Organisational design for an integrated oncological department

PubMed Central

Meiss-de Haas, Ch.L.; Falkmann, H.; Douma, J.; van Gassel, J.G.; Peters, W.G.; van Mierlo, R.; van Turnhout, J.M.; Verhagen, C.A.H.H.V.M.; Schrijvers, A.J.P.

2001-01-01

Abstract Objective The outcomes of a Strength, Weakness, Opportunities and Threat (SWOT) analysis of three Integrated Oncological Departments were compared with their present situation three years later to define factors that can influence a successful implementation and development of an Integrated Oncological Department in- and outside (i.e. home care) the hospital. Research design Comparative Qualitative Case Study. Methods Auditing based on care-as-usual norms by an external, experienced auditing committee. Research setting Integrated Oncological Departments of three hospitals. Results Successful multidisciplinary care in an integrated, oncological department needs broad support inside the hospital and a well-defined organisational plan. PMID:16896411

Feminist Science in the Case of a Reform-Minded Biology Department

NASA Astrophysics Data System (ADS)

Buxton, Cory A.

This study explores how science and scientists were produced and reproduced within the setting of a university biology department. Building on recent work in the anthropology of education and feminist science studies, the author explored the reflexive questions of whether increased women's representation in science changed science practice and whether changing science practice increased women's representation insolence. The author examined both the contextual and constitutive values of science as they were negotiated and played out in the training of scientists in this setting. The author found some ways in which these values were shifting as more women assumed places of leadership in the department. At the same time, the author identified other ways in which the presence of women did not seem to cause the types of changes that feminist science studies have hypothesized. These findings can be interpreted through the anthropological perspective of practice theory, in which individuals are seen as exerting agency both within and against institutional structures.

Internationalizing Educational Leadership: How a University Department Jumps the Curve from Local to International

ERIC Educational Resources Information Center

Bogotch, Ira; Maslin-Ostrowski, Patricia

2010-01-01

Purpose: This study describes how an educational leadership department transformed its regional identity and localized practices over a ten-year period (1997-2007) to become internationalized in terms of research, teaching, and service. Research Methods/Approach (e.g., Setting, Participants, Research Design, Data Collection and Analysis): A basic…

Evaluation, modification and validation of a set of asthma illustrations in children with chronic asthma in the emergency department.

PubMed

Tulloch, Joanie; Irwin, Danica; Pascuet, Elena; Vaillancourt, Régis

2012-01-01

To test, modify and validate a set of illustrations depicting different levels of asthma control and common asthma triggers in pediatric patients (and⁄or their parents) with chronic asthma who presented to the emergency department at the Children's Hospital of Eastern Ontario, Ottawa, Ontario. Semistructured interviews using guessability and translucency questionnaires tested the comprehensibility of 15 illustrations depicting different levels of asthma control and common asthma triggers in children 10 to 17 years of age, and parents of children one to nine years of age who presented to the emergency department. Illustrations with an overall guessability score <80% and⁄or translucency median score <6, were reviewed by the study team and modified by the study's graphic designer. Modifications were made based on key concepts identified by study participants. A total of 80 patients were interviewed. Seven of the original 15 illustrations (47%) required modifications to obtain the prespecified guessability and translucency goals. The authors successfully developed, modified and validated a set of 15 illustrations representing different levels of asthma control and common asthma triggers. These illustrations will be incorporated into a child-friendly asthma action plan that enables the child to be involved in his or her asthma self-management care.

7 CFR 1778.13 - Set-aside.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Set-aside. 1778.13 Section 1778.13 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) EMERGENCY AND IMMINENT COMMUNITY WATER ASSISTANCE GRANTS § 1778.13 Set-aside. (a) At least 70...

Effective Communication between Students and Lecturers: Improving Student-Led Communication in Educational Settings

ERIC Educational Resources Information Center

Merdian, Hannah Lena; Warrior, John Kyle

2015-01-01

This study investigated students' communication preferences in educational settings, resulting in an empirical model of effective communication between students and lecturers. Students from a psychology department at a UK university were asked about their preferred communication tool for academic purposes, including social networking, emails,…

Implementing Set Based Design into Department of Defense Acquisition

DTIC Science & Technology

2016-12-01

challenges for the DOD. This report identifies the original SBD principles and characteristics based on Toyota Motor Corporation’s Set Based Concurrent...Engineering Model. Additionally, the team reviewed DOD case studies that implemented SBD. The SBD principles , along with the common themes from the...perennial challenges for the DOD. This report identifies the original SBD principles and characteristics based on Toyota Motor Corporation’s Set

How English Language Head of Departments Perceive Their Roles in Teacher Development and Teacher Efficacy: A Study of Eight Jamaican Schools

ERIC Educational Resources Information Center

Wilmot, Ann-Marie

2017-01-01

This qualitative study sought to gain deeper insights into how English Language Heads of Department (H.O.D.) perceive their roles in teacher development and efficacy, what leadership styles inform their role enactment and the different skill sets and beliefs they take to their H.O.D. roles. The population was limited to selected schools in central…

Assessing the physical service setting: a look at emergency departments.

PubMed

Steinke, Claudia

2015-01-01

To determine the attributes of the physical setting that are important for developing a positive service climate within emergency departments and to validate a measure for assessing physical service design. The design of the physical setting is an important and contributing factor for creating a service climate in organizations. Service climate is defined as employee perceptions of the practices, procedures, and behaviors that get rewarded, supported, and expected with regard to customer service and customer service quality. There has been research conducted which identifies antecedents within organization that promotes a positive service climate which in turn creates service-oriented behaviors by employees toward clients. The antecedent of the physical setting and its impact on perceptions of service climate has been less commonly explored. Using the concept of the physical service setting (which may be defined as aspects of the physical, built environment that facilitate the delivery of quality service), attributes of the physical setting and their relationship with service climate were explored by means of a quantitative paper survey distributed to emergency nurses (n = 180) throughout a province in Canada. The results highlight the validity and reliability of six scales measuring the physical setting and its relation to service. Respondents gave low ratings to the physical setting of their departments, in addition to low ratings of service climate. Respondents feel that the design of the physical setting in the emergency departments where they work is not conducive to providing quality service to clients. Certain attributes of the physical setting were found to be significant in influencing perceptions of service climate, hence service quality, within the emergency department setting. © The Author(s) 2015.

Emergency department-based interventions for women suffering domestic abuse: a critical literature review.

PubMed

Ansari, Sereena; Boyle, Adrian

2017-02-01

Domestic abuse represents a serious public health and human rights concern. Interventions to reduce the risk of abuse include staff training and standardized documentation improving detection and adherence to referral pathways. Interventional studies have been conducted in primary care, maternity and outpatient settings. Women disclosing abuse in emergency departments differ from women attending other healthcare settings, and it is unclear whether these interventions can be transferred to the emergency care setting. This review examines interventional studies to evaluate the effectiveness of emergency department-based interventions in reducing domestic abuse-related morbidity. Medline, EMBASE, CINAHL, PsycINFO and Cochrane Library were searched, according to prespecified selection criteria. Study quality was assessed using the Jadad scale. Of 273 search results, nine were eligible for review. Interventions involving staff training demonstrated benefits in subjective measures, such as staff knowledge regarding abuse, but no changes in clinical practice, based on detection and referral rates. When staff training was implemented in conjunction with supporting system changes - for example, standardized documentation for assessment and referral - clinically relevant improvements were noted. Interventions centred around staff training are insufficient to bring about improvements in the management and, thus, outcome of patients suffering abuse. Instead, system changes, such as standardized documentation and referral pathways, supported by training, may bring about beneficial changes. It remains uncertain whether surrogate outcomes employed by most studies translate to changes in abuse-related morbidity: the ultimate goal.

Hypoalbuminemia, Low Base Excess Values, and Tachypnea Predict 28-Day Mortality in Severe Sepsis and Septic Shock Patients in the Emergency Department.

PubMed

Seo, Min Ho; Choa, Minhong; You, Je Sung; Lee, Hye Sun; Hong, Jung Hwa; Park, Yoo Seok; Chung, Sung Phil; Park, Incheol

2016-11-01

The objective of this study was to develop a new nomogram that can predict 28-day mortality in severe sepsis and/or septic shock patients using a combination of several biomarkers that are inexpensive and readily available in most emergency departments, with and without scoring systems. We enrolled 561 patients who were admitted to an emergency department (ED) and received early goal-directed therapy for severe sepsis or septic shock. We collected demographic data, initial vital signs, and laboratory data sampled at the time of ED admission. Patients were randomly assigned to a training set or validation set. For the training set, we generated models using independent variables associated with 28-day mortality by multivariate analysis, and developed a new nomogram for the prediction of 28-day mortality. Thereafter, the diagnostic accuracy of the nomogram was tested using the validation set. The prediction model that included albumin, base excess, and respiratory rate demonstrated the largest area under the receiver operating characteristic curve (AUC) value of 0.8173 [95% confidence interval (CI), 0.7605-0.8741]. The logistic analysis revealed that a conventional scoring system was not associated with 28-day mortality. In the validation set, the discrimination of a newly developed nomogram was also good, with an AUC value of 0.7537 (95% CI, 0.6563-0.8512). Our new nomogram is valuable in predicting the 28-day mortality of patients with severe sepsis and/or septic shock in the emergency department. Moreover, our readily available nomogram is superior to conventional scoring systems in predicting mortality.

Emergency department care for trauma patients in settings of active conflict versus urban violence: all of the same calibre?

PubMed

Valles, Pola; Van den Bergh, Rafael; van den Boogaard, Wilma; Tayler-Smith, Katherine; Gayraud, Olivia; Mammozai, Bashir Ahmad; Nasim, Masood; Cheréstal, Sophia; Majuste, Alberta; Charles, James Philippe; Trelles, Miguel

2016-11-01

Trauma is a leading cause of death and represents a major problem in developing countries where access to good quality emergency care is limited. Médecins Sans Frontières delivered a standard package of care in two trauma emergency departments (EDs) in different violence settings: Kunduz, Afghanistan, and Tabarre, Haiti. This study aims to assess whether this standard package resulted in similar performance in these very different contexts. A cross-sectional study using routine programme data, comparing patient characteristics and outcomes in two EDs over the course of 2014. 31 158 patients presented to the EDs: 22 076 in Kunduz and 9082 in Tabarre. Patient characteristics, such as delay in presentation (29.6% over 24 h in Kunduz, compared to 8.4% in Tabarre), triage score, and morbidity pattern differed significantly between settings. Nevertheless, both EDs showed an excellent performance, demonstrating low proportions of mortality (0.1% for both settings) and left without being seen (1.3% for both settings), and acceptable triage performance. Physicians' maximum working capacity was exceeded in both centres, and mainly during rush hours. This study supports for the first time the plausibility of using the same ED package in different settings. Mapping of patient attendance is essential for planning of human resources needs. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

77 FR 69548 - Price for the 2012 Limited Edition Silver Proof SetTM

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-19

... DEPARTMENT OF THE TREASURY United States Mint Price for the 2012 Limited Edition Silver Proof Set TM AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $149.95 for the 2012 Limited Edition Silver Proof Set TM . FOR FURTHER...

76 FR 67799 - Pricing for the American Eagle 25th Anniversary Silver Coin Set

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

... DEPARTMENT OF THE TREASURY United States Mint Pricing for the American Eagle 25th Anniversary Silver Coin Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the American Eagle 25th Anniversary Silver Coin Set. The...

77 FR 42365 - Price for the Making American History Coin and Currency Set

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-18

... DEPARTMENT OF THE TREASURY United States Mint Price for the Making American History Coin and Currency Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $72.95 for the Making American History Coin and Currency Set. FOR...

78 FR 70414 - Pricing for the 2013 Coin and Chronicles Set-Theodore Roosevelt

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-25

... DEPARTMENT OF THE TREASURY United States Mint Pricing for the 2013 Coin and Chronicles Set--Theodore Roosevelt AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $57.95 for the 2013 Coin and Chronicles Set--Theodore...

Safety of Rural Nursing Home-to-Emergency Department Transfers: Improving Communication and Patient Information Sharing Across Settings.

PubMed

Tupper, Judith B; Gray, Carolyn E; Pearson, Karen B; Coburn, Andrew F

2015-01-01

The "siloed" approach to healthcare delivery contributes to communication challenges and to potential patient harm when patients transfer between settings. This article reports on the evaluation of a demonstration in 10 rural communities to improve the safety of nursing facility (NF) transfers to hospital emergency departments by forming interprofessional teams of hospital, emergency medical service, and NF staff to develop and implement tools and protocols for standardizing critical interfacility communication pathways and information sharing. We worked with each of the 10 teams to document current communication processes and information sharing tools and to design, implement, and evaluate strategies/tools to increase effective communication and sharing of patient information across settings. A mixed methods approach was used to evaluate changes from baseline in documentation of patient information shared across settings during the transfer process. Study findings showed significant improvement in key areas across the three settings, including infection status and baseline mental functioning. Improvement strategies and performance varied across settings; however, accurate and consistent information sharing of advance directives and medication lists remains a challenge. Study results demonstrate that with neutral facilitation and technical support, collaborative interfacility teams can assess and effectively address communication and information sharing problems that threaten patient safety.

The Feasibility of Utilizing a Comic for Education in the Emergency Department Setting.

PubMed

Hanson, Aaron; Drendel, Amy L; Ashwal, Gary; Thomas, Alex

2017-05-01

The objective of this study was to determine the feasibility of a comic education module in the Emergency Department setting. A convenience sample of 50 injured children and their caregivers were enrolled. The comic was found to be likeable, easy to read, and provided important information to both children and their caregivers. Total time to read the comic was three minutes (SD 1.4, range 1.4-7.1). Most children (60%) read the comic independently, including all children over age 14 years. At 72-hour phone follow-up, 86% of caregivers had accurate recall of all three comic teaching points. This innovative comic educational module is feasible for use for children ages 4-18 years in the Emergency Department. Though this comic was intended to educate children, caregivers recalled all three teaching points 72 hours after discharge.

78 FR 24816 - Pricing for the 2013 American Eagle West Point Two-Coin Silver Set

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... DEPARTMENT OF THE TREASURY United States Mint Pricing for the 2013 American Eagle West Point Two-Coin Silver Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the 2013 American Eagle West Point Two-Coin Silver Set. The...

75 FR 17832 - Pricing for 2010 Lincoln One-Cent Coin Two-Roll Set

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-07

... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2010 Lincoln One-Cent Coin Two-Roll Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing the price of the 2010 Lincoln One-Cent Coin Two-Roll Set. The 2010 Lincoln One-Cent...

32 CFR 644.512 - DA-SBA joint set-aside determination.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true DA-SBA joint set-aside determination. 644.512 Section 644.512 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL... Stone § 644.512 DA-SBA joint set-aside determination. Section 15 of the Small Business Act (15 U.S.C...

Evaluation, modification and validation of a set of asthma illustrations in children with chronic asthma in the emergency department

PubMed Central

Tulloch, Joanie; Vaillancourt, Régis; Irwin, Danica; Pascuet, Elena

2012-01-01

OBJECTIVES: To test, modify and validate a set of illustrations depicting different levels of asthma control and common asthma triggers in pediatric patients (and/or their parents) with chronic asthma who presented to the emergency department at the Children’s Hospital of Eastern Ontario, Ottawa, Ontario. METHODS: Semistructured interviews using guessability and translucency questionnaires tested the comprehensibility of 15 illustrations depicting different levels of asthma control and common asthma triggers in children 10 to 17 years of age, and parents of children one to nine years of age who presented to the emergency department. Illustrations with an overall guessability score <80% and/or translucency median score <6, were reviewed by the study team and modified by the study’s graphic designer. Modifications were made based on key concepts identified by study participants. RESULTS: A total of 80 patients were interviewed. Seven of the original 15 illustrations (47%) required modifications to obtain the prespecified guessability and translucency goals. CONCLUSION: The authors successfully developed, modified and validated a set of 15 illustrations representing different levels of asthma control and common asthma triggers. PRACTICE IMPLICATIONS: These illustrations will be incorporated into a child-friendly asthma action plan that enables the child to be involved in his or her asthma self-management care. PMID:22332128

78 FR 38452 - Price for the 2013 Girl Scouts of the USA Young Collector Set

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-26

... DEPARTMENT OF THE TREASURY United States Mint Price for the 2013 Girl Scouts of the USA Young Collector Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $54.95 for the 2013 Girl Scouts of the USA Young Collector Set. FOR...

Community views and public health priority setting: how do health department priorities, community views, and health indicator data compare?

PubMed

Earle-Richardson, Giulia; Scribani, Melissa; Wyckoff, Lynae; Strogatz, David; May, John; Jenkins, Paul

2015-01-01

New York, like many other states, provides county-level health statistics for use in local priority settings but does not provide any data on public views about priority health issues. This study assessed whether health department priorities are notably different from community concerns about health, and how both groups' priorities compare with local health statistics. Data from a 2009 rural survey on community health concerns were compared to priorities named by the seven area county health departments, and to local health indicator data. Health care/insurance cost (60%), obesity (53%), and prescription cost (41%) were leading community concerns, regardless of age, education, sex, or Internet in the home. Six of seven county health departments selected access to quality health care (which includes health care/insurance cost) as a leading public health priority, but only three identified obesity. The following leading local health issues were suggested by health indicators: Physical activity and nutrition, Smoking, and Unintentional injury. Health departments diverged from community priorities, from health indicator data, and from one another in choosing priorities. Adding a question about community health priorities to existing state telephone surveys on health behavior and lifestyle would provide an important tool to local health departments. © 2014 Society for Public Health Education.

March toward Excellence: School Success and Minority Student Achievement in Department of Defense Schools. A Report to the National Education Goals Panel. Lessons from the States.

ERIC Educational Resources Information Center

Smrekar, Claire; Guthrie, James W.; Owens, Debra E.; Sims, Pearl G.

This study examined how Department of Defense (DoD) schools have attained high achievement levels among all students, emphasizing Hispanics and African Americans. Researchers investigated organizational and governmental structures linking the daily operations of DoD schools and districts to policy-setting authorities; the nature and quality of…

Comprehensive shear wave velocity study in the Popular Bluff Area, Southeast Missouri.

DOT National Transportation Integrated Search

2005-04-30

The University of Missouri-Rolla in collaboration with the Missouri Department of Transportation acquired : multiple geophysical, geotechnical and borehole data sets in the Poplar Bluff study area. The primary objective : was to evaluate the utility ...

THE MIXED EVIDENCE FOR BRIEF INTERVENTION IN EMERGENCY DEPARTMENTS, TRAUMA CARE CENTERS AND INPATIENT HOSPITAL SETTINGS: WHAT SHOULD WE DO?

PubMed Central

Field, Craig Andrew; Baird, Janette; Saitz, Richard; Caetano, Raul; Monti, Peter M.

2010-01-01

The purpose of this review is to provide a broad overview of the status of brief intervention in the emergency department, trauma center and inpatient hospital setting. This review is based on a symposia presented at the 2009 annual conference of the Research Society on Alcoholism (Baird et al., 2009; Field, et al., 2009; Monti et al., 2009; Saitz et al., 2009). While the general efficacy of brief alcohol interventions in these settings has been recognized, the evidence is increasingly mixed. Herein we discuss possible confounding factors; including the inconsistencies in interventions provided, differences in target population, study design and assessment procedures. Recent studies investigating potential moderators of treatment outcomes suggest that a more sophisticated approach to evaluating the effectiveness of brief interventions across varying patient populations is needed in order to further understand its effectiveness. Current dissemination efforts represent a significant advance in broadening the base of treatment for alcohol problems by providing an evidenced based intervention in health care settings and should not be curtailed. However, additional research is required to enhance treatment outcomes, refine current practice guidelines and continue to bridge the gap between science and practice. Given the current state of research, a multi-setting clinical trial is recommended to account for potential contextual differences while controlling for study design. PMID:20860610

23 CFR 771.101 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... regulations set forth all FHWA, FTA, and Department of Transportation (DOT) requirements under NEPA for the processing of highway and public transportation projects. This regulation also sets forth procedures to... HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RIGHT-OF-WAY AND ENVIRONMENT ENVIRONMENTAL IMPACT AND...

Career and Family Aspirations of Female Athletic Trainers Employed in the National Collegiate Athletic Association Division I Setting

PubMed Central

Mazerolle, Stephanie M.; Eason, Christianne M.; Ferraro, Elizabeth M.; Goodman, Ashley

2015-01-01

Context: Female athletic trainers (ATs) tend to depart the profession of athletic training after the age of 30. Factors influencing departure are theoretical. Professional demands, particularly at the collegiate level, have also been at the forefront of anecdotal discussion on departure factors. Objective: To understand the career and family intentions of female ATs employed in the collegiate setting. Design: Qualitative study. Setting: National Collegiate Athletic Association Division I. Patients or Other Participants: Twenty-seven female ATs (single = 14, married with no children = 6, married with children = 7) employed in the National Collegiate Athletic Association Division I setting. Data Collection and Analysis: All female ATs responded to a series of open-ended questions via reflective journaling. Data were analyzed via a general inductive approach. Trustworthiness was established by peer review, member interpretive review, and multiple-analyst triangulation. Results: Our participants indicated a strong desire to focus on family or to start a family as part of their personal aspirations. Professionally, many female ATs were unsure of their longevity within the Division I collegiate setting or even the profession itself, with 2 main themes emerging as factors influencing decisions to depart: family planning persistence and family planning departure. Six female ATs planned to depart the profession entirely because of conflicts with motherhood and the role of the AT. Only 3 female ATs indicated a professional goal of persisting at the Division I setting regardless of their family or marital status, citing their ability to maintain work-life balance because of support networks. The remaining 17 female ATs planned to make a setting change to balance the roles of motherhood and AT because the Division I setting was not conducive to parenting. Conclusions: Our results substantiate those of previous researchers, which indicate the Division I setting can be problematic for female ATs and stimulate departure from the setting and even the profession. PMID:25329349

75 FR 31749 - International Standard-Setting Activities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-04

... DEPARTMENT OF AGRICULTURE Food Safety and Inspection Service [Docket No. FSIS-2009-0033] International Standard-Setting Activities AGENCY: Office of Food Safety, USDA. ACTION: Notice. SUMMARY: This..., and hand- or courier-delivered items: Send to Docket Clerk, U.S. Department of Agriculture, Food...

The Use of an Antecedent-Based Intervention to Decrease Stereotypic Behavior in a General Education Classroom: A Case Study

ERIC Educational Resources Information Center

Conroy, Maureen A.; Asmus, Jennifer M.; Sellers, Jennifer A.; Ladwig, Crystal N.

2005-01-01

The incidence of children identified as having autism spectrum disorders (ASD) is increasing (U.S. Department of Education, Office of Special Education Programs, 2003). Many of these children are enrolled in general education settings, posing an ever-growing challenge for the teachers in those settings. There is a critical need to develop…

Quest for business intelligence in health care.

PubMed

Van De Graaff, Joe; Cameron, Austin

2013-02-01

In an era of reform, providers are examining more forward-thinking business intelligence strategies, according to a recent study. Enterprise business intelligence tool sets offer a breadth of design and functionality that often are capable of serving the enterprise. One limitation of broader tool sets is that they may lack needed application-specific functionality or prebuilt healthcare content for a specific department.

Development of a set of activities to evaluate the arm and hand function in children with obstetric brachial plexus lesion.

PubMed

Boeschoten, K H; Folmer, K B; van der Lee, J H; Nollet, F

2007-02-01

To develop an observational instrument that can be used to evaluate the quality of arm and hand skills in daily functional activities in children with obstetric brachial plexus lesion (OBPL). A set of functional activities was constructed and standardized, and the intra-observer reliability of the assessment of this set of activities was studied. Department of Occupational Therapy and Department of Rehabilitation Medicine, VU University Medical Centre. Twenty-six children with OBPL in the age range of 4 -6 years. The children were asked to perform 47 bimanual activities, which were recorded on videotape. The videotapes were scored twice by the same occupational therapist. The percentage of agreement in scoring 'hand-use', 'speed' and 'assistance' was over 80% for a substantial number of activities, indicating a strong agreement. However, in scoring 'deviations in movements and body posture' the percentage of agreement was insufficient in most activities. This set of activities has good potential for assessment of the performance of functional activities in children with OBPL. This study, however, showed a number of difficulties in observing and scoring the activities that have to be considered when developing a standardized video observation.

Injury in China: a systematic review of injury surveillance studies conducted in Chinese hospital emergency departments

PubMed Central

2011-01-01

Background Injuries represent a significant and growing public health concern in China. This Review was conducted to document the characteristics of injured patients presenting to the emergency department of Chinese hospitals and to assess of the nature of information collected and reported in published surveillance studies. Methods A systematic search of MEDLINE and China Academic Journals supplemented with a hand search of journals was performed. Studies published in the period 1997 to 2007 were included and research published in Chinese was the focus. Search terms included emergency, injury, medical care. Results Of the 268 studies identified, 13 were injury surveillance studies set in the emergency department. Nine were collaborative studies of which eight were prospective studies. Of the five single centre studies only one was of a prospective design. Transport, falls and industrial injuries were common mechanisms of injury. Study strengths were large patient sample sizes and for the collaborative studies a large number of participating hospitals. There was however limited use of internationally recognised injury classification and severity coding indices. Conclusion Despite the limited number of studies identified, the scope of each highlights the willingness and the capacity to conduct surveillance studies in the emergency department. This Review highlights the need for the adoption of standardized injury coding indices in the collection and reporting of patient health data. While high level injury surveillance systems focus on population-based priority setting, this Review demonstrates the need to establish an internationally comparable trauma registry that would permit monitoring of the trauma system and would by extension facilitate the optimal care of the injured patient through the development of informed quality assurance programs and the implementation of evidence-based health policy. PMID:22029774

34 CFR 300.117 - Nonacademic settings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 2 2010-07-01 2010-07-01 false Nonacademic settings. 300.117 Section 300.117 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION OF CHILDREN WITH...

5 CFR 9701.322 - Setting and adjusting rate ranges.

Code of Federal Regulations, 2010 CFR

2010-01-01

... MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate Ranges... operational reasons, these adjustments will become effective on or about the date of the annual General...

More than Just a Good Book: Employing U.S. Department of Education Guidelines to Teach Character Education Using Literature

ERIC Educational Resources Information Center

Besson-Martilotta, Suzy F.

2013-01-01

The purpose of this research study, which was conducted as a qualitative content analysis, was to discover to what extent children's literature from a popular anthology could be used to teach the tenets of character education according to U.S. Department of Education (2005) guidelines in a pre-Kindergarten through second grade setting. A team…

Career and family aspirations of female athletic trainers employed in the National Collegiate Athletic Association Division I setting.

PubMed

Mazerolle, Stephanie M; Eason, Christianne M; Ferraro, Elizabeth M; Goodman, Ashley

2015-02-01

Female athletic trainers (ATs) tend to depart the profession of athletic training after the age of 30. Factors influencing departure are theoretical. Professional demands, particularly at the collegiate level, have also been at the forefront of anecdotal discussion on departure factors. To understand the career and family intentions of female ATs employed in the collegiate setting. Qualitative study. National Collegiate Athletic Association Division I. Twenty-seven female ATs (single = 14, married with no children = 6, married with children = 7) employed in the National Collegiate Athletic Association Division I setting. All female ATs responded to a series of open-ended questions via reflective journaling. Data were analyzed via a general inductive approach. Trustworthiness was established by peer review, member interpretive review, and multiple-analyst triangulation. Our participants indicated a strong desire to focus on family or to start a family as part of their personal aspirations. Professionally, many female ATs were unsure of their longevity within the Division I collegiate setting or even the profession itself, with 2 main themes emerging as factors influencing decisions to depart: family planning persistence and family planning departure. Six female ATs planned to depart the profession entirely because of conflicts with motherhood and the role of the AT. Only 3 female ATs indicated a professional goal of persisting at the Division I setting regardless of their family or marital status, citing their ability to maintain work-life balance because of support networks. The remaining 17 female ATs planned to make a setting change to balance the roles of motherhood and AT because the Division I setting was not conducive to parenting. Our results substantiate those of previous researchers, which indicate the Division I setting can be problematic for female ATs and stimulate departure from the setting and even the profession.

78 FR 4147 - Notice of Development of Set 26 Toxicological Profiles

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-18

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Toxic Substances and Disease Registry [ATSDR-277] Notice of Development of Set 26 Toxicological Profiles AGENCY: Agency for Toxic Substances and Disease Registry (ATSDR), Department of Health and Human Services (HHS). ACTION: Notice. SUMMARY: This...

77 FR 6800 - Notice of Development of Set 25 Toxicological Profiles

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Toxic Substances and Disease Registry [ATSDR-273] Notice of Development of Set 25 Toxicological Profiles AGENCY: Agency for Toxic Substances and Disease Registry (ATSDR), Department of Health and Human Services (DHHS). ACTION: Notice. SUMMARY: This...

Creating an automated trigger for sepsis clinical decision support at emergency department triage using machine learning

PubMed Central

Halpern, Yoni; Jernite, Yacine; Shapiro, Nathan I.; Nathanson, Larry A.

2017-01-01

Objective To demonstrate the incremental benefit of using free text data in addition to vital sign and demographic data to identify patients with suspected infection in the emergency department. Methods This was a retrospective, observational cohort study performed at a tertiary academic teaching hospital. All consecutive ED patient visits between 12/17/08 and 2/17/13 were included. No patients were excluded. The primary outcome measure was infection diagnosed in the emergency department defined as a patient having an infection related ED ICD-9-CM discharge diagnosis. Patients were randomly allocated to train (64%), validate (20%), and test (16%) data sets. After preprocessing the free text using bigram and negation detection, we built four models to predict infection, incrementally adding vital signs, chief complaint, and free text nursing assessment. We used two different methods to represent free text: a bag of words model and a topic model. We then used a support vector machine to build the prediction model. We calculated the area under the receiver operating characteristic curve to compare the discriminatory power of each model. Results A total of 230,936 patient visits were included in the study. Approximately 14% of patients had the primary outcome of diagnosed infection. The area under the ROC curve (AUC) for the vitals model, which used only vital signs and demographic data, was 0.67 for the training data set, 0.67 for the validation data set, and 0.67 (95% CI 0.65–0.69) for the test data set. The AUC for the chief complaint model which also included demographic and vital sign data was 0.84 for the training data set, 0.83 for the validation data set, and 0.83 (95% CI 0.81–0.84) for the test data set. The best performing methods made use of all of the free text. In particular, the AUC for the bag-of-words model was 0.89 for training data set, 0.86 for the validation data set, and 0.86 (95% CI 0.85–0.87) for the test data set. The AUC for the topic model was 0.86 for the training data set, 0.86 for the validation data set, and 0.85 (95% CI 0.84–0.86) for the test data set. Conclusion Compared to previous work that only used structured data such as vital signs and demographic information, utilizing free text drastically improves the discriminatory ability (increase in AUC from 0.67 to 0.86) of identifying infection. PMID:28384212

Creating an automated trigger for sepsis clinical decision support at emergency department triage using machine learning.

PubMed

Horng, Steven; Sontag, David A; Halpern, Yoni; Jernite, Yacine; Shapiro, Nathan I; Nathanson, Larry A

2017-01-01

To demonstrate the incremental benefit of using free text data in addition to vital sign and demographic data to identify patients with suspected infection in the emergency department. This was a retrospective, observational cohort study performed at a tertiary academic teaching hospital. All consecutive ED patient visits between 12/17/08 and 2/17/13 were included. No patients were excluded. The primary outcome measure was infection diagnosed in the emergency department defined as a patient having an infection related ED ICD-9-CM discharge diagnosis. Patients were randomly allocated to train (64%), validate (20%), and test (16%) data sets. After preprocessing the free text using bigram and negation detection, we built four models to predict infection, incrementally adding vital signs, chief complaint, and free text nursing assessment. We used two different methods to represent free text: a bag of words model and a topic model. We then used a support vector machine to build the prediction model. We calculated the area under the receiver operating characteristic curve to compare the discriminatory power of each model. A total of 230,936 patient visits were included in the study. Approximately 14% of patients had the primary outcome of diagnosed infection. The area under the ROC curve (AUC) for the vitals model, which used only vital signs and demographic data, was 0.67 for the training data set, 0.67 for the validation data set, and 0.67 (95% CI 0.65-0.69) for the test data set. The AUC for the chief complaint model which also included demographic and vital sign data was 0.84 for the training data set, 0.83 for the validation data set, and 0.83 (95% CI 0.81-0.84) for the test data set. The best performing methods made use of all of the free text. In particular, the AUC for the bag-of-words model was 0.89 for training data set, 0.86 for the validation data set, and 0.86 (95% CI 0.85-0.87) for the test data set. The AUC for the topic model was 0.86 for the training data set, 0.86 for the validation data set, and 0.85 (95% CI 0.84-0.86) for the test data set. Compared to previous work that only used structured data such as vital signs and demographic information, utilizing free text drastically improves the discriminatory ability (increase in AUC from 0.67 to 0.86) of identifying infection.

[Investigation of the burnout syndrome among the employees of the Department of Emergency Medicine at the University of Szeged].

PubMed

Hompoth, Emőke Adrienn; Töreki, Annamária; Pető, Zoltán

2018-01-01

Burnout has been described as a growing problem amongst healthcare workers. Emergency department staffs experience the burden of stress day by day, yet only a few studies have examined their burnout. In this study we wanted to investigate the burnout and its relations to other variables amongst the employees of the Department of Emergency Medicine in Szeged. Cross-sectional design utilizing a self-administered questionnaire was used to collect data from the staff of the Department. Burnout was measured using the Maslach Burnout Inventory. Burnout is considerably prevalent among the workers of the Emergency Department, especially nurses and physicians. The study found negative relation between burnout and age, number of children, number of years in the healthcare system, number of physical symptoms, social support and psychological immune system. Being single was a risk factor. The risks and protective factors found to be associated with burnout in this study might help to set up institutional prevention and intervention strategies. Orv Hetil. 2018; 159(3): 113-118.

A Mission Counterstatement

ERIC Educational Resources Information Center

Berger, James

2008-01-01

Like many other colleges and universities, Hofstra University now requires each department to create a "mission statement." Then, on the basis of this statement, a set of more specific curricular goals and objectives have to be created and, finally, a set of quantitative, behavioral criteria by which to assess the department's efforts. This new…

Optimized probability sampling of study sites to improve generalizability in a multisite intervention trial.

PubMed

Kraschnewski, Jennifer L; Keyserling, Thomas C; Bangdiwala, Shrikant I; Gizlice, Ziya; Garcia, Beverly A; Johnston, Larry F; Gustafson, Alison; Petrovic, Lindsay; Glasgow, Russell E; Samuel-Hodge, Carmen D

2010-01-01

Studies of type 2 translation, the adaption of evidence-based interventions to real-world settings, should include representative study sites and staff to improve external validity. Sites for such studies are, however, often selected by convenience sampling, which limits generalizability. We used an optimized probability sampling protocol to select an unbiased, representative sample of study sites to prepare for a randomized trial of a weight loss intervention. We invited North Carolina health departments within 200 miles of the research center to participate (N = 81). Of the 43 health departments that were eligible, 30 were interested in participating. To select a representative and feasible sample of 6 health departments that met inclusion criteria, we generated all combinations of 6 from the 30 health departments that were eligible and interested. From the subset of combinations that met inclusion criteria, we selected 1 at random. Of 593,775 possible combinations of 6 counties, 15,177 (3%) met inclusion criteria. Sites in the selected subset were similar to all eligible sites in terms of health department characteristics and county demographics. Optimized probability sampling improved generalizability by ensuring an unbiased and representative sample of study sites.

