement of hospitality service quality. Materials and Methods: In this cross-sectional descriptive study, 10 hospitals of Iran were included. The subjects of the study included 480 patients and their companions from different internal and surgical wards. Simple random sampling method was performed at the hospitals, where patients were selected through stratified sampling based on hospital wards, and in each ward, through systematic sampling based on the bed numbers. A researcher-made questionnaire was used as the study tool which was developed through reviewing the literature and opinions of experts. Its internal reliability was determined based on Cronbach's alpha coefficient (α =0.85). Results: In reviewing the eleven aspects of hospital hotel services regarding the patients’ and their companions’ viewpoint, services related to all aspects, whether human, economic, operational, personnel identification, safety, health care services, physical, clinical welfare, cultural, patient guidance, or public welfare services, received mean scores of higher than three (out of five). Conclusion: The present study showed that in the patients’ and their companions’ viewpoint, factors affecting hospital hotel services in the country are very important. The tool used in this study can be a criterion for assessing the status of the hotel services of the country's major hospitals, so accordingly, the assessment and improvement of the existing conditions can be possible. PMID:27904592

  8. Nacelle LiDAR online wind field reconstruction applied to feedforward pitch control

    NASA Astrophysics Data System (ADS)

    GUILLEMIN, F.; DOMENICO, D. DI; NGUYEN, N.; SABIRON, G.; BOQUET, M.; GIRARD, N.; COUPIAC, O.

    2016-09-01

    This paper presents innovative filtering and reconstruction techniques of nacelle LiDAR data, and exploitation of obtained wind anticipation capabilities for wind turbine control strategy. The implemented algorithms are applied under industrial constraints, on a MAIA EOLIS wind turbine, equipped with a LEOSPHERE 5-beams pulsed LiDAR, during experimental campaigns of SMARTEOLE collaborative project.

  9. LiDAR, a great tool for archaeologists, but how do you interpret it?

    NASA Astrophysics Data System (ADS)

    Leisz, S.; Fisher, C.

    2013-05-01

    This paper focuses on the use of airborne LiDAR to identify archaeological features below forest canopies in Mesoamerica and the challenges faced in interpreting the data. To illustrate the issues involved in interpreting LiDAR point clouds and derived data sets for archaeological purposes, the case study of the use of airborne LiDAR at the archaeological site of Angamuco in West-Central Mexico is discussed. The case study details the reason LiDAR was collected, the challenges in interpreting it, methods and techniques that the authors are investigating to improve the interpretation of the LiDAR, and discoveries that have so far been made through the use of LiDAR. A key point discussed is the need to analyze the LiDAR point cloud in conjunction with products developed from the point cloud. Analyzing the various data sets jointly allows the user to better identify archaeological features of interest. New ways of utilizing hillshades of DEMs, such as creating 360 degree hillshades of the derived DEMs, are also presented. Last the authors discuss their experience in using object-based classification of the products derived from the LiDAR point cloud as an example of one possible technique for automating the delineation and classification of archaeological features.

  10. Remote sensing of Sonoran Desert vegetation structure and phenology with ground-based LiDAR

    USGS Publications Warehouse

    Sankey, Joel B.; Munson, Seth M.; Webb, Robert H.; Wallace, Cynthia S.A.; Duran, Cesar M.

    2015-01-01

    Long-term vegetation monitoring efforts have become increasingly important for understanding ecosystem response to global change. Many traditional methods for monitoring can be infrequent and limited in scope. Ground-based LiDAR is one remote sensing method that offers a clear advancement to monitor vegetation dynamics at high spatial and temporal resolution. We determined the effectiveness of LiDAR to detect intra-annual variability in vegetation structure at a long-term Sonoran Desert monitoring plot dominated by cacti, deciduous and evergreen shrubs. Monthly repeat LiDAR scans of perennial plant canopies over the course of one year had high precision. LiDAR measurements of canopy height and area were accurate with respect to total station survey measurements of individual plants. We found an increase in the number of LiDAR vegetation returns following the wet North American Monsoon season. This intra-annual variability in vegetation structure detected by LiDAR was attributable to a drought deciduous shrub Ambrosia deltoidea, whereas the evergreen shrub Larrea tridentata and cactus Opuntia engelmannii had low variability. Benefits of using LiDAR over traditional methods to census desert plants are more rapid, consistent, and cost-effective data acquisition in a high-resolution, 3-dimensional context. We conclude that repeat LiDAR measurements can be an effective method for documenting ecosystem response to desert climatology and drought over short time intervals and at detailed-local spatial scale.

  11. Wetland inundation mapping and change monitoring using landsat and airborne LiDAR data

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This paper presents a new approach for mapping wetland inundation change using Landsat and LiDAR intensity data. In this approach, LiDAR data were used to derive highly accurate reference subpixel inundation percentage (SIP) maps at the 30-m resolution. The reference SIP maps were then used to est...

  12. Modelling Sensor and Target effects on LiDAR Waveforms

    NASA Astrophysics Data System (ADS)

    Rosette, J.; North, P. R.; Rubio, J.; Cook, B. D.; Suárez, J.

    2010-12-01

    The aim of this research is to explore the influence of sensor characteristics and interactions with vegetation and terrain properties on the estimation of vegetation parameters from LiDAR waveforms. This is carried out using waveform simulations produced by the FLIGHT radiative transfer model which is based on Monte Carlo simulation of photon transport (North, 1996; North et al., 2010). The opportunities for vegetation analysis that are offered by LiDAR modelling are also demonstrated by other authors e.g. Sun and Ranson, 2000; Ni-Meister et al., 2001. Simulations from the FLIGHT model were driven using reflectance and transmittance properties collected from the Howland Research Forest, Maine, USA in 2003 together with a tree list for a 200m x 150m area. This was generated using field measurements of location, species and diameter at breast height. Tree height and crown dimensions of individual trees were calculated using relationships established with a competition index determined for this site. Waveforms obtained by the Laser Vegetation Imaging Sensor (LVIS) were used as validation of simulations. This provided a base from which factors such as slope, laser incidence angle and pulse width could be varied. This has enabled the effect of instrument design and laser interactions with different surface characteristics to be tested. As such, waveform simulation is relevant for the development of future satellite LiDAR sensors, such as NASA’s forthcoming DESDynI mission (NASA, 2010), which aim to improve capabilities of vegetation parameter estimation. ACKNOWLEDGMENTS We would like to thank scientists at the Biospheric Sciences Branch of NASA Goddard Space Flight Center, in particular to Jon Ranson and Bryan Blair. This work forms part of research funded by the NASA DESDynI project and the UK Natural Environment Research Council (NE/F021437/1). REFERENCES NASA, 2010, DESDynI: Deformation, Ecosystem Structure and Dynamics of Ice. http

  13. Applicability of Aerial Green LiDAR to a Large River in the Western United States

    NASA Astrophysics Data System (ADS)

    Conner, J. T.; Welcker, C. W.; Cooper, C.; Faux, R.; Butler, M.; Nayegandhi, A.

    2013-12-01

    In October 2012, aerial green LiDAR data were collected in the Snake River (within Idaho and Oregon) to test this emerging technology in a large river with poor water clarity. Six study areas (total of 30 river miles spread out over 250 river miles) were chosen to represent a variety of depths, channel types, and surface conditions to test the accuracy, depth penetration, data density of aerial green LiDAR. These characteristics along with cost and speed of acquisition were compared to other bathymetric survey techniques including rod surveys (total station and RTK-GPS), single-beam sonar, and multibeam echosounder (MBES). The green LiDAR system typically measured returns from the riverbed through 1-2 meters of water, which was less than one Secchi depth. However, in areas with steep banks or aquatic macrophytes, LiDAR returns from the riverbed were less frequent or non-existent. In areas of good return density, depths measured from green LiDAR data corresponded well with previously collected data sets from traditional bathymetric survey techniques. In such areas, the green LiDAR point density was much higher than both rod and single beam sonar surveys, yet lower than MBES. The green LiDAR survey was also collected more efficiently than all other methods. In the Snake River, green LiDAR does not provide a method to map the entire riverbed as it only receives bottom returns in shallow water, typically at the channel margins. However, green LiDAR does provide survey data that is an excellent complement to MBES, which is more effective at surveying the deeper portions of the channel. In some cases, the green LiDAR was able to provide data in areas that the MBES could not, often due to issues with navigating the survey boat in shallow water. Even where both MBES and green LiDAR mapped the river bottom, green LiDAR often provides more accurate data through a better angle of incidence and less shadowing than the MBES survey. For one MBES survey in 2013, the green LiDAR

  14. Monitoring changes in the Platte River riparian corridor with serial LiDAR surveys

    USGS Publications Warehouse

    Kinzel, Paul J.; Nelson, Jonathan M.; Wright, C. Wayne

    2006-01-01

    The Platte River in central Nebraska is a wide, sand-bedded river that provides habitat for migratory water birds along the North American flyway. The central Platte River functions as critical habitat for the endangered whooping crane (Grus americana) and also is an important habitat for the endangered least tern (Sterna antillarum) and the threatened piping plover (Charadrius melodus). Upstream water-resource development over the last century has decreased the water and sediment supplied to the central Platte River. This has resulted in vegetation encroachment and narrowing of Platte River channels. The National Academy of Sciences' National Research Council, in a recent review of these critical habitat designations, concluded that the current morphology of Platte River channels is limiting the recovery of the endangered and threatened avian species. Habitat-enhancement efforts along the Platte River currently (2006) are focused on the clearing of vegetation from in-channel and riparian areas, whereas future plans propose the release of water from upstream dams as a means to prevent vegetation from encroaching on the active river channel. For this reason, monitoring the physical response of the river channel to these management treatments is an important component of a proposed habitat recovery program. Understanding the effects of management strategies on Platte River riparian habitat also is a key objective of the U.S. Geological Survey's Platte River Priority Ecosystem Program (http://mcmcweb.er.usgs.gov/platte/). This fact sheet describes applications of LiDAR to monitor changes in the Platte River riparian corridor.

  15. Multipath estimation in urban environments from joint GNSS receivers and LiDAR sensors.

    PubMed

    Ali, Khurram; Chen, Xin; Dovis, Fabio; De Castro, David; Fernández, Antonio J

    2012-10-30

    In this paper, multipath error on Global Navigation Satellite System (GNSS) signals in urban environments is characterized with the help of Light Detection and Ranging (LiDAR) measurements. For this purpose, LiDAR equipment and Global Positioning System (GPS) receiver implementing a multipath estimating architecture were used to collect data in an urban environment. This paper demonstrates how GPS and LiDAR measurements can be jointly used to model the environment and obtain robust receivers. Multipath amplitude and delay are estimated by means of LiDAR feature extraction and multipath mitigation architecture. The results show the feasibility of integrating the information provided by LiDAR sensors and GNSS receivers for multipath mitigation.

  16. Multipath Estimation in Urban Environments from Joint GNSS Receivers and LiDAR Sensors

    PubMed Central

    Ali, Khurram; Chen, Xin; Dovis, Fabio; De Castro, David; Fernández, Antonio J.

    2012-01-01

    In this paper, multipath error on Global Navigation Satellite System (GNSS) signals in urban environments is characterized with the help of Light Detection and Ranging (LiDAR) measurements. For this purpose, LiDAR equipment and Global Positioning System (GPS) receiver implementing a multipath estimating architecture were used to collect data in an urban environment. This paper demonstrates how GPS and LiDAR measurements can be jointly used to model the environment and obtain robust receivers. Multipath amplitude and delay are estimated by means of LiDAR feature extraction and multipath mitigation architecture. The results show the feasibility of integrating the information provided by LiDAR sensors and GNSS receivers for multipath mitigation. PMID:23202177

  17. Using a multiwavelength LiDAR for improved remote sensing of natural waters.

    PubMed

    Gray, Deric J; Anderson, John; Nelson, Jean; Edwards, Jarrod

    2015-11-01

    This paper describes research to characterize the benefits of a multiwavelength oceanographic LiDAR for various water types. Field measurements were conducted to establish endmembers representative of both typical and extremely challenging natural conditions. Laboratory tests were performed using a prototype multiwavelength LiDAR in water tanks with optical conditions simulating both sediment-laden and biologically rich water types. LiDAR models were used to simulate the LiDAR signal from both field and laboratory experiments. Our measurements and models show that using a laser wavelength of 470-490 nm in the open ocean leads to an improvement factor of 1.50-1.75 compared to a 532 nm system. In more turbid areas using a laser wavelength of 560-580 nm leads to an improvement factor of 1.25. We conclude by demonstrating how using multiple LiDAR wavelengths can help detect and characterize constituents in the water column.

  18. Full waveform hyperspectral LiDAR for terrestrial laser scanning.

    PubMed

    Hakala, Teemu; Suomalainen, Juha; Kaasalainen, Sanna; Chen, Yuwei

    2012-03-26

    We present the design of a full waveform hyperspectral light detection and ranging (LiDAR) and the first demonstrations of its applications in remote sensing. The novel instrument produces a 3D point cloud with spectral backscattered reflectance data. This concept has a significant impact on remote sensing and other fields where target 3D detection and identification is crucial, such as civil engineering, cultural heritage, material processing, or geomorphological studies. As both the geometry and spectral information on the target are available from a single measurement, this technology will extend the scope of imaging spectroscopy into spectral 3D sensing. To demonstrate the potential of the instrument in the remote sensing of vegetation, 3D point clouds with backscattered reflectance and spectral indices are presented for a specimen of Norway spruce.

  19. Understanding hospitality.

    PubMed

    Patten, C S

    1994-03-01

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

  20. Individual tree crown delineation using localized contour tree method and airborne LiDAR data in coniferous forests

    NASA Astrophysics Data System (ADS)

    Wu, Bin; Yu, Bailang; Wu, Qiusheng; Huang, Yan; Chen, Zuoqi; Wu, Jianping

    2016-10-01

    Individual tree crown delineation is of great importance for forest inventory and management. The increasing availability of high-resolution airborne light detection and ranging (LiDAR) data makes it possible to delineate the crown structure of individual trees and deduce their geometric properties with high accuracy. In this study, we developed an automated segmentation method that is able to fully utilize high-resolution LiDAR data for detecting, extracting, and characterizing individual tree crowns with a multitude of geometric and topological properties. The proposed approach captures topological structure of forest and quantifies topological relationships of tree crowns by using a graph theory-based localized contour tree method, and finally segments individual tree crowns by analogy of recognizing hills from a topographic map. This approach consists of five key technical components: (1) derivation of canopy height model from airborne LiDAR data; (2) generation of contours based on the canopy height model; (3) extraction of hierarchical structures of tree crowns using the localized contour tree method; (4) delineation of individual tree crowns by segmenting hierarchical crown structure; and (5) calculation of geometric and topological properties of individual trees. We applied our new method to the Medicine Bow National Forest in the southwest of Laramie, Wyoming and the HJ Andrews Experimental Forest in the central portion of the Cascade Range of Oregon, U.S. The results reveal that the overall accuracy of individual tree crown delineation for the two study areas achieved 94.21% and 75.07%, respectively. Our method holds great potential for segmenting individual tree crowns under various forest conditions. Furthermore, the geometric and topological attributes derived from our method provide comprehensive and essential information for forest management.

  1. Dynamic LiDAR-NDVI classification of fluvial landscape units

    NASA Astrophysics Data System (ADS)

    Ramírez-Núñez, Carolina; Parrot, Jean-François

    2015-04-01

    The lower basin of the Coatzacoalcos River is a wide floodplain in which, during the wet season, local and major flooding are distinguished. Both types of floods, intermittent and regional, are important in terms of resources; the regional flood sediments enrich the soils of the plains and intermittent floods allow obtaining aquatic resources for subsistence during the heatwave. In the floodplain different abandoned meanders and intermittent streams are quickly colonized by aquatic vegetation. However, from the 1990s, the Coatzacoalcos River floodplain has important topographic changes due to mining, road and bridges construction; erosion and sedimentation requires continuous parcel boundaries along with the increasing demand of channel reparation, embankments, levees and bridges associated to tributaries. NDVI data, LiDAR point cloud and various types of flood simulations taking into account the DTM are used to classify the dynamic landscape units. These units are associated to floods in relation with water resources, agriculture and livestock. In the study area, the first returns of the point cloud allow extracting vegetation strata. The last returns correspond to the bare earth surface, especially in this area with few human settlements. The surface that is not covered by trees or by aquatic vegetation, correspond to crops, pastures and bare soils. The classification is obtained by using the NDVI index coupled with vegetation strata and water bodies. The result shows that 47.96% of the area does not present active vegetation and it includes 31.53% of bare soils. Concerning the active vegetation, pastures, bushes and trees represent respectively 25.59%, 11.14% and 13.25%. The remaining 1.25% is distributed between water bodies with aquatic vegetation, trees and shrubs. Dynamic landscape units' classification represents a tool for monitoring water resources in a fluvial plain. This approach can be also applied to forest management, environmental services and

  2. Development of forest growth inputs from LiDAR

    NASA Astrophysics Data System (ADS)

    Tinkham, W. T.; Falkowski, M. J.; Smith, A. M.; Hudak, A. T.; Crookston, N. L.

    2012-12-01

    Investigating the potential impacts of climate change on forest dynamics is a critical area of science, especially given the vast amount of ecosystems services forests provide. Critical understanding of these impacts is lacking, most visibly, at regional to local scales where on-the-ground management activities are implemented. To plan ahead and mitigate the impacts of climate change, land managers need of decision support tools that can be used to evaluate the future impacts of climate change on forest conditions, so that sustainable management practices that enhance ecosystem resilience can be defensibly developed, evaluated, and implemented. However, to be applicable to both regional forest planning and local operational forest management decisions, approaches must be capable of simulating forest dynamics across large spatial extents (required for regional planning) while maintaining a high-level of spatial detail (required for operational management). Numerous studies have demonstrated that LiDAR remote sensing is an effective tool for accurately measuring forest structure at landscape scales, providing information with a level of detail appropriate for operational forest management. This study attempts to develop a system to spatially parameterize and supply critical initial conditions for Climate-FVS and other forest growth models across major ecoregions (in terms of forest structure and composition) in the Pacific Northwest (PNW) of the US, via an integration of airborne LiDAR, spatial measures of productivity, and local climate. Integrating these inputs into forest growth models would be a big step towards planning and optimizing landscape level alterations to forest structure and productivity from climate change.

  3. Urban agriculture and Anopheles habitats in Dar es Salaam, Tanzania.

    PubMed

    Dongus, Stefan; Nyika, Dickson; Kannady, Khadija; Mtasiwa, Deo; Mshinda, Hassan; Gosoniu, Laura; Drescher, Axel W; Fillinger, Ulrike; Tanner, Marcel; Killeen, Gerry F; Castro, Marcia C

    2009-05-01

    A cross-sectional survey of agricultural areas, combined with routinely monitored mosquito larval information, was conducted in urban Dar es Salaam, Tanzania, to investigate how agricultural and geographical features may influence the presence of Anopheles larvae. Data were integrated into a geographical information systems framework, and predictors of the presence of Anopheles larvae in farming areas were assessed using multivariate logistic regression with independent random effects. It was found that more than 5% of the study area (total size 16.8 km2) was used for farming in backyard gardens and larger open spaces. The proportion of habitats containing Anopheles larvae was 1.7 times higher in agricultural areas compared to other areas (95% confidence interval = 1.56-1.92). Significant geographic predictors of the presence of Anopheles larvae in gardens included location in lowland areas, proximity to river, and relatively impermeable soils. Agriculture-related predictors comprised specific seedbed types, mid-sized gardens, irrigation by wells, as well as cultivation of sugar cane or leafy vegetables. Negative predictors included small garden size, irrigation by tap water, rainfed production and cultivation of leguminous crops or fruit trees. Although there was an increased chance of finding Anopheles larvae in agricultural sites, it was found that breeding sites originated by urban agriculture account for less than a fifth of all breeding sites of malaria vectors in Dar es Salaam. It is suggested that strategies comprising an integrated malaria control effort in malaria-endemic African cities include participatory involvement of farmers by planting shade trees near larval habitats.

  4. Hospital closure and economic efficiency.

    PubMed

    Capps, Cory; Dranove, David; Lindrooth, Richard C

    2010-01-01

    We present a new framework for assessing the effects of hospital closures on social welfare and the local economy. While patient welfare necessarily declines when patients lose access to a hospital, closures also tend to reduce costs. We study five hospital closures in two states and find that urban hospital bailouts reduce aggregate social welfare: on balance, the cost savings from closures more than offset the reduction in patient welfare. However, because some of the cost savings are shared nationally, total surplus in the local community may decline following a hospital closure.

  5. Pay More Attention: a national mixed methods study to identify the barriers and facilitators to ensuring equal access to high-quality hospital care and services for children and young people with and without learning disabilities and their families

    PubMed Central

    Oulton, Kate; Wray, Jo; Carr, Lucinda; Hassiotis, Angela; Jewitt, Carey; Kerry, Sam; Gibson, Faith

    2016-01-01

    Introduction Despite evidence of health inequalities for adults with intellectual disability (ID) there has yet to be a comprehensive review of how well hospital services are meeting the needs of children and young people (CYP) with ID and their families. We do not know how relevant existing recommendations and guidelines are to CYP, whether these are being applied in the paediatric setting or what difference they are making. Evidence of parental dissatisfaction with the quality, safety and accessibility of hospital care for CYP with ID exists. However, the extent to which their experience differs from parents of CYP without ID is not known and the views and experiences of CYP with ID have not been investigated. We will compare how services are delivered to, and experienced by CYP aged 5–15 years with and without ID and their families to see what inequalities exist, for whom, why and under what circumstances. Methods and analysis We will use a transformative, mixed methods case study design to collect data over four consecutive phases. We will involve CYP, parents and hospital staff using a range of methods; interviews, parental electronic diary, hospital and community staff questionnaire, patient and parent satisfaction questionnaire, content analysis of hospital documents and a retrospective mapping of patient hospital activity. Qualitative data will be managed and analysed using NVivo and quantitative data will be analysed using parametric and non-parametric descriptive statistics. Ethics and dissemination The study will run from December 2015 to November 2018. We have Health Authority Approval (IRAS project ID: 193932) for phase 1 involving staff only and ethical and Health Authority Approval for phases 2–4 (IRAS project ID: 178525). We will disseminate widely to relevant stakeholders, using a range of accessible formats, including social media. We will publish in international peer-reviewed journals and present to professional, academic and lay audiences

  6. Mapping and quantifying geodiversity in land-water transition zones using MBES and topobathymetric LiDAR

    NASA Astrophysics Data System (ADS)

    Brandbyge Ernstsen, Verner; Skovgaard Andersen, Mikkel; Gergely, Aron; Schulze Tenberge, Yvonne; Al-Hamdani, Zyad; Steinbacher, Frank; Rolighed Larsen, Laurids; Winter, Christian; Bartholomä, Alexander

    2016-04-01

    Land-water transition zones, like e.g. coastal and fluvial environments, are valuable ecosystems which are often characterised by high biodiversity and geodiversity. However, often these land-water transition zones are difficult or even impossible to map and investigate in high spatial resolution due to the challenging environmental conditions. Combining vessel borne shallow water multibeam echosounder (MBES) surveys ,to cover the subtidal coastal areas and the river channel areas, with airborne topobathymetric light detection and ranging (LiDAR) surveys, to cover the intertidal and supratidal coastal areas and the river floodplain areas, potentially enables full-coverage and high-resolution mapping in these challenging environments. We have carried out MBES and topobathymetric LiDAR surveys in the Knudedyb tidal inlet system, a coastal environment in the Danish Wadden Sea which is part of the Wadden Sea National Park and UNESCO World Heritage, and in the Ribe Vesterå, a fluvial environment in the Ribe Å river catchment discharging into the Knudedyb tidal basin. Detailed digital elevation models (DEMs) with a grid cell size of 0.5 m x 0.5 m were generated from the MBES and the LiDAR point clouds, which both have point densities in the order of 20 points/m2. Morphometric analyses of the DEMs enabled the identification and mapping of the different landforms within the coastal and fluvial environments. Hereby, we demonstrate that vessel borne MBES and airborne topobathymetric LiDAR, here in combination, are promising tools for seamless mapping across land-water transition zones as well as for the quantification of a range of landforms at landscape scale in different land-water transition zone environments. Hence, we demonstrate the potential for mapping and quantifying geomorphological diversity, which is one of the main components of geodiversity and a prerequisite for assessing geoheritage. Acknowledgements This work was funded by the Danish Council for

  7. Advances in animal ecology from 3D ecosystem mapping with LiDAR

    NASA Astrophysics Data System (ADS)

    Davies, A.; Asner, G. P.

    2015-12-01

    The advent and recent advances of Light Detection and Ranging (LiDAR) have enabled accurate measurement of 3D ecosystem structure. Although the use of LiDAR data is widespread in vegetation science, it has only recently (< 14 years) been applied to animal ecology. Despite such recent application, LiDAR has enabled new insights in the field and revealed the fundamental importance of 3D ecosystem structure for animals. We reviewed the studies to date that have used LiDAR in animal ecology, synthesising the insights gained. Structural heterogeneity is most conducive to increased animal richness and abundance, and increased complexity of vertical vegetation structure is more positively influential than traditionally measured canopy cover, which produces mixed results. However, different taxonomic groups interact with a variety of 3D canopy traits and some groups with 3D topography. LiDAR technology can be applied to animal ecology studies in a wide variety of environments to answer an impressive array of questions. Drawing on case studies from vastly different groups, termites and lions, we further demonstrate the applicability of LiDAR and highlight new understanding, ranging from habitat preference to predator-prey interactions, that would not have been possible from studies restricted to field based methods. We conclude with discussion of how future studies will benefit by using LiDAR to consider 3D habitat effects in a wider variety of ecosystems and with more taxa to develop a better understanding of animal dynamics.

  8. Positive predictive values of International Classification of Diseases, 10th revision codes for dermatologic events and hypersensitivity leading to hospitalization or emergency room visit among women with postmenopausal osteoporosis in the Danish and Swedish national patient registries

    PubMed Central

    Adelborg, Kasper; Christensen, Lotte Brix; Munch, Troels; Kahlert, Johnny; Trolle Lagerros, Ylva; Tell, Grethe S; Apalset, Ellen M; Xue, Fei; Ehrenstein, Vera

    2017-01-01

    Background Clinical epidemiology research studies, including pharmacoepidemiology and pharmacovigilance studies, use routinely collected health data, such as diagnoses recorded in national health and administrative registries, to assess clinical effectiveness and safety of treatments. We estimated positive predictive values (PPVs) of International Classification of Diseases, 10th revision (ICD-10) codes for primary diagnoses of dermatologic events and hypersensitivity recorded at hospitalization or emergency room visit in the national patient registries of Denmark and Sweden among women with postmenopausal osteoporosis (PMO). Methods This validation study included women with PMO identified from the Danish and Swedish national patient registries (2005–2014). Medical charts of the potential cases served as the gold standard for the diagnosis confirmation and were reviewed and adjudicated by physicians. Results We obtained and reviewed 189 of 221 sampled medical records (86%). The overall PPV was 92.4% (95% confidence interval [CI], 85.1%–96.3%) for dermatologic events, while the PPVs for bullous events and erythematous dermatologic events were 52.5% (95% CI, 37.5%–67.1%) and 12.5% (95% CI, 2.2%–47.1%), respectively. The PPV was 59.0% (95% CI, 48.3%–69.0%) for hypersensitivity; however, the PPV of hypersensitivity increased to 100.0% (95% CI, 67.6%–100.0%) when restricting to diagnostic codes for anaphylaxis. The overall results did not vary by country. Conclusion Among women with PMO, the PPV for any dermatologic event recorded as the primary diagnosis at hospitalization or at an emergency room visit was high and acceptable for epidemiologic research in the Danish and Swedish national patient registries. The PPV was substantially lower for hypersensitivity leading to hospitalization or emergency room visit.

