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  1. Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania

    PubMed Central

    Nyongole, Obadia; Akoko, Larry; Mwanga, Ally; Mchembe, Mabula; Kamala, Benjamin; Mbembati, Naboth

    2015-01-01

    Introduction Antimicrobial prophylaxis for urologic procedures is a major issue, as potential advantages of antibiotic administration should be carefully weighed against potential side effects, microbial resistance, and health care costs. This study aimed to review a six years trend of antibiotic use in urological surgeries at Muhimbili National Hospital (MNH) being an experience in a typical third world environment. Methods This was a six years hospital based descriptive, retrospective study conducted of which all case notes of urological patients operated on in between January 2007 to December, 2012 were reviewed by using a structured data collecting tool. The data were analyzed using SPSS software. Results Male patients were the majority at 62% (450). The age range was 0 - 90 years, with a mean of 30 ± 22.09. Among the urological surgeries done at MNH 86.5% (628) received prophylactic antibiotics regardless of the type surgery done. Majority 63.7% (463) received antibiotics during induction. Ceftriaxone was the commonly given antibiotic regardless of the type of urological surgery done. Most of patients (86.4%) were given antibiotics for five days regardless whether it was for prophylactic or treatment intention. Conclusion Antibiotic use is still a challenge at our hospital with over use of prophylactic antibiotics without obvious indications. Prolonged use of prophylactic antibiotics beyond five days was the main finding. Ceftriaxone was the most given antibiotic regardless of the urological surgery done and its level of contamination. Antibiotic stewardship needs to be addressed urgently to avoid serious drug resistances leaving alone the cost implication. PMID:26952184

  2. Challenges of caring for children with mental disorders: Experiences and views of caregivers attending the outpatient clinic at Muhimbili National Hospital, Dar es Salaam - Tanzania

    PubMed Central

    2012-01-01

    Background It is estimated that world-wide up to 20 % of children suffer from debilitating mental illness. Mental disorders that pose a significant concern include learning disorders, hyperkinetic disorders (ADHD), depression, psychosis, pervasive development disorders, attachment disorders, anxiety disorders, conduct disorder, substance abuse and eating disorders. Living with such children can be very stressful for caregivers in the family. Therefore, determination of challenges of living with these children is important in the process of finding ways to help or support caregivers to provide proper care for their children. The purpose of this study was to explore the psychological and emotional, social, and economic challenges that parents or guardians experience when caring for mentally ill children and what they do to address or deal with them. Methodology A qualitative study design using in-depth interviews and focus group discussions was applied. The study was conducted at the psychiatric unit of Muhimbili National Hospital in Tanzania. Two focus groups discussions (FGDs) and 8 in-depth interviews were conducted with caregivers who attended the psychiatric clinic with their children. Data analysis was done using content analysis. Results The study revealed psychological and emotional, social, and economic challenges caregivers endure while living with mentally ill children. Psychological and emotional challenges included being stressed by caring tasks and having worries about the present and future life of their children. They had feelings of sadness, and inner pain or bitterness due to the disturbing behaviour of the children. They also experienced some communication problems with their children due to their inability to talk. Social challenges were inadequate social services for their children, stigma, burden of caring task, lack of public awareness of mental illness, lack of social support, and problems with social life. The economic challenges were

  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. 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. PMID:18488621

  5. 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.

  6. 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.

  7. National hospital input price index.

    PubMed

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

    1979-01-01

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

  8. 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.

  9. Improving LiDAR Data Post-Processing Techniques for Archaeological Site Management and Analysis: A Case Study from Canaveral National Seashore Park

    NASA Astrophysics Data System (ADS)

    Griesbach, Christopher

    Methods used to process raw Light Detection and Ranging (LiDAR) data can sometimes obscure the digital signatures indicative of an archaeological site. This thesis explains the negative effects that certain LiDAR data processing procedures can have on the preservation of an archaeological site. This thesis also presents methods for effectively integrating LiDAR with other forms of mapping data in a Geographic Information Systems (GIS) environment in order to improve LiDAR archaeological signatures by examining several pre-Columbian Native American shell middens located in Canaveral National Seashore Park (CANA).

  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. Uncertainty estimation in integrated LiDAR- and radar-derived biomass maps at key national-level map scales

    NASA Astrophysics Data System (ADS)

    Joshi, N.; Fensholt, R.; Saatchi, S. S.; Mitchard, E. T.

    2013-12-01

    The international Reducing Emissions from Deforestation and Degradation (REDD) program requires accurate and cost-effective techniques of national-level mapping of above-ground biomass (AGB) and ground-sampling strategies. This paper explores a multi-sensor (radar and low-density airborne LiDAR) integration approach for country-wide AGB estimation and mapping in Denmark, selected as a test-country due to the unique availability of country-wide remote sensing and forest inventory data. We assess the potential use of ALOS PALSAR L-band radar and ENVISAT ASAR C-band radar in prediction and mapping of AGB with accuracies similar to LiDAR-derived AGB estimates at different map scales. We start by creating a LiDAR-based ';ground truth' map, using LiDAR-derived 95th Percentile of heights >1 m weighted by the Canopy Density ratio, together with 113 AGB plots to map AGB at a 0.25 ha resolution across the country. A leave-20%-out cross-validation indicates that the AGB estimates have a mean absolute error of 41 Mg ha-1 and a negative mean bias error of 1.7 Mg ha-1. Though the LiDAR model appears to have an overall species-specific bias for conifers and broadleaf (-5.2 Mg ha-1 and +12.3 Mg ha-1 respectively), these are found to be insignificant (p>0.05) when accounting for species sampling bias and the under-prediction of plots containing high-biomass (> 350 Mg ha-1). Using the LiDAR-derived biomass map as a ';truth-map', biomass-backscatter relations will be quantified at three map scales (0.25 ha, 1 ha and 100 ha) and using three spatial sampling frameworks (full-dataset, stratified random sampling equally representing low and high biomass pixels, clustered sampling). The approach aims to derive a minimal-sampling and mapping strategy for L- and C-band radar that achieves at least 20% accuracy in AGB estimation, along with quantified sources of error from ground-AGB estimates, scaling and sampling. It is expected that mapping techniques, uncertainty quantification and

  13. Cervical pre-malignant lesions in HIV infected women attending Care and Treatment Centre in a tertiary hospital, Dar es Salaam, Tanzania.

    PubMed

    Balandya, Belinda S; Pembe, Andrea B; Mwakyoma, Henry A

    2011-09-01

    The aims of this study was to determine proportion of HIV infected women with cervical pre-malignant lesions; and compare the use of Visual Inspection of the cervix after application of Acetic acid (VIA) and Papanicolau (Pap) smear in screening for cervical premalignant lesions in HIV positive women attending Care and Treatment Centre (CTC) at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. A total of 316 women aged 18-70 years had a Pap smear taken for cytology, followed by spraying onto the cervix with 4% acetic acid and then inspecting it. Cytology was considered negative when there was no Cervical Intraepithelial Neoplasia (CIN) lesion reported from the Pap smear taken, and positive if CIN lesion 1, 2 or 3 was reported. Detection of a well-defined, opaque acetowhite lesion close to the squamocolumnar junction or close to the external cervical os constituted a positive VIA. Out of 316 women, 132 women had acetowhite lesions on VIA, making the proportion of abnormal cervical lesions to be 42.4%. One hundred and one out of 312 women (32.4%) had CIN lesions detected on Pap smear. The proportion of agreement between these two tests was 0.3. The proportion of agreement was moderate in women with advanced WHO HIV clinical stage of the disease and in women not on ART (Anti Retroviral Therapy). Women with CD-4 count less than 200 cells/mm3 had more abnormal cervical lesions. There is considerable proportion of HIV positive women with premalignant lesions of the cervix. Considering the proportion of HIV women with abnormal lesions and the difficulty in logistics of doing Pap smear in low resource settings, these results supports the recommendation to introduce screening of premalignant lesions of the cervix using VIA to all HIV infected women.

  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. 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

  16. 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…

  17. 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

  18. 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

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

    PubMed Central

    Dorwart, R A; Hoover, C W

    1994-01-01

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

  20. 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

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

    PubMed Central

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

    1997-01-01

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

  2. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

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

  3. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-10-01

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

  5. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

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

    PubMed

    Crawford, S Y; Santell, J P

    1994-10-01

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

  7. 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…

  8. 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

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

    PubMed

    Nduati, R W; Muita, J W

    1992-07-01

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

  10. New Integrated Information System for Pusan National University Hospital

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2016-09-01

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

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

    PubMed

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

    2016-09-01

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

  13. 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

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

    MedlinePlus

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

  15. 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.

  16. Estimating Mangrove Canopy Height and Above-Ground Biomass in Everglades National Park with Airbone LiDAR and TanDEM-X Data.

    NASA Astrophysics Data System (ADS)

    Feliciano, E. A.; Wdowinski, S.; Potts, M. D.; Fatoyinbo, T. E.; Lee, S. K.

    2014-12-01

    The coastal mangroves forests of Everglades National Park (ENP) are well protected from development. Nevertheless, climate change, hurricanes and other anthropogenic disturbances have affected these intertidal ecosystems. Understanding and monitoring forest structural parameters such as canopy height and above-ground biomass (AGB) are important for the establishment of an historical database for past, present and future ecosystem comparison. Forest canopy height has a well understood and directly proportional correlation with AGB. It is possible to derive it using (1) airborne LiDAR/Laser Scanning (ALS) or (2) space-borne radar systems such as Shuttle Radar Topography Mission (SRTM) and TanDEM-X (TDX). A previous study of the mangrove canopy height and AGB in the ENP was conducted a decade ago based on ALS data acquired in 2004 in conjunction with SRTM data, which were acquired in 2000 (Simard et al. 2006). In this study we estimated canopy height and AGB using an ALS dataset acquired in 2012 and TDX data acquired during the years 2012-2014. The ALS dataset was acquired along a 16.5 x 1.5 km swath of mangrove forest with variable canopy height. The sampled areas were representative of mangrove stature and structure in the whole ENP. Analysis of the ALS dataset showed that mangrove canopy height can reach up to ~25 meters close to the coastal ENP waters. Additionally, by comparing our ALS results with those of a previous study by Simard et al. (2006) we identified areas where mangrove height changes greater than ± 3 meters occurred. To expand the study area to the full ENP mangrove ecosystem we processed single-polarization TDX data to obtain a Digital Canopy Model (DCM) that represents the mangrove canopy height. In order to obtain the true canopy height we calibrated the TDX phase center height with ALS true canopy height. Preliminary results of a corrected single-polarized (HH) TDX scene show that mangrove canopy height can reach up to ~25 meters in the western

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

    PubMed Central

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

    American Coll. of Healthcare Executives, Chicago, IL.

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

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

    PubMed

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

    2012-01-01

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

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

    PubMed

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

    2007-01-01

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

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

    PubMed

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

    2006-01-01

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

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

    PubMed

    Burda, D

    1989-08-25

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

  3. 45 CFR 60.12 - Information which hospitals must request from the National Practitioner Data Bank.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

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

    PubMed

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

    2016-10-01

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

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

    PubMed

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

    2016-10-01

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

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

    PubMed

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

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

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

    PubMed Central

    Yoo, Sooyoung; Hwang, Hee

    2016-01-01

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

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

    PubMed

    Yoo, Sooyoung; Hwang, Hee; Jheon, Sanghoon

    2016-08-01

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

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

    PubMed Central

    Yoo, Sooyoung; Hwang, Hee

    2016-01-01

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

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

    PubMed

    Burda, D

    1991-10-01

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

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

    PubMed

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

    2008-04-01

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

  12. 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

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

    PubMed

    Hermann, D H; Gorman, R D

    1989-08-01

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

  14. 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.

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

    PubMed

    Mason, William L

    2010-06-01

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

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

    PubMed

    1998-01-01

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

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

    PubMed

    Drees, Laurie Meijer

    2010-01-01

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

  18. Exploring tree species signature using waveform LiDAR data

    NASA Astrophysics Data System (ADS)

    Zhou, T.; Popescu, S. C.; Krause, K.

    2015-12-01

    Successful classification of tree species with waveform LiDAR data would be of considerable value to estimate the biomass stocks and changes in forests. Current approaches emphasize converting the full waveform data into discrete points to get larger amount of parameters and identify tree species using several discrete-points variables. However, ignores intensity values and waveform shapes which convey important structural characteristics. The overall goal of this study was to employ the intensity and waveform shape of individual tree as the waveform signature to detect tree species. The data was acquired by the National Ecological Observatory Network (NEON) within 250*250 m study area located in San Joaquin Experimental Range. Specific objectives were to: (1) segment individual trees using the smoothed canopy height model (CHM) derived from discrete LiDAR points; (2) link waveform LiDAR with above individual tree boundaries to derive sample signatures of three tree species and use these signatures to discriminate tree species in a large area; and (3) compare tree species detection results from discrete LiDAR data and waveform LiDAR data. An overall accuracy of the segmented individual tree of more than 80% was obtained. The preliminary results show that compared with the discrete LiDAR data, the waveform LiDAR signature has a higher potential for accurate tree species classification.

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

    PubMed

    Kazley, Abby Swanson; Ozcan, Yasar A

    2007-10-01

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

  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. 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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Lin, Hsien-Cheng

    2015-06-01

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

  4. 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

  5. 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.

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

    PubMed

    Muita, J W; Nduati, R W

    1990-12-01

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

  7. 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.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2009-08-01

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

  10. 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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2012-12-01

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

  17. 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.

  18. 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.

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

    PubMed

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

    2009-01-01

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

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

    PubMed

    Hung, Jung-Hua; Chang, Li

    2008-03-01

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

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Sussex, Jonathan; Farrar, Shelley

    2009-05-01

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

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

    PubMed Central

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

    2000-01-01

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

  7. 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

  8. 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.

  9. 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

  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

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

    2016-08-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

    Linden, Stefanie Caroline; Jones, Edgar

    2014-10-01

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

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

    PubMed

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

    2009-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2013-01-01

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

  1. Forest structures retrieval from LiDAR onboard ULA

    NASA Astrophysics Data System (ADS)

    Shang, Xiaoxia; Chazette, Patrick; Totems, Julien; Marnas, Fabien; Sanak, Joseph

    2013-04-01

    Following the United Nations Framework Convention on Climate Change, the assessment of forest carbon stock is one of the main elements for a better understanding of the carbon cycle and its evolution following the climate change. The forests sequester 80% of the continental biospheric carbon and this efficiency is a function of the tree species and the tree health. The airborne backscatter LiDAR onboard the ultra light aircraft (ULA) can provide the key information on the forest vertical structures and evolution in the time. The most important structural parameter is the tree top height, which is directly linked to the above-ground biomass using non-linear relationships. In order to test the LiDAR capability for retrieving the tree top height, the LiDAR ULICE (Ultraviolet LIdar for Canopy Experiment) has been used over different forest types, from coniferous (maritime pins) to deciduous (oaks, hornbeams ...) trees. ULICE works at the wavelength of 355 nm with a sampling along the line-of-sight between 15 and 75 cm. According to the LiDAR signal to noise ratio (SNR), two different algorithms have been used in our study. The first algorithm is a threshold method directly based on the comparison between the LiDAR signal and the noise distributions, while the second one used a low pass filter by fitting a Gaussian curve family. In this paper, we will present these two algorithms and their evolution as a function of the SNR. The main error sources will be also discussed and assessed for each algorithm. The results show that these algorithms have great potential for ground-segment of future space borne LiDAR missions dedicated to the forest survey at the global scale. Acknowledgements: the canopy LiDAR system ULICE has been developed by CEA (Commissariat à l'Energie Atomique). It has been deployed with the support of CNES (Centre National d'Etude Spariales) and ANR (Agence Nationale de la Recherche). We acknowledge the ULA pilots Franck Toussaint for logistical help

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

    Lin, Yea-Wen; Lin, Yueh-Ysen

    2011-09-01

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

  4. 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

  5. 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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

    de Micheli, Alfredo

    2016-01-01

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

  8. [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.

  9. 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

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

    PubMed

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

    2013-03-01

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

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

    PubMed

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

    1996-05-01

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

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

    PubMed Central

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

    2014-01-01

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

  13. 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

  14. 45 CFR 60.12 - Information which hospitals must request from the National Practitioner Data Bank.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

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

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

    PubMed

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

    2015-04-01

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

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

    PubMed

    Rawal, N; Allvin, R

    1998-05-01

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

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

    PubMed

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

    2009-01-01

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

  18. 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…

  19. 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,…

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed Central

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

    2012-01-01

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

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

    PubMed Central

    Ozcan, Y A; Luke, R D

    1993-01-01

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

  5. [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.

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

    PubMed

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

    2014-12-01

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

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

    PubMed Central

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

    2015-01-01

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

  8. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

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

  9. 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).

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

    PubMed

    Downey, Erin; Hebert, Anjanette

    2010-01-01

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

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

    PubMed

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

    1993-01-01

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

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

    PubMed

    Jones, Lorelei; Exworthy, Mark

    2015-01-01

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

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

    PubMed

    Jones, Lorelei; Exworthy, Mark

    2015-01-01

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

  14. 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.

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

    PubMed

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

    2006-03-01

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

  16. 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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2011-11-01

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

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

    PubMed

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

    2010-04-01

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

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

    PubMed

    1995-04-28

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

  2. 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.

  3. 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…

  4. 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…

  5. 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…

  6. 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

  7. 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

  8. National Estimates of Noncanine Bite and Sting Injuries Treated in US Hospital Emergency Departments, 2001–2010

    PubMed Central

    Langley, Ricky; Mack, Karin; Haileyesus, Tadesse; Proescholdbell, Scott; Annest, Joseph L.

    2015-01-01

    Objective Injuries resulting from contact with animals and insects are a significant public health concern. This study quantifies nonfatal bite and sting injuries by noncanine sources using data from the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP). Methods The NEISS-AIP is an ongoing nationally representative surveillance system used to monitor all types and causes of injuries treated in US hospital emergency departments (EDs). Cases were coded by trained hospital coders using information from medical records on animal and insect sources of bite and sting injuries being treated. Data were weighted to produce national annualized estimates, percentages, and rates based on the US population. Results From 2001 to 2010 an estimated 10.1 million people visited EDs for noncanine bite and sting injuries, based on an unweighted case count of 169,010. This translates to a rate of 340.1 per 100,000 people (95% CI, 232.9–447.3). Insects accounted for 67.5% (95% CI, 45.8–89.2) of bite and sting injuries, followed by arachnids 20.8% (95% CI, 13.8–27.9). The estimated number of ED visits for bedbug bite injuries increased more than 7-fold—from 2156 visits in 2007 to 15,945 visits in 2010. Conclusions This study provides an update of national estimates of noncanine bite and sting injuries and describes the diversity of animal exposures based on a national sample of EDs. Treatment of nonfatal bite and sting injuries are costly to society. Direct medical and work time lost translates to an estimated $7.5 billion annually. PMID:24433776

  9. Variations in Implementation of Acute Care Surgery: Results from a national survey of university-affiliated hospitals

    PubMed Central

    Santry, Heena P.; Madore, John C.; Collins, Courtney E.; Ayturk, M. Didem; Velmahos, George C.; Britt, LD; Kiefe, Catarina I.

    2015-01-01

    BACKGROUND To date, no studies have reported nationwide adoption of Acute Care Surgery (ACS) or identified structural and/or process variations for the care of emergency general surgery (EGS) patients within such models. METHODS We surveyed surgeons responsible for EGS coverage at University HealthSystems Consortium hospitals using an 8-page postal/email questionnaire querying respondents on hospital and EGS structure/process measures. Survey responses were analyzed using descriptive statistics, univariate comparisons, and multivariable regression models. RESULTS 258 of 319 (81%) potential respondents completed surveys. 81 hospitals (31%) had implemented ACS while 134 (52%) had a traditional general surgeon on-call model (GSOC). 38 (15%) hospitals had another model (HYBRID). Larger bed, university-based, teaching hospitals with Level 1 trauma center verification status located in urban areas were more likely to have adopted ACS. In multivariable modeling, hospital type, setting, and trauma center verification predicted ACS implementation. EGS processes of care varied with 28% GSOC having block time vs 67% ACS (p<0.0001); 45% GSOC providing ICU care to EGS patients in a surgical/trauma ICU vs 93% ACS (p<0.0001); GSOC sharing call among 5.7 (+/− 3.2) surgeons vs 7.9 (+/−2.3) ACS surgeons (p<0.0001); and 13% GSOC taking in-house EGS call vs 75% ACS (p<0.0001). Among ACS hospitals there were variations in patient cohorting (25% EGS patients alone; 21% EGS+trauma; 17% EGS+elective; 30% EGS+trauma+elective), data collection (26% had prospective EGS registries), and patient handoffs (56% had attending surgeon presence), call responsibilities (averaging 4.8 (+/− 1.3) calls per month with 60% providing extra call stipend and 40% with no post-call clinical duties). CONCLUSION The potential of the ACS on the national crisis in access to EGS care is not fully met. Variations in EGS processes of care among adopters of ACS suggest that standardized criteria for ACS

  10. 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

  11. The evolution of methicillin-resistant Staphylococcus aureus in Canadian hospitals: 5 years of national surveillance

    PubMed Central

    Simor, Andrew E.; Ofner-Agostini, Marianna; Bryce, Elizabeth; Green, Karen; McGeer, Allison; Mulvey, Michael; Paton, Shirley

    2001-01-01

    Background To better understand the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Canadian hospitals, surveillance has been conducted in sentinel hospitals across the country since 1995. We report the results of the first 5 years of the program. Methods For each newly identified inpatient with MRSA, medical records were reviewed for demographic and clinical data. Isolates were subjected to susceptibility testing and molecular typing by pulsed-field gel electrophoresis. Results A total of 4507 patients infected or colonized with MRSA were identified between January 1995 and December 1999. The rate of MRSA increased each year from a mean of 0.95 per 100 S. aureus isolates in 1995 to 5.97 per 100 isolates in 1999 (0.46 per 1000 admissions in 1995 to 4.12 per 1000 admissions in 1999) (p < 0.05). Most of the increase in MRSA occurred in Ontario, Quebec and the western provinces. Of the 3009 cases for which the site of MRSA acquisition could be determined, 86% were acquired in a hospital, 8% were acquired in a long-term care facility and 6% were acquired in the community. A total of 1603 patients (36%) were infected with MRSA. The most common sites of infection were skin or soft tissue (25% of MRSA infections), pulmonary tissues (24%) and surgical sites (23%); 13% of the patients were bacteremic. An epidemiologic link with a previously identified MRSA patient was suspected in 53% of the cases. Molecular typing indicated that most (81%) of the isolates could be classified as related to 1 of the 4 Canadian epidemic strains of MRSA. Interpretation There has been a significant increase in the rate of isolating MRSA in many Canadian hospitals, related to the transmission of a relatively small number of MRSA strains. PMID:11468949

  12. 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

  13. 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

  14. Interim Results of a National Test of the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD)

    PubMed Central

    Traino, H. M.; Alolod, G. P.; Shafer, T.; Siminoff, L. A.

    2012-01-01

    Organ donation remains a major public health challenge with over 114 000 people on the waitlist in the United States. Among other factors, extant research highlights the need to improve the identification and timely referral of potential donors by hospital health-care providers (HCPs) to organ procurement organizations (OPOs). We implemented a national test of the Rapid Assessment of hospital Procurement barriers in Donation (RAPiD) to identify assets and barriers to the organ donation and patient referral processes; assess hospital–OPO relationships and offer tailored recommendations for improving these processes. Having partnered with seven OPOs, data were collected at 70 hospitals with high donor potential in the form of direct observations and interviews with 2358 HCPs. We found that donation attitudes and knowledge among HCPs were high, but use of standard referral criteria was lacking. Significant differences were found in the donation-related attitudes, knowledge and behaviors of physicians and emergency department staff as compared to other staff in intensive care units with high organ donor potential. Also, while OPO staff were generally viewed positively, they were often perceived as outsiders rather than members of healthcare teams. Recommendations for improving the referral and donation processes are discussed. PMID:22900761

  15. ‘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

  16. A Retrospective Case Series of Surgical Implant Generation Network (SIGN) Placement at the Afghan National Police Hospital, Kabul, Afghanistan.