Distributed heterogeneous inspecting system and its middleware-based solution.

PubMed

Huang, Li-can; Wu, Zhao-hui; Pan, Yun-he

2003-01-01

There are many cases when an organization needs to monitor the data and operations of its supervised departments, especially those departments which are not owned by this organization and are managed by their own information systems. Distributed Heterogeneous Inspecting System (DHIS) is the system an organization uses to monitor its supervised departments by inspecting their information systems. In DHIS, the inspected systems are generally distributed, heterogeneous, and constructed by different companies. DHIS has three key processes-abstracting core data sets and core operation sets, collecting these sets, and inspecting these collected sets. In this paper, we present the concept and mathematical definition of DHIS, a metadata method for solving the interoperability, a security strategy for data transferring, and a middleware-based solution of DHIS. We also describe an example of the inspecting system at WENZHOU custom.

Presentation of a Swedish study program concerning recruitment, selection and training of student air traffic controllers: The MRU project phase 1

NASA Technical Reports Server (NTRS)

Haglund, Rune

1994-01-01

The Director of the ANS Department has set up an objective for the efficiency of screening and training procedures for air traffic controller students which implies that all students admitted 'shall be considered to have the qualification for - and be given the means of - completing the training'. As a consequence, a study project has been established. It is run by the ANS Department with members from the Swedish CAA, in close cooperation with Uppsala University.

Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs.

PubMed

Cowell, Alexander J; Dowd, William N; Mills, Michael J; Hinde, Jesse M; Bray, Jeremy W

2017-02-01

To examine the conditions under which Screening, Brief Intervention and Referral to Treatment (SBIRT) programs can be sustained by health insurance payments. A mathematical model was used to estimate the number of patients needed for revenues to exceed costs. Three medical settings in the United States were examined: in-patient, out-patient and emergency department. Components of SBIRT were delivered by combinations of health-care practitioners (generalists) and behavioral health specialists. Practitioners in seven SBIRT programs who received grants from the US Substance Abuse and Mental Health Services Administration (SAMHSA). Program costs and revenues were measured using data from grantees. Patient flows were measured from administrative data and adjusted with prevalence and screening estimates from the literature. SBIRT can be sustained through health insurance reimbursement in out-patient and emergency department settings in most staffing mixes. To sustain SBIRT in in-patient programs, a patient flow larger than the national average may be needed; if that flow is achieved, the range of screens required to maintain a surplus is narrow. Sensitivity analyses suggest that the results are very sensitive to changes in the proportion of insured patients. Screening, Brief Intervention and Referral to Treatment programs in the United States can be sustained by health insurance payments under a variety of staffing models. Screening, Brief Intervention and Referral to Treatment programs can be sustained only in an in-patient setting with above-average patient flow (more than 2500 screens). Screening, Brief Intervention and Referral to Treatment programs in out-patient and emergency department settings can be sustained with below-average patient flows (fewer than 125 000 out-patient visits and fewer than 27 000 emergency department visits). © 2017 Society for the Study of Addiction.

Using Experience-based Co-design with older patients, their families and staff to improve palliative care experiences in the Emergency Department: A reflective critique on the process and outcomes.

PubMed

Blackwell, Rebecca Wright Née; Lowton, Karen; Robert, Glenn; Grudzen, Corita; Grocott, Patricia

2017-03-01

Increasing use of emergency departments among older patients with palliative needs has led to the development of several service-level interventions intended to improve care quality. There is little evidence of patient and family involvement in developmental processes, and little is known about the experiences of - and preferences for - palliative care delivery in this setting. Participatory action research seeking to enable collaborative working between patients and staff should enhance the impact of local quality improvement work but has not been widely implemented in such a complex setting. To critique the feasibility of this methodology as a quality improvement intervention in complex healthcare settings, laying a foundation for future work. an Emergency Department in a large teaching hospital in the United Kingdom. Experience-based Co-design incorporating: 150h of nonparticipant observation; semi-structured interviews with 15 staff members about their experiences of palliative care delivery; 5 focus groups with 64 staff members to explore challenges in delivering palliative care; 10 filmed semi-structured interviews with palliative care patients or their family members; a co-design event involving staff, patients and family members. the study successfully identified quality improvement priorities leading to changes in Emergency Department-palliative care processes. Further outputs were the creation of a patient-family-staff experience training DVD to encourage reflective discussion and the identification and application of generic design principles for improving palliative care in the Emergency Department. There were benefits and challenges associated with using Experience-based Co-design in this setting. Benefits included the flexibility of the approach, the high levels of engagement and responsiveness of patients, families and staff, and the impact of using filmed narrative interviews to enhance the 'voice' of seldom heard patients and families. Challenges included high levels of staff turnover during the 19 month project, significant time constraints in the Emergency Department and the ability of older patients and their families to fully participate in the co-design process. Experience-based Co-design is a useful approach for encouraging collaborative working between vulnerable patients, family and staff in complex healthcare environments. The flexibility of the approach allows the specific needs of participants to be accounted for, enabling fuller engagement with those who typically may not be invited to contribute to quality improvement work. Recommendations for future studies in this and similar settings include testing the 'accelerated' form of the approach and experimenting with alternative ways of increasing involvement of patients/families in the co-design phase. Copyright © 2017 Elsevier Ltd. All rights reserved.

Adaptation of Screening, Brief Intervention, Referral to Treatment to Active Duty Military Personnel in an Emergency Department: Findings From a Formative Research Study.

PubMed

Holt, Megan; Reed, Mark; Woodruff, Susan I; DeMers, Gerard; Matteucci, Michael; Hurtado, Suzanne L

2017-07-01

The transient nature of military life coupled with environmental and psychosocial stressors increase the risk for alcohol misuse and abuse among active duty (AD) military service members and recent epidemiological studies demonstrate high rates of heavy drinking among AD personnel. Over the past decade, Department of Defense health care systems have observed increases in the utilization of substance use services among military personnel demobilizing from Operation Enduring Freedom and Operation Iraqi Freedom. Given the high rates of heavy drinking and increased use of substance use services in this population of AD personnel, the purpose of this study was to investigate how to best translate and implement an effective alcohol abuse prevention intervention tool (screening, brief intervention, and referral to treatment [SBIRT]) used in civilian populations to a military emergency department (ED) setting. We conducted focus groups with ED staff as well as short interviews with AD personnel at a Naval Medical Center in the southwestern United States to determine the suitability of SBIRT with military populations as well as how to best translate SBIRT to a military hospital setting. Participants expressed support for utilizing civilian health educators to conduct the SBIRT intervention; however, many were concerned with issues of confidentiality and were skeptical of whether AD would speak truthfully about alcohol consumption. Results of this formative research study clearly indicate the implementation and translation of SBIRT into a military medical setting require attention to issues related to confidentiality, the veracity of alcohol reporting, as well as use of civilians over AD military personnel to deliver the SBIRT intervention. Furthermore, most participants expressed support for the SBIRT model and felt it could be implemented, with caveats, into a military health care setting such as an ED. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

34 CFR 647.23 - How does the Secretary set the amount of a grant?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false How does the Secretary set the amount of a grant? 647.23 Section 647.23 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION RONALD E. MCNAIR POSTBACCALAUREATE ACHIEVEMENT...

78 FR 5245 - Pricing for New Product-America the Beautiful Quarters® Three-Roll Set

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... DEPARTMENT OF THE TREASURY United States Mint Pricing for New Product--America the Beautiful Quarters[supreg] Three-Roll Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing pricing for a new product, the America the Beautiful...

Epidemiology of Pediatric Convulsive Status Epilepticus With Fever in the Emergency Department: A Cohort Study of 381 Consecutive Cases.

PubMed

Hayakawa, Itaru; Miyama, Sahoko; Inoue, Nobuaki; Sakakibara, Hiroshi; Hataya, Hiroshi; Terakawa, Toshiro

2016-09-01

Pediatric convulsive status epilepticus with fever is common in the emergency setting but leads to severe neurological sequelae in some patients. To explore the epidemiology of convulsive status epilepticus with fever, a retrospective cohort covering all convulsive status epilepticus cases with fever seen in the emergency department of a tertiary care children's hospital were consecutively collected. Of the 381 consecutive cases gathered, 81.6% were due to prolonged febrile seizure, 6.6% to encephalopathy/encephalitis, 0.8% to meningitis, and 7.6% to epilepsy. In addition, seizures were significantly longer in encephalopathy/encephalitis cases than in prolonged febrile seizure cases (log rank test, P < .001). These results provide for the first time the pretest probability of final diagnoses in children with convulsive status epilepticus with fever in the emergency setting, and will help optimize the management of pediatric patients presenting to the emergency department with convulsive status epilepticus with fever. © The Author(s) 2016.

Improving operating room efficiency by applying bin-packing and portfolio techniques to surgical case scheduling.

PubMed

Van Houdenhoven, Mark; van Oostrum, Jeroen M; Hans, Erwin W; Wullink, Gerhard; Kazemier, Geert

2007-09-01

An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques. We applied advanced mathematical algorithms in combination with scenarios that model relaxation of various organizational barriers using prospectively collected data. The setting is the main inpatient OR department of a university hospital, which sets its surgical case schedules 2 wk in advance using a block planning method. The main outcome measures are the number of freed OR blocks and OR utilization. Lowering organizational barriers and applying mathematical algorithms can yield a 4.5% point increase in OR utilization (95% confidence interval 4.0%-5.0%). This is obtained by reducing the total required OR time. Efficient OR departments can further improve their efficiency. The paper shows that a radical cultural change that comprises the use of mathematical algorithms and lowering organizational barriers improves OR utilization.

Estimated financial savings associated with health information exchange and ambulatory care referral.

PubMed

Frisse, Mark E; Holmes, Rodney L

2007-12-01

Data and financial models based on an operational health information exchange suggest that health care delivery costs can be reduced by making clinical data available at the time of care in urban emergency departments. Reductions are the result of decreases in laboratory and radiographic tests, fewer admissions for observation, and lower overall emergency department costs. The likelihood of reducing these costs depends on the extent to which clinicians alter their workflow and take into account information available through the exchange from other institutions prior to initiating a treatment plan. Far greater savings can be realized in theory by identifying individuals presenting to emergency departments whose acute and long-term care needs are more suitably addressed at lower costs in ambulatory settings or medical homes. These alternative ambulatory settings can more effectively address the chronic care needs of those who receive most of their care in emergency departments. To support a shift from emergency room care to clinic care, health care information available through the health information exchange must be made available in both emergency department and ambulatory care settings. If practice workflow and patient behavior can be changed, a more effective and efficient care delivery system will be made possible through the secure exchange of clinical information across regional settings. These projections support the case for the financial viability of regional health information exchanges and motivate participation of hospitals and ambulatory care organizations-particularly in urban settings.

Patient satisfaction among Spanish-speaking patients in a public health setting.

PubMed

Welty, Elisabeth; Yeager, Valerie A; Ouimet, Claude; Menachemi, Nir

2012-01-01

Despite the growing literature on health care quality, few patient satisfaction studies have focused upon the public health setting; where many Hispanic patients receive care. The purpose of this study was to examine the differences in satisfaction between English and Spanish-speaking patients in a local health department clinical setting. We conducted a paper-based satisfaction survey of patients that visited any of the seven Jefferson County Department of Health primary care centers from March 19 to April 19, 2008. Using Chi-squared analyses we found 25% of the Spanish-speaking patients reported regularly having problems getting an appointment compared to 16.8% among English-speakers (p < .001). Results of logistic regression analyses indicated that, despite the availability of interpreters at all JCDH primary care centers, differences in satisfaction existed between Spanish and English speaking patients controlling for center location, purpose of visit, and time spent waiting. Specifically, Spanish speaking patients were more likely to report problems getting an appointment and less likely to report having their medical problems resolved when leaving their visit as compared to those who spoke English. Findings presented herein may provide insight regarding the quality of care received, specifically regarding patient satisfaction in the public health setting. © 2011 National Association for Healthcare Quality.

Identifying the turning point: using the transtheoretical model of change to map intimate partner violence disclosure in emergency department settings.

PubMed

Catallo, Cristina; Jack, Susan M; Ciliska, Donna; Macmillan, Harriet L

2012-01-01

Background. The transtheoretical model of change (TTM) was used as a framework to examine the steps that women took to disclose intimate partner violence (IPV) in urban emergency departments. Methods. Mapping methods portrayed the evolving nature of decisions that facilitated or inhibited disclosure. This paper is a secondary analysis of qualitative data from a mixed methods study that explored abused women's decision making process about IPV disclosure. Findings. Change maps were created for 19 participants with movement from the precontemplation to the maintenance stages of the model. Disclosure often occurred after a significant "turning point event" combined with a series of smaller events over a period of time. The significant life event often involved a weighing of options where participants considered the perceived risks against the potential benefits of disclosure. Conclusions. Abused women experienced intrusion from the chaotic nature of the emergency department. IPV disclosure was perceived as a positive experience when participants trusted the health care provider and felt control over their decisions to disclose IPV. Practice Implications. Nurses can use these findings to gauge the readiness of women to disclose IPV in the emergency department setting.

Identifying the Turning Point: Using the Transtheoretical Model of Change to Map Intimate Partner Violence Disclosure in Emergency Department Settings

PubMed Central

Catallo, Cristina; Jack, Susan M.; Ciliska, Donna; MacMillan, Harriet L.

2012-01-01

Background. The transtheoretical model of change (TTM) was used as a framework to examine the steps that women took to disclose intimate partner violence (IPV) in urban emergency departments. Methods. Mapping methods portrayed the evolving nature of decisions that facilitated or inhibited disclosure. This paper is a secondary analysis of qualitative data from a mixed methods study that explored abused women's decision making process about IPV disclosure. Findings. Change maps were created for 19 participants with movement from the precontemplation to the maintenance stages of the model. Disclosure often occurred after a significant “turning point event” combined with a series of smaller events over a period of time. The significant life event often involved a weighing of options where participants considered the perceived risks against the potential benefits of disclosure. Conclusions. Abused women experienced intrusion from the chaotic nature of the emergency department. IPV disclosure was perceived as a positive experience when participants trusted the health care provider and felt control over their decisions to disclose IPV. Practice Implications. Nurses can use these findings to gauge the readiness of women to disclose IPV in the emergency department setting. PMID:22792480

Setting the Record Straight: Strong Positive Impacts Found from the National Evaluation of Upward Bound. Re-Analysis Documents Significant Positive Impacts Masked by Errors in Flawed Contractor Reports

ERIC Educational Resources Information Center

Cahalan, Margaret; Goodwin, David

2014-01-01

In January 2009, in the last week of the Bush Administration, the U.S. Department of Education (ED), upon orders from the departing political appointee staff, published the final report in a long running National Evaluation of Upward Bound (UB). The study was conducted by the contractor, Mathematica Policy Research. After more than a year in…

Federal Criteria for Studies Grow

ERIC Educational Resources Information Center

Sparks, Sarah D.

2010-01-01

The author reports on the U.S. Department of Education's "What Works Clearinghouse" that goes beyond "gold standard" research and sets standards for accepting other types of studies. As part of the Institute of Education Sciences' push to make research more relevant to educators, the federal clearinghouse has devised standards by which it can…

Description of water-resource-related data compiled for Reno County, south-central Kansas

USGS Publications Warehouse

Hansen, C.V.

1993-01-01

Water-resource-related data for sites in Reno County, Kansas were compiled in cooperation with the Reno County Health Department as part of the Kansas Department of Health and Environment's Local Environmental Protection Program (LEPP). These data were entered into a relational data-base management system (RDBMS) to facilitate the spatial analysis required to meet the LEPP goals of developing plans for nonpoint-source management and for public- water-supply protection. The data in the RDBMS are organized into digital data sets. The data sets contain the water-resource-related data compiled by the U.S. Geological Survey for 958 wells; by the Kansas Department of Health and Environment for 3,936 wells; by the Kansas Department of Health and Environment for 51 wells, 18 public-water-supply distribution systems, and 7 streams; by the Kansas State Board of Agriculture for 643 wells and 23 streams or surface-water impoundments; and by well-drilling contractors and the Kansas Geological Survey for 96 wells. The data in these five data sets are available from the Reno County Health Department in Hutchinson, Kansas. (USGS)

78 FR 70414 - Pricing for the 2013 United States Mint Limited Edition Silver Proof SetTM

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-25

... DEPARTMENT OF THE TREASURY United States Mint Pricing for the 2013 United States Mint Limited Edition Silver Proof Set TM AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing a price of $139.95 for the 2013 United States Mint Limited...

77 FR 14600 - Pricing for 2012 Kennedy Half-Dollar Bags and Rolls, Bronze Medals, the First Spouse Bronze Medal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-12

... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2012 Kennedy Half-Dollar Bags and Rolls, Bronze Medals, the First Spouse Bronze Medal Set and the Birth Set AGENCY: United States Mint, Department of the Treasury. ACTION: Notice. SUMMARY: The United States Mint is announcing 2012 pricing for...

Impact of point-of-care ultrasound on clinical decision-making at an urban emergency department in Tanzania.

PubMed

Reynolds, Teri Ann; Amato, Stas; Kulola, Irene; Chen, Chuan-Jay Jeffrey; Mfinanga, Juma; Sawe, Hendry Robert

2018-01-01

Point of care ultrasound (PoCUS) is an efficient, inexpensive, safe, and portable imaging modality that can be particularly useful in resource-limited settings. However, its impact on clinical decision making in such settings has not been well studied. The objective of this study is to describe the utilization and impact of PoCUS on clinical decision making at an urban emergency department in Dar es Salaam, Tanzania. This was a prospective descriptive cross-sectional study of patients receiving PoCUS at Muhimbili National Hospital's Emergency Medical Department (MNH EMD). Data on PoCUS studies during a period of 10 months at MNH EMD was collected on consecutive patients during periods when research assistants were available. Data collected included patient age and sex, indications for ultrasound, findings, interpretations, and provider-reported diagnostic impression and disposition plan before and after PoCUS. Descriptive statistics, including medians and interquartile ranges, and counts and percentages, are reported. Pearson chi squared tests and p-values were used to evaluate categorical data for significant differences. PoCUS data was collected for 986 studies performed on 784 patients. Median patient age was 32 years; 56% of patients were male. Top indications for PoCUS included trauma, respiratory presentations, and abdomino-pelvic pain. The most frequent study types performed were eFAST, cardiac, and obstetric or gynaecologic studies. Overall, clinicians reported that the use of PoCUS changed either diagnostic impression or disposition plan in 29% of all cases. Rates of change in diagnostic impression or disposition plan increased to 45% in patients for whom more than one PoCUS study type was performed. In resource-limited emergency care settings, PoCUS can be utilized for a wide range of indications and has substantial impact on clinical decision making, especially when more than one study type is performed.

Self-assessment of public health essential services among Illinois local health department administrators.

PubMed

Polyak, Georgeen; Madamala, Kusuma; Vasireddy, Vamsi; Landrum, Laura B; Bassler, Elissa J; Stob, Nicole J

2010-01-01

This article uses data from a study commissioned by the Illinois Public Health Institute in 2007 as part of the Robert Wood Johnson Foundation Multistate Learning Collaborative Grant for exploring accreditation of health departments. Local health departments in Illinois were surveyed on their self-assessed performance in meeting a set of performance standards derived from the Illinois Practice Standards and the Operational Definition of a Functional Local Health Department. All state-certified local health departments were represented in the survey by the 81 respondents. The lowest scores were observed in the evaluate standard (evaluate programs and provide quality assurance in accordance with applicable professional and regulatory standards to ensure that programs are consistent with plans and policies, and provide feedback on inadequacies and changes needed to redirect programs and resources). The findings suggest that new approaches are needed to better integrate evaluation in local health departments beginning with training designed specifically for and informed by local health department administrators.

Stage 1 of the meaningful use incentive program for electronic health records: a study of readiness for change in ambulatory practice settings in one integrated delivery system.

PubMed

Shea, Christopher M; Reiter, Kristin L; Weaver, Mark A; McIntyre, Molly; Mose, Jason; Thornhill, Jonathan; Malone, Robb; Weiner, Bryan J

2014-12-14

Meaningful Use (MU) provides financial incentives for electronic health record (EHR) implementation. EHR implementation holds promise for improving healthcare delivery, but also requires substantial changes for providers and staff. Establishing readiness for these changes may be important for realizing potential EHR benefits. Our study assesses whether provider/staff perceptions about the appropriateness of MU and their departments' ability to support MU-related changes are associated with their reported readiness for MU-related changes. We surveyed providers and staff representing 47 ambulatory practices within an integrated delivery system. We assessed whether respondent's role and practice-setting type (primary versus specialty care) were associated with reported readiness for MU (i.e., willingness to change practice behavior and ability to document actions for MU) and hypothesized predictors of readiness (i.e., perceived appropriateness of MU and department support for MU). We then assessed associations between reported readiness and the hypothesized predictors of readiness. In total, 400 providers/staff responded (response rate approximately 25%). Individuals working in specialty settings were more likely to report that MU will divert attention from other patient-care priorities (12.6% vs. 4.4%, p = 0.019), as compared to those in primary-care settings. As compared to advanced-practice providers and nursing staff, physicians were less likely to have strong confidence in their department's ability to solve MU implementation problems (28.4% vs. 47.1% vs. 42.6%, p = 0.023) and to report strong willingness to change their work practices for MU (57.9% vs. 83.3% vs. 82.0%, p < 0.001). Finally, provider/staff perceptions about whether MU aligns with departmental goals (OR = 3.99, 95% confidence interval (CI) = 2.13 to 7.48); MU will divert attention from other patient-care priorities (OR = 2.26, 95% CI = 1.26 to 4.06); their department will support MU-related change efforts (OR = 3.99, 95% CI = 2.13 to 7.48); and their department will be able to solve MU implementation problems (OR = 2.26, 95% CI = 1.26 to 4.06) were associated with their willingness to change practice behavior for MU. Organizational leaders should gauge provider/staff perceptions about appropriateness and management support of MU-related change, as these perceptions might be related to subsequent implementation.

The impact of unstable housing on emergency department use in a cohort of HIV-positive people in a Canadian setting

PubMed Central

Chan, Keith; Milan, David; Grafstein, Eric; Palmer, Alexis K.; Rhodes, Chelsey; Montaner, Julio S.G.; Hogg, Robert S.

2014-01-01

The social-structural challenges experienced by people living with HIV (PHA) have been shown to contribute to increased use of the Emergency Department (ED). This study identified factors associated with frequent and non-urgent ED use within a cohort of people accessing antiretroviral therapy (ART) in a Canadian setting. Interviewer-administered surveys collected socio-demographic information; clinical variables were obtained through linkages with the provincial drug treatment registry; and ED admission data were abstracted from the Department of Emergency Medicine database. Multivariate logistic regression was used to compute odds of frequent and non-urgent ED use. Unstable housing was independently associated with ED use (adjusted odds ratio [AOR]=1.94, 95% confidence interval [CI] 1.24–3.04]), having three or more ED visits within 6 months of interview date [AOR: 2.03 (95% CI: 1.07–3.83)] and being triaged as non-urgent (AOR=2.71, 95% CI: 1.19–6.17). Frequent and non-urgent use of the ED in this setting is associated with conditions requiring interventions at the social-structural level. Supportive housing may contribute to decreased healthcare costs and improved health outcomes amongst marginalized PHA. PMID:23656484

Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

PubMed

Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

2017-04-28

Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health agencies and emergency department clinicians at the local level. Our framework which is grounded in qualitative evidence focuses on strategies to promote effective communication in the emerging public health incident setting and may be useful in informing practice.

A time and motion study of Screening, Brief Intervention, and Referral to Treatment implementation in health-care settings.

PubMed

Cowell, Alexander J; Dowd, William N; Landwehr, Justin; Barbosa, Carolina; Bray, Jeremy W

2017-02-01

Screening and brief intervention for harmful substance use in medical settings is being promoted heavily in the United States. To justify service provision fiscally, the field needs accurate estimates of the number and type of staff required to provide services, and thus the time taken to perform activities used to deliver services. This study analyzed the time spent in activities for the component services of the substance misuse Screening, Brief Intervention and Referral to Treatment (SBIRT) program implemented in emergency departments, in-patient units and ambulatory clinics. Observers timed activities according to 18 distinct codes among SBIRT practitioners. Twenty-six US sites within four grantees. Five hundred and one practitioner-patient interactions; 63 SBIRT practitioners. Timing of practitioner activities. Delivery of component services of SBIRT. The mean (standard error) time to deliver services was 1:19 (0:06) for a pre-screen (n = 210), 4:28 (0:24) for a screen (n = 97) and 6:51 (0:38) for a brief intervention (n = 66). Estimates of service duration varied by setting. Overall, practitioners spent 40% of their time supporting SBIRT delivery to patients and 13% of their time delivering services. In the United States, support activities (e.g. reviewing the patient's chart, locating the patient, writing case-notes) for substance abuse Screening, Brief Intervention and Referral to Treatment require more staff time than delivery of services. Support time for screens and brief interventions in the emergency department/trauma setting was high compared with the out-patient setting. © 2017 Society for the Study of Addiction.

The effect of patient death on medical students in the emergency department.

PubMed

Batley, Nicholas J; Bakhti, Rinad; Chami, Ali; Jabbour, Elsy; Bachir, Rana; El Khuri, Christopher; Mufarrij, Afif J

2017-07-10

The emotional consequences of patient deaths on physicians have been studied in a variety of medical settings. Reactions to patient death include distress, guilt, and grief. Comparatively, there are few studies on the effects of patient death on physicians and residents in the Emergency Department (ED). The ED setting is considered unique for having more sudden deaths that likely include the young and previously healthy and expectations for the clinician to return to a dynamic work environment. To date, no studies have looked at the effects of patient deaths on the more vulnerable population of medical students in the ED. This study examined aspects of patient deaths in the ED that most strongly influence students' reactions while comparing it to those of an inpatient setting. Semi-structured qualitative interviews were carried out with a total of 16 medical students from the American University of Beirut, Medical Center in Lebanon who had recently encountered a patient death in the ED. Questions included their reaction to the death, interaction with patients and their family members, the response of the medical team, and coping mechanisms adopted. The analysis revealed the following as determinant factors of student reaction to patient death: context of death; including age of patient, expectation of death, first death experience, relating patient death to personal deaths, and extent of interaction with patient and family members. Importantly, deaths in an inpatient setting were judged as more impactful than ED deaths. ED deaths, however, were especially powerful when a trauma case was deemed physically disturbing and cases in which family reactions were emotionally moving. The study demonstrates that students' emotional reactions differ as a function of the setting (surprise and shock in the ED versus sadness and grief in an inpatient setting). Debriefing and counseling sessions on ED deaths may benefit from this distinction.

5 CFR 9701.321 - Structure of bands.

Code of Federal Regulations, 2010 CFR

2010-01-01

....321 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and Adjusting Rate Ranges § 9701.321...

Implementation Intentions as a Strategy to Increase the Notification Rate of Potential Ocular Tissue Donors by Nurses: A Clustered Randomized Trial in Hospital Settings

PubMed Central

2014-01-01

Aim. The purpose of this study is to evaluate the impact, among nurses in hospital settings, of a questionnaire-based implementation intentions intervention on notification of potential ocular tissue donors to donation stakeholders. Methods. This randomized intervention was clustered at the level of hospital departments with two study arms: questionnaire-based implementation intentions intervention and control. In the intervention group, nurses were asked to plan specific actions if faced with a number of barriers when reporting potential ocular donors. The primary outcome was the potential ocular tissue donors' notification rate before and after the intervention. Analysis was based on a generalized linear model with an identity link and a binomial distribution. Results. We compared outcomes in 26 departments from 5 hospitals, 13 departments per condition. The implementation intentions intervention did not significantly increase the notification rate of ocular tissue donors (intervention: 23.1% versus control: 21.1%; χ 2 = 1.14, 2; P = 0.56). Conclusion. A single and brief implementation intentions intervention among nurses did not modify the notification rate of potential ocular tissue donors to donation stakeholders. Low exposure to the intervention was a major challenge in this study. Further studies should carefully consider a multicomponent intervention to increase exposure to this type of intervention. PMID:25132990

The Subjective Visual Vertical: Validation of a Simple Test

ERIC Educational Resources Information Center

Tesio, Luigi; Longo, Stefano; Rota, Viviana

2011-01-01

The study sought to provide norms for a simple test of visual perception of verticality (subjective visual vertical). The study was designed as a cohort study with a balanced design. The setting was the Rehabilitation Department of a University Hospital. Twenty-two healthy adults, of 23-58 years, 11 men (three left handed) and 11 women (three left…

Generic Behavioural Criteria of Managerial Effectiveness: An Empirical and Comparative Case Study of UK Local Government

ERIC Educational Resources Information Center

Hamlin, Robert G.; Serventi, Susan A.

2008-01-01

Purpose: The purpose of this paper is to present the findings of a "partnership-research" study of effective and ineffective managerial behaviour within the "local government" setting of the Wolverhampton City Council Social Care Department, and to describe how the research supports and challenges the organisation's existing…

Authenticity in Learning--Nursing Students' Experiences at a Clinical Education Ward

ERIC Educational Resources Information Center

Manninen, Katri; Henriksson, Elisabet Welin; Scheja, Max; Silen, Charlotte

2013-01-01

Purpose: This study aims to explore and understand first year nursing students' experiences of learning at a clinical education ward. Design/methodology/approach: The setting is a clinical education ward for nursing students at a department of infectious diseases. A qualitative study was carried out exploring students' encounters with patients,…

A Critical Thinking Benchmark for a Department of Agricultural Education and Studies

ERIC Educational Resources Information Center

Perry, Dustin K.; Retallick, Michael S.; Paulsen, Thomas H.

2014-01-01

Due to an ever changing world where technology seemingly provides endless answers, today's higher education students must master a new skill set reflecting an emphasis on critical thinking, problem solving, and communications. The purpose of this study was to establish a departmental benchmark for critical thinking abilities of students majoring…

Interdisciplinarity: Policies and Practices. AIR Forum Paper 1978.

ERIC Educational Resources Information Center

Assimopoulos, Nadia; Belanger, Charles H.

Interdisciplinary policies and practices at the University of Montreal were studied to determine their effectiveness. The three study objectives were to: (1) determine the magnitude of the range set up by the department degree structure to give student majors an opportunity to take courses outside their basic discipline; (2) assess the degree of…

Supporting Assessment in Undergraduate Mathematics

ERIC Educational Resources Information Center

Steen, Lynn Arthur, Ed.

2006-01-01

This publication contains 29 case studies offering lessons learned during a four year NSF-supported MAA project designed to support mathematicians and mathematics departments in the increasingly important challenge of assessing student learning. Three introductory essays set assessment in broader academic and national contexts; an appendix…

Modeling of 85th percentile speed for rural highways for enhanced traffic safety.

DOT National Transportation Integrated Search

2011-03-01

Traffic operation on two-lane rural highways and setting posted speed limits are some of the difficult tasks faced by the : Oklahoma Department of Transportation (ODOT) and other transportation agencies. The present study was undertaken to : develop ...

Feasibility of online nutrition education in the workplace: Working Toward Healthy Lifestyles

USDA-ARS?s Scientific Manuscript database

Objective: Determination of feasibility of online nutrition education in the federal workplace. Design: Pre-test/post-test pilot study with data collection occurring from September to December 2016. Setting: Two United States Department of Agriculture workplaces. Participants: Convenience sample ...

Validity of the International Classification of Diseases 10th revision code for hyperkalaemia in elderly patients at presentation to an emergency department and at hospital admission

PubMed Central

Fleet, Jamie L; Shariff, Salimah Z; Gandhi, Sonja; Weir, Matthew A; Jain, Arsh K; Garg, Amit X

2012-01-01

Objectives Evaluate the validity of the International Classification of Diseases, 10th revision (ICD-10) code for hyperkalaemia (E87.5) in two settings: at presentation to an emergency department and at hospital admission. Design Population-based validation study. Setting 12 hospitals in Southwestern Ontario, Canada, from 2003 to 2010. Participants Elderly patients with serum potassium values at presentation to an emergency department (n=64 579) and at hospital admission (n=64 497). Primary outcome Sensitivity, specificity, positive-predictive value and negative-predictive value. Serum potassium values in patients with and without a hyperkalaemia code (code positive and code negative, respectively). Results The sensitivity of the best-performing ICD-10 coding algorithm for hyperkalaemia (defined by serum potassium >5.5 mmol/l) was 14.1% (95% CI 12.5% to 15.9%) at presentation to an emergency department and 14.6% (95% CI 13.3% to 16.1%) at hospital admission. Both specificities were greater than 99%. In the two settings, the positive-predictive values were 83.2% (95% CI 78.4% to 87.1%) and 62.0% (95% CI 57.9% to 66.0%), while the negative-predictive values were 97.8% (95% CI 97.6% to 97.9%) and 96.9% (95% CI 96.8% to 97.1%). In patients who were code positive for hyperkalaemia, median (IQR) serum potassium values were 6.1 (5.7 to 6.8) mmol/l at presentation to an emergency department and 6.0 (5.1 to 6.7) mmol/l at hospital admission. For code-negative patients median (IQR) serum potassium values were 4.0 (3.7 to 4.4) mmol/l and 4.1 (3.8 to 4.5) mmol/l in each of the two settings, respectively. Conclusions Patients with hospital encounters who were ICD-10 E87.5 hyperkalaemia code positive and negative had distinct higher and lower serum potassium values, respectively. However, due to very low sensitivity, the incidence of hyperkalaemia is underestimated. PMID:23274674

Joining the club: Conforming to and resisting biology in practice

NASA Astrophysics Data System (ADS)

Buxton, Cory Alexander

2000-10-01

This study explores how science and scientists were produced and reproduced within the setting of a university biology department. It builds upon recent work in anthropology of education and feminist science studies. My purpose was to look at both the contextual and constitutive values of science as they were negotiated and played out in the training of scientists in a setting where: (1) women were well represented in leadership positions; and (2) "mainstream" science was being both taught and practiced. Findings included the organization of a status hierarchy within the department, the meanings of science and scientists that students constructed within the social spaces they occupied, examples of individual resistance to certain norms of biology practice, and examples of institutional opposition to that resistance. There was some evidence that the unusually high representation of women in positions of leadership in the biology department did result in changes in both the contextual and constitutive values of how science was conceptualized, practiced and taught in this setting. Contextually, social spaces controlled by women were likely to emphasize: (1) teamwork bringing together participants with varied backgrounds and perspectives; (2) flexible and collaborative use of physical space; and (3) willingness to do work for which they went unacknowledged or to share rewards equally even when the work distribution was not equitable. Constitutively, these social spaces were prone to: (1) interdisciplinary synthesis and comprehensive approaches; (2) the study of topics that reconsidered beliefs about gender roles in plant and animal reproduction; (3) work that would be slower and take longer to produce (and publish) but might make a large contribution (be a high quality product) eventually; and (4) an awareness by women that their practices were different in some ways than the practices of their male colleagues.

The Impact of Emotional Intelligence on Conditions of Trust among Leaders at the Kentucky Department for Public Health

PubMed Central

Knight, Jennifer Redmond; Bush, Heather M.; Mase, William A.; Riddell, Martha Cornwell; Liu, Meng; Holsinger, James W.