  9. [Référentiel de bon usage and Thésaurus national de cancérologie digestive: analysis of non-conform prescriptions in Tenon hospital].

    PubMed

    Debrix, I; Sitbon, M; Khalil, A; Benomar, A; Becker, A; André, T

    2009-02-01

    The financial orders of French health insurance system for anticancer treatment are guided by the National recommendations of "Good Use" of anticancer treatment (law article dated August 25, 2005 for the good use of anticancer outside the classic financial hospitals). This law of "Good Use" is based on the recommendations of référentiels de bon usage (RBU). RBU include drugs with labelling or protocoles thérapeutiques temporaires (PTT). If the prescriptions do not conform with RBU, it will be considered as not confirmed and the prescriptor has to explain clearly his point of view in the medical file supported by national and international references and publications and also that of the experts' opinions. The objective of this study, made in 2007 in Tenon Hospital, Paris, was to evaluate the percentage of the prescriptions conform with RBU and the analysis of the other different prescriptions in regards to Thésaurus national de cancérologie digestive (TNCD). We found out that 25% of the anticancer prescriptions for digestive tumours in Tenon hospital are not known by the law of "Good Use". Half of these percentages were clearly recommended via the TNCD. The other half of these non-conform prescriptions were realized in an advanced disease in which there were no clear recommendations or references and there were no other choice. The TNCD validation by the National Cancer Institute can reduce the prescriptions, which are considered as non-conform. In the other hand, for the uncertain prescriptions (non-conform), the decision must be systematically discussed in multidisciplinary stuff with detailed argumentations and clear written explications in the medical file.

  10. DArT Markers Effectively Target Gene Space in the Rye Genome

    PubMed Central

    Gawroński, Piotr; Pawełkowicz, Magdalena; Tofil, Katarzyna; Uszyński, Grzegorz; Sharifova, Saida; Ahluwalia, Shivaksh; Tyrka, Mirosław; Wędzony, Maria; Kilian, Andrzej; Bolibok-Brągoszewska, Hanna

    2016-01-01

    Large genome size and complexity hamper considerably the genomics research in relevant species. Rye (Secale cereale L.) has one of the largest genomes among cereal crops and repetitive sequences account for over 90% of its length. Diversity Arrays Technology is a high-throughput genotyping method, in which a preferential sampling of gene-rich regions is achieved through the use of methylation sensitive restriction enzymes. We obtained sequences of 6,177 rye DArT markers and following a redundancy analysis assembled them into 3,737 non-redundant sequences, which were then used in homology searches against five Pooideae sequence sets. In total 515 DArT sequences could be incorporated into publicly available rye genome zippers providing a starting point for the integration of DArT- and transcript-based genomics resources in rye. Using Blast2Go pipeline we attributed putative gene functions to 1101 (29.4%) of the non-redundant DArT marker sequences, including 132 sequences with putative disease resistance-related functions, which were found to be preferentially located in the 4RL and 6RL chromosomes. Comparative analysis based on the DArT sequences revealed obvious inconsistencies between two recently published high density consensus maps of rye. Furthermore we demonstrated that DArT marker sequences can be a source of SSR polymorphisms. Obtained data demonstrate that DArT markers effectively target gene space in the large, complex, and repetitive rye genome. Through the annotation of putative gene functions and the alignment of DArT sequences relative to reference genomes we obtained information, that will complement the results of the studies, where DArT genotyping was deployed, by simplifying the gene ontology and microcolinearity based identification of candidate genes. PMID:27833625

  11. Automatic registration of UAV-borne sequent images and LiDAR data

    NASA Astrophysics Data System (ADS)

    Yang, Bisheng; Chen, Chi

    2015-03-01

    Use of direct geo-referencing data leads to registration failure between sequent images and LiDAR data captured by mini-UAV platforms because of low-cost sensors. This paper therefore proposes a novel automatic registration method for sequent images and LiDAR data captured by mini-UAVs. First, the proposed method extracts building outlines from LiDAR data and images and estimates the exterior orientation parameters (EoPs) of the images with building objects in the LiDAR data coordinate framework based on corresponding corner points derived indirectly by using linear features. Second, the EoPs of the sequent images in the image coordinate framework are recovered using a structure from motion (SfM) technique, and the transformation matrices between the LiDAR coordinate and image coordinate frameworks are calculated using corresponding EoPs, resulting in a coarse registration between the images and the LiDAR data. Finally, 3D points are generated from sequent images by multi-view stereo (MVS) algorithms. Then the EoPs of the sequent images are further refined by registering the LiDAR data and the 3D points using an iterative closest-point (ICP) algorithm with the initial results from coarse registration, resulting in a fine registration between sequent images and LiDAR data. Experiments were performed to check the validity and effectiveness of the proposed method. The results show that the proposed method achieves high-precision robust co-registration of sequent images and LiDAR data captured by mini-UAVs.

  12. [Considering the current state of fire safety in Taiwan's care environment from the perspective of the nation's worst recent hospital fire].

    PubMed

    Tseng, Wei-Wen; Shih, Chung-Liang; Chien, Shen-Wen

    2013-04-01

    Taiwan's worst hospital fire in history on October 23rd, 2012 at Sinying Hospital's Bei-Men Branch resulted in 13 elderly patient deaths and over 70 injuries. The heavy casualties were due in part to the serious condition of patients. Some patients on life-support machines were unable to move or be moved. This disaster highlights the issue of fire safety in small-scale hospitals that have transformed existing hospital space into special care environments for elderly patients. Compared with medical centers and general hospitals, these small-scale health facilities are ill equipped to deal properly with fire safety management and emergency response issues due to inadequate fire protection facilities, fire safety equipment, and human resources. Small-scale facilities that offer health care and medical services to mostly immobile patients face fire risks that differ significantly from general health care facilities. This paper focuses on fire risks in small-scale facilities and suggests a strategy for fire prevention and emergency response procedures, including countermeasures for fire risk assessment, management, and emergency response, in order to improve fire safety at these institutions in Taiwan.

  13. 4D Near Real-Time Environmental Monitoring Using Highly Temporal LiDAR

    NASA Astrophysics Data System (ADS)

    Höfle, Bernhard; Canli, Ekrem; Schmitz, Evelyn; Crommelinck, Sophie; Hoffmeister, Dirk; Glade, Thomas

    2016-04-01

    The last decade has witnessed extensive applications of 3D environmental monitoring with the LiDAR technology, also referred to as laser scanning. Although several automatic methods were developed to extract environmental parameters from LiDAR point clouds, only little research has focused on highly multitemporal near real-time LiDAR (4D-LiDAR) for environmental monitoring. Large potential of applying 4D-LiDAR is given for landscape objects with high and varying rates of change (e.g. plant growth) and also for phenomena with sudden unpredictable changes (e.g. geomorphological processes). In this presentation we will report on the most recent findings of the research projects 4DEMON (http://uni-heidelberg.de/4demon) and NoeSLIDE (https://geomorph.univie.ac.at/forschung/projekte/aktuell/noeslide/). The method development in both projects is based on two real-world use cases: i) Surface parameter derivation of agricultural crops (e.g. crop height) and ii) change detection of landslides. Both projects exploit the "full history" contained in the LiDAR point cloud time series. One crucial initial step of 4D-LiDAR analysis is the co-registration over time, 3D-georeferencing and time-dependent quality assessment of the LiDAR point cloud time series. Due to the high amount of datasets (e.g. one full LiDAR scan per day), the procedure needs to be performed fully automatically. Furthermore, the online near real-time 4D monitoring system requires to set triggers that can detect removal or moving of tie reflectors (used for co-registration) or the scanner itself. This guarantees long-term data acquisition with high quality. We will present results from a georeferencing experiment for 4D-LiDAR monitoring, which performs benchmarking of co-registration, 3D-georeferencing and also fully automatic detection of events (e.g. removal/moving of reflectors or scanner). Secondly, we will show our empirical findings of an ongoing permanent LiDAR observation of a landslide (Gresten

  14. LiDAR-derived snowpack data sets from mixed conifer forests across the Western United States

    NASA Astrophysics Data System (ADS)

    Harpold, A. A.; Guo, Q.; Molotch, N.; Brooks, P. D.; Bales, R.; Fernandez-Diaz, J. C.; Musselman, K. N.; Swetnam, T. L.; Kirchner, P.; Meadows, M. W.; Flanagan, J.; Lucas, R.

    2014-03-01

    Airborne-based Light Detection and Ranging (LiDAR) offers the potential to measure snow depth and vegetation structure at high spatial resolution over large extents and thereby increase our ability to quantify snow water resources. Here we present airborne LiDAR data products at four Critical Zone Observatories (CZO) in the Western United States: Jemez River Basin, NM, Boulder Creek Watershed, CO, Kings River Experimental Watershed, CA, and Wolverton Basin, CA. We make publicly available snow depth data products (1 m2 resolution) derived from LiDAR with an estimated accuracy of <30 cm compared to limited in situ snow depth observations.

  15. Compression strategies for LiDAR waveform cube

    NASA Astrophysics Data System (ADS)

    Jóźków, Grzegorz; Toth, Charles; Quirk, Mihaela; Grejner-Brzezinska, Dorota

    2015-01-01

    Full-waveform LiDAR data (FWD) provide a wealth of information about the shape and materials of the surveyed areas. Unlike discrete data that retains only a few strong returns, FWD generally keeps the whole signal, at all times, regardless of the signal intensity. Hence, FWD will have an increasingly well-deserved role in mapping and beyond, in the much desired classification in the raw data format. Full-waveform systems currently perform only the recording of the waveform data at the acquisition stage; the return extraction is mostly deferred to post-processing. Although the full waveform preserves most of the details of the real data, it presents a serious practical challenge for a wide use: much larger datasets compared to those from the classical discrete return systems. Atop the need for more storage space, the acquisition speed of the FWD may also limit the pulse rate on most systems that cannot store data fast enough, and thus, reduces the perceived system performance. This work introduces a waveform cube model to compress waveforms in selected subsets of the cube, aimed at achieving decreased storage while maintaining the maximum pulse rate of FWD systems. In our experiments, the waveform cube is compressed using classical methods for 2D imagery that are further tested to assess the feasibility of the proposed solution. The spatial distribution of airborne waveform data is irregular; however, the manner of the FWD acquisition allows the organization of the waveforms in a regular 3D structure similar to familiar multi-component imagery, as those of hyper-spectral cubes or 3D volumetric tomography scans. This study presents the performance analysis of several lossy compression methods applied to the LiDAR waveform cube, including JPEG-1, JPEG-2000, and PCA-based techniques. Wide ranges of tests performed on real airborne datasets have demonstrated the benefits of the JPEG-2000 Standard where high compression rates incur fairly small data degradation. In

  16. Le Bonheur Childrens Hospital CHAMPS Program in Memphis, Tennessee Recognized with the 2015 National Environmental Leadership Award by EPA Memphis Program Recognized as National Model for Asthma Care During Asthma Awareness Month

    EPA Pesticide Factsheets

    05/05/15 - ATLANTA - One in ten kids in America suffers from asthma, and communities of color and low-income families are disproportionately impacted. During Asthma Awareness Month, EPA recognizes Le Bonheur Children's Hospital CHAMPS Program in Memp

  17. Frontiers in Using LiDAR to Analyze Urban Landscape Heterogeneity

    NASA Astrophysics Data System (ADS)

    Singh, Kunwar Krishna Veer

    Light Detection and Ranging (LiDAR) technology has facilitated extraordinary advances in our ability to remotely sense precise details of both built and natural environments. The inherent complexity of urban landscapes and the massive data volumes produced by LiDAR require unique methodological considerations for big data remote sensing over large metropolitan regions. The heterogeneous landscapes of the rapidly urbanizing Charlotte Metropolitan Region of North Carolina provided an ideal testing ground for developing methods of analysis for urban ecosystems over large regional extents, including: (1) fusion of LiDAR digital surface models (DSMs) with Landsat TM imagery to balance spatial resolution, data volume, and mapping accuracy of urban land covers, (2) comparison of LiDAR-derived metrics to fine grain optical imagery -- and their integration -- for detecting forest understory plant invaders, and (3) data reduction techniques for computationally efficient estimation of aboveground woody biomass in urban forests. In Chapter 1, I examined tradeoffs between potential gains in mapping accuracy and computational costs by integrating DSMs (structural and intensity) extracted from LiDAR with TM imagery and evaluating the degree to which TM, LiDAR, and LiDAR-TM fusion data discriminated land covers. I used Maximum Likelihood and Classification Tree algorithms to classify TM data, LiDAR data, and LiDAR-TM fusions. I assessed the relative contributions of LiDAR DSMs to map classification accuracy and identified an optimal spatial resolution of LiDAR DSMs for large area assessments of urban land cover. In Chapter 2, I analyzed combinations of datasets developed from categorized LiDAR-derived variables (Overstory, Understory, Topography, and Overall Vegetation Characteristics) and IKONOS imagery ( Optical) to detect and map the understory plant invader, Ligustrum sinense, using Random Forest (RF) and logistic regression (LR) algorithms, and I assessed the relative

  18. Hospitality Management Education and Training.

    ERIC Educational Resources Information Center

    Brotherton, Bob, Ed.; And Others

    1995-01-01

    Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…

  19. "A means of restoring the health and preserving the lives of His Majesty's subjects": Ireland's 18th-Century National Hospital System.

    PubMed

    Mullaney, Susan

    2012-01-01

    In 1765, the Irish parliament enacted legislation that established a nationwide hospital network funded by a mixture of taxation and philanthropic donations. The county infirmaries had a similar ethos to the British and Irish voluntary hospitals; only those with an admission ticket were admitted. The legislation also regulated the qualifications of the County Infirmary Surgeons who were authorised to run the infirmaries. This was the first statutory nationwide network of care in Ireland. No other country in contemporary Europe passed similar legislation. The Irish parliamentarians and Charles Lucas in particular appear to have been the impetus for this innovative legislation.

  20. Morphometry and core type of streamlined bedforms in southern Sweden from high resolution LiDAR

    NASA Astrophysics Data System (ADS)

    Dowling, Thomas P. F.; Spagnolo, Matteo; Möller, Per

    2015-05-01

    This paper generates a new data set of streamlined glacial bedforms in southern Sweden, which is used both to test conclusions from previous work on streamlined bedform morphometrics and to advance our knowledge of streamlined bedforms on the Scandinavian Shield. The data set consists of streamlined glacial bedforms in southeast Sweden mapped from the new LiDAR-derived Swedish National Height Model, which has a pixel resolution of 2.0 m with a vertical resolution of 1 cm. We have mapped 10,311 features; of the mapped features, 135 are known to have an unconsolidated sediment core, 2120 a bedrock component, and 8055 whose core composition is unknown. The extracted morphological variables are then subjected to a univariate and bivariate analysis. We find that the extracted characteristics broadly fit into the lower end of the modal and median value spectrum of similar bedforms from around the world. The distribution of the variables is found to be log-normal to a first-order approximation. The covariant relationships between height and length, width and area are examined after the variables have been log-transformed and are found to be significant, if not particularly strong. Rock-cored features are found to have a longer modal length than soft-cored features, which suggests that reconstructions of past flow velocities from streamlined landforms need to closely consider core-type. Additionally, we find no support for a derived scaling law for streamlined features by plotting length, width, and elongation ratio against one another.

  1. Nursing Home Residents at Risk of Hospitalization and the Characteristics of Their Hospital Stays.

    ERIC Educational Resources Information Center

    Murtaugh, Christopher M.; Freiman, Marc P.

    1995-01-01

    Analysis of national medical data identified elderly nursing home residents with an elevated risk of hospitalization and the characteristics of their hospital stays. Findings indicate an elevated risk of hospitalization for residents diagnosed with one of several different primary diagnoses. Infections accounted for over 25% of hospital stays.…

  2. Homicide death in Dar es Salaam, Tanzania 2005.

    PubMed

    Outwater, Anne H; Campbell, Jacquelyn C; Mgaya, Edward; Abraham, Alison G; Kinabo, Linna; Kazaura, Method; Kub, Joan

    2008-12-01

    Violence disproportionately affects low- and middle-income countries. Deeper understanding is needed in areas where little research has occurred. The objectives of the study were to: (a) ascertain rate of homicide death; (b) describe the victims and circumstances surrounding their deaths in Dar es Salaam, Tanzania in 2005. This study was developed by adapting the WHO/CDC Injury Surveillance Guidelines (Holder et al., 2001). Data on 12 variables were collected on all homicide deaths. Descriptive statistics and hypothesis tests were done when appropriate. Age standardised, age-specific and cause-specific mortality rates are presented. The overall homicide rate was 12.57 (males and females respectively: 22.26 and 2.64). Homicide deaths were 93.4% male, mostly unemployed, with a mean age of 28.2 years. Most deaths occurred in urban areas. Mob violence was the cause of 57% of deaths. The risk of homicide death for males was greater than the world average, but for females it was less. Most homicides were committed by community members policing against thieves.

  3. Validation points generation for LiDAR-extracted hydrologic features

    NASA Astrophysics Data System (ADS)

    Felicen, M. M.; De La Cruz, R. M.; Olfindo, N. T.; Borlongan, N. J. B.; Ebreo, D. J. R.; Perez, A. M. C.

    2016-10-01

    This paper discusses a novel way of generating sampling points of hydrologic features, specifically streams, irrigation network and inland wetlands, that could provide a promising measure of accuracy using combinations of traditional statistical sampling methods. Traditional statistical sampling techniques such as simple random sampling, systematic sampling, stratified sampling and disproportionate random sampling were all designed to generate points in an area where all the cells are classified and subjected to actual field validation. However, these sampling techniques are not applicable when generating points along linear features. This paper presents the Weighted Disproportionate Stratified Systematic Random Sampling (WDSSRS), a tool that combines the systematic and disproportionate stratified random sampling methods in generating points for accuracy computation. This tool makes use of a map series boundary shapefile covering around 27 by 27 kilometers at a scale of 1:50000, and the LiDAR-extracted hydrologic features shapefiles (e.g. wetland polygons and linear features of stream and irrigation network). Using the map sheet shapefile, a 10 x 10 grid is generated, and grid cells with water and non-water features are tagged accordingly. Cells with water features are checked for the presence of intersecting linear features, and the intersections are given higher weights in the selection of validation points. The grid cells with non-intersecting linear features are then evaluated and the remaining points are generated randomly along these features. For grid cells with nonwater features, the sample points are generated randomly.

  4. Lessons learned in using hospital discharge data for state and national public health surveillance: implications for Centers for Disease Control and prevention tracking program.

    PubMed

    Love, Denise; Rudolph, Barbara; Shah, Gulzar H

    2008-01-01

    The goal of the Centers for Disease Control and Prevention Environmental Public Health Tracking (EPHT) Program is to build a nationwide network of integrated health and environmental data to measure impact of environmental factors on public health. This article describes how hospital discharge data can provide essential information for public health programs, including EPHT. The state inpatient hospital discharge data systems have properties that are highly desirable for surveillance and multistate initiatives, like EPHT, yet accessing and using the data can create challenges for the end user. This article highlights the strengths and limitations of hospital discharge data and references crash outcome data and evaluation system and Healthcare Cost and Utilization Project as models for accessing, linking, and aggregating hospital discharge data. These federal-state data partnerships have overcome many of these challenges and have the potential to serve as models for the EPHT Program. The lessons learned from these "early adopters" can shortcut the implementation period for the Centers for Disease Control and Prevention EPHT Program.

  5. Evidence for a persistent, major excess in all cause admissions to hospital in children with type-1 diabetes: results from a large Welsh national matched community cohort study

    PubMed Central

    Sayers, Adrian; Thayer, Daniel; Harvey, John N; Luzio, Stephen; Atkinson, Mark D; French, Robert; Warner, Justin T; Dayan, Colin M; Wong, Susan F; Gregory, John W

    2015-01-01

    Objectives To estimate the excess in admissions associated with type1 diabetes in childhood. Design Matched-cohort study using anonymously linked hospital admission data. Setting Brecon Group Register of new cases of childhood diabetes in Wales linked to hospital admissions data within the Secure Anonymised Information Linkage Databank. Population 1577 Welsh children (aged between 0 and 15 years) from the Brecon Group Register with newly-diagnosed type-1 diabetes between 1999–2009 and 7800 population controls matched on age, sex, county, and deprivation, randomly selected from the local population. Main outcome measures Difference in all-cause hospital admission rates, 30-days post-diagnosis until 31 May 2012, between participants and controls. Results Children with type-1 diabetes were followed up for a total of 12 102 person years and were at 480% (incidence rate ratios, IRR 5.789, (95% CI 5.34 to 6.723), p<0.0001) increased risk of hospital admission in comparison to matched controls. The highest absolute excess of admission was in the age group of 0–5 years, with a 15.4% (IRR 0.846, (95% CI 0.744 to 0.965), p=0.0061) reduction in hospital admissions for every 5-year increase in age at diagnosis. A trend of increasing admission rates in lower socioeconomic status groups was also observed, but there was no evidence of a differential rate of admissions between men and women when adjusted for background risk. Those receiving outpatient care at large centres had a 16.1% (IRR 0.839, (95% CI 0.709 to 0.990), p=0.0189) reduction in hospital admissions compared with those treated at small centres. Conclusions There is a large excess of hospital admissions in paediatric patients with type-1 diabetes. Rates are highest in the youngest children with low socioeconomic status. Factors influencing higher admission rates in smaller centres (eg, “out of hours resources”) need to be explored with the aim of targeting modifiable influences on admission rates. PMID

  6. Surface characteristics modeling and performance evaluation of urban building materials using LiDAR data.

    PubMed

    Li, Xiaolu; Liang, Yu

    2015-05-20

    Analysis of light detection and ranging (LiDAR) intensity data to extract surface features is of great interest in remote sensing research. One potential application of LiDAR intensity data is target classification. A new bidirectional reflectance distribution function (BRDF) model is derived for target characterization of rough and smooth surfaces. Based on the geometry of our coaxial full-waveform LiDAR system, the integration method is improved through coordinate transformation to establish the relationship between the BRDF model and intensity data of LiDAR. A series of experiments using typical urban building materials are implemented to validate the proposed BRDF model and integration method. The fitting results show that three parameters extracted from the proposed BRDF model can distinguish the urban building materials from perspectives of roughness, specular reflectance, and diffuse reflectance. A comprehensive analysis of these parameters will help characterize surface features in a physically rigorous manner.

  7. Automatic representation and reconstruction of DBM from LiDAR data using Recursive Minimum Bounding Rectangle

    NASA Astrophysics Data System (ADS)

    Kwak, Eunju; Habib, Ayman

    2014-07-01

    Three-dimensional building models are important for various applications, such as disaster management and urban planning. The development of laser scanning sensor technologies has resulted in many different approaches for efficient building model generation using LiDAR data. Despite this effort, generation of these models lacks economical and reliable techniques that fully exploit the advantage of LiDAR data. Therefore, this research aims to develop a framework for fully-automated building model generation by integrating data-driven and model-driven methods using LiDAR datasets. The building model generation starts by employing LiDAR data for building detection and approximate boundary determination. The generated building boundaries are then integrated into a model-based processing strategy because LiDAR derived planes show irregular boundaries due to the nature of LiDAR point acquisition. The focus of the research is generating models for the buildings with right-angled-corners, which can be described with a collection of rectangles under the assumption that the majority of the buildings in urban areas belong to this category. Therefore, by applying the Minimum Bounding Rectangle (MBR) algorithm recursively, the LiDAR boundaries are decomposed into sets of rectangles for further processing. At the same time, the quality of the MBRs is examined to verify that the buildings, from which the boundaries are generated, are buildings with right-angled-corners. The parameters that define the model primitives are adjusted through a model-based boundary fitting procedure using LiDAR boundaries. The level of details in the final Digital Building Model is based on the number of recursions during the MBR processing, which in turn are determined by the LiDAR point density. The model-based boundary fitting improves the quality of the generated boundaries and as seen in experimental results, the quality depends on the average LiDAR point spacing. This research thus develops an

  8. Detecting understory plant invasion in urban forests using LiDAR

    NASA Astrophysics Data System (ADS)

    Singh, Kunwar K.; Davis, Amy J.; Meentemeyer, Ross K.

    2015-06-01

    Light detection and ranging (LiDAR) data are increasingly used to measure structural characteristics of urban forests but are rarely used to detect the growing problem of exotic understory plant invaders. We explored the merits of using LiDAR-derived metrics alone and through integration with spectral data to detect the spatial distribution of the exotic understory plant Ligustrum sinense, a rapidly spreading invader in the urbanizing region of Charlotte, North Carolina, USA. We analyzed regional-scale L. sinense occurrence data collected over the course of three years with LiDAR-derived metrics of forest structure that were categorized into the following groups: overstory, understory, topography, and overall vegetation characteristics, and IKONOS spectral features - optical. Using random forest (RF) and logistic regression (LR) classifiers, we assessed the relative contributions of LiDAR and IKONOS derived variables to the detection of L. sinense. We compared the top performing models developed for a smaller, nested experimental extent using RF and LR classifiers, and used the best overall model to produce a predictive map of the spatial distribution of L. sinense across our country-wide study extent. RF classification of LiDAR-derived topography metrics produced the highest mapping accuracy estimates, outperforming IKONOS data by 17.5% and the integration of LiDAR and IKONOS data by 5.3%. The top performing model from the RF classifier produced the highest kappa of 64.8%, improving on the parsimonious LR model kappa by 31.1% with a moderate gain of 6.2% over the county extent model. Our results demonstrate the superiority of LiDAR-derived metrics over spectral data and fusion of LiDAR and spectral data for accurately mapping the spatial distribution of the forest understory invader L. sinense.

  9. Aboveground Biomass Modeling from Field and LiDAR Data in Brazilian Amazon Tropical Rain Forest

    NASA Astrophysics Data System (ADS)

    Silva, C. A.; Hudak, A. T.; Vierling, L. A.; Keller, M. M.; Klauberg Silva, C. K.

    2015-12-01

    Tropical forests are an important component of global carbon stocks, but tropical forest responses to climate change are not sufficiently studied or understood. Among remote sensing technologies, airborne LiDAR (Light Detection and Ranging) may be best suited for quantifying tropical forest carbon stocks. Our objective was to estimate aboveground biomass (AGB) using airborne LiDAR and field plot data in Brazilian tropical rain forest. Forest attributes such as tree density, diameter at breast height, and heights were measured at a combination of square plots and linear transects (n=82) distributed across six different geographic zones in the Amazon. Using previously published allometric equations, tree AGB was computed and then summed to calculate total AGB at each sample plot. LiDAR-derived canopy structure metrics were also computed at each sample plot, and random forest regression modelling was applied to predict AGB from selected LiDAR metrics. The LiDAR-derived AGB model was assessed using the random forest explained variation, adjusted coefficient of determination (Adj. R²), root mean square error (RMSE, both absolute and relative) and BIAS (both absolute and relative). Our findings showed that the 99th percentile of height and height skewness were the best LiDAR metrics for AGB prediction. The AGB model using these two best predictors explained 59.59% of AGB variation, with an Adj. R² of 0.92, RMSE of 33.37 Mg/ha (20.28%), and bias of -0.69 (-0.42%). This study showed that LiDAR canopy structure metrics can be used to predict AGC stocks in Tropical Forest with acceptable precision and accuracy. Therefore, we conclude that there is good potential to monitor carbon sequestration in Brazilian Tropical Rain Forest using airborne LiDAR data, large field plots, and the random forest algorithm.