    PubMed

    Ertl, Christian W; Royal, David; Arzoiey, Humayoon Abdul; Shefa, Azizullah; Sultani, Salim; Mosafa, Mohammed Omar; Sadat, Safiullah; Zirkle, Lewis

    2016-01-01

    In Afghanistan, adequate and cost-effective medical care for even routine conditions is lacking; especially for complex injuries like long-bone fractures. The Surgical Implant Generation Network (SIGN) intramedullary nail is used for treatment of long-bone fractures from blunt injuries and does not require imaging. We are reporting for the first time results of the SIGN intramedullary nail at the Afghan National Police Hospital, a tertiary care facility in Kabul. 71 records from the SIGN Online Surgical Database were reviewed for gender, age, date of injury, implant date, patient's home of record, and type/ mechanism of injury. Mean age was 26.7 years, all but one being male; time from injury to implant ranged 1 to 401 days, with mean of 40.6 days. Long-bone fractures from motor vehicle accidents remained constant, and war injuries peaked in summer. Follow-up is limited because of security and financial burdens of travel. However, personal communication with Afghan National Police Hospital surgeons suggests that patients included in the current study have not experienced any adverse outcomes. While it remains to be seen if the SIGN Online Surgical Database will facilitate more comprehensive outcome studies, our results provide support for the efficacy of SIGN nails in treating long-bone fractures from war injuries. PMID:26741473

  17. Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

    PubMed Central

    2011-01-01

    Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH) in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment) study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572) received an intravenous haemodiluting agent such as mannitol (96%) or a neuroprotectant (72%), and there was high use of intravenous traditional Chinese medicine (TCM) (42%). Neurosurgery was undertaken in 137 (9%) patients; being overweight, having a low Glasgow Coma Scale (GCS) score on admission, and Total Anterior Circulation Syndrome (TACS) clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p < 0.001). Continuation of antihypertensives in-hospital and at 3 and 12 months post-stroke was reported in 732/935 (78%), 775/935 (83%), and 752/935 (80%) living patients with hypertension, respectively. Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH. PMID:21276264

  18. Motor vehicle related injuries among American Indian and Alaskan Native youth, 1981–92: analysis of a national hospital discharge database

    PubMed Central

    Quinlan, K.; Wallace, L; Furner, S.; Brewer, R.; Bolen, J.; Schieber, R.

    1998-01-01

    Objective—To describe national trends in hospitalizations for motor vehicle related injuries among children and youth (0–24 years) of the United States Indian Health Service (IHS) from 1981–92. Design—Descriptive epidemiologic study of the E coded national hospital discharge database of the IHS. Results—From 1981 to 1992, the age standardized annual incidence of motor vehicle related injury hospitalizations (per 100 000 population) among American Indian and Alaskan Native (AI/AN) youth decreased more than 65% from 269 to 93. Substantial declines in hospitalization rates for all age and sex groups, all IHS areas, and most injury types were seen over this time. Injuries to vehicle occupants accounted for 78% of all motor vehicle related injury hospitalizations. The annual incidence of hospitalization (per 100 000 population) ranged from 291 in the Billings (Wyoming/Montana) and Aberdeen (the Dakotas) areas to 38 in the Portland area (Pacific Northwest). Conclusions—National motor vehicle related injury hospitalization rates of AI/AN children and youth decreased significantly from 1981–92. This may be due to a reduction in the incidence of severe motor vehicle related trauma, changing patterns of medical practice, and changes in the use of services. Additional measures, such as passage and enforcement of tribal laws requiring the use of occupant restraints and stronger laws to prevent alcohol impaired driving, might further reduce the incidence of serious motor vehicle related injuries in this high risk population. PMID:9887418

  19. 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.

  20. [Cardiovascular emergencies and their morbimortality at the hospital. Report of 733 cases at the CHU campus in Lome (national reference hospital in Togo)].

    PubMed

    Damorou, F; Pessinaba, S; Lawson, B; Abdoulaye, S; Soussou, B; Grunitzky, K

    2008-01-01

    Due to the recent establishment of the emergencies Units in Black Africa, their epidemiological aspects are not well known. Our aims was to describe the epidemiology of this desease in Togo. Through a retrospective analysis we study over a period of 42 mouths. From January first, 2001 to June 30th, 2004. It was carried out exclusively at CHU-Campus, the hospital of Lomé Campus, the second national medical center of reference. Included were all the patients with cardio-vascular emergency cases. We have studied the epidemilogical aspects according to the age, sex, profession, morbidity, and mortality. The treatment of results have been done by Computer. The registered emergency cases were 733 il all with is a frequency of the patients admitted at CHU-CAMPUS. The average age is 56 +/- 13 years with extreme ages from 20 to 97 years. The age group most affected is between 30 and 69 years--The ratio according to the sex is 1.09 in favour of men. Housewives are the professional category most affected (42.3%). Constitute the essential of the cardiovascular emergency cases with a ratio of the 78.3%. The mortality is 17.1% which in most registered between 30 and 69 years. The morbidity ratio is 64.1% We have to keep in mind that cardio-vascular emergency cases are very frequent in Togo. A very active population of young people is concerned. The poor are the most threatened. Henceforth the establishment and equipment of cardiological units are absolutely necessary, for they constitute the only solution by which the level of morbi-mortality can be reduced. PMID:19434971

  1. Factors associated with hospital retention of RNs in the New York City Metropolitan Area: an analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses.

    PubMed

    Rosenfeld, Peri; Adams, Richard E

    2008-08-01

    The nursing shortage is well documented, and government estimates indicate that shortfalls will worsen in the future. As the largest employer of registered nurses (RNs), hospitals are the most seriously affected by shortages, as they compete with other employment settings for limited nursing resources. Recruitment remains the primary avenue for ensuring staffing levels, but retention is increasingly important as applicant pools shrink because of demographic and employment trends. Effective retention strategies must address the factors that contribute to exodus of RNs from hospitals, as well as isolating the factors that enable RNs to remain in hospital employment. This secondary analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses examines the demographic, employment, and educational factors associated with working in hospitals, having full-time status, and holding patient care positions. The findings suggest that hospitals must address nonwork issues to retain nursing personnel. Relevant policy issues are examined and strategies for effective retention are offered. PMID:18509198

  2. 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

  3. 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.

  4. Measuring and mapping forest wildlife habitat characteristics using LiDAR remote sensing and multi-sensor function

    NASA Astrophysics Data System (ADS)

    Hyde, Peter

    Managing forests for multiple, often competing uses is challenging; managing Sierra National Forest's fire regime and California spotted owl habitat is difficult and compounded by lack of information about habitat quality. Consistent and accurate measurements of forest structure will reduce uncertainties regarding the amount of habitat reduction or alteration that spotted owls can tolerate. Current methods of measuring spotted owl habitat are mostly field-based and emphasize the important of canopy cover. However, this is more because of convenience than because canopy cover is a definitive predictor of owl presence or fecundity. Canopy cover is consistently and accurately measured in the field using a moosehorn densitometer; comparable measurements can be made using airphoto interpretation or from examining satellite imagery, but the results are not consistent. LiDAR remote sensing can produce consistent and accurate measurements of canopy cover, as well as other aspects of forest structure (such as canopy height and biomass) that are known or thought to be at least as predictive as canopy cover. Moreover, LiDAR can be used to produce maps of forest structure rather than the point samples available from field measurements. However, LiDAR data sets are expensive and not available everywhere. Combining LiDAR with other, remote sensing data sets with less expensive, wall-to-wall coverage will result in broader scale maps of forest structure than have heretofore been possible; these maps can then be used to analyze spotted owl habitat. My work consists of three parts: comparison of LiDAR estimates of forest structure with field measurements, statistical fusion of LiDAR and other remote sensing data sets to produce broad scale maps of forest structure, and analysis of California spotted owl presence and fecundity as a function of LiDAR-derived canopy structure. I found that LiDAR was able to replicate field measurements accurately. Additionally, I was able to

  5. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27175280

  6. 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

  7. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions. PMID:27648258

  8. Understanding the recruitment and retention of overseas nurses: realist case study research in National Health Service Hospitals in the UK.

    PubMed

    O'Brien, Terri; Ackroyd, Stephen

    2012-03-01

    This paper illustrates one of the possible applications of critical realist ideas to the analysis of health services, in the use of comparative case study research design, to elucidate the causal social processes underlying events. In the research reported here, a comparative research design was used as a basis for improving our understanding of the processes involved in the assimilation of overseas nurses (OSN) into the salient long-term workforce of the National Health Service (NHS) hospitals in the UK. The work brought to light the salient experiences of overseas nurses during their initial work in the NHS hospitals, and these were used as a basis for developing an account of the general mechanisms typically underlying the recruitment and assimilation at work. The authors conclude that successful assimilation is often hindered by the presence of occupational closure mechanisms, by which home nurses effectively excluded recruits from participation and promotion; these mechanisms, which articulate with everyday racism, threaten successful assimilation for obvious reasons. If the treatment recruits receive does not lead to withdrawal, it is because they typically have very strong economic motives to continue despite unfavourable and sometimes inhumane treatment. Thus, the research offered substantial reasons why recruitment policies should be reviewed by policy-makers.

  9. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data

    PubMed Central

    Atun, Rifat; Gurol–Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno

    2016-01-01

    Background Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Methods Using routinely collected health billing records for 2005–2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co–morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply–side variables, and PHC use. Findings Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow–up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Interpretation Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions.

  10. Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study

    PubMed Central

    Langan Martin, Julie; McLean, Gary; Cantwell, Roch; Smith, Daniel J

    2016-01-01

    Objective To describe weekly admission rates for affective and non-affective psychosis, major depression and other psychiatric disorders in the early and late postpartum periods. To assess the impact of socioeconomic status, age and parity on admission rates. Methods Scottish maternity records were linked to psychiatric hospital admissions. 3290 pregnancy-related psychiatric admissions were assessed. Weekly admission rates were calculated for the pregnancy period, early postpartum period (6 weeks after birth) and late postpartum period (up to 2 years after birth), and compared with pre-pregnancy rates (up to 2 years before pregnancy). Admission rates were generated by calculating the total number of admissions for each time period divided by the number of weeks in the period. Incidence rate ratios (IRRs) were generated for each time period, using deprivation, age, parity and record of previous psychiatric hospital care-adjusted Poisson regression models. Results Women from more deprived social quintiles accounted for the largest proportion of admissions across all time periods. Compared with pre-pregnancy period, admission rates fell during pregnancy, increased markedly during the early postpartum period, and remained elevated for 2 years after childbirth. Within the most affluent quintile, admission IRRs were higher in the early postpartum period (IRR=1.29, 95% CI 1.02 to 1.59) than in the late postpartum period (IRR=0.87, 95% CI 0.74 to 0.98). For the late postpartum period, there was a positive association between higher maternal age and admission IRRs (ages 20–35 years, IRR=1.35, 95% CI 1.16 to 1.54 and age>40 years IRR=1.72, 95% CI 1.41 to 2.09). Conclusions Rates of psychiatric admission fell during pregnancy and increased in the early postpartum period (particularly during the first 2 weeks after birth), and remained elevated above baseline during the 2-year late postpartum period. An understanding of how social deprivation, age and parity

  11. The impact of new national HIV testing guidelines at a district general hospital in an area of high HIV seroprevalence.

    PubMed

    Page, I; Phillips, M; Flegg, P; Palmer, R

    2011-03-01

    The latest UK national human immunodeficiency virus (HIV) testing guidelines, released in September 2008, state that HIV testing should be offered to all patients with indicator conditions and considered in all general medical admissions in high-prevalence areas. We audited testing rates at Blackpool Victoria Hospital, a high-prevalence area, one year before and one year after the publication of the new guidelines. In the year after publication the rate of HIV testing in patients with indicator diseases was as follows: hepatitis B 6%, hepatitis C 28%, tuberculosis 9% and lymphoma 14%. The overall rate of HIV testing in acute medical admissions was 0.5%. Our results demonstrate that traditional methods of guideline dissemination did not lead to implementation. We are now assessing alternative methods such as marking all positive laboratory results for indicator diseases with the phrase 'HIV testing should be considered' and implementing universal opt-out screening in our Clinical Decisions Unit.

  12. The EASTR Study: indications for transfusion and estimates of transfusion recipient numbers in hospitals supplied by the National Blood Service.

    PubMed

    Wells, A W; Llewelyn, C A; Casbard, A; Johnson, A J; Amin, M; Ballard, S; Buck, J; Malfroy, M; Murphy, M F; Williamson, L M

    2009-12-01

    This study provides data on National Blood Service (NBS) red blood cell (RBC, n = 9142), platelet (PLT, n = 4232) and fresh frozen plasma (FFP, n = 3584) recipients independently sampled by monthly quota from 29 representative hospitals over 12 months in 2001-2002. Hospitals were stratified by size according to total yearly RBC issues. Transfusion indications were chosen from diagnostic and procedural codes, and recipients grouped into Epidemiology and Survival of Transfusion Recipients Case-mix Groups (E-CMGs). The main E-CMGs were digestive [19% of RBC recipients; including 5% gastrointestinal (GI) bleeds and 3% colorectal surgery], musculoskeletal (15%; 12% hip and knee replacement), haematology (13%) and obstetrics and gynaecology (10%). Renal failure, fractured neck of femur, cardiac artery by-pass grafting (CABG) and paediatrics, each accounted for 3-4% recipients. FFP recipients: the main E-CMGs were digestive (21% of FFP recipients; including 7% GI bleeds and 3% colorectal surgery), hepatobiliary (15%; 7% liver disease and 2% liver transplant), cardiac (12%) and paediatrics (9%) The renal, paediatrics, vascular and haematology E-CMGs each had 6-7% of recipients. PLT recipients: the main E-CMGs were haematology (27% of PLT recipients; including 9% lymphoma and 8% acute leukaemia), cardiac (17%), paediatrics (13%), hepatobiliary (10%) and digestive (9%). Back-weighting gave national estimates of 433 000 RBC, 57 500 FFP and 41 500 PLT recipients/year in England and North Wales, median age 69, 64 and 59 years, respectively. Digestive and hepatobiliary indications emerged as the top reason for transfusion in RBC and FFP recipients, and was also a frequent indication in PLT recipients.

  13. 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

  14. Reliability and validity of the American Hospital Association's national longitudinal survey of health information technology adoption

    PubMed Central

    Everson, Jordan; Lee, Shoou-Yih D; Friedman, Charles P

    2014-01-01

    Objective To evaluate the internal consistency, construct validity, and criterion validity of a battery of items measuring information technology (IT) adoption, included in the American Hospital Association (AHA) IT Supplement Survey. Methods We analyzed the 2012 release of the AHA IT Supplement Survey. We performed reliability analysis using Cronbach's α and part-whole correlations, construct validity analysis using principal component analysis (PCA), and criterion validity analysis by assessing the items’ sensitivity and specificity of predicting attestation to Medicare Meaningful Use (MU). Results Twenty-eight items of the 31-item instrument and five of six functionality subcategories defined by the AHA all produced reliable scales (α’s between 0.833 and 0.958). PCA mostly confirmed the AHA's categorization of functionalities; however, some items loaded only weakly onto the factor most associated with their survey category, and one category loaded onto two separate factors. The battery of items was a valid predictor of attestation to MU, producing a sensitivity of 0.82 and a specificity of 0.72. Discussion The battery of items performed well on most indices of reliability and validity. However, they lack some components of ideal survey design, leaving open the possibility that respondents are not responding independently to each item in the survey. Despite measuring only a portion of the objectives required for attestation to MU, the items are a moderately sensitive and specific predictor of attestation. Conclusions The analyzed instrument exhibits satisfactory reliability and validity. PMID:24623194

  15. 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…

  16. 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

  17. Variations in U.S. pediatric burn injury hospitalizations using the national burn repository data.

    PubMed

    Kramer, C Bradley; Rivara, Frederick P; Klein, Matthew B

    2010-01-01

    An understanding of population-specific variation in pediatric burn injuries is essential to the development of effective prevention strategies. The purpose of this study was to examine the etiology of pediatric burn injury considering age and race categories using the National Burn Repository. The authors reviewed the records of all pediatric patients (age <18 years) in the American Burn Association's National Burn Registry injured between 1995 and 2007. The authors compared patient and injury characteristics across race, age, etiology, and payor status. A total of 46,582 patients were included in this study. The etiology of burn injury varied by both age and race. Populations of color were younger, constituting 53.8% of patients younger than 5 years, whereas 53.9% of the total study population identified as Caucasian. Scald etiology was disproportionately less common in patients identifying as Caucasian (39.9 vs 61.4%, P < .001), and scald was a common etiology in older children identifying as African American, Asian, and Hispanic. Inhalation injuries were also higher in patients identifying as Native American (5.4%), Hispanic (4.2%), and African American (3.7%). Pediatric burn injury etiology varies with age and race. These data should encourage careful consideration of race, age, and other differences in formulating the most effective, population-specific prevention and outreach strategies.

  18. 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

  19. Development of the Philippine Hydrologic Dataset (PHD) from LiDAR and other remotely-sensed data

    NASA Astrophysics Data System (ADS)

    Perez, A. M. C.; Gaspa, M. C.; Aloc, D. S.; Mahor, M. A. P.; Gonzalez, K. A. C.; Borlongan, N. J. B.; De La Cruz, R. M.; Olfindo, N. T.; Blanco, A. C.

    2015-10-01

    Water resource monitoring and management has been an important concern in the Philippines, considering that the country is archipelagic in nature and is exposed to a lot of disasters imposed by the global effects of climate change. The design and implementation of an effective management scheme relies heavily on accurate, complete, and updated water resource inventories, usually in the form of digital maps and geodatabases. With the aim of developing a detailed and comprehensive database of all water resources in the Philippines, the 3-year project "Development of the Philippine Hydrologic Dataset (PHD) for Watersheds from LiDAR Surveys" under the Phil-LiDAR 2 Program (National Resource Inventory), has been initiated by the University of the Philippines Diliman (UPD) and the Department of Science and Technology (DOST). Various workflows has already been developed to extract inland hydrologic features in the Philippines using accurate Light Detection and Ranging (LiDAR) Digital Terrain Models (DTMs) and LiDAR point cloud data obtained through other government-funded programs such as Disaster Risk and Exposure Assessment for Mitigation (DREAM) and Phil-LiDAR 1, supplemented with other remotely-sensed imageries and ancillary information from Local Government Units (LGUs) and National Government Agencies (NGAs). The methodologies implemented are mainly combinations of object-based image analysis, pixel-based image analysis, modeling, and field surveys. This paper presents the PHD project, the methodologies developed, and some sample outputs produced.

  20. 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

  1. [Optimalisation of the antibiotic policy in The Netherlands. XI. The national electronic antibiotic guide'SWAB-ID' for use in hospitals].

    PubMed

    van Vonderen, M G A; Gyssens, I C; Hartwig, N G; Kullberg, B J; Leverstein-van Hall, M A; Natsch, S; Prins, J M

    2006-11-18

    The 'Stichting Werkgroep Antibioticabeleid' (Dutch Working Party on Antibiotic Policy) has developed an electronic national antibiotic guide for the antibiotic treatment and prophylaxis of common infectious diseases in hospitals. This guide also contains information on the most important characteristics of antimicrobial drugs. Advice on antibiotic treatment is based on existing national evidence-based guidelines, where available. Where no guideline is available, the advice is based on an inventory of the antibiotic policies of the 12 Dutch centres with an infectious disease or medical microbiology training programme. The national antibiotic guide can be accessed through the SWAB website (www.swab.nl) and can also be downloaded on PDA/PocketPC, free of charge. Every hospital antibiotic formulary committee in the Netherlands will be offered the opportunity to edit The national version for local use.

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

    PubMed

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

    2015-10-01

    De nombreux pays s'efforcent d'élaborer et de mettre en œuvre des stratégies pour contrôler les hôpitaux à l'échelle nationale. C'est un défi de taille, en particulier pour les pays à faible revenu, qui disposent de peu de ressources pour effectuer des mesures et des comptes-rendus. Nous avons analysé l'expérience qui a consisté à élaborer et mettre en œuvre un système national de contrôle des performances de 130 hôpitaux publics en Éthiopie. Des observations participatives ont révélé que ce système de contrôle a entraîné une communication plus systématique des données sur les performances aux bureaux régionaux de la santé et au gouvernement fédéral de la part des hôpitaux, a amélioré la transparence concernant les performances de ces derniers et a permis d'élaborer plusieurs projets d'amélioration de la qualité. L'élaboration et la mise en œuvre de ce système, qui ont nécessité des investissements et des soutiens techniques et politiques, n'auraient pas été possibles sans d'importantes capacités de gestion dans les hôpitaux. Il peut être utile, aux premiers stades de la conception et de la mise en œuvre, d'évaluer de manière approfondie l'ouverture au changement du secteur de la santé ainsi que son souhait de placer au premier plan la qualité des services hospitaliers. Cette évaluation peut s'appuyer sur des entretiens avec des informateurs clés, sur la collecte de données au sujet des établissements de santé et des ressources humaines, ou encore sur une discussion avec des partenaires universitaires. Le fait d'associer des partenaires et des donateurs à l'objectif d'amélioration de la qualité visé par le gouvernement peut permettre de renforcer son acceptabilité ainsi que le soutien politique en la matière. Cela peut permettre de faire converger les ressources de façon stratégique vers un même effort national, plutôt que de les éparpiller dans des dizaines de projets potentiellement concurrents

  3. 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

  4. Makerere University College of Health Sciences’ role in addressing challenges in health service provision at Mulago National Referral Hospital

    PubMed Central

    2011-01-01

    Background Mulago National Referral Hospital (MNRH), Uganda’s primary tertiary and teaching hospital, and Makerere University College of Health Sciences (MakCHS) have a close collaborative relationship. MakCHS students complete clinical rotations at MNRH, and MakCHS faculty partner with Mulago staff in clinical care and research. In 2009, as part of a strategic planning process, MakCHS undertook a qualitative study to examine care and service provision at MNRH, identify challenges, gaps, and solutions, and explore how MakCHS could contribute to improving care and service delivery at MNRH. Methods Key informant interviews (n=23) and focus group discussions (n=7) were conducted with nurses, doctors, administrators, clinical officers and other key stakeholders. Interviews and focus groups were tape recorded and transcribed verbatim, and findings were analyzed through collaborative thematic analysis. Results Challenges to care and service delivery at MNRH included resource constraints (staff, space, equipment, and supplies), staff inadequacies (knowledge, motivation, and professionalism), overcrowding, a poorly functioning referral system, limited quality assurance, and a cumbersome procurement system. There were also insufficiencies in the teaching of professionalism and communication skills to students, and patient care challenges that included lack of access to specialized services, risk of infections, and inappropriate medications. Suggestions for how MakCHS could contribute to addressing these challenges included strengthening referral systems and peripheral health center capacity, and establishing quality assurance mechanisms. The College could also strengthen the teaching of professionalism, communication and leadership skills to students, and monitor student training and develop courses that contribute to continuous professional development. Additionally, the College could provide in-service education for providers on professionalism, communication skills

  5. 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.

  6. 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…

  7. Relationship between mean daily ambient temperature range and hospital admissions for schizophrenia: Results from a national cohort of psychiatric inpatients.