2015-01-01

There has been limited leadership research on emotional intelligence and trust in governmental public health settings. The purpose of this study was to identify and seek to understand the relationship between trust and elements of emotional intelligence, including stress management, at the Kentucky Department for Public Health (KDPH). The KDPH serves as Kentucky’s state governmental health department. KDPH is led by a Commissioner and composed of seven primary divisions and 25 branches within those divisions. The study was a non-randomized cross-sectional study utilizing electronic surveys that evaluated conditions of trust among staff members and emotional intelligence among supervisors. Pearson correlation coefficients and corresponding p-values are presented to provide the association between emotional intelligence scales and the conditions of trust. Significant positive correlations were observed between supervisors’ stress management and the staff members’ trust or perception of supervisors’ loyalty (r = 0.6, p = 0.01), integrity (r = 0.5, p = 0.03), receptivity (r = 0.6, p = 0.02), promise fulfillment (r = 0.6, p = 0.02), and availability (r = 0.5, p = 0.07). This research lays the foundation for emotional intelligence and trust research and leadership training in other governmental public health settings, such as local, other state, national, or international organizations. This original research provides metrics to assess the public health workforce with attention to organizational management and leadership constructs. The survey tools could be used in other governmental public health settings in order to develop tailored training opportunities related to emotional intelligence and trust organizations. PMID:25821778

Should health professionals screen women for domestic violence? Systematic review

PubMed Central

Ramsay, Jean; Richardson, Jo; Carter, Yvonne H; Davidson, Leslie L; Feder, Gene

2002-01-01

Objective To assess the evidence for the acceptability and effectiveness of screening women for domestic violence in healthcare settings. Design Systematic review of published quantitative studies. Search strategy Three electronic databases (Medline, Embase, and CINAHL) were searched for articles published in the English language up to February 2001. Included studies Surveys that elicited the attitudes of women and health professionals on the screening of women in health settings; comparative studies conducted in healthcare settings that measured rates of identification of domestic violence in the presence and absence of screening; studies measuring outcomes of interventions for women identified in health settings who experience abuse from a male partner or ex-partner compared with abused women not receiving an intervention. Results 20 papers met the inclusion criteria. In four surveys, 43-85% of women respondents found screening in healthcare settings acceptable. Two surveys of health professionals' views found that two thirds of physicians and almost half of emergency department nurses were not in favour of screening. In nine studies of screening compared with no screening, most detected a greater proportion of abused women identified by healthcare professionals. Six studies of interventions used weak study designs and gave inconsistent results. Other than increased referral to outside agencies, little evidence exists for changes in important outcomes such as decreased exposure to violence. No studies measured quality of life, mental health outcomes, or potential harm to women from screening programmes. Conclusion Although domestic violence is a common problem with major health consequences for women, implementation of screening programmes in healthcare settings cannot be justified. Evidence of the benefit of specific interventions and lack of harm from screening is needed. What is already known on this topicAround one quarter of women in the United Kingdom have been physically assaulted by a current or former male partnerScreening for domestic violence in healthcare settings is the policy of many health professional bodies in the United StatesThe Department of Health recommends that health professionals should consider “routine enquiry” of women patients about whether they have experienced domestic violenceWhat this study addsScreening by health professionals increases the identification of domestic violence, and many women do not object to being askedMost health professionals surveyed do not agree with screening of women in healthcare settingsInsufficient evidence exists to show whether screening and intervention can lead to improved outcomes for women identified as abusedImplementation of screening programmes in healthcare settings is not justified by current evidence PMID:12169509

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

45 CFR 162.1011 - Valid code sets.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Valid code sets. 162.1011 Section 162.1011 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS ADMINISTRATIVE REQUIREMENTS Code Sets § 162.1011 Valid code sets. Each code set is valid within the dates...

The Process of Organizational Capacity Development in Action in Post-Conflict Setting of the Literacy Department of Afghanistan

ERIC Educational Resources Information Center

Wajdi, Habibullah

2013-01-01

This paper presents a model of capacity development for public organizations in post-conflict settings. The paper reveals the challenges faced by the author as a "change agent" who tried to understand and develop the basic capacity of the Literacy Department of the Ministry of Education in Afghanistan. The author used an action-research…

Adult Status Epilepticus: A Review of the Prehospital and Emergency Department Management

PubMed Central

Billington, Michael; Kandalaft, Osama R.; Aisiku, Imoigele P.

2016-01-01

Seizures are a common presentation in the prehospital and emergency department setting and status epilepticus represents an emergency neurologic condition. The classification and various types of seizures are numerous. The objectives of this narrative literature review focuses on adult patients with a presentation of status epilepticus in the prehospital and emergency department setting. In summary, benzodiazepines remain the primary first line therapeutic agent in the management of status epilepticus, however, there are new agents that may be appropriate for the management of status epilepticus as second- and third-line pharmacological agents. PMID:27563928

Independent component analysis decomposition of hospital emergency department throughput measures

NASA Astrophysics Data System (ADS)

He, Qiang; Chu, Henry

2016-05-01

We present a method adapted from medical sensor data analysis, viz. independent component analysis of electroencephalography data, to health system analysis. Timely and effective care in a hospital emergency department is measured by throughput measures such as median times patients spent before they were admitted as an inpatient, before they were sent home, before they were seen by a healthcare professional. We consider a set of five such measures collected at 3,086 hospitals distributed across the U.S. One model of the performance of an emergency department is that these correlated throughput measures are linear combinations of some underlying sources. The independent component analysis decomposition of the data set can thus be viewed as transforming a set of performance measures collected at a site to a collection of outputs of spatial filters applied to the whole multi-measure data. We compare the independent component sources with the output of the conventional principal component analysis to show that the independent components are more suitable for understanding the data sets through visualizations.

5 CFR 531.216 - Setting pay when an employee moves from a Department of Defense or Coast Guard nonappropriated...

Code of Federal Regulations, 2012 CFR

2012-01-01

... Department of Defense or Coast Guard nonappropriated fund instrumentality. 531.216 Section 531.216... employee moves from a Department of Defense or Coast Guard nonappropriated fund instrumentality. (a... Department of Defense or the Coast Guard from a position in a nonappropriated fund instrumentality (NAFI) (as...

5 CFR 531.216 - Setting pay when an employee moves from a Department of Defense or Coast Guard nonappropriated...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Department of Defense or Coast Guard nonappropriated fund instrumentality. 531.216 Section 531.216... employee moves from a Department of Defense or Coast Guard nonappropriated fund instrumentality. (a... Department of Defense or the Coast Guard from a position in a nonappropriated fund instrumentality (NAFI) (as...

5 CFR 531.216 - Setting pay when an employee moves from a Department of Defense or Coast Guard nonappropriated...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Department of Defense or Coast Guard nonappropriated fund instrumentality. 531.216 Section 531.216... employee moves from a Department of Defense or Coast Guard nonappropriated fund instrumentality. (a... Department of Defense or the Coast Guard from a position in a nonappropriated fund instrumentality (NAFI) (as...

5 CFR 531.216 - Setting pay when an employee moves from a Department of Defense or Coast Guard nonappropriated...

Code of Federal Regulations, 2014 CFR

2014-01-01

... Department of Defense or Coast Guard nonappropriated fund instrumentality. 531.216 Section 531.216... employee moves from a Department of Defense or Coast Guard nonappropriated fund instrumentality. (a... Department of Defense or the Coast Guard from a position in a nonappropriated fund instrumentality (NAFI) (as...

5 CFR 531.216 - Setting pay when an employee moves from a Department of Defense or Coast Guard nonappropriated...

Code of Federal Regulations, 2013 CFR

2013-01-01

... Department of Defense or Coast Guard nonappropriated fund instrumentality. 531.216 Section 531.216... employee moves from a Department of Defense or Coast Guard nonappropriated fund instrumentality. (a... Department of Defense or the Coast Guard from a position in a nonappropriated fund instrumentality (NAFI) (as...

45 CFR 162.1000 - General requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... sets. Use the applicable medical data code sets described in § 162.1002 as specified in the...) Nonmedical data code sets. Use the nonmedical data code sets as described in the implementation... Public Welfare Department of Health and Human Services ADMINISTRATIVE DATA STANDARDS AND RELATED...

45 CFR 162.1000 - General requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... sets. Use the applicable medical data code sets described in § 162.1002 as specified in the...) Nonmedical data code sets. Use the nonmedical data code sets as described in the implementation... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED...

45 CFR 162.1000 - General requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... sets. Use the applicable medical data code sets described in § 162.1002 as specified in the...) Nonmedical data code sets. Use the nonmedical data code sets as described in the implementation... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED...

45 CFR 162.1000 - General requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... sets. Use the applicable medical data code sets described in § 162.1002 as specified in the...) Nonmedical data code sets. Use the nonmedical data code sets as described in the implementation... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED...

45 CFR 162.1000 - General requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... sets. Use the applicable medical data code sets described in § 162.1002 as specified in the...) Nonmedical data code sets. Use the nonmedical data code sets as described in the implementation... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA STANDARDS AND RELATED...

Understanding Primary Care Behavioral Health Across Military Settings: A Preliminary Comparison Between Deployed and In-Garrison Care.

PubMed

Landoll, Ryan R; Nielsen, Matthew K; Waggoner, Kathryn K

2017-03-01

Integrated primary care behavioral health (PCBH) is a growing trend in health care delivery, particularly in the Department of Defense and the Department of Veterans Affairs. This consultative model has been applied within the U.S. Air Force for over 15 years and has demonstrated positive health impacts and patient satisfaction. With extended conflicts and engagements, including Operation Enduring Freedom and Operation Iraqi Freedom, deployment behavioral health care has expanded and positively received, but there is less empirical support of particular models of care in a deployed environment. Brief, solution-focused strategies commonly utilized in PCBH are likely to be particularly good candidates for the deployed environment. One key feature the Air Force's PCBH program is the collaborative team-based approach to care centered around a patient and driven by a primary care manager. This study expands the evaluation of the Air Force's PCBH program to include its novel application in a combat setting. A retrospective review of 516 archival patient satisfaction surveys across Air Force military treatment facilities utilizing a PCBH program compared patient satisfaction surveys collected in a deployed environment at a large combat support hospital to noncombat facilities. Results indicated that patient satisfaction in theater was comparable to satisfaction at Air Force military treatment facilities in noncombat environments, with one exception; patients seen in garrison rated higher satisfaction with the treatment plan than those seen in a deployed setting, F(509) = 5.36, p < 0.01, consistent with limited resources available in theater. Given patient satisfaction across settings was found to be relatively equivalent, results suggests that the PCBH consultation model may be an appropriate model of care to meet a majority of the population's needs for a deployed environment. This pilot study has implications not only for military combat environments, but other austere settings, including civilian rural mental health settings. These findings inform provision of care in a deployed environment by demonstrating the benefits of the primary care behavioral model. Additionally, the Department of Veterans Affairs and other federal health care agencies will benefit from reviewing the structured and standardized PCBH model employed by the U.S. Air Force for nearly two decades as they expand care in rural mental health settings across the country. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Human Development, Early Childhood Care and Education and Family Welfare. Compendium of Researches, Volume III.

ERIC Educational Resources Information Center

Saraswathi, T. S., Ed.; And Others

This volume encompasses 44 research studies that were conducted mainly by graduate students in the Department of Human Development and Family Studies, M.S. University of Baroda, India. The studies are organized in six broad categories: (1) child care in tribal, rural and urban poor, and institutional settings; (2) early childhood care and…

Pre-Creating the HyperNews Classroom Community: (Not)Speaking, (Not)Writing the Subtext.

ERIC Educational Resources Information Center

Satie, Stephanie

As two groups of teachers met to set up a HyperNews network for a grant project, it became clear that politics cannot be kept out of the classroom. In creating a community of diverse writers via HyperNews, six composition classes were linked for online discourse among departments: Asian American Studies, Chicano Studies, Pan African Studies, and…

Women and Teaching in Academic Psychiatry

ERIC Educational Resources Information Center

Hirshbein, Laura D.; Fitzgerald, Kate; Riba, Michelle

2004-01-01

Objective: This article explores past, present, and future issues for women and teaching in academic psychiatry. A small study of didactic teaching responsibilities along faculty groups in one academic psychiatry department helps to illustrate challenges and opportunities for women in psychiatric teaching settings. Background: Although women have…

[Management policy-making for work and education in health: the case of the Bahia State Health Department, Brazil, 2007-2008].

PubMed

Pinto, Isabela Cardoso de Matos; Teixeira, Carmen Fontes

2011-09-01

The construction of Brazil's Unified National Health System (SUS) has raised a set of challenges for the health sector's administrators and personnel, including issues of work management and continuing education for health workers, in view of the financial, political, and organizational constraints in the process of changing the healthcare model. The current study aimed to analyze the process of formulating the Health Work and Education Management Policy by the Bahia State Health Department. Public policy cycle was used as the theoretical framework. The study analyzed data from institutional documents and records of participant observation by one of the authors. The results include mapping the governmental and nongovernmental stakeholders that participated in the process. The analysis highlights a series of problems in the SUS in Bahia related to work management and health workers' profile, taken as the point of departure for priority-setting in the State Strategic Agenda and Health Plan for 2008-2011.

Swedish nursing students' experience of stress during clinical practice in relation to clinical setting characteristics and the organisation of the clinical education.

PubMed

Blomberg, Karin; Bisholt, Birgitta; Kullén Engström, Agneta; Ohlsson, Ulla; Sundler Johansson, Annelie; Gustafsson, Margareta

2014-08-01

To describe nursing students' experience of stress during clinical practice and evaluate the risk of stress in relation to the clinical setting characteristics and the organisation of the clinical education. Stress during clinical practice is well documented, but there is a lack of knowledge concerning whether the clinical setting characteristics and the organisation of the education make a difference. A cross-sectional study with evaluative design. Data were collected by means of a numerical rating scale for the assessment of stress and questions about the clinical setting characteristics and the organisation of the education. One hundred and eighty-four students who had completed their final year on the nursing programme at three universities in Sweden were included. Nearly half of the students (43%) experienced high level of stress during clinical practice. Measured by decision in the tree analysis, the absolute risk of stress was 57% in students with placements in hospital departments, as compared to 13% in students with placements in other clinical settings. The risk of stress increased to 71% if the students with placement in a hospital took the national clinical final examination. Performance of practice in a hospital department overcrowded with patients was also associated with increased risk of stress. The organisation of supervision and number of students at the clinical placement had an effect on the experience of stress, but did not prove to be risk factors in the analysis. The risk of stress in nursing students during their clinical practice differs depending on clinical setting characteristics. The taking of the national clinical final examination could be a source of stress, but this requires further investigation. It is important that supervisors are aware that students in hospital departments overcrowded with patients are at risk of stress and may have increased need of support. © 2014 John Wiley & Sons Ltd.

Trends in rates of acetaminophen-related adverse events in the United States

PubMed Central

Major, Jacqueline M.; Zhou, Esther H.; Wong, Hui-Lee; Trinidad, James P.; Pham, Tracy M.; Mehta, Hina; Ding, Yulan; Staffa, Judy A.; Iyasu, Solomon; Wang, Cunlin; Willy, Mary E.

2017-01-01

Purpose The goal of this study is to summarize trends in rates of adverse events attributable to acetaminophen use, including hepatotoxicity and mortality. Methods A comprehensive analysis of data from three national surveillance systems estimated rates of acetaminophen-related events identified in different settings, including calls to poison centers (2008–2012), emergency department visits (2004–2012), and inpatient hospitalizations (1998–2011). Rates of acetaminophen-related events were calculated per setting, census population, and distributed drug units. Results Rates of poison center calls with acetaminophen-related exposures decreased from 49.5/1000 calls in 2009 to 43.5/1000 calls in 2012. Rates of emergency department visits for unintentional acetaminophen-related adverse events decreased from 58.0/1000 emergency department visits for adverse drug events in 2009 to 50.2/1000 emergency department visits in 2012. Rates of hospital inpatient discharges with acetaminophen-related poisoning decreased from 119.8/100 000 hospitalizations in 2009 to 108.6/100 000 hospitalizations in 2011. After 2009, population rates of acetaminophen-related events per 1million census population decreased for poison center calls and hospitalizations, while emergency department visit rates remained stable. However, when accounting for drug sales, the rate of acetaminophen-related events (per 1 million distributed drug units) increased after 2009. Prior to 2009, the rates of acetaminophen-related hospitalizations had been slowly increasing (p-trend = 0.001). Conclusions Acetaminophen-related adverse events continue to be a public health burden. Future studies with additional time points are necessary to confirm trends and determine whether recent risk mitigation efforts had a beneficial impact on acetaminophen-related adverse events. PMID:26530380

The IGNITE (investigation to guide new insight into translational effectiveness) trial: Protocol for a translational study of an evidenced-based wellness program in fire departments

PubMed Central

2010-01-01

Background Worksites are important locations for interventions to promote health. However, occupational programs with documented efficacy often are not used, and those being implemented have not been studied. The research in this report was funded through the American Reinvestment and Recovery Act Challenge Topic 'Pathways for Translational Research,' to define and prioritize determinants that enable and hinder translation of evidenced-based health interventions in well-defined settings. Methods The IGNITE (investigation to guide new insights for translational effectiveness) trial is a prospective cohort study of a worksite wellness and injury reduction program from adoption to final outcomes among 12 fire departments. It will employ a mixed methods strategy to define a translational model. We will assess decision to adopt, installation, use, and outcomes (reach, individual outcomes, and economic effects) using onsite measurements, surveys, focus groups, and key informant interviews. Quantitative data will be used to define the model and conduct mediation analysis of each translational phase. Qualitative data will expand on, challenge, and confirm survey findings and allow a more thorough understanding and convergent validity by overcoming biases in qualitative and quantitative methods used alone. Discussion Findings will inform worksite wellness in fire departments. The resultant prioritized influences and model of effective translation can be validated and manipulated in these and other settings to more efficiently move science to service. PMID:20932290

Allocating limited resources in a time of fiscal constraints: a priority setting case study from Dalhousie University Faculty of Medicine.

PubMed

Mitton, Craig; Levy, Adrian; Gorsky, Diane; MacNeil, Christina; Dionne, Francois; Marrie, Tom

2013-07-01

Facing a projected $1.4M deficit on a $35M operating budget for fiscal year 2011/2012, members of the Dalhousie University Faculty of Medicine developed and implemented an explicit, transparent, criteria-based priority setting process for resource reallocation. A task group that included representatives from across the Faculty of Medicine used a program budgeting and marginal analysis (PBMA) framework, which provided an alternative to the typical public-sector approaches to addressing a budget deficit of across-the-board spending cuts and political negotiation. Key steps to the PBMA process included training staff members and department heads on priority setting and resource reallocation, establishing process guidelines to meet immediate and longer-term fiscal needs, developing a reporting structure and forming key working groups, creating assessment criteria to guide resource reallocation decisions, assessing disinvestment proposals from all departments, and providing proposal implementation recommendations to the dean. All departments were required to submit proposals for consideration. The task group approved 27 service reduction proposals and 28 efficiency gains proposals, totaling approximately $2.7M in savings across two years. During this process, the task group faced a number of challenges, including a tight timeline for development and implementation (January to April 2011), a culture that historically supported decentralized planning, at times competing interests (e.g., research versus teaching objectives), and reductions in overall health care and postsecondary education government funding. Overall, faculty and staff preferred the PBMA approach to previous practices. Other institutions should use this example to set priorities in times of fiscal constraints.

Using a set-aside to encourage the evaluation of public health service programs.

PubMed

Riggin, L J; Shipman, S L; York, R L

1995-03-01

For over 20 years, the secretary of the Department of Health and Human Services (HHS) has had the authority to use up to 1% of the annual Public Health Service (PHS) appropriations for the evaluation of federal health programs. However, recent changes to the Public Health Service Act put not only a ceiling (1%) but also a floor (0.2%) on the funds that the secretary can set aside for evaluation. The changes to the legislation are intended to encourage HHS to dedicate more funds to evaluation, focus the funds set aside for evaluation on studies of PHS program implementation and effectiveness, and regularly report the findings of the evaluations to Congress. These changes respond to concerns raised by the U.S. General Accounting Office in a study of the PHS evaluation set-aside conducted for Congress.

Flipped Classroom with Problem Based Activities: Exploring Self-Regulated Learning in a Programming Language Course

ERIC Educational Resources Information Center

Çakiroglu, Ünal; Öztürk, Mücahit

2017-01-01

This study intended to explore the development of self-regulation in a flipped classroom setting. Problem based learning activities were carried out in flipped classrooms to promote self-regulation. A total of 30 undergraduate students from Mechatronic department participated in the study. Self-regulation skills were discussed through students'…

Entering the Minds of Students: A Study in Assessment

ERIC Educational Resources Information Center

Oldham, Daniel H.

2010-01-01

Assessing student knowledge is one of the primary functions of accountability under the No Child Left Behind Act. Finding a means of truly assessing student knowledge has become a major focus of most state departments of education. This study compared two different assessment approaches based on the same set of standards as a means of determining…

An Examination of Biomedical Intellectual Reputation in Relationship to Graduates' Productivity, Regional Innovation and Absorptive Capacity at Selected Universities Worldwide

ERIC Educational Resources Information Center

Cavanaugh, Gesulla

2014-01-01

The purpose of this study was first to determine factors associated with intellectual reputation, specifically among selected biomedical departments worldwide within the university setting. Second, the study aimed to examine intellectual reputation in relationship to doctoral graduates' productivity in the biomedical sciences and in relationship…

48 CFR 1301.000 - Scope of part.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Scope of part. 1301.000 Section 1301.000 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE GENERAL DEPARTMENT OF COMMERCE ACQUISITION REGULATIONS SYSTEM 1301.000 Scope of part. This part sets out general Department of...

48 CFR 1301.000 - Scope of part.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Scope of part. 1301.000 Section 1301.000 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE GENERAL DEPARTMENT OF COMMERCE ACQUISITION REGULATIONS SYSTEM 1301.000 Scope of part. This part sets out general Department of...

48 CFR 1301.000 - Scope of part.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Scope of part. 1301.000 Section 1301.000 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE GENERAL DEPARTMENT OF COMMERCE ACQUISITION REGULATIONS SYSTEM 1301.000 Scope of part. This part sets out general Department of...

32 CFR 728.56 - Treasury Department beneficiaries.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other... may be beneficiaries of the Treasury Department and may be rendered care as set forth below. (1.... Customs Service. (5) Prisoners (detainees) of the U.S. Customs Service. (b) Care authorized. (1) Secret...

5 CFR 9701.355 - Setting pay upon movement to a different occupational cluster.

Code of Federal Regulations, 2010 CFR

2010-01-01

... occupational cluster. 9701.355 Section 9701.355 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Pay Administration § 9701...

10 CFR 221.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PRIORITY SUPPLY OF CRUDE OIL AND PETROLEUM PRODUCTS TO THE DEPARTMENT OF DEFENSE UNDER THE DEFENSE PRODUCTION ACT General § 221.1 Scope. This part sets forth the procedures to be utilized by the Economic Regulatory Administration of the Department of Energy and the Department of Defense whenever the priority...

Knowledge translation studies in paediatric emergency medicine: A systematic review of the literature.

PubMed

Wilson, Catherine L; Johnson, David; Oakley, Ed

2016-02-01

Systematic review of knowledge translation studies focused on paediatric emergency care to describe and assess the interventions used in emergency department settings. Electronic databases were searched for knowledge translation studies conducted in the emergency department that included the care of children. Two researchers independently reviewed the studies. From 1305 publications identified, 15 studies of varied design were included. Four were cluster-controlled trials, two patient-level randomised controlled trials, two interrupted time series, one descriptive study and six before and after intervention studies. Knowledge translation interventions were predominantly aimed at the treating clinician, with some targeting the organisation. Studies assessed effectiveness of interventions over 6-12 months in before and after studies, and 3-28 months in cluster or patient level controlled trials. Changes in clinical practice were variable, with studies on single disease and single treatments in a single site showing greater improvement. Evidence for effective methods to translate knowledge into practice in paediatric emergency medicine is fairly limited. More optimal study designs with more explicit descriptions of interventions are needed to facilitate other groups to effectively apply these procedures in their own setting. © 2016 The Authors Journal of Paediatrics and Child Health © 2016 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Urgent consultations at the dermatology department of Basel University Hospital, Switzerland: characterisation of patients and setting - a 12-month study with 2,222 patients data and review of the literature.

PubMed

Ruzza, N; Itin, P H; Beltraminelli, H

2014-01-01

Urgent consultations for skin disorders are commonly done in different settings. Scarce data exist about the characteristics of these patients. The aim of this study was to analyse specific characteristics of patients receiving an urgent consultation at a dermatology department in a university hospital. We prospectively recorded the data of all patients having had an urgent consultation during a period of 12 months. We registered 2,222 urgent consultations. The most frequent diagnoses were eczemas (24.8%), dermatomycoses (5.1%) and dermatitis not otherwise specified (4.8%). The most frequent treatments were topical steroids, emollients, topical antibiotics, systemic antihistamines, antibiotics and virostatics. 2.2% of patients were hospitalized, 78.8% asked for a consultation for a disease lasting less than 4 weeks, and 6.9% presented the same day as the skin disease appeared. This study shows the characteristics of patients receiving an urgent dermatologic consultation. It underlines the need for collaboration between dermatologists, other physicians, general practitioners and nurses. © 2014 S. Karger AG, Basel.

Improving geriatric prescribing in the ED: a qualitative study of facilitators and barriers to clinical decision support tool use.

PubMed

Vandenberg, Ann E; Vaughan, Camille P; Stevens, Melissa; Hastings, Susan N; Powers, James; Markland, Alayne; Hwang, Ula; Hung, William; Echt, Katharina V

2017-02-01

Clinical decision support (CDS) may improve prescribing for older adults in the Emergency Department (ED) if adopted by providers. Existing prescribing order entry processes were mapped at an initial Veterans Administration Medical Center site, demonstrating cognitive burden, effort and safety concerns. Geriatric order sets incorporating 2012 Beers guidelines and including geriatric prescribing advice and prepopulated order options were developed. Geriatric order sets were implemented at two sites as part of the multicomponent 'Enhancing Quality of Prescribing Practices for Older Veterans Discharged from the Emergency Department' quality improvement initiative. Facilitators and barriers to order sets use at the two sites were evaluated. Phone interviews were conducted with two provider groups (n = 20), those 'EQUiPPED' with the interventions (n = 10, 5 at each site) and Comparison providers who were only exposed to order sets through a clickable option on the ED order menu within the patient's medical record (n = 10, 5 at each site). All providers were asked about order set 'use' and 'usefulness'. Users (n = 11) were asked about 'usability'. Order set adopters described 'usefulness' in terms of 'safety' and 'efficiency', whereas order set consultants and order set non-users described 'usefulness' in terms of 'information' or 'training'. Provider 'autonomy', 'comfort' level with existing tools, and 'learning curve' were stated as barriers to use. Quantifying efficiency advantages and communicating safety benefit over preexisting practices and tools may improve adoption of CDS in ED and in other settings of care. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Antimicrobial Stewardship in the Emergency Department and Guidelines for Development

PubMed Central

May, Larissa; Cosgrove, Sara; L’Archeveque, Michelle; Talan, David A.; Payne, Perry; Rothman, Richard E.

2013-01-01

Antimicrobial resistance is a mounting public health concern. Emergency departments (EDs) represent a particularly important setting for addressing inappropriate antimicrobial prescribing practices, given the frequent use of antibiotics in this setting that sits at the interface of the community and the hospital. This article outlines the importance of antimicrobial stewardship in the ED setting and provides practical recommendations drawn from existing evidence for the application of various strategies and tools that could be implemented in the ED including advancement of clinical guidelines, clinical decision support systems, rapid diagnostics, and expansion of ED pharmacist programs. PMID:23122955

Treatment of acute burn blisters in unscheduled care settings.

PubMed

Payne, Sarah; Cole, Elaine

2012-09-01

Many patients with minor burns present at emergency departments and urgent care centres, where their management is often undertaken by experienced nurses rather than experts in treating burns. This article describes a small study of the clinical decision making that underpins nurses' management of minor burns in these non-specialist settings. The results suggest that, due to a lack of relevant research, nurses base their decisions on previous experience or expert colleagues' opinions and advice rather than on the evidence.

Residential Indoor Temperature Study

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

Booten, Chuck; Robertson, Joseph; Christensen, Dane

2017-04-07

In this study, we are adding to the body of knowledge around answering the question: What are good assumptions for HVAC set points in U.S. homes? We collected and analyzed indoor temperature data from US homes using funding from the U.S. Department of Energy's Building America (BA) program, due to the program's reliance on accurate energy simulation of homes. Simulations are used to set Building America goals, predict the impact of new building techniques and technologies, inform research objectives, evaluate home performance, optimize efficiency packages to meet savings goals, customize savings approaches to specific climate zones, and myriad other uses.

Self-study packets: an in-service strategy for today's emergency department.

PubMed

Macari, G H

1993-04-01

The self-study program has been a great success. Staff seized the opportunity for "hands-on," nonthreatening learning. The fear of asking questions and appearing less knowledgeable than peers in a group setting is removed, and new employees are grateful for the rapid accessibility of concise reference material. Everyone enjoys the freedom of fitting the in-service program into a routine day, rather than trying to adapt to a set time. Last, but not least, management reaps to the benefit of a program that satisfies the expectations of regulatory agencies and is virtually cost-free.

Teacher Educator Technology Competencies

ERIC Educational Resources Information Center

Foulger, Teresa S.; Graziano, Kevin J.; Schmidt-Crawford, Denise A.; Slykhuis, David A.

2017-01-01

The U.S. National Educational Technology Plan recommends the need to have a common set of technology competencies specifically for teacher educators who prepare teacher candidates to teach with technology (U.S. Department of Education, Office of Educational Technology, 2017). This study facilitated the co-creation of the Teacher Educator…

USDA Nutrient Data Set for Retail Veal Cuts

USDA-ARS?s Scientific Manuscript database

The U.S. Department of Agriculture (USDA) Nutrient Data Laboratory (NDL), in collaboration with Colorado State University, conducted a research study designed to update and expand the data on veal cuts in the USDA National Nutrient Database for Standard Reference (SR). This research has been necess...

Standard operating procedures for clinical research departments.

PubMed

Kee, Ashley Nichole

2011-01-01

A set of standard operating procedures (SOPs) provides a clinical research department with clear roles, responsibilities, and processes to ensure compliance, accuracy, and timeliness of data. SOPs also serve as a standardized training program for new employees. A practice may have an employee that can assist in the development of SOPs. There are also consultants that specialize in working with a practice to develop and write practice-specific SOPs. Making SOPs a priority will save a practice time and money in the long run and make the research practice more attractive to corporate study sponsors.

Women and teaching in academic psychiatry.

PubMed

Hirshbein, Laura D; Fitzgerald, Kate; Riba, Michelle

2004-01-01

This article explores past, present, and future issues for women and teaching in academic psychiatry. A small study of didactic teaching responsibilities along faculty groups in one academic psychiatry department helps to illustrate challenges and opportunities for women in psychiatric teaching settings. Although women have comprised half of all medical school admissions for over a decade, tenure-track positions are still largely dominated by men. In contrast, growing numbers of women have been entering academic medicine through clinical-track positions in which patient care and teaching, rather than research, are the key factors for promotion. Thus, the authors hypothesized better representation of clinical-track women in formal, didactic teaching within the medical school setting. The authors compared the numbers of tenure and clinical-track men and women teaching lectures to medical students and residents at the University of Michigan, Department of Psychiatry. Contrary to the hypothesis, the majority of didactic teaching was done by tenure-track men. Possible explanations and remedies for the continuing under-representation of women in academic psychiatry, particularly teaching settings, are explored. Suggestions are made for future areas in which female faculty might have opportunities for participation and leadership.

Fiscal Year 2007 Program Performance Plan

ERIC Educational Resources Information Center

US Department of Education, 2006

2006-01-01

The strategic goals and objectives set forth in the Department of Education's "FY (Fiscal Year) 2002-2007 Strategic Plan" form the context for the broad outcomes that the Department believes should characterize American education. The Department administers more than 150 programs in support of these goals and objectives. This "FY 2007 Program…

Pride and confidence at work: potential predictors of occupational health in a hospital setting

PubMed Central

Nilsson, Kerstin; Hertting, Anna; Petterson, Inga-Lill; Theorell, Töres

2005-01-01

Background This study focuses on determinants of a healthy work environment in two departments in a Swedish university hospital. The study is based on previously conducted longitudinal studies at the hospital (1994–2001), concerning working conditions and health outcomes among health care personnel in conjunction with downsizing processes. Overall, there was a general negative trend in relation to mental health, as well as long-term sick leave during the study period. The two departments chosen for the current study differed from the general hospital trend in that they showed stable health development. The aim of the study was to identify and analyse experiential determinants of healthy working conditions. Methods Thematic open-ended interviews were carried out with seventeen managers and key informants, representing different groups of co-workers in the two departments. The interviews were transcribed verbatim and an inductive content analysis was made. Results In the two studied departments the respondents perceived that it was advantageous to belong to a small department, and to work in cooperation-oriented care. The management approaches described by both managers and co-workers could be interpreted as transformational, due to a strain of visionary, delegating, motivating, confirmative, supportive attitudes and a strongly expressed solution-oriented attitude. The daily work included integrated learning activities. The existing organisational conditions, approaches and attitudes promoted tendencies towards a work climate characterised by trust, team spirit and professionalism. In the description of the themes organisational conditions, approaches and climate, two core determinants, work-pride and confidence, for healthy working conditions were interpreted. Our core determinants augment the well-established concepts: manageability, comprehensiveness and meaningfulness. These favourable conditions seem to function as a buffer against the general negative effects of downsizing observed elsewhere in the hospital, and in the literature. Conclusion Research illuminating health-promoting aspects is rather unusual. This study could be seen as explorative. The themes and core dimensions we found could be used as a basis for further intervention studies in similar health-care settings. The result could also be used in future health promotion studies in larger populations. One of the first steps in such a strategy is to formulate relevant questions, and we consider that this study contributes to this. PMID:16137331

Pride and confidence at work: potential predictors of occupational health in a hospital setting.

PubMed

Nilsson, Kerstin; Hertting, Anna; Petterson, Inga-Lill; Theorell, Töres

2005-09-01

This study focuses on determinants of a healthy work environment in two departments in a Swedish university hospital. The study is based on previously conducted longitudinal studies at the hospital (1994-2001), concerning working conditions and health outcomes among health care personnel in conjunction with downsizing processes. Overall, there was a general negative trend in relation to mental health, as well as long-term sick leave during the study period. The two departments chosen for the current study differed from the general hospital trend in that they showed stable health development. The aim of the study was to identify and analyse experiential determinants of healthy working conditions. Thematic open-ended interviews were carried out with seventeen managers and key informants, representing different groups of co-workers in the two departments. The interviews were transcribed verbatim and an inductive content analysis was made. In the two studied departments the respondents perceived that it was advantageous to belong to a small department, and to work in cooperation-oriented care. The management approaches described by both managers and co-workers could be interpreted as transformational, due to a strain of visionary, delegating, motivating, confirmative, supportive attitudes and a strongly expressed solution-oriented attitude. The daily work included integrated learning activities. The existing organisational conditions, approaches and attitudes promoted tendencies towards a work climate characterised by trust, team spirit and professionalism. In the description of the themes organisational conditions, approaches and climate, two core determinants, work-pride and confidence, for healthy working conditions were interpreted. Our core determinants augment the well-established concepts: manageability, comprehensiveness and meaningfulness. These favourable conditions seem to function as a buffer against the general negative effects of downsizing observed elsewhere in the hospital, and in the literature. Research illuminating health-promoting aspects is rather unusual. This study could be seen as explorative. The themes and core dimensions we found could be used as a basis for further intervention studies in similar health-care settings. The result could also be used in future health promotion studies in larger populations. One of the first steps in such a strategy is to formulate relevant questions, and we consider that this study contributes to this.