  10. Synergy of VSWIR and LiDAR for Ecosystem Structure, Biomass, and Canopy Diversity

    NASA Technical Reports Server (NTRS)

    Cook, Bruce D.; Asner, Gregory P.

    2010-01-01

    This slide presentation reviews the use of Visible ShortWave InfraRed (VSWIR) Imaging Spectrometer and LiDAR to study ecosystem structure, biomass and canopy diversity. It is shown that the biophysical data from LiDAR and biochemical information from hyperspectral remote sensing provides complementary data for: (1) describing spatial patterns of vegetation and biodiversity, (2) characterizing relationships between ecosystem form and function, and (3) detecting natural and human induced change that affects the biogeochemical cycles.

  11. Modeling marbled murrelet (Brachyramphus marmoratus) habitat using LiDAR-derived canopy data

    USGS Publications Warehouse

    Hagar, Joan C.; Eskelson, Bianca N.I.; Haggerty, Patricia K.; Nelson, S. Kim; Vesely, David G.

    2014-01-01

    LiDAR (Light Detection And Ranging) is an emerging remote-sensing tool that can provide fine-scale data describing vertical complexity of vegetation relevant to species that are responsive to forest structure. We used LiDAR data to estimate occupancy probability for the federally threatened marbled murrelet (Brachyramphus marmoratus) in the Oregon Coast Range of the United States. Our goal was to address the need identified in the Recovery Plan for a more accurate estimate of the availability of nesting habitat by developing occupancy maps based on refined measures of nest-strand structure. We used murrelet occupancy data collected by the Bureau of Land Management Coos Bay District, and canopy metrics calculated from discrete return airborne LiDAR data, to fit a logistic regression model predicting the probability of occupancy. Our final model for stand-level occupancy included distance to coast, and 5 LiDAR-derived variables describing canopy structure. With an area under the curve value (AUC) of 0.74, this model had acceptable discrimination and fair agreement (Cohen's κ = 0.24), especially considering that all sites in our sample were regarded by managers as potential habitat. The LiDAR model provided better discrimination between occupied and unoccupied sites than did a model using variables derived from Gradient Nearest Neighbor maps that were previously reported as important predictors of murrelet occupancy (AUC = 0.64, κ = 0.12). We also evaluated LiDAR metrics at 11 known murrelet nest sites. Two LiDAR-derived variables accurately discriminated nest sites from random sites (average AUC = 0.91). LiDAR provided a means of quantifying 3-dimensional canopy structure with variables that are ecologically relevant to murrelet nesting habitat, and have not been as accurately quantified by other mensuration methods.

  12. Urban Classification Techniques Using the Fusion of LiDAR and Spectral Data

    DTIC Science & Technology

    2012-09-01

    TECHNIQUES USING THE FUSION OF LIDAR AND SPECTRAL DATA by Justin E. Mesina September 2012 Thesis Advisor: Richard C. Olsen Second...TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE Urban Classification Techniques Using the Fusion of LiDAR and Spectral Data 5...the potential to be more accurate than a single sensor. This research fused airborne LiDAR data and WorldView-2 (WV-2) multispectral imagery (MSI) data

  13. Automated Aerial Refueling Position Estimation Using a Scanning LiDAR

    DTIC Science & Technology

    2012-03-22

    early analysis of algorithms that use LiDAR measurements [20]. Powell et al. [21] have shown LiDAR simulation with commercial ray tracing software is... tracing , where ray tracing is considered the true measurement. The speedup from using these two methods over the brute force methods is required to...as dark green arrows, are used to determine the green set of points. These points trace out the base of a cone created by all the slope lines

  14. Have I Been Here Before? A Method for Detecting Loop Closure With LiDAR

    DTIC Science & Technology

    2015-01-01

    JOHN G ROGERS III (1 HC, 1 PDF) JASON M GREGORY (1 HC, 1 PDF) STUART H YOUNG (1 PDF) 18 INTENTIONALLY LEFT BLANK. ...Have I Been Here Before? A Method for Detecting Loop Closure With LiDAR by John G Rogers III and Jason M Gregory ARL-TR-7165 January...TR-7165 January 2015 Have I Been Here Before? A Method for Detecting Loop Closure With LiDAR John G Rogers III and Jason M

  15. A national case-crossover analysis of the short-term effect of PM2.5 on hospitalizations and mortality in subjects with diabetes and neurological disorders

    PubMed Central

    2014-01-01

    Background Diabetes and neurological disorders are a growing burden among the elderly, and may also make them more susceptible to particulate air matter with aerodynamic diameter less than 2.5 μg (PM2.5). The same biological responses thought to effect cardiovascular disease through air pollution-mediated systemic oxidative stress, inflammation and cerebrovascular dysfunction could also be relevant for diabetes and neurodegenerative diseases. Methods We conducted multi-site case-crossover analyses of all-cause deaths and of hospitalizations for diabetes or neurological disorders among Medicare enrollees (>65 years) during the period 1999 to 2010 in 121 US communities. We examined whether 1) short-term exposure to PM2.5 increases the risk of hospitalization for diabetes or neurological disorders, and 2) the association between short-term exposure to PM2.5 and all-cause mortality is modified by having a previous hospitalization of diabetes or neurological disorders. Results We found that short term exposure to PM2.5 is significantly associated with an increase in hospitalization risks for diabetes (1.14% increase, 95% CI: 0.56, 1.73 for a 10 μg/m3 increase in the 2 days average), and for Parkinson’s disease (3.23%, 1.08, 5.43); we also found an increase in all-cause mortality risks (0.64%, 95% CI: 0.42, 0.85), but we didn’t find that hospitalization for diabetes and neurodegenerative diseases modifies the association between short term exposure to PM2.5 and all-cause mortality. Conclusion We found that short-term exposure to fine particles increased the risk of hospitalizations for Parkinson’s disease and diabetes, and of all-cause mortality. While the association between short term exposure to PM2.5 and mortality was higher among Medicare enrollees that had a previous admission for diabetes and neurological disorders than among Medicare enrollees that did not had a prior admission for these diseases, the effect modification was not statistically

  16. On the impact of a refined stochastic model for airborne LiDAR measurements

    NASA Astrophysics Data System (ADS)

    Bolkas, Dimitrios; Fotopoulos, Georgia; Glennie, Craig

    2016-09-01

    Accurate topographic information is critical for a number of applications in science and engineering. In recent years, airborne light detection and ranging (LiDAR) has become a standard tool for acquiring high quality topographic information. The assessment of airborne LiDAR derived DEMs is typically based on (i) independent ground control points and (ii) forward error propagation utilizing the LiDAR geo-referencing equation. The latter approach is dependent on the stochastic model information of the LiDAR observation components. In this paper, the well-known statistical tool of variance component estimation (VCE) is implemented for a dataset in Houston, Texas, in order to refine the initial stochastic information. Simulations demonstrate the impact of stochastic-model refinement for two practical applications, namely coastal inundation mapping and surface displacement estimation. Results highlight scenarios where erroneous stochastic information is detrimental. Furthermore, the refined stochastic information provides insights on the effect of each LiDAR measurement in the airborne LiDAR error budget. The latter is important for targeting future advancements in order to improve point cloud accuracy.

  17. Patterns and loss of sexual activity in the year following hospitalization for acute myocardial infarction (a United States National Multisite Observational Study).

    PubMed

    Lindau, Stacy Tessler; Abramsohn, Emily; Gosch, Kensey; Wroblewski, Kristen; Spatz, Erica S; Chan, Paul S; Spertus, John; Krumholz, Harlan M

    2012-05-15

    A multisite observational study of sexual activity-related outcomes in patients enrolled in the TRIUMPH registry during hospitalization for an acute myocardial infarction (AMI) was conducted to identify patterns and loss of sexual activity 1 year after hospitalization for AMI. Gender-specific multivariable hierarchical models were used to identify correlates of loss of sexual activity including physician counseling. Main outcome measurements included "loss of sexual activity" (less frequent or no sexual activity 1 year after an AMI in those who were sexually active in the year before the AMI) and 1-year mortality. Mean ages were 61.1 years for women (n = 605) and 58.6 years for men (n = 1,274). Many were sexually active in the year before and 1 year after hospitalization (44% and 40% of women, 74% and 68% of men, respectively). One third of women and 47% of men reported receiving hospital discharge instructions about resuming sex. Those who did not receive instructions were more likely to report loss of sexual activity (women, adjusted relative risk 1.44, 95% confidence interval 1.16 to 1.79; men, adjusted relative risk 1.27, 95% confidence interval 1.11 to 1.46). One year mortality after AMI was similar in those who reported sexual activity in the first month after AMI (2.1%) and those who were sexually inactive (4.1%, p = 0.08). In conclusion, although many patients were sexually active before AMI, only a minority received discharge counseling about resuming sexual activity. Lack of counseling was associated with loss of sexual activity 1 year later. Mortality was not significantly increased in patients who were sexually active soon after their AMI.

  18. The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation

    PubMed Central

    Doran, Tim; Cookson, Richard

    2016-01-01

    Background There are substantial socioeconomic inequalities in both life expectancy and healthcare use in England. In this study, we describe how these two sets of inequalities interact by estimating the social gradient in hospital costs across the life course. Methods Hospital episode statistics, population and index of multiple deprivation data were combined at lower-layer super output area level to estimate inpatient hospital costs for 2011/2012 by age, sex and deprivation quintile. Survival curves were estimated for each of the deprivation groups and used to estimate expected annual costs and cumulative lifetime costs. Results A steep social gradient was observed in overall inpatient hospital admissions, with rates ranging from 31 298/100 000 population in the most affluent fifth of areas to 43 385 in the most deprived fifth. This gradient was steeper for emergency than for elective admissions. The total cost associated with this inequality in 2011/2012 was £4.8 billion. A social gradient was also observed in the modelled lifetime costs where the lower life expectancy was not sufficient to outweigh the higher average costs in the more deprived populations. Lifetime costs for women were 14% greater than for men, due to higher costs in the reproductive years and greater life expectancy. Conclusions Socioeconomic inequalities result in increased morbidity and decreased life expectancy. Interventions to reduce inequality and improve health in more deprived neighbourhoods have the potential to save money for health systems not only within years but across peoples’ entire lifetimes, despite increased costs due to longer life expectancies. PMID:27189975

  19. Syndromic approach to treatment of snake bite in Sri Lanka based on results of a prospective national hospital-based survey of patients envenomed by identified snakes.

    PubMed

    Ariaratnam, Christeine A; Sheriff, Mohamed H Rezvi; Arambepola, Carukshi; Theakston, R David G; Warrell, David A

    2009-10-01

    Of 860 snakes brought to 10 hospitals in Sri Lanka with the patients they had bitten, 762 (89%) were venomous. Russell's vipers (Daboia russelii) and hump-nosed pit vipers (Hypnale hypnale) were the most numerous and H. hypnale was the most widely distributed. Fifty-one (6%) were misidentified by hospital staff, causing inappropriate antivenom treatment of 13 patients. Distinctive clinical syndromes were identified to aid species diagnosis in most cases of snake bite in Sri Lanka where the biting species is unknown. Diagnostic sensitivities and specificities of these syndromes for envenoming were 78% and 96% by Naja naja, 66% and 100% by Bungarus caeruleus, 14% and 100% by Daboia russelii, and 10% and 97% by Hypnale hypnale, respectively. Although only polyspecific antivenoms are used in Sri Lanka, species diagnosis remains important to anticipate life-threatening complications such as local necrosis, hemorrhage and renal and respiratory failure and to identify likely victims of envenoming by H. hypnale who will not benefit from existing antivenoms. The technique of hospital-based collection, labeling and preservation of dead snakes brought by bitten patients is recommended for rapid assessment of a country's medically-important herpetofauna.

  20. Mother-baby friendly hospital.

    PubMed

    Aragon-choudhury, P

    1996-01-01

    In Manila, the Philippines, the Dr. Jose Fabella Memorial Hospital has been a maternity hospital for 75 years. It averages 90 deliveries a day. Its fees are P200-P500 for a normal delivery and P800-P2000 for a cesarean section. Patients pay what they can and pay the balance when they can. The hospital provides a safe motherhood package that encompasses teaching responsible parenthood, prenatal care, labor, delivery, postpartum care, breast feeding, family planning, and child survival. In 1986, the hospital introduced innovative policies and procedures that promote, protect, and support breast feeding. It has a rooming-in policy that has saved the hospital P6.5 million so far. In the prenatal stage, hospital staff inform pregnant women that colostrum protects the newborn against infections, that suckling stimulates milk production, and that there is no basis to the claim of having insufficient breast milk. Sales representatives of milk substitutes are banned from the hospital. Staff confiscate milk bottles or formula. A lactation management team demonstrates breast feeding procedures. Mothers also receive support on the correct way of breast feeding from hospital staff, volunteers from the Catholic Women's League, consumer groups, and women lawyers. The hospital's policy is no breast milk, no discharge. This encourages mothers to motivate each other to express milk immediately after birth. The hospital has received numerous awards for its breast feeding promotion efforts. UNICEF has designated Fabella Hospital as a model of the Baby-Friendly Hospital Initiative. The hospital serves as the National Lactation Management Education Training Center. People from other developing countries have received training in lactation management here. The First Lady of the Philippines, the First Lady of the US, and the Queen of Spain have all visited the hospital. The hospital has also integrated its existing services into a women's health care center.

  1. Homicide of children in Dar es Salaam, Tanzania, 2005

    PubMed Central

    Outwater, Anne; Mgaya, Edward; Campbell, Jacquelyn C.; Becker, Stan; Kinabo, Linna; Menick, Daniel Mbassa

    2014-01-01

    Background Although data are sparse, it has been estimated that the highest rates of homicide death amongst children are in Africa. Little information is available on ages 0 -< 15 years. No reliable quantitative surveillance analysis of neonaticide (killed at less than one week) has been done. Methods A Violent Death Survey following WHO/CDC Guidelines was completed in Dar es Salaam region, Tanzania (DSM) (population 2.845 million) in 2005. Qualitative and quantitative data were gathered and analyzed using mixed methods techniques. Results The overall age adjusted rate of discarded and killed children in DSM was 2.05. The rate of neonaticide was 27.7 per 100,000) while the rate of homicide incidence for children > one day was Discussion The overall estimated homicide rate for Africa of children under age 15 was 4.53 per 100,000, whereas. The estimated global rate is 1.7 per 100,000 closer to DSM‘s rate. The results in DSM show that broad age groupings such as ” <1 year” or “0–4 years” or “0 – <15 years” may mask a high incidence of neonaticide and an otherwise low incidence of murdered children. The print media provided good in-depth coverage for a few cases but it is not known if the reported cases are representative. Conclusion Eighty percent of homicides of children in DSM are neonaticides. Since it is believed that the forces behind neonaticide are fundamentally different than homicides of older children, it is suggested that data of future surveys be parsed to include neonates, until the phenomenon is more clearly understood and addressed. Further understanding of the mother and father of the deceased is needed. Continued surveillance data collection is important to expand the sample size. PMID:22066333

  2. Quantifying Forest Carbon and Structure with Terrestrial LiDAR

    NASA Astrophysics Data System (ADS)

    Stovall, A. E.; Shugart, H. H., Jr.

    2014-12-01

    Current rising atmospheric CO2 concentrations are a major concern with significant global ramifications, however, of the carbon (C) fluxes that are known to occur on Earth, the terrestrial sink has the greatest amount of uncertainty. Improved monitoring of forest cover and change is required for reducing emissions from deforestation and forest degradation (REDD). We determine C storage from volume measurements with a high-precision Terrestrial Laser Scanner (TLS), substantially improving current standard ground validation techniques. This technology is utilized on several 30 m x 30 m plots in a Virginia temperate forest. Aboveground C is calculated on each of the study sites with commonly used allometric equations to offer a realistic comparison of field-based estimations to TLS-derived methods. The TLS and aerial LiDAR point cloud data are compared via the development of canopy height models at the plot scale. The novel method of point cloud voxelization is applied to our TLS data in order to produce detailed volumetric calculations in these complex forest ecosystems. Statistical output from the TLS data allows us to resolve and compare forest structure on scales from the individual plot to the entire forest landscape. The estimates produced from this research will be used to inform more widely available remote sensing datasets provided by NASA's Landsat satellites, significantly reducing the uncertainty of the terrestrial C cycle in temperate forests. Preliminary findings corroborate previous research, suggesting the potential for highly detailed monitoring of forest C storage as defined by the REDD initiative and analysis of complex ecosystem structure.

  3. Classification of LiDAR Data with Point Based Classification Methods

    NASA Astrophysics Data System (ADS)

    Yastikli, N.; Cetin, Z.

    2016-06-01

    LiDAR is one of the most effective systems for 3 dimensional (3D) data collection in wide areas. Nowadays, airborne LiDAR data is used frequently in various applications such as object extraction, 3D modelling, change detection and revision of maps with increasing point density and accuracy. The classification of the LiDAR points is the first step of LiDAR data processing chain and should be handled in proper way since the 3D city modelling, building extraction, DEM generation, etc. applications directly use the classified point clouds. The different classification methods can be seen in recent researches and most of researches work with the gridded LiDAR point cloud. In grid based data processing of the LiDAR data, the characteristic point loss in the LiDAR point cloud especially vegetation and buildings or losing height accuracy during the interpolation stage are inevitable. In this case, the possible solution is the use of the raw point cloud data for classification to avoid data and accuracy loss in gridding process. In this study, the point based classification possibilities of the LiDAR point cloud is investigated to obtain more accurate classes. The automatic point based approaches, which are based on hierarchical rules, have been proposed to achieve ground, building and vegetation classes using the raw LiDAR point cloud data. In proposed approaches, every single LiDAR point is analyzed according to their features such as height, multi-return, etc. then automatically assigned to the class which they belong to. The use of un-gridded point cloud in proposed point based classification process helped the determination of more realistic rule sets. The detailed parameter analyses have been performed to obtain the most appropriate parameters in the rule sets to achieve accurate classes. The hierarchical rule sets were created for proposed Approach 1 (using selected spatial-based and echo-based features) and Approach 2 (using only selected spatial-based features

  4. National Policies towards Broadcasting in Tanzania.

    ERIC Educational Resources Information Center

    Samwilu-Mwaffisi, M.

    The main thesis of this paper, which uses Tanzania's broadcasting system--Radio Tanzania Dar Es Salaam (RTD)--as a case study, is that media systems reflect the political and economic systems of the nation within which they operate subject to certain constraints. This discussion includes: (1) the history of the country's broadcasting policy before…

  5. The risks of getting hospital discharge wrong.

    PubMed

    2016-08-01

    Hospital discharge remains a hot topic for all of us who work with older people. As the recent National Audit Office (NAO) 2016 report on discharging older patients from hospital rather bluntly put it: 'There are currently far too many older people in hospitals who do not need to be there.'

  6. Hospital marketing.

    PubMed

    Carter, Tony

    2003-01-01

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

  7. Hospital philanthropy.

    PubMed

    Smith, Dean G; Clement, Jan P

    2013-01-01

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

  8. The effect of ozone and PM10 on hospital admissions for pneumonia and chronic obstructive pulmonary disease: a national multicity study.

    PubMed

    Medina-Ramón, Mercedes; Zanobetti, Antonella; Schwartz, Joel

    2006-03-15

    A case-crossover study was conducted in 36 US cities to evaluate the effect of ozone and particulate matter with an aerodynamic diameter of < or =10 microm (PM10) on respiratory hospital admissions and to identify which city characteristics may explain the heterogeneity in risk estimates. Respiratory hospital admissions and air pollution data were obtained for 1986-1999. In a meta-analysis based on the city-specific regression models, several city characteristics were evaluated as effect modifiers. During the warm season, the 2-day cumulative effect of a 5-ppb increase in ozone was a 0.27% (95% confidence interval (CI): 0.08, 0.47) increase in chronic obstructive pulmonary disease admissions and a 0.41% (95% CI: 0.26, 0.57) increase in pneumonia admissions. Similarly, a 10-microg/m(3) increase in PM10 during the warm season resulted in a 1.47% (95% CI: 0.93, 2.01) increase in chronic obstructive pulmonary disease at lag 1 and a 0.84% (95% CI: 0.50, 1.19) increase in pneumonia at lag 0. Percentage of households with central air conditioning reduced the effect of air pollution, and variability of summer apparent temperature reduced the effect of ozone on chronic obstructive pulmonary disease. The study confirmed, in a large sample of cities, that exposure to ozone and PM10 is associated with respiratory hospital admissions and provided evidence that the effect of air pollution is modified by certain city characteristics.

  9. Effects of LiDAR point density and landscape context on estimates of urban forest biomass

    NASA Astrophysics Data System (ADS)

    Singh, Kunwar K.; Chen, Gang; McCarter, James B.; Meentemeyer, Ross K.

    2015-03-01

    Light Detection and Ranging (LiDAR) data is being increasingly used as an effective alternative to conventional optical remote sensing to accurately estimate aboveground forest biomass ranging from individual tree to stand levels. Recent advancements in LiDAR technology have resulted in higher point densities and improved data accuracies accompanied by challenges for procuring and processing voluminous LiDAR data for large-area assessments. Reducing point density lowers data acquisition costs and overcomes computational challenges for large-area forest assessments. However, how does lower point density impact the accuracy of biomass estimation in forests containing a great level of anthropogenic disturbance? We evaluate the effects of LiDAR point density on the biomass estimation of remnant forests in the rapidly urbanizing region of Charlotte, North Carolina, USA. We used multiple linear regression to establish a statistical relationship between field-measured biomass and predictor variables derived from LiDAR data with varying densities. We compared the estimation accuracies between a general Urban Forest type and three Forest Type models (evergreen, deciduous, and mixed) and quantified the degree to which landscape context influenced biomass estimation. The explained biomass variance of the Urban Forest model, using adjusted R2, was consistent across the reduced point densities, with the highest difference of 11.5% between the 100% and 1% point densities. The combined estimates of Forest Type biomass models outperformed the Urban Forest models at the representative point densities (100% and 40%). The Urban Forest biomass model with development density of 125 m radius produced the highest adjusted R2 (0.83 and 0.82 at 100% and 40% LiDAR point densities, respectively) and the lowest RMSE values, highlighting a distance impact of development on biomass estimation. Our evaluation suggests that reducing LiDAR point density is a viable solution to regional

  10. Elements of systemic sensitivity and propagated uncertainty in LiDAR-based forest attribute maps (Invited)

    NASA Astrophysics Data System (ADS)

    Hopkinson, C.; Chasmer, L.; Kljun, N.; van Gorsel, E.

    2013-12-01

    The application of airborne LiDAR to vegetation and forest attribute extraction and modeling is now common place. Direct estimates of tree-, plot- or stand-level height and canopy cover are frequently made as pre-cursors to more complex and indirect attribute derivations such as leaf area, biomass, basal area, fuel, even species. Frequently, the faith placed in LiDAR to produce these spatial variables appears so complete that raw data properties or the methods employed in the modeling of direct or indirect attributes are glossed over. The assumption being that if basic variables and derivatives can be easily predicted across a few studies, then it follows this will always be the case. Few studies address explicitly the range of sensitivity in direct and indirect forest attribute estimations: a) derived from LiDAR data of differing fundamental acquisition or point cloud properties; or b) produced using different data extraction, filtering or raster interpolation approaches. The paper will illustrate some of the critical acquisition and point cloud attributes (such as pulse power, flight line configuration, timing and point density) that strongly influence mapped and modeled forest attributes at a range of case study sites in North America and Australia. Further, the influence of multiple seemingly defensible canopy height model generation criteria will be compared to illustrate the high sensitivity in even the most basic of LiDAR-based forest attribute maps. We conclude that not all LiDAR are created equal and that both raw data properties and all data manipulation steps must be communicated when utilising such data. Finally, we believe that as with more standard products like LiDAR point cloud formats and digital terrain models (DTMs), an international committee is needed to provide guidance on airborne LiDAR vegetation products so that uncertainties can be mitigated when data are shared or compared across sites and through time.

  11. Estimation of effective plant area index for South Korean forests using LiDAR system.

    PubMed

    Kwak, Doo-Ahn; Lee, Woo-Kyun; Kafatos, Menas; Son, Yowhan; Cho, Hyun-Kook; Lee, Seung-Ho

    2010-07-01

    Light Detection and Ranging (LiDAR) systems can be used to estimate both vertical and horizontal forest structure. Woody components, the leaves of trees and the understory can be described with high precision, using geo-registered 3D-points. Based on this concept, the Effective Plant Area Indices (PAI(e)) for areas of Korean Pine (Pinus koraiensis), Japanese Larch (Larix leptolepis) and Oak (Quercus spp.) were estimated by calculating the ratio of intercepted and incident LIDAR laser rays for the canopies of the three forest types. Initially, the canopy gap fraction (G ( LiDAR )) was generated by extracting the LiDAR data reflected from the canopy surface, or inner canopy area, using k-means statistics. The LiDAR-derived PAI(e) was then estimated by using G ( LIDAR ) with the Beer-Lambert law. A comparison of the LiDAR-derived and field-derived PAI(e) revealed the coefficients of determination for Korean Pine, Japanese Larch and Oak to be 0.82, 0.64 and 0.59, respectively. These differences between field-based and LIDAR-based PAI(e) for the different forest types were attributed to the amount of leaves and branches in the forest stands. The absence of leaves, in the case of both Larch and Oak, meant that the LiDAR pulses were only reflected from branches. The probability that the LiDAR pulses are reflected from bare branches is low as compared to the reflection from branches with a high leaf density. This is because the size of the branch is smaller than the resolution across and along the 1 meter LIDAR laser track. Therefore, a better predictive accuracy would be expected for the model if the study would be repeated in late spring when the shoots and leaves of the deciduous trees begin to appear.

  12. Estimating FPAR of maize canopy using airborne discrete-return LiDAR data.

    PubMed

    Luo, Shezhou; Wang, Cheng; Xi, Xiaohuan; Pan, Feifei

    2014-03-10

    The fraction of absorbed photosynthetically active radiation (FPAR) is a key parameter for ecosystem modeling, crop growth monitoring and yield prediction. Ground-based FPAR measurements are time consuming and labor intensive. Remote sensing provides an alternative method to obtain repeated, rapid and inexpensive estimates of FPAR over large areas. LiDAR is an active remote sensing technology and can be used to extract accurate canopy structure parameters. A method to estimating FPAR of maize from airborne discrete-return LiDAR data was developed and tested in this study. The raw LiDAR point clouds were processed to separate ground returns from vegetation returns using a filter method over a maize field in the Heihe River Basin, northwest China. The fractional cover (fCover) of maize canopy was computed using the ratio of canopy return counts or intensity sums to the total of returns or intensities. FPAR estimation models were established based on linear regression analysis between the LiDAR-derived fCover and the field-measured FPAR (R(2) = 0.90, RMSE = 0.032, p < 0.001). The reliability of the constructed regression model was assessed using the leave-one-out cross-validation procedure and results show that the regression model is not overfitting the data and has a good generalization capability. Finally, 15 independent field-measured FPARs were used to evaluate accuracy of the LiDAR-predicted FPARs and results show that the LiDAR-predicted FPAR has a high accuracy (R(2) = 0.89, RMSE = 0.034). In summary, this study suggests that the airborne discrete-return LiDAR data could be adopted to accurately estimate FPAR of maize.