    PubMed

    Sung, Tzu-I; Chen, Mu-Jean; Lin, Chuan-Yao; Lung, Shih-Chun; Su, Huey-Jen

    2011-12-01

    Environmental temperature is known to correlate with schizophrenia, but little is known about the association with changes in temperature. This 12-year study aimed to evaluate the relationship between the mean daily range of ambient temperature and schizophrenia admissions in a national cohort of psychiatric inpatients in Taiwan. Meteorological data provided by the Central Weather Bureau of Taiwan were interpolated to create representative estimates. Psychiatric inpatient admissions in all hospitals with medical services enrolled in the current health care insurance system were retrieved from the 1996-2007 Psychiatric Inpatient Medical Claim dataset of the National Health Insurance Research Database. Generalized linear models with Poisson distributions were used to analyze the impact of mean diurnal change of temperature on schizophrenia admissions, controlling for internal correlations and demographic covariates. The daily temperature range varied between 1.7°C and 12.1°C (1st to 99th percentile). The relative risk of schizophrenia admission was significantly increased at a temperature range of 3.2°C (10th percentile), and the maximum was at 12.1°C (99th percentile); however, no such association was found with schizoaffective disorder. When restricted to the capital and largest city, the effects of temperature range were prominent and may correlate with temperature itself. The joint effect of temperature and temperature range was associated with elevated risk, particularly at cooler temperatures. A positive correlation was found between increasing temperature range and schizophrenia admissions. The increase in morbidity at high percentiles suggests that the increasing dynamics of temperature range are a valid reflection of risk, highlighting the need for precautionary action. PMID:22018962

  8. 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

  9. Using LiDAR to characterize logjams in lowland rivers

    NASA Astrophysics Data System (ADS)

    Abalharth, Mahdi; Hassan, Marwan A.; Klinkenberg, Brian; Leung, Vivian; McCleary, Richard

    2015-10-01

    Logjams significantly influence watershed hydrology, flow regime, channel morphology and stability, and processes in lowland rivers. Consequently, logjams play a major role in the existence and conservation of the riparian and aquatic ecosystems along major waterways. In this paper, we attempt to detect and quantify logjams in river channels using LiDAR technology in conjunction with traditional fieldwork. To the best of our knowledge, LiDAR-based analysis has not been used to characterize logjams in streams. Overall, when applied in a lowland river environment, LiDAR-based analysis demonstrates a comprehensive solution for detecting logjams in relation to the fieldwork, with a low rate of omission. A filtered approach predicted the presence of 95% of fieldwork-reported logjams (a 5% rate of omission), but also identified six logjams not identified in the field (a 10% rate of commission). A nonfiltered approach identified 87% of field-reported logjams, producing a 13% rate of omission and a 6.7% rate of commission. Dimension measurements were more consistent in the filtered LiDAR approach, showing 53%, 34%, and 90% of R2 improvements for the length, width, and height, respectively, over the unfiltered LiDAR values. As vegetation cover hindered accurate delineation of logjam boundaries by LiDAR, field and LiDAR measurements of nonvegetation-obstructed logjams were more highly correlated than the field and LiDAR measurements of partially and completely vegetation-obstructed logjams.

  10. Rigorous LiDAR Strip Adjustment with Triangulated Aerial Imagery

    NASA Astrophysics Data System (ADS)

    Zhang, Y. J.; Xiong, X. D.; Hu, X. Y.

    2013-10-01

    This paper proposes a POS aided LiDAR strip adjustment method. Firstly, aero-triangulation of the simultaneously obtained aerial images is conducted with a few photogrammetry-specific ground control points. Secondly, LiDAR intensity images are generated from the reflectance signals of laser foot points, and conjugate points are automatically matched between the LiDAR intensity image and the aero-triangulated aerial image. Control points used in LiDAR strip adjustment are derived from these conjugate points. Finally, LiDAR strip adjustment of real data is conducted with the POS aided LiDAR strip adjustment method proposed in this paper, and comparison experiment using three-dimensional similarity transformation method is also performed. The results indicate that the POS aided LiDAR strip adjustment method can significantly correct the planimetric and vertical errors of LiDAR strips. The planimetric correction accuracy is higher than average point distance while the vertical correction accuracy is comparable to that of the result of aero-triangulation. Moreover, the proposed method is obliviously superior to the traditional three-dimensional similarity transformation method.

  11. [Noma and HIV infection: apropos of a case at the National Hospital Center in Bobo-Dioulasso (Burkina Faso)].

    PubMed

    Ki-Zerbo, G A; Guigma, Y

    2001-12-01

    Noma (Cancrum oris) is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles. Recently, cases have been reported in adults especially elderly patients or during immunodeficiency states. Reconstructive surgery is often necessary to deal with destruction and sequel but is rarely accessible in developing countries. We report one case of noma (cancrum oris) in an HIV seropositive patient at the National Hospital in Bobo-Dioulasso. The noma was inaugural of AIDS in a 40 years old labourer coming back from Ivory Coast and no major opportunistic infection was associated. The course was fulminant leading to extensive facial gangrene with recurrent bacterial infections. The disease was fatal in this depressive, malnourished and diarrhoeic patient despite local surgical treatment, prolonged antibiotherapy and supportive care. Pathogenic mechanisms, management and preventive issues are discussed. PMID:11887587

  12. [Noma and HIV infection: apropos of a case at the National Hospital Center in Bobo-Dioulasso (Burkina Faso)].

    PubMed

    Ki-Zerbo, G A; Guigma, Y

    2001-12-01

    Noma (Cancrum oris) is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles. Recently, cases have been reported in adults especially elderly patients or during immunodeficiency states. Reconstructive surgery is often necessary to deal with destruction and sequel but is rarely accessible in developing countries. We report one case of noma (cancrum oris) in an HIV seropositive patient at the National Hospital in Bobo-Dioulasso. The noma was inaugural of AIDS in a 40 years old labourer coming back from Ivory Coast and no major opportunistic infection was associated. The course was fulminant leading to extensive facial gangrene with recurrent bacterial infections. The disease was fatal in this depressive, malnourished and diarrhoeic patient despite local surgical treatment, prolonged antibiotherapy and supportive care. Pathogenic mechanisms, management and preventive issues are discussed.

  13. 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

  14. Hypnotics and the Occurrence of Bone Fractures in Hospitalized Dementia Patients: A Matched Case-Control Study Using a National Inpatient Database

    PubMed Central

    Tamiya, Hiroyuki; Yasunaga, Hideo; Matusi, Hiroki; Fushimi, Kiyohide; Ogawa, Sumito; Akishita, Masahiro

    2015-01-01

    Background Preventing falls and bone fractures in hospital care is an important issue in geriatric medicine. Use of hypnotics is a potential risk factor for falls and bone fractures in older patients. However, data are lacking on the association between use of hypnotics and the occurrence of bone fracture. Methods We used a national inpatient database including 1,057 hospitals in Japan and included dementia patients aged 50 years or older who were hospitalized during a period of 12 months between April 2012 and March 2013. The primary outcome was the occurrence of bone fracture during hospitalization. Use of hypnotics was compared between patients with and without bone fracture in this matched case-control study. Results Of 140,494 patients, 830 patients suffered from in-hospital fracture. A 1:4 matching with age, sex and hospital created 817 cases with fracture and 3,158 matched patients without fracture. With adjustment for the Charlson comorbidity index, emergent admission, activities of daily living, and scores for level walking, a higher occurrence of fractures were seen with short-acting benzodiazepine hypnotics (odds ratio, 1.43; 95% confidence interval, 1.19–1.73; P<0.001), ultrashort-acting non-benzodiazepine hypnotics (1.66; 1.37–2.01; P<0.001), hydroxyzine (1.45; 1.15–1.82, P=0.001), risperidone and perospirone (1.37; 1.08–1.73; P=0.010). Other drug groups were not significantly associated with the occurrence of in-hospital fracture. Conclusions Short-acting benzodiazepine hypnotics and ultrashort-acting non-benzodiazepine hypnotics may increase risk of bone fracture in hospitalized dementia patients. PMID:26061231

  15. Lava flow texture LiDAR signatures

    NASA Astrophysics Data System (ADS)

    Whelley, P.; Garry, W. B.; Scheidt, S. P.; Irwin, R. P., III; Fox, J.; Bleacher, J. E.; Hamilton, C. W.

    2014-12-01

    High-resolution point clouds and digital elevation models (DEMs) are used to investigate lava textures on the Big Island of Hawaii. An experienced geologist can distinguish fresh or degraded lava textures (e.g., blocky, a'a and pahoehoe) visually in the field. Lava texture depends significantly on eruption conditions, and it is therefore instructive, if accurately determined. In places where field investigations are prohibitive (e.g., Mercury, Venus, the Moon, Mars, Io and remote regions on Earth) lava texture must be assessed from remote sensing data. A reliable method for differentiating lava textures in remote sensing data remains elusive. We present preliminary results comparing properties of lava textures observed in airborne and terrestrial Light Detection and Ranging (LiDAR) data. Airborne data, in this study, were collected in 2011 by Airborne 1 Corporation and have a ~1m point spacing. The authors collected the terrestrial data during a May 2014 field season. The terrestrial scans have a heterogeneous point density. Points close to the scanner are 1 mm apart while 200 m in the distance points are 10 cm apart. Both platforms offer advantages and disadvantages beyond the differences in scale. Terrestrial scans are a quantitative representation of what a geologist sees "on the ground". Airborne scans are a point of view routinely imaged by other remote sensing tools, and can therefore be quickly compared to complimentary data sets (e.g., spectral scans or image data). Preliminary results indicate that LiDAR-derived surface roughness, from both platforms, is useful for differentiating lava textures, but at different spatial scales. As all lava types are quite rough, it is not simply roughness that is the most advantageous parameter; rather patterns in surface roughness can be used to differentiate lava surfaces of varied textures. This work will lead to faster and more reliable volcanic mapping efforts for planetary exploration as well as terrestrial

  16. Case study: analysis of end-user requests on electronic medical record and computerized physician order entry system of Seoul National University Hospital in Korea.

    PubMed

    Kim, Young-Ah; Shin, Soo-Yong; Jo, Eun-Mi; Park, Chan-Hee; Hwang, Min-A; Kim, Kyung Hwan; Chung, Chun Kee

    2010-01-01

    Seoul National University Hospital (SNUH) in Korea has utilized the full Electronic Medical Record (EMR) system since October 2004. Unlike other countries, most EMR systems in Korean teaching and general hospitals are in-house development systems. Therefore, we can actively respond to user requests on EMR. Here, based on 5 years of experience in EMR system operation, we analyzed 2,339 SNUH EMR user requests from 2006 to 2008 for improvement of EMR system operation and management. We classify user requests into 9 criteria based on guidelines from the SNUH medical information management team. In conclusion, the most common requests (73%) are for improvement of improving quality of care. However, requests associated with hospital enterprise, public policy, and customer service are gradually increased every year. Therefore, we suggest that suitable EMR management criteria are necessary for reliable EMR operation and management.

  17. Nasal carriage rate of methicillin resistant Staphylococcus aureus among at National Medical College Teaching Hospital, Birgunj, Nepal.

    PubMed

    Shakya, B; Shrestha, S; Mitra, T

    2010-03-01

    Present study was conducted to assess the nasal carriage rate of methicilin resistant Staphylococcus aureus (MRSA) among patients, visitors/patient attendants and healthcare personnel at National Medical College Teaching Hospital, Birgunj, Nepal. A total of 112 nasal swabs (patients: 31, visitors/patient attendants: 61, and healthcare personnel: 20) were subjected to bacteriological investigation following standard protocol. S. aureus isolates were identified by mannitol fermentation and coagulase positivity. Antimicrobial susceptibility test was performed by Kirby-Bauer's disc diffusion method on Muller-Hinton agar medium. S. aureus was isolated in 14 (12.5%) of participants (M: 11.3%, F: 13.6%). Highest nasal colonization rate was found among healthcare personnel (25.0%) followed by the visitors/patient attendants (13.1%) and the patients (3.2%) (P>0.05). Highest positive rate was observed in the age group d"14 years (33.3%), followed by 15 to 50 years (13.2%) and >50 years (5.6%) (P>0.05). Out of 14 S. aureus isolates, 57.1% were methicillin resistant, prevalence rate of MRSA among total subjects being 7.1%. MRSA prevalence rate were 5.6% and 8.5% in total male and female participants, respectively (P>0.05). Highest MRSA prevalence rate was among health-care personnel (10.0%), followed by visitors/patient attendants (8.2%) and the patients (3.2%) (P>0.05). All MRSA isolates were resistant to Ampicillin, followed by Cephalexin (37.5%), Ciprofloxacin (37.5%), Tetracycline (37.5%), Gentamycin (25.0%), Erythromycin (0.0%) and Vancomycin (0.0%). High rate of nasal MRSA carriage rate found in this study indicates the need for standard infection control to prevent MRSA transmission.

  18. 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.

  19. 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

  20. 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.

  1. 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…

  2. 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

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. 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.

  9. 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

  10. Does long-term care use within primary health care reduce hospital use among older people in Norway? A national five-year population-based observational study

    PubMed Central

    2011-01-01

    Background Population ageing may threaten the sustainability of future health care systems. Strengthening primary health care, including long-term care, is one of several measures being taken to handle future health care needs and budgets. There is limited and inconsistent evidence on the effect of long-term care on hospital use. We explored the relationship between the total use of long-term care within public primary health care in Norway and the use of hospital beds when adjusting for various effect modifiers and confounders. Methods This national population-based observational study consists of all Norwegians (59% women) older than 66 years (N = 605676) (13.2% of total population) in 2002-2006. The unit of analysis was defined by municipality, age and sex. The association between total number of recipients of long-term care per 1000 inhabitants (LTC-rate) and hospital days per 1000 inhabitants (HD-rate) was analysed in a linear regression model. Modifying and confounding effects of socioeconomic, demographic and geographic variables were included in the final model. We defined a difference in hospitalization rates of more than 1000 days per 1000 inhabitants as clinically important. Results Thirty-one percent of women and eighteen percent of men were long-term care users. Men had higher HD-rates than women. The crude association between LTC-rate and HD-rate was weakly negative. We identified two effect modifiers (age and sex) and two strong confounders (travel time to hospital and mortality). Age and sex stratification and adjustments for confounders revealed a positive statistically significant but not clinically important relationship between LTC-rates and hospitalization for women aged 67-79 years and all men. For women 80 years and over there was a weak but negative relationship which was neither statistically significant nor clinically important. Conclusions We found a weak positive adjusted association between LTC-rates and HD-rates. Opposite to common

  11. 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

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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. PMID:22163952

  17. 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

  18. 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

  19. 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.

  20. Implementing a national program to reduce catheter-associated urinary tract infection: a quality improvement collaboration of state hospital associations, academic medical centers, professional societies, and governmental agencies.

    PubMed

    Fakih, Mohamad G; George, Christine; Edson, Barbara S; Goeschel, Christine A; Saint, Sanjay

    2013-10-01

    Catheter-associated urinary tract infection (CAUTI) represents a significant proportion of healthcare-associated infections (HAIs). The US Department of Health and Human Services issued a plan to reduce HAIs with a target 25% reduction of CAUTI by 2013. Michigan's successful collaborative to reduce unnecessary use of urinary catheters and CAUTI was based on a partnership between diverse hospitals, the state hospital association (SHA), and academic medical centers. Taking the lessons learned from Michigan, we are now spreading this work throughout the 50 states. This national spread leverages the expertise of different groups and organizations for the unified goal of reducing catheter-related harm. The key components of the project are (1) centralized coordination of the effort and dissemination of information to SHAs and hospitals, (2) data collection based on established definitions and approaches, (3) focused guidance on the technical practices that will prevent CAUTI, (4) emphasis on understanding the socioadaptive aspects (both the general, unit-wide issues and CAUTI-specific challenges), and (5) partnering with specialty organizations and governmental agencies who have expertise in the relevant subject area. The work may serve in the future as a model for other large improvement efforts to address other hospital-acquired conditions, such as venous thromboembolism and falls.

  1. US hospitals violate WHO policy on the distribution of formula sample packs: results of a national survey.

    PubMed

    Merewood, Anne; Grossman, Xena; Cook, John; Sadacharan, Radha; Singleton, Marcella; Peters, Karen; Navidi, Tina

    2010-11-01

    The World Health Organization's International Code of Marketing of Breast-Milk Substitutes, as well as most major medical authorities, opposes hospital-based distribution of free infant formula at discharge. The goal of this cross-sectional telephone survey of 3209 US maternity sites, conducted from 2006 to 2007, was to determine the extent of this practice. It was found that 91% of hospitals distributed formula sample packs, and a trend toward discontinuation of the practice was statistically significant (P < .001). It was concluded that most US hospitals distribute infant formula samples, in violation of the WHO Code and the recommendations of organizations including the US Government Accountability Office, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention. PMID:20871089

  2. Establishing a National Maternal Morbidity Outcome Indicator in England: A Population-Based Study Using Routine Hospital Data

    PubMed Central

    Nair, Manisha; Kurinczuk, Jennnifer J.; Knight, Marian

    2016-01-01

    Introduction As maternal deaths become rarer, monitoring near-miss or severe maternal morbidity becomes important as a tool to measure changes in care quality. Many calls have been made to use routinely available hospital administration data to monitor the quality of maternity care. We investigated 1) the feasibility of developing an English Maternal Morbidity Outcome Indicator (EMMOI) by reproducing an Australian indicator using routinely available hospital data, 2) the impact of modifications to the indicator to address potential data quality issues, 3) the reliability of the indicator. Methods We used data from 6,389,066 women giving birth in England from April 2003 to March 2013 available in the Hospital Episode Statistics (HES) database of the Health and Social care Information centre (HSCIC). A composite indicator, EMMOI, was generated from the diagnoses and procedure codes. Rates of individual morbid events included in the EMMOI were compared with the rates in the UK reported by population-based studies. Results EMMOI included 26 morbid events (17 diagnosis and 9 procedures). Selection of the individual morbid events was guided by the Australian indicator and published literature for conditions associated with maternal morbidity and mortality in the UK, but was mainly driven by the quality of the routine hospital data. Comparing the rates of individual morbid events of the indicator with figures from population-based studies showed that the possibility of false positive and false negative cases cannot be ruled out. Conclusion While routine English hospital data can be used to generate a composite indicator to monitor trends in maternal morbidity during childbirth, the quality and reliability of this monitoring indicator depends on the quality of the hospital data, which is currently inadequate. PMID:27054761

  3. Rural and Urban Hospitals' Role in Providing Inpatient Care, 2010

    MedlinePlus

    ... CDC/NCHS, National Hospital Discharge Survey, 2010. How did rural hospital inpatients differ from urban hospital inpatients ... CDC/NCHS, National Hospital Discharge Survey, 2010. How did patients' first-listed diagnoses differ in rural and ...

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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…

  9. 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…

  10. Quality of human-computer interaction - results of a national usability survey of hospital-IT in Germany

    PubMed Central

    2011-01-01

    Background Due to the increasing functionality of medical information systems, it is hard to imagine day to day work in hospitals without IT support. Therefore, the design of dialogues between humans and information systems is one of the most important issues to be addressed in health care. This survey presents an analysis of the current quality level of human-computer interaction of healthcare-IT in German hospitals, focused on the users' point of view. Methods To evaluate the usability of clinical-IT according to the design principles of EN ISO 9241-10 the IsoMetrics Inventory, an assessment tool, was used. The focus of this paper has been put on suitability for task, training effort and conformity with user expectations, differentiated by information systems. Effectiveness has been evaluated with the focus on interoperability and functionality of different IT systems. Results 4521 persons from 371 hospitals visited the start page of the study, while 1003 persons from 158 hospitals completed the questionnaire. The results show relevant variations between different information systems. Conclusions Specialised information systems with defined functionality received better assessments than clinical information systems in general. This could be attributed to the improved customisation of these specialised systems for specific working environments. The results can be used as reference data for evaluation and benchmarking of human computer engineering in clinical health IT context for future studies. PMID:22070880

  11. National Trends in Pulmonary Embolism Hospitalization Rates and Outcomes for Adults Aged ≥65 Years in the United States (1999 to 2010).

    PubMed

    Minges, Karl E; Bikdeli, Behnood; Wang, Yun; Kim, Nancy; Curtis, Jeptha P; Desai, Mayur M; Krumholz, Harlan M

    2015-11-01

    Little is known about national trends of pulmonary embolism (PE) hospitalizations and outcomes in older adults in the context of recent diagnostic and therapeutic advances. Therefore, we conducted a retrospective cohort study of 100% Medicare fee-for-service beneficiaries hospitalized from 1999 to 2010 with a principal discharge diagnosis code for PE. The adjusted PE hospitalization rate increased from 129/100,000 person-years in 1999 to 302/100,000 person-years in 2010, a relative increase of 134% (p <0.001). Black patients had the highest rate of increase (174 to 548/100,000 person-years) among all age, gender, and race categories. The mean (standard deviation) length of hospital stay decreased from 7.6 (5.7) days in 1999 to 5.8 (4.4) days in 2010, and the proportion of patients discharged to home decreased from 51.1% (95% confidence interval [CI] 50.5 to 51.6) to 44.1% (95% CI 43.7 to 44.6), whereas more patients were discharged with home health care and to skilled nursing facilities. The in-hospital mortality rate decreased from 8.3% (95% CI 8.0 to 8.6) in 1999 to 4.4% (95% CI 4.2 to 4.5) in 2010, as did adjusted 30-day (from 12.3% [95% CI 11.9 to 12.6] to 9.1% [95% CI 8.5 to 9.7]) and 6-month mortality rates (from 23.0% [95% CI 22.5 to 23.4] to 19.6% [95% CI 18.8 to 20.5]). There were no significant racial differences in mortality rates by 2010. There was no change in the adjusted 30-day all-cause readmission rate from 1999 to 2010. In conclusion, PE hospitalization rates increased substantially from 1999 to 2010, with a higher rate for black patients. All mortality rates decreased but remained high. The increase in hospitalization rates and continued high mortality and readmission rates confirm the significant burden of PE for older adults. PMID:26409636

  12. 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. PMID:18365761

  13. Biomass Estimation for Individual Trees using Waveform LiDAR

    NASA Astrophysics Data System (ADS)

    Wang, K.; Kumar, P.; Dutta, D.

    2015-12-01

    Vegetation biomass information is important for many ecological models that include terrestrial vegetation in their simulations. Biomass has strong influences on carbon, water, and nutrient cycles. Traditionally biomass estimation requires intensive, and often destructive, field measurements. However, with advances in technology, airborne LiDAR has become a convenient tool for acquiring such information on a large scale. In this study, we use infrared full waveform LiDAR to estimate biomass information for individual trees in the Sangamon River basin in Illinois, USA. During this process, we also develop automated geolocation calibration algorithms for raw waveform LiDAR data. In the summer of 2014, discrete and waveform LiDAR data were collected over the Sangamon River basin. Field measurements commonly used in biomass equations such as diameter at breast height and total tree height were also taken for four sites across the basin. Using discrete LiDAR data, individual trees are delineated. For each tree, a voxelization methods is applied to all waveforms associated with the tree to result in a pseudo-waveform. By relating biomass extrapolated using field measurements from a training set of trees to waveform metrics for each corresponding tree, we are able to estimate biomass on an individual tree basis. The results can be especially useful as current models increase in resolution.

  14. 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

  15. 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

  16. 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.

  17. Do consultant obstetricians and gynaecologists comply with motor traffic regulations when recalled to hospital to attend emergencies? A national audit.

    PubMed

    Ogah, J; Pring, D W

    2009-10-01

    Consultant obstetricians and gynaecologists are often recalled from home back into hospital to attend emergencies. We audited their driving practices and compliance to motor traffic regulations on recall to these emergencies with the aid of a questionnaire survey. A total of 218 of the 300 UK consultants surveyed responded. Some 65% of those who owned a green warning light beacon (GWL) admitted to speeding on some journeys and 46% ignored red lights; 84% of non-owners of a GWL would speed and 28% would ignore a red light. A total of 37 consultants had been stopped for traffic violations, nine with a GWL and 28 without. Five consultants had been involved in accidents returning to hospital to attend an emergency. Obstetricians and gynaecologists are disregarding motor traffic regulations in order to attend emergencies.