Experience in Strategic Networking to Promote Palliative Care in a Clinical Academic Setting in India

PubMed Central

Nair, Shoba; Tarey, SD; Barathi, B; Mary, Thiophin Regina; Mathew, Lovely; Daniel, Sudha Pauline

2016-01-01

Background: Palliative care in low and middle-income countries is a new discipline, responding to a greater patient need, than in high-income countries. By its very nature, palliative as a specialty has to network with other specialties to provide quality care to patients. For any medical discipline to grow as a specialty, it should be well established in the teaching medical institutions of that country. Data show that palliative care is more likely to establish and grow in an academic health care institution. It is a necessity that multiple networking strategies are adopted to reach this goal. Objectives: (1) To describe a strategic approach to palliative care service development and integration into clinical academic setting. (2) To present the change in metrics to evaluate progress. Design and Setting: This is a descriptive study wherein, the different strategies that are adopted by the Department of Palliative Medicine for networking in an academic health care institution and outside the institution are scrutinized. Measurement: The impact of this networking was assessed, one, at the level of academics and the other, at the level of service. The number of people who attended various training programs conducted by the department and the number of patients who availed palliative care service over the years were assessed. Results: Ten different strategies were identified that helped with networking of palliative care in the institution. During this time, the referrals to the department increased both for malignant diseases (52–395) and nonmalignant diseases (5–353) from 2000 to 2013. The academic sessions conducted by the department for undergraduates also saw an increase in the number of hours from 6 to 12, apart from the increase in a number of courses conducted by the department for doctors and nurses. Conclusion: Networking is an essential strategy for the establishment of a relatively new medical discipline like palliative care in a developing and populous country like India, where the service is disproportionate to the demands. PMID:26962274

Recruitment Strategies for Geoscience Majors: Conceptual Framework and Practical Suggestions

NASA Astrophysics Data System (ADS)

Richardson, R. M.; Eyles, C.; Ormand, C. J.

2009-12-01

One characteristic of strong geoscience departments is that they recruit and retain quality students. In a survey to over 900 geoscience departments in the US and Canada several years ago nearly 90% of respondents indicated that recruiting and retaining students was important. Two years ago we offered a pre-GSA workshop on recruiting and retaining students that attracted over 30 participants from over 20 different institutions, from liberal arts colleges to state universities to research intensive universities. Since then we have sought additional feedback from a presentation to the AGU Heads & Chairs at a Fall AGU meeting, and most recently from a workshop on strengthening geoscience programs in June 2009. In all of these settings, a number of themes and concrete strategies have emerged. Key themes included strategies internal to the department/institution; strategies that reach beyond the department/institution; determining how scalable/transferable strategies that work in one setting are to your own setting; identifying measures of success; and developing or improving on an existing action plan specific to your departmental/institutional setting. The full results of all of these efforts to distill best practices in recruiting students will be shared at the Fall AGU meeting, but some of the best practices for strategies local to the department/institution include: 1) focusing on introductory classes (having the faculty who are most successful in that setting teach them, having one faculty member make a common presentation to all classes about what one can do with a geoscience major, offering topical seminars, etc.); 2) informing students of career opportunities (inviting alumni back to talk to students, using AGI resources, etc.,); 3) creating common space for students to work, study, and be a community; 4) inviting all students earning an ‘A’ (or ‘B’) in introductory classes to a departmental event just for them; and 5) creating a field trip for incoming freshmen, whether they are planning to major in geoscience or not. Some of the best practices for strategies reaching beyond the department include: 1) working with college/university academic advisors, admissions, career services, especially for undecided students; 2) working with local high schools and community colleges, especially for underrepresented students; and 3) advertising where students communicate (Facebook, Twitter, etc.). As important as recruitment strategies are, it is critical to have an assessment plan in place to measure the success of recruitment efforts. It takes effort and resources, often human capital, to recruit students. If enrollments increase, regardless of recruitment efforts, then scarce resources have been wasted. Some of the best assessment practices include: 1) surveying students, especially those who have recently declared a geoscience major; and 2) surveying students who have been recruited but who have not become majors.

48 CFR 919.502-2 - Total small business set-asides.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Total small business set-asides. 919.502-2 Section 919.502-2 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 919.502-2 Total small business set...

48 CFR 1419.506 - Withdrawing or modifying small business set-asides.

Code of Federal Regulations, 2014 CFR

2014-10-01

... small business set-asides. 1419.506 Section 1419.506 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 1419.506 Withdrawing or modifying small business set-asides. The HCA is authorized, without the power of redelegation...

48 CFR 1419.506 - Withdrawing or modifying small business set-asides.

Code of Federal Regulations, 2012 CFR

2012-10-01

... small business set-asides. 1419.506 Section 1419.506 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 1419.506 Withdrawing or modifying small business set-asides. The HCA is authorized, without the power of redelegation...

48 CFR 919.502-2 - Total small business set-asides.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Total small business set-asides. 919.502-2 Section 919.502-2 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 919.502-2 Total small business set...

48 CFR 1419.506 - Withdrawing or modifying small business set-asides.

Code of Federal Regulations, 2013 CFR

2013-10-01

... small business set-asides. 1419.506 Section 1419.506 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 1419.506 Withdrawing or modifying small business set-asides. The HCA is authorized, without the power of redelegation...

48 CFR 919.502-2 - Total small business set-asides.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Total small business set-asides. 919.502-2 Section 919.502-2 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 919.502-2 Total small business set...

48 CFR 1419.506 - Withdrawing or modifying small business set-asides.

Code of Federal Regulations, 2011 CFR

2011-10-01

... small business set-asides. 1419.506 Section 1419.506 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 1419.506 Withdrawing or modifying small business set-asides. The HCA is authorized, without the power of redelegation...

48 CFR 919.502-2 - Total small business set-asides.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Total small business set-asides. 919.502-2 Section 919.502-2 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Set-Asides for Small Business 919.502-2 Total small business set...

How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China?

PubMed Central

Wang, Manli; Tao, Hongbing

2017-01-01

Objectives: Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design: This research is a cross-sectional study. Methods: In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures: The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t-tests and X2 tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results: A total of 56.49% of respondents were from surgical departments. The PPRs for “teamwork within units” and “organizational learning and continuous improvement” were ≥75%, which denoted strengths, and the PPRs for “staffing” and “non-punitive response to errors” were ≤50%, which denoted weaknesses in surgical units and other units. Three dimensions for surgical departments were weaker than those for other departments (p < 0.05). The staff from surgical units reported more events compared with the other units, but only a few respondents in surgical settings evaluated patient safety grade as good/excellent. Four dimensions influenced patient safety grade, and three dimensions influenced event reporting in surgical units. Conclusions: Strategies including recruiting workers, using the reporting system, and building a non-punitive culture should be adopted in the surgical units of county hospitals in China to improve safety culture. Supervisors should also prioritise patient safety. PMID:28954427

Graduate Medical Education Funding and Curriculum in Physical Medicine and Rehabilitation: A Survey of Physical Medicine and Rehabilitation Department Chairs.

PubMed

Perret, Danielle; Knowlton, Tiffany; Worsowicz, Gregory

2018-03-01

This national survey highlights graduate medical education funding sources for physical medicine and rehabilitation (PM&R) residency programs as well as perceived funding stability, alignment of the current funding and educational model, the need of further education in postacute care settings, and the practice of contemporary PM&R graduates as perceived by PM&R department/division chairs. Approximately half of the reported PM&R residency positions seem to be funded by Centers of Medicare and Medicaid Services; more than 40% of PM&R chairs believe that their residency program is undersized and nearly a quarter feel at risk for losing positions. A total of 30% of respondents report PM&R resident experiences in home health, 15% in long-term acute care, and 52.5% in a skilled nursing facility/subacute rehabilitation facility. In programs that do not offer these experiences, most chairs feel that this training should be included. In addition, study results suggest that most PM&R graduates work in an outpatient setting. Based on the results that chairs strongly feel the need for resident education in postacute care settings and that most graduates go on to practice in outpatient settings, there is a potential discordance for our current Centers of Medicare and Medicaid Services graduate medical education funding model being linked to the acute care setting.

Impact of Nitrate Use on Survival in Acute Heart Failure: A Propensity-Matched Analysis.

PubMed

Ho, Edwin C; Parker, John D; Austin, Peter C; Tu, Jack V; Wang, Xuesong; Lee, Douglas S

2016-02-12

There is limited evidence that the use of nitrates in acute decompensated heart failure early after presentation to a hospital can improve clinical outcomes. We aimed to determine whether early nitrate exposure is associated with improved survival in a large retrospective cohort study. We examined 11 078 acute decompensated heart failure patients who presented to emergency departments in Ontario, Canada, between 2004 and 2007, in the Enhanced Feedback For Effective Cardiac Treatment and the Emergency Heart failure Mortality Risk Grade studies. In propensity-matched analyses, we examined the effect of nitrate administration in the acute emergency department setting for its impact on death at 7, 30, and 365 days. In propensity-matched analyses, we found no difference in survival between those who received nitrates in the emergency department and the non-nitrate comparator group. Hazard ratios for mortality were 0.76 (95% CI; 0.51, 1.12) over 7 days, 0.97 (95% CI; 0.77, 1.21) over 30 days, and 0.91 (95% CI; 0.82, 1.02) over 1 year of follow-up. There was no significant difference in survival or hospital length of stay between nitrate and non-nitrate controls in extended follow-up. There was also no significant effect of nitrates in subgroups stratified by presence of chest pain, troponin elevation, chronic nitrate use, and known coronary artery disease. In acute decompensated heart failure, use of nitrates acutely in the emergency department setting was not associated with improvement in short-term or near-term survival. Our study does not support generalized use of nitrates when the primary goal of therapy is to reduce mortality. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Testing of low-risk patients presenting to the emergency department with chest pain: a scientific statement from the American Heart Association.

PubMed

Amsterdam, Ezra A; Kirk, J Douglas; Bluemke, David A; Diercks, Deborah; Farkouh, Michael E; Garvey, J Lee; Kontos, Michael C; McCord, James; Miller, Todd D; Morise, Anthony; Newby, L Kristin; Ruberg, Frederick L; Scordo, Kristine Anne; Thompson, Paul D

2010-10-26

The management of low-risk patients presenting to emergency departments is a common and challenging clinical problem entailing 8 million emergency department visits annually. Although a majority of these patients do not have a life-threatening condition, the clinician must distinguish between those who require urgent treatment of a serious problem and those with more benign entities who do not require admission. Inadvertent discharge of patients with acute coronary syndrome from the emergency department is associated with increased mortality and liability, whereas inappropriate admission of patients without serious disease is neither indicated nor cost-effective. Clinical judgment and basic clinical tools (history, physical examination, and electrocardiogram) remain primary in meeting this challenge and affording early identification of low-risk patients with chest pain. Additionally, established and newer diagnostic methods have extended clinicians' diagnostic capacity in this setting. Low-risk patients presenting with chest pain are increasingly managed in chest pain units in which accelerated diagnostic protocols are performed, comprising serial electrocardiograms and cardiac injury markers to exclude acute coronary syndrome. Patients with negative findings usually complete the accelerated diagnostic protocol with a confirmatory test to exclude ischemia. This is typically an exercise treadmill test or a cardiac imaging study if the exercise treadmill test is not applicable. Rest myocardial perfusion imaging has assumed an important role in this setting. Computed tomography coronary angiography has also shown promise in this setting. A negative accelerated diagnostic protocol evaluation allows discharge, whereas patients with positive findings are admitted. This approach has been found to be safe, accurate, and cost-effective in low-risk patients presenting with chest pain.

Trends in broad-spectrum antibiotic prescribing for children with acute otitis media in the United States, 1998–2004

PubMed Central

Coco, Andrew S; Horst, Michael A; Gambler, Angela S

2009-01-01

Background Overuse of broad-spectrum antibiotics is associated with antibiotic resistance. Acute otitis media (AOM) is responsible for a large proportion of antibiotics prescribed for US children. Rates of broad-spectrum antibiotic prescribing for AOM are unknown. Methods Analysis of the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1998 to 2004 (N = 6,878). Setting is office-based physicians, hospital outpatient departments, and emergency departments. Patients are children aged 12 years and younger prescribed antibiotics for acute otitis media. Main outcome measure is percentage of broad-spectrum antibiotics, defined as amoxicillin/clavulanate, macrolides, cephalosporins and quinolones. Results Broad-spectrum prescribing for acute otitis media increased from 34% of visits in 1998 to 45% of visits in 2004 (P < .001 for trend). The trend was primarily attributable to an increase in prescribing of amoxicillin/clavulanate (8% to 15%; P < .001 for trend) and macrolides (9% to 15%; P < .001 for trend). Prescribing remained stable for amoxicillin and cephalosporins while decreasing for narrow-spectrum agents (12% to 3%; P < .001 for trend) over the study period. Independent predictors of broad-spectrum antibiotic prescribing were ear pain, non-white race, public and other insurance (compared to private), hospital outpatient department setting, emergency department setting, and West region (compared to South and Midwest regions), each of which was associated with lower rates of broad-spectrum prescribing. Age and fever were not associated with prescribing choice. Conclusion Prescribing of broad-spectrum antibiotics for acute otitis media has steadily increased from 1998 to 2004. Associations with non-clinical factors suggest potential for improvement in prescribing practice. PMID:19552819

Validity of the International Classification of Diseases, Tenth Revision code for acute kidney injury in elderly patients at presentation to the emergency department and at hospital admission

PubMed Central

Hwang, Y Joseph; Shariff, Salimah Z; Gandhi, Sonja; Wald, Ron; Clark, Edward; Fleet, Jamie L; Garg, Amit X

2012-01-01

Objective To evaluate the validity of the International Classification of Diseases, Tenth Revision (ICD-10) code N17x for acute kidney injury (AKI) in elderly patients in two settings: at presentation to the emergency department and at hospital admission. Design A population-based retrospective validation study. Setting Southwestern Ontario, Canada, from 2003 to 2010. Participants Elderly patients with serum creatinine measurements at presentation to the emergency department (n=36 049) or hospital admission (n=38 566). The baseline serum creatinine measurement was a median of 102 and 39 days prior to presentation to the emergency department and hospital admission, respectively. Main outcome measures Sensitivity, specificity and positive and negative predictive values of ICD-10 diagnostic coding algorithms for AKI using a reference standard based on changes in serum creatinine from the baseline value. Median changes in serum creatinine of patients who were code positive and code negative for AKI. Results The sensitivity of the best-performing coding algorithm for AKI (defined as a ≥2-fold increase in serum creatinine concentration) was 37.4% (95% CI 32.1% to 43.1%) at presentation to the emergency department and 61.6% (95% CI 57.5% to 65.5%) at hospital admission. The specificity was greater than 95% in both settings. In patients who were code positive for AKI, the median (IQR) increase in serum creatinine from the baseline was 133 (62 to 288) µmol/l at presentation to the emergency department and 98 (43 to 200) µmol/l at hospital admission. In those who were code negative, the increase in serum creatinine was 2 (−8 to 14) and 6 (−4 to 20) µmol/l, respectively. Conclusions The presence or absence of ICD-10 code N17× differentiates two groups of patients with distinct changes in serum creatinine at the time of a hospital encounter. However, the code underestimates the true incidence of AKI due to a limited sensitivity. PMID:23204077

How to set up a departmental comparative effectiveness research unit: one department's experience.

PubMed

McDonald, Jennifer S; Port, John D; Bender, Claire E

2014-03-01

Comparative effectiveness research (CER) is the comparison of clinical interventions in real-world settings. The purpose of this article is to discuss the experiences of a CER unit created within the radiology department of one medical institution to provide an example of how to pursue CER within the field of radiology. Medical institutions would benefit from investing in CER by creating research groups specifically devoted to this evolving field.

Planning a Safe Environment: Occupational Safety in a University Setting.

ERIC Educational Resources Information Center

Drost, Donald A.

1988-01-01

A study of occupational safety issues at a state university with data collected from forms filed with the state's Department of Worker's Compensation Industrial Commission is discussed. University occupations that appear to be more susceptible to injury and the causes of these injuries are identified. (MLW)

INFO RELEASE. National Information Network for Recreation, Leisure and Sport.

ERIC Educational Resources Information Center

Sharma, Vidya S.

A study by the Northern Territories Department of Community Development systematically and specifically identified information needs and categories of clients through a set of intellectual concepts in the fields of sport, recreation, and leisure. A survey of Australia's serials holdings was conducted to assess the country's existing information…

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

Orientations to Academic Workloads at Department Level

ERIC Educational Resources Information Center

Wolf, Amanda

2010-01-01

Universities confront many challenges in their efforts to manage staff activity with the aid of workload assessment and allocation systems. This article sets out fresh perspectives from an exploratory study designed to uncover patterns of subjective views about various aspects of workloads. Using Q methodology, academic staff in a single…

Economics: Canada. Senior Division.

ERIC Educational Resources Information Center

Ontario Dept. of Education, Toronto.

This resource guide sets out a structure from which units, semester courses, or one-year courses may be developed in Canadian economic studies in the senior high. The Ontario Department of Education lists five possible aims for courses developed from this resource guide: 1) student awareness of fundamental problems, basic forces at work, and key…

10 CFR 602.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Purpose and scope. 602.1 Section 602.1 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS EPIDEMIOLOGY AND OTHER HEALTH STUDIES FINANCIAL ASSISTANCE PROGRAM § 602.1 Purpose and scope. This part sets forth the policies and procedures applicable to...

Patient Preference for Physician Gender in the Emergency Department

PubMed Central

Nolen, Haley A.; Moore, Justin Xavier; Rodgers, Joel B.; Wang, Henry E.; Walter, Lauren A.

2016-01-01

Despite historical gender bias against female physicians, few studies have investigated patients’ physician gender preference in the emergency department (ED) setting. We sought to determine if there is an association between ED patient demographics and physician gender preference. We surveyed patients presenting to an ED to determine association between patient demographics and patient physician gender preference for five ED situations: 1) ‘routine’ visit, 2) emergency visit, 3) ‘sensitive’ medical visit, 4) minor surgical/‘procedural’ visit, and 5) ‘bad news’ delivery. A total of 200 ED patients were surveyed. The majority of ED patients reported no physician gender preference for ‘routine’ visits (89.5 percent), ‘emergent’ visits (89 percent), ‘sensitive’ medical visits (59 percent), ‘procedural’ visits (89 percent) or when receiving ‘bad news’ (82 percent). In the setting of ‘routine’ visits and ‘sensitive’ medical visits, there was a propensity for same-sex physician preference. PMID:27354840

Differences in the Implementation of Diagnosis-Related Groups across Clinical Departments: A German Hospital Case Study

PubMed Central

Ridder, Hans-Gerd; Doege, Vanessa; Martini, Susanne

2007-01-01

Objective This article aims to examine the implementation process of diagnosis-related groups (DRGs) in the clinical departments of a German hospital group and to explain why some gain competitive advantage while others do not. Study Setting To investigate this research question, we conducted a qualitative study based on primary data obtained in six clinical departments in a German hospital group between 2003 and 2005. Study Design We chose the case study method in order to gain deep insights into the process dynamics of the implementation of DRGs in the six clinical departments. The dynamic capability approach is used as a theoretical foundation. Employing theory-driven categories we focused on idiosyncratic and common patterns of “successful coders” and “unsuccessful coders.” Data Collection To observe the implementation process of DRGs, we conducted 43 semistructured interviews with key persons, carried out direct observations of the monthly meetings of the DRG project group, and sampled written materials. Principal Findings “Successful coders” invest into change resources, demonstrate a high level of acceptance of innovations, and organize effective processes of coordination and learning. Conclusions All clinical departments only put an emphasis on the coding aspects of the DRGs. There is a lack of vision regarding the optimization of patient treatment processes and specialization. Physicians are the most important key actors, rather than the main barriers. PMID:17995556

Development of balanced key performance indicators for emergency departments strategic dashboards following analytic hierarchical process.

PubMed

Safdari, Reza; Ghazisaeedi, Marjan; Mirzaee, Mahboobeh; Farzi, Jebrail; Goodini, Azadeh

2014-01-01

Dynamic reporting tools, such as dashboards, should be developed to measure emergency department (ED) performance. However, choosing an effective balanced set of performance measures and key performance indicators (KPIs) is a main challenge to accomplish this. The aim of this study was to develop a balanced set of KPIs for use in ED strategic dashboards following an analytic hierarchical process. The study was carried out in 2 phases: constructing ED performance measures based on balanced scorecard perspectives and incorporating them into analytic hierarchical process framework to select the final KPIs. The respondents placed most importance on ED internal processes perspective especially on measures related to timeliness and accessibility of care in ED. Some measures from financial, customer, and learning and growth perspectives were also selected as other top KPIs. Measures of care effectiveness and care safety were placed as the next priorities too. The respondents placed least importance on disease-/condition-specific "time to" measures. The methodology can be presented as a reference model for development of KPIs in various performance related areas based on a consistent and fair approach. Dashboards that are designed based on such a balanced set of KPIs will help to establish comprehensive performance measurements and fair benchmarks and comparisons.

Mean Normal Portal Vein Diameter Using Sonography among Clients Coming to Radiology Department of Jimma University Hospital, Southwest Ethiopia.

PubMed

Geleto, Gemechu; Getnet, Wondim; Tewelde, Tsegaye

2016-05-01

Mean portal vein diameter is considered as the best indicator for portal hypertension. However, the cutoff point differs from study to study (above 10-15 mm) despite the existence of normal mean portal vein diameter between 10-15 mm in different settings.This implies the existence of limited evidence on normal portal vein diameter for all populations in all countries prior to setting the cutoff points. Therefore, the aim of this study was sonographic assessment of normal mean portal vein diameter among patients referred to The Department of Radiology in Jimma University Hospital. A facility based cross-sectional study was conducted from November to December 2014 at Jimma University Hospital on a total of 195 clients. Data about portal vein diameter for eligible clients were collected by radiologists using Sonography. Data were edited manually, entered and analyzed using SPSS version 16. Data were collected from a total of 195 participants. Among these, 121(62.1%) were males and the median age of the participants was 35 years. The study revealed a normal mean portal vein diameter of 10.6 mm ±1.8 SD with a respirophasic variation of 25.6%. Likewise, the normal mean portal vein diameter seemed to have varied significantly by age and sex. The study revealed a normal mean portal vein diameter ranging below 13 mm. Hence, decisions made in clinical settings should base on these findings. Besides, there is a need for large scale study to determine portal vein diameter variation by age and sex, controlling other confounders.

5 CFR 9701.334 - Setting and adjusting locality and special rate supplements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Locality and...

Speed limits set lower than engineering recommendations : project summary report.

DOT National Transportation Integrated Search

2016-08-01

The Montana Department of Transportation (MDT) generally ensures that posted speed limits are set in accordance with engineering recommendations, which means that speed limits are typically set such that they are about equal to the observed 85th-perc...

Effectiveness of Written Materials in a Rehabilitative Program for Female Offenders: A Case Study at the Montana Women's Prison

ERIC Educational Resources Information Center

Dillon, Laura; Colling, Kyle

2010-01-01

This case study of the Therapeutic Community Program at Montana Women's Prison investigates the relationship between inmate reading levels and the self-help materials used for rehabilitative purposes within prison settings. The Therapeutic Community Handbook, published by the Montana Department of Corrections, is used as the primary method of…

The Effective Use of Scientific and Technical Information in Industrial and Non-Profit Settings: A Study of Managerial Interventions.

ERIC Educational Resources Information Center

Shapero, Albert; And Others

A study conducted in a non profit research and development organization and the technical development department of a profit corporation was designed to develop and implement interventions that would modify the information-communication behaviors of the technical professionals in these organizations, and to measure and analyze the effects of the…

A Survey of Faculty Perceptions Regarding Workplace Democracy: A Descriptive Case Study of an Institution of Higher Education.

ERIC Educational Resources Information Center

Dottin, Erskine S.

A study investigated the attitudes, feelings, and perceptions of faculty members at the University of West Florida toward the larger workplace (the organization) and, in particular, their immediate work setting (climate). The two primary questions to be answered were: (1) do faculty perceive their departments as promoting or restricting workplace…

Antimicrobial Stewardship in the Emergency Department: Challenges, Opportunities, and a Call to Action for Pharmacists.

PubMed

Bishop, Bryan M

2016-12-01

Antimicrobial resistance is a national public health concern. Misuse of antimicrobials for conditions such as upper respiratory infection, urinary tract infections, and cellulitis has led to increased resistance to antimicrobials commonly utilized to treat those infections, such as sulfamethoxazole/trimethoprim and flouroquinolones. The emergency department (ED) is a site where these infections are commonly encountered both in ambulatory patients and in patients requiring admission to a hospital. The ED is uniquely positioned to affect the antimicrobial use and resistance patterns in both ambulatory settings and inpatient settings. However, implementing antimicrobial stewardship programs in the ED is fraught with challenges including diagnostic uncertainty, distractions secondary to patient or clinician turnover, and concerns with patient satisfaction to name just a few. However, this review article highlights successful interventions that have stemmed inappropriate antimicrobial use in the ED setting and warrant further study. This article also proposes other, yet to be validated proposals. Finally, this article serves as a call to action for pharmacists working in antimicrobial stewardship programs and in emergency medicine settings. There needs to be further research on the implementation of these and other interventions to reduce inappropriate antimicrobial use to prevent patient harm and curb the development of antimicrobial resistance. © The Author(s) 2015.

[Patient satisfaction in the outpatient department--a pilot study for customer satisfaction in ENT].

PubMed

Schmidt, K; Meyer, J; Jahnke, I; Wollenberg, B; Schmidt, C

2009-03-01

Customer satisfaction in German hospitals is becoming more important because of increasing competition in the healthcare market. Because the majority of patients with ear-nose-throat (ENT) problems are treated in an outpatient setting, this competition is not only taking place among hospitals but also among specialists in private practices. To assess patient preferences, reliable and valid questionnaires are necessary, which so far exist only for inpatients. The aim of the study was to develop an instrument with which to discover areas for potential improvement of the outpatient department. The questionnaire was developed according to the guidelines of the EORTC and tested in a prestudy. During the time of observation, 98 patients were available, of whom 79 could be included in the study. The return rate was 71%. Of these patients, 18 were female and 38 male; the median age was 56 years. There were no differences between the study group and the yearly clinic average in terms of age, gender, or ratio of tumor patients. Patients mainly complained about waiting times in the outpatient department and diagnostic units as well as high patient turnover. Concerning positive aspects, patients mentioned the medical competence of the treating physicians; concerning negative aspects, the building infrastructure was noted. The questionnaire showed sufficient psychometric properties and helped find areas for improvement in the outpatient department. However, a complete picture of the department will be feasible only with repeated measures, especially when taking steps to improve the department's processes.

Child Nutrition: MedlinePlus Health Topic

MedlinePlus

... 10 Tips for Setting Good Examples (Department of Agriculture) - PDF Also in Spanish Better Nutrition Every Day: ... 10 Tips to Decrease Added Sugars (Department of Agriculture) - PDF Also in Spanish Feeding Your Child Athlete ( ...

Toddler Nutrition: MedlinePlus Health Topic

MedlinePlus

... in Spanish Healthy Eating for Preschoolers (Department of Agriculture) - PDF Also in Spanish Nutrition Guide for Toddlers ( ... 10 Tips for Setting Good Examples (Department of Agriculture) - PDF Also in Spanish Children's Nutrition: Tips for ...

5 CFR 9701.323 - Eligibility for pay increase associated with a rate range adjustment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM (DEPARTMENT OF HOMELAND SECURITY-OFFICE OF PERSONNEL MANAGEMENT) DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Setting and...

Continuous Quality Improvement in a University Setting: The Case of the Department of Vocational and Technical Education at the University of Minnesota.

ERIC Educational Resources Information Center

Copa, George H.

1993-01-01

Discusses the application of continuous quality improvement principles in the Department of Vocational and Technical Education at the University of Minnesota. Reviews the processes that the department incorporated to implement this program and lists future steps and categories of action. (Author)

The life-cycle research productivity of mathematicians and scientists.

PubMed

Diamond, A M

1986-07-01

Declining research productivity with age is implied by economic models of life-cycle human capital investment but is denied by some recent empirical studies. The purpose of the present study is to provide new evidence on whether a scientist's output generally declines with advancing age. A longitudinal data set has been compiled for scientists and mathematicians at six major departments, including data on age, salaries, annual citations (stock of human capital), citations to current output (flow of human capital), and quantity of current output measured both in number of articles and in number of pages. Analysis of the data indicates that salaries peak from the early to mid-60s, whereas annual citations appear to peak from age 39 to 89 for different departments with a mean age of 59 for the 6 departments. The quantity and quality of current research output appear to decline continuously with age.

Competences for enhancing interprofessional collaboration in a paediatrics setting: Enabling and hindering factors.

PubMed

Solevåg, Anne Lee; Karlgren, Klas

2016-01-01

In 2011 an interprofessional educational programme called "Pediatric systematic assessment and communication for preventing emergencies" designed to increase clinical staff's competence in treating sick children was introduced in one paediatrics department in Norway. To elicit an in-depth understanding of the perceptions of clinical staff about the programme and enact adjustments according to identified enabling and hindering factors for learning, nurses and paediatricians were invited to participate in focus group interviews. The interviews were analysed by content analysis. Enabling factors for learning included improved interprofessional collaboration and positive feedback on performance. Hindering factors included perceptions that the programme was redundant and the fact that collaborating departments, such as the surgical departments, were not familiar with the programme. Peer learning, more interprofessional learning activities, and the fostering of a learning organization were suggestions for sustained learning. Based on the results of the study we have now included collaborating departments in the programme.

Chronic substance use and self-harm in a primary health care setting.

PubMed

Breet, Elsie; Bantjes, Jason; Lewis, Ian

2018-06-19

Chronic substance use (CSU) is associated with health problems, including selfharm, placing a significant burden on health care resources and emergency departments (EDs). This is problematic in low- and middle-income countries like South Africa (SA), where primary care facilitates and emergency departments (EDs) are often poorly resourced. To investigate the epidemiology of CSU and self-harm and to consider the implications for primary health care service delivery and suicide prevention in SA. Data were collected from 238 consecutive self-harm patients treated at the emergency department (ED) of an urban hospital in SA. The data were analysed using bivariate and multivariate analyses. Approximately 37% of self-harm patients reported CSU. The patients in the CSU subgroup, compared to other self-harm patients, were more likely to be men (odds ratio[OR] = 8.33, 95% confidence interval [CI] = 3.19-20.9, p < 0.001), to have self-harmed by inflicting damage to their body tissue OR = 4.45, 95% CI = 1.77-11.2, p < 0.01) and to have a history of self-harm (OR = 3.71, 95% CI = 1.44-9.54, p = 0.007). A significantly smaller proportion of CSU patients, compared to other self-harm patients, were referred for psychiatric assessment (OR = 8.05, 95% CI = 4.16-15.7, p < 0.001). The findings of this study confirm that CSU is associated with greater service utilisation and repetition of self-harm among patients in primary health care settings. Treating self-harm as the presenting problem within primary care settings does not necessarily ensure that patients receive the care that they need. It might be helpful to include psychiatric assessments and screening for CSU as an integral component of care for self-harm patientswho present in primary health care settings.

Relationship between Bullying and Suicidal Behaviour in Youth presenting to the Emergency Department

PubMed Central

Alavi, Nazanin; Reshetukha, Taras; Prost, Eric; Antoniak, Kristen; Patel, Charmy; Sajid, Saad; Groll, Dianne

2017-01-01

Objective Increasing numbers of adolescents are visiting emergency departments with suicidal ideation. This study examines the relationship between bullying and suicidal ideation in emergency department settings. Method A chart review was conducted for all patients under 18 years of age presenting with a mental health complaint to the emergency departments at Kingston General or Hotel Dieu Hospitals in Kingston, Canada, between January 2011 and January 2015. Factors such as age, gender, history of abuse, history of bullying, type and time of bullying, and diagnoses were documented. Results 77% of the adolescents had experienced bullying, while 68.9% had suicide ideation at presentation. While controlling for age, gender, grade, psychiatric diagnosis, and abuse, a history of bullying was the most significant predictor of suicidal ideation. Individuals in this study who reported cyber bullying were 11.5 times more likely to have suicidal ideation documented on presentation, while individuals reporting verbal bullying were 8.4 times more likely. Conclusions The prevalence of bullying in adolescent patients presenting to emergency departments is high. The relationship found between suicidal ideation and bullying demonstrates that clinicians should ask questions about bullying as a risk factor for suicide ideation during the assessment of children and adolescents. PMID:28747929

Portland cement based fast-setting concrete demonstration, district 07, Los Angeles County

DOT National Transportation Integrated Search

2001-09-01

The California Department of Transportation currently uses fast-setting concrete to accommodate short working windows. The current special provision for fast-setting concrete requires that the concrete reach a flexural strength of 2.8 MPa (400 psi) b...

Sketching Awareness: A Participatory Study to Elicit Designs for Supporting Ad Hoc Emergency Medical Teamwork

PubMed Central

Kusunoki, Diana; Sarcevic, Aleksandra; Zhang, Zhan; Yala, Maria

2014-01-01

Prior CSCW research on awareness in clinical settings has mostly focused on higher-level team coordination spanning across longer-term trajectories at the department and inter-department levels. In this paper, we offer a perspective on what awareness means within the context of an ad hoc, time- and safety-critical medical setting by looking at teams treating severely ill patients with urgent needs. We report findings from four participatory design workshops conducted with emergency medicine clinicians at two regional emergency departments. Workshops were developed to elicit design ideas for information displays that support awareness in emergency medical situations. Through analysis of discussions and clinicians’ sketches of information displays, we identified five features of teamwork that can be used as a foundation for supporting awareness from the perspective of clinicians. Based on these findings, we contribute rich descriptions of four facets of awareness that teams manage during emergency medical situations: team member awareness, elapsed time awareness, teamwork-oriented and patient-driven task awareness, and overall progress awareness. We then discuss these four awareness types in relation to awareness facets found in the CSCW literature. PMID:25870498

Evaluation of Suitability of Selected Set of Department of Defense Military Bases and Department of Energy Facilities for Siting a Small Modular Reactor

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

Poore III, Willis P; Belles, Randy; Mays, Gary T

This report summarizes the approach that ORNL developed for screening a sample set of US Department of Defense (DOD) military base sites and DOE sites for possible powering with an SMR; the methodology employed, including spatial modeling; and initial results for several sample sites. The objective in conducting this type of siting evaluation is demonstrate the capability to characterize specific DOD and DOE sites to identify any particular issues associated with powering the sites with an SMR using OR-SAGE; it is not intended to be a definitive assessment per se as to the absolute suitability of any particular site.

Current management of hyperglycemia in acute coronary syndromes: a national Dutch survey.