  13. Using satellite and airborne LiDAR to model woodpecker habitat occupancy at the landscape scale.

    PubMed

    Vierling, Lee A; Vierling, Kerri T; Adam, Patrick; Hudak, Andrew T

    2013-01-01

    Incorporating vertical vegetation structure into models of animal distributions can improve understanding of the patterns and processes governing habitat selection. LiDAR can provide such structural information, but these data are typically collected via aircraft and thus are limited in spatial extent. Our objective was to explore the utility of satellite-based LiDAR data from the Geoscience Laser Altimeter System (GLAS) relative to airborne-based LiDAR to model the north Idaho breeding distribution of a forest-dependent ecosystem engineer, the Red-naped sapsucker (Sphyrapicus nuchalis). GLAS data occurred within ca. 64 m diameter ellipses spaced a minimum of 172 m apart, and all occupancy analyses were confined to this grain scale. Using a hierarchical approach, we modeled Red-naped sapsucker occupancy as a function of LiDAR metrics derived from both platforms. Occupancy models based on satellite data were weak, possibly because the data within the GLAS ellipse did not fully represent habitat characteristics important for this species. The most important structural variables influencing Red-naped Sapsucker breeding site selection based on airborne LiDAR data included foliage height diversity, the distance between major strata in the canopy vertical profile, and the vegetation density near the ground. These characteristics are consistent with the diversity of foraging activities exhibited by this species. To our knowledge, this study represents the first to examine the utility of satellite-based LiDAR to model animal distributions. The large area of each GLAS ellipse and the non-contiguous nature of GLAS data may pose significant challenges for wildlife distribution modeling; nevertheless these data can provide useful information on ecosystem vertical structure, particularly in areas of gentle terrain. Additional work is thus warranted to utilize LiDAR datasets collected from both airborne and past and future satellite platforms (e.g. GLAS, and the planned IceSAT2

  14. Demonstration of LiDAR and Orthophotography for Wide Area Assessment at Pueblo Precision Bombing Range #2, Colorado

    DTIC Science & Technology

    2008-01-01

    for classification of LiDAR points into vegetation, ground, and “other,” creating bare earth and surface model digital terrain models ( DTM ...for rectification of the photography to the DTM . 2.1.6 Data Analysis Once processed, the LiDAR /orthophotography datasets are analyzed to...creation: Triangulation results were loaded into ortho-processing software, along with a LiDAR -derived DTM and aerial photography. Aerial photographs

  15. Quantifying wind blown landscapes using time-series airborne LiDAR at White Sands Dune Field, New Mexico

    NASA Astrophysics Data System (ADS)

    Ewing, R. C.

    2011-12-01

    Wind blown landscapes are a default geomorphic and sedimentary environment in our solar system. Wind sand dunes are ubiquitous features on the surfaces of Earth, Mars and Titan and prevalent within the aeolian rock records of Earth and Mars. Dunes are sensitive to environmental and climatic changes and a complete understanding of this system promises a unique, robust and quantitative record of paleoclimate extending to the early histories of these worlds. However, our understanding of how aeolian dune landscapes evolve and how the details of the wind are recorded in cross-strata is limited by our lack of understanding of three-dimensional dune morphodynamics related to changing boundary conditions such as wind direction and magnitude and sediment source area. We use airborne LiDAR datasets over 40 km2 of White Sands Dune Field collected from June 2007, June 2008, January 2009, September 2009 and June 2010 to quantify 1) three-dimensional dune geometries, 2) annual and seasonal patterns of erosion and deposition across dune topography, 3) spatial changes in sediment flux related to position within the field, 4) spatial changes in sediment flux across sinuous crestlines and 5) morphologic changes through dune-dune interactions. In addition to measurements, we use the LiDAR data along with wind data from two near-by weather stations to develop a simple model that predicts depositional and stratigraphic patterns on dune lee slopes. Several challenges emerged using time series LiDAR data sets at White Sands Dune Field. The topography upon which the dunes sit is variable and rises by 16 meters over the length of the dune field. In order to compare individual dune geometries across the field and between data sets a base surface was interpolated from local minima and subtracted from the dune topography. Co-registration and error calculation between datasets was done manually using permanent vegetated features within the active dune field and structures built by the

  16. Risk Factors of Loss to Follow up Among HIV Positive Pediatric Patients in Dar es Salaam, Tanzania

    PubMed Central

    MCCORMICK, Nora M.; LI, Nan; SANDO, David; MUYA, Aisa; MANJI, Karim P.; KISENGE, Rodrick; DUGGAN, Christopher; CHALAMILLA, Guerino; FAWZI, Wafaie W.; SPIEGELMAN, Donna

    2015-01-01

    Objective To identify risk factors for loss to follow up (LTFU) in an HIV-infected pediatric population in Dar es Salaam, Tanzania between 2004 and 2011. Design Longitudinal analysis of 6236 HIV-infected children. Methods We conducted a prospective cohort study of 6236 pediatric patients enrolled in care and treatment in Dar es Salaam from October 2004 to September 2011. LTFU was defined as missing a clinic visit for >90 days for patients on ART and for >180 days for patients in care and monitoring. The relationship of baseline and time-varying characteristics to risk of LTFU was examined using a Cox proportional hazards model. Results 2130 children (34%) were LTFU over a median follow up of 16.7 months (IQR, 3.4–36.9). Factors independently associated with a higher risk of LTFU were age 2 years (RR=1.59, 95% CI 1.40–1.80), diarrhea at enrollment (RR=1.20, 95% CI 1.03–1.41), a low mid-upper arm circumference for age (RR=1.20, CI 1.05–1.37), eating protein 3 times a week (RR=1.39, 95% CI 1.05–1.90), taking cotrimoxazole (RR=1.39, 95% CI 1.06–1.81), initiating onto antiretrovirals (RR=1.37, 95% CI 1.17–1.61), receiving treatment at a hospital instead of a local facility (RR=1.39, 95% CI 1.06–1.41), and starting treatment in 2006 or later (RR=1.10, 95% CI 1.04–1.16). Conclusions Health workers should be aware of pediatric patients who are at greatest risk of LTFU, such as younger and undernourished patients, so that they can proactively counsel families about the importance of visit adherence. Findings support decentralization of HIV care to local facilities as opposed to hospitals. PMID:26247894

  17. Evaluation of an experimental LiDAR for surveying a shallow, braided, sand-bedded river

    USGS Publications Warehouse

    Kinzel, P.J.; Wright, C.W.; Nelson, J.M.; Burman, A.R.

    2007-01-01

    Reaches of a shallow (<1.0m), braided, sand-bedded river were surveyed in 2002 and 2005 with the National Aeronautics and Space Administration's Experimental Advanced Airborne Research LiDAR (EAARL) and concurrently with conventional survey-grade, real-time kinematic, global positioning system technology. The laser pulses transmitted by the EAARL instrument and the return backscatter waveforms from exposed sand and submerged sand targets in the river were completely digitized and stored for postflight processing. The vertical mapping accuracy of the EAARL was evaluated by comparing the ellipsoidal heights computed from ranging measurements made using an EAARL terrestrial algorithm to nearby (<0.5m apart) ground-truth ellipsoidal heights. After correcting for apparent systematic bias in the surveys, the root mean square error of these heights with the terrestrial algorithm in the 2002 survey was 0.11m for the 26 measurements taken on exposed sand and 0.18m for the 59 measurements taken on submerged sand. In the 2005 survey, the root mean square error was 0.18m for 92 measurements taken on exposed sand and 0.24m for 434 measurements on submerged sand. In submerged areas the waveforms were complicated by reflections from the surface, water column entrained turbidity, and potentially the riverbed. When applied to these waveforms, especially in depths greater than 0.4m, the terrestrial algorithm calculated the range above the riverbed. A bathymetric algorithm has been developed to approximate the position of the riverbed in these convolved waveforms and preliminary results are encouraging. ?? 2007 ASCE.

  18. Evaluation Of Airborne LiDAR Data To Predict Presence / Absence

    NASA Astrophysics Data System (ADS)

    Palaseanu, M.; Nayegandhi, A.; Brock, J.; Woodman, R.; Wright, W. C.

    2008-12-01

    This study evaluates the capabilities of the NASA Experimental Advanced Airborne Research Lidar (EAARL) system in delineating vegetation assemblages in Jean Lafitte National Park, Louisiana. Five-meter-resolution grids of bare earth (BE), canopy height (CH), canopy-reflection ratio (CRR), and height of median energy (HOME) were derived from EAARL data acquired in September 2006. Ground-truth data were collected along transects to assess species composition, canopy cover, and ground cover. Comparisons of the capabilities of general linear models (GLM) and generalized additive models (GAM) were conducted using conventional evaluation methods (sensitivity, specificity, kappa statistics, area under the curve) and two new indexes, net reclassification improvement (NRI) and integrated discrimination improvement (IDI). GAMs were superior to GLMs in modeling the vegetation training data, but no statistically significant differences between the two models were achieved for predicting vegetation validation data using conventional evaluation methods, although statistically significant improvements in net reclassifications were observed. The goodness-of-fit and prediction accuracy for both models are influenced by data prevalence and occurrence, although GAM models perform much better in the case of training data for all vegetation communities. Vegetation communities with less than 60% prevalence (e.g., coarse woody debris, herbs, shrubs, floating aquatics, and palms) have less than 40% maximum deviance explained, with the exception of bare ground for which the deviance explained by the GAM model is 64%. Midstory and canopy trees that have over 80% prevalence and over 10% occurrence have 99% deviance explained by the GAM model. For the validation dataset with vegetation community prevalence above 35%, GAM models show improvements in NRI only for vegetation categories with occurrences above 10%, and improvements in IDI for vegetation categories with occurrences above 20

  19. [Retrieval of forest topsoil organic matter's spatial pattern based on LiDAR data].

    PubMed

    Li, Chao; Liu, Zhao-Gang; Yue, Shu-Feng; Li, Feng-Ri; Dong, Ling-Bo; Bi, Meng

    2012-09-01

    Forest soil is one of the main carbon pools in terrestrial ecosystem. Its organic matter content can provide basic information for estimating soil carbon storage, and also, is an important index for evaluating the function of soil carbon sink. Based on the LiDAR data and the topsoil organic matter contents in 55 permanent plots at Liangshui National Nature Reserve, Heilongjiang Province of Northeast China in August 2009, and by using partial least squares (PLS) method, this paper retrieved the forest topsoil organic matter's spatial pattern in the Reserve, extracted and screened the variables related to the distribution of the topsoil organic matter (e. g. , intensity, counts, elevation, slope, and aspect), and analyzed and defined the correlations between the screened variables and topsoil organic matter content, with the prediction model of forest soil organic matter content established and validated. In the Reserve, the forest topsoil organic matter content was significantly and positively correlated with three variables (intensity, r = 0.765; counts, r = 0.423; and elevation r = 0.475; all P<0.001). The model prediction on the topsoil organic matter content was reliable (precision = 83.3%, R2 = 0.725, RMSE = 1.955 ). In the areas of forest edge and of low canopy stands, the topsoil organic matter content was less than 100 g x kg(-1). The majority of the study area had a topsoil organic matter content of 100-150 g x kg(-1), while a few areas had the topsoil organic matter content as high as 150-318.4 g x kg(-1).

  20. Study of Ground Subsidence in North West Houston using GPS, LiDAR and InSAR techniques

    NASA Astrophysics Data System (ADS)

    Karacay, A.; Khan, S. D.

    2012-12-01

    Land subsidence can be caused by natural or human activities, such as carbonate dissolution, extraction of material from mines, soil compaction and fluid withdrawal. This phenomenon affects many cities around the world, such as Nagoya-Japan, Venice-Italy, San Joaquin Valley and Long Beach in California. Recent work by Engelkemeir et al, (2010), suggested that subsidence occurred as high as 5.6 cm/year in northwest Houston. The processes that may contribute to land subsidence in the Houston-Galveston area includes faulting, soil compaction, salt tectonic, water pumping and hydrocarbon extraction. This study aims to assess the possible role of water pumping on subsidence. Northwest Houston has two aquifer systems, the Evangeline and Chicot aquifers that dip in the southeast direction. The effect of water pumping on subsidence from these two aquifers was monitored using InSAR, GPS and LiDAR data. The data from eleven GPS stations were processed using Online Positioning User Service (OPUS) of National Geodetic Survey (NGS). Three of these GPS stations are Continuously Operating Reference Stations (CORS) and eight are Port-A-Measure (PAM) sites. All the GPS data were obtained from Harris-Galveston Subsidence District (HGSD). CORS sites were used as reference stations for processing GPS data from the PAM stations. GPS data show that subsidence rate in northwest Houston decreased to approximately 2 cm/year. In addition, the surface deformation is also estimated using Light Detection and Ranging (LiDAR) technique. For this purpose, raw LiDAR (LAS-Long ASCII Standart) files of 2001 and 2008 were processed. The subsidence rate near the Hockley Fault was calculated by applying zonal statistics method on LiDAR data which shows about 10 cm of subsidence in nine years. This result is supported by processed GPS data from PAM site 48 that show subsidence rate of 1.3 cm/yr. For the InSAR (Interferometric Synthetic Aperture Radar) technique, an image pair of PALSAR (The Phased Array

  1. Development of LiDAR measurements for the German offshore test site

    NASA Astrophysics Data System (ADS)

    Rettenmeier, A.; Kühn, M.; Wächter, M.; Rahm, S.; Mellinghoff, H.; Siegmeier, B.; Reeder, L.

    2008-05-01

    The paper introduces the content of the recently started joint research project 'Development of LiDAR measurements for the German Offshore Test Site' which has the objective to support other research projects at the German offshore test site 'alpha ventus'. The project has started before the erection of the offshore wind farm and one aim is to give recommendations concerning LiDAR technology useable for offshore measurement campaigns and data analysis. The work is organized in four work packages. The work package LiDAR technology deals with the specification, acquisition and calibration of a commercial LiDAR system for the measurement campaigns. Power curve measurements are dedicated to power curve assessment with ground-based LiDAR using standard statistical methods. Additionally, it deals with the development of new methods for the measurement of non-steady short-term power curves. Wind field research aims at the development of wake loading simulation methods of wind turbines and the exploration of loading control strategies and nacelle-based wind field measurement techniques. Finally, dissemination of results to the industry takes place in work package Technology transfer.

  2. Determinants of Outcome in Hospitalized Patients With Methicillin-Resistant Staphylococcus aureus Bloodstream Infection: Results From National Surveillance in Canada, 2008-2012.

    PubMed

    Simor, Andrew E; Pelude, Linda; Golding, George; Fernandes, Rachel; Bryce, Elizabeth; Frenette, Charles; Gravel, Denise; Katz, Kevin; McGeer, Allison; Mulvey, Michael R; Smith, Stephanie; Weiss, Karl

    2016-04-01

    BACKGROUND Bloodstream infection (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with considerable morbidity and mortality. OBJECTIVE To determine the incidence of MRSA BSI in Canadian hospitals and to identify variables associated with increased mortality. METHODS Prospective surveillance for MRSA BSI conducted in 53 Canadian hospitals from January 1, 2008, through December 31, 2012. Thirty-day all-cause mortality was determined, and logistic regression analysis was used to identify variables associated with mortality. RESULTS A total of 1,753 patients with MRSA BSI were identified (incidence, 0.45 per 1,000 admissions). The most common sites presumed to be the source of infection were skin/soft tissue (26.6%) and an intravascular catheter (22.0%). The most common spa types causing MRSA BSI were t002 (USA100/800; 55%) and t008 (USA300; 29%). Thirty-day all-cause mortality was 23.8%. Mortality was associated with increasing age (odds ratio, 1.03 per year [95% CI, 1.02-1.04]), the presence of pleuropulmonary infection (2.3 [1.4-3.7]), transfer to an intensive care unit (3.2 [2.1-5.0]), and failure to receive appropriate antimicrobial therapy within 24 hours of MRSA identification (3.2 [2.1-5.0]); a skin/soft-tissue source of BSI was associated with decreased mortality (0.5 [0.3-0.9]). MRSA genotype and reduced susceptibility to vancomycin were not associated with risk of death. CONCLUSIONS This study provides additional insight into the relative impact of various host and microbial factors associated with mortality in patients with MRSA BSI. The results emphasize the importance of ensuring timely receipt of appropriate antimicrobial agents to reduce the risk of an adverse outcome.

  3. Internet connectivity for hospitals and hospital libraries: strategies.

    PubMed

    Fuller, S S

    1995-01-01

    Access to Internet resources and communications has rapidly become a necessity in many hospitals nationally. The results of a Pacific Northwest pilot Intenet connections project provides important evidence of the value of librarians in establishing such connections in their institutions The pilot project has resulted in a wealth of information regarding approaches to promoting the utility of the Internet to health professionals in hospitals. Roles that librarians are playing in support of such connections include facilitator, negotiator, provider, publisher, integrator, and educator.

  4. Octree-based segmentation for terrestrial LiDAR point cloud data in industrial applications

    NASA Astrophysics Data System (ADS)

    Su, Yun-Ting; Bethel, James; Hu, Shuowen

    2016-03-01

    Automated and efficient algorithms to perform segmentation of terrestrial LiDAR data is critical for exploitation of 3D point clouds, where the ultimate goal is CAD modeling of the segmented data. In this work, a novel segmentation technique is proposed, starting with octree decomposition to recursively divide the scene into octants or voxels, followed by a novel split and merge framework that uses graph theory and a series of connectivity analyses to intelligently merge components into larger connected components. The connectivity analysis, based on a combination of proximity, orientation, and curvature connectivity criteria, is designed for the segmentation of pipes, vessels, and walls from terrestrial LiDAR data of piping systems at industrial sites, such as oil refineries, chemical plants, and steel mills. The proposed segmentation method is exercised on two terrestrial LiDAR datasets of a steel mill and a chemical plant, demonstrating its ability to correctly reassemble and segregate features of interest.

  5. The role of terrestrial 3D LiDAR scan in bridge health monitoring

    NASA Astrophysics Data System (ADS)

    Liu, Wanqiu; Chen, Shen-En; Sajedi, Allen; Hauser, Edd

    2010-04-01

    This paper addresses the potential applications of terrestrial 3D LiDAR scanning technologies for bridge monitoring. High resolution ground-based optical-photonic images from LiDAR scans can provide detailed geometric information about a bridge. Applications of simple algorithms can retrieve damage information from the geometric point cloud data, which can be correlated to possible damage quantification including concrete mass loss due to vehicle collisions, large permanent steel deformations, and surface erosions. However, any proposed damage detection technologies should provide information that is relevant and useful to bridge managers for their decision making process. This paper summaries bridge issues that can be detected from the 3D LiDAR technologies, establishes the general approach in using 3D point clouds for damage evaluation and suggests possible bridge state ratings that can be used as supplements to existing bridge management systems (BMS).

  6. The IsoDAR high intensity H2+ transport and injection tests

    NASA Astrophysics Data System (ADS)

    Alonso, J.; Axani, S.; Calabretta, L.; Campo, D.; Celona, L.; Conrad, J. M.; Day, A.; Castro, G.; Labrecque, F.; Winklehner, D.

    2015-10-01

    This technical report reviews the tests performed at the Best Cyclotron Systems, Inc. facility in regards to developing a cost effective ion source, beam line transport system, and acceleration system capable of high H2+ current output for the IsoDAR (Isotope Decay At Rest) experiment. We begin by outlining the requirements for the IsoDAR experiment then provide overviews of the Versatile Ion Source (VIS), Low Energy Beam Transport (LEBT) system, spiral inflector, and cyclotron. The experimental measurements are then discussed and the results are compared with a thorough set of simulation studies. Of particular importance we note that the VIS proved to be a reliable ion source capable of generating a large amount of H2+ current. The results suggest that with further upgrades, the VIS could potentially be a suitable candidate for IsoDAR. The conclusion outlines the key results from our tests and introduces the forthcoming work this technical report has motivated.

  7. [Analysis of an Air Pollution Process Using LiDAR in Nanjing, Spring of 2014].

    PubMed

    Bao, Qing; He, Jun-liang; Zha, Yong; Cheng, Feng; Li, Qian-nan

    2015-04-01

    Based on environmental monitoring data, meteorological data and the results of numerical simulation, a typical air pollution process in Nanjing, from 26th May to 1st June, 2014 was deeply analyzed combining aerosol extinction coefficient derived from LiDAR system. Experimental results showed that the entire pollution process was affected by both local pollution and exogenous inputs including dust and smoke. Meteorological factors played a significant role in the generation and elimination of pollutants. Low pressure and temperature inversion also hindered the diffusion of pollutants, while strong rainfall terminated the pollution process. During the pollution, the height of atmospheric boundary layer was lower than normal situation and changed little during the pollution period, which provided a poor diffusion condition for pollutants. LiDAR could accurately detect aerosol vertical structure which was able to capture the temporal and spatial variation of pollutant distributions. Therefore, LiDAR can be of great significance for the atmospheric pollution monitoring.

  8. Index Blood Tests and National Early Warning Scores within 24 Hours of Emergency Admission Can Predict the Risk of In-Hospital Mortality: A Model Development and Validation Study

    PubMed Central

    Mohammed, Mohammed A.; Rudge, Gavin; Watson, Duncan; Wood, Gordon; Smith, Gary B.; Prytherch, David R.; Girling, Alan; Stevens, Andrew

    2013-01-01

    Background We explored the use of routine blood tests and national early warning scores (NEWS) reported within ±24 hours of admission to predict in-hospital mortality in emergency admissions, using empirical decision Tree models because they are intuitive and may ultimately be used to support clinical decision making. Methodology A retrospective analysis of adult emergency admissions to a large acute hospital during April 2009 to March 2010 in the West Midlands, England, with a full set of index blood tests results (albumin, creatinine, haemoglobin, potassium, sodium, urea, white cell count and an index NEWS undertaken within ±24 hours of admission). We developed a Tree model by randomly splitting the admissions into a training (50%) and validation dataset (50%) and assessed its accuracy using the concordance (c-) statistic. Emergency admissions (about 30%) did not have a full set of index blood tests and/or NEWS and so were not included in our analysis. Results There were 23248 emergency admissions with a full set of blood tests and NEWS with an in-hospital mortality of 5.69%. The Tree model identified age, NEWS, albumin, sodium, white cell count and urea as significant (p<0.001) predictors of death, which described 17 homogeneous subgroups of admissions with mortality ranging from 0.2% to 60%. The c-statistic for the training model was 0.864 (95%CI 0.852 to 0.87) and when applied to the testing data set this was 0.853 (95%CI 0.840 to 0.866). Conclusions An easy to interpret validated risk adjustment Tree model using blood test and NEWS taken within ±24 hours of admission provides good discrimination and offers a novel approach to risk adjustment which may potentially support clinical decision making. Given the nature of the clinical data, the results are likely to be generalisable but further research is required to investigate this promising approach. PMID:23734195

  9. LiDAR remote sensing observations for forest assessment and recovery responses following disturbance

    NASA Astrophysics Data System (ADS)

    Rosette, J.; Suárez, J.; Fonweben, J.; North, P.

    2013-12-01

    LiDAR data covering 400 km2 in the Cowal and Trossacs Forest District, Scotland, U.K., were used to provide a low cost solution to update the database of public forests and to produce multi-scale cartographic products for supporting management decisions in the event of forest disturbance such as infestation or wind damage. All parameter estimates were directly obtained from the LiDAR data without the necessity of field calibration. This was achieved using a hybrid approach integrating current stand models for Sitka spruce (Picea sitchensis bong. Carr) and LiDAR analysis. More conventional field methods offer percentage sampling, permitting only a proportion of stands to be surveyed each year and aiming to represent stand-level conditions. The use of LiDAR is advantageous in allowing a complete observation-based assessment throughout the forest and greatly-improved spatial representation of important forest parameters. Time-series analysis was performed using LiDAR data collected in the past 10 years. This analysis allowed us to establish growth trajectories in the forest stands, automatically discriminating areas of growth, those whose growth had been affected by disease and the occurrence of windthrow gaps. The results were compared to the cartography produced by the Forest District after a severe wind storm that affected the area in 2012. This analysis showed the ability of LiDAR to create a more precise location and extent of catastrophic damage and windthrow gaps. In addition, once windthrow has occurred, progression of further damage in existing canopy gaps can be observed. This approach additionally allows the impact of disease on forest growth and subsequent recovery response to be monitored.

  10. Estimating stem volume and biomass of Pinus koraiensis using LiDAR data.

    PubMed

    Kwak, Doo-Ahn; Lee, Woo-Kyun; Cho, Hyun-Kook; Lee, Seung-Ho; Son, Yowhan; Kafatos, Menas; Kim, So-Ra

    2010-07-01

    The objective of this study was to estimate the stem volume and biomass of individual trees using the crown geometric volume (CGV), which was extracted from small-footprint light detection and ranging (LiDAR) data. Attempts were made to analyze the stem volume and biomass of Korean Pine stands (Pinus koraiensis Sieb. et Zucc.) for three classes of tree density: low (240 N/ha), medium (370 N/ha), and high (1,340 N/ha). To delineate individual trees, extended maxima transformation and watershed segmentation of image processing methods were applied, as in one of our previous studies. As the next step, the crown base height (CBH) of individual trees has to be determined; information for this was found in the LiDAR point cloud data using k-means clustering. The LiDAR-derived CGV and stem volume can be estimated on the basis of the proportional relationship between the CGV and stem volume. As a result, low tree-density plots had the best performance for LiDAR-derived CBH, CGV, and stem volume (R (2) = 0.67, 0.57, and 0.68, respectively) and accuracy was lowest for high tree-density plots (R (2) = 0.48, 0.36, and 0.44, respectively). In the case of medium tree-density plots accuracy was R (2) = 0.51, 0.52, and 0.62, respectively. The LiDAR-derived stem biomass can be predicted from the stem volume using the wood basic density of coniferous trees (0.48 g/cm(3)), and the LiDAR-derived above-ground biomass can then be estimated from the stem volume using the biomass conversion and expansion factors (BCEF, 1.29) proposed by the Korea Forest Research Institute (KFRI).