  18. 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

  19. Understanding the determinants of Australian hospital nurses' hand hygiene decisions following the implementation of a national hand hygiene initiative.

    PubMed

    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

    2015-12-01

    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 study was to understand the determinants of nurses' hand hygiene decisions, using an extension of a common health decision-making model, the theory of planned behaviour (TPB), to inform future health education strategies to increase compliance. Nurses from 50 Australian hospitals (n = 2378) completed standard TPB measures (attitude, subjective norm, perceived behavioural control [PBC], intention) and the extended variables of group norm, risk perceptions (susceptibility, severity) and knowledge (subjective, objective) at Time 1, while a sub-sample (n = 797) reported their hand hygiene behaviour 2 weeks later. Regression analyses identified subjective norm, PBC, group norm, subjective knowledge and risk susceptibility as the significant predictors of nurses' hand hygiene intentions, with intention and PBC predicting their compliance behaviour. Rather than targeting attitudes which are already very favourable among nurses, health education strategies should focus on normative influences and perceptions of control and risk in efforts to encourage hand hygiene adherence. PMID:26590244

  20. [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. PMID:21467804

  1. Ecosystem Mapping Approaches Based on Vegetation Structure Using NEON Prototype Airborne LiDAR and Field Data

    NASA Astrophysics Data System (ADS)

    Krause, K.; Emery, W. J.; Barnett, D.; Petroy, S. B.; Meier, C. L.; Wessman, C. A.

    2014-12-01

    Remote sensing is a powerful tool for measuring the current state of vegetation and monitoring changes over time with repeated data collections. Airborne Light Detection and Ranging (LiDAR) data is especially well suited for mapping 3D vegetation structure. In 2010, the National Ecological Observatory Network (NEON) contracted LiDAR and hyperspectral airborne data collections over the Ordway-Swisher Biological Station (OSBS). Ground truth campaigns were also conducted in 2010, 2011, and 2014 including structural measurements and generation of species lists for a set of ground validation plots. The vegetation communities at OSBS can be characterized by the Florida Natural Areas Inventory (FNAI) classification system, with a large area of the property belonging to the Sandhill community. For this study, classification algorithm training locations are hand selected for each FNAI community type using photo-interpretation. A series of LiDAR metrics are calculated on the discrete return point clouds and derived digital elevation (DEM) and canopy height models (CHM). A decision tree classification algorithm is run using R package "rpart". A main goal of the project is to relate the LiDAR metrics used by the decision tree to direct canopy structural quantities. For instance, the canopy 75th minus the 50th percentile height in the LiDAR point clouds are related to the uniformity and light penetration in the upper canopy. A prototype of the decision tree achieved a classification accuracy of 89% on the training data itself, suggesting that some locations in different FNAI vegetation communities have similar structure and could not be distinguished in the LiDAR metrics used. An improved decision tree is currently under development which will include more training locations and more LiDAR metrics as input features. Results from this improved model will be presenting using the NEON ground truth locations as an independent and quantitative validation measure of the decision tree

  2. Application of High-resolution Aerial LiDAR Data in Calibration of a Two-dimensional Urban Flood Simulation

    NASA Astrophysics Data System (ADS)

    Piotrowski, J.; Goska, R.; Chen, B.; Krajewski, W. F.; Young, N.; Weber, L.

    2009-12-01

    In June 2008, the state of Iowa experienced an unprecedented flood event which resulted in an economic loss of approximately $2.88 billion. Flooding in the Iowa River corridor, which exceeded the previous flood of record by 3 feet, devastated several communities, including Coralville and Iowa City, home to the University of Iowa. Recognizing an opportunity to capture a unique dataset detailing the impacts of the historic flood, the investigators contacted the National Center for Airborne Laser Mapping (NCALM), which performed an aerial Light Detection and Ranging (LiDAR) survey along the Iowa River. The survey, conducted immediately following the flood peak, provided coverage of a 60-mile reach. The goal of the present research is to develop a process by which flood extents and water surface elevations can be accurately extracted from the LiDAR data set and to evaluate the benefit of such data in calibrating one- and two-dimensional hydraulic models. Whereas data typically available for model calibration include sparsely distributed point observations and high water marks, the LiDAR data used in the present study provide broad-scale, detailed, and continuous information describing the spatial extent and depth of flooding. Initial efforts were focused on a 10-mile, primarily urban reach of the Iowa River extending from Coralville Reservoir, a United States Army Corps of Engineers flood control project, downstream through the Coralville and Iowa City. Spatial extent and depth of flooding were estimated from the LiDAR data. At a given cross-sectional location, river channel and floodplain measurements were compared. When differences between floodplain and river channel measurements were less than a standard deviation of the vertical uncertainty in the LiDAR survey, floodplain measurements were classified as flooded. A flood water surface DEM was created using measurements classified as flooded. A two-dimensional, depth-averaged numerical model of a 10-mile reach of

  3. [Collaboration between Fukushimura Brain Bank,based in a private geriatric hospital and a national/international network].

    PubMed

    Akatsu, Hiroyasu

    2010-10-01

    Fukushimura Brain Bank (FBB) was established in 1994, and to date, has accumulated 477 fresh frozen brain tissue samples. Our brain bank is based in Choju Medical Institute, Fukushimura Hospital, Toyohashi in Japan. At the time of its foundation, the institute could not establish working relationships with clinicopathological investigators and others engaged in basic neuroscience research. At this stage, we received the assistance of Yokohama City University in setting up standards for neuropathological diagnosis as well as the aid of Chiba University in establishing a method for Vancouver style snap-frozen sampling of brain tissue. However, both systems require considerable manpower and time. We now plan to introduce several improvements in these systems. At its inception, the Brain Bank operated without financial support from grants or foundation funding and was managed only as a hospital expense. However, since 1998, we have collaborated with researchers from several institutes, and the results of our labors have been presented at congresses, in journal publications and in foundation reports. In 2004, we obtained the status required to apply for a grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan. Fukushimura Hospital is a geriatric institution that specializes in dementia. There are no other hospitals or nursing homes in the Toyohashi area that specialize in this field. Half of our patients have Alzheimer's disease,and a number of them have enormous plaques and huge neurofibrillary tangles patient for over 10 years. In general,private geriatric hospitals that care for such patients with severe AD lack the systems required for performing autopsies. Research carried out with animal models are not comparable with neuropathological and biochemical investigations using human tissues,and in terms of the quality,the range and size of our collection at FBB is unique. In the future,we intend to expand our network in order to share

  4. Integrating LiDAR Data into Earth Science Education

    NASA Astrophysics Data System (ADS)

    Robinson, S. E.; Arrowsmith, R.; de Groot, R. M.; Crosby, C. J.; Whitesides, A. S.; Colunga, J.

    2010-12-01

    The use of high-resolution topography derived from Light Detection and Ranging (LiDAR) in the study of active tectonics is widespread and has become an indispensable tool to better understand earthquake hazards. For this reason and the spectacular representation of the phenomena the data provide, it is appropriate to integrate these data into the Earth science education curriculum. A collaboration between Arizona State University, the OpenTopography Facility, and the Southern California Earthquake Center are developing, three earth science education products to inform students and other audiences about LiDAR and its application to active tectonics research. First, a 10-minute introductory video titled LiDAR: Illuminating Earthquakes was produced and is freely available online through the OpenTopography portal and SCEC. The second product is an update and enhancement of the Wallace Creek Interpretive Trail website (www.scec.org/wallacecreek). LiDAR topography data products have been added along with the development of a virtual tour of the offset channels at Wallace Creek using the B4 LiDAR data within the Google Earth environment. The virtual tour to Wallace Creek is designed as a lab activity for introductory undergraduate geology courses to increase understanding of earthquake hazards through exploration of the dramatic offset created by the San Andreas Fault (SAF) at Wallace Creek and Global Positioning System-derived displacements spanning the SAF at Wallace Creek . This activity is currently being tested in courses at Arizona State University. The goal of the assessment is to measure student understanding of plate tectonics and earthquakes after completing the activity. Including high-resolution topography LiDAR data into the earth science education curriculum promotes understanding of plate tectonics, faults, and other topics related to earthquake hazards.

  5. National trends in the morbidity and mortality of asthma in the US. Prevalence, hospitalization and death from asthma over two decades: 1965-1984.

    PubMed

    Evans, R; Mullally, D I; Wilson, R W; Gergen, P J; Rosenberg, H M; Grauman, J S; Chevarley, F M; Feinleib, M

    1987-06-01

    National population-based data systems of the National Center for Health Statistics (NCHS) were used to study the epidemiology of asthma in the United States over the last 20 years. Asthma is more prevalent among males, those living below the poverty level, persons living in the South and West, and blacks; however, this difference did not attain statistical significance. Death rates from asthma among the older age groups probably increased between 1968 and 1982, with a substantial increase since 1979. For children, the evidence is less clear, but the death rate has increased for children over five years of age during the period from 1979 to 1982. Between 1964 and 1980, asthma has become more prevalent in children under 17 years of age, but this does not reflect an increase in the severity of asthma over this same time period. Hospitalization rates for asthma between 1965 and 1983 increased by 50 percent in adults and by over 200 percent in children. Rates for black patients are 50 percent higher in adults and 150 percent greater in children. It is concluded that there has been a marked increase in hospitalization rates for asthma, a moderate increase in death rates from asthma and a smaller increase in overall prevalence of the disease in the United States.

  6. Atherosclerotic Risk Factors and Their Association With Hospital Mortality Among Patients With First Myocardial Infarction (from the National Registry of Myocardial Infarction)

    PubMed Central

    Canto, John G.; Kiefe, Catarina I.; Rogers, William J.; Peterson, Eric D.; Frederick, Paul D.; French, William J.; Gibson, C. Michael; Pollack, Charles V.; Ornato, Joseph P.; Zalenski, Robert J.; Penney, Jan; Tiefenbrunn, Alan J.; Greenland, Philip

    2013-01-01

    Few studies have examined associations between atherosclerotic risk factors and short-term mortality after first myocardial infarction (MI). Histories of 5 traditional atherosclerotic risk factors at presentation (diabetes, hypertension, smoking, dyslipidemia, and family history of premature heart disease) and hospital mortality were examined among 542,008 patients with first MIs in the National Registry of Myocardial Infarction (1994 to 2006). On initial MI presentation, history of hypertension (52.3%) was most common, followed by smoking (31.3%). The least common risk factor was diabetes (22.4%). Crude mortality was highest in patients with MI with diabetes (11.9%) and hypertension (9.8%) and lowest in those with smoking histories (5.4%) and dyslipidemia (4.6%). The inclusion of 5 atherosclerotic risk factors in a stepwise multivariate model contributed little toward predicting hospital mortality over age alone (C-statistic = 0.73 and 0.71, respectively). After extensive multivariate adjustments for clinical and sociodemographic factors, patients with MI with diabetes had higher odds of dying (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.20 to 1.26) than those without diabetes and similarly for hypertension (OR 1.08, 95% CI 1.06 to 1.11). Conversely, family history (OR 0.71, 95% CI 0.69 to 0.73), dyslipidemia (OR 0.62, 95% CI 0.60 to 0.64), and smoking (OR 0.85, 95% CI 0.83 to 0.88) were associated with decreased mortality (C-statistic = 0.82 for the full model). In conclusion, in the setting of acute MI, histories of diabetes and hypertension are associated with higher hospital mortality, but the inclusion of atherosclerotic risk factors in models of hospital mortality does not improve predictive ability beyond other major clinical and sociodemographic characteristics. PMID:22840346

  7. Atherosclerotic risk factors and their association with hospital mortality among patients with first myocardial infarction (from the National Registry of Myocardial Infarction).

    PubMed

    Canto, John G; Kiefe, Catarina I; Rogers, William J; Peterson, Eric D; Frederick, Paul D; French, William J; Gibson, C Michael; Pollack, Charles V; Ornato, Joseph P; Zalenski, Robert J; Penney, Jan; Tiefenbrunn, Alan J; Greenland, Philip

    2012-11-01

    Few studies have examined associations between atherosclerotic risk factors and short-term mortality after first myocardial infarction (MI). Histories of 5 traditional atherosclerotic risk factors at presentation (diabetes, hypertension, smoking, dyslipidemia, and family history of premature heart disease) and hospital mortality were examined among 542,008 patients with first MIs in the National Registry of Myocardial Infarction (1994 to 2006). On initial MI presentation, history of hypertension (52.3%) was most common, followed by smoking (31.3%). The least common risk factor was diabetes (22.4%). Crude mortality was highest in patients with MI with diabetes (11.9%) and hypertension (9.8%) and lowest in those with smoking histories (5.4%) and dyslipidemia (4.6%). The inclusion of 5 atherosclerotic risk factors in a stepwise multivariate model contributed little toward predicting hospital mortality over age alone (C-statistic = 0.73 and 0.71, respectively). After extensive multivariate adjustments for clinical and sociodemographic factors, patients with MI with diabetes had higher odds of dying (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.20 to 1.26) than those without diabetes and similarly for hypertension (OR 1.08, 95% CI 1.06 to 1.11). Conversely, family history (OR 0.71, 95% CI 0.69 to 0.73), dyslipidemia (OR 0.62, 95% CI 0.60 to 0.64), and smoking (OR 0.85, 95% CI 0.83 to 0.88) were associated with decreased mortality (C-statistic = 0.82 for the full model). In conclusion, in the setting of acute MI, histories of diabetes and hypertension are associated with higher hospital mortality, but the inclusion of atherosclerotic risk factors in models of hospital mortality does not improve predictive ability beyond other major clinical and sociodemographic characteristics. PMID:22840346

  8. 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

  9. Atherosclerotic risk factors and their association with hospital mortality among patients with first myocardial infarction (from the National Registry of Myocardial Infarction).

    PubMed

    Canto, John G; Kiefe, Catarina I; Rogers, William J; Peterson, Eric D; Frederick, Paul D; French, William J; Gibson, C Michael; Pollack, Charles V; Ornato, Joseph P; Zalenski, Robert J; Penney, Jan; Tiefenbrunn, Alan J; Greenland, Philip

    2012-11-01

    Few studies have examined associations between atherosclerotic risk factors and short-term mortality after first myocardial infarction (MI). Histories of 5 traditional atherosclerotic risk factors at presentation (diabetes, hypertension, smoking, dyslipidemia, and family history of premature heart disease) and hospital mortality were examined among 542,008 patients with first MIs in the National Registry of Myocardial Infarction (1994 to 2006). On initial MI presentation, history of hypertension (52.3%) was most common, followed by smoking (31.3%). The least common risk factor was diabetes (22.4%). Crude mortality was highest in patients with MI with diabetes (11.9%) and hypertension (9.8%) and lowest in those with smoking histories (5.4%) and dyslipidemia (4.6%). The inclusion of 5 atherosclerotic risk factors in a stepwise multivariate model contributed little toward predicting hospital mortality over age alone (C-statistic = 0.73 and 0.71, respectively). After extensive multivariate adjustments for clinical and sociodemographic factors, patients with MI with diabetes had higher odds of dying (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.20 to 1.26) than those without diabetes and similarly for hypertension (OR 1.08, 95% CI 1.06 to 1.11). Conversely, family history (OR 0.71, 95% CI 0.69 to 0.73), dyslipidemia (OR 0.62, 95% CI 0.60 to 0.64), and smoking (OR 0.85, 95% CI 0.83 to 0.88) were associated with decreased mortality (C-statistic = 0.82 for the full model). In conclusion, in the setting of acute MI, histories of diabetes and hypertension are associated with higher hospital mortality, but the inclusion of atherosclerotic risk factors in models of hospital mortality does not improve predictive ability beyond other major clinical and sociodemographic characteristics.

  10. Modeling loblolly pine dominant height using airborne LiDAR

    NASA Astrophysics Data System (ADS)

    Maceyka, Andy

    The dominant height of 73 georeferenced field sample plots were modeled from various canopy height metrics derived by means of a small-footprint laser scanning technology, known as light detection and ranging (or just LiDAR), over young and mature forest stands using regression analysis. LiDAR plot metrics were regressed against field measured dominant height using Best Subsets Regression to reduce the number of models. From those models, regression assumptions were evaluated to determine which model was actually the best. The best model included the 1st and 90th height percentiles as predictors and explained 95% of the variance in average dominant height.

  11. 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

  12. 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

  13. 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

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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

  20. Measuring Hospital Productivity

    PubMed Central

    Ruchlin, Hirsch S.; Leveson, Irving

    1974-01-01

    This study presents a comprehensive method for quantifying hospital output and estimating hospital productivity. A number of less comprehensive productivity measures that can be quantified from data available from regional third-party payers and from the American Hospital Association are also developed and evaluated as proxies for the comprehensive measure, which is based on local area data. Methods are discussed for estimating the necessary variables on a regional or national level. PMID:4461703

  1. Landslide displacement vectors derived from multi-temporal topographic LiDAR data

    NASA Astrophysics Data System (ADS)

    Fey, Christine; Rutzinger, Martin; Bremer, Magnus; Prager, Christoph; Zangerl, Christian

    2014-05-01

    Information about slope geometry and kinematics of landslides is essential for hazard assessment, monitoring and planning of protection and mitigation measures. Especially for remote and inaccessible slopes, subsurface data (e.g. boreholes, tunnels, investigation adits) are often not available and thus the deformation characteristics must be derived from surface displacement data. In recent years, multi-temporal topographic LiDAR (Light Detection and Ranging) data became an increasingly improved tool for detecting topographic surface deformations. In this context, LiDAR-based change detection is commonly applied for quantifying surface elevation changes. Advanced change detection methods derive displacement vectors with direction and velocities of slope movements. To extract displacement vectors from LiDAR raster data (i) an approach based on feature tracking by image correlation and (ii) an approach based on feature tracking by vectors breaklines are investigated. The image correlation method is based on the IMCORR software (National Snow and Ice Data Center, University of Colorado, Boulder), implemented in a SAGA GIS module. The image correlation algorithm is based on a normalized cross-covariance method. The algorithm searches tie points in two feature rasters derived from a digital surface model acquired at different time stamps. The method assesses automatically the displacement rates and directions of distinct terrain features e.g. displaced mountain ridges or striking boulders. In contrast the vector-based breakline methods require manual selection of tie points. The breaklines are the product of vectorized curvature raster images and extracting the "upper terrain edges" (topographic ridges) and "lower terrain edges" (topographic depressions). Both methods were tested on simulated terrain with determined displacement rates in order to quantify i) the accuracy ii) the minimum detectable movement rates iii) the influence of terrain characteristics iv) the

  2. 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

  3. 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.

  4. 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

  5. The relationship of multiple aspects of stigma and personal contact with someone hospitalized for mental illness, in a nationally representative sample.

    PubMed

    Boyd, Jennifer E; Katz, Emerald P; Link, Bruce G; Phelan, Jo C

    2010-11-01

    The stigma of mental illness has been shown to be affected by personal contact with mental illness and by a belief in the genetic heritability of mental illness. We use data from a nationally representative survey to test whether the relationship of stigma with contact remains after taking into account the effects of genetic beliefs and other background characteristics. Contact was defined as a history of psychiatric hospitalization among respondents themselves, their family members, or their friends. Respondents answered questions about a vignette character with a mental illness. We found that respondents with contact felt less anger and blame toward the character, thought that the character had a more serious problem, and would want less social distance from the character, including both casual and intimate aspects of social distance. Respondents with contact were not significantly different from the general population in the degree to which they expressed sympathy, thought the problem would last a lifetime, or wanted to restrict reproduction. Thus, contact is associated with having a less ostracizing, critical attitude toward a stranger with mental illness. The results underscore the importance of this experienced group as a resource in fighting stigma in society. Since many people who have had a psychiatric hospitalization have not told their friends or family members about it, this lower-stigma group could be enlarged.

  6. [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.

  7. [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. PMID:26338388

  8. GeoEarthScope Airborne LiDAR and Satellite InSAR Imagery

    NASA Astrophysics Data System (ADS)

    Phillips, D. A.; Jackson, M. E.; Meertens, C.

    2008-12-01

    UNAVCO has successfully acquired a significant volume of aerial and satellite geodetic imagery as part of GeoEarthScope, a component of the EarthScope Facility project funded by the National Science Foundation. All GeoEarthScope acquisition activities are now complete. Airborne LiDAR data acquisitions took place in 2007 and 2008 and cover a total area of more than 5000 square kilometers. The primary LiDAR survey regions cover features in Northern California, Southern/Eastern California, the Pacific Northwest, the Intermountain Seismic Belt (including the Wasatch and Teton faults and Yellowstone), and Alaska. We have ordered and archived more than 28,000 scenes (more than 81,000 frames) of synthetic aperture radar (SAR) data suitable for interferometric analyses covering most of the western U.S. and parts of Alaska and Hawaii from several satellite platforms, including ERS-1/2, ENVISAT and RADARSAT. In addition to ordering data from existing archives, we also tasked the ESA ENVISAT satellite to acquire new SAR data in 2007 and 2008. GeoEarthScope activities were led by UNAVCO, guided by the community and conducted in partnership with the USGS and NASA. Processed imagery products, in addition to formats intended for use in standard research software, can also be viewed using general purpose tools such as Google Earth. We present a summary of these vast geodetic imagery datasets, totaling tens of terabytes, which are freely available to the community.

  9. 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

  10. Cholera in pregnant women: the 2012 epidemic at the reference center at the Donka National Hospital in Conakry.

    PubMed

    Sako, F B; Traoré, F A; Camara, M K; Sylla, M; Bangoura, E F; Baldé, O

    2016-05-01

    Cholera is an epidemic diarrheal disease transmitted through the digestive tract; it can cause obstetric complications in pregnant women. The objective of this study was to describe the epidemiological, clinical, and therapeutic aspects of cholera in pregnant women, as well as its course, during the 2012 epidemic in Conakry. This retrospective, descriptive studied examined the records of this epidemic over a 7-month period (from May 15 to December 15, 2012). Of 2,808 cholera patients at our hospital, 80 were pregnant, that is, 2.85%. Their mean age was 30 years [range: 15-45 years], 94% were from Conakry (94%), and 69% were in the third trimester of pregnancy. Choleriform diarrhea and vomiting were the main signs, found respectively in 100% and 95% of the women; dehydration was mild for 16%, moderate for 45%, and severe for 39%. Support consisted of rehydration, by plans A (16%), B (45%) or C (39%) and antibiotic treatment based on erythromycin (85%), doxycycline (14%), or azithromycin (1%). Other drugs that were used included phloroglucinol-trimethylphloroglucinol (Spasfon(®)) for 45%, acetaminophen for 65%, and iron/folic acid for 1% of cases. The major obstetric complications were 4 intrauterine deaths (5%), 2 cases of threatened abortion (2%), 1 preterm delivery (1%), and 1 maternal death. The cholera outbreak in 2012 affected a large number of pregnant women in Conakry, most during their third trimester. The classic clinical manifestations were associated with obstetric complications and maternal-fetal risks. PMID:27412979

  11. Implementation of the presence of companions during hospital admission for childbirth: data from the Birth in Brazil national survey.