PubMed

de Mulder, Maarten; Oemrawsingh, Rohit M; Stam, Frank; Boersma, Eric; Umans, Victor A W M

2009-06-01

Hyperglycemia is common among patients admitted with acute coronary syndromes (ACS) and is associated with less favorable clinical outcomes. Guidelines for the treatment of hyperglycemia in myocardial infarction are confusing, partly because of lack of sufficient evidence. Neither do we know what the everyday practice on hyperglycemia in ACS is. Therefore the aim of our study is to describe current glucose management in ACS patients in The Netherlands. We designed a multiple-choice questionnaire that was emailed to all 94 independent cardiology departments of each of the 114 hospitals within The Netherlands. We interviewed cardiologists about their specific hospital setting, the presence, content, and actual use of a dedicated hyperglycemia protocol in the setting of ACS. Ninety-four questionnaires were returned (response rate 100%). Only 32% of the respondents reported to have a routinely applied, dedicated hyperglycemia protocol in the setting of ACS. An admission glucose of 13.0 mmol/L is considered a stress value by 60% of respondents. Treatment of hyperglycemia is postponed until after the acute phase (ie, after >6 hours) in 41% of the cardiology departments and in 76% HbA1c is not routinely measured before discharge. Only a minority of Dutch cardiology departments have a routinely applied, dedicated hyperglycemia protocol for patients admitted with ACS. Different views exist on the interpretation of admission hyperglycemia in patients without previously diagnosed diabetes. Dedicated protocols with well-established treatment goals allow early treatment and are mandatory to improve timely metabolic regulation.

Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

PubMed

Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

2016-06-01

This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases. © The Author(s) 2014.

Understanding the barriers to setting up a healthcare quality improvement process in resource-limited settings: a situational analysis at the Medical Department of Kamuzu Central Hospital in Lilongwe, Malawi.

PubMed

Agyeman-Duah, Josephine Nana Afrakoma; Theurer, Antje; Munthali, Charles; Alide, Noor; Neuhann, Florian

2014-01-02

Knowledge regarding the best approaches to improving the quality of healthcare and their implementation is lacking in many resource-limited settings. The Medical Department of Kamuzu Central Hospital in Malawi set out to improve the quality of care provided to its patients and establish itself as a recognized centre in teaching, operations research and supervision of district hospitals. Efforts in the past to achieve these objectives were short-lived, and largely unsuccessful. Against this background, a situational analysis was performed to aid the Medical Department to define and prioritize its quality improvement activities. A mix of quantitative and qualitative methods was applied using checklists for observed practice, review of registers, key informant interviews and structured patient interviews. The mixed methods comprised triangulation by including the perspectives of the clients, healthcare providers from within and outside the department, and the field researcher's perspectives by means of document review and participatory observation. Human resource shortages, staff attitudes and shortage of equipment were identified as major constraints to patient care, and the running of the Medical Department. Processes, including documentation in registers and files and communication within and across cadres of staff were also found to be insufficient and thus undermining the effort of staff and management in establishing a sustained high quality culture. Depending on their past experience and knowledge, the stakeholder interviewees revealed different perspectives and expectations of quality healthcare and the intended quality improvement process. Establishing a quality improvement process in resource-limited settings is an enormous task, considering the host of challenges that these facilities face. The steps towards changing the status quo for improved quality care require critical self-assessment, the willingness to change as well as determined commitment and contributions from clients, staff and management.

Patient compliance with managed care emergency department referral: an orthopaedic view.

PubMed

Saroff, Don; Dell, Rick; Brown, E Richard

2002-04-01

Patient compliance with emergency department (ED)-generated referral is an important part of the delivery of quality health care. Although many studies from non-managed care health centers have reported on ED patient compliance, no studies have reported on this in a managed care setting. The objective of this study is to examine patient compliance with ED-generated referral and to produce a benchmark of follow-up rates possible in a capitated managed care system. That is to say, in a health care system whose members pay a uniform per capita payment or fee, one that has salaried physicians, owns its own hospitals, and has a mechanism of transition from ED to outpatient clinic that ensures referral accessibility. Retrospective review of consecutive ED patient compliance with ED-generated referral. All consecutive patients who presented to a managed care hospital's ED with an acute fracture and who were given an outpatient referral during the period from 23rd December 1998 to 23rd January, 1999. Of 8000 consecutive ED patients, 234 were included in the study. Compliance with ED-generated referral was determined from outpatient clinic records. Of the 234 patients treated in the ED and referred, 222 (94.9%) complied with follow-up appointments. We have demonstrated that an ED patient follow-up compliance rate of 94.9% can be obtained. It is probable that the high compliance rate is due to the features of the system studied. The high rate may also be related to the specific diagnosis studied, although previous literature reports poor ED patient compliance for the same diagnosis in a different ED setting. Additional research is needed to determine whether the high compliance rate reported in this study can be obtained in ED settings that are not part of a similar managed care system and to determine the role of referral accessibility (or inaccessibility) in current ED settings.

5 CFR 9701.354 - Setting pay upon demotion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Setting pay upon demotion. 9701.354 Section 9701.354 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT... HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Pay Administration § 9701.354 Setting pay...

5 CFR 9701.351 - Setting an employee's starting pay.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Setting an employee's starting pay. 9701.351 Section 9701.351 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES... SECURITY HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Pay Administration § 9701.351 Setting...

5 CFR 9701.353 - Setting pay upon promotion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Setting pay upon promotion. 9701.353 Section 9701.353 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT... HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Pay Administration § 9701.353 Setting pay...

The pediatric resuscitative thoracotomy during combat operations in Iraq and Afghanistan - A retrospective cohort study.

PubMed

Schauer, Steven G; Hill, Guyon J; Connor, Richard E; Oh, John S; April, Michael D

2018-05-01

Combat zone trauma poses a unique set of challenges and injury patterns not seen in the civilian setting. The role of the pediatric resuscitative thoracotomy in combat zones remains unclear given a paucity of data regarding procedure outcomes in this setting. We compare outcomes among children in traumatic arrest undergoing resuscitative thoracotomy versus cardiopulmonary (CPR) resuscitation only. We queried the Department of Defense Trauma Registry (DODTR) from 2007 to 2016 for all pediatric subjects that underwent a resuscitative thoracotomy or CPR in the prehospital or emergency department setting during operations in Iraq or Afghanistan. We removed CPR subjects with mechanisms of injury not matched in the thoracotomy cohort. During the study period, there were 3439 pediatric encounters. We identified 13 subjects who underwent a resuscitative thoracotomy and 66 subjects who underwent CPR without thoracotomy with matching mechanisms of injury. When comparing the two cohorts those in the thoracotomy group had higher median thorax body region scores (median 3 versus 0, p = .001), but a trend towards higher rates of survival to discharge (31% versus 9%, p = .108). The youngest survivor in the thoracotomy cohort was less than 1 year old. We observed a trend towards higher survival among subjects that underwent a resuscitative thoracotomy survived to hospital discharge compared to subjects undergoing CPR without thoracotomy. The literature will benefit from further data to confirm an association between this procedure and a survival benefit among pediatric subjects in the resource limited setting. Furthermore, improvements in documentation will guide equipping and training providers expected to care for pediatric trauma patients. Published by Elsevier Ltd.

Understanding management and support for domestic violence and abuse within emergency departments: A systematic literature review from 2000-2015.

PubMed

Hinsliff-Smith, Kathryn; McGarry, Julie

2017-12-01

To identify, review and critically evaluate published empirical studies concerned with the prevalence, management and support for survivors of domestic violence and abuse who present at emergency department. Domestic violence and abuse is a global phenomenon with a wealth of studies that explore the different aspects of the issue including the economic, social and health effects on survivors and on society as a whole. Emergency department is widely recognised as one healthcare facility where domestic violence and abuse survivors will often disclose domestic violence and abuse. In the UK, National Institute of Clinical Excellence produced guidelines in 2014 requiring all sectors of health care and those they work alongside to recognise support and manage survivors of domestic violence and abuse. Whilst there is an increasing body of research on domestic violence and abuse, limited synthesised work has been conducted in the context of domestic violence and abuse within emergency department. This review encompasses empirical studies conducted in emergency department for screening interventions, management and support for domestic violence and abuse patients including prevalence. This review included studies that included emergency department staff, emergency department service users and domestic violence and abuse survivors. A systematic approach across five electronic bibliographic databases found 35 studies meeting the inclusion criteria published between 2000-2015. From the 35 studies, four descriptive overarching themes were identified (i) prevalence of domestic violence and abuse in emergency department, (ii) use of domestic violence and abuse screening tools and emergency department interventions, (iii) current obstacles for staff working in emergency department and (iv) emergency department users and survivor perspectives. Having knowledgeable and supportive emergency department staff can have a positive benefit for the longer-term health of the domestic violence and abuse survivor who seeks help. The physical characteristics of domestic violence and abuse are often easier to identify and manage, but emotional and psychological aspects of domestic violence and abuse are often more complex and difficult for staff to identify. This therefore raises questions as to what approaches can be used, within these busy settings, when often survivors do not want to disclose. Domestic violence and abuse has been shown to have a direct impact on the health and well-being of survivors who will often access emergency department services with direct injuries and associated medical conditions. This article is relevant to those working in the emergency department in raising awareness in a number of areas of practice for example the prevalence of male intimate partner violence survivors. Furthermore, patients do not always disclose domestic violence and abuse even in cases where there is clear sustained injury thus requiring staff to be vigilant to repeat attendees and patient history. This requires a well-maintained and effective reporting system for instances of suspected and disclosed domestic violence and abuse in order that staff can provide the appropriate care and support. Emergency department staff often deal with complex cases, this includes different aspects of domestic violence and abuse including physical, emotional and psychological abuse. Continual support and guidance, including educational interventions, would assist emergency department clinical staff to manage and discuss instances of domestic violence and abuse in their workplace and their interactions with domestic violence and abuse patients. Whilst training for emergency department staff is welcomed, there also needs to be a greater awareness of the potential complexity of domestic violence and abuse presentations beyond physical injury in order for staff to remain observant throughout consultations. It is also suggested that clear domestic violence and abuse assessment and referral mechanisms should be embedded into clinical practice, including emergency department, as described in the UK National Institute of Clinical Excellence guidelines (2014). Overall improvements in reporting mechanisms in emergency department for the identification, management and support for domestic violence and abuse survivors would add to the collective and growing body of evidence surrounding domestic violence and abuse and their presentations within healthcare settings. Such measures would enable those working in emergency department to support disclosure of domestic violence and abuse more effectively. © 2017 John Wiley & Sons Ltd.

77 FR 31153 - Providing an Order of Succession Within the Department of Agriculture

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-24

... Providing an Order of Succession Within the Department of Agriculture By the authority vested in me as... set forth in the Act, the following officials of the Department of Agriculture, in the order listed, shall act as and perform the functions and duties of the office of Secretary of Agriculture (Secretary...

Development of Leadership Skills in Community College Department Chairs

ERIC Educational Resources Information Center

Sirkis, Jocelyn Eager

2011-01-01

The role of a community college department chairperson is not well defined and the job is often perceived as more of a burden than an honor. Faculty come to the position frequently by "default" and without a ready set of management and leadership skills. The matter is of concern since chairs influence academic department strategy, culture, and…

[Impact of quality-indicator-based measures to improve the treatment of acute poisoning in pediatric emergency patients].

PubMed

Martínez Sánchez, Lidia; Trenchs Sainz de la Maza, Victoria; Azkunaga Santibáñez, Beatriz; Nogué-Xarau, Santiago; Ferrer Bosch, Nuria; García González, Elsa; Luaces I Cubells, Carles

2016-02-01

To analyze the impact of quality-indicator-based measures for improving quality of care for acute poisoning in pediatric emergency departments. Recent assessments of quality indicators were compared with benchmark targets and with results from previous studies. The first study evaluated 6 basic indicators in the pediatric emergency departments of members of to the working group on poisoning of the Spanish Society of Pediatric Emergency Medicine (GTI-SEUP). The second study evaluated 20 indicators in a single emergency department of GTI-SEUP members. Based on the results of those studies, the departments implemented the following corrective measures: creation of a team for gastric lavage follow-up, preparation of a new GTI-SEUP manual on poisoning, implementation of a protocol for poisoning incidents, and creation of specific poisoning-related fields for computerized patient records. The benchmark targets were reached on 4 quality indicators in the first study. Improvements were seen in the availability of protocols, as indicators exceeded the target in all the pediatric emergency departments (vs 29.2% of the departments in an earlier study, P < .001). No other significant improvements were observed. In the second study the benchmarks were reached on 13 indicators. Improvements were seen in compliance with incident reporting to the police (recently, 44.4% vs 19.2% previously, P = .036), case registration in the minimum basic data set (51.0% vs 1.9%, P < .001), and a trend toward increased administration of activated carbon within 2 hours (93.1% vs 83.5%, P = .099). No other significant improvements were seen. The corrective measures led to improvements in some quality indicators. There is still room for improvement in these emergency departamens' care of pediatric poisoning.

High Aspirations: Transforming Dance Students from Print Consumers to Digital Producers

ERIC Educational Resources Information Center

Alvarez, Inma

2013-01-01

During 2012, the Dance Department at the University of Surrey developed a set of Open Educational Resources with a Creative Commons license (Attribution, Non- Commercial, Share Alike) for dance studies as part of the JISC-funded project Contexts, Culture and Creativity: Enriching E-learning in Dance (CCC:EED) see…

Leveraging Technology to Improve Developmental Mathematics Course Completion: Evaluation of a Large-Scale Intervention

ERIC Educational Resources Information Center

Wladis, Claire; Offenholley, Kathleen; George, Michael

2014-01-01

This study hypothesizes that course passing rates in remedial mathematics classes can be improved through early identification of at-risk students using a department-wide midterm, followed by a mandated set of online intervention assignments incorporating immediate and elaborate feedback for all students identified as "at-risk" by their…

Visualizing Three-Dimensional Calculus Concepts: The Study of a Manipulative's Effectiveness

ERIC Educational Resources Information Center

McGee, Daniel, Jr.; Moore-Russo, Deborah; Ebersole, Dennis; Lomen, David O.; Quintero, Maider Marin

2012-01-01

With the help of the National Science Foundation, the Department of Mathematics at the University of Puerto Rico in Mayaguez has developed a set of manipulatives to help students of science and engineering visualize concepts relating to points, surfaces, curves, contours, and vectors in three dimensions. This article will present the manipulatives…

Learning To Compete.

ERIC Educational Resources Information Center

National Advisory Commission on Work-Based Learning (DOL), Washington, DC.

The National Advisory Commission on Work-Based Learning worked to identify practical steps that the Labor Department could take to help increase the skill levels of the U.S. work force and expand work-based training. The findings gained from a series of roundtables and further studies were synthesized into a set of recommendations in five major…

Massachusetts Study of Teacher Supply and Demand: Trends and Projections

ERIC Educational Resources Information Center

Levin, Jesse; Berg-Jacobson, Alex; Atchison, Drew; Lee, Katelyn; Vontsolos, Emily

2015-01-01

In April 2015, the Massachusetts Department of Elementary and Secondary Education (ESE) commissioned American Institutes for Research (AIR) to develop a comprehensive set of 10-year projections of teacher supply and demand in order to inform planning for future workforce needs. This included state-level projections both in the aggregate, as well…

Universal Leadership Behaviors and the Occupational Information Network's Generalized Work Activities

ERIC Educational Resources Information Center

Hurt, Andrew C.; Homan, Scott R.

2008-01-01

Recent leadership literature suggests that there is a growing trend to explore the idea of identifying universally accepted leadership behaviors. Before common leadership behaviors can be identified a standardized set of descriptors must be utilized. This study looks at the potential role of the U.S. Department of Labor's Occupational Information…

Known and Unknown Weaknesses in Software Animated Demonstrations (Screencasts): A Study in Self-Paced Learning Settings

ERIC Educational Resources Information Center

Palaigeorgiou, George; Despotakis, Theofanis

2010-01-01

Learning about computers continues to be regarded as a rather informal and complex landscape dominated by individual exploratory and opportunistic approaches, even for students and instructors in Computer Science Departments. During the last two decades, software animated demonstrations (SADs), also known as screencasts, have attracted particular…

Making Teaching Community Property: A Menu for Peer Collaboration and Peer Review. AAHE Teaching Initiative.

ERIC Educational Resources Information Center

Hutchings, Pat

A collection of program descriptions and case studies in college faculty peer collaboration and peer review includes: "Setting a Scholarly Tone: Teaching Circles in the History Department at Kent State University"; "Fostering Collective Responsibility for Student Learning: Teaching Seminars in the University of North Carolina at Charlotte…

Heart Rate Variability during Simulated Hemorrhage with Lower Body Negative Pressure in High and Low Tolerant Subjects

DTIC Science & Technology

2011-11-01

Army Institute of Surgical Research, Fort Sam Houston, TX, USA 2 Department of Health and Kinesiology , University of Texas at San Antonio, San Antonio...reduced HRV (Thayer and Sternberg, 2006).HRVhas been extensively studied in hospital settings such as intensive care units to assess cardiovascular

Department of Defense Gateway Information System (DGIS) Users’ Guide

DTIC Science & Technology

1993-10-01

all citations about any or all of ’he search terms of interest . Usually, all of the search terms combined using the OR operator are different ways to...Form at ........................................................................ 5-6 Baud Rate ...Set parity to none Set duplex (or echo)to full or Set duplex (or echo)to full Set baud rate to 300, 1200, 2400, 9600 Set baud rate to

Interprofessional education in a student-led emergency department: A realist evaluation.

PubMed

Ericson, Anne; Löfgren, Susanne; Bolinder, Gunilla; Reeves, Scott; Kitto, Simon; Masiello, Italo

2017-03-01

This article reports a realist evaluation undertaken to identify factors that facilitated or hindered the successful implementation of interprofessional clinical training for undergraduate students in an emergency department. A realist evaluation provides a framework for understanding how the context and underlying mechanisms affect the outcome patterns of an intervention. The researchers gathered both qualitative and quantitative data from internal documents, semi-structured interviews, observations, and questionnaires to study what worked, for whom, and under what circumstances in this specific interprofessional setting. The study participants were medical, nursing, and physiotherapy students, their supervisors, and two members of the emergency department's management staff. The data analysis indicated that the emergency ward provided an excellent environment for interprofessional education (IPE), as attested by the students, supervisors, and the clinical managers. An essential prerequisite is that the students have obtained adequate skills to work independently. Exemplary conditions for IPE to work well in an emergency department demand the continuity of effective and encouraging supervision throughout the training period and supervisors who are knowledgeable about developing a team.

A Comparison of Teachers' Perceptions of Principal Effectiveness in National Blue Ribbon Schools and Matched Sets of Selected Non-Blue Ribbon Schools in Pennsylvania

ERIC Educational Resources Information Center

Giffing, Ryan Robert

2010-01-01

With a focus on leadership, this study examines the leadership characteristics of principals in schools that are recognized as National Blue Ribbon Schools by the United States Department of Education. This mixed methodology study utilizes the causal comparative method to compare what teachers consider to be effective leadership characteristics of…

Corporate Culture in a University Setting: An Analysis of Theory "X," Theory "Y" and Theory "Z" Cultures within University Academic Departments.

ERIC Educational Resources Information Center

Semlak, William D.; And Others

A study used M. Cuffe and J. F. Cragan's three-dimensional model for understanding corporate culture within an organization to describe the managerial styles of chairpersons at Illinois State University. Case studies were completed for 18 chairpersons, who then sorted 60 statements on leadership style on a forced choice continuum from most…

77 FR 3035 - Pricing for 2012 Annual Sets and America the Beautiful Quarters® Bags & Rolls

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-20

... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2012 Annual Sets and America the...: Notice. SUMMARY: The United States Mint is announcing 2012 pricing for annual sets and the America the... States Mint Uncirculated Coin Set[supreg] 27.95 2012 United States Mint America the Beautiful Quarters...

Mental Health Concerns: Veterans & Active Duty

MedlinePlus

... recent years to encourage better mental health. The Department of Defense acknowledges that untreated mental health conditions pose a ... your care provider will inform you that the Department of Defense follows the privacy guidelines set down by HIPAA ...

Iowa Department of Transportation's Disadvantaged Business Enterprise Program.

DOT National Transportation Integrated Search

2006-04-01

The Iowa Department of Transportation (DOT) has prepared its disadvantaged business enterprise (DBE) program to meet Federal DBE regulations set forth in 49 CFR part 26. To continue receiving Federal financial assistance, appropriated under Safe, Acc...

Food Service Recycling: Whose Responsibility Is It?

ERIC Educational Resources Information Center

Settanni, Barbara

1990-01-01

The food service department at a Pennsylvania school district recycles polystyrene "styrofoam" cups, plates, and food trays. In addition, the department recycles glass, aluminum, and paper. Offers advice on how to set up a school program. (MLF)

76 FR 18163 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... methodological or analytical issues relevant to the Department's conduct of Sunset Reviews is set forth in the... antidumping and countervailing duty orders: DOC Case No. ITC Case No. Country Product Department contact A-588...

U.S. Department of Transportation strategic plan

DOT National Transportation Integrated Search

2010-01-01

This Strategic Plan describes the Department of Transportations new ideas through : goals, strategies and the results we will achieve to improve the United States : transportation sector. We have set policy goals in five strategic areas: Safety, R...

Best strategies to implement clinical pathways in an emergency department setting: study protocol for a cluster randomized controlled trial.

PubMed

Jabbour, Mona; Curran, Janet; Scott, Shannon D; Guttman, Astrid; Rotter, Thomas; Ducharme, Francine M; Lougheed, M Diane; McNaughton-Filion, M Louise; Newton, Amanda; Shafir, Mark; Paprica, Alison; Klassen, Terry; Taljaard, Monica; Grimshaw, Jeremy; Johnson, David W

2013-05-22

The clinical pathway is a tool that operationalizes best evidence recommendations and clinical practice guidelines in an accessible format for 'point of care' management by multidisciplinary health teams in hospital settings. While high-quality, expert-developed clinical pathways have many potential benefits, their impact has been limited by variable implementation strategies and suboptimal research designs. Best strategies for implementing pathways into hospital settings remain unknown. This study will seek to develop and comprehensively evaluate best strategies for effective local implementation of externally developed expert clinical pathways. We will develop a theory-based and knowledge user-informed intervention strategy to implement two pediatric clinical pathways: asthma and gastroenteritis. Using a balanced incomplete block design, we will randomize 16 community emergency departments to receive the intervention for one clinical pathway and serve as control for the alternate clinical pathway, thus conducting two cluster randomized controlled trials to evaluate this implementation intervention. A minimization procedure will be used to randomize sites. Intervention sites will receive a tailored strategy to support full clinical pathway implementation. We will evaluate implementation strategy effectiveness through measurement of relevant process and clinical outcomes. The primary process outcome will be the presence of an appropriately completed clinical pathway on the chart for relevant patients. Primary clinical outcomes for each clinical pathway include the following: Asthma--the proportion of asthmatic patients treated appropriately with corticosteroids in the emergency department and at discharge; and Gastroenteritis--the proportion of relevant patients appropriately treated with oral rehydration therapy. Data sources include chart audits, administrative databases, environmental scans, and qualitative interviews. We will also conduct an overall process evaluation to assess the implementation strategy and an economic analysis to evaluate implementation costs and benefits. This study will contribute to the body of evidence supporting effective strategies for clinical pathway implementation, and ultimately reducing the research to practice gaps by operationalizing best evidence care recommendations through effective use of clinical pathways. ClinicalTrials.gov: NCT01815710.

Comparison of the International Crowding Measure in Emergency Departments (ICMED) and the National Emergency Department Overcrowding Score (NEDOCS) to measure emergency department crowding: pilot study.

PubMed

Boyle, Adrian; Abel, Gary; Raut, Pramin; Austin, Richard; Dhakshinamoorthy, Vijayasankar; Ayyamuthu, Ravi; Murdoch, Iona; Burton, Joel

2016-05-01

There is uncertainty about the best way to measure emergency department crowding. We have previously developed a consensus-based measure of crowding, the International Crowding Measure in Emergency Departments (ICMED). We aimed to obtain pilot data to evaluate the ability of a shortened form of the ICMED, the sICMED, to predict senior emergency department clinicians' concerns about crowding and danger compared with a very well-studied measure of emergency department crowding, the National Emergency Department Overcrowding Score (NEDOCS). We collected real-time observations of the sICMED and NEDOCS and compared these with clinicians' perceptions of crowding and danger on a visual analogue scale. Data were collected in four emergency departments in the East of England. Associations were explored using simple regression, random intercept models and models accounting for correlation between adjacent time points. We conducted 82 h of observation in 10 observation sets. Naive modelling suggested strong associations between sICMED and NEDOCS and clinician perceptions of crowding and danger. Further modelling showed that, due to clustering, the association between sICMED and danger persisted, but the association between these two measures and perception of crowding was no longer statistically significant. Both sICMED and NEDOCS can be collected easily in a variety of English hospitals. Further studies are required but initial results suggest both scores may have potential use for assessing crowding variation at long timescales, but are less sensitive to hour-by-hour variation. Correlation in time is an important methodological consideration which, if ignored, may lead to erroneous conclusions. Future studies should account for such correlation in both design and analysis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

48 CFR 206.203 - Set-asides for small business concerns.

Code of Federal Regulations, 2010 CFR

2010-10-01

... REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE ACQUISITION PLANNING COMPETITION REQUIREMENTS Full and Open Competition After Exclusion of Sources 206.203 Set-asides for small business concerns. (b) Also no separate...

Assessment of an intervention to train teaching hospital care providers in quality management

PubMed Central

Francois, P; Vinck, D; Labarere, J; Reverdy, T; Peyrin, J

2005-01-01

Background: Successful implementation of continuous quality improvement (CQI) programs in hospitals remains rare in all countries, making it necessary to experiment with implementation methods while considering the cultural factors of resistance to change. Objective: To assess the impact of an educational intervention on involvement of clinical department staff in the quality process. Setting: Twelve voluntary clinical departments (six experimental and six controls) in a French 2000-bed university hospital comprising 40 clinical departments. Intervention: Three day training seminar to a group of 12–20 staff members from each department. Design: Quasi-experimental post-test only design study with control group conducted 12 months after the intervention with a questionnaire completed in a face-to-face interview. Subjects: 98 trained staff and 100 untrained staff from the six experimental departments and 100 staff from the six control departments. Principal measurements: Declared knowledge of the CQI methods and participation in quality management activities. Results: 286 people (96%) were involved in the study. More of the trained staff knew the CQI methods (62.4%) than staff in the control departments (16.5%) (adjusted odds ratio (ORa) = 10.6 (95% CI 4.97 to 22.62)). More trained staff also participated in quality improvement work groups than control department staff (76.3% v 14.0%; ORa = 27.4 (95% CI 11.6 to 64.4)). In the experimental departments the untrained staff's knowledge of CQI methods and their participation in work groups did not differ from that of control department staff. Conclusions: A continuing education intervention can involve care providers in CQI. Dissemination of knowledge from trained personnel to other staff members remains limited. PMID:16076785

Validity of the International Classification of Diseases 10th revision code for hospitalisation with hyponatraemia in elderly patients

PubMed Central

Gandhi, Sonja; Shariff, Salimah Z; Fleet, Jamie L; Weir, Matthew A; Jain, Arsh K; Garg, Amit X

2012-01-01

Objective To evaluate the validity of the International Classification of Diseases, 10th Revision (ICD-10) diagnosis code for hyponatraemia (E87.1) in two settings: at presentation to the emergency department and at hospital admission. Design Population-based retrospective validation study. Setting Twelve hospitals in Southwestern Ontario, Canada, from 2003 to 2010. Participants Patients aged 66 years and older with serum sodium laboratory measurements at presentation to the emergency department (n=64 581) and at hospital admission (n=64 499). Main outcome measures Sensitivity, specificity, positive predictive value and negative predictive value comparing various ICD-10 diagnostic coding algorithms for hyponatraemia to serum sodium laboratory measurements (reference standard). Median serum sodium values comparing patients who were code positive and code negative for hyponatraemia. Results The sensitivity of hyponatraemia (defined by a serum sodium ≤132 mmol/l) for the best-performing ICD-10 coding algorithm was 7.5% at presentation to the emergency department (95% CI 7.0% to 8.2%) and 10.6% at hospital admission (95% CI 9.9% to 11.2%). Both specificities were greater than 99%. In the two settings, the positive predictive values were 96.4% (95% CI 94.6% to 97.6%) and 82.3% (95% CI 80.0% to 84.4%), while the negative predictive values were 89.2% (95% CI 89.0% to 89.5%) and 87.1% (95% CI 86.8% to 87.4%). In patients who were code positive for hyponatraemia, the median (IQR) serum sodium measurements were 123 (119–126) mmol/l and 125 (120–130) mmol/l in the two settings. In code negative patients, the measurements were 138 (136–140) mmol/l and 137 (135–139) mmol/l. Conclusions The ICD-10 diagnostic code for hyponatraemia differentiates between two groups of patients with distinct serum sodium measurements at both presentation to the emergency department and at hospital admission. However, these codes underestimate the true incidence of hyponatraemia due to low sensitivity. PMID:23274673

Characteristics and Outcomes of Psychology Referrals in Palliative Care Department.

PubMed

Ann-Yi, Sujin; Bruera, Eduardo; Wu, Jimin; Liu, Diane D; Agosta, Monica; Williams, Janet L; Balankari, Vishidha Reddy; Carmack, Cindy L

2018-06-06

Psychologists can provide unique contributions to interdisciplinary palliative care. Despite research indicating high distress in palliative care cancer patients, little has been reported regarding the feasibility and practice of psychology in this setting. To review the integration of clinical psychology practice in a palliative care department at a major comprehensive cancer center. Retrospective chart review of 1940 unique cancer patients (6451 total patient contacts) referred for psychology services provided by clinical psychologists in palliative care from 9/1/2013 to 2/29/2016. Psychologists provided services to 1644 in-patients (24% of palliative care in-patients) and 296 out-patients (19% of palliative care out-patients). The majority (85%) received services in the in-patient setting. Most patients were female (57%) and white (68%) with a variety of cancer diagnoses. Adjustment disorders were the most prevalent in both settings with significant differences in other DSM-5 diagnoses by service location (p<0.0001). Psychological assessment (86%) and supportive expressive counseling (79%) were the most frequent services provided in the initial consult. Duration of initial visit was significantly longer in out-patient (median=60 minutes) compared to in-patient setting (median=40 minutes) (p<.0001). No significant differences were noted between settings regarding the median number of counseling sessions per patient; however, the majority (70%) only received 1 or 2 sessions. Over time, total patient encounters increased in the in-patient setting (p<0.0001), while session lengths in both settings significantly decreased (p<0.0001). Palliative care psychology services successfully integrated into an interdisciplinary palliative care department and rapidly grew in both in-patient and out-patient settings. Copyright © 2018. Published by Elsevier Inc.

U.S. Army Medical Research Institute of Infectious Diseases

MedlinePlus

... Health Organization. As a reference laboratory for the Department of Defense, we set the standard for identification of biological agents. Our customers in the Army and the Department of Defense know us as a "tech base" organization that ...

Training Heads of Department in Effective Leadership.

ERIC Educational Resources Information Center

Meijer, Folke

1989-01-01

Sweden's Karolinska Institute has developed a course in leadership that emphasizes these leader qualities: enthusiasm and support for the program's aims and operations; goal-setting for the department; insight into people's motivation; and an ability to deal with conflict. (MSE)

7 CFR 50.1 - Scope and applicability of rules of practice.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 50.1 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE MARKETING OF PERISHABLE AGRICULTURAL... failure to comply with any similar requirements set forth in applicable regulations. ...

78 FR 46575 - Initiation of Five-Year (“Sunset”) Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-01

... methodological or analytical issues relevant to the Department's conduct of Sunset Reviews is set forth in the...: Department DOC Case No. ITC Case No. Country Product contact A-570-912 731-TA-1117.... China New Pneumatic...

Heparin-Binding Protein Measurement Improves the Prediction of Severe Infection With Organ Dysfunction in the Emergency Department

PubMed Central

Arnold, Ryan; Boyd, John H.; Zindovic, Marko; Zindovic, Igor; Lange, Anna; Paulsson, Magnus; Nyberg, Patrik; Russell, James A.; Pritchard, David; Christensson, Bertil; Åkesson, Per

2015-01-01

Objectives: Early identification of patients with infection and at risk of developing severe disease with organ dysfunction remains a difficult challenge. We aimed to evaluate and validate the heparin-binding protein, a neutrophil-derived mediator of vascular leakage, as a prognostic biomarker for risk of progression to severe sepsis with circulatory failure in a multicenter setting. Design: A prospective international multicenter cohort study. Setting: Seven different emergency departments in Sweden, Canada, and the United States. Patients: Adult patients with a suspected infection and at least one of three clinical systemic inflammatory response syndrome criteria (excluding leukocyte count). Intervention: None. Measurements and Main Results: Plasma levels of heparin-binding protein, procalcitonin, C-reactive protein, lactate, and leukocyte count were determined at admission and 12–24 hours after admission in 759 emergency department patients with suspected infection. Patients were defined depending on the presence of infection and organ dysfunction. Plasma samples from 104 emergency department patients with suspected sepsis collected at an independent center were used to validate the results. Of the 674 patients diagnosed with an infection, 487 did not have organ dysfunction at enrollment. Of these 487 patients, 141 (29%) developed organ dysfunction within the 72-hour study period; 78.0% of the latter patients had an elevated plasma heparin-binding protein level (> 30 ng/mL) prior to development of organ dysfunction (median, 10.5 hr). Compared with other biomarkers, heparin-binding protein was the best predictor of progression to organ dysfunction (area under the receiver operating characteristic curve = 0.80). The performance of heparin-binding protein was confirmed in the validation cohort. Conclusion: In patients presenting at the emergency department, heparin-binding protein is an early indicator of infection-related organ dysfunction and a strong predictor of disease progression to severe sepsis within 72 hours. PMID:26468696

48 CFR 1480.504-1 - Set-asides for Indian economic enterprises.

Code of Federal Regulations, 2014 CFR

2014-10-01

... economic enterprises. 1480.504-1 Section 1480.504-1 Federal Acquisition Regulations System DEPARTMENT OF...-asides for Indian economic enterprises. (a) Each proposed procurement for supplies or services that has....003 must be set aside exclusively for IEEs, and referred to as an “Indian Economic Enterprise Set...

78 FR 30398 - Re-pricing of the 2012 and 2013 United States America the Beautiful Quarters Silver Proof Set...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-22

...], and 2013 United States Mint Congratulations Set AGENCY: United States Mint, Department of the Treasury..., and the 2013 United States Mint Congratulations Set. 2012 and 2013 United States Mint America the... Silver Proof Set will be offered for sale at a price of $60.95. 2013 United States Mint Congratulations...

Passing the baton: a grounded practical theory of handoff communication between multidisciplinary providers in two Department of Veterans Affairs outpatient settings.