  11. Reconstruction and analysis of a deciduous sapling using digital photographs or terrestrial-LiDAR technology

    PubMed Central

    Delagrange, Sylvain; Rochon, Pascal

    2011-01-01

    Background and Aims To meet the increasing need for rapid and non-destructive extraction of canopy traits, two methods were used and compared with regard to their accuracy in estimatating 2-D and 3-D parameters of a hybrid poplar sapling. Methods The first method consisted of the analysis of high definition photographs in Tree Analyser (TA) software (PIAF-INRA/Kasetsart University). TA allowed the extraction of individual traits using a space carving approach. The second method utilized 3-D point clouds acquired from terrestrial light detection and ranging (T-LiDAR) scans. T-LiDAR scans were performed on trees without leaves to reconstruct the lignified structure of the sapling. From this skeleton, foliage was added using simple modelling rules extrapolated from field measurements. Validation of the estimated dimension and the accuracy of reconstruction was then achieved by comparison with an empirical data set. Key Results TA was found to be slightly less precise than T-LiDAR for estimating tree height, canopy height and mean canopy diameter, but for 2-D traits both methods were, however, fully satisfactory. TA tended to over-estimate total leaf area (error up to 50 %), but better estimates were obtained by reducing the size of the voxels used for calculations. In contrast, T-LiDAR estimated total leaf area with an error of <6 %. Finally, both methods led to an over-estimation of canopy volume. With respect to this trait, T-LiDAR (14·5 % deviation) greatly surpassed the accuracy of TA (up to 50 % deviation), even if the voxels used were reduced in size. Conclusions Taking into account their magnitude of data acquisition and analysis and their accuracy in trait estimations, both methods showed contrasting potential future uses. Specifically, T-LiDAR is a particularly promising tool for investigating the development of large perennial plants, by itself or in association with plant modelling. PMID:21515607

  12. Detailed Hydrographic Feature Extraction from High-Resolution LiDAR Data

    SciTech Connect

    Danny L. Anderson

    2012-05-01

    Detailed hydrographic feature extraction from high-resolution light detection and ranging (LiDAR) data is investigated. Methods for quantitatively evaluating and comparing such extractions are presented, including the use of sinuosity and longitudinal root-mean-square-error (LRMSE). These metrics are then used to quantitatively compare stream networks in two studies. The first study examines the effect of raster cell size on watershed boundaries and stream networks delineated from LiDAR-derived digital elevation models (DEMs). The study confirmed that, with the greatly increased resolution of LiDAR data, smaller cell sizes generally yielded better stream network delineations, based on sinuosity and LRMSE. The second study demonstrates a new method of delineating a stream directly from LiDAR point clouds, without the intermediate step of deriving a DEM. Direct use of LiDAR point clouds could improve efficiency and accuracy of hydrographic feature extractions. The direct delineation method developed herein and termed “mDn”, is an extension of the D8 method that has been used for several decades with gridded raster data. The method divides the region around a starting point into sectors, using the LiDAR data points within each sector to determine an average slope, and selecting the sector with the greatest downward slope to determine the direction of flow. An mDn delineation was compared with a traditional grid-based delineation, using TauDEM, and other readily available, common stream data sets. Although, the TauDEM delineation yielded a sinuosity that more closely matches the reference, the mDn delineation yielded a sinuosity that was higher than either the TauDEM method or the existing published stream delineations. Furthermore, stream delineation using the mDn method yielded the smallest LRMSE.

  13. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

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

  14. Hospital finance.

    PubMed

    Herman, M J

    1998-01-01

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

  15. Academic Hospitality

    ERIC Educational Resources Information Center

    Phipps, Alison; Barnett, Ronald

    2007-01-01

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

  16. Demographic and socioeconomic inequalities in the risk of emergency hospital admission for violence: cross-sectional analysis of a national database in Wales

    PubMed Central

    Fone, David; Gartner, Andrea; Bellis, Mark A

    2016-01-01

    Objectives To investigate the risk of emergency hospital admissions for violence (EHAV) associated with demographic and socioeconomic factors in Wales between 2007/2008 and 2013/2014, and to describe the site of injury causing admission. Design Database analysis of 7 years’ hospital admissions using the Patient Episode Database for Wales (PEDW). Setting and participants Wales, UK, successive annual populations ∼2.8 million aged 0–74 years. Primary outcome The first emergency admission for violence in each year of the study, defined by the International Classification of Diseases V.10 (ICD-10) codes for assaults (X85-X99, Y00-Y09) in any coding position. Results A total of 11 033 admissions for assault. The majority of admissions resulted from head injuries. The overall crude admission rate declined over the study period, from 69.9 per 100 000 to 43.2 per 100 000, with the largest decrease in the most deprived quintile of deprivation. A generalised linear count model with a negative binomial log link, adjusted for year, age group, gender, deprivation quintile and settlement type, showed the relative risk was highest in age group 18–19 years (RR=6.75, 95% CI 5.88 to 7.75) compared with the reference category aged 10–14 years. The risk decreased with age after 25 years. Risk of admission was substantially higher in males (RR=4.55, 95% CI 4.31 to 4.81), for residents of the most deprived areas of Wales (RR=3.60, 95% CI 3.32 to 3.90) compared with the least deprived, and higher in cities (RR=1.37, 95% CI 1.27 to 1.49) and towns (RR=1.32, 95% CI 1.21 to 1.45) compared with villages. Conclusions Despite identifying a narrowing in the gap between prevalence of violence in richer and poorer communities, violence remains strongly associated with young men living in areas of socioeconomic deprivation. There is potential for a greater reduction, given that violence is mostly preventable. Recommendations for reducing inequalities in the risk of

  17. Parallel algorithm for linear feature detection from airborne LiDAR data

    NASA Astrophysics Data System (ADS)

    Mareboyana, Manohar; Chi, Paul

    2006-05-01

    Linear features from airport images correspond to runways, taxiways and roads. Detecting runways helps pilots to focus on runway incursions in poor visibility conditions. In this work, we attempt to detect linear features from LiDAR swath in near real time using parallel implementation on G5-based apple cluster called Xseed. Data from LiDAR swath is converted into a uniform grid with nearest neighbor interpolation. The edges and gradient directions are computed using standard edge detection algorithms such as Canny's detector. Edge linking and detecting straight-line features are described. Preliminary results on Reno, Nevada airport data are included.

  18. LiDAR DTMs and anthropogenic feature extraction: testing the feasibility of geomorphometric parameters in floodplains

    NASA Astrophysics Data System (ADS)

    Sofia, G.; Tarolli, P.; Dalla Fontana, G.

    2012-04-01

    In floodplains, massive investments in land reclamation have always played an important role in the past for flood protection. In these contexts, human alteration is reflected by artificial features ('Anthropogenic features'), such as banks, levees or road scarps, that constantly increase and change, in response to the rapid growth of human populations. For these areas, various existing and emerging applications require up-to-date, accurate and sufficiently attributed digital data, but such information is usually lacking, especially when dealing with large-scale applications. More recently, National or Local Mapping Agencies, in Europe, are moving towards the generation of digital topographic information that conforms to reality and are highly reliable and up to date. LiDAR Digital Terrain Models (DTMs) covering large areas are readily available for public authorities, and there is a greater and more widespread interest in the application of such information by agencies responsible for land management for the development of automated methods aimed at solving geomorphological and hydrological problems. Automatic feature recognition based upon DTMs can offer, for large-scale applications, a quick and accurate method that can help in improving topographic databases, and that can overcome some of the problems associated with traditional, field-based, geomorphological mapping, such as restrictions on access, and constraints of time or costs. Although anthropogenic features as levees and road scarps are artificial structures that actually do not belong to what is usually defined as the bare ground surface, they are implicitly embedded in digital terrain models (DTMs). Automatic feature recognition based upon DTMs, therefore, can offer a quick and accurate method that does not require additional data, and that can help in improving flood defense asset information, flood modeling or other applications. In natural contexts, morphological indicators derived from high

  19. United Kingdom National Ophthalmology Database Study: Diabetic Retinopathy; Report 1: prevalence of centre-involving diabetic macular oedema and other grades of maculopathy and retinopathy in hospital eye services

    PubMed Central

    Keenan, T D L; Johnston, R L; Donachie, P H J; Sparrow, J M; Stratton, I M; Scanlon, P

    2013-01-01

    Aims To report estimates of the prevalence of diabetic retinopathy (DR) and maculopathy grades for a large cohort of patients managed by the UK hospital eye service (HES). Methods Anonymised data were extracted from 30 UK NHS hospital trusts using a single ophthalmic electronic medical record (EMR) for the period from April 2000 to November 2010 to create the National Ophthalmology Database (NOD). From 2007, the EMR facilitated capture of a nationally agreed-upon standardised data set (DR Structured Assessment) relating to the presence or absence of clinical signs of DR and maculopathy. An algorithm in the software automatically calculated the Early Treatment of Diabetic Retinopathy Study grades of retinopathy and maculopathy. Results Between 2007 and 2010, 307 538 patients had data on the NOD, with 76 127 (24.8%) patients having been recorded as having diabetes. The proportion of patients with diabetes who had a structured assessment increased from 50.7% (2007) to 86.8% (2010). In each NHS year, 12.6–20.6% of eyes with structured assessments had no DR; 59.6–67.3% had non-proliferative DR; and 18.3–20.9% had active or regressed proliferative DR. Clinically significant macular oedema was present in 15.8–18.1% of eyes, and in 8.7–10.0% of eyes, this involved the central macula. Conclusion This study provides contemporary estimates of the prevalence of retinopathy and maculopathy grades in a large cohort of patients with diabetes managed by the UK HES. Centre-involving diabetic macular oedema, potentially amenable to anti-VEGF therapy, is present in the eyes of almost 10% of these patients. This information is useful for clinicians, health-care economists, and commissioners involved in planning and delivering diabetic eye services. PMID:24051410

  20. Blood pressure response to the first 36 hours of heart failure therapy with perindopril versus captopril. French General Hospitals National College of Cardiologists.

    PubMed

    Haïat, R; Piot, O; Gallois, H; Hanania, G

    1999-06-01

    An open randomized hospital study conducted in 169 centers in France compared the blood pressure response to the first 36 h of treatment with perindopril (PER), 2 mg once daily, with that to captopril (CAP), 6.25 mg t.i.d., in 725 patients (mean age, 70 years; men, 67%) with echocardiographic left ventricular systolic dysfunction (fractional shortening, < or = 28%) due to ischemia (56.7%) or hypertension (34.5%) and a systolic blood pressure (SBP) > or = 120 mm Hg. Each dose of CAP induced a sharp and rapid decrease in blood pressure (maximum, 1.5-2 h); with PER, the decrease was gradual (maximum, 6 h) and variation was less marked. However, at 36 h, the decrease in blood pressure versus baseline was similar on both treatments. Over the 36-h period, there were 22 (3%) dropouts due to marked orthostatic hypotension (SBP, <90 mm Hg), and they were fewer with PER than with CAP: 16 cases in the CAP group versus six in the PER group (p = 0.036). At 36 h, heart rate was lower with CAP than with PER: 75.2 versus 77.5 beats/min, respectively (p = 0.039). As initial therapy for stabilized left ventricular systolic dysfunction, the first dose of PER (2 mg) induced a significantly smaller decrease in blood pressure than the first dose of CAP (6.25 mg); dropouts due to orthostatic hypotension were also significantly fewer with PER than with CAP.

  1. A study and comparative analysis of managerial and leadership effectiveness in the National Health Service: an empirical factor analytic study within an NHS Trust hospital.

    PubMed

    Hamlin, R G

    2002-11-01

    The research described in this article was concerned primarily with identifying the criteria of managerial/leadership effectiveness applying at the middle and front line levels of management within an NHS Trust Hospital using critical incident technique and factor analysis methods. The findings suggest that the self-perceptions of managers and the perceptions of superiors and subordinates are very similar, and only differ on a limited number of criteria. This challenges the 'perspective-specific' models of managerial effectiveness advocated by some researchers. The results are compared against those from a near identical study carried out by the author within one part of the British Civil Service, and the results from a different but comparable factor analytic study carried out by other researchers elsewhere in the NHS. The results suggest the existence of generalized criteria of managerial effectiveness, which lend considerable support to the notion of the 'universally effective manager'. This challenges the 'contingent models' of managerial effectiveness advocated by various expert commentators. In addition, the research supports the new model of transformational leadership offered by Alimo-Metcalfe and Alban-Metcalfe for application within both the NHS and local government, and adds to the empirical base supporting the current drive towards evidence-based practice in management within the healthcare sector.

  2. A profile of the belief system and attitudes to end-of-life decisions of senior clinicians working in a National Health Service Hospital in the United Kingdom.

    PubMed

    Pugh, E J; Song, R; Whittaker, V; Blenkinsopp, J

    2009-03-01

    There is evidence from outside the United Kingdom to show that physicians' religious beliefs influence their decision making at the end of life. This UK study explores the belief system of consultants, nurse key workers and specialist registrars and their attitudes to decisions which commonly must be taken when caring for individuals who are dying. All consultants (N = 119), nurse key workers (N = 36) and specialist registrars (N = 44) working in an acute hospital in the north-east of England were asked to complete a postal questionnaire. In all, 65% of consultants, 67% of nurse key workers and 41% of specialist registrars responded. Results showed that consultants' religion and belief systems differed from those of nurses and the population they served. Consultants and nurses had statistically significant differences in their attitudes to common end of life decisions with consultants more likely to continue hydration and not withdraw treatment. Nurses were more sympathetic to the idea of physician-assisted suicide for unbearable suffering. This study shows the variability in belief system and attitudes to end of life decision making both within and between clinical groups. This may have practical implications for the clinical care given and the place of care. The personal belief system of consultants was not shown to affect their overall attitudes to withdrawing life-sustaining treatment or physician-assisted suicide.

  3. Investigation of the Hector Mine Earthquake Surface Rupture with Airborne LiDAR data

    NASA Astrophysics Data System (ADS)

    Chen, T.; Zhang, D.; Akciz, S. O.; Hudnut, K. W.

    2011-12-01

    The 16 October 1999 Hector Mine earthquake (Mw7.1) generated significant surface rupture along the Lavic Lake Fault through almost 60 kilometers of sparsely vegetated, relatively barren desert terrain. It was the first large earthquake for which post-earthquake airborne LiDAR, collected to image the fault surface rupture, exists. Despite the lack of pre-earthquake high-resolution topographic data, we were able to make both horizontal and vertical displacement measurements, which complement published field investigation results that include ~254 data points (164 of which are within LiDAR coverage area). We made 255 new horizontal and 83 vertical displacement measurements using a 0.5 m DEM generated from the LiDAR dataset. The maximum horizontal offset value is 6.6 ± 1.1 m, and is located approximately ~700 m south of the maximum horizontal offset observed during the field work. The average horizontal offset value from LiDAR measurements is ~2.27 m, whereas the average calculated from field data is ~2.5 m. The maximum vertical displacement is ~1.2 m, and the average vertical offset value is less than 1 m. No consistent trends are apparent in the sense of the vertical component, except in the north of the mountainous section, which is predominated by east-side-down measurements. Compared to field data, LiDAR-based measurements (a) have larger measurement uncertainties, (b) have slightly higher values, (c) do not include many measurements of offsets <1 m due to the DEM resolution, and (d) are spatially denser. The field investigation produced measurements of higher quality in alluvial deposits (e.g. tire tracks, offset rock or pebble lineaments) which are not typically visible with 0.5 m resolution DEMs unless a piercing feature has a very large or clear offset. LiDAR measurements included more geomorphic features with larger measurement uncertainties, which may not have been measured in the field due to their proximity to higher quality measurements. However, along

  4. A Forgotten Sector; The Training of Ancillary Staff in Hospitals.

    ERIC Educational Resources Information Center

    Smith, Duncan N.

    A study was made, in England and Wales, of training needs of hospital ancillary staff; it concentrated on a group of hospitals in each of six Hospital Regions. In addition, information was collected at the national level and brief visits were made in other regions. Findings showed large differences in staffing between hospitals of similar types,…

  5. Evaluation of the national Cleanyourhands campaign to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England and Wales by improved hand hygiene: four year, prospective, ecological, interrupted time series study

    PubMed Central

    Fuller, Christopher; Savage, Joan; Cookson, Barry; Hayward, Andrew; Cooper, Ben; Duckworth, Georgia; Michie, Susan; Murray, Miranda; Jeanes, Annette; Roberts, J; Teare, Louise; Charlett, Andre

    2012-01-01

    Objective To evaluate the impact of the Cleanyourhands campaign on rates of hospital procurement of alcohol hand rub and soap, report trends in selected healthcare associated infections, and investigate the association between infections and procurement. Design Prospective, ecological, interrupted time series study from 1 July 2004 to 30 June 2008. Setting 187 acute trusts in England and Wales. Intervention Installation of bedside alcohol hand rub, materials promoting hand hygiene and institutional engagement, regular hand hygiene audits, rolled out nationally from 1 December 2004. Main outcome measures Quarterly (that is, every three months) rates for each trust of hospital procurement of alcohol hand rub and liquid soap; Staphylococcus aureus bacteraemia (meticillin resistant (MRSA) and meticillin sensitive (MSSA)) and Clostridium difficile infection for each trust. Associations between procurement and infection rates assessed by mixed effect Poisson regression model (which also accounted for effect of bed occupancy, hospital type, and timing of other national interventions targeting these infections). Results Combined procurement of soap and alcohol hand rub tripled from 21.8 to 59.8 mL per patient bed day; procurement rose in association with each phase of the campaign. Rates fell for MRSA bacteraemia (1.88 to 0.91 cases per 10 000 bed days) and C difficile infection (16.75 to 9.49 cases). MSSA bacteraemia rates did not fall. Increased procurement of soap was independently associated with reduced C difficile infection throughout the study (adjusted incidence rate ratio for 1 mL increase per patient bed day 0.993, 95% confidence interval 0.990 to 0.996; P<0.0001). Increased procurement of alcohol hand rub was independently associated with reduced MRSA bacteraemia, but only in the last four quarters of the study (0.990, 0.985 to 0.995; P<0.0001). Publication of the Health Act 2006 was strongly associated with reduced MRSA bacteraemia (0.86, 0.75 to 0.98; P=0

  6. A Cautionary Tale of Downloading Public Health in Ontario: What Does It Say about the Need for National Standards for More Than Doctors and Hospitals?

    PubMed

    Deber, Raisa B; Millan, Kris; Shapiro, Howard; McDougall, Christopher W

    2006-11-01

    The 2003 SARS outbreak highlighted the importance of maintaining an adequate public health (PH) infrastructure, and cast doubt on the wisdom of basing the system locally without adequate provisions for higher-level oversight and coordination. Structurally, it highlighted the policy legacy of the 1998 Ontario decision to download full responsibility for funding PH services to municipal governments, forcing such services into budgetary competition with the "hard" services traditionally provided by local government. The federal role in PH has traditionally been minimal; PH was never included as a mandatory service in the Canada Health Act, while reform proposals have focused upon such admittedly important directions as pharmacare and home care rather than PH. Although PH has moved up the policy agenda, with a focus on pandemic preparedness, the Ontario events suggest a pressing need for setting national and provincial/territorial standards for PH, and developing mechanisms for enforcing them.

  7. Differential regulation of dendritic and axonal development by the novel Krüppel-like factor Dar1

    PubMed Central

    Ye, Bing; Kim, Jung Hwan; Yang, Limin; McLachlan, Ian; Younger, Susan; Jan, Lily Yeh; Jan, Yuh Nung

    2011-01-01

    Dendrites and axons are two major neuronal compartments with differences that are critical for neuronal functions. To learn about the differential regulation of dendritic and axonal development, we conducted a genetic screen in Drosophila and isolated the dendritic arbor reduction 1 (dar1) mutants, which display defects in dendritic but not axonal growth. The dar1 gene encodes a novel transcription regulator in the Krüppel-like factor family. Neurons lacking dar1 function have severely reduced growth of microtubule- but not F-actin-based dendritic branches. In contrast, overexpression of Dar1 dramatically increased the growth of microtubule-based dendritic branches. Our results suggest that Dar1 promotes dendrite growth in part by suppressing the expression of the microtubule severing protein Spastin. Our study thus uncovers a novel transcriptional program for microtubule regulation that preferentially controls dendrite growth. PMID:21368042

  8. Deciphering the Precision of Stereo IKONOS Canopy Height Models for U.S. Forests with G-LiHT Airborne LiDAR

    NASA Technical Reports Server (NTRS)

    Rudasill-Neigh, Christopher S.; Masek, Jeffrey G.; Bourget, Paul; Cook, Bruce; Huang, Chengquan; Rishmawi, Khaldoun; Zhao, Feng

    2014-01-01

    Few studies have evaluated the precision of IKONOS stereo data for measuring forest canopy height. The high cost of airborne light detection and ranging (LiDAR) data collection for large area studies and the present lack of a spaceborne instrument lead to the need to explore other low cost options. The US Government currently has access to a large archive of commercial high-resolution imagery, which could be quite valuable to forest structure studies. At 1 m resolution, we here compared canopy height models (CHMs) and height data derived from Goddard's airborne LiDAR Hyper-spectral and Thermal Imager (G-LiHT) with three types of IKONOS stereo derived digital surface models (DSMs) that estimate CHMs by subtracting National Elevation Data (NED) digital terrain models (DTMs). We found the following in three different forested regions of the US after excluding heterogeneous and disturbed forest samples: (1) G-LiHT DTMs were highly correlated with NED DTMs with R (sup 2) greater than 0.98 and root mean square errors (RMSEs) less than 2.96 m; (2) when using one visually identifiable ground control point (GCP) from NED, G-LiHT DSMs and IKONOS DSMs had R (sup 2) greater than 0.84 and RMSEs of 2.7 to 4.1 m; and (3) one GCP CHMs for two study sites had R (sup 2) greater than 0.7 and RMSEs of 2.6 to 3 m where data were collected less than four years apart. Our results suggest that IKONOS stereo data are a useful LiDAR alternative where high-quality DTMs are available.

  9. Integrating ICT into Teaching and Learning at the University of Dar es Salaam

    ERIC Educational Resources Information Center

    Mtebe, Joel S.; Dachi, Hilary; Raphael, Christina

    2011-01-01

    Since 1985, Tanzania has been undergoing significant political and economic changes from a centralized to a more market-oriented and globally connected economy. The University of Dar es Salaam (UDSM) has responded to these changes by reviewing its legal status, vision, and functions, particularly those related to research, teaching, and public…

  10. Students' Experiences and Challenges of Blended Learning at the University of Dar Es Salaam, Tanzania

    ERIC Educational Resources Information Center

    Mtebe, Joel S.; Raphael, Christina

    2013-01-01

    Recent developments in Information and Communication Technologies (ICTs), especially eLearning, have heightened the need for University of Dar es Salaam (UDSM) to supplement on-campus face-to-face delivery as well as meeting increased students' enrolments through blended distance learning. Since 2008, the University has been offering three…

  11. Biomass estimation of Douglas fir stands using airborne LiDAR data

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Biomass is an important parameter not only for carbon cycle modeling, but also for supporting land management operations (e.g. land use policy, forest fire management). Various remote sensing data have been utilized for biomass estimation, especially in forested areas. LiDAR (Light Detection And Ran...

  12. Mapping of post-event earthquake induced landslides in Sg. Mesilou using LiDAR

    NASA Astrophysics Data System (ADS)

    Hanan Mat Yusoff, Habibah; Azahari Razak, Khamarrul; Yuen, Florence; Harun, Afifi; Talib, Jasmi; Mohamad, Zakaria; Ramli, Zamri; Abd Razab, Razain

    2016-06-01

    Earthquake is a common natural disaster in active tectonic regions. The disaster can induce cascading disasters such as debris flow, mudflow and reactivated old landslides. M 6.0 Ranau earthquake dated on June 05, 2015 coupling with intense and prolonged rainfall caused several mass movements such as debris flow, deep-seated and shallow landslides in Mesilou, Sabah. This study aims at providing a better insight into the use of advanced LiDAR mapping technology for recognizing landslide induced by earthquakes particularly in a vegetated terrain, assessing post event hazard and analyzing its distribution for hazard zonation. We developed the landslide inventory using LiDAR-derived visual analysis method and validated in the field. A landslide inventory map improved with the support of LiDAR derivative data. Finally, landslide inventory was analysed by emphasizing its distribution and density in such a way that it provides clues of risky zone as a result of debris flow. We recommend that mitigation action and risk reduction should be taken place at a transport zone of the channel compared to other zones. This study indicates that modern airborne LiDAR can be a good complementary tool for improving landslide inventory in a complex environment, and an effective tool for rapid regional hazard and risk assessment in the tropics.

  13. Geospatial revolution and remote sensing LiDAR in Mesoamerican archaeology

    PubMed Central

    Chase, Arlen F.; Fisher, Christopher T.; Leisz, Stephen J.; Weishampel, John F.

    2012-01-01

    The application of light detection and ranging (LiDAR), a laser-based remote-sensing technology that is capable of penetrating overlying vegetation and forest canopies, is generating a fundamental shift in Mesoamerican archaeology and has the potential to transform research in forested areas world-wide. Much as radiocarbon dating that half a century ago moved archaeology forward by grounding archaeological remains in time, LiDAR is proving to be a catalyst for an improved spatial understanding of the past. With LiDAR, ancient societies can be contextualized within a fully defined landscape. Interpretations about the scale and organization of densely forested sites no longer are constrained by sample size, as they were when mapping required laborious on-ground survey. The ability to articulate ancient landscapes fully permits a better understanding of the complexity of ancient Mesoamerican urbanism and also aids in modern conservation efforts. The importance of this geospatial innovation is demonstrated with newly acquired LiDAR data from the archaeological sites of Caracol, Cayo, Belize and Angamuco, Michoacán, Mexico. These data illustrate the potential of technology to act as a catalytic enabler of rapid transformational change in archaeological research and interpretation and also underscore the value of on-the-ground archaeological investigation in validating and contextualizing results. PMID:22802623

  14. Clinical, Virologic, and Epidemiologic Characteristics of Dengue Outbreak, Dar es Salaam, Tanzania, 2014

    PubMed Central

    Mboera, Leonard E.G.; De Nardo, Pasquale; Oriyo, Ndekya M.; Meschi, Silvia; Rumisha, Susan F.; Colavita, Francesca; Mhina, Athanas; Carletti, Fabrizio; Mwakapeje, Elibariki; Capobianchi, Maria Rosaria; Castilletti, Concetta; Di Caro, Antonino; Nicastri, Emanuele; Malecela, Mwelecele N.; Ippolito, Giuseppe

    2016-01-01

    We investigated a dengue outbreak in Dar es Salaam, Tanzania, in 2014, that was caused by dengue virus (DENV) serotype 2. DENV infection was present in 101 (20.9%) of 483 patients. Patient age and location of residence were associated with infection. Seven (4.0%) of 176 patients were co-infected with malaria and DENV. PMID:27088845

  15. Line-Based Registration of Panoramic Images and LiDAR Point Clouds for Mobile Mapping

    PubMed Central

    Cui, Tingting; Ji, Shunping; Shan, Jie; Gong, Jianya; Liu, Kejian

    2016-01-01

    For multi-sensor integrated systems, such as the mobile mapping system (MMS), data fusion at sensor-level, i.e., the 2D-3D registration between an optical camera and LiDAR, is a prerequisite for higher level fusion and further applications. This paper proposes a line-based registration method for panoramic images and a LiDAR point cloud collected by a MMS. We first introduce the system configuration and specification, including the coordinate systems of the MMS, the 3D LiDAR scanners, and the two panoramic camera models. We then establish the line-based transformation model for the panoramic camera. Finally, the proposed registration method is evaluated for two types of camera models by visual inspection and quantitative comparison. The results demonstrate that the line-based registration method can significantly improve the alignment of the panoramic image and the LiDAR datasets under either the ideal spherical or the rigorous panoramic camera model, with the latter being more reliable. PMID:28042855

  16. Registration of optical imagery and LiDAR data using an inherent geometrical constraint.

    PubMed

    Zhang, Wuming; Zhao, Jing; Chen, Mei; Chen, Yiming; Yan, Kai; Li, Linyuan; Qi, Jianbo; Wang, Xiaoyan; Luo, Jinghui; Chu, Qing

    2015-03-23

    A novel method for registering imagery with Light Detection And Ranging (LiDAR) data is proposed. It is based on the phenomenon that the back-projection of LiDAR point cloud of an object should be located within the object boundary in the image. Using this inherent geometrical constraint, the registration parameters computation of both data sets only requires LiDAR point clouds of several objects and their corresponding boundaries in the image. The proposed registration method comprises of four steps: point clouds extraction, boundary extraction, back-projection computation and registration parameters computation. There are not any limitations on the geometrical and spectral properties of the object. So it is suitable not only for structured scenes with man-made objects but also for natural scenes. Moreover, the proposed method based on the inherent geometrical constraint can register two data sets derived from different parts of an object. It can be used to co-register TLS (Terrestrial Laser Scanning) LiDAR point cloud and UAV (Unmanned aerial vehicle) image, which are obtaining more attention in the forest survey application. Using initial registration parameters comparable to POS (position and orientation system) accuracy, the performed experiments validated the feasibility of the proposed registration method.