    PubMed

    Diniz, Carmen Simone Grilo; d'Orsi, Eleonora; Domingues, Rosa Maria Soares Madeira; Torres, Jacqueline Alves; Dias, Marcos Augusto Bastos; Schneck, Camilla A; Lansky, Sônia; Teixeira, Neuma Zamariano Fanaia; Rance, Susanna; Sandall, Jane

    2014-08-01

    Robust evidence of the benefits of continuous support during childbirth led to the recommendation that it should be offered for all women. In Brazil, it has been guaranteed by law since 2005, but scarce data on implementation is available. We aimed to estimate the frequency and associated socio-demographic, obstetric and institutional predictors of women having companionship during childbirth in the Birth in Brazil survey. Descriptive statistical analysis was done for the characterization of companions (at different moments of hospital stay), maternal and institutional factors; associations were investigated in bivariate and multivariate models. We found that 24.5% of women had no companion at all, 18.8% had continuous companionship and 56.7% had partial companionship. Independent predictors of having no or partial companionship at birth were: lower income and education, brown color of skin, using the public sector, multiparity, and vaginal delivery. Implementation of companionship was associated with having an appropriate environment, and clear institution al rules about women's rights to companionship. PMID:25167174

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 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

  17. High-intensity cyclotron for the IsoDAR experiment

    NASA Astrophysics Data System (ADS)

    Campo, D.; IsoDAR Collaboration

    2015-03-01

    The IsoDAR experiment is the MIT proposal to investigate about several neutrino properties, in order to explain some anomalies experimentally observed. It requires 10mA of proton beam at the energy of 60MeV to produce a high-intensity electron antineutrino flux from the production and the decay of 8Li: it is an ambitious goal for the accelerator design, due also to the fact that the machine has to be placed near a neutrino detector, like KAMLAND or WATCHMAN, located in underground sites. A compact cyclotron able to accelerate H2+ molecule beam up to energy of 60MeV/amu is under study. The critical issues of this machine concern the beam injection due to the effects of space charge, the efficiency of the beam extraction and the technical solutions needed to the machine assembly. Here, the innovative solutions and the preliminary results achieved by the IsoDAR team are discussed.

  18. 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%

  19. Compact Adaptable Mobile LiDAR System Deployment

    NASA Astrophysics Data System (ADS)

    Glennie, C. L.; Brooks, B. A.; Ericksen, T. L.; Hudnut, K. W.; Foster, J. H.; Hauser, D.; Avery, J.

    2012-12-01

    Airborne LiDAR (LIght Detection And Ranging) systems have become a standard mechanism for acquiring dense high-precision topography, making it possible to perform large scale documentation (100's of km2) per day at spatial scales as fine as a few decimeters horizontally and a few centimeters vertically. However, current airborne and terrestrial LiDAR systems suffer from a number of drawbacks. They are expensive, bulky, require significant power supplies, and are often optimized for use in only one type of mobility platform. It would therefore be advantageous to design a lightweight, compact and relatively inexpensive multipurpose LiDAR and imagery system that could be used from a variety of mobility platforms - both terrestrial and airborne. The system should be quick and easy to deploy, and require a minimum amount of existing infrastructure for operational support. With these goals in mind, our research teams have developed a prototype field deployable compact dynamic laser scanning system that is configured for use on a variety of mobility platforms, including backpack wearable, as well as unmanned aerial vehicles (e.g. balloons & helicopters) and small off-road vehicles such as ATV's. The system is small, self-contained, relatively inexpensive, and easy to deploy. The first version of this multipurpose LiDAR system has been successfully tested in both backpack configuration and on a tethered flight attached to a helium balloon. We will present system design and development details, along with field experiences and a detailed accuracy analysis of the acquired point clouds which show that accuracy of 3-5 cm (1 sigma) vertical can be achieved in both backpack and balloon modalities.

  20. 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

  1. 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

  2. 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

  3. An investigation into the level and impact of merger activity amongst hospitals in the UK's National Health Service.

    PubMed

    Cereste, Marco; Doherty, Neil F; Travers, Cheryl J

    2003-01-01

    Since 1990 the National Health Service (NHS) has undergone a sustained period of change. This change has been necessary to prepare the NHS for the task of meeting a demand for services that continues to rise more rapidly than the availability of resources. Anecdotal evidence suggests that one of the most popular ways for trusts to improve their ability to meet demand is through mergers with other trusts. However, little rigorous research has been conducted to assess the extent or effectiveness of this strategy. A research project was, therefore, initiated to better understand the extent and impact of merger activity within the NHS. A questionnaire was developed and distributed to the chief executive, finance director, medical director and human resources director in all the 460 trusts that are currently members of the NHS confederation. In total the survey generated 459 responses out of a possible total of 1,840; an encouraging response rate of 25 per cent. The results of this research provide significant new evidence that "merger mania" has taken hold within the NHS. While 46 per cent of all responding trusts indicated that they had already merged, are actively involved in a merger, proposing to merge or are talking to prospective partners, a further 18.7 per cent of all trusts are forming strategic alliances rather than opting for a full merger. The dominant justification for merging are the beliefs that it will facilitate the reconfiguration of services and ultimately improve patient care. The paper concludes with a discussion of the significance of these results, before making recommendations with regard to their implications for future merger activity within the NHS. PMID:12800277

  4. 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

  5. External ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital in Kampala, Uganda

    PubMed Central

    2013-01-01

    Background Endophthalmitis is a severe complication of cataract surgery which leads to high ocular morbidity and visual loss even with antibiotic treatment. Bacterial ocular floras are the implicated causative agents. This study was undertaken to evaluate the external ocular surface bacterial isolates and their antimicrobial susceptibility patterns among pre-operative cataract patients at Mulago National Hospital. Methods This cross sectional study enrolled consecutively 131 patients scheduled for routine cataract surgery in the Department of Ophthalmology at Mulago National Hospital in Kampala, Uganda. Eyelid margin and conjunctival swabs were collected and processed using standard microbiological procedures to identify bacterial isolates and their respective antimicrobial susceptibility patterns. Results Of 131 patients involved (mean age 63.3 ± 14.5 years), 54.2% (71/131) were females. The eyelid margin and conjunctival samples were culture positive in 59.5% (78/138) and 45.8% (60/138) respectively. The most common organisms identified were Coagulase-negative Staphylococci (CoNS) [65.9% (91/138)] and Staphylococcus aureus [21.0% (29/138)]. CoNS showed the highest resistance to tetracycline (58.2%, 53/91) and erythromycin (38.5%, 35/91), whereas in S. aureus the resistance to tetracycline and erythromycin were 55.2% (16/29) and 31.0% (9/29) respectively. Methicillin resistant CoNS (MRS) and Methicillin resistance S. aureus (MRSA) were 31.9% (29/91) and 27.6% (8/29) respectively. There were low resistance rates for CoNS, S. aureus and other bacterial isolates to ciprofloxacin (11.1%-24.2%), gentamicin (5.6-31.0%), tobramycin (17.2% -25.3%) and vancomycin (0.0%). Conclusion CoNS and S. aureus are the most common bacterial isolates found on the external ocular surface of the pre-operative cataract patients. Ciprofloxacin, gentamicin, tobramycin and vancomycin showed the lowest resistance rates to all bacterial isolates, therefore may be used to reduce bacteria

  6. 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

  7. 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.

  8. Assessing the Burden of Diabetes Mellitus in Emergency Departments in the United States: The National Hospital Ambulatory Medical Care Survey (NHAMCS)

    PubMed Central

    Asao, Keiko; Kaminski, James; McEwen, Laura N.; Wu, Xiejian; Lee, Joyce M.; Herman, William H.

    2014-01-01

    Objective To evaluate the performance of three alternative methods to identify diabetes in patients visiting Emergency Departments (EDs), and to describe the characteristics of patients with diabetes who are not identified when the alternative methods are used. Research Design and Methods We used data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2009 and 2010. We assessed the sensitivity and specificity of using providers’ diagnoses and diabetes medications (both excluding and including biguanides) to identify diabetes compared to using the checkbox for diabetes as the gold standard. We examined the characteristics of patients whose diabetes was missed using multivariate Poisson regression models. Results The checkbox identified 5,567 ED visits by adult patients with diabetes. Compared to the checkbox, the sensitivity was 12.5% for providers’ diagnoses alone, 20.5% for providers’ diagnoses and diabetes medications excluding biguanides, and 21.5% for providers’ diagnoses and diabetes medications including biguanides. The specificity of all three of the alternative methods was >99%. Older patients were more likely to have diabetes not identified. Patients with self-payment, those who had glucose measured or received IV fluids in the ED, and those with more diagnosis codes and medications, were more likely to have diabetes identified. Conclusions NHAMCS's providers’ diagnosis codes and medication lists do not identify the majority of patients with diabetes visiting EDs. The newly introduced checkbox is helpful in measuring ED resource utilization by patients with diabetes. PMID:24680472

  9. Synergy Between LiDAR and Image Data in Context of Building Extraction

    NASA Astrophysics Data System (ADS)

    Dal Poz, A. P.

    2014-11-01

    This paper compares the paradigms of LiDAR and aerophotogrammetry in the context of building extraction and briefly discusses a photogrammetric strategy for refining building roof polyhedrons previously extracted from LiDAR data. In general, empirical and theoretical studies have confirmed that LiDAR-based methodologies are more suitable in extracting planar roof faces and ridges of the roof, whereas the aerophotogrammetry are more suitable in extracting building roof outlines. In order to exemplify how to explore these properties, it is presented a photogrammetric method for refining 3D building roof contours extracted from airborne LiDAR data. Examples of application are provided for this refining approach.

  10. 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)

  11. Assessing and Adapting LiDAR-Derived Pit-Free Canopy Height Model Algorithm for Sites with Varying Vegetation Structure

    NASA Astrophysics Data System (ADS)

    Scholl, V.; Hulslander, D.; Goulden, T.; Wasser, L. A.

    2015-12-01

    Spatial and temporal monitoring of vegetation structure is important to the ecological community. Airborne Light Detection and Ranging (LiDAR) systems are used to efficiently survey large forested areas. From LiDAR data, three-dimensional models of forests called canopy height models (CHMs) are generated and used to estimate tree height. A common problem associated with CHMs is data pits, where LiDAR pulses penetrate the top of the canopy, leading to an underestimation of vegetation height. The National Ecological Observatory Network (NEON) currently implements an algorithm to reduce data pit frequency, which requires two height threshold parameters, increment size and range ceiling. CHMs are produced at a series of height increments up to a height range ceiling and combined to produce a CHM with reduced pits (referred to as a "pit-free" CHM). The current implementation uses static values for the height increment and ceiling (5 and 15 meters, respectively). To facilitate the generation of accurate pit-free CHMs across diverse NEON sites with varying vegetation structure, the impacts of adjusting the height threshold parameters were investigated through development of an algorithm which dynamically selects the height increment and ceiling. A series of pit-free CHMs were generated using three height range ceilings and four height increment values for three ecologically different sites. Height threshold parameters were found to change CHM-derived tree heights up to 36% compared to original CHMs. The extent of the parameters' influence on modelled tree heights was greater than expected, which will be considered during future CHM data product development at NEON. (A) Aerial image of Harvard National Forest, (B) standard CHM containing pits, appearing as black speckles, (C) a pit-free CHM created with the static algorithm implementation, and (D) a pit-free CHM created through varying the height threshold ceiling up to 82 m and the increment to 1 m.

  12. 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

  13. “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

  14. 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.

  15. 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.

  16. Terrestrial LiDAR monitoring of rock slope-channel coupling

    NASA Astrophysics Data System (ADS)

    Bell, R.; Blöthe, J. H.; Meyer, N. K.; Hoffmann, T.; Hoffert, H.; Kreiner, D.; Elverfeldt, K. V.

    2009-04-01

    In steep terrain, various types of landslides (e.g. rock falls, debris flows and slides) are important erosional processes which often have a major impact on fluvial systems. On the one hand, they may divert river channels to opposite slopes or even block entire river channels, leading to the formation of landslide-dammed lakes. On the other hand, rivers prepare or even trigger landslides by undercutting slopes, which again will have an impact on the river channel. Our focus is on two study areas. One of them, the Schlichem Valley, is located in the Swabian Alb (SW-Germany), a lower mountain range consisting of Jurassic sedimentary rocks forming a cuesta landscape. There, the focus is on a larger landslide complex which blocked the river Schlichem three times during the 18th century and which is still active. Recent activity, especially at the location where the landslide enters the fluvial system, is investigated using Terrestrial LiDAR monitoring. The second study area is located in the Gesaeuse National Park in the Austrian Alps. There, various geomorphic environments are investigated by Terrestrial LiDAR including a vertical rock face in Dachstein limestone, which talus slope is directly coupled to the river Enns. The talus slope is built up by rock fall deposits, eroded mainly through smaller debris flow events. Furthermore, the talus slope is undercut by flood events of the river Enns. In this study a concept and first results are presented. They suggest how rock slope processes and their interactions with river channels can be monitored.

  17. Norovirus - hospital

    MedlinePlus

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... Symptoms start within 24 to 48 hours of infection, and can last for 1 ... norovirus. Hospital patients who are very old, very young, or ...

  18. Direct admission to the hospital: An alternative approach to hospitalization.

    PubMed

    Leyenaar, JoAnna K; Lagu, Tara; Lindenauer, Peter K

    2016-04-01

    Appropriate use of emergency departments (EDs) is a focus of national healthcare reform efforts, and patients requiring hospital admission account for a substantial proportion of ED utilization. Despite this, little attention has been paid to evaluating direct admission to the hospital as an alternative to hospital admissions beginning in the ED. In this Perspective, we discuss the role of hospital medicine in the changing epidemiology of hospital admissions, the potential risks and benefits of direct admission to the hospital, and the need for research to evaluate the safety and effectiveness of this admission approach. We propose that transitions of care research and quality improvement, historically focused on hospital-to-home transitions, be expanded to address transitions into the hospital. PMID:26588666

  19. 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

  20. 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

  1. 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.

  2. 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.

  3. 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.

  4. IsoDAR - A Definitive Search for Sterile Neutrinos

    NASA Astrophysics Data System (ADS)

    Barletta, William

    2013-04-01

    The steady development of high power cyclotrons, mostly in industry, is making possible a definitive, highly cost effective approach to the search for sterile neutrinos. In the proposed IsoDAR experiment a 600 kW beam of protons from a 60 MeV, H2+ cyclotron will impinge on a lithium target to generate copious Li-8. The Li-8 then decays at rest to yield a powerful source of anti-neutrinos that can be located ˜20 m from a hydrogenous detector. In particular our collaboration has been designing the accelerator / target system to be consistent with installation in the Kamioka mine to use the Kamland detector to record inverse beta decay events. We show that this source / detector combination can reveal or exclude the global-fit allowed region at 5 sigma in four months and differentiate between 1 and 2 sterile neutrinos with a few years of continued running. Our studies also show that high power cyclotrons will provide the most cost effective source for such an experiment. In addition, the 60 MeV IsoDAR cyclotron would be an ideal injector for DAEdALUS, our approach to measuring CP violation in the neutrino sector with decay-at-rest experiment.

  5. Prescription of Opioid and Non-opioid Analgesics for Dental Care in Emergency Departments: Findings from the National Hospital Ambulatory Medical Care Survey

    PubMed Central

    Okunseri, Christopher; Okunseri, Elaye; Xiang, Qun; Thorpe, Joshua M.; Szabo, Aniko

    2014-01-01

    Objective The aim of this study was to examine trends and associated factors in the prescription of opioid analgesics, non-opioid analgesics, opioid and non-opioid analgesic combinations and no analgesics by emergency physicians for nontraumatic dental condition (NTDC)-related visits. Our secondary aim was to investigate whether race/ethnicity is a possible predictor of receiving a prescription for either type of medication for NTDC visits in emergency departments (EDs) after adjustment for potential covariates. Methods We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997–2000 and 2003–2007, and used multinomial multivariate logistic regression to estimate the probability of receiving a prescription for opioid analgesics, non-opioid analgesics, or a combination of both compared to receiving no analgesics for NTDC-related visits. Results During 1997–2000 and 2003–2007, prescription of opioid analgesics and combinations of opioid and non-opioid analgesics increased and that of no analgesics decreased over time. The prescription rates for opioid analgesics, non-opioid analgesics, opioid and non-opioid analgesic combinations and no analgesics for NTDC-related visits in EDs were 43%, 20%, 12% and 25% respectively. Majority of patients categorized as having severe pain received prescriptions for opioids for NTDC-related visits in EDs. After adjusting for covariates, patients with self-reported dental reasons for visit and severe pain had a significantly higher probability of receiving prescriptions for opioid analgesics and opioid and non-opioid analgesic combinations. Conclusion Prescription of opioid analgesics increased over time. ED physicians were more likely to prescribe opioid analgesics and opioid and non-opioid analgesic combinations for NTDC-related visits with reported severe pain. PMID:24863407

  6. 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.

  7. Prevalence of human papillomavirus infection in Argentinean women attending two different hospitals prior to the implementation of the National vaccination program

    PubMed Central

    Chouhy, Diego; D’Andrea, Rubén Mamprín; Iglesias, Mercedes; Messina, Analía; Ivancovich, Juan J.; Cerda, Belen; Galimberti, Diana; Bottai, Hebe; Giri, Adriana A.

    2012-01-01

    Cervarix vaccine was included in the National Immunization Program of Argentina in 2011 but data about the local distribution of human papillomavirus (HPV) infection in women exposed to the virus are scarce. This cross-sectional study determined the prevalence and type distribution of HPV infection in unvaccinated women attending routine gynaecological screening in two public hospitals located in Buenos Aires and Santa Fe, Argentina. Socio-demographic, sexual behaviour and co-factors information was obtained from all participants (Buenos Aires, n=429; Santa Fe, n=433). Cervicovaginal swabs were tested with an MY11/09 primer-based assay and with the CUT primer system targeting mucosal/cutaneous HPVs. Participants from Buenos Aires showed significantly higher rates of HPV infection (52.4% vs. 40.6%), of multiple infections (24.2% vs. 16.4%), and of low-risk (20.3% vs. 13.9%) and high-risk types (44.1% vs. 33.3%) than those from Santa Fe. HPV-66 (Buenos Aires: 17%) and HPV-16 (Santa Fe: 8.5%) were the most prevalent types. Novel HPV-66 putative subtype and variants were identified. Vaccine types 16 and 18 were frequent (Buenos Aires: 13.5%; Santa Fe F: 10.2%) but few participants had co-infections with both (Buenos Aires: 1.4%; Santa Fe: 0.2%). A common risk factor for HPV infection was having a new sexual partner in the last year (Buenos Aires: OR 2.53, p<0.001; Santa Fe: OR 1.85, p=0.04). This study provides valuable baseline data for future assessment of the impact of massive vaccination in Argentina and it underlines the use of additional HPV testing strategies, such as the CUT system, for surveillance and vaccinology. PMID:23296573

  8. Management of snakebite cases by national treatment protocol at Jalpaiguri District Hospital in West Bengal in the year 2010--a retrospective study.

    PubMed

    Ghosh, Manab Kumar

    2011-08-01

    Snakebite remains a public health problem in India, occurring most frequently in the summer and rainy seasons. Bites are maximal in lower limbs. Victims are typically male and between 17 and 27 years of age. Children and the elderly have higher mortality. The worst affected states are Kerala, Maharashtra, Tamil Nadu, Orissa, Assam and West Bengal. There was no uniform guideline for treatment of snakebite cases. The five common venomous Indian snakes biting humans are common cobra, krait, Russell's viper, saw scaled viper and the hump nose pit viper. Seventy per cent of all snakebites are non-venomous. Even in bites by venomous snakes, envenomation occurs in only 50% of cases. Immobilisation is much more important than tight ligature, which may cause gangrene. Only a minority need antivenom, which is expensive, short in supply and may cause severe reaction. Antivenom treatment is recommended on the basis of local and systemic signs and symptoms and 20 minutes whole blood clotting test (20WBCT). Delay in starting AVS treatment is the main cause of mortality and morbidity. Skin test is of no value. But antivenom should not be used unless specifically indicated. The "Do it RIGHT" approach of national treatment protocol indicates the initial steps to be taken before reaching a hospital or primary healthcare facility. And it resulted in a 66% decline in the amount of ASV administration and an absolute reduction of mortality by 24%. However first aid treatment of the bitten limb/area with broad-spectrum antibiotics, injection tetanus antitoxin and Supportive treatment with blood transfusion, ventilatory support, anticholinesterase and peritoneal dialysis may also be required. PMID:22315862

  9. Prevalence of human papillomavirus infection in Argentinean women attending two different hospitals prior to the implementation of the National Vaccination Program.

    PubMed

    Chouhy, Diego; D'Andrea, Rubén Mamprín; Iglesias, Mercedes; Messina, Analía; Ivancovich, Juan J; Cerda, Belen; Galimberti, Diana; Bottai, Hebe; Giri, Adriana A

    2013-04-01

    Cervarix vaccine was included in the National Immunization Program of Argentina in 2011 but data about the local distribution of human papillomavirus (HPV) infection in women exposed to the virus are scarce. This cross-sectional study determined the prevalence and type distribution of HPV infection in unvaccinated women attending routine gynecological screening in two public hospitals located in Buenos Aires and Santa Fe, Argentina. Socio-demographic, sexual behavior, and co-factors information was obtained from all participants (Buenos Aires, n = 429; Santa Fe, n = 433). Cervicovaginal swabs were tested with an MY11/09 primer-based assay and with the CUT primer system targeting mucosal/cutaneous HPVs. Participants from Buenos Aires showed significantly higher rates of HPV infection (52.4% vs. 40.6%), of multiple infections (24.2% vs. 16.4%), and of low-risk (20.3% vs. 13.9%) and high-risk types (44.1% vs. 33.3%) than those from Santa Fe. HPV-66 (Buenos Aires: 17%) and HPV-16 (Santa Fe: 8.5%) were the most prevalent types. Novel HPV-66 putative subtype and variants were identified. Vaccine types 16 and 18 were frequent (Buenos Aires: 13.5%; Santa Fe: 10.2%) but few participants had co-infections with both (Buenos Aires: 1.4%; Santa Fe: 0.2%). A common risk factor for HPV infection was having a new sexual partner in the last year (Buenos Aires: OR 2.53, P < 0.001; Santa Fe: OR 1.85, P = 0.04). This study provides valuable baseline data for future assessment of the impact of massive vaccination in Argentina and it underlines the use of additional HPV testing strategies, such as the CUT system, for surveillance and vaccinology.

  10. 4D Terrestrial LiDAR Data Collection: Geomorphic and Hydraulic Applications (Invited)

    NASA Astrophysics Data System (ADS)

    Minear, J. T.; Wright, S. A.; Kinzel, P. J.; Draut, A. E.; Logan, J.

    2013-12-01

    Terrestrial LiDAR, also known as T-LiDAR, ground-based LiDAR, or Terrestrial Laser Scanning, can provide great insights into some types of geomorphic and hydraulic studies, particularly when collected repeatedly over time. Because T-LiDAR collects a large amount of data on a set grid, oftentimes processes are inadvertently captured that are not part of the initial research question but can be important factors in their own right. In addition, though T-LiDAR is most often used at relatively small sites for high-precision scanning, it also can be used for relatively rapid meso-scale site measurements, albeit typically with less precision. Using examples from the Elwha River dam removals, WA, a canal experiment in NE, and several small river restoration sites in CA, we highlight several important and innovative uses of T-LiDAR measurements, including quick temporal scale changes in water surface features and larger temporal- and spatial-scale changes in reservoir deltaic deposits and longitudinal profile features. Also discussed will be some considerations for improving T-LiDAR error estimation and a comparison to other data collection techniques, including aerial LiDAR, structure-from-motion photogrammetry, and UAV- and plane-captured photogrammetry.

  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. Dia de Dar Gracias. Modulo Nivel Primario. (Day to Give Thanks. Module Primary Level.)

    ERIC Educational Resources Information Center

    Espinoza, Delia; Lopez, Santiago, III

    Dia de Dar Gracias (Thanksgiving) is the subject of this primary level unit. The unit objectives are to: (1) know about El Dia de Dar Gracias as it is celebrated in the United States; (2) know how the Mayas celebrated it; (3) understand the context of the stories in the unit; (4) know about the main food used, the turkey; (5) distinguish other…

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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.