PubMed

Koenig, Christopher J; Maguen, Shira; Daley, Aaron; Cohen, Greg; Seal, Karen H

2013-01-01

Handoffs are communication processes that enact the transfer of responsibility between providers across clinical settings. Prior research on handoff communication has focused on inpatient settings between provider teams and has emphasized patient safety. This study examines handoff communication within multidisciplinary provider teams in two outpatient settings. To conduct an exploratory study that describes handoff communication among multidisciplinary providers, to develop a theory-driven descriptive framework for outpatient handoffs, and to evaluate the strengths and weaknesses of different handoff types. Qualitative, in-depth, semi-structured interviews with 31 primary care, mental health, and social work providers in two Department of Veterans Affairs (VA) Medical Center outpatient clinics. Audio-recorded interviews were transcribed and analyzed using Grounded Practical Theory to develop a theoretical model of and a descriptive framework for handoff communication among multidisciplinary providers. Multidisciplinary providers reported that handoff decisions across settings were made spontaneously and without clear guidelines. Two situated values, clinic efficiency and patient-centeredness, shaped multidisciplinary providers' handoff decisions. Providers reported three handoff techniques along a continuum: the electronic handoff, which was the most clinically efficient; the provider-to-provider handoff, which balanced clinic efficiency and patient-centeredness; and the collaborative handoff, which was the most patient-centered. Providers described handoff choice as a practical response to manage constituent features of clinic efficiency (time, space, medium of communication) and patient-centeredness (information continuity, management continuity, relational continuity, and social interaction). We present a theoretical and descriptive framework to help providers evaluate differential handoff use, reflect on situated values guiding clinic communication, and guide future research. Handoff communication reflected multidisciplinary providers' efforts to balance clinic efficiency with patient-centeredness within the constraints of day-to-day clinical practice. Evaluating the strengths and weaknesses among alternative handoff options may enhance multidisciplinary provider handoff decision-making and may contribute to increased coordination and continuity of care across outpatient settings.

Point-of-care ultrasound education for non-physician clinicians in a resource-limited emergency department.

PubMed

Stolz, Lori A; Muruganandan, Krithika M; Bisanzo, Mark C; Sebikali, Mugisha J; Dreifuss, Bradley A; Hammerstedt, Heather S; Nelson, Sara W; Nayabale, Irene; Adhikari, Srikar; Shah, Sachita P

2015-08-01

To describe the outcomes and curriculum components of an educational programme to train non-physician clinicians working in a rural, Ugandan emergency department in the use of POC ultrasound. The use of point-of-care ultrasound was taught to emergency care providers through lectures, bedsides teaching and hands-on practical sessions. Lectures were tailored to care providers' knowledge base and available therapeutic means. Every ultrasound examination performed by these providers was recorded over 4.5 years. Findings of these examinations were categorised as positive, negative, indeterminate or procedural. Other radiologic studies ordered over this same time period were also recorded. A total of 22,639 patients were evaluated in the emergency department by emergency care providers, and 2185 point-of-care ultrasound examinations were performed on 1886 patients. Most commonly used were the focused assessment with sonography in trauma examination (53.3%) and echocardiography (16.4%). Point-of-care ultrasound studies were performed more frequently than radiology department-performed studies. Positive findings were documented in 46% of all examinations. We describe a novel curriculum for point-of-care ultrasound education of non-physician emergency practitioners in a resource-limited setting. These non-physician clinicians integrated ultrasound into clinical practice and utilised this imaging modality more frequently than traditional radiology department imaging with a large proportion of positive findings. © 2015 John Wiley & Sons Ltd.

48 CFR 1313.301 - Governmentwide commercial purchase card.

Code of Federal Regulations, 2010 CFR

2010-10-01

... purchase card. 1313.301 Section 1313.301 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE....301 Governmentwide commercial purchase card. The Department's procedures for the use and control of the Governmentwide commercial purchase card are set forth in CAM 1313.301. ...

7 CFR 254.1 - General purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS AND POLICIES-FOOD DISTRIBUTION ADMINISTRATION OF THE FOOD DISTRIBUTION PROGRAM FOR INDIAN HOUSEHOLDS IN OKLAHOMA § 254.1 General purpose. This part sets the requirement under which...

7 CFR 254.1 - General purpose.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE GENERAL REGULATIONS AND POLICIES-FOOD DISTRIBUTION ADMINISTRATION OF THE FOOD DISTRIBUTION PROGRAM FOR INDIAN HOUSEHOLDS IN OKLAHOMA § 254.1 General purpose. This part sets the requirement under which...

7 CFR 32.403 - Cost of samples for mohair top grades.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 32.403 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD... top grades. (a) Complete set. Twenty-seven dollars each, delivered to any destination within the...

Implementation of gINT software at the Virginia Department of Transportation.

DOT National Transportation Integrated Search

2008-01-01

A set of software tools was developed to enable staff of the Virginia Department of Transportation (VDOT) and consultants to streamline processing of subsurface exploration data. Built around the gINT program (geotechnical database and graphics packa...

The Impact of an Urban Professional Development School Model on Attitudes and Self-Efficacy of Developing Preservice Teachers

ERIC Educational Resources Information Center

Holbein, Marie; Woong, Lim; Annis, Kathy; Doll, Victoria

2016-01-01

The purpose of this study was to investigate the impact of an 8þ million dollar U.S. Department of Education grant on the climate of a Professional Development School (PDS) network where pre-service candidates in the Urban Education (UE) option were placed for their clinical internship experiences. The setting for the study was a network of seven…

Developing Effective Wording and Format Options for a Children's Nutrition Behavior Questionnaire for Mothers of Children in Kindergarten. Contractor and Cooperator Report No. 10

ERIC Educational Resources Information Center

US Department of Agriculture, 2005

2005-01-01

This study focuses on a set of eating habit questions proposed for inclusion in the U.S. Department of Education's Early Childhood Longitudinal Survey, Birth Cohort. The study assesses the wording and format of a series of questions for mothers of children in kindergarten and/or first grade regarding the child's food consumption habits. Most…

Is There Variation in Procedural Utilization for Lumbar Spine Disorders Between a Fee-for-Service and Salaried Healthcare System?

PubMed

Schoenfeld, Andrew J; Makanji, Heeren; Jiang, Wei; Koehlmoos, Tracey; Bono, Christopher M; Haider, Adil H

2017-12-01

Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated. (1) Were proportions of interbody fusions higher in the fee-for-service setting as opposed to the salaried Department of Defense setting? (2) Were the odds of interbody fusion increased in a fee-for-service setting after controlling for indications for surgery? Patients surgically treated for lumbar disc herniation, spinal stenosis, and spondylolisthesis (2006-2014) were identified. Patients were divided into two groups based on whether the surgery was performed in the fee-for-service setting (beneficiaries receive care at a civilian facility with expenses covered by TRICARE insurance) or at a Department of Defense facility (direct care). There were 28,344 patients in the entire study, 21,290 treated in fee-for-service and 7054 treated in Department of Defense facilities. Differences in the rates of fusion-based procedures, discectomy, and decompression between both healthcare settings were assessed using multinomial logistic regression to adjust for differences in case-mix and surgical indication. TRICARE beneficiaries treated for lumbar spinal disorders in the fee-for-service setting had higher odds of receiving interbody fusions (fee-for-service: 7267 of 21,290 [34%], direct care: 1539 of 7054 [22%], odds ratio [OR]: 1.25 [95% confidence interval 1.20-1.30], p < 0.001). Purchased care patients were more likely to receive interbody fusions for a diagnosis of disc herniation (adjusted OR 2.61 [2.36-2.89], p < 0.001) and for spinal stenosis (adjusted OR 1.39 [1.15-1.69], p < 0.001); however, there was no difference for patients with spondylolisthesis (adjusted OR 0.99 [0.84-1.16], p = 0.86). The preferential use of interbody fusion procedures was higher in the fee-for-service setting irrespective of the underlying diagnosis. These results speak to the existence of provider inducement within the field of spine surgery. This reality portends poor performance for surgical practices and hospitals in Accountable Care Organizations and bundled payment programs in which provider inducement is allowed to persist. Level III, economic and decision analysis.

An Empirical Evaluation of Distance Learning's Effectiveness in the K-12 Setting

ERIC Educational Resources Information Center

Harris-Packer, Jerilyn D.; Ségol, Geneviève

2015-01-01

This study evaluated the effect of online instruction on the academic achievement of K--12 students in ten states as measured by the percentage of proficient students in reading and mathematics at the school level. We used publicly available data provided by the Department of Education in Florida, Michigan, Minnesota, Nevada, Ohio, Pennsylvania,…

Transfer Students, Financial Aid, and a New Perspective on Undermatching. Research Report

ERIC Educational Resources Information Center

Fernandez, Chris; Fletcher, Carla

2014-01-01

In December 2012, the Texas Guaranteed Student Loan Corporation (TG) released a report outlining an unexpected set of conclusions. Citing data from the U.S. Department of Education's Baccalaureate and Beyond (B&B) study, the report found that, among students who earned bachelor's degrees during the 2007-2008 academic year (AY) and borrowed…

Experts' Perspectives on the Application and Relevancy of Depth and Complexity to Academic Disciplines of Study

ERIC Educational Resources Information Center

Lauer, Joanna L.

2010-01-01

Depth and Complexity a set of prompts or concepts, represented an approach to curriculum differentiation for gifted students, that originated from a California Department of Education (1994) document describing educational needs for gifted students. Derived from three sources: (1) a review of Advance Placement curriculum and assessment, (2) a…

Diet Quality Is Low among Female Food Pantry Clients in Eastern Alabama

ERIC Educational Resources Information Center

Duffy, Patricia; Zizza, Claire; Jacoby, Jocelynn; Tayie, Francis A.

2009-01-01

Objective: Examine diet quality, food security, and obesity among female food pantry clients. Design: Cross-sectional study. Setting: A food pantry in Lee County, Alabama. Participants: Fifty-five female food pantry clients between 19 and 50 years of age. Main Outcome Measure(s): Diet quality using United States (US) Department of Agriculture…

Nurse Education and Communities of Practice. Researching Professional Education Research Reports Series.

ERIC Educational Resources Information Center

Burkitt, Ian; Husband, Charles; Mackenzie, Jennifer; Torn, Alison

The processes whereby nurses develop the skills and knowledge required to deliver individualized and holistic care were examined in a 2-year study of nurses in a range of clinical settings and a university department of nursing in England. Members of two research teams of qualified nurses joined various communities of nursing practice as…

Department of Defense Chiropractic Internships

PubMed Central

Dunn, Andrew S.

2006-01-01

Objective: Department of Defense (DoD) chiropractic internships first began in July of 2001. At the time of this study, 30 New York Chiropractic College student interns had completed part of their clinical education within chiropractic clinics at either the National Naval Medical Center or Naval Hospital Camp Lejeune. The purpose of this study was to evaluate and compare the careers of DoD chiropractic internship participants with comparable nonparticipants in terms of demographics, professional activities, income, and satisfaction. Methods: Survey research was employed to gather data from DoD chiropractic internship participants and comparable nonparticipants. Statistical analysis was carried out to determine significant differences with a nominal significance level set as.05. Results: There were no statistically significant differences in demographics, professional activities, income, or career satisfaction between the 21 DoD chiropractic internship participants (70% response rate) and 35 internship nonparticipants (35% response rate). Conclusions: This study utilized practice parameters as a form of feedback for a comparative analysis of DoD chiropractic internship participants and nonparticipants and found no significant differences between these groups. Limitations of the study may have influenced the results. Opportunities for chiropractic students to train within these settings remains limited and should be further explored, as should additional research into this component of chiropractic clinical education. PMID:18483629

Scleroderma in hospital settings in Lomé: 50 cases.

PubMed

Akakpo, A S; Teclessou, J N; Mouhari-Touré, A; Saka, B; Matakloe, H; Kakpovi, K; Kombate, K; Pitché, P

2017-11-01

The aim of this study was to document the epidemiological and clinical profile, treatment used, and outcome of patients with scleroderma in hospital settings in Lomé. This descriptive study examined the records of all patients seen as outpatients or admitted for scleroderma in hospital dermatology and rheumatology departments in Lomé during the 20-year period of 1993-2012. During the study period, 50 (0.04%) of the 121,021 patients seen in these departments had scleroderma. There were 29 cases of localized scleroderma and 21 systemic cases, predominantly women (sex-ratio=0.2). The patients' mean age was 36 years. All patients with systemic scleroderma had speckled achromia (100%), and most (90.48%) had cutaneous sclerosis. After a mean follow-up period of 43.5 days, 71.43% of the patients had been lost to follow-up. All of the patients with localized scleroderma had cutaneous sclerosis, and the rate of loss to follow-up (after a mean of 17 days) was 96.55%. The results of this study confirm the extreme rarity of scleroderma in the teaching hospitals in Lomé and a clear female predominance. It points out the difficulty of management, which both influences and is aggravated by the high rate of loss to follow-up.

Moderate sensitivity and high specificity of emergency department administrative data for transient ischemic attacks.

PubMed

Yu, Amy Y X; Quan, Hude; McRae, Andrew; Wagner, Gabrielle O; Hill, Michael D; Coutts, Shelagh B

2017-09-18

Validation of administrative data case definitions is key for accurate passive surveillance of disease. Transient ischemic attack (TIA) is a condition primarily managed in the emergency department. However, prior validation studies have focused on data after inpatient hospitalization. We aimed to determine the validity of the Canadian 10th International Classification of Diseases (ICD-10-CA) codes for TIA in the national ambulatory administrative database. We performed a diagnostic accuracy study of four ICD-10-CA case definition algorithms for TIA in the emergency department setting. The study population was obtained from two ongoing studies on the diagnosis of TIA and minor stroke versus stroke mimic using serum biomarkers and neuroimaging. Two reference standards were used 1) the emergency department clinical diagnosis determined by chart abstractors and 2) the 90-day final diagnosis, both obtained by stroke neurologists, to calculate the sensitivity, specificity, positive and negative predictive values (PPV and NPV) of the ICD-10-CA algorithms for TIA. Among 417 patients, emergency department adjudication showed 163 (39.1%) TIA, 155 (37.2%) ischemic strokes, and 99 (23.7%) stroke mimics. The most restrictive algorithm, defined as a TIA code in the main position had the lowest sensitivity (36.8%), but highest specificity (92.5%) and PPV (76.0%). The most inclusive algorithm, defined as a TIA code in any position with and without query prefix had the highest sensitivity (63.8%), but lowest specificity (81.5%) and PPV (68.9%). Sensitivity, specificity, PPV, and NPV were overall lower when using the 90-day diagnosis as reference standard. Emergency department administrative data reflect diagnosis of suspected TIA with high specificity, but underestimate the burden of disease. Future studies are necessary to understand the reasons for the low to moderate sensitivity.

Improving pain management of abdominal pain in children presenting to the paediatric emergency department: a pre-post interventional study.

PubMed

Williams, Suzanne; Holzhauser, Kerri; Bonney, Donna; Burmeister, Elizabeth; Gilhotra, Yuri; Oliver, Randall; Gordon, Kerry

2012-08-01

In 2007, the Mater Children's Hospital Emergency Department participated in the Emergency Care Pain Management Initiative funded by the National Health and Medical Research Council National Institute of Clinical Studies (NHMRC-NICS). The findings of this NHMRC-NICS research across eleven paediatric emergency departments highlighted deficits in pain management of abdominal pain. Specifically pain assessment, timeliness of analgesia, and pain management guidelines were found to be lacking. In response to the NICS report local practice was reviewed and a pilot research project undertaken to develop a clinical guideline for the pain management of abdominal pain in children presenting to the emergency department. The guideline was developed by an expert panel and trialled using a pre and post intervention design. The results demonstrated improved compliance to assessment and documentation of pain scores and assimilation of the best practice principles recommended in the guideline. This project raised local awareness in the pain management of abdominal pain and provides baseline information for future improvement. The guideline has been trialled in the clinical setting of paediatric emergency and has the potential to improve pain management practices in children presenting to the emergency department with abdominal pain. Copyright © 2012 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

A comprehensive review of prehospital and in-hospital delay times in acute stroke care.

PubMed

Evenson, K R; Foraker, R E; Morris, D L; Rosamond, W D

2009-06-01

The purpose of this study was to systematically review and summarize prehospital and in-hospital stroke evaluation and treatment delay times. We identified 123 unique peer-reviewed studies published from 1981 to 2007 of prehospital and in-hospital delay time for evaluation and treatment of patients with stroke, transient ischemic attack, or stroke-like symptoms. Based on studies of 65 different population groups, the weighted Poisson regression indicated a 6.0% annual decline (P<0.001) in hours/year for prehospital delay, defined from symptom onset to emergency department arrival. For in-hospital delay, the weighted Poisson regression models indicated no meaningful changes in delay time from emergency department arrival to emergency department evaluation (3.1%, P=0.49 based on 12 population groups). There was a 10.2% annual decline in hours/year from emergency department arrival to neurology evaluation or notification (P=0.23 based on 16 population groups) and a 10.7% annual decline in hours/year for delay time from emergency department arrival to initiation of computed tomography (P=0.11 based on 23 population groups). Only one study reported on times from arrival to computed tomography scan interpretation, two studies on arrival to drug administration, and no studies on arrival to transfer to an in-patient setting, precluding generalizations. Prehospital delay continues to contribute the largest proportion of delay time. The next decade provides opportunities to establish more effective community-based interventions worldwide. It will be crucial to have effective stroke surveillance systems in place to better understand and improve both prehospital and in-hospital delays for acute stroke care.

Multislice coronary computed tomographic angiography in emergency department presentations of unsuspected acute myocardial infarction.

PubMed

Hecht, Harvey S; Bhatti, Tandeep

2009-01-01

Coronary computed tomographic angiography (CCTA) is not indicated in the setting of acute myocardial infarction in the emergency department (ED). Nonetheless, acute coronary syndromes may have atypical presentations, and CCTA may be inadvertently performed in this setting. This study was designed to determine the frequency and characteristics of CCTA imaging of unsuspected acute myocardial infarction in the ED. All CCTAs performed in the ED at Lenox Hill Hospital were reviewed for clinical indications and subsequent course; patients with documented acute myocardial infarction were identified. Of the 500 CCTAs performed on ED patients in the Lenox Hill laboratory, 5 patients (1%) were imaged during the initial phase of an unsuspected acute myocardial infarction; in all cases the CCTAs were key to the diagnosis. The imaging characteristics were (1) total or subtotal occlusion and (2) transmural hypodensity in the infarct area. Although acute myocardial infarction on CCTA in ED patients is an infrequent event, proper and prompt recognition is critical for appropriate patient care, particularly as applications to the ED increase.

Establishment of ultrasound as a diagnostic aid in the referral of patients with abdominal pain in an emergency department – a pilot study

PubMed Central

Poulsen, Liv la Cour; Bækgaard, Emilie Stokholm; Istre, Per Grosen; Schmidt, Thomas Andersen; Larsen, Torben

2015-01-01

Purpose Ultrasonography is a noninvasive, cheap, and fast way of assessing abdominal pain in an emergency department. Many physicians working in emergency departments do not have pre-existing ultrasound experience. The purpose of this study was to investigate the ability of first-year internship doctors to perform a reliable ultrasound examination on patients with abdominal pain in an emergency setting. Materials and methods This study took place in an emergency department in Denmark. Following a 1-day ultrasound introduction course, three doctors without prior ultrasound experience scanned 45 patients during a 2-month period. The applicability of the examinations was evaluated by subsequent control examination: computed tomography, operation, or ultrasound by a trained radiologist or gynecologist or, in cases where the patient was immediately discharged, by ultrasound image evaluation. Results In 14 out of 21 patients with a control examination, there was diagnostic agreement between the project ultrasound examination and the control. Image evaluation of all patients showed useful images of the gallbladder, kidneys, liver, abdominal aorta, and urinary bladder, but no useful images for either the pancreas or colon. Conclusion With only little formal training, it is possible for first-year internship doctors to correctly visualize some abdominal organs with ultrasonography. However, a longer study time frame, including more patients, and an ultrasound course specifically designed for the purpose of use in an emergency department, is needed to enhance the results. PMID:27147884

Decree No. 12-88 of 4 December 1988, setting forth the functions of the Minister Responsible for the status of Women, Artisan Industries, and Tourism and the organization of the central administration of his department.

PubMed

1989-01-01

This Mauritania Decree provides that the Minister Responsible for the Status of Women, Artisan Industries, and Tourism has as a general objective the formulation and implementation of a policy promoting women and developing the artisan and tourism sectors. With respect to the status of women, the Minister is responsible for studying and devising programs promoting women, supporting the productive participation of women in development, and ensuring women social and primary education that will permit them to assume an active role in society. Among the directorates of the Ministry is a Directorate on the Status of Women, which has the following responsibilities: 1) to study all measures tending to strengthen the position and role of women, taking into consideration a healthy view of the country's traditional values and the requirements of contemporary society; 2) to work with the media in popularizing the rights and obligations of women; 3) to organize specific interventionist activities for the benefit of rural women; 4) to work with interested departments in developing educational and training programs for women; 5) to work with interested parties in studying employment conditions for women and in supervising the effective insertion of women into the dynamics of development; and 6) to work with educational institutions in promoting women's organizations on the national and international level. Further provisions of the Decree set forth the responsibilities of other departments of the Ministry.

An Analysis of the Hidden Costs of Competition in the Procurement of Spare Parts at the Navy Ships Parts Control Center: A Framework for Process Improvement

DTIC Science & Technology

1992-03-01

setting of sub- optimal goals and quotas, barriers between departments, and awarding contracts primarily on price are all anti-TQM practices that hinder...customer focus, the setting of sub- optimal goals and quotas, barriers between departments, and awarding contracts primarily on price are all anti-TQM/L...surveys are often required to determine if a lower competitive price could be achieved before exercising options. This requirement is a sub- optimal

An Iterative Procedure for Obtaining I-Projections onto the Intersection of Convex Sets.

DTIC Science & Technology

1984-06-01

Dykstra Department of Statistics and Actuarial Science The University of Iowa Iowa City, Iowa 52242 Technical Report #106 June 1984D I e ELECTE lSEP...t Theorem ~ ~ 2.. Asm i where the 4 are closed, convex sets of PD’s and R d 0 is a nonnegative vector such that there exists a T E 4 where I(TIR) < M...PERFOMING ORGANIZATION NAME AND ADDRESS 1. PROGIRA ILEMNT. PROJECT. TAK Department of Statistics and Actuarial Science AEAS a WORK UNIT Numaa The

A Quasi-Experimental, Before-After Trial Examining the Impact of an Emergency Department Mechanical Ventilator Protocol on Clinical Outcomes and Lung-Protective Ventilation in Acute Respiratory Distress Syndrome.

PubMed

Fuller, Brian M; Ferguson, Ian T; Mohr, Nicholas M; Drewry, Anne M; Palmer, Christopher; Wessman, Brian T; Ablordeppey, Enyo; Keeperman, Jacob; Stephens, Robert J; Briscoe, Cristopher C; Kolomiets, Angelina A; Hotchkiss, Richard S; Kollef, Marin H

2017-04-01

To evaluate the impact of an emergency department mechanical ventilation protocol on clinical outcomes and adherence to lung-protective ventilation in patients with acute respiratory distress syndrome. Quasi-experimental, before-after trial. Emergency department and ICUs of an academic center. Mechanically ventilated emergency department patients experiencing acute respiratory distress syndrome while in the emergency department or after admission to the ICU. An emergency department ventilator protocol which targeted variables in need of quality improvement, as identified by prior work: 1) lung-protective tidal volume, 2) appropriate setting of positive end-expiratory pressure, 3) oxygen weaning, and 4) head-of-bed elevation. A total of 229 patients (186 preintervention group, 43 intervention group) were studied. In the emergency department, the intervention was associated with significant changes (p < 0.01 for all) in tidal volume, positive end-expiratory pressure, respiratory rate, oxygen administration, and head-of-bed elevation. There was a reduction in emergency department tidal volume from 8.1 mL/kg predicted body weight (7.0-9.1) to 6.4 mL/kg predicted body weight (6.1-6.7) and an increase in lung-protective ventilation from 11.1% to 61.5%, p value of less than 0.01. The intervention was associated with a reduction in mortality from 54.8% to 39.5% (odds ratio, 0.38; 95% CI, 0.17-0.83; p = 0.02) and a 3.9 day increase in ventilator-free days, p value equals to 0.01. This before-after study of mechanically ventilated patients with acute respiratory distress syndrome demonstrates that implementing a mechanical ventilator protocol in the emergency department is feasible and associated with improved clinical outcomes.

Blood-Banking Techniques for Plateletpheresis in Swine

DTIC Science & Technology

2014-05-01

automatically calculates the blood volume for that patient according to an internal formula . However, to circumvent the human-based algorithm, for a 60-kg...blood volume (µL) in the percentage recovery formula given earlier. The maximal recovery percent- age was calculated by setting the 3-min results to 100...Control Resuscitation Department, the Veterinary Support Department, and the Laboratory Support Department for their expert technical assistance

43 CFR 5441.1-3 - SBA set-aside sales.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false SBA set-aside sales. 5441.1-3 Section 5441... MANAGEMENT, DEPARTMENT OF THE INTERIOR FOREST MANAGEMENT (5000) CONDUCT OF SALES Advertised Sales § 5441.1-3 SBA set-aside sales. Only bids of small business concerns which have filed a self-certification...

43 CFR 5441.1-3 - SBA set-aside sales.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false SBA set-aside sales. 5441.1-3 Section 5441... MANAGEMENT, DEPARTMENT OF THE INTERIOR FOREST MANAGEMENT (5000) CONDUCT OF SALES Advertised Sales § 5441.1-3 SBA set-aside sales. Only bids of small business concerns which have filed a self-certification...

43 CFR 5441.1-3 - SBA set-aside sales.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false SBA set-aside sales. 5441.1-3 Section 5441... MANAGEMENT, DEPARTMENT OF THE INTERIOR FOREST MANAGEMENT (5000) CONDUCT OF SALES Advertised Sales § 5441.1-3 SBA set-aside sales. Only bids of small business concerns which have filed a self-certification...

77 FR 47797 - Federal Acquisition Regulation; Small Business Set Asides for Research and Development Contracts

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-10

... Acquisition Regulation; Small Business Set Asides for Research and Development Contracts AGENCY: Department of... Acquisition Regulation (FAR) to clarify that contracting officers shall set aside acquisitions for research..., and NASA are proposing to amend the Federal Acquisition Regulation (FAR) to revise paragraph (b)(2) of...

75 FR 25844 - Class Deviation From FAR 52.219-7, Notice of Partial Small Business Set-Aside

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-10

... Small Business Set-Aside AGENCY: Defense Logistics Agency, DoD. ACTION: Notice. SUMMARY: This is to...) regarding partial small business set-asides for Defense Logistics Agency (DLA), Defense Energy Support Center (DESC) bulk fuels solicitations and resulting contract awards. DLA is requesting Department of...

48 CFR 1480.504-1 - Set-asides for Indian economic enterprises.

Code of Federal Regulations, 2013 CFR

2013-10-01

... economic enterprises. 1480.504-1 Section 1480.504-1 Federal Acquisition Regulations System DEPARTMENT OF... 1480.504-1 Set-asides for Indian economic enterprises. (a) Each proposed procurement for supplies or... FAR Part 13.003 must be set aside exclusively for IEEs, and referred to as an “Indian Economic...

14 CFR 302.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) PROCEDURAL... in this part is the official authorized to issue final decisions of the Department as set forth in § 302.18. This includes the Assistant Secretary for Aviation and International Affairs, the senior...

14 CFR 302.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) PROCEDURAL... in this part is the official authorized to issue final decisions of the Department as set forth in § 302.18. This includes the Assistant Secretary for Aviation and International Affairs, the senior...

14 CFR 302.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) PROCEDURAL... in this part is the official authorized to issue final decisions of the Department as set forth in § 302.18. This includes the Assistant Secretary for Aviation and International Affairs, the senior...

14 CFR 302.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) PROCEDURAL... in this part is the official authorized to issue final decisions of the Department as set forth in § 302.18. This includes the Assistant Secretary for Aviation and International Affairs, the senior...

14 CFR 302.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) PROCEDURAL... in this part is the official authorized to issue final decisions of the Department as set forth in § 302.18. This includes the Assistant Secretary for Aviation and International Affairs, the senior...

76 FR 26220 - Federal Acquisition Regulation; Socioeconomic Program Parity

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... DEPARTMENT OF DEFENSE GENERAL SERVICES ADMINISTRATION NATIONAL AERONAUTICS AND SPACE... Federal Acquisition Regulation; Socioeconomic Program Parity AGENCY: Department of Defense (DoD), General... expectation exists (see 19.502-3 as to partial set-asides). Although past acquisition history of an item or...

7 CFR 735.400 - Administration.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Administration. 735.400 Section 735.400 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... Administration. This subpart sets forth the regulations under which DACO may authorize one or more electronic...

7 CFR 31.402 - Cost of samples for wool top grades.

Code of Federal Regulations, 2010 CFR

2010-01-01

....402 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER... set: $42 each, delivered to any destination within the United States and $44 each, delivered to any...

7 CFR 766.56 - Security requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Security requirements. 766.56 Section 766.56 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS DIRECT LOAN SERVICING-SPECIAL Disaster Set-Aside § 766.56 Security requirements...

7 CFR 766.56 - Security requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Security requirements. 766.56 Section 766.56 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS DIRECT LOAN SERVICING-SPECIAL Disaster Set-Aside § 766.56 Security requirements...

7 CFR 735.400 - Administration.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false Administration. 735.400 Section 735.400 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... Administration. This subpart sets forth the regulations under which DACO may authorize one or more electronic...

7 CFR 735.400 - Administration.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 7 2012-01-01 2012-01-01 false Administration. 735.400 Section 735.400 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... Administration. This subpart sets forth the regulations under which DACO may authorize one or more electronic...

7 CFR 735.400 - Administration.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Administration. 735.400 Section 735.400 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... Administration. This subpart sets forth the regulations under which DACO may authorize one or more electronic...

The development of a contract quality assurance program within the Virginia Department of Highways.

DOT National Transportation Integrated Search

1989-01-01

In order to assure the quality of construction products and processes, the Virginia Department of Transportation has established three levels of construction control. First, contractors themselves provide oversight and quality control as set out in t...

7 CFR 550.55 - Retention and access requirements for records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 550.55 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE GENERAL ADMINISTRATIVE POLICY FOR NON-ASSISTANCE COOPERATIVE AGREEMENTS... set out in § 550.42(d). (b) Financial records, supporting documents, statistical records, and all...

Implementation of emergency department transfer communication measures in Minnesota critical access hospitals.

PubMed

Klingner, Jill; Moscovice, Ira; Casey, Michelle; McEllistrem Evenson, Alex

2015-01-01

Previously published findings based on field tests indicated that emergency department patient transfer communication measures are feasible and worthwhile to implement in rural hospitals. This study aims to expand those findings by focusing on the wide-scale implementation of these measures in the 79 Critical Access Hospitals (CAHs) in Minnesota from 2011 to 2013. Information was obtained from interviews with key informants involved in implementing the emergency department patient transfer communication measures in Minnesota as part of required statewide quality reporting. The first set of interviews targeted state-level organizations regarding their experiences working with providers. A second set of interviews targeted quality and administrative staff from CAHs regarding their experiences implementing measures. Implementing the measures in Minnesota CAHs proved to be successful in a number of respects, but informants also faced new challenges. Our recommendations, addressed to those seeking to successfully implement these measures in other states, take these challenges into account. Field-testing new quality measure implementations with volunteers may not be indicative of a full-scale implementation that requires facilities to participate. The implementation team's composition, communication efforts, prior relationships with facilities and providers, and experience with data collection and abstraction tools are critical factors in successfully implementing required reporting of quality measures on a wide scale. © 2014 National Rural Health Association.

Speed limits set lower than engineering recommendations.

DOT National Transportation Integrated Search

2016-08-01

The purpose of this project is to provide the Montana Department of Transportation (MDT) with a better understanding of the : operational and safety impacts of setting posted speed limits below engineering recommended values. This practice has been :...

Safety Policy and Procedure Manual (Electronic Version)

DOT National Transportation Integrated Search

1997-08-18

The state Secretary of Transportation has set a goal of zero accidents for the : North Carolina Department of Transportation (NCDOT). To guide the NCDOT towards : that goal, this safety manual sets for philosophy, goals, cardinal rules : (grounds for...

Identifying ethical issues of the Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists.

PubMed

Jenkins, Constance L; Elliott, Aaron R; Harris, Janet R

2006-08-01

The purposes of this study were to identify the ethical issues Department of the Army civilian and Army Nurse Corps certified registered nurse anesthetists (CRNAs) encountered in their anesthesia practice and how disturbed they were by these issues. This descriptive study used a secondary data analysis of a cross-sectional survey of Army Nurse Corps officers and Department of the Army civilian registered nurses (N = 5,293). The CRNA subset (n = 97) was obtained from questionnaires that indicated a primary practice setting as anesthesia. The most frequently occurring ethical issue identified was conflict in the nurse-physician relationship, whereas the most disturbing issue was working with incompetent/impaired colleagues. Unresolved ethical conflicts can negatively influence the nurses' morale, leading to avoidance of the issue and contributing to burnout. Identifying the ethical issues and disturbance level experienced by CRNAs should contribute to the development of an ethics education program that addresses issues encountered in CRNA practice.

Improving the application of a practice guideline for the assessment and treatment of suicidal behavior by training the full staff of psychiatric departments via an e-learning supported Train-the-Trainer program: study protocol for a randomized controlled trial.

PubMed

de Beurs, Derek P; de Groot, Marieke H; de Keijser, Jos; Verwey, Bastiaan; Mokkenstorm, Jan; Twisk, Jos W R; van Duijn, Erik; van Hemert, Albert M; Verlinde, Lia; Spijker, Jan; van Luijn, Bert; Vink, Jan; Kerkhof, Ad J F M

2013-01-09

In 2012, in The Netherlands a multidisciplinary practice guideline for the assessment and treatment of suicidal behavior was issued. The release of guidelines often fails to change professional behavior due to multiple barriers. Structured implementation may improve adherence to guidelines. This article describes the design of a study measuring the effect of an e-learning supported Train-the-Trainer program aiming at the training of the full staff of departments in the application of the guideline. We hypothesize that both professionals and departments will benefit from the program. In a multicenter cluster randomized controlled trial, 43 psychiatric departments spread over 10 regional mental health institutions throughout The Netherlands will be clustered in pairs with respect to the most prevalent diagnostic category of patients and average duration of treatment. Pair members are randomly allocated to either the experimental or the control condition. In the experimental condition, the full staff of departments, that is, all registered nurses, psychologists, physicians and psychiatrists (n = 532, 21 departments) will be trained in the application of the guideline, in a one-day small interactive group Train-the-Trainer program. The program is supported by a 60-minute e-learning module with video vignettes of suicidal patients and additional instruction. In the control condition (22 departments, 404 professionals), the guideline shall be disseminated in the traditional way: through manuals, books, conferences, internet, reviews and so on. The effectiveness of the program will be assessed at the level of both health care professionals and departments. We aim to demonstrate the effect of training of the full staff of departments with an e-learning supported Train-the-Trainer program in the application of a new clinical guideline. Strengths of the study are the natural setting, the training of full staff, the random allocation to the conditions, the large scale of the study and the willingness of both staff and management to participate in the study. Dutch trial register: NTR3092.