  17. Clinical, Virologic, and Epidemiologic Characteristics of Dengue Outbreak, Dar es Salaam, Tanzania, 2014.

    PubMed

    Vairo, Francesco; Mboera, Leonard E G; De Nardo, Pasquale; Oriyo, Ndekya M; Meschi, Silvia; Rumisha, Susan F; Colavita, Francesca; Mhina, Athanas; Carletti, Fabrizio; Mwakapeje, Elibariki; Capobianchi, Maria Rosaria; Castilletti, Concetta; Di Caro, Antonino; Nicastri, Emanuele; Malecela, Mwelecele N; Ippolito, Giuseppe

    2016-05-01

    We investigated a dengue outbreak in Dar es Salaam, Tanzania, in 2014, that was caused by dengue virus (DENV) serotype 2. DENV infection was present in 101 (20.9%) of 483 patients. Patient age and location of residence were associated with infection. Seven (4.0%) of 176 patients were co-infected with malaria and DENV.

  18. An Analysis of Student Reading as Measured on the Diagnostic Assessment of Reading (DAR)

    ERIC Educational Resources Information Center

    Baca, Jo-Ann M.; Shepperson, Barbara A.

    2006-01-01

    As part of the reporting of Delaware's State Improvement Grant (DelaSIG), the Delaware Education Research and Development Center (R&D Center) completed a study on the Diagnostic Assessment of Reading (DAR) scores of students whose teachers attended a professional development program designed to help focus teacher instruction of struggling …

  19. Spatial Patterns of Trees from Airborne LiDAR Using a Simple Tree Segmentation Algorithm

    NASA Astrophysics Data System (ADS)

    Jeronimo, S.; Kane, V. R.; McGaughey, R. J.; Franklin, J. F.

    2015-12-01

    Objectives for management of forest ecosystems on public land incorporate a focus on maintenance and restoration of ecological functions through silvicultural manipulation of forest structure. The spatial pattern of residual trees - the horizontal element of structure - is a key component of ecological restoration prescriptions. We tested the ability of a simple LiDAR individual tree segmentation method - the watershed transform - to generate spatial pattern metrics similar to those obtained by the traditional method - ground-based stem mapping - on forested plots representing the structural diversity of a large wilderness area (Yosemite NP) and a large managed area (Sierra NF) in the Sierra Nevada, Calif. Most understory and intermediate-canopy trees were not detected by the LiDAR segmentation; however, LiDAR- and field-based assessments of spatial pattern in terms of tree clump size distributions largely agreed. This suggests that (1) even when individual tree segmentation is not effective for tree density estimates, it can provide a good measurement of tree spatial pattern, and (2) a simple segmentation method is adequate to measure spatial pattern of large areas with a diversity of structural characteristics. These results lay the groundwork for a LiDAR tool to assess clumping patterns across forest landscapes in support of restoration silviculture. This tool could describe spatial patterns of functionally intact reference ecosystems, measure departure from reference targets in treatment areas, and, with successive acquisitions, monitor treatment efficacy.

  20. a Data Driven Method for Building Reconstruction from LiDAR Point Clouds

    NASA Astrophysics Data System (ADS)

    Sajadian, M.; Arefi, H.

    2014-10-01

    Airborne laser scanning, commonly referred to as LiDAR, is a superior technology for three-dimensional data acquisition from Earth's surface with high speed and density. Building reconstruction is one of the main applications of LiDAR system which is considered in this study. For a 3D reconstruction of the buildings, the buildings points should be first separated from the other points such as; ground and vegetation. In this paper, a multi-agent strategy has been proposed for simultaneous extraction and segmentation of buildings from LiDAR point clouds. Height values, number of returned pulse, length of triangles, direction of normal vectors, and area are five criteria which have been utilized in this step. Next, the building edge points are detected using a new method named "Grid Erosion". A RANSAC based technique has been employed for edge line extraction. Regularization constraints are performed to achieve the final lines. Finally, by modelling of the roofs and walls, 3D building model is reconstructed. The results indicate that the proposed method could successfully extract the building from LiDAR data and generate the building models automatically. A qualitative and quantitative assessment of the proposed method is then provided.

  1. Dynamic displacement estimation by fusing LDV and LiDAR measurements via smoothing based Kalman filtering

    NASA Astrophysics Data System (ADS)

    Kim, Kiyoung; Sohn, Hoon

    2017-01-01

    This paper presents a smoothing based Kalman filter to estimate dynamic displacement in real-time by fusing the velocity measured from a laser Doppler vibrometer (LDV) and the displacement from a light detection and ranging (LiDAR). LiDAR can measure displacement based on the time-of-flight information or the phase-shift of the laser beam reflected off form a target surface, but it typically has a high noise level and a low sampling rate. On the other hand, LDV primarily measures out-of-plane velocity of a moving target, and displacement is estimated by numerical integration of the measured velocity. Here, the displacement estimated by LDV suffers from integration error although LDV can achieve a lower noise level and a much higher sampling rate than LiDAR. The proposed data fusion technique estimates high-precision and high-sampling rate displacement by taking advantage of both LiDAR and LDV measurements and overcomes their limitations by adopting a real-time smoothing based Kalman filter. To verify the performance of the proposed dynamic displacement estimation technique, a series of lab-scale tests are conducted under various loading conditions.

  2. An Algorithm to Identify and Localize Suitable Dock Locations from 3-D LiDAR Scans

    DTIC Science & Technology

    2013-05-10

    3-D) LiDARs have proved themselves very useful on many autonomous ground vehicles, such as the Google Driverless Car Project, the DARPA, Defense...appear in a typical point cloud data set, relative to other clusters such as cars , trees, boulders, etc. In this algorithm, these values were

  3. Diversity Arrays Technology (DArT) platform for genotyping and mapping in carrot (Daucus carota L.)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Carrot is one of the most important root vegetable crops grown worldwide on more than one million hectares. Its progenitor, wild Daucus carota, is a weed commonly occurring across continents in the temperate climatic zone. Diversity Array Technology (DArT) is a microarray-based molecular marker syst...

  4. Pit Latrine Emptying Behavior and Demand for Sanitation Services in Dar Es Salaam, Tanzania

    PubMed Central

    Jenkins, Marion W.; Cumming, Oliver; Cairncross, Sandy

    2015-01-01

    Pit latrines are the main form of sanitation in unplanned areas in many rapidly growing developing cities. Understanding demand for pit latrine fecal sludge management (FSM) services in these communities is important for designing demand-responsive sanitation services and policies to improve public health. We examine latrine emptying knowledge, attitudes, behavior, trends and rates of safe/unsafe emptying, and measure demand for a new hygienic latrine emptying service in unplanned communities in Dar Es Salaam (Dar), Tanzania, using data from a cross-sectional survey at 662 residential properties in 35 unplanned sub-wards across Dar, where 97% had pit latrines. A picture emerges of expensive and poor FSM service options for latrine owners, resulting in widespread fecal sludge exposure that is likely to increase unless addressed. Households delay emptying as long as possible, use full pits beyond what is safe, face high costs even for unhygienic emptying, and resort to unsafe practices like ‘flooding out’. We measured strong interest in and willingness to pay (WTP) for the new pit emptying service at 96% of residences; 57% were WTP ≥U.S. $17 to remove ≥200 L of sludge. Emerging policy recommendations for safe FSM in unplanned urban communities in Dar and elsewhere are discussed. PMID:25734790

  5. How Children Living in Poor Areas of Dar Es Salaam, Tanzania Perceive Their Own Multiple Intelligences

    ERIC Educational Resources Information Center

    Dixon, Pauline; Humble, Steve; Chan, David W.

    2016-01-01

    This study was carried out with 1,857 poor children from 17 schools, living in low-income areas of Dar Es Salaam, Tanzania. All children took the "Student Multiple Intelligences Profile" (SMIP) questionnaire as part of a bigger project that gathered data around concepts and beliefs of talent. This paper sets out two aims, first to…

  6. High-throughput genotyping of hop (Humulus lupulus L.) utilising diversity arrays technology (DArT)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Implementation of molecular methods in hop breeding is dependent on the availability of sizeable numbers of polymorphic markers and a comprehensive understanding of genetic variation. Diversity Arrays Technology (DArT) is a high-throughput cost-effective method for the discovery of large numbers of...

  7. High-throughput genotyping of hop (Humulus lupulus L.) utilising diversity arrays technology (DArT).

    PubMed

    Howard, E L; Whittock, S P; Jakše, J; Carling, J; Matthews, P D; Probasco, G; Henning, J A; Darby, P; Cerenak, A; Javornik, B; Kilian, A; Koutoulis, A

    2011-05-01

    Implementation of molecular methods in hop (Humulus lupulus L.) breeding is dependent on the availability of sizeable numbers of polymorphic markers and a comprehensive understanding of genetic variation. However, use of molecular marker technology is limited due to expense, time inefficiency, laborious methodology and dependence on DNA sequence information. Diversity arrays technology (DArT) is a high-throughput cost-effective method for the discovery of large numbers of quality polymorphic markers without reliance on DNA sequence information. This study is the first to utilise DArT for hop genotyping, identifying 730 polymorphic markers from 92 hop accessions. The marker quality was high and similar to the quality of DArT markers previously generated for other species; although percentage polymorphism and polymorphism information content (PIC) were lower than in previous studies deploying other marker systems in hop. Genetic relationships in hop illustrated by DArT in this study coincide with knowledge generated using alternate methods. Several statistical analyses separated the hop accessions into genetically differentiated North American and European groupings, with hybrids between the two groups clearly distinguishable. Levels of genetic diversity were similar in the North American and European groups, but higher in the hybrid group. The markers produced from this time and cost-efficient genotyping tool will be a valuable resource for numerous applications in hop breeding and genetics studies, such as mapping, marker-assisted selection, genetic identity testing, guidance in the maintenance of genetic diversity and the directed breeding of superior cultivars.

  8. The Effect of Lava Texture on LiDAR Attributes and Full Waveform

    NASA Astrophysics Data System (ADS)

    Anderson, S. W.; Finnegan, D. C.; LeWinter, A.

    2013-12-01

    The distribution of glassy, vesicular, and crystalline textures on lava flow and dome surfaces provides insights regarding the physical and chemical processes occurring during emplacement. For silicic flows, these textures may reflect variations in the volatile content of lava upon eruption. To assess the efficacy of texture detection with our terrestrial full waveform LiDAR system capable of measuring ~125,000 topographic points/second, we analyzed attribute and full waveform data from a variety of lava textures displayed on recent rhyolitic obsidian flows of the Inyo Dome chain (California) and pahoehoe and aa flows at Kilauea volcano (Hawaii). We find that attributes such as intensity, amplitude and deviation of the returned 1550nm laser pulse fall into discrete ranges associated with glassy, pumiceous and crystalline textures on both the rhyolitic and basaltic surfaces. This enables detection of vesicularity at ranges in excess of 500 m, making LiDAR a useful tool for remotely determining lava texture. Scan times using our Riegl VZ1000 and VZ400 systems require only minutes, allowing for repeated scans over a short time period, and processing times are <1 hour. We have also analyzed the full digitized waveforms of LiDAR pulses returned from these surfaces, and find that they also have unique signatures related to texture. We therefore suggest that LiDAR can provide reliable information on lava texture during eruption, aiding in the interpretation of eruption hazards from increasing volatile contents.

  9. Airborne hyperspectral and LiDAR data integration for weed detection

    NASA Astrophysics Data System (ADS)

    Tamás, János; Lehoczky, Éva; Fehér, János; Fórián, Tünde; Nagy, Attila; Bozsik, Éva; Gálya, Bernadett; Riczu, Péter

    2014-05-01

    Agriculture uses 70% of global available fresh water. However, ca. 50-70% of water used by cultivated plants, the rest of water transpirated by the weeds. Thus, to define the distribution of weeds is very important in precision agriculture and horticulture as well. To survey weeds on larger fields by traditional methods is often time consuming. Remote sensing instruments are useful to detect weeds in larger area. In our investigation a 3D airborne laser scanner (RIEGL LMS-Q680i) was used in agricultural field near Sopron to scouting weeds. Beside the airborne LiDAR, hyperspectral imaging system (AISA DUAL) and air photos helped to investigate weed coverage. The LiDAR survey was carried out at early April, 2012, before sprouting of cultivated plants. Thus, there could be detected emerging of weeds and direction of cultivation. However airborne LiDAR system was ideal to detect weeds, identification of weeds at species level was infeasible. Higher point density LiDAR - Terrestrial laser scanning - systems are appropriate to distinguish weed species. Based on the results, laser scanner is an effective tool to scouting of weeds. Appropriate weed detection and mapping systems could contribute to elaborate water and herbicide saving management technique. This publication was supported by the OTKA project K 105789.

  10. Line-Based Registration of Panoramic Images and LiDAR Point Clouds for Mobile Mapping.

    PubMed

    Cui, Tingting; Ji, Shunping; Shan, Jie; Gong, Jianya; Liu, Kejian

    2016-12-31

    For multi-sensor integrated systems, such as the mobile mapping system (MMS), data fusion at sensor-level, i.e., the 2D-3D registration between an optical camera and LiDAR, is a prerequisite for higher level fusion and further applications. This paper proposes a line-based registration method for panoramic images and a LiDAR point cloud collected by a MMS. We first introduce the system configuration and specification, including the coordinate systems of the MMS, the 3D LiDAR scanners, and the two panoramic camera models. We then establish the line-based transformation model for the panoramic camera. Finally, the proposed registration method is evaluated for two types of camera models by visual inspection and quantitative comparison. The results demonstrate that the line-based registration method can significantly improve the alignment of the panoramic image and the LiDAR datasets under either the ideal spherical or the rigorous panoramic camera model, with the latter being more reliable.

  11. Errors in LiDAR-derived shrub height and crown area on sloped terrain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This study developed and tested four methodologies for determining shrub height measurements with LiDAR data in a semiarid shrub-steppe in southwestern Idaho, USA. Unique to this study was the focus of sagebrush height measurements on sloped terrain. The study also developed one of the first metho...

  12. Shape Detection from Raw LiDAR Data with Subspace Modeling.

    PubMed

    Wang, Jun; Xu, Kevin Kai

    2016-08-31

    LiDAR scanning has become a prevalent technique for digitalizing large-scale outdoor scenes. However, the raw LiDAR data often contain imperfections, e.g., missing large regions, anisotropy of sampling density, and contamination of noise and outliers, which are the major obstacles that hinder its more ambitious and higher level applications in digital city modeling. Observing that 3D urban scenes can be locally described with several low dimensional subspaces, we propose to locally classify the neighborhoods of the scans to model the substructures of the scenes. The key enabler is the adaptive kernel-scale scoring, filtering and clustering of substructures, making it possible to recover the local structures at all points simultaneously, even in the presence of severe data imperfections. Integrating the local analyses leads to robust shape detection from raw LiDAR data. On this basis, we develop several urban scene applications and verify them on a number of LiDAR scans with various complexities and styles, which demonstrates the effectiveness and robustness of our methods.

  13. A comparison of two open source LiDAR surface classification algorithms

    Technology Transfer Automated Retrieval System (TEKTRAN)

    With the progression of LiDAR (Light Detection and Ranging) towards a mainstream resource management tool, it has become necessary to understand how best to process and analyze the data. While most ground surface identification algorithms remain proprietary and have high purchase costs; a few are op...

  14. Geospatial revolution and remote sensing LiDAR in Mesoamerican archaeology.

    PubMed

    Chase, Arlen F; Chase, Diane Z; Fisher, Christopher T; Leisz, Stephen J; Weishampel, John F

    2012-08-07

    The application of light detection and ranging (LiDAR), a laser-based remote-sensing technology that is capable of penetrating overlying vegetation and forest canopies, is generating a fundamental shift in Mesoamerican archaeology and has the potential to transform research in forested areas world-wide. Much as radiocarbon dating that half a century ago moved archaeology forward by grounding archaeological remains in time, LiDAR is proving to be a catalyst for an improved spatial understanding of the past. With LiDAR, ancient societies can be contextualized within a fully defined landscape. Interpretations about the scale and organization of densely forested sites no longer are constrained by sample size, as they were when mapping required laborious on-ground survey. The ability to articulate ancient landscapes fully permits a better understanding of the complexity of ancient Mesoamerican urbanism and also aids in modern conservation efforts. The importance of this geospatial innovation is demonstrated with newly acquired LiDAR data from the archaeological sites of Caracol, Cayo, Belize and Angamuco, Michoacán, Mexico. These data illustrate the potential of technology to act as a catalytic enabler of rapid transformational change in archaeological research and interpretation and also underscore the value of on-the-ground archaeological investigation in validating and contextualizing results.

  15. Genetics and Human Agency: Comment on Dar-Nimrod and Heine (2011)

    ERIC Educational Resources Information Center

    Turkheimer, Eric

    2011-01-01

    Dar-Nimrod and Heine (2011) decried genetic essentialism without denying the importance of genetics in the genesis of human behavior, and although I agree on both counts, a deeper issue remains unaddressed: how should we adjust our cognitions about our own behavior in light of genetic influence, or is it perhaps not necessary to take genetics into…

  16. Draft genome sequence of Bacillus thuringiensis strain DAR 81934, which exhibits molluscicidal activity.

    PubMed

    Wang, Aisuo; Pattemore, Julie; Ash, Gavin; Williams, Angela; Hane, James

    2013-03-21

    Bacillus thuringiensis has been widely used as a biopesticide for a long time. Its molluscicidal activity, however, is rarely realized. Here, we report the genome sequence of B. thuringiensis strain DAR 81934, a strain with molluscicidal activity against the pest snail Cernuella virgata.

  17. Child Labour in Urban Agriculture: The Case of Dar es Salaam, Tanzania.

    ERIC Educational Resources Information Center

    Mlozi, Malongo R. S.

    1995-01-01

    Urban agriculture in Dar es Salaam was found to use child labor of both children with parents of higher and lower socioeconomic status (SES). Discusses policy implications and calls for the education of parents of lower SES not to expect an economic contribution from their children's labor, and the education of children about their rights. (LZ)

  18. Genetic Essentialism, Neuroessentialism, and Stigma: Commentary on Dar-Nimrod and Heine (2011)

    ERIC Educational Resources Information Center

    Haslam, Nick

    2011-01-01

    Dar-Nimrod and Heine (2011) presented a masterfully broad review of the implications of genetic essentialism for understandings of human diversity. This commentary clarifies the reasons that essentialist thinking has problematic social consequences and links genetic forms of essentialism to those invoking neural essences. The mounting evidence…

  19. Multitemporal Error Analysis of LiDAR Data for Geomorphological Feature Detection

    NASA Astrophysics Data System (ADS)

    Sailer, R.; Höfle, B.; Bollmann, E.; Vetter, M.; Stötter, J.; Pfeifer, N.; Rutzinger, M.; Geist, T.

    2009-04-01

    Since 2001 airborne LiDAR measurements have been carried out regularly at the Hintereisferner region (Ötztal, Tyrol, Austria). This results in a worldwide unique data set, which is primarily used for multitemporal glacial and periglacial analyses. Several methods and tools i) to delineate the glacier boundary, ii) to derive standard glaciological mass balance parameters (e.g. volume changes), iii) to excerpt crevasse zones or iv) to classify glacier surface features (e.g. snow, firn, glacier ice, debris covered glacier ice) have been developed as yet. Furthermore, the available multitemporal LiDAR data set offers the opportunity to identify surface changes occurring outside the glacier boundary, which have not been recognized until now. The respective areas are characterized by small variations of the surface topography from year to year. These changes of the surface topography are primarily caused by periglacial processes further initiating secondary gravitative mass movements. The present study aims at quantifying the error range of LiDAR measurements. The error analysis, which is based on (at least) 66 cross-combinations of the single LiDAR measurement campaigns, excluding areas which are obviously related to glacial surface changes, results in statistically derived error margins. Hence, surface changes which exceed these error margins have to be assigned to periglacial or gravitative process activities. The study further aims at identifying areas which are explicitly related to those periglacial and gravitative processes.

  20. Pit latrine emptying behavior and demand for sanitation services in Dar Es Salaam, Tanzania.

    PubMed

    Jenkins, Marion W; Cumming, Oliver; Cairncross, Sandy

    2015-02-27

    Pit latrines are the main form of sanitation in unplanned areas in many rapidly growing developing cities. Understanding demand for pit latrine fecal sludge management (FSM) services in these communities is important for designing demand-responsive sanitation services and policies to improve public health. We examine latrine emptying knowledge, attitudes, behavior, trends and rates of safe/unsafe emptying, and measure demand for a new hygienic latrine emptying service in unplanned communities in Dar Es Salaam (Dar), Tanzania, using data from a cross-sectional survey at 662 residential properties in 35 unplanned sub-wards across Dar, where 97% had pit latrines. A picture emerges of expensive and poor FSM service options for latrine owners, resulting in widespread fecal sludge exposure that is likely to increase unless addressed. Households delay emptying as long as possible, use full pits beyond what is safe, face high costs even for unhygienic emptying, and resort to unsafe practices like 'flooding out'. We measured strong interest in and willingness to pay (WTP) for the new pit emptying service at 96% of residences; 57% were WTP≥U.S. $17 to remove ≥200 L of sludge. Emerging policy recommendations for safe FSM in unplanned urban communities in Dar and elsewhere are discussed.

  1. Effects of atmospheric stability on the evolution of wind turbine wakes: Volumetric LiDAR scans

    NASA Astrophysics Data System (ADS)

    Valerio Iungo, Giacomo; Porté-Agel, Fernando

    2014-05-01

    Aerodynamic optimization of wind farm layout is a fundamental task to reduce wake effects on downstream wind turbines, thus to maximize wind power harvesting. However, downstream evolution and recovery of wind turbine wakes are strongly affected by the characteristics of the incoming atmospheric boundary layer (ABL) flow, like the vertical profiles of the mean wind velocity and the turbulence intensity, which are in turn affected by the ABL stability regime. Therefore, the characterization of the variability of wind turbine wakes under different ABL stability regimes becomes fundamental to better predict wind power harvesting and improve wind farm efficiency. To this aim, wind velocity measurements of the wake produced by a 2 MW Enercon E-70 wind turbine were performed with three scanning Doppler wind Light Detection and Ranging (LiDAR) instruments. One LiDAR was typically devoted to the characterization of the incoming wind, in particular wind velocity, shear and turbulence intensity at the height of the rotor disc. The other two LiDARs performed scans in order to characterize the wake velocity field produced by the tested wind turbine. The main challenge in performing field measurements of wind turbine wakes is represented by the varying wind conditions, and by the consequent adjustments of the turbine yaw angle needed to maximize power production. Consequently, taking into account possible variations of the relative position between LiDAR measurement volume and wake location, different LiDAR measurement procedures were carried out in order to perform 2-D and 3-D characterizations of the mean wake velocity field. However, larger measurement volumes and higher spatial resolution require longer sampling periods; thus, to investigate wake turbulence tests were also performed by staring the LiDAR laser beam over fixed directions and with the maximum sampling frequency. Furthermore, volumetric scans of the wind turbine wake were performed under different wind

  2. Using Satellite and Airborne LiDAR to Model Woodpecker Habitat Occupancy at the Landscape Scale

    PubMed Central

    Vierling, Lee A.; Vierling, Kerri T.; Adam, Patrick; Hudak, Andrew T.

    2013-01-01

    Incorporating vertical vegetation structure into models of animal distributions can improve understanding of the patterns and processes governing habitat selection. LiDAR can provide such structural information, but these data are typically collected via aircraft and thus are limited in spatial extent. Our objective was to explore the utility of satellite-based LiDAR data from the Geoscience Laser Altimeter System (GLAS) relative to airborne-based LiDAR to model the north Idaho breeding distribution of a forest-dependent ecosystem engineer, the Red-naped sapsucker (Sphyrapicus nuchalis). GLAS data occurred within ca. 64 m diameter ellipses spaced a minimum of 172 m apart, and all occupancy analyses were confined to this grain scale. Using a hierarchical approach, we modeled Red-naped sapsucker occupancy as a function of LiDAR metrics derived from both platforms. Occupancy models based on satellite data were weak, possibly because the data within the GLAS ellipse did not fully represent habitat characteristics important for this species. The most important structural variables influencing Red-naped Sapsucker breeding site selection based on airborne LiDAR data included foliage height diversity, the distance between major strata in the canopy vertical profile, and the vegetation density near the ground. These characteristics are consistent with the diversity of foraging activities exhibited by this species. To our knowledge, this study represents the first to examine the utility of satellite-based LiDAR to model animal distributions. The large area of each GLAS ellipse and the non-contiguous nature of GLAS data may pose significant challenges for wildlife distribution modeling; nevertheless these data can provide useful information on ecosystem vertical structure, particularly in areas of gentle terrain. Additional work is thus warranted to utilize LiDAR datasets collected from both airborne and past and future satellite platforms (e.g. GLAS, and the planned IceSAT2

  3. Building Damage Assessment after Earthquake Using Post-Event LiDAR Data

    NASA Astrophysics Data System (ADS)

    Rastiveis, H.; Eslamizade, F.; Hosseini-Zirdoo, E.

    2015-12-01

    After an earthquake, damage assessment plays an important role in leading rescue team to help people and decrease the number of mortality. Damage map is a map that demonstrates collapsed buildings with their degree of damage. With this map, finding destructive buildings can be quickly possible. In this paper, we propose an algorithm for automatic damage map generation after an earthquake using post-event LiDAR Data and pre-event vector map. The framework of the proposed approach has four main steps. To find the location of all buildings on LiDAR data, in the first step, LiDAR data and vector map are registered by using a few number of ground control points. Then, building layer, selected from vector map, are mapped on the LiDAR data and all pixels which belong to the buildings are extracted. After that, through a powerful classifier all the extracted pixels are classified into three classes of "debris", "intact building" and "unclassified". Since textural information make better difference between "debris" and "intact building" classes, different textural features are applied during the classification. After that, damage degree for each candidate building is estimated based on the relation between the numbers of pixels labelled as "debris" class to the whole building area. Calculating the damage degree for each candidate building, finally, building damage map is generated. To evaluate the ability proposed method in generating damage map, a data set from Port-au-Prince, Haiti's capital after the 2010 Haiti earthquake was used. In this case, after calculating of all buildings in the test area using the proposed method, the results were compared to the damage degree which estimated through visual interpretation of post-event satellite image. Obtained results were proved the reliability of the proposed method in damage map generation using LiDAR data.

  4. Mapping the Risk of Forest Wind Damage Using Airborne Scanning LiDAR

    NASA Astrophysics Data System (ADS)

    Saarinen, N.; Vastaranta, M.; Honkavaara, E.; Wulder, M. A.; White, J. C.; Litkey, P.; Holopainen, M.; Hyyppä, J.

    2015-03-01

    Wind damage is known for causing threats to sustainable forest management and yield value in boreal forests. Information about wind damage risk can aid forest managers in understanding and possibly mitigating damage impacts. The objective of this research was to better understand and quantify drivers of wind damage, and to map the probability of wind damage. To accomplish this, we used open-access airborne scanning light detection and ranging (LiDAR) data. The probability of wind-induced forest damage (PDAM) in southern Finland (61°N, 23°E) was modelled for a 173 km2 study area of mainly managed boreal forests (dominated by Norway spruce and Scots pine) and agricultural fields. Wind damage occurred in the study area in December 2011. LiDAR data were acquired prior to the damage in 2008. High spatial resolution aerial imagery, acquired after the damage event (January, 2012) provided a source of model calibration via expert interpretation. A systematic grid (16 m x 16 m) was established and 430 sample grid cells were identified systematically and classified as damaged or undamaged based on visual interpretation using the aerial images. Potential drivers associated with PDAM were examined using a multivariate logistic regression model. Risk model predictors were extracted from the LiDAR-derived surface models. Geographic information systems (GIS) supported spatial mapping and identification of areas of high PDAM across the study area. The risk model based on LiDAR data provided good agreement with detected risk areas (73 % with kappa-value 0,47). The strongest predictors in the risk model were mean canopy height and mean elevation. Our results indicate that open-access LiDAR data sets can be used to map the probability of wind damage risk without field data, providing valuable information for forest management planning.