  20. Public and private maternal health service capacity and patient flows in southern Tanzania: using a geographic information system to link hospital and national census data

    PubMed Central

    Tabatabai, Patrik; Henke, Stefanie; Sušac, Katharina; Kisanga, Oberlin M. E.; Baumgarten, Inge; Kynast-Wolf, Gisela; Ramroth, Heribert; Marx, Michael

    2014-01-01

    Background Strategies to improve maternal health in low-income countries are increasingly embracing partnership approaches between public and private stakeholders in health. In Tanzania, such partnerships are a declared policy goal. However, implementation remains challenging as unfamiliarity between partners and insufficient recognition of private health providers prevail. This hinders cooperation and reflects the need to improve the evidence base of private sector contribution. Objective To map and analyse the capacities of public and private hospitals to provide maternal health care in southern Tanzania and the population reached with these services. Design A hospital questionnaire was applied in all 16 hospitals (public n=10; private faith-based n=6) in 12 districts of southern Tanzania. Areas of inquiry included selected maternal health service indicators (human resources, maternity/delivery beds), provider-fees for obstetric services and patient turnover (antenatal care, births). Spatial information was linked to the 2002 Population Census dataset and a geographic information system to map patient flows and socio-geographic characteristics of service recipients. Results The contribution of faith-based organizations (FBOs) to hospital maternal health services is substantial. FBO hospitals are primarily located in rural areas and their patient composition places a higher emphasis on rural populations. Also, maternal health service capacity was more favourable in FBO hospitals. We approximated that 19.9% of deliveries in the study area were performed in hospitals and that the proportion of c-sections was 2.7%. Mapping of patient flows demonstrated that women often travelled far to seek hospital care and where catchment areas of public and FBO hospitals overlap. Conclusions We conclude that the important contribution of FBOs to maternal health services and capacity as well as their emphasis on serving rural populations makes them promising partners in health

  1. 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.

  2. Towards a LiDAR based geomorphological database of Sweden

    NASA Astrophysics Data System (ADS)

    Peterson, Gustaf; Smith, Colby A.

    2013-04-01

    Geomorphological maps can be important for both societal development and scientific research especially with the use of new technology and consideration for the end user's needs. Since 2009, the Swedish mapping agency (Lantmäteriet) has been using airborne light detection and ranging (LiDAR) to create a detailed "bare earth" digital elevation model (DEM) of Sweden. Presently, a LiDAR derived DEM with 2 m horizontal and 0.25 m vertical resolution exist for about half of the country. This data set enables viewing of the landscape in a new more detailed way; landforms never before seen can now be delineated easily in a desktop environment. We are using this DEM to map the geomorphology, bringing into existence a highly detailed, digitial, geomorphologic database and map. While prior geomorphological maps exist for Sweden, the new map being compiled by the Geological Survey of Sweden (SGU) will be the first one to be derived from and presented in an entirely digital format. With the use of GIS technology, it is possible to present a map with different layers and symbology depending on the scale of the area of interest. For example, when looking at a map at a small scale, every moraine within a moraine complex is visible, but when viewed at a larger scale the moraine complex is presented as a single object. The digital presentation allows users to select scale-appropriate geomorphological data to their needs. By coupling other SGU or external databases with the geomorphological database it is possible to produce a wide range of products suitable for a wide range of uses. For example, by adding bedrock or geochemical data to landforms indicative of ice flow direction, a product useful for mineral prospecting is created. Other derivative applications may include groundwater studies or evaluation of geoheritage areas. Regarding scientific applications, the new LiDAR data have enabled mapping of geomorphic landforms in greater detail than previous Swedish maps. In addition

  3. 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

  4. 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.

  5. An automated algorithm for extracting road edges from terrestrial mobile LiDAR data

    NASA Astrophysics Data System (ADS)

    Kumar, Pankaj; McElhinney, Conor P.; Lewis, Paul; McCarthy, Timothy

    2013-11-01

    Terrestrial mobile laser scanning systems provide rapid and cost effective 3D point cloud data which can be used for extracting features such as the road edge along a route corridor. This information can assist road authorities in carrying out safety risk assessment studies along road networks. The knowledge of the road edge is also a prerequisite for the automatic estimation of most other road features. In this paper, we present an algorithm which has been developed for extracting left and right road edges from terrestrial mobile LiDAR data. The algorithm is based on a novel combination of two modified versions of the parametric active contour or snake model. The parameters involved in the algorithm are selected empirically and are fixed for all the road sections. We have developed a novel way of initialising the snake model based on the navigation information obtained from the mobile mapping vehicle. We tested our algorithm on different types of road sections representing rural, urban and national primary road sections. The successful extraction of road edges from these multiple road section environments validates our algorithm. These findings and knowledge provide valuable insights as well as a prototype road edge extraction tool-set, for both national road authorities and survey companies.

  6. 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.

  7. 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. PMID:22453394

  8. [The ANMCO (National Association of Hospital Cardiologists) in a changing health care system. Consensus development of the Organizing Symposium of the XXXI National Congress of Cardiology--ANMCO; Florence, May 21, 2000].

    PubMed

    2000-12-01

    This year's symposium, while following the 30-year-old tradition of Organizational Symposia which have become a trademark of the National Association of Hospital Cardiologists (ANMCO) annual meetings, is characterized by a novel approach in terms of method and content. Prompted by the profound changes affecting the socio-cultural, organizational and economic context in which the Health Service operates, the Board of the Association decided to invite the community of hospital-based cardiologists to reflect on and make proposals concerning a number of leading topics not strictly related to the organization of hospital-based cardiology, but of a wider relevance pertaining to the whole issue of the relationship between a Scientific Society and the other components of the Health Service: national and regional institutions, other doctors, the lay public and the pharmaceutical industry, etc. The main aim of this exercise was to stimulate the Society to adapt to a changing environment and so render it more capable of effectively fulfilling its duties. Naturally the larger the consensus regarding the strategies to adopt the greater this efficacy will be. Out of the many possible subjects, four were chosen as preeminent: 1. ANMCO and research: what fields of research should be prioritized, and with what kind of internal organization, and external relations? 2. ANMCO and professional training: what should be the professional standards governing the cardiologist in a changing society, what strategies for continuing education and institutional accreditation? 3. ANMCO and the community-based Health Service: the need to establish clear and efficient organizational relations with community-based cardiology and especially with general practitioners, in order to ensure that the health service is in tune with the real world, guarantee real continuity of care and reduce unnecessary hospital admissions; 4. ANMCO and the general population: how to support the citizen-user in the

  9. Peptic ulcer in hospital

    PubMed Central

    Johnson, H. Daintree

    1962-01-01

    This study corresponds to an estimated 142,250 admissions for peptic ulcer to the wards of National Health Service hospitals in England and Wales during the two years 1956 and 1957. It presents a picture of the incidence and mortality of complications and surgical treatment throughout England and Wales. PMID:14036965

  10. 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

  11. S-DARS broadcast from inclined, elliptical orbits

    NASA Astrophysics Data System (ADS)

    Briskman, Robert D.; Prevaux, Robert J.

    2004-04-01

    The first Sirius spacecraft was launched on July 1, 2000. Exactly 5 months later, on December 1, the third spacecraft was launched, completing the three satellite S-DARS (Satellite Digital Audio Radio Service) constellation. The three satellites are deployed in inclined, elliptical, geosynchronous orbits, which allow seamless broadcast coverage to mobile users in the contiguous US. Terrestrial broadcast repeaters provide service in urban cores. The system is in operation, providing the first ever S-DARS service. The constellation design results in satellite ground tracks over North America with two satellites always above the equator. High elevation look angles from the mobile ground terminals to the satellites minimize performance degradation due to blockage, foliage attenuation and multi-path. The spacecraft were built by Space Systems/Loral using the 1300 bus modified for operation in high inclination orbits. Each spacecraft was launched using a dedicated Russian Proton booster. The satellite payload is a bent pipe repeater using 7.1 GHz for the uplink and 2.3 GHz for the broadcast transmission. The repeater high-power amplification stage consists of 32 Traveling Wave Tube Amplifiers phase combined to yield a total radio frequency output power of nearly 4 kW at saturated operation. The satellite antennas are mechanically steered to maintain the transmit beam centered on the Contiguous United States and the receive beam centered on the uplink earth station located in Vernon Valley, New Jersey. The satellite payload design and performance are described. The principal spacecraft bus systems are described with emphasis on improvements made for operation in the inclined, elliptical geosynchronous orbits.

  12. 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.

  13. 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

  14. 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…

  15. 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.…

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. Financing hospital disaster preparedness.

    PubMed

    De Lorenzo, Robert A

    2007-01-01

    Disaster preparedness and response have gained increased attention in the United States as a result of terrorism and disaster threats. However, funding of hospital preparedness, especially surge capacity, has lagged behind other preparedness priorities. Only a small portion of the money allocated for national preparedness is directed toward health care, and hospitals receive very little of that. Under current policy, virtually the entire funding stream for hospital preparedness comes from general tax revenues. Medical payers (e.g., Medicare, Medicaid, and private insurance) directly fund little, if any, of the current bill. Funding options to improve preparedness include increasing the current federal grants allocated to hospitals, using payer fees or a tax to subsidize preparedness, and financing other forms of expansion capability, such as mobile hospitals. Alternatively, the status quo of marginal preparedness can be maintained. In any event, achieving higher levels of preparedness likely will take the combined commitment of the hospital industry, public and private payers, and federal, state, and local governments. Ultimately, the costs of preparedness will be borne by the public in the form of taxes, higher healthcare costs, or through the acceptance of greater risk.

  1. Hospital fundamentals.

    PubMed

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

    2014-07-01

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

  2. Hospital fundamentals.

    PubMed

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

    2014-07-01

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

  3. LiDAR improves fire behaviour predictions using a biophysical, mechanistic model

    NASA Astrophysics Data System (ADS)

    Zylstra, Philip; Horsey, Bronwyn; Yebra, Marta; Marselis, Suzanne

    2016-04-01

    Numerous studies have attempted to address the utility of LiDAR as a tool for measuring fuel inputs to fire behaviour models, however the direct effect of this approach on fire behaviour prediction requires quantification. We used a biophysical, mechanistic model validated for eucalypt forest in SE Australia to assess the improvement in prediction accuracy afforded using LiDAR-derived inputs. The accuracy of modelling with these inputs was compared to modelling using detailed site-specific field surveys of a dry sclerophyll forest to represent the highest standard of inputs, and values derived from desktop-available community-wide descriptors to represent baseline inputs. Use of LiDAR significantly improved on baseline predictions and enabled site-specific decision making across the study area. When used with an appropriate model, LiDAR can facilitate improved decision-making in regard to forest fire behaviour.

  4. 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.

  5. Needlestick/sharps injuries and HIV exposure among health care workers. National estimates based on a survey of U.S. hospitals.

    PubMed

    Henry, K; Campbell, S

    1995-11-01

    Exposure to HIV in the workplace is a major concern for health care workers. The greatest risk for bloodborne pathogen transmission is associated with percutaneous injuries involving hollow-bore needles contaminated with patient blood. Limited data are available about how many sharps injuries (SIs) and needlesticks (NSs) occur in the United States, with estimates ranging from 100,000 to 1 million injuries per year. We conducted a survey of 100 infection control practitioners located at randomly selected U.S. hospitals to assess the number of SIs or NSs occurring during 1990; 65 (65%) responded. The mean number of NS/SIs reported was 45, with a mean of 1.1 known HIV-related NS/SIs. The underreporting rate was estimated to be 18.5%. Assuming that the hospitals provided exact numbers of injuries and were representative of the approximately 5,100 U.S. hospitals, then about 252,000 NS/SIs were reported in U.S. hospitals in 1990 (95% CI = 193,000-312,000). If the under-reporting rate was 33% to 66%, then the point estimate for the total number of NS/SIs ranges from 378,000 to 756,000. Similar extrapolation involving the reported number of NS/SIs contaminated with blood from an HIV-infected patient yields an estimate of 5,610 exposures in 1990 (95% CI = 1,300-8,300). The number of U.S. hospital workers sustaining NS/SIs with potential exposure to HIV appears to be considerable. Efforts to reduce the risk of bloodborne pathogen transmission from NS/SIs are warranted. PMID:8531904

  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. PMID:23614267

  8. 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. PMID:14753323

  9. 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.

  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. 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.

  12. 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.

  13. Development of LiDAR aware allometrics for Abies grandis: A Case Study

    NASA Astrophysics Data System (ADS)

    Stone, G. A.; Tinkham, W. T.; Smith, A. M.; Hudak, A. T.; Falkowski, M. J.; Keefe, R.

    2012-12-01

    Forest managers rely increasingly on accurate allometric relationships to inform decisions regarding stand rotations, silvilcultural treatments, timber harvesting, and biometric modeling. At the same time, advances in remote sensing techniques like LiDAR (light detection and ranging) have brought about opportunities to advance how we assess forest growth, and thus are contributing to the need for more accurate allometries. Past studies have attempted to relate LiDAR data to both plot and individual tree measures of forest biomass. However, many of these studies have been limited by the accuracy of their coincident observations. In this study, 24 Abies grandis were measured, felled, and dissected for the explicit objective of developing LiDAR aware allometrics. The analysis predicts spatial variables of competition, growth potential (e.g, trees per acre, aspect, elevation, etc.) and common statistical distributional metrics (e.g., mean, mode, percentiles, variance, skewness, kurtosis, etc.) derived from LiDAR point cloud returns to coincident in situ measures of Abies grandis stem biomass. The resulting allometries exemplify a new approach for predicting structural attributes of interest (biomass, basal area, volume, etc.) directly from LiDAR point cloud data, precluding the measurement errors that are propogated by indirectly predicting these structure attributes of interest from LiDAR data using traditional plot-based measurements.

  14. 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.

  15. Internal auditing in hospitals.

    PubMed

    Edwards, Don; Kusel, Jim; Oxner, Tom

    2003-01-01

    The authors analyzed two national surveys to determine answers for two basic questions: How do the roles of internal auditors compare with those of their counterparts in other industries and to what extent over the past 6 years have the activities of internal auditors changed? Internal auditors in hospitals allocate their time primarily to financial/compliance and operational types of audits, as do their counterparts. The current trend is toward more operational types of audits. In the early years of employment, staff turnover in hospitals is significantly higher than in all combined industries, often leading to internal auditors' filling other positions in the organization. Hospital staff salaries are higher than are salaries in other industries combined. Staff composition continues to reflect the growing presence of women in the field. The majority of internal auditing directors believe that their salaries are fair, would recommend internal auditing as a career position, and are treated as valued consultants in the organization.

  16. 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

  17. 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.

  18. Trends of hospitalized acute stroke care in Germany from clinical trials to bedside. Comparison of nation-wide administrative data 2008-2012.

    PubMed

    Krogias, Christos; Bartig, Dirk; Kitzrow, Martin; Weber, Ralph; Eyding, Jens

    2014-10-15

    Promising advances in stroke medicine have been reported recently regarding specialized stroke unit (SU) care, expansion of the time window of iv thrombolysis (IVT), mechanical thrombectomy (MT), and decompressive hemicraniectomy (DHC) for malignant brain infarction. It remains unclear to what extent new evidence of therapeutic procedures is transferred to the "real-world" of everyday hospital care. We analyzed epidemiologic and procedural therapeutic trends of hospitalized acute stroke patients in Germany by the comparison of administrative hospital data of the years 2008 (n=219,359) and 2012 (n=239,394). Proportion of specialized SU care rose from 43.4% to 56.9%. Even in age-matched analysis women were less likely to obtain this procedure. Rate of IVT increased from 5.6% to 10.2%. 32% of IVT therapies in 2012 were performed in patients over 80 years. Number of MT increased exponentially from 298 to 3906 procedures. Number of DHC did not increase significantly (2008=636; 2011=796). A strong momentum in transferring scientific insights to the "real-world" stroke care in Germany was documented. Increase of IVT therapy is largely due to the increase of off-label treatment. Almost every 46 th patient <80 years was treated by MT in 2012. Despite proven benefits in selected patients, utilization of DHC remained almost stable. PMID:25109534

  19. 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

  20. Potential and limit of LiDAR data for earthquake recurrence characterization

    NASA Astrophysics Data System (ADS)

    Zielke, Olaf

    2013-04-01

    The characterization of earthquake (EQ) recurrence --assessing timing and size of past EQs along a given fault (section)-- has proven difficult, largely due the relatively short time span that is covered by instrumental seismic observations. While major EQs along a given fault are inferred to occur roughly on centennial to millennial time scales, seismographs to record them emerged little more than 100 years ago. Thus, recurrence of major EQs has essentially not yet been observed instrumentally. Stratigraphic and geomorphic evidence is used instead to describe and constrain recurrence of surface rupturing EQs. In the 1980s, analysis of such data sets culminated in the formulation of now classical EQ recurrence models. The debate about the correctness and thus applicability of these in part contradicting models is still ongoing. Over the last 10 years or so Light Detection and Ranging (LiDAR) technology became available to paleoseismic and tectono-geomorphic investigations. High spatial resolution, precision, and accuracy --the key features of LiDAR data-- revealed details in the tectono-geomorphic record that could not be resolved previously by field investigation or air photo analysis. As a result LiDAR data sets contributed and continues to contribute to improvements in the recurrence characterization of (surface rupturing) EQs. Here, I will present an overview on LiDAR data implementation in paleoseismic and tectono-geomorphic studies, including trench-based LiDAR, terrestrial LiDAR, and airborne LiDAR and I will discuss the impact of LiDAR data on constraining EQ recurrence characteristics as well as their relation to the classical EQ recurrence models. Additionally, I will discuss the intrinsic limits (that even LiDAR data cannot overcome) that arise when investigating geomorphic and stratigraphic evidence for EQ recurrence characterization. The natural complexity of the rupture process itself and its imprint on the analyzed data sets puts an unavoidable limit

  1. 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.

  2. 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

  3. Elevation and mass balance changes in Alaska glaciers from airborne LiDAR surveys

    NASA Astrophysics Data System (ADS)

    Murphy, Nathaniel; Larsen, Chris; Johnson, Austin

    2013-04-01

    Since 1993, the University of Alaska (UAF) Glaciers Group has monitored glacier elevation changes across Alaska (AK) and northwest Canada (NWC) using airborne laser altimetry surveys. Since 2009, this effort has been part of NASA's Operation Ice Bridge. The ongoing campaign has measured centerline elevation profiles for over 200 glaciers in the region. We will present updated mass balance and volume change estimates of glaciers and ice fields throughout AK and NWC. In addition, we estimate the contribution to sea level rise (SLR) from AK and NWC glaciers. In 2009 the single-point laser altimeter was replaced by a scanning LiDAR system, which vastly improves the sampling rate and spatial coverage of the laser returns. The combination of updated glacier outlines, upgraded LiDAR system, and improved analysis techniques provides more accurate results and more robust uncertainty analysis of the glacier mass balances and SLR calculations. Our recent results suggest that AK and NWC glaciers overall continue to show loss of surface elevation and decreasing mass balances. AK and NWC glaciers show high variability in the relationships between mass balances and glacier-type, geographic distribution, and climate. In Denali National Park, most of the surveyed glaciers show negative mass balances increasing by approximately 50% from about -0.7 m/yr w.e. to -1.2 m/yr w.e. Mountain glaciers in Lake Clark National Park followed similar trends of slightly positive mass balances from 1996-2001 (~0.2 m/yr w.e.),and slightly negative mass balances from 2001-2008 (~ -0.6 m/yr w.e.). In the Juneau Icefield, Taku Glacier has maintained positive mass balances in recent decades, but from 2007 to 2011 its mass balance decreased to values of zero to slightly negative (-0.1 ± 0.1 m/yr w.e.). This decrease in the mass balance of Taku Glacier appears to be driven by loss of surface elevations in the upper areas of the glacier. The mass balances of glaciers in Glacier Bay National Park generally

  4. Improved estimates of forest vegetation structure and biomass with a LiDAR-optimized sampling design

    NASA Astrophysics Data System (ADS)

    Hawbaker, Todd J.; Keuler, Nicholas S.; Lesak, Adrian A.; Gobakken, Terje; Contrucci, Kirk; Radeloff, Volker C.

    2009-06-01

    LiDAR data are increasingly available from both airborne and spaceborne missions to map elevation and vegetation structure. Additionally, global coverage may soon become available with NASA's planned DESDynI sensor. However, substantial challenges remain to using the growing body of LiDAR data. First, the large volumes of data generated by LiDAR sensors require efficient processing methods. Second, efficient sampling methods are needed to collect the field data used to relate LiDAR data with vegetation structure. In this paper, we used low-density LiDAR data, summarized within pixels of a regular grid, to estimate forest structure and biomass across a 53,600 ha study area in northeastern Wisconsin. Additionally, we compared the predictive ability of models constructed from a random sample to a sample stratified using mean and standard deviation of LiDAR heights. Our models explained between 65 to 88% of the variability in DBH, basal area, tree height, and biomass. Prediction errors from models constructed using a random sample were up to 68% larger than those from the models built with a stratified sample. The stratified sample included a greater range of variability than the random sample. Thus, applying the random sample model to the entire population violated a tenet of regression analysis; namely, that models should not be used to extrapolate beyond the range of data from which they were constructed. Our results highlight that LiDAR data integrated with field data sampling designs can provide broad-scale assessments of vegetation structure and biomass, i.e., information crucial for carbon and biodiversity science.

  5. 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.

  6. 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

  7. 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.

  8. Diversity arrays technology (DArT) for high-throughput profiling of the hexaploid wheat genome.

    PubMed

    Akbari, Mona; Wenzl, Peter; Caig, Vanessa; Carling, Jason; Xia, Ling; Yang, Shiying; Uszynski, Grzegorz; Mohler, Volker; Lehmensiek, Anke; Kuchel, Haydn; Hayden, Mathew J; Howes, Neil; Sharp, Peter; Vaughan, Peter; Rathmell, Bill; Huttner, Eric; Kilian, Andrzej

    2006-11-01

    Despite a substantial investment in the development of panels of single nucleotide polymorphism (SNP) markers, the simple sequence repeat (SSR) technology with a limited multiplexing capability remains a standard, even for applications requiring whole-genome information. Diversity arrays technology (DArT) types hundreds to thousands of genomic loci in parallel, as previously demonstrated in a number diploid plant species. Here we show that DArT performs similarly well for the hexaploid genome of bread wheat (Triticum aestivum L.). The methodology previously used to generate DArT fingerprints of barley also generated a large number of high-quality markers in wheat (99.8% allele-calling concordance and approximately 95% call rate). The genetic relationships among bread wheat cultivars revealed by DArT coincided with knowledge generated with other methods, and even closely related cultivars could be distinguished. To verify the Mendelian behaviour of DArT markers, we typed a set of 90 Cranbrook x Halberd doubled haploid lines for which a framework (FW) map comprising a total of 339 SSR, restriction fragment length polymorphism (RFLP) and amplified fragment length polymorphism (AFLP) markers was available. We added an equal number of DArT markers to this data set and also incorporated 71 sequence tagged microsatellite (STM) markers. A comparison of logarithm of the odds (LOD) scores, call rates and the degree of genome coverage indicated that the quality and information content of the DArT data set was comparable to that of the combined SSR/RFLP/AFLP data set of the FW map. PMID:17033786

  9. Comparison of Inhospital Outcomes of Surgical Aortic Valve Replacement in Hospitals With and Without Availability of a Transcatheter Aortic Valve Implantation Program (from a Nationally Representative Database).