Improving the application of a practice guideline for the assessment and treatment of suicidal behavior by training the full staff of psychiatric departments via an e-learning supported Train-the-Trainer program: study protocol for a randomized controlled trial

PubMed Central

2013-01-01

Background In 2012, in The Netherlands a multidisciplinary practice guideline for the assessment and treatment of suicidal behavior was issued. The release of guidelines often fails to change professional behavior due to multiple barriers. Structured implementation may improve adherence to guidelines. This article describes the design of a study measuring the effect of an e-learning supported Train-the-Trainer program aiming at the training of the full staff of departments in the application of the guideline. We hypothesize that both professionals and departments will benefit from the program. Method In a multicenter cluster randomized controlled trial, 43 psychiatric departments spread over 10 regional mental health institutions throughout The Netherlands will be clustered in pairs with respect to the most prevalent diagnostic category of patients and average duration of treatment. Pair members are randomly allocated to either the experimental or the control condition. In the experimental condition, the full staff of departments, that is, all registered nurses, psychologists, physicians and psychiatrists (n = 532, 21 departments) will be trained in the application of the guideline, in a one-day small interactive group Train-the-Trainer program. The program is supported by a 60-minute e-learning module with video vignettes of suicidal patients and additional instruction. In the control condition (22 departments, 404 professionals), the guideline shall be disseminated in the traditional way: through manuals, books, conferences, internet, reviews and so on. The effectiveness of the program will be assessed at the level of both health care professionals and departments. Discussion We aim to demonstrate the effect of training of the full staff of departments with an e-learning supported Train-the-Trainer program in the application of a new clinical guideline. Strengths of the study are the natural setting, the training of full staff, the random allocation to the conditions, the large scale of the study and the willingness of both staff and management to participate in the study. Trial registration Dutch trial register: NTR3092 PMID:23302322

Concordance of motor vehicle crash, emergency department, and inpatient hospitalization data sets in the identification of drugs in injured drivers.

PubMed

Bunn, T; Singleton, M; Nicholson, V; Slavova, S

2013-01-01

Prescription drug overdoses, abuse, and sales have increased dramatically in the United States in the last decade. The purpose of the present study was to link crash data with emergency department (ED) and inpatient hospitalization data to assess the concordance between the data sets in the identification of the presence of drugs among injured motor vehicle drivers (passenger cars, passenger trucks, light trucks, and semi-trucks) in Kentucky. Kentucky CRASH data were probabilistically linked to ED data sets for years 2008-2010 and to inpatient hospitalization data sets for years 2000-2010. Statistical analyses were performed. Of the 72,529 linked crash/ED visits, there were 473 drivers with an associated nondependent abuse of drugs diagnosis in the ED, and 930 drivers had drug involvement recorded in the CRASH data (only 163 cases overlapped with drug involvement both recorded in CRASH data and coded as nondependent abuse of drugs in the ED); 64 drivers had multiple drug types present in their system. Of the 20,860 total linked crash/inpatient hospitalization cases, there were 973 drivers diagnosed with nondependent abuse of drugs in the inpatient hospitalization record and 499 drivers had drug involvement recorded in the CRASH data (only 207 overlapped); 250 drivers were diagnosed with multiple drugs in their system. Surveillance data from multiple public health data sets is necessary to identify the presence of drugs in injured drivers involved in motor vehicle crashes. The use of a single surveillance data set alone may significantly underreport the number of drugged drivers who were injured in a motor vehicle collision.

Pilot Integration of HIV Screening and Healthcare Settings with Multi- Component Social Network and Partner Testing for HIV Detection.

PubMed

Rentz, Michael F; Ruffner, Andrew H; Ancona, Rachel M; Hart, Kimberly W; Kues, John R; Barczak, Christopher M; Lindsell, Christopher J; Fichtenbaum, Carl J; Lyons, Michael S

2017-11-23

Healthcare settings screen broadly for HIV. Public health settings use social network and partner testing ("Transmission Network Targeting (TNT)") to select high-risk individuals based on their contacts. HIV screening and TNT systems are not integrated, and healthcare settings have not implemented TNT. The study aimed to evaluate pilot implementation of multi-component, multi-venue TNT in conjunction with HIV screening by a healthcare setting. Our urban, academic health center implemented a TNT program in collaboration with the local health department for five months during 2011. High-risk or HIV positive patients of the infectious diseases clinic and emergency department HIV screening program were recruited to access social and partner networks via compensated peer-referral, testing of companions present with them, and partner notification services. Contacts became the next-generation index cases in a snowball recruitment strategy. The pilot TNT program yielded 485 HIV tests for 482 individuals through eight generations of recruitment with five (1.0%; 95% CI = 0.4%, 2.3%) new diagnoses. Of these, 246 (51.0%; 95% CI = 46.6%, 55.5%) reported that they had not been tested for HIV within the last 12 months and 383 (79.5%; 95% CI = 75.7%, 82.9%) had not been tested by the existing ED screening program within the last five years. TNT complements population screening by more directly targeting high-risk individuals and by expanding the population receiving testing. Information from existing healthcare services could be used to seed TNT programs, or TNT could be implemented within healthcare settings. Research evaluating multi-component, multi-venue HIV detection is necessary to maximize complementary approaches while minimizing redundancy. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Psychology departments in medical schools: there's one in Canada, eh?

PubMed

McIlwraith, Robert D

2014-12-01

Comments on the original article by Robiner et al. (see record 2014-07939-001) regarding psychologists in medical schools and academic medical center settings. Robiner et al. reported that their extensive review "revealed no independent departments of psychology in U.S. medical schools." The current authors note north of the border in Canada there is one department of psychology in a medical school. The Department of Clinical Health Psychology has been a department within the Faculty of Medicine of the University of Manitoba since 1995. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Historical cohort study of US man-made vitreous fiber production workers: VIII. Exposure-specific job analysis.

PubMed

Quinn, M M; Smith, T J; Youk, A O; Marsh, G M; Stone, R A; Buchanich, J M; Gula, M J

2001-09-01

All jobs held by a cohort of US man-made vitreous fiber production workers were analyzed for airborne fiber exposure. This exposure-specific job analysis was part of an exposure assessment for an epidemiologic study of mortality patterns, with particular focus on respiratory cancer, among 35,145 workers employed in 10 fiberglass and five rock or slag wool plants. The exposure assessment was conducted from the start-up date of each plant (1917 to 1946) to 1990. For the job analysis, 15,465 crude department names and 47,693 crude job titles were grouped into 1668 unique department and job pairs (UDJobs), which represented a job title linked to a specific department within each plant. Every UDJob was evaluated according to a set of job elements related to airborne fiber exposure. The distribution of the cohort person-years by UDJob and the job-exposure elements was then evaluated. The results show the main departments and jobs that employed the workers for each plant. The distribution of person-years varies across the job-exposure elements. The same job title was used in different departments within and across plants. When job titles not linked to departments were evaluated, the values of the job-exposure elements varied considerably across all plants and within plant. (1) exposure misclassification could occur if job title alone were used for the exposure assessment; (2) the job-exposure elements analysis provides an efficient way to identify major job determinants of exposure without relying on the more detailed, resource-intensive task-based approach; and (3) the evaluation of the cohort person-years by UDJobs and job-exposure elements is an effective way to identify which plants, departments, and jobs have sufficient information for making precise risk estimates in the broader epidemiologic study.

[Measurement of airborne asbestos fibers on railroad rolling stock].

PubMed

Camilucci, L; Catasta, P F; Chiappino, G; Governa, M; Munafò, E; Verduchi, P; Paba, G

2000-01-01

In February 1995 the Italian Railways Health Department set up a special study group in order to assess the effectiveness of the measures adopted against hazards due to the presence of asbestos in rolling stock currently in use on the rail network. The group set up specific procedures for sampling and analysis, on the basis of the criteria fixed for civil buildings in Ministerial Decree of 6/9/94, which was subsequently applied to rolling stock by Ministerial Decree of 26/10/95. In accordance with these procedures the study group carried out environmental studies via test runs programmed by the Railways Technical Departments, on trains made up of different types of vehicles. Insulated, completely or partially deinsulated and originally non-insulated vehicles were studied. Samples were analysed via scanning electron microscopy (SEM) with elementary dispersion X spectroscopy (EDXS) carried out by highly qualified public laboratories (ISPESL--National Institute for Prevention and Work Safety, ARPA--Regional Environmental Protection Agency, CRA--Veneto Region, University Departments). Altogether, from the start of the programme up to September 1998, 1464 samples in 170 test runs on 619 rolling stock vehicles were examined. These involved 83 locomotives, 83 electric rail-cars and 453 carriages. The results showed that in over 99% of the samples the fibre concentrations were below 2 fibres/litre, which is the value fixed by law for buildings and rail vehicles in order to qualify for effective decontamination status. Values exceeding 2 fibres/litre were found in only 4 vehicles, which were withdrawn or blocked for further checks. As a precaution, 18 vehicles where concentrations over 1 but less than 2 fibres/litre were found, were also blocked and their return to service has been postponed for further checks and analyses until the results show concentrations below 1 fibre/litre. Environmental analyses carried out up to the present indicate an overall situation comparable to that usually found in the general environmental without any asbestos dispersion sources. Surveillance and investigations are still under way in order to achieve the aims of the safety programme set up by the Italian Railways to ensure health and environmental protection.

Nursing and finance: making the connection.

PubMed

Brennan, Terry; Hinson, Nancy; Taylor, Mardy

2008-01-01

Nursing and finance are critical to each other's success in maintaining financial viability and providing high-quality care. Finance departments should educate, inform, communicate, and empathize. Nursing departments should think creatively, get involved in budget committees and board meetings, and set an example of collaboration and cooperation.

7 CFR 277.1 - General purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PAYMENTS OF CERTAIN ADMINISTRATIVE COSTS OF STATE... management of administrative funds provided to State agencies and sets forth principles for claiming costs of...

7 CFR 780.1 - General.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 7 2014-01-01 2014-01-01 false General. 780.1 Section 780.1 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE SPECIAL PROGRAMS APPEAL REGULATIONS § 780.1 General. This part sets forth rules applicable to appealability reviews...

5 CFR 9901.501 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Purpose. 9901.501 Section 9901.501 Administrative Personnel DEPARTMENT OF DEFENSE HUMAN RESOURCES MANAGEMENT AND LABOR RELATIONS SYSTEMS (DEPARTMENT... personnel practices). (c) The Secretary will adhere to veterans' preference principles set forth in 5 U.S.C...

34 CFR 104.34 - Educational setting.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE... handicapped person in its jurisdiction with persons who are not handicapped to the maximum extent appropriate...

34 CFR 104.34 - Educational setting.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE... handicapped person in its jurisdiction with persons who are not handicapped to the maximum extent appropriate...

34 CFR 104.34 - Educational setting.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE... handicapped person in its jurisdiction with persons who are not handicapped to the maximum extent appropriate...

34 CFR 104.34 - Educational setting.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE... handicapped person in its jurisdiction with persons who are not handicapped to the maximum extent appropriate...

34 CFR 104.34 - Educational setting.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Regulations of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE... handicapped person in its jurisdiction with persons who are not handicapped to the maximum extent appropriate...

7 CFR 32.401 - Cost of samples for grease mohair grades.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 32.401 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD... mohair grades. (a) Complete set. $22 each, delivered to any destination with the United States and $25...

15 CFR 705.2 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND SECURITY, DEPARTMENT OF COMMERCE NATIONAL SECURITY INDUSTRIAL BASE REGULATIONS EFFECT OF IMPORTED ARTICLES ON THE NATIONAL SECURITY § 705.2 Purpose. These regulations set forth the procedures by which the Department shall commence and conduct an investigation to determine the effect on the national security of...

76 FR 12718 - National Board for Education Sciences Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... DEPARTMENT OF EDUCATION National Board for Education Sciences Meeting AGENCY: Institute of Education Sciences, Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education...

77 FR 57079 - National Board for Education Sciences; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-17

... DEPARTMENT OF EDUCATION National Board for Education Sciences; Meeting AGENCY: Institute of Education Sciences, Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education...

76 FR 27035 - Regional Advisory Committees: Open Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-10

... DEPARTMENT OF EDUCATION Regional Advisory Committees: Open Meeting AGENCY: Office of Elementary and Secondary Education, U.S. Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the date and agenda of the upcoming meeting of the 10 Regional Advisory...

77 FR 49963 - Organization and Delegation of Powers and Duties

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-17

... subpart sets forth the OST's key responsibilities, its basic organizational structure, and the line of... statutory responsibilities and organizational changes within the Department. Third, it clarifies the text... the current statutory and organizational posture of the Department. The final rule is ministerial in...

Photocopy of War Department drawing (original located at Fort McCoy, ...

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

Photocopy of War Department drawing (original located at Fort McCoy, Wisconsin). FOUNDATION SETTING (PLAN, DETAILS),PLAN NUMBER 6150-20-B - Fort McCoy, Building No. T-10127, Northwest of Hospital Boiler House, Building T-10111, Block 10, Sparta, Monroe County, WI

Subpart H: National Emission Standards for Emissions of Radionuclides Other Than Radon From Department of Energy Facilities

EPA Pesticide Factsheets

Subpart H sets a limit on the emission of radionuclides that ensures no member of the public receives an effective dose equivalent of more than 10 mrem/year emissions from Department of Energy (DOE) facilities.

75 FR 13265 - National Board for Education Sciences

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... DEPARTMENT OF EDUCATION National Board for Education Sciences AGENCY: Institute of Education Sciences, Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education Sciences. The...

75 FR 53280 - National Board for Education Sciences

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-31

... DEPARTMENT OF EDUCATION National Board for Education Sciences AGENCY: Department of Education, Institute of Education Sciences. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education Sciences. The...

7 CFR 1776.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 12 2014-01-01 2013-01-01 true Purpose. 1776.1 Section 1776.1 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM General § 1776.1 Purpose. This part sets forth the...

7 CFR 1776.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Purpose. 1776.1 Section 1776.1 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM General § 1776.1 Purpose. This part sets forth the...

7 CFR 1776.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 12 2012-01-01 2012-01-01 false Purpose. 1776.1 Section 1776.1 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM General § 1776.1 Purpose. This part sets forth the...

7 CFR 1776.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 12 2013-01-01 2013-01-01 false Purpose. 1776.1 Section 1776.1 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM General § 1776.1 Purpose. This part sets forth the...

7 CFR 1776.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Purpose. 1776.1 Section 1776.1 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) HOUSEHOLD WATER WELL SYSTEM GRANT PROGRAM General § 1776.1 Purpose. This part sets forth the...

10 CFR 950.2 - Scope and applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DEPARTMENT OF ENERGY STANDBY SUPPORT FOR CERTAIN NUCLEAR PLANT DELAYS General Provisions § 950.2 Scope and applicability. This part sets forth the policies and procedures for the award and administration of Standby Support Contracts between the Department and sponsors of new advanced nuclear facilities. ...

Effect of a Stewardship Intervention on Adherence to Uncomplicated Cystitis and Pyelonephritis Guidelines in an Emergency Department Setting

PubMed Central

Hecker, Michelle T.; Fox, Clinton J.; Son, Andrea H.; Cydulka, Rita K.; Siff, Jonathan E.; Emerman, Charles L.; Sethi, Ajay K.; Muganda, Christine P.; Donskey, Curtis J.

2014-01-01

Objective To evaluate adherence to uncomplicated urinary tract infections (UTI) guidelines and UTI diagnostic accuracy in an emergency department (ED) setting before and after implementation of an antimicrobial stewardship intervention. Methods The intervention included implementation of an electronic UTI order set followed by a 2 month period of audit and feedback. For women age 18 – 65 with a UTI diagnosis seen in the ED with no structural or functional abnormalities of the urinary system, we evaluated adherence to guidelines, antimicrobial use, and diagnostic accuracy at baseline, after implementation of the order set (period 1), and after audit and feedback (period 2). Results Adherence to UTI guidelines increased from 44% (baseline) to 68% (period 1) to 82% (period 2) (P≤.015 for each successive period). Prescription of fluoroquinolones for uncomplicated cystitis decreased from 44% (baseline) to 14% (period 1) to 13% (period 2) (P<.001 and P = .7 for each successive period). Unnecessary antibiotic days for the 200 patients evaluated in each period decreased from 250 days to 119 days to 52 days (P<.001 for each successive period). For 40% to 42% of cases diagnosed as UTI by clinicians, the diagnosis was deemed unlikely or rejected with no difference between the baseline and intervention periods. Conclusions A stewardship intervention including an electronic order set and audit and feedback was associated with increased adherence to uncomplicated UTI guidelines and reductions in unnecessary antibiotic therapy and fluoroquinolone therapy for cystitis. Many diagnoses were rejected or deemed unlikely, suggesting a need for studies to improve diagnostic accuracy for UTI. PMID:24498394

[Economic impact of consultation-liaison psychiatry in a French University Hospital Centre].

PubMed

Yrondi, A; Petiot, D; Arbus, C; Schmitt, L

2016-02-01

In times of fiscal restraint for health structures, apart from the clinical input, it seems important to discuss the economic impact of liaison psychiatry. There are only a few studies on the economic added value provided by a liaison psychiatry team. In addition to this, only a few psychiatric pathologies are coded as they should be, hence we make the assumption of an additional development provided by a specialised team. Over a short period of 4months, in three departments of the Toulouse University Hospital Centre, the added value to the general pricing system of liaison psychiatry was studied. The population was represented by all the consecutive requests for consultations from patients over 18years old, men and women, hospitalised at that time. These three departments frequently request consultations with the psychiatry liaison team. They set a diagnostic, and if this is associated with a higher Homogeneous Group of Patients (HGP), it provides added value. Fifty-two patients benefited from a psychiatric consultation over 4months. The results highlight a development of € 8630.43 for the traumatology department, € 3325.03 for the internal medicine department, and € 513.61 for the haematology department over the study period. The overall development over this period was € 12,469.07. To our knowledge, this approach is one of the first in France to highlight an economic impact of the intervention of liaison psychiatry in the claiming departments. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Delivery of calibration workshops covering herbicide application equipment : final report.

DOT National Transportation Integrated Search

2014-03-31

Proper herbicide sprayer set-up and calibration are critical to the success of the Oklahoma Department of Transportation (ODOT) herbicide program. Sprayer system set-up and calibration training is provided in annual continuing education herbicide wor...

Optimising the emergency to ward handover process: A mixed methods study.

PubMed

Bakon, Shannon; Millichamp, Tracey

2017-11-01

The effective handover of patient health data from the emergency department to other hospital units is integral for the continuity of patient care. Yet no handover process has been identified as superior to others within this context. This study within a regional Australian hospital employed mixed methods approach including focus groups and key stakeholder consultation to develop a handover form appropriate for patient transfer from the emergency department to a variety of clinical areas. Paper-based surveys and audits were then employed to evaluate the implementation and understand staff perceptions of the form. The implementation of a patient handover form within the emergency setting was well received. Participants indicated that the form is clear, well designed and easy to navigate. It provided prompts to standardise their clinical handover and increased their accountability and responsibility within this process. To deliver an optimal nursing handover from the emergency department to various wards handovers should be structured and provide standardised content. The positive reception and use of this form provides evidence that a structured handover process can ensure standardisation of emergency department to ward nursing handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Impact of Implementing a Wiki to Develop Structured Electronic Order Sets on Physicians' Intention to Use Wiki-Based Order Sets

PubMed Central

Beaupré, Pierre; Bégin, Laura; Dupuis, Audrey; Côté, Mario; Légaré, France

2016-01-01

Background Wikis have the potential to promote best practices in health systems by sharing order sets with a broad community of stakeholders. However, little is known about the impact of using a wiki on clinicians’ intention to use wiki-based order sets. Objective The aims of this study were: (1) to describe the use of a wiki to create structured order sets for a single emergency department; (2) to evaluate whether the use of this wiki changed emergency physicians’ future intention to use wiki-based order sets; and (3) to understand the impact of using the wiki on the behavioral determinants for using wiki-based order sets. Methods This was a pre/post-intervention mixed-methods study conducted in one hospital in Lévis, Quebec. The intervention was comprised of receiving access to and being motivated by the department head to use a wiki for 6 months to create electronic order sets designed to be used in a computer physician order entry system. Before and after our intervention, we asked participants to complete a previously validated questionnaire based on the Theory of Planned Behavior. Our primary outcome was the intention to use wiki-based order sets in clinical practice. We also assessed participants’ attitude, perceived behavioral control, and subjective norm to use wiki-based order sets. Paired pre- and post-Likert scores were compared using Wilcoxon signed-rank tests. The post-questionnaire also included open-ended questions concerning participants’ comments about the wiki, which were then classified into themes using an existing taxonomy. Results Twenty-eight emergency physicians were enrolled in the study (response rate: 100%). Physicians’ mean intention to use a wiki-based reminder was 5.42 (SD 1.04) before the intervention, and increased to 5.81 (SD 1.25) on a 7-point Likert scale (P=.03) after the intervention. Participants’ attitude towards using a wiki-based order set also increased from 5.07 (SD 0.90) to 5.57 (SD 0.88) (P=.003). Perceived behavioral control and subjective norm did not change. Easier information sharing was the most frequently positive impact raised. In order of frequency, the three most important facilitators reported were: ease of use, support from colleagues, and promotion by the departmental head. Although participants did not mention any perceived negative impacts, they raised the following barriers in order of frequency: poor organization of information, slow computers, and difficult wiki access. Conclusions Emergency physicians’ intention and attitude to use wiki-based order sets increased after having access to and being motivated to use a wiki for 6 months. Future studies need to explore if this increased intention will translate into sustained actual use and improve patient care. Certain barriers need to be addressed before implementing a wiki for use on a larger scale. PMID:27189046

Recruitment bias in chronic pain research: whiplash as a model.

PubMed

Nijs, Jo; Inghelbrecht, Els; Daenen, Liesbeth; Hachimi-Idrissi, Said; Hens, Luc; Willems, Bert; Roussel, Nathalie; Cras, Patrick; Wouters, Kristien; Bernheim, Jan

2011-11-01

In science findings which cannot be extrapolated to other settings are of little value. Recruitment methods vary widely across chronic whiplash studies, but it remains unclear whether this generates recruitment bias. The present study aimed to examine whether the recruitment method accounts for differences in health status, social support, and personality traits in patients with chronic whiplash-associated disorders (WAD). Two different recruitment methods were compared: recruiting patients through a local whiplash patient support group (group 1) and local hospital emergency department (group 2). The participants (n=118) filled in a set of questionnaires: the Neck Disability Index, Medical Outcome Study Short-Form General Health Survey, Anamnestic Comparative Self-Assessment measure of overall well-being, Symptom Checklist-90, Dutch Personality Questionnaire, and the Social Support List. The recruitment method (either through the local emergency department or patient support group) accounted for the differences in insufficiency, somatization, disability, quality of life, self-satisfaction, and dominance (all p values <.01). The recruitment methods generated chronic WAD patients comparable for psychoneurotism, social support, self-sufficiency, (social) inadequacy, rigidity, and resentment (p>.01). The recruitment of chronic WAD patients solely through patient support groups generates bias with respect to the various aspects of health status and personality, but not social support. In order to enhance the external validity of study findings, chronic WAD studies should combine a variety of recruitment procedures.

Predators and Prey: Jordan Lake State Recreation Area. An Environmental Education Learning Experience Designed for Grades K-3.

ERIC Educational Resources Information Center

Boswell, Henry, III; Stamm, Daniel K.

This document provides hands-on environmental education activities for the classroom and the outdoor setting of Jordan Lake State Recreation Area. The activity packet, designed for grades K-3, meets curriculum objectives of the standard course of study established by the North Carolina Department of Public Instruction. It includes on-site…

Principal and Teacher Perceptions of Implementation of Multiple-Measure Teacher Evaluation Systems in Arizona. REL 2015-062

ERIC Educational Resources Information Center

Ruffini, Stephen J.; Makkonen, Reino; Tejwani, Jaclyn; Diaz, Marycruz

2014-01-01

This study describes how multiple-measure teacher evaluations were put into practice in a set of ten volunteering local education agencies (LEAs) in Arizona. After a key shift in state policy, five "pilot" LEAs implemented the new Arizona Department of Education teacher evaluation model in the 2012/13 school year, while five other…

A case of methicillin-resistant Staphylococcus aureus wound infection: phylogenetic analysis to establish if nosocomial or community acquired.

PubMed

Cancilleri, Francesco; Ciccozzi, Massimo; Fogolari, Marta; Cella, Eleonora; De Florio, Lucia; Berton, Alessandra; Salvatore, Giuseppe; Dicuonzo, Giordano; Spoto, Silvia; Denaro, Vincenzo; Angeletti, Silvia

2018-05-01

Methicillin-resistant Staphylococcus aureus (MRSA) infection is rapidly increasing in both hospital and community settings. A 71-year-old man admitted at the Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, with MRSA wound infection consequent to orthopedic surgery was studied and the MRSA transmission evaluated by phylogenetic analysis.

Introducing a longitudinal study of community gardeners and gardens in New York City

Treesearch

Erika S. Svendsen; Lindsay K. Campbell; Nancy Falxa-Raymond; Jessica Northridge; Edie Stone

2012-01-01

For almost a decade, the NYC Department of Parks and Recreation GreenThumb program has collected data about hundreds of New York City community gardens citywide to understand how these gardens function. Building on a data set that includes surveys and interviews conducted periodically with garden representatives since 2003, GreenThumb and USDA Forest Service...

Youths' and Parents' Views on the Acceptability and Design of a Video-Based Tobacco Prevention Intervention

ERIC Educational Resources Information Center

Mahabee-Gittens, E. Melinda; Vaughn, Lisa; Gordon, Judith S.

2010-01-01

The purpose of this study was to evaluate the acceptability of a brief, video-based parental intervention that modeled parent-child communication about tobacco, delivered within an emergency department (ED) setting. While waiting to be seen by a physician in the ED, 20 parent-youth dyads watched the video together and then private, semi-structured…

The Power of the Pen: Writing Mentorship and Chicana/o M. A. Students

ERIC Educational Resources Information Center

Negrón-Gonzales, Genevieve M.

2014-01-01

This article draws on my experience as an adjunct professor in the Master's program of the Department of Mexican-American Studies at a large public university in California. Seeing my students' struggles with writing, I conceived of a set of practices of writing mentorship anchored by a series of writing workshops held in Summer 2012. In this…

A Multi-Site Pilot Test Study to Measure Safety Climate in the University Work Setting

ERIC Educational Resources Information Center

Gutierrez, Janet M.

2011-01-01

Next to leisure, sport, and household activities, the most common activity resulting in medically consulted injuries and poisonings in the United States is work, with an estimated 4 million workplace related episodes reported in 2008 (U.S. Department of Health and Human Services, 2009). To address the risks inherent to various occupations, risk…

Compelled to Be Connected: An Ethnographic Exploration of Organizational Culture, Work-Life Balance, and the Use of Mobile Workplace Technologies

ERIC Educational Resources Information Center

Thomas, Kristopher J.

2013-01-01

This study is an ethnographic exploration of organizational culture, work-life balance, and the use of information and communication technology ("ICT") in the work and home settings. The researcher was embedded for nine weeks within the Information Technology ("IT") department at the corporate headquarters of a mid-sized…

Economics and Business Coursework by Undergraduate Students: Findings from Baccalaureate and Beyond Transcripts

ERIC Educational Resources Information Center

Bosshardt, William; Walstad, William B.

2017-01-01

The Baccalaureate and Beyond study from the National Center for Education Statistics at the U.S. Department of Education contains a nationally representative set of transcript data from colleges and university graduates in the 2007-2008 academic year, the latest year for which such data are available. The authors use the transcript data to analyze…

How Can We Retain Them? An Investigation into the Early Cancellation of Courses in a Distance Learning Institution

ERIC Educational Resources Information Center

van Schoor, W. A.; Potgieter, D.

2011-01-01

Throughput and retention are important issues in higher education in South Africa mainly due to the stronger emphasis on accountability from funding agencies like the Department of Education. This study, which is set in a distance education institution, was aimed at understanding why students cancel courses early on in the academic year. A…

Cite Globally, Analyze Locally: Citation Analysis from a Local Latin American Studies Perspective

ERIC Educational Resources Information Center

Schadl, Suzanne M.; Todeschini, Marina

2015-01-01

This citation analysis examines the use of Spanish- and Portuguese-language books and articles in PhD dissertations on Latin America at the University of New Mexico between 2000 and 2009. Two sets of data are presented: The first identifies the use of Spanish- and Portuguese-language books and articles across 17 academic departments; and the…

Teachers' Experiences of Technology-Based Teaching and Learning in the Foundation Phase

ERIC Educational Resources Information Center

Hannaway, D. M.; Steyn, M. G.

2017-01-01

This paper presents one aspect of a larger scale doctoral study, namely the teachers' experiences of technology-based teaching and learning in the Foundation Phase. Technology is a huge driver of change and South African education has to change regularly to meet the requirements set out by the Department of Education, including the development of…

48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

48 CFR 852.219-10 - VA Notice of total service-disabled veteran-owned small business set-aside.

Code of Federal Regulations, 2014 CFR

2014-10-01

...-disabled veteran-owned small business set-aside. 852.219-10 Section 852.219-10 Federal Acquisition... CLAUSES Texts of Provisions and Clauses 852.219-10 VA Notice of total service-disabled veteran-owned small...-Disabled Veteran-Owned Small Business Set-Aside (DEC 2009) (a) Definition. For the Department of Veterans...

Developing New Models of the COMP-LAB College Basic Writing Course for Other Settings. Final Report.

ERIC Educational Resources Information Center

Epes, Mary T.; And Others

A course designed for college students with severe writing problems, especially those stemming from nonstandard speech patterns, was adapted to a variety of noncollege settings: two high schools, a labor union, a manpower training program, and the staff education department of a psychiatric hospital. Each setting attempted to integrate classroom…

3 CFR - Federal Employee Pay Schedules and Rates That Are Set by Administrative Discretion

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Federal Employee Pay Schedules and Rates That Are Set by Administrative Discretion Presidential Documents Other Presidential Documents Memorandum of April 5, 2013 Federal Employee Pay Schedules and Rates That Are Set by Administrative Discretion Memorandum for the Heads of Executive Departments and...

42 CFR 137.204 - How will this voluntary national uniform data set be developed?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false How will this voluntary national uniform data set... HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Health Status Reports § 137.204 How will this voluntary national uniform data set be...

75 FR 10345 - Pricing for 2010 United States Mint America the Beautiful Quarters Proof Set, etc.

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-05

... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2010 United States Mint America the.... SUMMARY: The United States Mint is announcing the prices of the 2010 United States Mint America the Beautiful Quarters Proof Set; 2010 United States Mint America the Beautiful Quarters Silver Proof Set; 2010...

29 Has the licensing ACT 2003 affected levels of violence in England and Wales? A systematic review of hospital and police studies.

PubMed

Callan, Caitríona; Boyle, Adrian

2017-12-01

Population-level legislation has been implemented in many countries to try and address alcohol misuse and related harms, including assault. Most violent incidents in the UK are alcohol-related, with alcohol misuse accounting for a substantial proportion of Accident and Emergency Department attendances. The Licensing Act 2003 aimed to reduce alcohol-related crime and disorder by abolishing set closing times and giving local authorities control over premises licensing in England and Wales. Concerns were raised, however, that greater availability of alcohol would lead to increased consumption and violence. This review examines primary research from hospital and police settings to evaluate whether the implementation of the Act in 2005 reduced or increased violence rates in England and Wales. We performed an inclusive systematic review of the major biomedical databases. We included original research that evaluated changes in violence rates before and after the implementation of the Licensing Act, including hospital- and police- defined measures for this primary outcome. Our secondary outcome was whether there was change in temporal distribution of violent incidents after implementation of the Act. We identified 184 studies. 15 studies were included. The evidence was of overall poor quality, with the majority of included studies being uncontrolled before-after studies. 8 of these studies were conducted in the hospital setting, and 7 were from the police setting. Overall, 7 studies found reduced violence rates after implementation of the Licensing Act, 3 found increased rates, and 5 found no significant change. A subset of 9 papers analysed temporal distribution of violent incidents, 8 finding evidence of temporal displacement of assaults further into the early hours of the morning. This is the most complete analysis to date of the effects of the Licensing Act on violence. There is no evidence for the Act having a significant or consistent effect on community violence rates, either in emergency departments or policing. There is consistent evidence from both hospital and police settings of a proportional increase in late-night violence since the implementation of the Act. © 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

32 CFR 505.1 - General information.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.1 General information. (a) Purpose. This part sets forth policies... Relating to Individual Persons, November 30, 1943. (9) Public Law 100-503, the Computer Matching and...

48 CFR 801.000 - Scope of part.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Scope of part. 801.000 Section 801.000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION SYSTEM 801.000 Scope of part. This part sets out general...

48 CFR 801.000 - Scope of part.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Scope of part. 801.000 Section 801.000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION SYSTEM 801.000 Scope of part. This part sets out general...

48 CFR 801.000 - Scope of part.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Scope of part. 801.000 Section 801.000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION SYSTEM 801.000 Scope of part. This part sets out general...

48 CFR 801.000 - Scope of part.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Scope of part. 801.000 Section 801.000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION SYSTEM 801.000 Scope of part. This part sets out general...

48 CFR 801.000 - Scope of part.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Scope of part. 801.000 Section 801.000 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS GENERAL DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION SYSTEM 801.000 Scope of part. This part sets out general...

77 FR 484 - Equity and Excellence Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-05

... DEPARTMENT OF EDUCATION Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an up-coming meeting of the Equity and Excellence Commission (Commission). The notice...

76 FR 62394 - Equity and Excellence Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-07

... DEPARTMENT OF EDUCATION Equity and Excellence Commission AGENCY: Office for Civil Rights, U.S. Department of Education. ACTION: Notice of An Open Meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an up-coming meeting of the Equity and Excellence Commission (Commission). The notice...

48 CFR 871.100 - Scope of subpart.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Scope of subpart. 871.100 Section 871.100 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS DEPARTMENT... Direct Loan Programs 871.100 Scope of subpart. This subpart sets forth policy and procedures with respect...

The Futuring Process

Treesearch

Delmer L. Albright

1987-01-01

Futuring" is becoming a widely accepted approach to organization management and goal setting. Strategic planners for the United States military as well as the Forest Service, U.S. Department of Agriculture, and the California Department of Forestry and Fire Protection, use Futuring to develop action plans and organizational directions for their agencies.

78 FR 32639 - National Advisory Council on Indian Education (NACIE)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-31

... DEPARTMENT OF EDUCATION National Advisory Council on Indian Education (NACIE) AGENCY: U.S. Department of Education. ACTION: Notice of an open teleconference meeting. SUMMARY: This notice sets forth... Council on Indian Education (the Council) and is intended to notify the general public of the meeting...

76 FR 34069 - National Board for Education Sciences; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-10

... DEPARTMENT OF EDUCATION National Board for Education Sciences; Meeting AGENCY: U.S. Department of Education, Institute of Education Sciences. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education...

76 FR 58789 - National Board for Education Sciences; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-22

... DEPARTMENT OF EDUCATION National Board for Education Sciences; Meeting AGENCY: Institute of Education Sciences, U.S. Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education...

78 FR 28811 - National Board for Education Sciences; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... DEPARTMENT OF EDUCATION National Board for Education Sciences; Meeting AGENCY: Institute of Education Sciences, U.S. Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education...

78 FR 8499 - National Board for Education Sciences; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-06

... DEPARTMENT OF EDUCATION National Board for Education Sciences; Meeting AGENCY: U.S. Department of Education, Institute of Education Sciences. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education...

77 FR 6789 - National Board for Education Sciences; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... DEPARTMENT OF EDUCATION National Board for Education Sciences; Meeting AGENCY: Institute of Education Sciences, U.S. Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education...

77 FR 11514 - National Advisory Council on Indian Education (NACIE)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-27

... DEPARTMENT OF EDUCATION National Advisory Council on Indian Education (NACIE) AGENCY: U.S. Department of Education. ACTION: Notice of an open teleconference meeting. SUMMARY: This notice sets forth... Council on Indian Education (the Council) and is intended to notify the general public of the meeting...

77 FR 33732 - National Board for Education Sciences; Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-07

... DEPARTMENT OF EDUCATION National Board for Education Sciences; Meeting AGENCY: ED, Institute of Education Sciences, U.S. Department of Education. ACTION: Notice of an Open Meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Board for Education...