  5. Object-Based Land Use Classification using Airborne LiDAR

    NASA Astrophysics Data System (ADS)

    Antonarakis, A. S.; Richards, K. S.; Brasington, J.

    2007-12-01

    Better information on roughness of various types of vegetation is needed for use in resistance equations and eventually in flood modelling. These types include woody riparian species with different structural characteristics. Remote Sensing information such as 3D point cloud data from LiDAR can be used as a tool for extracting simple roughness information relevant for the condition of below canopy flow, as well as roughness relevant for more complex tree morphology that affects the flow when it enters the canopy levels. A strategy for extracting roughness parameters from remote sensing techniques is to use a data fusion object classification model. This means that multiple datasets such as LiDAR, digital aerial photography, ground data and satellite data can be combined to produce roughness parameters estimated for different vegetative patches, which can subsequently be mapped spatially using a classification methodology. Airborne LiDAR is used in this study in order to classify forest and ground types quickly and efficiently without the need for manipulating multispectral image files. LiDAR has the advantage of being able to create elevation surfaces that are in 3D, while also having information on LiDAR intensity values, thus it is a spatial and spectral segmentation tool. This classification method also uses point distribution frequency criteria to differentiate between land cover types. The classification of three meanders of the Garonne and Allier rivers in France has demonstrated overall classification accuracies of 95%. Five types of riparian forest were classified with accuracies between 66-98%. These forest types included planted and natural forest stands of different ages. Classifications of short vegetation and bare earth also produced high accuracies averaging above 90%.

  6. Effects of LiDAR Derived DEM Resolution on Hydrographic Feature Extraction

    NASA Astrophysics Data System (ADS)

    Yang, P.; Ames, D. P.; Glenn, N. F.; Anderson, D.

    2010-12-01

    This paper examines the effect of LiDAR-derived digital elevation model (DEM) resolution on digitally extracted stream networks with respect to known stream channel locations. Two study sites, Reynolds Creek Experimental Watershed (RCEW) and Dry Creek Experimental Watershed (DCEW), which represent terrain characteristics for lower and intermediate elevation mountainous watersheds in the Intermountain West, were selected as study areas for this research. DEMs reflecting bare earth ground were created from the LiDAR observations at a series of raster cell sizes (from 1 m to 60 m) using spatial interpolation techniques. The effect of DEM resolution on resulting hydrographic feature (specifically stream channel) derivation was studied. Stream length, watershed area, and sinuosity were explored at each of the raster cell sizes. Also, variation from known channel location as estimated by root mean square error (RMSE) between surveyed channel location and extracted channel was computed for each of the DEMs and extracted stream networks. As expected, the results indicate that the DEM based hydrographic extraction process provides more detailed hydrographic features at a finer resolution. RMSE between the known channel location and modeled locations generally increased with larger cell size DEM with a greater effect in the larger RCEW. Sensitivity analyses on sinuosity demonstrated that the resulting shape of streams obtained from LiDAR data matched best with the reference data at an intermediate cell size instead of highest resolution, which is at a range of cell size from 5 to 10 m likely due to original point spacing, terrain characteristics, and LiDAR noise influence. More importantly, the absolute sinuosity deviation displayed a smallest value at the cell size of 10 m in both experimental watersheds, which suggests that optimal cell size for LiDAR-derived DEMs used for hydrographic feature extraction is 10 m.

  7. Combined use of LiDAR data and multispectral earth observation imagery for wetland habitat mapping

    NASA Astrophysics Data System (ADS)

    Rapinel, Sébastien; Hubert-Moy, Laurence; Clément, Bernard

    2015-05-01

    Although wetlands play a key role in controlling flooding and nonpoint source pollution, sequestering carbon and providing an abundance of ecological services, the inventory and characterization of wetland habitats are most often limited to small areas. This explains why the understanding of their ecological functioning is still insufficient for a reliable functional assessment on areas larger than a few hectares. While LiDAR data and multispectral Earth Observation (EO) images are often used separately to map wetland habitats, their combined use is currently being assessed for different habitat types. The aim of this study is to evaluate the combination of multispectral and multiseasonal imagery and LiDAR data to precisely map the distribution of wetland habitats. The image classification was performed combining an object-based approach and decision-tree modeling. Four multispectral images with high (SPOT-5) and very high spatial resolution (Quickbird, KOMPSAT-2, aerial photographs) were classified separately. Another classification was then applied integrating summer and winter multispectral image data and three layers derived from LiDAR data: vegetation height, microtopography and intensity return. The comparison of classification results shows that some habitats are better identified on the winter image and others on the summer image (overall accuracies = 58.5 and 57.6%). They also point out that classification accuracy is highly improved (overall accuracy = 86.5%) when combining LiDAR data and multispectral images. Moreover, this study highlights the advantage of integrating vegetation height, microtopography and intensity parameters in the classification process. This article demonstrates that information provided by the synergetic use of multispectral images and LiDAR data can help in wetland functional assessment

  8. A universal airborne LiDAR approach for tropical forest carbon mapping.

    PubMed

    Asner, Gregory P; Mascaro, Joseph; Muller-Landau, Helene C; Vieilledent, Ghislain; Vaudry, Romuald; Rasamoelina, Maminiaina; Hall, Jefferson S; van Breugel, Michiel

    2012-04-01

    Airborne light detection and ranging (LiDAR) is fast turning the corner from demonstration technology to a key tool for assessing carbon stocks in tropical forests. With its ability to penetrate tropical forest canopies and detect three-dimensional forest structure, LiDAR may prove to be a major component of international strategies to measure and account for carbon emissions from and uptake by tropical forests. To date, however, basic ecological information such as height-diameter allometry and stand-level wood density have not been mechanistically incorporated into methods for mapping forest carbon at regional and global scales. A better incorporation of these structural patterns in forests may reduce the considerable time needed to calibrate airborne data with ground-based forest inventory plots, which presently necessitate exhaustive measurements of tree diameters and heights, as well as tree identifications for wood density estimation. Here, we develop a new approach that can facilitate rapid LiDAR calibration with minimal field data. Throughout four tropical regions (Panama, Peru, Madagascar, and Hawaii), we were able to predict aboveground carbon density estimated in field inventory plots using a single universal LiDAR model (r ( 2 ) = 0.80, RMSE = 27.6 Mg C ha(-1)). This model is comparable in predictive power to locally calibrated models, but relies on limited inputs of basal area and wood density information for a given region, rather than on traditional plot inventories. With this approach, we propose to radically decrease the time required to calibrate airborne LiDAR data and thus increase the output of high-resolution carbon maps, supporting tropical forest conservation and climate mitigation policy.

  9. Water turbidity estimation from airborne hyperspectral imagery and full waveform bathymetric LiDAR

    NASA Astrophysics Data System (ADS)

    Pan, Z.; Glennie, C. L.; Fernandez-Diaz, J. C.

    2015-12-01

    The spatial and temporal variations in water turbidity are of great interest for the study of fluvial and coastal environments; and for predicting the performance of remote sensing systems that are used to map these. Conventional water turbidity estimates from remote sensing observations have normally been derived using near infrared reflectance. We have investigated the potential of determining water turbidity from additional remote sensing sources, namely airborne hyperspectral imagery and single wavelength bathymetric LiDAR (Light Detection and Ranging). The confluence area of the Blue and Colorado River, CO was utilized as a study area to investigate the capabilities of both airborne bathymetric LiDAR and hyperspectral imagery for water turbidity estimation. Discrete and full waveform bathymetric data were collected using Optech's Gemini (1064 nm) and Aquarius (532 nm) LiDAR sensors. Hyperspectral imagery (1.2 m pixel resolution and 72 spectral bands) was acquired using an ITRES CASI-1500 imaging system. As an independent reference, measurements of turbidity were collected concurrent with the airborne remote sensing acquisitions, using a WET Labs EcoTriplet deployed from a kayak and turbidity was then derived from the measured backscatter. The bathymetric full waveform dataset contains a discretized sample of the full backscatter of water column and benthic layer. Therefore, the full waveform records encapsulate the water column characteristics of turbidity. A nonparametric support vector regression method is utilized to estimate water turbidity from both hyperspectral imagery and voxelized full waveform LiDAR returns, both individually and as a fused dataset. Results of all the evaluations will be presented, showing an initial turbidity prediction accuracy of approximately 1.0 NTU. We will also discuss our future strategy for enhanced fusion of the full waveform LiDAR and hyperspectral imagery for improved turbidity estimation.

  10. Estimating Above Ground Biomass using LiDAR in the Northcoast Redwood Forests

    NASA Astrophysics Data System (ADS)

    Rao, M.; Stewart, E.

    2010-12-01

    In recent years, LiDAR (Light Intensity Detection Amplification and Ranging) is increasingly being used in estimating biophysical parameters related to forested environments. The main goal of the project is to estimate long-term biomass accumulation and carbon sequestration potential of the redwoods ecosystem. The project objectives are aimed at providing an assessment of carbon pools within the redwood ecosystem. Specifically, we intend to develop a relational model based on LiDAR-based canopy estimates and extensive ground-based measurements available for the old-growth redwood forest located within the Prairie Creek Redwoods State Park, CA. Our preliminary analysis involved developing a geospatial database, including LiDAR data collected in 2007 for the study site, and analyzing the data using USFS Fusion software. The study area comprised of a 12-acres section of coastal redwood (Sequoia sempervirens) in the Prairie Creek Redwoods State Park, located in Orick, CA. A series of analytical steps were executed using the USFS FUSION software to produce some intermediate data such as bare earth model, canopy height model, canopy coverage model, and canopy maxima treelist. Canopy maxima tree tops were compared to ground layer to determine height of tree tops. A total of over 1000 trees were estimated, and then with thinning (to eliminate errors due to low vegetation > 3 meters tall), a total of 950 trees were delineated. Ground measurements were imported as a point based shapefile and then compared to the treetop heights created from LiDAR data to the actual ground referenced data. The results were promising as most estimated treetops were within 1-3 meters of the ground measurements and generally within 3-5m of the actual tree height. Finally, we are in the process of applying some allometric equations to estimate above ground biomass using some of the LiDAR-derived canopy metrics.

  11. Characterizing Wildlife Habitat With LiDAR Data: Distribution Mapping Of Snags And Understory Shrubs

    NASA Astrophysics Data System (ADS)

    Martinuzzi, S.; Vierling, L.; Gould, W.; Falkowski, M.; Evans, J.; Hudak, A.; Vierling, K.

    2008-12-01

    Spatial data about the distribution of snags and understory shrubs is a major need for managing wildlife habitat in forests. We are evaluating the use of discrete return LiDAR data for predicting the distribution (presence/absence) of understory shrubs and different classes (i.e. diameters) of snags, in a managed, mixed-conifer forest in Northern Idaho, US. We are using a variety of ground and vegetation metrics derived from LiDAR data and the Random Forest algorithm to build our distribution models, and have obtained overall accuracies >80%. These preliminary results indicate that LiDAR data are valuable for predicting the distribution of understory shrubs and common snag diameter classes in the study area. In particular, LiDAR-derived metrics allow us to 1) quantify a variety of ecological factors (e.g. canopy structure, topography) that are known to influence the distribution and abundance of understory vegetation and snags in temperate, mountainous forests, and 2) quantify structural characteristics that are known to directly or indirectly indicate the presence of our classes of interest, such as the percent of vegetation returns in the lower strata of the canopy (for the shrubs), and the structural heterogeneity of the forest canopy (for the snags). Finally, and in order to further evaluate the use of LiDAR data for characterizing wildlife habitat, we integrate our maps of snags and shrubs distribution into models of habitat suitability, using four avian species (i.e. three woodpeckers and a flycatcher) as a case study.

  12. Applying a weighted random forests method to extract karst sinkholes from LiDAR data

    NASA Astrophysics Data System (ADS)

    Zhu, Junfeng; Pierskalla, William P.

    2016-02-01

    Detailed mapping of sinkholes provides critical information for mitigating sinkhole hazards and understanding groundwater and surface water interactions in karst terrains. LiDAR (Light Detection and Ranging) measures the earth's surface in high-resolution and high-density and has shown great potentials to drastically improve locating and delineating sinkholes. However, processing LiDAR data to extract sinkholes requires separating sinkholes from other depressions, which can be laborious because of the sheer number of the depressions commonly generated from LiDAR data. In this study, we applied the random forests, a machine learning method, to automatically separate sinkholes from other depressions in a karst region in central Kentucky. The sinkhole-extraction random forest was grown on a training dataset built from an area where LiDAR-derived depressions were manually classified through a visual inspection and field verification process. Based on the geometry of depressions, as well as natural and human factors related to sinkholes, 11 parameters were selected as predictive variables to form the dataset. Because the training dataset was imbalanced with the majority of depressions being non-sinkholes, a weighted random forests method was used to improve the accuracy of predicting sinkholes. The weighted random forest achieved an average accuracy of 89.95% for the training dataset, demonstrating that the random forest can be an effective sinkhole classifier. Testing of the random forest in another area, however, resulted in moderate success with an average accuracy rate of 73.96%. This study suggests that an automatic sinkhole extraction procedure like the random forest classifier can significantly reduce time and labor costs and makes its more tractable to map sinkholes using LiDAR data for large areas. However, the random forests method cannot totally replace manual procedures, such as visual inspection and field verification.

  13. [Leadership in the hospital].

    PubMed

    Schrappe, Matthias

    2009-01-01

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

  14. Reporting hospital adverse events using the Alfred Hospital's morbidity data.

    PubMed

    Carroll, Rhonda; McLean, Jenny; Walsh, Michael

    2003-01-01

    Hospital morbidity data were analysed to determine their usefulness for reporting adverse events. The entire ICD-10-AM classification system was reviewed in conjunction with the Australian Coding Standards to identify external cause codes and code prefixes associated with adverse events. For the 50,712 separations registered at The Alfred from July 2000-June 2001, 4,740 external cause codes were associated with adverse events. Place of occurrence code CY92.22 was considered the best indicator of the number of separations associated with adverse events. Approximately 4% of all separations were associated with adverse events occurring during an episode of care. Results suggest that hospital morbidity data are useful for monitoring adverse events at hospital level. Reliable reporting across the health care industry requires consistent reporting requirements at state and national levels and the adoption of standard code prefixes nationally.

  15. Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania

    PubMed Central

    2014-01-01

    Background Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. Case description The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. Discussion and evaluation The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. Conclusions The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam’s City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes. PMID

  16. Improving estimation of tree carbon stocks by harvesting aboveground woody biomass within airborne LiDAR flight areas

    NASA Astrophysics Data System (ADS)

    Colgan, M.; Asner, G. P.; Swemmer, A. M.

    2011-12-01

    The accurate estimation of carbon stored in a tree is essential to accounting for the carbon emissions due to deforestation and degradation. Airborne LiDAR (Light Detection and Ranging) has been successful in estimating aboveground carbon density (ACD) by correlating airborne metrics, such as canopy height, to field-estimated biomass. This latter step is reliant on field allometry which is applied to forest inventory quantities, such as stem diameter and height, to predict the biomass of a given tree stem. Constructing such allometry is expensive, time consuming, and requires destructive sampling. Consequently, the sample sizes used to construct such allometry are often small, and the largest tree sampled is often much smaller than the largest in the forest population. The uncertainty resulting from these sampling errors can lead to severe biases when the allometry is applied to stems larger than those harvested to construct the allometry, which is then subsequently propagated to airborne ACD estimates. The Kruger National Park (KNP) mission of maintaining biodiversity coincides with preserving ecosystem carbon stocks. However, one hurdle to accurately quantifying carbon density in savannas is that small stems are typically harvested to construct woody biomass allometry, yet they are not representative of Kruger's distribution of biomass. Consequently, these equations inadequately capture large tree variation in sapwood/hardwood composition, root/shoot/leaf allocation, branch fall, and stem rot. This study eliminates the "middleman" of field allometry by directly measuring, or harvesting, tree biomass within the extent of airborne LiDAR. This enables comparisons of field and airborne ACD estimates, and also enables creation of new airborne algorithms to estimate biomass at the scale of individual trees. A field campaign was conducted at Pompey Silica Mine 5km outside Kruger National Park, South Africa, in Mar-Aug 2010 to harvest and weigh tree mass. Since

  17. Processes of in-hospital psychiatric care and subsequent criminal behaviour among patients with schizophrenia: a national population-based, follow-up study.

    PubMed

    Pedersen, Charlotte Gjørup; Olrik Wallenstein Jensen, Signe; Johnsen, Søren Paaske; Nordentoft, Merete; Mainz, Jan

    2013-09-01

    Objectifs : On ne sait pas si les processus de soins à l’hôpital bas sur des données probantes peuvent influencer le risque de comportement criminel chez des patients souffrant de schizophrénie. Notre étude visait à examiner l’association entre soins psychiatriques à l’hôpital recommandés par des lignes directrices et le comportement criminel chez des patients souffrant de schizophrénie. Méthodes : Des patients danois souffrant de schizophrénie (de 18 ans et plus) et ayant reçu leur congé d’une unité psychiatrique entre janvier 2004 et mars 2009 ont été identifiés à l’aide du registre national de la schizophrénie dans la population (n = 10 757). Les données des soins à l’hôpital et des caractéristiques des patients ont été couplées avec les données sur les accusations criminelles obtenues du registre danois de la criminalité jusqu’en novembre 2010. Résultats : Vingt pour cent (n = 2175) des patients ont été accusés d’un crime durant le suivi (moyenne = 428 jours). Les crimes violents représentaient 59 % (n = 1282) des infractions criminelles. Le risque de comportement criminel le plus faible a été constaté chez les patients recevant le plus de processus de soins à l’hôpital (quartile supérieur des soins recommandés reçus, comparé aux quartiles inférieurs, rapport de risques corrigé = 0.86, IC à 95 % 0,75 à 0,99). Les processus de soins individuels associés au risque le plus faible de comportement criminel étaient le traitement par antipsychotiques et les contacts du personnel avec les membres de la famille. Conclusions : Les soins psychiatriques de grande qualité, à l’hôpital, étaient associés à un risque plus faible de comportement criminel après le congé chez des patients souffrant de schizophrénie.

  18. LiDAR-IMU Time Delay Calibration Based on Iterative Closest Point and Iterated Sigma Point Kalman Filter.

    PubMed

    Liu, Wanli

    2017-03-08

    The time delay calibration between Light Detection and Ranging (LiDAR) and Inertial Measurement Units (IMUs) is an essential prerequisite for its applications. However, the correspondences between LiDAR and IMU measurements are usually unknown, and thus cannot be computed directly for the time delay calibration. In order to solve the problem of LiDAR-IMU time delay calibration, this paper presents a fusion method based on iterative closest point (ICP) and iterated sigma point Kalman filter (ISPKF), which combines the advantages of ICP and ISPKF. The ICP algorithm can precisely determine the unknown transformation between LiDAR-IMU; and the ISPKF algorithm can optimally estimate the time delay calibration parameters. First of all, the coordinate transformation from the LiDAR frame to the IMU frame is realized. Second, the measurement model and time delay error model of LiDAR and IMU are established. Third, the methodology of the ICP and ISPKF procedure is presented for LiDAR-IMU time delay calibration. Experimental results are presented that validate the proposed method and demonstrate the time delay error can be accurately calibrated.

  19. LiDAR-IMU Time Delay Calibration Based on Iterative Closest Point and Iterated Sigma Point Kalman Filter

    PubMed Central

    Liu, Wanli

    2017-01-01

    The time delay calibration between Light Detection and Ranging (LiDAR) and Inertial Measurement Units (IMUs) is an essential prerequisite for its applications. However, the correspondences between LiDAR and IMU measurements are usually unknown, and thus cannot be computed directly for the time delay calibration. In order to solve the problem of LiDAR-IMU time delay calibration, this paper presents a fusion method based on iterative closest point (ICP) and iterated sigma point Kalman filter (ISPKF), which combines the advantages of ICP and ISPKF. The ICP algorithm can precisely determine the unknown transformation between LiDAR-IMU; and the ISPKF algorithm can optimally estimate the time delay calibration parameters. First of all, the coordinate transformation from the LiDAR frame to the IMU frame is realized. Second, the measurement model and time delay error model of LiDAR and IMU are established. Third, the methodology of the ICP and ISPKF procedure is presented for LiDAR-IMU time delay calibration. Experimental results are presented that validate the proposed method and demonstrate the time delay error can be accurately calibrated. PMID:28282897

  20. Development and validation of the Dimensional Anhedonia Rating Scale (DARS) in a community sample and individuals with major depression.

    PubMed

    Rizvi, Sakina J; Quilty, Lena C; Sproule, Beth A; Cyriac, Anna; Michael Bagby, R; Kennedy, Sidney H

    2015-09-30

    Anhedonia, a core symptom of Major Depressive Disorder (MDD), is predictive of antidepressant non-response. In contrast to the definition of anhedonia as a "loss of pleasure", neuropsychological studies provide evidence for multiple facets of hedonic function. The aim of the current study was to develop and validate the Dimensional Anhedonia Rating Scale (DARS), a dynamic scale that measures desire, motivation, effort and consummatory pleasure across hedonic domains. Following item selection procedures and reliability testing using data from community participants (N=229) (Study 1), the 17-item scale was validated in an online study with community participants (N=150) (Study 2). The DARS was also validated in unipolar or bipolar depressed patients (n=52) and controls (n=50) (Study 3). Principal components analysis of the 17-item DARS revealed a 4-component structure mapping onto the domains of anhedonia: hobbies, food/drink, social activities, and sensory experience. Reliability of the DARS subscales was high across studies (Cronbach's α=0.75-0.92). The DARS also demonstrated good convergent and divergent validity. Hierarchical regression analysis revealed the DARS showed additional utility over the Snaith-Hamilton Pleasure Scale (SHAPS) in predicting reward function and distinguishing MDD subgroups. These studies provide support for the reliability and validity of the DARS.

  1. Demonstration of a conceptual model for using LiDAR to improve the estimation of floodwater mitigation potential of Prairie Pothole Region wetlands

    USGS Publications Warehouse

    Huang, S.; Young, Caitlin; Feng, M.; Heidemann, K.; Cushing, M.; Mushet, D.M.; Liu, S.

    2011-01-01

    Recent flood events in the Prairie Pothole Region of North America have stimulated interest in modeling water storage capacities of wetlands and their surrounding catchments to facilitate flood mitigation efforts. Accurate estimates of basin storage capacities have been hampered by a lack of high-resolution elevation data. In this paper, we developed a 0.5 m bare-earth model from Light Detection And Ranging (LiDAR) data and, in combination with National Wetlands Inventory data, delineated wetland catchments and their spilling points within a 196 km2 study area. We then calculated the maximum water storage capacity of individual basins and modeled the connectivity among these basins. When compared to field survey results, catchment and spilling point delineations from the LiDAR bare-earth model captured subtle landscape features very well. Of the 11 modeled spilling points, 10 matched field survey spilling points. The comparison between observed and modeled maximum water storage had an R2 of 0.87 with mean absolute error of 5564 m3. Since maximum water storage capacity of basins does not translate into floodwater regulation capability, we further developed a Basin Floodwater Regulation Index. Based upon this index, the absolute and relative water that could be held by wetlands over a landscape could be modeled. This conceptual model of floodwater downstream contribution was demonstrated with water level data from 17 May 2008.

  2. Market orientation in the hospital industry.

    PubMed

    Bhuian, S N; Abdul-Gader, A

    1997-01-01

    Using the more recent methodological developments in the assessment of the unidemensionality, reliability, and validity, the authors developed and examined a scale of market orientation for the hospital industry. The scale is based on a clear definition of the content of the construct of market orientation in the hospital industry. To this end, a national random sample of 237 hospital administrators was used. In addition to the support for the reliability and validity, the scale promises parsimony, pragmatism, and wide-ranging applicability.

  3. Importance of High-Resolution LiDAR Data in Modeling Runoff Levels Over Impervious Surfaces

    NASA Astrophysics Data System (ADS)

    Melosh, C.; Rao, M.

    2013-12-01

    Directly connected impervious areas collect and deliver unfiltered runoff to modified and impacted waterways. Modeling water flow over the landscape is an effective method of observing drainage patterns and predicting pollutant and sediment loadings. Improved models applying high-resolution elevation data can identify key areas with high pollutant output. This is a crucial issue in the Lake Tahoe Basin where lakeshore urban development has increased and lake clarity has been declining for years. This study aims to evaluate an integrated LiDAR and GIS-based modeling approach that uses a fine-scaled ground surface and impervious surface connectivity to predict the pollutant load in the Lake Tahoe Basin This study produced a fine-scaled surface model of nine subset catchments in the South Tahoe basin, including areas of low (below 20%), medium (30% to 50%) and high (above 50%) impervious surface cover. Our method integrated LiDAR, multispectral imagery, and GIS data to develop accurate terrain models, hydrologic routing, and directly connected impervious area layers for the Lake Tahoe basin. The high-density ground and object elevation data collected using Light Detection and Ranging (LiDAR) creates an accurate picture of water flow over the land, and obstacles to the flow such as buildings. High-resolution LiDAR data was obtained from the Round 10 Lake Tahoe Southern Nevada Public Land Management capital program from the year 2010. This data was processed to create a digital elevation model of the ground surface. Land use classification used object height information from the LiDAR cloud, NAIP 4-band images with 1-meter resolution and a normalized difference vegetation index image derived from the NAIP imagery. The US Army Core of Engineers hydrologic modeling system (HEC-HMS) will be used to model runoff. Based on long-term simulations the effect of directly connected impervious area on rainfall-runoff characteristics for the South Lake Tahoe catchments will be

  4. Investigating the spatial distribution of water levels in the Mackenzie Delta using airborne LiDAR

    USGS Publications Warehouse

    Hopkinson, C.; Crasto, N.; Marsh, P.; Forbes, D.; Lesack, L.