    PubMed

    Singh, Vikas; Badheka, Apurva O; Patel, Samir V; Patel, Nileshkumar J; Thakkar, Badal; Patel, Nilay; Arora, Shilpkumar; Patel, Nish; Patel, Achint; Savani, Chirag; Ghatak, Abhijit; Panaich, Sidakpal S; Jhamnani, Sunny; Deshmukh, Abhishek; Chothani, Ankit; Sonani, Rajesh; Patel, Aashay; Bhatt, Parth; Dave, Abhishek; Bhimani, Ronak; Mohamad, Tamam; Grines, Cindy; Cleman, Michael; Forrest, John K; Mangi, Abeel

    2015-10-15

    We hypothesized that the availability of a transcatheter aortic valve implantation (TAVI) program in hospitals impacts the overall management of patients with aortic valve disease and hence may also improve postprocedural outcomes of conventional surgical aortic valve replacement (SAVR). The aim of the present study was to compare the inhospital outcomes of SAVR in centers with versus without availability of a TAVI program in an unrestricted large nationwide patient population >50 years of age. SAVRs performed on patients aged >50 years were identified from the Nationwide Inpatient Sample (NIS) for the years 2011 and 2012 using the International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes. SAVR cases were divided into 2 categories: those performed at hospitals with a TAVI program (SAVR-TAVI) and those without (SAVR-non-TAVI). A total of 9,674 SAVR procedures were identified: 4,526 (46.79%) in the SAVR-TAVI group and 5,148 (53.21%) in SAVR-non-TAVI group. The mean age of the study population was 70.2 ± 0.1 years with majority (53%) of the patients aged >70 years. The mean Charlson's co-morbidity score for patients in SAVR-TAVI group was greater (greater percentage of patients were aged >80 years, had hypertension, congestive heart failure, renal failure, and peripheral arterial disease) than that of patients in SAVR-non-TAVI group (1.6 vs 1.4, p <0.001). The propensity score matching analysis showed a statistically significant lower inhospital mortality (1.25% vs 1.72%, p = 0.001) and complications rate (35.6% vs 37.3%, p = 0.004) in SAVR-TAVI group compared to SAVR-non-TAVI group. The mean length of hospital stay was similar in the 2 groups the cost of hospitalization was higher in the SAVR-TAVI group ($43,894 ± 483 vs $41,032 ± 473, p <0.0001). Having a TAVI program was a significant predictor of reduced mortality and complications rate after SAVR in multivariate analysis. In conclusion, this largest direct

  10. 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.…

  11. 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…

  12. Geotechnical applications of LiDAR pertaining to geomechanical evaluation and hazard identification

    NASA Astrophysics Data System (ADS)

    Lato, Matthew J.

    Natural hazards related to ground movement that directly affect the safety of motorists and highway infrastructure include, but are not limited to, rockfalls, rockslides, debris flows, and landslides. This thesis specifically deals with the evaluation of rockfall hazards through the evaluation of LiDAR data. Light Detection And Ranging (LiDAR) is an imaging technology that can be used to delineate and evaluate geomechanically-controlled hazards. LiDAR has been adopted to conduct hazard evaluations pertaining to rockfall, rock-avalanches, debris flows, and landslides. Characteristics of LiDAR surveying, such as rapid data acquisition rates, mobile data collection, and high data densities, pose problems to traditional CAD or GIS-based mapping methods. New analyses methods, including tools specifically oriented to geomechanical analyses, are needed. The research completed in this thesis supports development of new methods, including improved survey techniques, innovative software workflows, and processing algorithms to aid in the detection and evaluation of geomechanically controlled rockfall hazards. The scientific research conducted between the years of 2006-2010, as presented in this thesis, are divided into five chapters, each of which has been published by or is under review by an international journal. The five research foci are: (i) geomechanical feature extraction and analysis using LiDAR data in active mining environments; (ii) engineered monitoring of rockfall hazards along transportation corridors: using mobile terrestrial LiDAR; (iii) optimization of LiDAR scanning and processing for automated structural evaluation of discontinuities in rockmasses; (iv) location orientation bias when using static LiDAR data for geomechanical analysis; and (v) evaluating roadside rockmasses for rockfall hazards from LiDAR data: optimizing data collection and processing protocols. The research conducted pertaining to this thesis has direct and significant implications with

  13. Specular and diffuse object extraction from a LiDAR derived Digital Surface Model (DSM)

    NASA Astrophysics Data System (ADS)

    Saraf, N. M.; Hamid, J. R. A.; Kamaruddin, M. H.

    2014-02-01

    This paper intents to investigate the indifferent behaviour quantitatively of target objects of interest due to specular and diffuse reflectivity based on generated LiDAR DSM of the study site in Ampang, Kuala Lumpur. The LiDAR data to be used was initially checked for its reliability and accuracy. The point cloud LiDAR data was converted to raster to allow grid analysis of the next process of generating the DSM and DTM. Filtering and masking were made removing the features of interest (i.e. building and tree) and other unwanted above surface features. A normalised DSM and object segmentation approach were conducted on the trees and buildings separately. Error assessment and findings attained were highlighted and documented. The result of LiDAR verification certified that the data is reliable and useable. The RMSE obtained is within the tolerance value of horizontal and vertical accuracy (x, y, z) i.e. 0.159 m, 0.211 m 0.091 m respectively. Building extraction inclusive of roof top based on slope and contour analysis undertaken indicate the capability of the approach while single tree extraction through aspect analysis appears to preserve the accuracy of the extraction accordingly. The paper has evaluated the suitable methods of extracting non-ground features and the effective segmentation of the LiDAR data.

  14. Detection of fault structures with airborne LiDAR point-cloud data

    NASA Astrophysics Data System (ADS)

    Chen, Jie; Du, Lei

    2015-08-01

    The airborne LiDAR (Light Detection And Ranging) technology is a new type of aerial earth observation method which can be used to produce high-precision DEM (Digital Elevation Model) quickly and reflect ground surface information directly. Fault structure is one of the key forms of crustal movement, and its quantitative description is the key to the research of crustal movement. The airborne LiDAR point-cloud data is used to detect and extract fault structures automatically based on linear extension, elevation mutation and slope abnormal characteristics. Firstly, the LiDAR point-cloud data is processed to filter out buildings, vegetation and other non-surface information with the TIN (Triangulated Irregular Network) filtering method and Burman model calibration method. TIN and DEM are made from the processed data sequentially. Secondly, linear fault structures are extracted based on dual-threshold method. Finally, high-precision DOM (Digital Orthophoto Map) and other geological knowledge are used to check the accuracy of fault structure extraction. An experiment is carried out in Beiya Village of Yunnan Province, China. With LiDAR technology, results reveal that: the airborne LiDAR point-cloud data can be utilized to extract linear fault structures accurately and automatically, measure information such as height, width and slope of fault structures with high precision, and detect faults in areas with vegetation coverage effectively.

  15. Flow Characteristics of Tidewater Glaciers in Greenland and Alaska using Ground-Based LiDAR

    NASA Astrophysics Data System (ADS)

    Finnegan, D. C.; Stearns, L. A.; Hamilton, G. S.; O'Neel, S.

    2010-12-01

    LiDAR scanning systems have been employed to characterize and quantify multi-temporal glacier and ice sheet changes for nearly three decades. Until recently, LiDAR scanning systems were limited to airborne and space-based platforms which come at a significant cost to deploy and are limited in spatial and temporal sampling capabilities necessary to compare with in-situ field measurements. Portable ground-based LiDAR scanning systems are now being used as a glaciological tool. We discuss research efforts to employ ground-based near-infrared LiDAR systems at two differing tidewater glacier systems in the spring of 2009; Helheim Glacier in southeast Greenland and Columbia Glacier in southeast Alaska. Preliminary results allow us to characterize short term displacement rates and detailed observations of calving processes. These results highlight the operational limitations and capabilities of commercially available LiDAR systems, and allow us to identify optimal operating characteristics for monitoring small to large-scale tidewater glaciers in near real-time. Furthermore, by identifying the operational limitations of these sensors it allows for optimal design characteristics of new sensors necessary to meet ground-based calibration and validation requirements of ongoing scientific missions.

  16. 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

  17. Energy audits at 48 hospitals

    NASA Astrophysics Data System (ADS)

    Hirst, E.

    1981-11-01

    Staff at the Oak Ridge Associated Universities (ORAU) conducted energy audits at 48 hospitals in four states (New York, Pennsylvania, Virginia, Tennessee) between 1978 and 1980. Staff at the Oak Ridge National Laboratory (ORNL) and ORAU developed and organized a computerized data base containing information from these audits. This paper describes the ORAU audit process; summarizes the data collected from these audits on hospital characteristics annual energy use, and the audit recommendations; and analyzes the audit data in terms of cost effectiveness, type of recommendations, and the relationship between potential energy saving and characteristics of the individual hospital.

  18. 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.

  19. 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

  20. Reporting for duty. One year after terrorist attacks shook the nation, hospitals confront a changed landscape--and seek to do their part to defend the homeland.

    PubMed

    Haugh, Richard; Joch, Alan; Selvam, Ashok; Serb, Chris

    2002-09-01

    As we observe the first anniversary of the Sept. 11 terrorist attacks that changed our nation, health care providers prepare to deal with potential disasters that in better times were merely the realm of science fiction. In communities across the country, readiness is the new goal, bioterrorism the new threat.

  1. Comparison of the process of care of acute severe asthma in adults admitted to hospital before and 1 yr after the publication of national guidelines.

    PubMed

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

    1996-10-01

    This study set out to assess the effect of publication of the British Guidelines on Asthma Management on the processes and outcomes of the inpatient care of acute severe asthma in the U.K. A criterion-based audit of all acute asthma admissions during August and September 1990 (immediately before) and in 1991 (1 yr after publication of the Guidelines) using eight criteria of process and outcome was performed. Thirty-six teaching and district general hospitals in England, Scotland and Wales took part. In total, 766 patients admitted in 1990, and 900 patients admitted in 1991, were studied. The 1990 and 1991 cohorts were very similar demographically and had asthma of comparable severity. Respiratory physicians achieved similar high performance rates of between 75 and 91% for seven of the eight criteria for both years. Respiratory physicians were significantly more likely to provide patients with a written management plan in 1991. General physicians' performance was significantly lower in both years, but overall there was a very small, but just significant, improvement in their performance in 1991. Some hospitals performed consistently well in both years. It is concluded that respiratory physicians consistently provide better asthma care than general physicians. Though statistically significant, the small degree of improvement was disappointing. Possible reasons include: insufficient time for the Guidelines to be incorporated into practice; inaccessibility of the Guidelines to general physicians; failure to accept responsibility for implementing the good practice reflected in the Guidelines; and an explicit need for strategies to implement the Guidelines beyond publication in a widely-read general medical journal.

  2. To close or not to close? Analysis of 4 year's data from national surveillance of norovirus outbreaks in hospitals in England

    PubMed Central

    Harris, John P; Adak, Goutam K; O'Brien, Sarah J

    2014-01-01

    Objective To assess the impact of ward or bay closures, specifically, whether prompt closure of an affected ward shortens the duration of norovirus outbreaks and the resulting disruption in hospitals. Design Analysis of summary data from hospitals on outbreaks of norovirus from 2009 to 2012. Methods Using a large outbreak surveillance dataset, we examined the duration of outbreaks, duration of disruption, ward closures, the number of patients and staff affected and the number of lost bed-days, as functions of the timing of closure. We conducted Quasi-Poisson regression analyses to assess the effect of ward closure (timing of closure) on outcome measures, controlling for time of year (winter or summer), ward size and ward type (elderly care wards). Results Regression analysis indicates that after controlling for season ward size and type, the duration of outbreak and duration of disruption were shorter, fewer patients were affected by the time of closure and fewer patients were affected overall, when closure occurred promptly (within 3 days of the first case becoming ill) compared with non-prompt closure groups. However, in outbreaks where wards were not closed, the length of outbreaks were similar to the prompt closure group and also had fewer patients and staff affected and fewer cases per day of outbreak compared with prompt closure. Conclusions Closing a bay or ward promptly in an outbreak of norovirus leads to a shorter duration of outbreaks, a shorter duration of disruption and fewer patients being affected compared with outbreaks where wards were not promptly closed. However, the interpretation of these results is not straightforward. The outbreaks where the ward was not closed at all have similar characteristics in terms of the duration of outbreak and fewer people were affected compared with the baseline prompt closure group. PMID:24413345

  3. Health information technology and hospital quality of care.

    PubMed

    Furukawa, Michael; Adam, Terrence

    2008-01-01

    This study evaluates the association between health information technology (HIT) implementation and hospital quality of care using nationally representative datasets from HIMSS Analytics and CMS. The results show that the availability of HIT is associated with higher hospital quality of care when adjusted for hospital characteristics and geographic location. The effects varied by specific HIT application and across hospital quality measures.

  4. Planning Australia's hospital workforce.

    PubMed

    Harris, Mary; Gavel, Paul; Conn, Warwick

    2002-01-01

    Growing government support has been evident during the past decade for macro-level workforce planning to ensure that future populations have access to appropriate health care services. Population ageing is impacting on workforce requirements and on workforce supply within Australia and internationally. Changes in financing and the organisation of health services are impacting on the availability of training and on the quality of working life. The age and gender profile and career expectations of young Australians are changing. These factors are all adding to the importance and complexity of workforce planning. This paper draws on data from various sources to describe Australia's hospital workforce, to explore supply-side workforce trends and to discuss some contemporary issues of concern to policy makers and workforce planners. The paper finds that in recent years there has been a 3 per cent decline in the number of full time equivalent staff in public hospitals, while the number in the private hospital workforce has increased by 28 per cent. The paper concludes that, nationally, there are serious limitations in the data available to describe and monitor the hospital workforce and that there is a need to remedy this situation.

  5. 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.

  6. Automatic extraction of building boundaries using aerial LiDAR data

    NASA Astrophysics Data System (ADS)

    Wang, Ruisheng; Hu, Yong; Wu, Huayi; Wang, Jian

    2016-01-01

    Building extraction is one of the main research topics of the photogrammetry community. This paper presents automatic algorithms for building boundary extractions from aerial LiDAR data. First, segmenting height information generated from LiDAR data, the outer boundaries of aboveground objects are expressed as closed chains of oriented edge pixels. Then, building boundaries are distinguished from nonbuilding ones by evaluating their shapes. The candidate building boundaries are reconstructed as rectangles or regular polygons by applying new algorithms, following the hypothesis verification paradigm. These algorithms include constrained searching in Hough space, enhanced Hough transformation, and the sequential linking technique. The experimental results show that the proposed algorithms successfully extract building boundaries at rates of 97%, 85%, and 92% for three LiDAR datasets with varying scene complexities.

  7. Using 3D visual tools with LiDAR for environmental outreach

    NASA Astrophysics Data System (ADS)

    Glenn, N. F.; Mannel, S.; Ehinger, S.; Moore, C.

    2009-12-01

    The project objective is to develop visualizations using light detection and ranging (LiDAR) data and other data sources to increase community understanding of remote sensing data for earth science. These data are visualized using Google Earth and other visualization methods. Final products are delivered to K-12, state, and federal agencies to share with their students and community constituents. Once our partner agencies were identified, we utilized a survey method to better understand their technological abilities and use of visualization products. The final multimedia products include a visualization of LiDAR and well data for water quality mapping in a southeastern Idaho watershed; a tour of hydrologic points of interest in southeastern Idaho visited by thousands of people each year, and post-earthquake features near Borah Peak, Idaho. In addition to the customized multimedia materials, we developed tutorials to encourage our partners to utilize these tools with their own LiDAR and other scientific data.

  8. [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. PMID:26164889

  9. 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.

  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). PMID:20182905

  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. 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.

  13. Neglected user perspectives in the design of an online hospital bed-state system: implications for the National Programme for IT in the NHS.

    PubMed

    Harrop, Nick; Wood-Harper, Trevor; Gillies, Alan

    2006-12-01

    Technical aspects of the National Programme for IT in the National Health Service have run ahead of genuine engagement with front-line users. We have explored with front-line NHS staff the factors which limit their contribution to management information from operational systems. Staff place psychological distance between 'the real job' and the reporting of information. Even where accurate reporting is heavily incentivized, and operational control is shared between staff and shift leader, the reporting of information to the computer represents a division between caregiving and computer input, and between information openly declared and that waiting to be disclosed. The Programme needs to reconsider how clinicians are to be engaged. Equally, information systems designers, if they expect to obtain management information and want to understand the limitations of that process, need to be socialized into the fields where systems are to be deployed.

  14. 'Dar Kenn Ghal Sahhtek'--an eating disorder and obesity service in Malta.

    PubMed

    Aquilina, Francesca Falzon; Grech, Anton; Zerafa, Darleen; Agius, Mark; Voon, Valerie

    2015-09-01

    This paper will describe the incidence of eating disorders, with particular focus on obesity and binge eating, within the Island of Malta. The development of and 'Dar Kenn Ghal Sahhtek', the first centre for eating disorders in Malta will then be recounted, and the effective therapeutic interventions provided in it will be described. One important function of this unit is the treatment of excessive obesity. Some epidemiological data on the Obese Patients in DKS, relating to the incidence of Binge Eating Disorder in the DKS patient group will be given. This data was collected during a collaboritive research project between the Psychiatry Department of Cambridge University and 'Dar Kenn Ghal Sahhtek'.

  15. Direct injection into the IsoDAR Cyclotron using a RFQ

    NASA Astrophysics Data System (ADS)

    Axani, Spencer; IsoDAR Collaboration

    2015-04-01

    Beginning in the 1970s, the use of Radio Frequency Quadrupoles (RFQs) has been pervasive in linear accelerators in order to accelerate, bunch, and separate ion species. Current research suggests this may be an ideal way to inject a low energy H2+ beam axially into a cyclotron. The IsoDAR (Isotope Decay At Rest) experiment aims to implement this injection system in order to achieve higher Low Energy Beam Transport (LEBT) efficiencies and ultimately construct a novel compact neutrino factory to test the hypothesis of sterile neutrinos. This talk will focus on the research and development needed to implement a RFQ into the IsoDAR experiment.

  16. DArT markers: diversity analyses and mapping in Sorghum bicolor

    PubMed Central

    Mace, Emma S; Xia, Ling; Jordan, David R; Halloran, Kirsten; Parh, Dipal K; Huttner, Eric; Wenzl, Peter; Kilian, Andrzej

    2008-01-01

    Background The sequential nature of gel-based marker systems entails low throughput and high costs per assay. Commonly used marker systems such as SSR and SNP are also dependent on sequence information. These limitations result in high cost per data point and significantly limit the capacity of breeding programs to obtain sufficient return on investment to justify the routine use of marker-assisted breeding for many traits and particularly quantitative traits. Diversity Arrays Technology (DArT™) is a cost effective hybridisation-based marker technology that offers a high multiplexing level while being independent of sequence information. This technology offers sorghum breeding programs an alternative approach to whole-genome profiling. We report on the development, application, mapping and utility of DArT™ markers for sorghum germplasm. Results A genotyping array was developed representing approximately 12,000 genomic clones using PstI+BanII complexity with a subset of clones obtained through the suppression subtractive hybridisation (SSH) method. The genotyping array was used to analyse a diverse set of sorghum genotypes and screening a Recombinant Inbred Lines (RIL) mapping population. Over 500 markers detected variation among 90 accessions used in a diversity analysis. Cluster analysis discriminated well between all 90 genotypes. To confirm that the sorghum DArT markers behave in a Mendelian manner, we constructed a genetic linkage map for a cross between R931945-2-2 and IS 8525 integrating DArT and other marker types. In total, 596 markers could be placed on the integrated linkage map, which spanned 1431.6 cM. The genetic linkage map had an average marker density of 1/2.39 cM, with an average DArT marker density of 1/3.9 cM. Conclusion We have successfully developed DArT markers for Sorghum bicolor and have demonstrated that DArT provides high quality markers that can be used for diversity analyses and to construct medium-density genetic linkage maps. The

  17. 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

  18. 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

  19. 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

  20. [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.

  1. [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. PMID:19545081

  2. Predictors of Prolonged Hospital Length of Stay Following Stage II Palliation of Hypoplastic Left Heart Syndrome (and Variants): Analysis of the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) Database.

    PubMed

    Baker-Smith, Carissa M; Goldberg, Sara W; Rosenthal, Geoffrey L

    2015-12-01

    The objective of this study is to identify predictors of prolonged hospital length of stay (LOS) for single ventricle patients following stage 2 palliation (S2P), excluding patients who underwent a hybrid procedure. We explore the impact of demographic features, stage 1 palliation (S1P), interstage I (IS1) management, S2P, and post-surgical care on hospital LOS following S2P. We conducted a retrospective analysis of the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) database. The NPC-QIC database is an established registry of patients with hypoplastic left heart syndrome (HLHS) and its variants. It contains detailed information regarding the demographic features, S1P, IS1, S2P, and interstage 2 (IS2) management of children with HLHS and related single ventricle cardiac malformations. Between 2008 and 2012, there were 477 participants with recorded LOS data in the NPC-QIC registry. Excluding the 29 patients who underwent hybrid procedure, there were 448 participants who underwent a Norwood (or Norwood-variant procedure) as S1P. In order to be included in the NPC-QIC database, participants were discharged to home following S1P and prior to S2P. We found that postoperative LOS among the 448 S2P procedure recipients is most strongly influenced by the need for reoperation following S2P, the need for an additional cardiac catheterization procedure following S2P, the use of non-oral methods of nutrition (e.g., nasogastric tube, total parental nutrition, gastrostomy tube), and the development of postoperative complications. Factors such as age at the time of S2P, the presence of a major non-cardiac anomaly, site participant volume, IS1 course, the type and number of vasoactive agents used following S2P, and the need for more than 1 intensive care unit (ICU) hospitalization (following discharge to the ward but prior to discharge to home) were significant predictors by univariate analysis but not by multivariate analysis. We excluded participants

  3. 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.

  4. Validating LiDAR Derived Estimates of Canopy Height, Structure and Fractional Cover in Riparian Areas: A Comparison of Leaf-on and Leaf-off LiDAR Data

    NASA Astrophysics Data System (ADS)

    Wasser, L. A.; Chasmer, L. E.; Taylor, A.; Day, R.

    2010-12-01

    Characterization of riparian buffers is integral to understanding the landscape scale impacts of disturbance on wildlife and aquatic ecosystems. Riparian buffers may be characterized using in situ plot sampling or via high resolution remote sensing. Field measurements are time-consuming and may not cover a broad range of ecosystem types. Further, spectral remote sensing methods introduce a compromise between spatial resolution (grain) and area extent. Airborne LiDAR can be used to continuously map and characterize riparian vegetation structure and composition due to the three-dimensional reflectance of laser pulses within and below the canopy, understory and at the ground surface. The distance between reflections (or ‘returns’) allows for detection of narrow buffer corridors at the landscape scale. There is a need to compare leaf-off and leaf-on surveyed LiDAR data with in situ measurements to assess accuracy in landscape scale analysis. These comparisons are particularly important considering increased availability of leaf-off surveyed LiDAR datasets. And given this increased availability, differences between leaf-on and leaf-off derived LiDAR metrics are largely unknown for riparian vegetation of varying composition and structure. This study compares the effectiveness of leaf-on and leaf-off LiDAR in characterizing riparian buffers of varying structure and composition as compared to field measurements. Field measurements were used to validate LiDAR derived metrics. Vegetation height, canopy cover, density and overstory and understory species composition were recorded in 80 random plots of varying vegetation type, density and structure within a Pennsylvania watershed (-77.841, 40.818). Plot data were compared with LiDAR data collected during leaf on and leaf off conditions to determine 1) accuracy of LiDAR derived metrics compared to field measures and 2) differences between leaf-on and leaf-off LiDAR metrics. Results illustrate that differences exist between

  5. 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.

  6. 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

  7. 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

    2012-08-01

    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.

  8. 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…

  9. 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)

  10. 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.

  11. 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…

  12. 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.

  13. 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…

  14. 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…

  15. 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.

  16. 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.

  17. 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.

  18. 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. PMID:21243330

  19. 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...

  20. 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...

  1. 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…

  2. 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

  3. 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.

  4. 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. PMID:25837107

  5. 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

  6. Development of DArT-based PCR markers for selecting drought-tolerant spring barley.

    PubMed

    Fiust, Anna; Rapacz, Marcin; Wójcik-Jagła, Magdalena; Tyrka, Mirosław

    2015-08-01

    The tolerance of spring barley (Hordeum vulgare L.) cultivars to spring drought is an important agronomic trait affecting crop yield and quality in Poland. Therefore, breeders require new molecular markers to select plants with lower spring drought susceptibility. With the advent of genomic selection technology, simple molecular tools may still be applicable to screen material for markers of the most important traits and in-depth genome scanning. In previous studies, diversity arrays technology (DArT)-based genetic maps were constructed for F2 populations of Polish fodder and malt barley elite breeding lines, and 15 and 18 quantitative trait loci (QTLs) related to spring drought tolerance were identified, respectively. In this paper, we show the results of a conversion of 30 DArT markers corresponding to 11 QTLs into simple sequence repeat (SSR) and sequence tagged site (STS) markers. Twenty-two polymorphic markers were obtained, including 13 DArT-based SSRs. Additionally, 31 SSR markers, located in close proximity to the DArT markers, were selected from the GrainGenes database and tested. Further analyses of 24 advanced breeding lines with different drought tolerances confirmed that five out of the 30 converted markers, as well as three out of the 31 additional SSR markers, were effective in marker-assisted selection for drought tolerance. The possible function of clones related to these markers in drought tolerance is discussed. PMID:25716655

  7. 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

  8. 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

  9. Field and LiDAR observations of the Hector Mine California 1999 surface rupture

    NASA Astrophysics Data System (ADS)

    Sousa, F.; Akciz, S. O.; Harvey, J. C.; Hudnut, K. W.; Lynch, D. K.; Scharer, K. M.; Stock, J. M.; Witkosky, R.; Kendrick, K. J.; Wespestad, C.

    2014-12-01

    We report new field- and computer-based investigations of the surface rupture of the October 16, 1999 Hector Mine Earthquake. Since May 2012, in cooperation with the United States Marine Corps Air Ground Combat Center (MCAGCC) at Twentynine Palms, CA, our team has been allowed ground and aerial access to the entire surface rupture. We have focused our new field-based research and imagery analysis along the ~10 kilometer-long maximum slip zone (MSZ) which roughly corresponds to the zone of >4 meter dextral horizontal offset. New data include: 1) a 1 km wide aerial LiDAR survey along the entire surface rupture (@ 10 shots/m2, May 2012, www.opentopography.org); 2) terrestrial LiDAR surveys at 5 sites within the MSZ (@ >1000 shots/m2, April 2014); 3) low altitude aerial photography and ground based photography of the entire MSZ; 4) a ground-truthed database of 87 out of the 94 imagery-based offset measurements made within the MSZ; and 5) a database of 50 new field-based offset measurements made within the MSZ by our team on the ground, 31 of which have also been made on the computer (Ladicaoz) with both the 2000 LiDAR data (@ 0.5 m DEM resolution; Chen et al, in review) and 2012 LiDAR data (@ 35 cm DEM resolution; our team). New results to date include 1) significant variability (> 2 m) in horizontal offsets measured along short distances of the surface rupture (~100 m) within segments of the surface rupture that are localized to a single fault strand; 2) strong dependence of decadal scale fault scarp preservation on local lithology (bedrock vs. alluvial fan vs. fine sediment) and geomorphology (uphill vs. downhill facing scarp); 3) newly observed offset features which were never measured during the post-event field response; 4) newly observed offset features too small to be resolved in airborne LiDAR data (< 1 m); 5) nearly 25% of LiDAR imagery-based measurements that were later ground-truthed were judged by our team to warrant removal from the database due to

  10. Application of LiDAR to hydrologic flux estimation in Australian eucalypt forests (Invited)

    NASA Astrophysics Data System (ADS)

    Lane, P. N.; Mitchell, P. J.; Jaskierniak, D.; Hawthorne, S. N.; Griebel, A.

    2013-12-01

    The potential of LiDAR in ecohydrology is significant as characterising catchment vegetation is crucial to accurate estimation of evapotranspiration (ET). While this may be done at large scales for model parameterisation, stand-scale applications are equally appropriate where traditional methods of measurement of LAI or sapwood areas are time consuming and reliant on assumptions of representative sampling. This is particularly challenging in mountain forests where aspect, soil properties and energy budgets can vary significantly, reflected in the vegetation or where there are changes in the spatial distribution of structural attributes following disturbance. Recent research has investigated the spatial distribution of ET in a eucalypt forest in SE Australia using plot-scale sapflow, interception and forest floor ET measurements. LiDAR was used scale up these measurements. LiDAR (0.16 m scanner footprint) canopy indices were correlated via stepwise regression with 4 water use scalars: basal area (BA), sapwood area (SA), leaf area index (LAI) and canopy coverage (C), with Hmed, Hmean, H80, H95 the best predictors. Combining these indices with empirical relationships between SA and BA, and SA and transpiration (T), and inventory plot 'ground truthing' transpiration was estimated across the 1.3 km2 catchment. Interception was scaled via the Gash model with LiDAR derived inputs. The up-scaling showed a significant variability in the spatial distribution of ET, related to the distribution of SA. The use of LiDAR meant scaling could be achieved at an appropriate spatial scale (20 x 20 m) to the measurements. The second example is the use of airborne LiDAR in developing growth forest models for hydrologic modeling. LiDAR indices were used to stratify multilayered forests using mixed-effect models with a wide range of theoretical distribution functions. When combined with historical plot-scale inventory data we show demonstrated improved growth modeling over traditional

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. LiDAR Segmentation using Suitable Seed Points for 3D Building Extraction

    NASA Astrophysics Data System (ADS)

    Abdullah, S. M.; Awrangjeb, M.; Lu, G.

    2014-08-01

    Effective building detection and roof reconstruction has an influential demand over the remote sensing research community. In this paper, we present a new automatic LiDAR point cloud segmentation method using suitable seed points for building detection and roof plane extraction. Firstly, the LiDAR point cloud is separated into "ground" and "non-ground" points based on the analysis of DEM with a height threshold. Each of the non-ground point is marked as coplanar or non-coplanar based on a coplanarity analysis. Commencing from the maximum LiDAR point height towards the minimum, all the LiDAR points on each height level are extracted and separated into several groups based on 2D distance. From each group, lines are extracted and a coplanar point which is the nearest to the midpoint of each line is considered as a seed point. This seed point and its neighbouring points are utilised to generate the plane equation. The plane is grown in a region growing fashion until no new points can be added. A robust rule-based tree removal method is applied subsequently to remove planar segments on trees. Four different rules are applied in this method. Finally, the boundary of each object is extracted from the segmented LiDAR point cloud. The method is evaluated with six different data sets consisting hilly and densely vegetated areas. The experimental results indicate that the proposed method offers a high building detection and roof plane extraction rates while compared to a recently proposed method.

  17. 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.

  18. 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.

  19. Object-oriented identification of forested landslides with derivatives of single pulse LiDAR data

    NASA Astrophysics Data System (ADS)

    Van Den Eeckhaut, Miet; Kerle, Norman; Poesen, Jean; Hervás, Javier

    2012-11-01

    In contrast to the many studies that use expert-based analysis of LiDAR derivatives for landslide mapping in forested terrain, only few studies have attempted to develop (semi-)automatic methods for extracting landslides from LiDAR derivatives. While all these studies are pixel-based, it has not yet been tested whether object-oriented analysis (OOA) could be an alternative. This study investigates the potential of OOA using only single-pulse LiDAR derivatives, such as slope gradient, roughness and curvature to map landslides. More specifically, the focus is on both LiDAR data segmentation and classification of slow-moving landslides in densely vegetated areas, where spectral data do not allow accurate landslide identification. A multistage procedure has been developed and tested in the Flemish Ardennes (Belgium). The procedure consists of (1) image binarization and multiresolution segmentation, (2) classification of landslide parts (main scarps and landslide body segments) and non-landslide features (i.e. earth banks and cropland fields) with supervised support vector machines at the appropriate scale, (3) delineation of landslide flanks, (4) growing of a landslide body starting from its main scarp, and (5) final cleaning of the inventory map. The results obtained show that OOA using LiDAR derivatives allows recognition and characterization of profound morphologic properties of forested deep-seated landslides on soil-covered hillslopes, because more than 90% of the main scarps and 70% of the landslide bodies of an expert-based inventory were accurately identified with OOA. For mountainous areas with bedrock, on the other hand, creation of a transferable model is expected to be more difficult.

  20. A DArT marker genetic map of perennial ryegrass (Lolium perenne L.) integrated with detailed comparative mapping information; comparison with existing DArT marker genetic maps of Lolium perenne, L. multiflorum and Festuca pratensis

    PubMed Central

    2013-01-01

    Background Ryegrasses and fescues (genera, Lolium and Festuca) are species of forage and turf grasses which are used widely in agricultural and amenity situations. They are classified within the sub-family Pooideae and so are closely related to Brachypodium distachyon, wheat, barley, rye and oats. Recently, a DArT array has been developed which can be used in generating marker and mapping information for ryegrasses and fescues. This represents a potential common marker set for ryegrass and fescue researchers which can be linked through to comparative genomic information for the grasses. Results A F2 perennial ryegrass genetic map was developed consisting of 7 linkage groups defined by 1316 markers and deriving a total map length of 683 cM. The marker set included 866 DArT and 315 gene sequence-based markers. Comparison with previous DArT mapping studies in perennial and Italian ryegrass (L. multiflorum) identified 87 and 105 DArT markers in common, respectively, of which 94% and 87% mapped to homoeologous linkage groups. A similar comparison with meadow fescue (F. pratensis) identified only 28 DArT markers in common, of which c. 50% mapped to non-homoelogous linkage groups. In L. perenne, the genetic distance spanned by the DArT markers encompassed the majority of the regions that could be described in terms of comparative genomic relationships with rice, Brachypodium distachyon, and Sorghum bicolor. Conclusions DArT markers are likely to be a useful common marker resource for ryegrasses and fescues, though the success in aligning different populations through the mapping of common markers will be influenced by degrees of population interrelatedness. The detailed mapping of DArT and gene-based markers in this study potentially allows comparative relationships to be derived in future mapping populations characterised using solely DArT markers. PMID:23819624

  1. Hospital union election activity, 1974-85

    PubMed Central

    Becker, Edmund R.; Rakich, Jonathon S.

    1988-01-01

    This study, using National Labor Relations Board data and American Hospital Association data, reports on the status of union election activity in the hospital industry for a 65-month period, January 1980-May 1985, and contrasts it with earlier data for a similar 65-month time period (1974-79). Together these data provide a comprehensive overview of union election activity in non-Federal, nongovernment hospitals since the passage of the 1974 Nonprofit Hospital Amendments to the Taft-Hartley Act. The study analyzes union, election, hospital, and environmental characteristics. Comparisons over the two time periods show that, while union victory rates in hospital elections have remained constant, the total number of elections has declined dramatically in the hospital industry. PMID:10312518

  2. Pediatric hospitalizations for bicycle‐related injuries

    PubMed Central

    Shah, Summit; Sinclair, Sara A; Smith, Gary A; Xiang, Huiyun

    2007-01-01

    Objectives To determine the incidence of bicycle‐related injury hospitalizations among children and adolescents 20 years of age and younger and to examine the associated use of healthcare resources. Design Nationally representative data from the 2003 Healthcare Cost and Utilization Project's Kids' Inpatient Database (KID). Outcome measures National estimates of hospitalization for bicycle‐related injuries according to patient demographics, type of injury, total hospital charges, and length of hospital stay. Results In 2003, an estimated 10 700 children were hospitalized for a bicycle‐related injury in the USA. Inpatient charges totaled nearly $200 million with a mean charge of $18 654 per hospitalization. The national rate was 12.7 hospitalizations per 100 000 children. Young adolescents aged 10–13 years accounted for the highest percentage of cases (36.6%) followed by children aged 6–9 years (25.1%). Most patients were male (76.7%) and resided in an urban area (94.4%). A head injury was diagnosed in one out of three hospitalized bicyclists; 30% were due to a motor vehicle collision. Conclusions Pediatric bicycle‐related hospitalizations are a significant public health problem. The morbidity and mortality among children and the economic costs to society are large. The patient characteristics and injury types identified by this study should be used to develop targeted prevention strategies. PMID:17916888

  3. Enhanced detection of 3D individual trees in forested areas using airborne full-waveform LiDAR data by combining normalized cuts with spatial density clustering

    NASA Astrophysics Data System (ADS)

    Yao, W.; Krzystek, P.; Heurich, M.

    2013-10-01

    A detailed understanding of the spatial distribution of forest understory is important but difficult. LiDAR remote sensing has been developing as a promising additional instrument to the conventional field work towards automated forest inventory. Unfortunately, understory (up to 50% of the top-tree height) in mixed and multilayered forests is often ignored due to a difficult observation scenario and limitation of the tree detection algorithm. Currently, the full-waveform (FWF) LiDAR with high penetration ability against overstory crowns can give us new hope to resolve the forest understory. Former approach based on 3D segmentation confirmed that the tree detection rates in both middle and lower forest layers are still low. Therefore, detecting sub-dominant and suppressed trees cannot be regarded as fully solved. In this work, we aim to improve the performance of the FWF laser scanner for the mapping of forest understory. The paper is to develop an enhanced methodology for detecting 3D individual trees by partitioning point clouds of airborne LiDAR. After extracting 3D coordinates of the laser beam echoes, the pulse intensity and width by waveform decomposition, the newly developed approach resolves 3D single trees are by an integrated approach, which delineates tree crowns by applying normalized cuts segmentation to the graph structure of local dense modes in point clouds constructed by mean shift clustering. In the context of our strategy, the mean shift clusters approximate primitives of (sub) single trees in LiDAR data and allow to define more significant features to reflect geometric and reflectional characteristics towards the single tree level. The developed methodology can be regarded as an object-based point cloud analysis approach for tree detection and is applied to datasets captured with the Riegl LMS-Q560 laser scanner at a point density of 25 points/m2 in the Bavarian Forest National Park, Germany, respectively under leaf-on and leaf-off conditions

  4. 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…

  5. 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…

  6. 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

  7. Hospitals for sale.

    PubMed

    Costello, Michael M; West, Daniel J; Ramirez, Bernardo

    2011-01-01

    The pace of hospital merger and acquisition activity reflects the economic theory of supply and demand: Publicly traded hospital companies, private equity funds, and large nonprofit hospital systems are investing capital to purchase and operate freestanding community hospitals at a time when many of those hospitals find themselves short of capital reserves and certain forms of management expertise. But the sale of those community hospitals also raises questions about the impact of absentee ownership on the communities which those hospitals serve.

  8. 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. PMID:26250147

  9. Spatial accounting for errors in LiDAR-derived products: Snow volume and snow water equivalent estimation

    NASA Astrophysics Data System (ADS)

    Tinkham, W. T.; Hoffman, C. M.; Falkowski, M. J.; Smith, A. M.; Link, T. E.; Marshall, H.

    2011-12-01

    Light Detection and Ranging (LiDAR) has become one of the most effective and reliable means of characterizing surface topography and vegetation structure. Most LiDAR-derived estimates such as vegetation height, snow depth, and floodplain boundaries rely on the accurate creation of digital terrain models (DTM). As a result of the importance of an accurate DTM in using LiDAR data to estimate snow depth, it is necessary to understand the variables that influence the DTM accuracy in order to assess snow depth error. A series of 4 x 4 m plots that were surveyed at 0.5 m spacing in a semi-arid catchment were used for training the Random Forests algorithm along with a series of 35 variables in order to spatially predict vertical error within a LiDAR derived DTM. The final model was utilized to predict the combined error resulting from snow volume and snow water equivalent estimates derived from a snow-free LiDAR DTM and a snow-on LiDAR acquisition of the same site. The methodology allows for a statistical quantification of the spatially-distributed error patterns that are incorporated into the estimation of snow volume and snow water equivalents from LiDAR.

  10. [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

  11. 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

  12. 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.

  13. Hospital prices and market structure in the hospital and insurance industries.

    PubMed

    Moriya, Asako S; Vogt, William B; Gaynor, Martin

    2010-10-01

    There has been substantial consolidation among health insurers and hospitals, recently, raising questions about the effects of this consolidation on the exercise of market power. We analyze the relationship between insurer and hospital market concentration and the prices of hospital services. We use a national US dataset containing transaction prices for health care services for over 11 million privately insured Americans. Using three years of panel data, we estimate how insurer and hospital market concentration are related to hospital prices, while controlling for unobserved market effects. We find that increases in insurance market concentration are significantly associated with decreases in hospital prices, whereas increases in hospital concentration are non-significantly associated with increases in prices. A hypothetical merger between two of five equally sized insurers is estimated to decrease hospital prices by 6.7%.

  14. Change detection of riverbed movements using river cross-sections and LiDAR data

    NASA Astrophysics Data System (ADS)

    Vetter, Michael; Höfle, Bernhard; Mandlburger, Gottfried; Rutzinger, Martin

    2010-05-01

    Today, Airborne LiDAR derived digital terrain models (DTMs) are used for several aspects in different scientific disciplines, such as hydrology, geomorphology or archaeology. In the field of river geomorphology, LiDAR data sets can provide information on the riverine vegetation, the level and boundary of the water body, the elevation of the riparian foreland and their roughness. The LiDAR systems in use for topographic data acquisition mainly operate with wavelengths of at least 1064nm and, thus, are not able to penetrate water. LiDAR sensors with two wavelengths are available (bathymetric LiDAR), but they can only provide elevation information of riverbeds or lakes, if the water is clear and the minimum water depth exceeds 1.5m. In small and shallow rivers it is impossible to collect information of the riverbed, regardless of the used LiDAR sensor. In this article, we present a method to derive a high-resolution DTM of the riverbed and to combine it with the LiDAR DTM resulting in a watercourse DTM (DTM-W) as a basis for calculating the changes in the riverbed during several years. To obtain such a DTM-W we use river cross-sections acquired by terrestrial survey or echo-sounding. First, a differentiation between water and land has to be done. A highly accurate water surface can be derived by using a water surface delineation algorithm, which incorporates the amplitude information of the LiDAR point cloud and additional geometrical features (e.g. local surface roughness). The second step is to calculate a thalweg line, which is the lowest flow path in the riverbed. This is achieved by extracting the lowest point of each river cross section and by fitting a B-spline curve through those points. In the next step, the centerline of the river is calculated by applying a shrinking algorithm of the water boundary polygon. By averaging the thalweg line and the centerline, a main flow path line can be computed. Subsequently, a dense array of 2D-profiles perpendicular to the

  15. In-hospital Cardiac Arrest at Cork University Hospital.

    PubMed

    O'Sullivan, E; Deasy, C

    2016-01-01

    We describe the incidence and outcomes of in-hospital cardiac arrest (IHCA) at Cork University Hospital over a one year time period (2011), prior to the implementation of national early warning scoring (NEWS) systems. There were 43 217 coded CUH admissions, in 2011, to 518 in-patient beds. The Hospital In-Patient Enquiry Database was used to identify adults (>/= 18 years) who sustained IHCA. Available Utstein variables were collected. Fifty-two patients were found to be incorrectly coded IHCA. 17 of 63 (27.0%) IHCA survived to discharge. IHCA with shockable rhythm had significantly higher survival. IHCA survival was significantly lower on wards versus any other hospital location. Median days of stay prior to arrest were significantly different between survivors and non-survivors. All survivors (n = 17) had intact neurological outcome post-event. Our outcomes from IHCA are poorest on hospital wards when compared to other areas of the hospital. Those that survive have excellent function and one-year survival.

  16. Capabilities of the bathymetric Hawk Eye LiDAR for coastal habitat mapping: A case study within a Basque estuary

    NASA Astrophysics Data System (ADS)

    Chust, Guillem; Grande, Maitane; Galparsoro, Ibon; Uriarte, Adolfo; Borja, Ángel

    2010-10-01

    The bathymetric LiDAR system is an airborne laser that detects sea bottom at high vertical and horizontal resolutions in shallow coastal waters. This study assesses the capabilities of the airborne bathymetric LiDAR sensor (Hawk Eye system) for coastal habitat mapping in the Oka estuary (within the Biosphere Reserve of Urdaibai, SE Bay of Biscay, northern Spain), where water conditions are moderately turbid. Three specific objectives were addressed: 1) to assess the data quality of the Hawk Eye LiDAR, both for terrestrial and subtidal zones, in terms of height measurement density, coverage, and vertical accuracy; 2) to compare bathymetric LiDAR with a ship-borne multibeam echosounder (MBES) for different bottom types and depth ranges; and 3) to test the discrimination potential of LiDAR height and reflectance information, together with multi-spectral imagery (three visible and near infrared bands), for the classification of 22 salt marsh and rocky shore habitats, covering supralittoral, intertidal and subtidal zones. The bathymetric LiDAR Hawk Eye data enabled the generation of a digital elevation model (DEM) of the Oka estuary, at 2 m of horizontal spatial resolution in the terrestrial zone (with a vertical accuracy of 0.15 m) and at 4 m within the subtidal, extending a water depth of 21 m. Data gaps occurred in 14.4% of the area surveyed with the LiDAR (13.69 km 2). Comparison of the LiDAR system and the MBES showed no significant mean difference in depth. However, the Root Mean Square error of the former was high (0.84 m), especially concentrated upon rocky (0.55-1.77 m) rather than in sediment bottoms (0.38-0.62 m). The potential of LiDAR topographic variables and reflectance alone for discriminating 15 intertidal and submerged habitats was low (with overall classification accuracy between 52.4 and 65.4%). In particular, reflectance retrieved for this case study has been found to be not particularly useful for classification purposes. The combination of the LiDAR

  17. 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

  18. 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

  19. 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

  20. Petrology, chemistry, and isotopic compositions of the Lunar highland regolith breccia Dar AL Gani 262

    NASA Astrophysics Data System (ADS)

    Bischoff, A.; Weber, D.; Clayton, R. N.; Faestermann, T.; Franchi, I. A.; Herpers, U.; Knie, K.; Korschinek, G.; Kubik, P. W.; Mayeda, T. K.; Merchel, S.; Michel, R.; Neumann, S.; Palme, H.; Pillinger, C. T.; Schultz, L.; Sexton, A. S.; Spettel, B.; Verchovsky, A. B.; Weber, H. W.; Weckwerth, G.; Wolf, D.

    1998-11-01

    Lunar meteorite Dar al Gani 262 (DG 262) found in the Libyan part of the Sahara is a mature, anorthositic regolith breccia with highland affinities. The origin from the Moon is undoubtedly indicated by its bulk chemical composition, radionuclide concentrations, noble gas, nitrogen, and oxygen isotopic compositions and petrographic features. Dar al Gani 262 is a typical anorthositic highland breccia similar in mineralogy and chemical composition to QUE93069. About 52 vol% of the studied thin sections of Dar al Gani 262 consist of fine-grained (smaller than ?100 microns) constituents, and 48 vol% is mineral and lithic clasts and impact melt veins. The most abundant clast types are feldspathic fine-grained to microporphyritic crystalline melt breccias (50.2 vol%; includes recrystallized melt breccias), whereas mafic crystalline melt breccias are extremely rare (1.4 vol%). Granulitic lithologies are 12.8 vol%, intragranularly recrystallized anorthosites and cataclastic anorthosites are 8.8 and 8.2 vol%, respectively, and (devitrified) glasses are 2.7 vol%. Impact melt veins (5.5 vol% of the whole thin sections) cutting across the entire thin section were probably formed subsequent to the lithification process of the bulk rock at pressures below 20 GPa, because the bulk rock never experienced a higher peak shock pressure. Mafic crystalline melt breccias are very rare in Dar al Gani 262 and similar in abundance to those in QUE93069. The extremely low abundance of mafic components and the bulk composition may constrain possible areas of the Moon from which the breccia was derived. The source area of Dar al Gani 262 must be a highland terrain lacking significant mafic impact melts or mare components. Based on radionuclide activities an irradiation position of DG 262 on the Moon at a depth of 55-85 g/cm3 and a maximum transit time to Earth less than 0.15 Ma is suggested. Dar al Gani 262 contains high concentrations of solar wind implanted noble gases. The isotopic abundance