    2011-01-01

    Airborne light detection and ranging (LiDAR) data were used to map water level (WL) and hydraulic gradients (??H/??x) in the Mackenzie Delta. The LiDAR WL data were validated against eight independent hydrometric gauge measurements and demonstrated mean offsets from - 0??22 to + 0??04 m (??< 0??11). LiDAR-based WL gradients could be estimated with confidence over channel lengths exceeding 5-10 km where the WL change exceeded local noise levels in the LiDAR data. For the entire Delta, the LiDAR sample coverage indicated a rate of change in longitudinal gradient (??2H/??x) of 5??5 ?? 10-10 m m-2; therefore offering a potential means to estimate average flood stage hydraulic gradient for areas of the Delta not sampled or monitored. In the Outer Delta, within-channel and terrain gradient measurements all returned a consistent estimate of - 1 ?? 10-5 m m-1, suggesting that this is a typical hydraulic gradient for the downstream end of the Delta. For short reaches (<10 km) of the Peel and Middle Channels in the middle of the Delta, significant and consistent hydraulic gradient estimates of - 5 ?? 10-5 m m-1 were observed. Evidence that hydraulic gradients can vary over short distances, however, was observed in the Peel Channel immediately upstream of Aklavik. A positive elevation anomaly (bulge) of > 0??1 m was observed at a channel constriction entering a meander bend, suggesting a localized modification of the channel hydraulics. Furthermore, water levels in the anabranch channels of the Peel River were almost 1 m higher than in Middle Channel of the Mackenzie River. This suggests: (i) the channels are elevated and have shallower bank heights in this part of the delta, leading to increased cross-delta and along-channel hydraulic gradients; and/or (ii) a proportion of the Peel River flow is lost to Middle Channel due to drainage across the delta through anastamosing channels. This study has demonstrated that airborne LiDAR data contain valuable information describing

  5. DArT markers: diversity analyses, genomes comparison, mapping and integration with SSR markers in Triticum monococcum

    PubMed Central

    Jing, Hai-Chun; Bayon, Carlos; Kanyuka, Kostya; Berry, Simon; Wenzl, Peter; Huttner, Eric; Kilian, Andrzej; E Hammond-Kosack, Kim

    2009-01-01

    Background Triticum monococcum (2n = 2x = 14) is an ancient diploid wheat with many useful traits and is used as a model for wheat gene discovery. DArT (Diversity Arrays Technology) employs a hybridisation-based approach to type thousands of genomic loci in parallel. DArT markers were developed for T. monococcum to assess genetic diversity, compare relationships with hexaploid genomes, and construct a genetic linkage map integrating DArT and microsatellite markers. Results A DArT array, consisting of 2304 hexaploid wheat, 1536 tetraploid wheat, 1536 T. monococcum as well as 1536 T. boeoticum representative genomic clones, was used to fingerprint 16 T. monococcum accessions of diverse geographical origins. In total, 846 polymorphic DArT markers were identified, of which 317 were of T. monococcum origin, 246 of hexaploid, 157 of tetraploid, and 126 of T. boeoticum genomes. The fingerprinting data indicated that the geographic origin of T. monococcum accessions was partially correlated with their genetic variation. DArT markers could also well distinguish the genetic differences amongst a panel of 23 hexaploid wheat and nine T. monococcum genomes. For the first time, 274 DArT markers were integrated with 82 simple sequence repeat (SSR) and two morphological trait loci in a genetic map spanning 1062.72 cM in T. monococcum. Six chromosomes were represented by single linkage groups, and chromosome 4Am was formed by three linkage groups. The DArT and SSR genetic loci tended to form independent clusters along the chromosomes. Segregation distortion was observed for one third of the DArT loci. The Ba (black awn) locus was refined to a 23.2 cM region between the DArT marker locus wPt-2584 and the microsatellite locus Xgwmd33 on 1Am; and the Hl (hairy leaf) locus to a 4.0 cM region between DArT loci 376589 and 469591 on 5Am. Conclusion DArT is a rapid and efficient approach to develop many new molecular markers for genetic studies in T. monococcum. The constructed genetic

  6. 45 CFR 211.8 - Continuing hospitalization.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES CARE AND TREATMENT OF MENTALLY ILL NATIONALS OF THE UNITED STATES, RETURNED FROM FOREIGN COUNTRIES § 211.8 Continuing hospitalization... in need of continuing care and treatment in a hospital cannot be accomplished under § 211.7, or...

  7. Youth Employment in the Hospitality Sector.

    ERIC Educational Resources Information Center

    Schiller, Bradley R.

    A study used data from the National Longitudinal Surveys of Youth to analyze the long-term effects of hospitality industry employment on youth. The subsample extracted for the study included all youth who were aged 16-24 in 1980 and employed in the civilian sector for pay at any time in the year. Statistics indicated the hospitality sector was…

  8. Implementing Patient Safety Initiatives in Rural Hospitals

    ERIC Educational Resources Information Center

    Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary

    2009-01-01

    Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

  9. LiDAR in extreme environment: surveying in Antarctica

    NASA Astrophysics Data System (ADS)

    Abate, D.; Pierattini, S.; Bianchi Fasani, G.

    2013-10-01

    This study was performed under the patronage of the Italian National Research Programme in Antarctica (PNRA) with the aim to realize a high resolution Digital Elevation Model (DEM) of the moraine named "Boulder Clay" which insists approximately 7 km far from the Italian Research Base "Mario Zucchelli Station" in the Terra Nova Bay area. The DEM will be included in the project for the construction of two runways to be used as support facilities for the scientific research campaigns which take place on regular basis each year. Although the research efforts to realize a detailed cartography of the area is on-going, for the specific aim and urgency of this project it was decided to perform a laser scanning survey in this extreme environment in order to obtain contour lines describing the terrain elevation each 50 cm and volume analysis. The final result will be super imposed on a photogrammetric DEM with contour lines each 2.5 m and satellite images. This paper focus both on the final scientific data and on all the challenges have to be faced in such extreme and particular environment during the laser scanning survey.

  10. Weekly LiDAR snow depth mapping for operational snow hydrology - the NASA JPL Airborne Snow Observatory (Invited)

    NASA Astrophysics Data System (ADS)

    Deems, J. S.; Painter, T. H.; McGurk, B. J.

    2013-12-01

    Operational hydrologic simulation and forecasting in snowmelt-dominated watersheds currently relies on indices of snow accumulation and melt from measurements at a small number of point locations or geographically-limited manual surveys. These data sources cannot adequately characterize the spatial distribution of snow depth/water equivalent, which is the primary determinant of snowpack volume and runoff rates. The NASA JPL Airborne Snow Observatory's airborne laser scanning system maps snow depth at high spatial and temporal resolutions, providing an unprecedented snowpack monitoring capability and enabling a new operational paradigm. In the Spring of 2013, the ASO mapped snow depth in the Tuolumne River Basin in California's Yosemite National Park on a nominally weekly basis, and provided fast-turnaround spatial snow depth and water equivalent maps to the operators of Hetch Hetchy Reservoir, the water supply for 2.5 million people on the San Francisco peninsula. These products enabled more accurate runoff simulation and optimal reservoir management in a year of very low snow accumulation. We present the initial results from this new application of multi-temporal LiDAR mapping in operational snow hydrology.

  11. Evaluation of hyperspectral LiDAR for monitoring rice leaf nitrogen by comparison with multispectral LiDAR and passive spectrometer

    NASA Astrophysics Data System (ADS)

    Sun, Jia; Shi, Shuo; Gong, Wei; Yang, Jian; Du, Lin; Song, Shalei; Chen, Biwu; Zhang, Zhenbing

    2017-01-01

    Fast and nondestructive assessment of leaf nitrogen concentration (LNC) is critical for crop growth diagnosis and nitrogen management guidance. In the last decade, multispectral LiDAR (MSL) systems have promoted developments in the earth and ecological sciences with the additional spectral information. With more wavelengths than MSL, the hyperspectral LiDAR (HSL) system provides greater possibilities for remote sensing crop physiological conditions. This study compared the performance of ASD FieldSpec Pro FR, MSL, and HSL for estimating rice (Oryza sativa) LNC. Spectral reflectance and biochemical composition were determined in rice leaves of different cultivars (Yongyou 4949 and Yangliangyou 6) throughout two growing seasons (2014–2015). Results demonstrated that HSL provided the best indicator for predicting rice LNC, yielding a coefficient of determination (R2) of 0.74 and a root mean square error of 2.80 mg/g with a support vector machine, similar to the performance of ASD (R2 = 0.73). Estimation of rice LNC could be significantly improved with the finer spectral resolution of HSL compared with MSL (R2 = 0.56).

  12. Evaluation of hyperspectral LiDAR for monitoring rice leaf nitrogen by comparison with multispectral LiDAR and passive spectrometer

    PubMed Central

    Sun, Jia; Shi, Shuo; Gong, Wei; Yang, Jian; Du, Lin; Song, Shalei; Chen, Biwu; Zhang, Zhenbing

    2017-01-01

    Fast and nondestructive assessment of leaf nitrogen concentration (LNC) is critical for crop growth diagnosis and nitrogen management guidance. In the last decade, multispectral LiDAR (MSL) systems have promoted developments in the earth and ecological sciences with the additional spectral information. With more wavelengths than MSL, the hyperspectral LiDAR (HSL) system provides greater possibilities for remote sensing crop physiological conditions. This study compared the performance of ASD FieldSpec Pro FR, MSL, and HSL for estimating rice (Oryza sativa) LNC. Spectral reflectance and biochemical composition were determined in rice leaves of different cultivars (Yongyou 4949 and Yangliangyou 6) throughout two growing seasons (2014–2015). Results demonstrated that HSL provided the best indicator for predicting rice LNC, yielding a coefficient of determination (R2) of 0.74 and a root mean square error of 2.80 mg/g with a support vector machine, similar to the performance of ASD (R2 = 0.73). Estimation of rice LNC could be significantly improved with the finer spectral resolution of HSL compared with MSL (R2 = 0.56). PMID:28091610

  13. Evaluation of hyperspectral LiDAR for monitoring rice leaf nitrogen by comparison with multispectral LiDAR and passive spectrometer.

    PubMed

    Sun, Jia; Shi, Shuo; Gong, Wei; Yang, Jian; Du, Lin; Song, Shalei; Chen, Biwu; Zhang, Zhenbing

    2017-01-16

    Fast and nondestructive assessment of leaf nitrogen concentration (LNC) is critical for crop growth diagnosis and nitrogen management guidance. In the last decade, multispectral LiDAR (MSL) systems have promoted developments in the earth and ecological sciences with the additional spectral information. With more wavelengths than MSL, the hyperspectral LiDAR (HSL) system provides greater possibilities for remote sensing crop physiological conditions. This study compared the performance of ASD FieldSpec Pro FR, MSL, and HSL for estimating rice (Oryza sativa) LNC. Spectral reflectance and biochemical composition were determined in rice leaves of different cultivars (Yongyou 4949 and Yangliangyou 6) throughout two growing seasons (2014-2015). Results demonstrated that HSL provided the best indicator for predicting rice LNC, yielding a coefficient of determination (R(2)) of 0.74 and a root mean square error of 2.80 mg/g with a support vector machine, similar to the performance of ASD (R(2) = 0.73). Estimation of rice LNC could be significantly improved with the finer spectral resolution of HSL compared with MSL (R(2) = 0.56).

  14. Climate change induced heat wave hazard in eastern Africa: Dar Es Salaam (Tanzania) and Addis Ababa (Ethiopia) case study

    NASA Astrophysics Data System (ADS)

    Capuano, Paolo; Sellerino, Mariangela; Di Ruocco, Angela; Kombe, Wilbard; Yeshitela, Kumelachew

    2013-04-01

    Last decades, new records were set in the world for tornadoes, drought, wind, floods, wildfires and hot temperatures, testifying unusual weather and climate patterns with increasing frequency and intensity of extreme weather events. Extreme heat events are natural hazards affecting many regions in the world, nevertheless limited work has been done on the analysis and effects of extreme heat events in Africa, that is considered a continent particularly vulnerable to the effects of climate change. In fact, the increase of temperature expected in the African continent during the 21st century is larger than the global mean warming, being about 3° to 4° C, about 1.5 times the global temperature increase (Christensen et al., 2007; Gualdi et al., 2012), with the subtropical regions projected to warm more than the tropical regions. Observations and downscaled model simulations (RCP4.5 and RCP8.5 IPCC scenarios) are analyzed to describe heat wave characteristics in Dar es Salaam (Tanzania) and Addis Ababa (Ethiopia), spanning the last five decades as well as that projected for the 21st century. Observed data are daily maximum and minimum temperature collected in the period 1961-2011; downscaled model simulations span up to 2050. Heat waves are defined following a peak over threshold approach by statistical comparison to historical meteorological baselines (site dependent), using a fixed absolute threshold. Projected future warming in the Dar es Salaam and Addis Ababa shows a further increase in the heat waves parameters. Heat wave duration and hot days number are strictly correlated showing that the temperature rise could generate not only an increase of heat waves number but mainly a longer average duration, that can strongly affect the resilience capacity of the population, particularly the elder people. In fact, the impacts of heat waves on the society are determined also by temporal duration (Stephenson, 2008), in addition to their frequency, in fact the capacity of

  15. Estimating Evapotranspiration over Heterogeneously Vegetated Surfaces using Large Aperture Scintillometer, LiDAR, and Airborne Multispectral Imagery

    NASA Astrophysics Data System (ADS)

    Geli, H. M.; Neale, C. M.; Pack, R. T.; Watts, D. R.; Osterberg, J.

    2011-12-01

    Estimates of evapotranspiration (ET) over heterogeneous areas is challenging especially in water-limited sparsely vegetated environments. New techniques such as airborne full-waveform LiDAR (Light Detection and Ranging) and high resolution multispectral and thermal imagery can provide enough detail of sparse canopies to improve energy balance model estimations as well as footprint analysis of scintillometer data. The objectives of this study were to estimate ET over such areas and develop methodologies for the use of these airborne data technologies. Because of the associated heterogeneity, this study was conducted over the Cibola National wildlife refuge, southern California on an area dominated with tamarisk (salt cedar) forest (90%) interspersed with arrowweed and bare soil (10%). A set of two large aperture scintillometers (LASs) were deployed over the area to provide estimates of sensible heat flux (HLAS). The LASs were distributed over the area in a way that allowed capturing different surface spatial heterogeneity. Bowen ratio systems were used to provide hydrometeorological variables and surface energy balance fluxes (SEBF) (i.e. Rn, G, H, and LE) measurements. Scintillometer-based estimates of HLAS were improved by considering the effect of the corresponding 3D footprint and the associated displacement height (d) and the roughness length (z0) following Geli et al. (2011). The LiDAR data were acquired using the LASSI Lidar developed at Utah State University (USU). The data was used to obtain 1-m spatial resolution DEM's and vegetation canopy height to improve the HLAS estimates. The BR measurements of Rn and G were combined with LAS estimates, HLAS, to provide estimates of LELASas a residual of the energy balance equation. A thermal remote sensing model namely the two source energy balance (TSEB) of Norman et al. (1995) was applied to provide spatial estimates of SEBF. Four airborne images at 1-4 meter spatial resolution acquired using the USU airborne

  16. [Hospital clinical ethics committees].

    PubMed

    Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor

    2007-01-01

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

  17. Internet connectivity for hospitals and hospital libraries: strategies.

    PubMed Central

    Fuller, S S

    1995-01-01

    Access to Internet resources and communications has rapidly become a necessity in many hospitals nationally. The results of a Pacific Northwest pilot Intenet connections project provides important evidence of the value of librarians in establishing such connections in their institutions The pilot project has resulted in a wealth of information regarding approaches to promoting the utility of the Internet to health professionals in hospitals. Roles that librarians are playing in support of such connections include facilitator, negotiator, provider, publisher, integrator, and educator. PMID:7703936

  18. LiDAR Point Cloud and Stereo Image Point Cloud Fusion

    DTIC Science & Technology

    2013-09-01

    Photogrammetry , Fusion, Accuracy 15. NUMBER OF PAGES 81 16. PRICE CODE 17. SECURITY CLASSIFICATION OF REPORT Unclassified 18. SECURITY CLASSIFICATION...similar to those of Photogrammetry . In Photogrammetry , the objective is to extract precision three-dimensional representations of the earth’s surface...knowledge problems. 4 The history of LiDAR and photogrammetry fusion shows that many individuals with diverse interests are studying this problem

  19. Use of LiDAR to Assist in Delineating Waters of the United States, Including Wetlands

    DTIC Science & Technology

    2014-03-01

    position in the land- scape. Wetness indices are often calculated using the general formula WI = ln(A/tanβ) where A is the catchment area (m2/m...delineations of an Ordinary High Water Mark (OHWM) boundary, LiDAR data or products may be used to view the OHWM signature across a project area ...view vegeta- tive, topographic, and hydrologic patterns across a project area and to focus the investigation on transitional areas . They cannot

  20. Estimating Volume, Biomass, and Carbon in Hedmark County, Norway Using a Profiling LiDAR

    NASA Technical Reports Server (NTRS)

    Nelson, Ross; Naesset, Erik; Gobakken, T.; Gregoire, T.; Stahl, G.

    2009-01-01

    A profiling airborne LiDAR is used to estimate the forest resources of Hedmark County, Norway, a 27390 square kilometer area in southeastern Norway on the Swedish border. One hundred five profiling flight lines totaling 9166 km were flown over the entire county; east-west. The lines, spaced 3 km apart north-south, duplicate the systematic pattern of the Norwegian Forest Inventory (NFI) ground plot arrangement, enabling the profiler to transit 1290 circular, 250 square meter fixed-area NFI ground plots while collecting the systematic LiDAR sample. Seven hundred sixty-three plots of the 1290 plots were overflown within 17.8 m of plot center. Laser measurements of canopy height and crown density are extracted along fixed-length, 17.8 m segments closest to the center of the ground plot and related to basal area, timber volume and above- and belowground dry biomass. Linear, nonstratified equations that estimate ground-measured total aboveground dry biomass report an R(sup 2) = 0.63, with an regression RMSE = 35.2 t/ha. Nonstratified model results for the other biomass components, volume, and basal area are similar, with R(sup 2) values for all models ranging from 0.58 (belowground biomass, RMSE = 8.6 t/ha) to 0.63. Consistently, the most useful single profiling LiDAR variable is quadratic mean canopy height, h (sup bar)(sub qa). Two-variable models typically include h (sup bar)(sub qa) or mean canopy height, h(sup bar)(sub a), with a canopy density or a canopy height standard deviation measure. Stratification by productivity class did not improve the nonstratified models, nor did stratification by pine/spruce/hardwood. County-wide profiling LiDAR estimates are reported, by land cover type, and compared to NFI estimates.

  1. Combining LiDAR and IKONOS data for eco-hydrological classification of an ombrotrophic peatland.

    PubMed

    Anderson, K; Bennie, J J; Milton, E J; Hughes, P D M; Lindsay, R; Meade, R

    2010-01-01

    Remote sensing techniques have potential for peatland monitoring, but most previous work has focused on spectral approaches that often result in poor discrimination of cover types and neglect structural information. Peatlands contain structural "microtopes" (e.g., hummocks and hollows) which are linked to hydrology, biodiversity and carbon sequestration, and information on surface structure is thus a useful proxy for peatland condition. The objective of this work was to develop and test a new eco-hydrological mapping technique for ombrotrophic (rain-fed) peatlands using a combined spectral-structural remote sensing approach. The study site was Wedholme Flow, Cumbria, UK. Airborne light dectection and ranging (LiDAR) data were used with IKONOS data in a combined multispectral-structural approach for mapping peatland condition classes. LiDAR data were preprocessed so that spatial estimates of minimum and maximum land surface height, variance and semi-variance (from semi-variogram analysis) were extracted. These were assimilated alongside IKONOS data into a maximum likelihood classification procedure, and thematic outputs were compared. Ecological survey data were used to validate the results. Considerable improvements in thematic separation of peatland classes were achieved when spatially-distributed measurements of LiDAR variance or semi-variance were included. Specifically, the classification accuracy improved from 71.8% (IKONOS data only) to 88.0% when a LiDAR semi-variance product was used. Of note was the improved delineation of management classes (including Eriophorum bog, active raised bog and degraded raised bog). The application of a combined textural-optical approach can improve land cover mapping in areas where reliance on purely spectral discrimination approaches would otherwise result in considerable thematic uncertainty.

  2. Flying Under the LiDAR: Relating Forest Structure to Bat Community Diversity

    NASA Astrophysics Data System (ADS)

    Swanson, A. C.; Weishampel, J. F.

    2015-12-01

    Bats are important to many ecological processes such as pollination, insect (and by proxy, disease) control, and seed dispersal and can be used to monitor ecosystem health. However, they are facing unprecedented extinction risks from habitat degradation as well as pressures from pathogens (e.g., white-nose syndrome) and wind turbines. LiDAR allows ecologists to measure structural variables of forested landscapes with increased precision and accuracy at broader spatial scales than previously possible. This study used airborne LiDAR to classify forest habitat/canopy structure at the Ordway-Swisher Biological Station (OSBS) in north central Florida. LiDAR data were acquired by the NEON airborne observation platform in summer 2014. OSBS consists of open-canopy pine savannas, closed-canopy hardwood hammocks, and seasonally wet prairies. Multiple forest structural parameters (e.g., mean, maximum, and standard deviation of height returns) were derived from LiDAR point clouds using the USDA software program FUSION. K-means clustering was used to segregate each 5x5 m raster across the ~3765 ha OSBS area into six different clusters based on the derived canopy metrics. Cluster averages for maximum, mean, and standard deviation of return heights ranged from 0 to 19.4 m, 0 to 15.3 m, and 0 to 3.0 m, respectively. To determine the relationships among these landscape-canopy features and bat species diversity and abundances, AnaBat II bat detectors were deployed from May to September in 2015 stratified by these distinct clusters. Bat calls were recorded from sunset to sunrise during each sampling period. Species were identified using AnalookW. A statistical regression model selection approach was performed in order to evaluate how forest attributes such as understory clutter, open regions, open and closed canopy, etc. influence bat communities. This knowledge provides a deeper understanding of habitat-species interactions to better manage survival of these species.

  3. Road centerline extraction from airborne LiDAR point cloud based on hierarchical fusion and optimization

    NASA Astrophysics Data System (ADS)

    Hui, Zhenyang; Hu, Youjian; Jin, Shuanggen; Yevenyo, Yao Ziggah

    2016-08-01

    Road information acquisition is an important part of city informatization construction. Airborne LiDAR provides a new means of acquiring road information. However, the existing road extraction methods using LiDAR point clouds always decide the road intensity threshold based on experience, which cannot obtain the optimal threshold to extract a road point cloud. Moreover, these existing methods are deficient in removing the interference of narrow roads and several attached areas (e.g., parking lot and bare ground) to main roads extraction, thereby imparting low completeness and correctness to the city road network extraction result. Aiming at resolving the key technical issues of road extraction from airborne LiDAR point clouds, this paper proposes a novel method to extract road centerlines from airborne LiDAR point clouds. The proposed approach is mainly composed of three key algorithms, namely, Skewness balancing, Rotating neighborhood, and Hierarchical fusion and optimization (SRH). The skewness balancing algorithm used for the filtering was adopted as a new method for obtaining an optimal intensity threshold such that the "pure" road point cloud can be obtained. The rotating neighborhood algorithm on the other hand was developed to remove narrow roads (corridors leading to parking lots or sidewalks), which are not the main roads to be extracted. The proposed hierarchical fusion and optimization algorithm caused the road centerlines to be unaffected by certain attached areas and ensured the road integrity as much as possible. The proposed method was tested using the Vaihingen dataset. The results demonstrated that the proposed method can effectively extract road centerlines in a complex urban environment with 91.4% correctness and 80.4% completeness.

  4. Fast Surface Reconstruction and Segmentation with Terrestrial LiDAR Range Data

    DTIC Science & Technology

    2009-05-18

    SUPPLEMENTARY NOTES 14. ABSTRACT Recent advances in range measurement devices have opened up new opportunities and challenges for fast 3D modeling of...which are composed of partially ordered terrestrial range data. Our algorithms can be applied to a large class of LiDAR data acquisition systems, where...obtained by two different terrestrial acquisition systems. The first dataset contains 94 million points obtained by a vehicle-borne acquisition system

  5. Abu Dhabi Basemap Update Using the LiDAR Mobile Mapping Technology

    NASA Astrophysics Data System (ADS)

    Alshaiba, Omar; Amparo Núñez-Andrés, M.; Lantada, Nieves

    2016-04-01

    Mobile LiDAR system provides a new technology which can be used to update geospatial information by direct and rapid data collection. This technology is faster than the traditional survey ways and has lower cost. Abu Dhabi Municipal System aims to update its geospatial system frequently as the government entities have invested heavily in GIS technology and geospatial data to meet the repaid growth in the infrastructure and construction projects in recent years. The Emirate of Abu Dhabi has witnessed a huge growth in infrastructure and construction projects in recent years. Therefore, it is necessary to develop and update its basemap system frequently to meet their own organizational needs. Currently, the traditional ways are used to update basemap system such as human surveyors, GPS receivers and controller (GPS assigned computer). Then the surveyed data are downloaded, edited and reviewed manually before it is merged to the basemap system. Traditional surveying ways may not be applicable in some conditions such as; bad weather, difficult topographic area and boundary area. This paper presents a proposed methodology which uses the Mobile LiDAR system to update basemap in Abu Dhabi by using daily transactions services. It aims to use and integrate the mobile LiDAR technology into the municipality's daily workflow such that it becomes the new standard cost efficiency operating procedure for updating the base-map in Abu Dhabi Municipal System. On another note, the paper will demonstrate the results of the innovated workflow for the base-map update using the mobile LiDAR point cloud and few processing algorithms.

  6. 3D turbulence measurements in inhomogeneous boundary layers with three wind LiDARs

    NASA Astrophysics Data System (ADS)

    Carbajo Fuertes, Fernando; Valerio Iungo, Giacomo; Porté-Agel, Fernando

    2014-05-01

    One of the most challenging tasks in atmospheric anemometry is obtaining reliable turbulence measurements of inhomogeneous boundary layers at heights or in locations where is not possible or convenient to install tower-based measurement systems, e.g. mountainous terrain, cities, wind farms, etc. Wind LiDARs are being extensively used for the measurement of averaged vertical wind profiles, but they can only successfully accomplish this task under the limiting conditions of flat terrain and horizontally homogeneous flow. Moreover, it has been shown that common scanning strategies introduce large systematic errors in turbulence measurements, regardless of the characteristics of the flow addressed. From the point of view of research, there exist a variety of techniques and scanning strategies to estimate different turbulence quantities but most of them rely in the combination of raw measurements with atmospheric models. Most of those models are only valid under the assumption of horizontal homogeneity. The limitations stated above can be overcome by a new triple LiDAR technique which uses simultaneous measurements from three intersecting Doppler wind LiDARs. It allows for the reconstruction of the three-dimensional velocity vector in time as well as local velocity gradients without the need of any turbulence model and with minimal assumptions [EGU2013-9670]. The triple LiDAR technique has been applied to the study of the flow over the campus of EPFL in Lausanne (Switzerland). The results show the potential of the technique for the measurement of turbulence in highly complex boundary layer flows. The technique is particularly useful for micrometeorology and wind engineering studies.

  7. Step by step error assessment in braided river sediment budget using airborne LiDAR data

    NASA Astrophysics Data System (ADS)

    Lallias-Tacon, S.; Liébault, F.; Piégay, H.

    2014-06-01

    Sequential airborne LiDAR surveys were used to reconstruct the sediment budget of a 7-km-long braided river channel in southeastern France following a 14-year return period flood and to improve its accuracy step by step. Data processing involved (i) surface matching of the sequential point clouds, (ii) spatially distributed propagation of uncertainty based on surface conditions of the channel, and (iii) water depth subtraction from the digital elevation models based on water depths measured in the field. The respective influence of each processing step on sediment budget computation was systematically documented. This showed that surface matching and water depth subtraction both have a considerable effect on the net sediment budget. Although DEM of difference thresholding based on uncertainty analysis on absolute elevation values had a smaller effect on the sediment budget, this step is crucial for the production of a comprehensive map of channel deformations. A large independent data set of RTK-GPS checkpoints was used to control the quality of the LiDAR altimetry. The results showed that high density (7-9 points/m2) airborne LiDAR surveys can provide a very high level of detection of elevation changes on the exposed surfaces of the channel, with a 95% confidence interval level of detection between 19 and 30 cm. Change detection from LiDAR data revealed that 54% of the pre-flood active channel was reworked by the flood. The braided channel pattern was highly disturbed by the flood owing to the occurrence of several channel avulsions.