77 FR 74546 - Determination Concerning the Bolivian Military and Police

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-14

... DEPARTMENT OF STATE [Public Notice 8118] Determination Concerning the Bolivian Military and Police Pursuant to the authority vested in the Secretary of State, including that set forth in the ``International Narcotics Control and Law Enforcement'' account of the Department of State, Foreign Operations, and Related...

32 CFR 632.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Purpose. 632.1 Section 632.1 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL... regulation implements DOD Directive 5210.65. It sets uniform policy for use of force by DA law enforcement...

75 FR 4844 - Notice of Meeting for Acadia National Park Advisory Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-29

... DEPARTMENT OF THE INTERIOR National Park Service Notice of Meeting for Acadia National Park Advisory Commission AGENCY: National Park Service, Department of Interior. ACTION: Notice of February 19, 2010, Meeting for Acadia National Park Advisory Commission. SUMMARY: This notice sets the date of...

The electronic security partnership of safety/security and information systems departments.

PubMed

Yow, J Art

2012-01-01

The ever-changing world of security electronics is reviewed in this article. The author focuses on its usage in a hospital setting and the need for safety/security and information systems departments to work together to protect and get full value from IP systems.

Photocopy of War Department drawing (original located at Fort McCoy, ...

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

Photocopy of War Department drawing (original located at Fort McCoy, Wisconsin). FOUNDATION SETTING (FRAMING ELEVATIONS, DETAILS, PLAN NUMBER 6150-21-B - Fort McCoy, Building No. T-10127, Northwest of Hospital Boiler House, Building T-10111, Block 10, Sparta, Monroe County, WI

Pharmaceutical advertising in emergency departments.

PubMed

Marco, Catherine A

2004-04-01

Promotion of prescription drugs represents a growing source of pharmaceutical marketing expenditures. This study was undertaken to identify the frequency of items containing pharmaceutical advertising in clinical emergency departments (EDs). In this observational study, emergency physician on-site investigators quantified a variety of items containing pharmaceutical advertising present at specified representative times and days, in clinical EDs. Measurements were obtained by 65 on-site investigators, representing 22 states. Most EDs in this study were community EDs (87% community and 14% university or university affiliate), and most were in urban settings (50% urban, 38% suburban, and 13% rural). Investigators measured 42 items per ED (mean = 42; median = 31; interquartile range of 14-55) containing pharmaceutical advertising in the clinical area. The most commonly observed items included pens (mean 15 per ED; median 10), product brochures (mean 5; median 3), stethoscope labels (mean 4; median 2), drug samples (mean 3; median 0), books (mean 3.4), mugs (mean 2.4), and published literature (mean 3.1). EDs with a policy restricting pharmaceutical representatives in the ED had significantly fewer items containing pharmaceutical advertising (median 7.5; 95% CI = 0 to 27) than EDs without such a policy (median 35; 95% CI = 27 to 47, p = 0.005, nonparametric Wilcoxon two-sample test). There were no differences in quantities of pharmaceutical advertising for EDs in community compared with university settings (p = 0.5), rural compared with urban settings (p = 0.3), or annual ED volumes (p = 0.9). Numerous items containing pharmaceutical advertising are frequently observed in EDs. Policies restricting pharmaceutical representatives in the ED are associated with reduced pharmaceutical advertising.

Evidence-Based Diabetes Prevention and Control Programs and Policies in Local Health Departments.

PubMed

Zwald, Marissa; Elliott, Lindsay; Brownson, Ross C; Skala, Mahree

2015-12-01

The purpose of this study is to: (1) assess implementation of evidence-based programs and policies (EBPPs) related to diabetes prevention and control in local health departments, (2) assess feasibility of non-implemented diabetes prevention and control EBPPs, and (3) examine individual- and organizational-level factors associated with implementation of diabetes prevention and control EBPPs. An online survey was administered in January 2015 to key representatives of all local health departments in Missouri. Descriptive statistics were used to describe implementation and perceived feasibility of 20 diabetes prevention and control EBPPs. Logistic regression was used to examine the association between individual and organizational factors and diabetes prevention and control EBPP implementation. One hundred local health departments participated (89% response rate) in the online survey. Most frequently implemented diabetes-related EBPPs in local health departments included: nutrition education for agency or community members, increased fruit and vegetable access in community settings, and community-wide campaigns to promote physical activity. Increased encouragement to others in the department to use evidence-based decision making and agency incentives to help employees use evidence-based decision making were positively associated with implementation of diabetes prevention and control EBPPs. Local health departments are on the "front line" of public health, and this study demonstrates the important role these organizations play in implementing diabetes prevention and control EBPPs. Potential leverage points for more widespread adoption of diabetes-related EBPPs in local health departments include education about and encouragement of evidence-based decision making and organizational incentives for employees to integrate evidence-based decision making into their diabetes prevention and control activities. © 2015 The Author(s).

Evidence-based diabetes prevention and control programs and policies in local health departments

PubMed Central

Zwald, Marissa; Elliott, Lindsay; Brownson, Ross C.; Skala, Mahree

2016-01-01

Purpose The purpose of this study is to: (1) assess implementation of evidence-based programs and policies (EBPPs) related to diabetes prevention and control in local health departments; (2) assess feasibility of non-implemented diabetes prevention and control EBPPs; and (3) examine individual- and organizational-level factors associated with implementation of diabetes prevention and control EBPPs. Methods An online survey was administered in January 2015 to key representatives of all local health departments in Missouri. Descriptive statistics were used to describe implementation and perceived feasibility of 20 diabetes prevention and control EBPPs. Logistic regression was used to examine the association between individual and organizational factors and diabetes prevention and control EBPP implementation. Results One hundred local health departments participated (89% response rate) in the online survey. Most frequently implemented diabetes-related EBPPs in local health departments included: nutrition education for agency or community members; increased fruit and vegetable access in community settings; and community-wide campaigns to promote physical activity. Increased encouragement to others in the department to use evidence-based decision making and agency incentives to help employees use evidence-based decision making were positively associated with implementation of diabetes prevention and control EBPPs. Conclusions Local health departments are the “front line” of public health and this study demonstrates the important role these organizations play in implementing diabetes prevention and control EBPPs. Potential leverage points for more widespread adoption of diabetes-related EBPPs in local health departments include education about and encouragement of evidence-based decision making and organizational incentives for employees to integrate evidence-based decision making into their diabetes prevention and control activities. PMID:26297714

Work Motivation: Theory and Practice

DTIC Science & Technology

1981-09-01

D department of a large international corporation. Ivancevich (1976) cautions, though, that participatory goal setting may not always enhance...Applied Psycholoqy, 1979, 64(4), 349-371. Ivancevich , J. M. Effects of goal setting on perfor-mance and job satisfaction. Journal of Applied Psycho_ gy

78 FR 37505 - International Standard-Setting Activities

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-21

... Code of Practice for Weed Control to Prevent and Reduce Pyrrolizidine Alkaloid Contamination in Food... DEPARTMENT OF AGRICULTURE Food Safety and Inspection Service [Docket No. FSIS-2013-0002] International Standard-Setting Activities AGENCY: Office of Food Safety, USDA. ACTION: Notice. SUMMARY: This...

Overcoming barriers to the use of osteopathic manipulation techniques in the emergency department.

PubMed

Roberge, Raymond J; Roberge, Marc R

2009-08-01

Osteopathic Manipulation Techniques (OMT) have been shown to be effective therapeutic modalities in various clinical settings, but appear to be underutilized in the emergency department (ED) setting. To examine barriers to the use of OMT in the ED and provide suggestions to ameliorate these barriers. Literature review While the medical literature cites numerous obstacles to the use of OMT in the ED setting, most can be positively addressed through education, careful planning, and ongoing research into use of these techniques. Recent prospective clinical trials of OMT have demonstrated the utility of these modalities. Osteopathic Manipulation Techniques are useful therapeutic modalities that could be utilized to a greater degree in the ED. As the number of osteopathic emergency physicians increases, the opportunity to employ these techniques should increase.

A study on the impact of prioritising emergency department arrivals on the patient waiting time.

PubMed

Van Bockstal, Ellen; Maenhout, Broos

2018-05-03

In the past decade, the crowding of the emergency department has gained considerable attention of researchers as the number of medical service providers is typically insufficient to fulfil the demand for emergency care. In this paper, we solve the stochastic emergency department workforce planning problem and consider the planning of nurses and physicians simultaneously for a real-life case study in Belgium. We study the patient arrival pattern of the emergency department in depth and consider different patient acuity classes by disaggregating the arrival pattern. We determine the personnel staffing requirements and the design of the shifts based on the patient arrival rates per acuity class such that the resource staffing cost and the weighted patient waiting time are minimised. In order to solve this multi-objective optimisation problem, we construct a Pareto set of optimal solutions via the -constraints method. For a particular staffing composition, the proposed model minimises the patient waiting time subject to upper bounds on the staffing size using the Sample Average Approximation Method. In our computational experiments, we discern the impact of prioritising the emergency department arrivals. Triaging results in lower patient waiting times for higher priority acuity classes and to a higher waiting time for the lowest priority class, which does not require immediate care. Moreover, we perform a sensitivity analysis to verify the impact of the arrival and service pattern characteristics, the prioritisation weights between different acuity classes and the incorporated shift flexibility in the model.

Emergency department waiting room stress: can music or aromatherapy improve anxiety scores?

PubMed

Holm, Lydia; Fitzmaurice, Laura

2008-12-01

The aim of this study was to determine the effect of music alone, aromatherapy alone, and music in addition to aromatherapy on anxiety levels of adults accompanying children to a pediatricemergency department waiting area. The study was conducted over 28 consecutive days, assigned to 1 of 4 groups: no intervention, music, aromatherapy, and both music and aromatherapy. Adults accompanying children to the emergency department of an urban pediatric tertiary care referral center were given a survey including a Spielberger state anxiety inventory with additional questions about whether they noticed an aroma or music and if so their response to it. The music was classic ingenre with a tempo of 60 to 70 beats per minute. The aromatherapyused the essential oil Neroli dispersed using 2 aromatherapydiffusers placed in strategic airflow ends of the emergency department. The 1104 surveys were completed. There was a statistically significant decrease in anxietylevel on those days when music was playing (36.3 vs. 39.2; P = 0.017). There was no difference in anxiety levels on those days when aromatherapy was present compared with the nonaromatherapy days (37.3 vs. 38.0; P = 0.347). Music is an easy and useful way to decrease the anxiety of visitors in an emergency department waiting area. Although no difference was detected for the aromatherapy group, this could be because of environmental conditions or imprecise application of the aromatherapy; further study is needed to either prove or disprove its effectiveness in this setting.

The needs of families accompanying injured patients into the emergency department in a tertiary hospital in Gauteng.

PubMed

Botes, Meghan L; Langley, Gayle

2016-06-24

Families are not prepared for traumatic injuries of loved ones. Emergency nurses have the important role of caring for patients and families in this time of crisis. Family needs in the critical care setting have been explored using the Critical Care Family Needs Inventory (CCFNI), however little is known about family needs in the emergency department. This study sought to determine the needs of family members accompanying injured patients into the emergency department, and if these needs were met. A quantitative, descriptive, study was conducted in a level 1 trauma facility in Johannesburg, South Africa. The population included families of patients admitted to the emergency department, sampling 100 participants. The instrument, based on the CCFNI, was validated in a pilot study in Melbourne, Australia and re-evaluated using the Cronbach Alpha validity test to ensure internal consistency.Five themes were explored: 'meaning', 'proximity', 'communication', 'comfort' and 'support' and data were analysed using descriptive statistics. Responses to open-ended questions were analysed using content analysis. Permission from the Human Research Ethics Committee was granted and participants were ensured confidentiality and the option for counselling if required. Themes ranked highly important were 'meaning' and 'communication'. Satisfaction was highest for 'meaning'. Low satisfaction levels for 'communication' were found. Issues regarding prolonged time spent in the emergency department and discrimination were raised. These findings have a negative impact on the family's satisfaction with care and it is recommended that the nurse's role in family care be further explored and emphasised.

Contextual Exploration of a New Family Caregiver Support Concept for Geriatric Settings Using a Participatory Health Research Strategy.

PubMed

Dorant, Elisabeth; Krieger, Theresia

2017-11-28

Family caregivers are the backbone of the long-term care support system within the home environment. Comprehensive caregiver support programs require collaboration and coordination within the system. A new public health concept, Vade Mecum, aims to harmonize and professionalize family caregiver support initiatives in geriatric care settings in the Euregion Maas-Rhine. Exploration of the new concept recently started in Germany to gain in-depth insight into current support and the needs of the geriatric care team and family caregivers. Within the context of an exploratory qualitative study, a participatory health research (PHR) strategy was applied to make optimal use of experience and knowledge from the system. Care professionals, engaged as co-researchers, were responsible for decisions about the research question, data collection methods and procedures of engaging family caregivers. A research team representing all professions within the geriatric department was formed. Research objectives were formulated and an appropriate mix of qualitative data collection methods consisting of interviews, focus groups and story-telling was chosen. Needs and expectations of the new concept, and practical solutions for involving family caregivers were discussed. A PHR strategy resulted in initiating a qualitative study in a geriatric care setting carried out by care professionals from the department. Knowledge was generated in a co-creative manner, and co-researchers were empowered. A comprehensive understanding of the system serves as a starting point for advancement of the new family caregiver concept.

19 CFR 171.21 - Written decisions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 2 2013-04-01 2013-04-01 false Written decisions. 171.21 Section 171.21 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... statement setting forth the decision on the matter and the findings of fact and conclusions of law upon...

19 CFR 171.21 - Written decisions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 2 2012-04-01 2012-04-01 false Written decisions. 171.21 Section 171.21 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... statement setting forth the decision on the matter and the findings of fact and conclusions of law upon...

19 CFR 171.21 - Written decisions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Written decisions. 171.21 Section 171.21 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... statement setting forth the decision on the matter and the findings of fact and conclusions of law upon...

19 CFR 171.21 - Written decisions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 2 2014-04-01 2014-04-01 false Written decisions. 171.21 Section 171.21 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... statement setting forth the decision on the matter and the findings of fact and conclusions of law upon...

19 CFR 171.21 - Written decisions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Written decisions. 171.21 Section 171.21 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY... statement setting forth the decision on the matter and the findings of fact and conclusions of law upon...

48 CFR 1301.603-2 - Selection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Selection. 1301.603-2 Section 1301.603-2 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE GENERAL DEPARTMENT OF... 1301.603-2 Selection. In addition to the criteria set forth in FAR 1.603-2, selection of contracting...

Improved Cosmological Constraints from New, Old, and Combined Supernova

Science.gov Websites

Data Set SAO/NASA ADS Astronomy Abstract Service Title: Improved Cosmological Constraints from , Harvard University, 60 Garden Street, Cambridge, MA 02138), AK(Department of Astronomy and Astrophysics Berkeley National Laboratory, 1 Cyclotron Road, Berkeley, CA 94720), BI(Department of Physics and Astronomy

77 FR 35666 - The Fund for the Improvement of Postsecondary Education (FIPSE) National Board

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-14

... DEPARTMENT OF EDUCATION The Fund for the Improvement of Postsecondary Education (FIPSE) National Board AGENCY: The Fund for the Improvement of Postsecondary Education (FIPSE) National Board, U.S. Department of Education. ACTION: Notice of an open teleconference meeting. SUMMARY: This notice sets forth...

7 CFR 215.1 - General purpose and scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL MILK PROGRAM FOR CHILDREN § 215.1 General purpose and scope. This... Program for Children, under the Child Nutrition Act of 1966, as amended, and sets forth the general...

7 CFR 215.1 - General purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL MILK PROGRAM FOR CHILDREN § 215.1 General purpose and scope. This... Program for Children, under the Child Nutrition Act of 1966, as amended, and sets forth the general...

7 CFR 215.1 - General purpose and scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL MILK PROGRAM FOR CHILDREN § 215.1 General purpose and scope. This... Program for Children, under the Child Nutrition Act of 1966, as amended, and sets forth the general...

7 CFR 215.1 - General purpose and scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL MILK PROGRAM FOR CHILDREN § 215.1 General purpose and scope. This... Program for Children, under the Child Nutrition Act of 1966, as amended, and sets forth the general...

7 CFR 215.1 - General purpose and scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL MILK PROGRAM FOR CHILDREN § 215.1 General purpose and scope. This... Program for Children, under the Child Nutrition Act of 1966, as amended, and sets forth the general...

78 FR 45617 - Student Assistance General Provisions, Federal Perkins Loan Program, Federal Family Education...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-29

... estimates were based on behavior as reflected in various Department data sets and longitudinal surveys...) of the HEA. The Department committed, however, to authorize, to the extent possible, early... to designate regulatory provisions for early implementation by program participants under section 482...

7 CFR 966.11 - Pack.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE TOMATOES GROWN IN FLORIDA Order Regulating Handling Definitions § 966.11 Pack. Pack means any of the packs of tomatoes as defined and set forth in the United States Standards for Fresh Tomatoes issued by the United States Department of Agriculture (§§ 51...

Early Learning and Educational Technology Policy Brief

ERIC Educational Resources Information Center

Lee, Joan

2016-01-01

Recognizing the growth of technology use in early learning settings, the U.S. Department of Education and U.S. Department of Health and Human Services collaborated in the development of the "Early Learning and Educational Technology Policy Brief" to promote developmentally appropriate use of technology in homes and early learning…

76 FR 24870 - National Advisory Council on Indian Education (NACIE) Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

... DEPARTMENT OF EDUCATION National Advisory Council on Indian Education (NACIE) Meeting AGENCY: U.S. Department of Education. ACTION: Notice of a Closed Meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming closed meeting of the National Advisory Council on Indian Education (the...

76 FR 18539 - National Advisory Council on Indian Education (NACIE)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-04

... DEPARTMENT OF EDUCATION National Advisory Council on Indian Education (NACIE) AGENCY: U.S. Department of Education. ACTION: Notice of an open meeting SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Advisory Council on Indian Education (the Council...

76 FR 64081 - National Advisory Council on Indian Education (NACIE)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... DEPARTMENT OF EDUCATION National Advisory Council on Indian Education (NACIE) AGENCY: U.S. Department of Education. ACTION: Notice of an Open Meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming meeting of the National Advisory Council on Indian Education (the Council...

75 FR 64716 - National Advisory Council on Indian Education (NACIE)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-20

... DEPARTMENT OF EDUCATION National Advisory Council on Indian Education (NACIE) AGENCY: U.S. Department of Education. ACTION: Notice of an open meeting with a closed session. SUMMARY: This notice sets... Education (the Council) and is intended to notify the general public of the meeting. This notice also...

78 FR 4399 - National Advisory Council on Indian Education (NACIE)

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-22

... DEPARTMENT OF EDUCATION National Advisory Council on Indian Education (NACIE) AGENCY: U.S. Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule for the upcoming public meeting of the National Advisory Council on Indian Education (the Council) and is...

76 FR 33745 - National Advisory Council on Indian Education (NACIE)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-09

... DEPARTMENT OF EDUCATION National Advisory Council on Indian Education (NACIE) AGENCY: U.S. Department of Education. ACTION: Notice of a Closed Meeting. SUMMARY: This notice sets forth the schedule and proposed agenda of an upcoming closed meeting of the National Advisory Council on Indian Education (the...

77 FR 23230 - National Advisory Council on Indian Education (NACIE)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... DEPARTMENT OF EDUCATION National Advisory Council on Indian Education (NACIE) AGENCY: U.S. Department of Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule for the upcoming public meeting of the National Advisory Council on Indian Education (the Council) and is...

19 CFR 102.0 - Scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY RULES OF ORIGIN § 102.0 Scope. With the exception of §§ 102.21 through 102.25, this part sets forth rules for...-Bahrain Free Trade Agreement regulations. The rules for determining the country of origin of textile and...

7 CFR 3400.4 - How to apply for a grant.

Code of Federal Regulations, 2010 CFR

2010-01-01

...). Each set of such materials must be identified with the title of the research project as it appears in... Agriculture Regulations of the Department of Agriculture (Continued) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE SPECIAL RESEARCH GRANTS PROGRAM General § 3400.4 How...

29 CFR 215.3 - Employees represented by a labor organization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... subrecipients, the Department will refer and process each subrecipient's respective portion of the project in... agreement, the referral will be based on those terms and conditions. (4) The referral procedures set forth... area. (1) For applicants with existing protections the Department's referral will be based on those...

78 FR 69099 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-18

... DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency [Docket ID: FEMA-2013-0033... addressed to the Desk Officer for the Department of Homeland Security, Federal Emergency Management Agency... 089-17, RCPT Membership List. Abstract: The RCPGP is an important tool among a comprehensive set of...

Strategic Plan for Fiscal Years 2007-12

ERIC Educational Resources Information Center

US Department of Education, 2007

2007-01-01

Five years after the bipartisan passage of the "No Child Left Behind Act of 2001," the U.S. Department of Education remains dedicated to promoting education excellence in every corner of the country. The Department's "Strategic Plan for Fiscal Years 2007-12" sets high expectations for America's schools and students, and for…

32 CFR 813.5 - Shipping or transmitting visual information documentation images.

Code of Federal Regulations, 2010 CFR

2010-07-01

... documentation images. 813.5 Section 813.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE... visual information documentation images. (a) COMCAM images. Send COMCAM images to the DoD Joint Combat... the approval procedures that on-scene and theater commanders set. (b) Other non-COMCAM images. After...

32 CFR 813.5 - Shipping or transmitting visual information documentation images.

Code of Federal Regulations, 2013 CFR

2013-07-01

... documentation images. 813.5 Section 813.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE... visual information documentation images. (a) COMCAM images. Send COMCAM images to the DoD Joint Combat... the approval procedures that on-scene and theater commanders set. (b) Other non-COMCAM images. After...

32 CFR 813.5 - Shipping or transmitting visual information documentation images.

Code of Federal Regulations, 2011 CFR

2011-07-01

... documentation images. 813.5 Section 813.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE... visual information documentation images. (a) COMCAM images. Send COMCAM images to the DoD Joint Combat... the approval procedures that on-scene and theater commanders set. (b) Other non-COMCAM images. After...

32 CFR 813.5 - Shipping or transmitting visual information documentation images.

Code of Federal Regulations, 2012 CFR

2012-07-01

... documentation images. 813.5 Section 813.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE... visual information documentation images. (a) COMCAM images. Send COMCAM images to the DoD Joint Combat... the approval procedures that on-scene and theater commanders set. (b) Other non-COMCAM images. After...

32 CFR 813.5 - Shipping or transmitting visual information documentation images.

Code of Federal Regulations, 2014 CFR

2014-07-01

... documentation images. 813.5 Section 813.5 National Defense Department of Defense (Continued) DEPARTMENT OF THE... visual information documentation images. (a) COMCAM images. Send COMCAM images to the DoD Joint Combat... the approval procedures that on-scene and theater commanders set. (b) Other non-COMCAM images. After...

New Mexico Higher Education Department Annual Report, 2015

ERIC Educational Resources Information Center

New Mexico Higher Education Department, 2015

2015-01-01

The New Mexico Higher Education Department (HED) and higher education institutions (HEIs) have set long-term statewide goals to increase 4-year graduation rates, improve transfer and articulation, and improve remedial education outcomes. HED is pursuing these goals through the following initiatives: (1) Statewide common course numbering and…

Inpatient Complexity in Radiology-a Practical Application of the Case Mix Index Metric.

PubMed

Mabotuwana, Thusitha; Hall, Christopher S; Flacke, Sebastian; Thomas, Shiby; Wald, Christoph

2017-06-01

With ongoing healthcare payment reforms in the USA, radiology is moving from its current state of a revenue generating department to a new reality of a cost-center. Under bundled payment methods, radiology does not get reimbursed for each and every inpatient procedure, but rather, the hospital gets reimbursed for the entire hospital stay under an applicable diagnosis-related group code. The hospital case mix index (CMI) metric, as defined by the Centers for Medicare and Medicaid Services, has a significant impact on how much hospitals get reimbursed for an inpatient stay. Oftentimes, patients with the highest disease acuity are treated in tertiary care radiology departments. Therefore, the average hospital CMI based on the entire inpatient population may not be adequate to determine department-level resource utilization, such as the number of technologists and nurses, as case length and staffing intensity gets quite high for sicker patients. In this study, we determine CMI for the overall radiology department in a tertiary care setting based on inpatients undergoing radiology procedures. Between April and September 2015, CMI for radiology was 1.93. With an average of 2.81, interventional neuroradiology had the highest CMI out of the ten radiology sections. CMI was consistently higher across seven of the radiology sections than the average hospital CMI of 1.81. Our results suggest that inpatients undergoing radiology procedures were on average more complex in this hospital setting during the time period considered. This finding is relevant for accurate calculation of labor analytics and other predictive resource utilization tools.

Benefit-cost analysis of SBIRT interventions for substance using patients in emergency departments.

PubMed

Horn, Brady P; Crandall, Cameron; Forcehimes, Alyssa; French, Michael T; Bogenschutz, Michael

2017-08-01

Screening, brief intervention, and referral to treatment (SBIRT) has been widely implemented as a method to address substance use disorders in general medical settings, and some evidence suggests that its use is associated with decreased societal costs. In this paper, we investigated the economic impact of SBIRT using data from Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED), a multisite, randomized controlled trial. Utilizing self-reported information on medical status, health services utilization, employment, and crime, we conduct a benefit-cost analysis. Findings indicate that neither of the SMART-ED interventions resulted in any significant changes to the main economic outcomes, nor had any significant impact on total economic benefit. Thus, while SBIRT interventions for substance abuse in Emergency Departments may be appealing from a clinical perspective, evidence from this economic study suggests resources could be better utilized supporting other health interventions. Copyright © 2017 Elsevier Inc. All rights reserved.

Quantitative evaluation of expression difference in report assignments between nursing and radiologic technology departments.

PubMed

Nishimoto, Naoki; Yokooka, Yuki; Yagahara, Ayako; Uesugi, Masahito; Ogasawara, Katsuhiko

2011-01-01

Our purpose in this study was to investigate the expression differences in report assignments between students in nursing and radiologic technology departments. We have known that faculties could identify differences, such as word usage, through grading their students' assignments. However, there are no reports in the literature dealing with expression differences in vocabulary usage in medical informatics education based on statistical techniques or other quantitative measures. The report assignment asked for students' opinions in the event that they found a rare case of a disease in a hospital after they graduated from professional school. We processed student report data automatically, and we applied the space vector model and TF/IDF (term frequency/inverse document frequency) scoring to 129 report assignments. The similarity-score distributions among the assignments for these two departments were close to normal. We focused on the sets of terms that occurred exclusively in either department. For terms such as "radiation therapy" or "communication skills" that occurred in the radiologic technology department, the TF/IDF score was 8.01. The same score was obtained for terms such as "privacy guidelines" or "consent of patients" that occurred in the nursing department. These results will help faculties to provide a better education based on identified expression differences from students' background knowledge.

78 FR 54485 - Apex Tool Group, LLC; Gastonia Operation Division; Including On-Site Leased Workers From Adecco...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... Carolina. The workers are engaged in activities related to the production of mechanic's hand tool sets. The... production of mechanic's hand tool sets to a foreign country. Based on these findings, the Department is...

28 CFR 2.15 - Petition for consideration of parole prior to date set at hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... prior to date set at hearing. 2.15 Section 2.15 Judicial Administration DEPARTMENT OF JUSTICE PAROLE... hearing. When a prisoner has served the minimum term of imprisonment required by law, the Bureau of... consideration for parole prior to the date set by the Commission at the initial or review hearing. The petition...

77 FR 32716 - Price for the 2012 American Eagle San Francisco Two-Coin Silver Proof Set

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-01

... DEPARTMENT OF THE TREASURY United States Mint Price for the 2012 American Eagle San Francisco Two...: The United States Mint is announcing the price of the 2012 American Eagle San Francisco Two-Coin Silver Proof Set. The coin set will be offered for sale at a price of $149.95. FOR FURTHER INFORMATION...

26 CFR 301.6501(n)-3 - Certain set-asides described in section 4942(g)(2).

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Certain set-asides described in section 4942(g)(2). 301.6501(n)-3 Section 301.6501(n)-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Assessment and Collection § 301.6501(n)-3 Certain set-asides described in section 4942(g)(2). Where a...

46 CFR 52.20-25 - Setting (modifies PFT-46).

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 2 2013-10-01 2013-10-01 false Setting (modifies PFT-46). 52.20-25 Section 52.20-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Firetube Boilers § 52.20-25 Setting (modifies PFT-46). (a) The method of supporting firetube boilers shall be as indicated in PFT-46 of...

46 CFR 52.20-25 - Setting (modifies PFT-46).

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 2 2014-10-01 2014-10-01 false Setting (modifies PFT-46). 52.20-25 Section 52.20-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Firetube Boilers § 52.20-25 Setting (modifies PFT-46). (a) The method of supporting firetube boilers shall be as indicated in PFT-46 of...

46 CFR 52.20-25 - Setting (modifies PFT-46).

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 2 2012-10-01 2012-10-01 false Setting (modifies PFT-46). 52.20-25 Section 52.20-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Firetube Boilers § 52.20-25 Setting (modifies PFT-46). (a) The method of supporting firetube boilers shall be as indicated in PFT-46 of...

46 CFR 52.20-25 - Setting (modifies PFT-46).

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Setting (modifies PFT-46). 52.20-25 Section 52.20-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Firetube Boilers § 52.20-25 Setting (modifies PFT-46). (a) The method of supporting firetube boilers shall be as indicated in PFT-46 of...

46 CFR 52.20-25 - Setting (modifies PFT-46).

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 2 2011-10-01 2011-10-01 false Setting (modifies PFT-46). 52.20-25 Section 52.20-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING POWER BOILERS Requirements for Firetube Boilers § 52.20-25 Setting (modifies PFT-46). (a) The method of supporting firetube boilers shall be as indicated in PFT-46 of...

26 CFR 301.6501(n)-3 - Certain set-asides described in section 4942(g)(2).

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Certain set-asides described in section 4942(g)(2). 301.6501(n)-3 Section 301.6501(n)-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE... Assessment and Collection § 301.6501(n)-3 Certain set-asides described in section 4942(g)(2). Where a...

76 FR 15047 - Pricing for 2010 United States Mint America the Beautiful Quarters Silver Proof SetTM

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... Beautiful Quarters Silver Proof Set. In accordance with 31 U.S.C. 9701(b)(2)(B), the United States Mint is... DEPARTMENT OF THE TREASURY United States Mint Pricing for 2010 United States Mint America the Beautiful Quarters Silver Proof Set\\TM\\, etc. ACTION: Pricing for 2010 United States Mint America the...

Evaluation of Physicians' and Nurses' Knowledge, Attitudes, and Compliance With Family Presence During Resuscitation in an Emergency Department Setting After an Educational Intervention.

PubMed

Ferrara, Gineen; Ramponi, Denise; Cline, Thomas W

2016-01-01

Family presence during resuscitation (FPDR) has been an ongoing topic of discussion in many hospital emergency departments throughout the United States. With the current emphasis promoting patient- and family-centered care, families are now exercising their right to be present at the bedside during resuscitation. With or without a policy, there is continued resistance to allow families to remain with their loved ones during resuscitation. The purpose of this study was to evaluate if an evidence-based educational intervention would increase physicians' and nurses' knowledge, attitudes, and compliance with allowing FPDR. This quasi-experimental study evaluated 30 attending physicians' and 65 registered nurses' knowledge of an existing family presence policy and their attitudes toward family presence post-educational intervention in an emergency department setting. Compliance of family presence was observed for 2 months pre- and post-educational intervention. Results show that most physicians and nurses either were not sure or were not aware that there was an existing written policy. The study demonstrated that nurses agree more than physicians that the option of FPDR is a patient/family right. The results also showed that the educational intervention had no effect on the physicians and nurses attitudes for FPDR, but it did change behaviors. Of the events involving professionals who were exposed to the educational intervention, family members were present 87.5% of the time. In contrast, only 23% of the events involving professionals who did not receive the educational intervention had families present. Ongoing staff education will heighten awareness to FPDR, make the staff more comfortable with families being present, and will presumably continue to increase invitations for FPDR.

Factors Perceived to Influence the Decision for African Americans to Become Registered Organ Donors at the Department of Motorized Vehicles.

PubMed

DuBay, Derek A; Ivankova, Nataliya; Herby, Ivan; Schoenberger, Yu-Mei; Redden, David T; Holt, Cheryl; Siminoff, Laura; Fouad, Mona; Martin, Michelle Y

2017-01-01

African Americans (AA) are a third as likely as Caucasians to become registered organ donors at the Department of Motorized Vehicles (DMV). The Department of Health and Human Services has set the goal that at least 50% of adults in each state are registered donors. The purpose of this study was to explore the personal, behavioral and environmental factors associated with AA donor registration decision-making at the DMV. Guided by the Social Cognitive Theory, 13 focus groups (n = 100 participants) were conducted with AAs within 3 months of visiting a DMV and making a decision regarding whether to become or to not become a registered donor. The data were analyzed using inductive thematic and qualitative content analyses. Study participants expressed a desire to learn more information while waiting in line at the DMV. Knowing a family member or friend in need of an organ transplant, and the desire to make one's own decision were two salient factors associated with the decision to become a registered organ donor. Several aspects of the DMV environment (e.g., noisy, overcrowded, lacking privacy) were cited as deterrents to becoming a registered donor. This study highlights the personal, behavioral and environmental factors associated with AA organ donor registration decision-making at the DMV. The DMV is a setting where many adults make a decision about organ donation. Policies that create an environment in the DMV to support informed decision-making (e.g., privacy, informed clerks, available educational materials, etc.) are indicated. Copyright © 2017 National Medical Association. Published by Elsevier Inc. All rights reserved.

Technical Feasibility Study for Zero Energy K-12 Schools

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

Bonnema, Eric; Goldwasser, David; Torcellini, Paul

This technical feasibility study provides documentation and research results supporting a possible set of strategies to achieve source zero energy K-12 school buildings as defined by the U.S. Department of Energy (DOE) zero energy building (ZEB) definition (DOE 2015a). Under this definition, a ZEB is an energy-efficient building in which, on a source energy basis, the actual annual delivered energy is less than or equal to the on-site renewable exported energy.

Procurement, Cost Overruns and Severance. A Study in Commitment and Renegotiation

DTIC Science & Technology

1984-12-01

projects involve a decentralization of responsibility to a research or a production department. The purpose of this paper is to analyze deci- sion... rationality constraints, which affect the set of possible allocations. Section T uses a two-period version of the general model to study this issue...determines the q function, which in turn affects e.. -^/ This point is made in a somewhat different context hy Williamson who notices that "a king

Demographic and Treatment Patterns for Infections in Ambulatory Settings in the United States, 2006-2010

PubMed Central

May, Larissa; Mullins, Peter; Pines, Jesse

2013-01-01

Objectives Many factors may influence choice of care setting for treatment of acute infections. The authors evaluated a national sample of U.S. outpatient clinic and emergency department (ED) visits for three common infections (urinary tract infection [UTI], skin and soft tissue infection [SSTI], and upper respiratory infection [URI]), comparing setting, demographics, and care. Methods This was a retrospective analysis of 2006–2010 data from the National Hospital Ambulatory Care Survey (NHAMCS) and National Ambulatory Care Survey (NAMCS). Patients age ≥ 18 years with primary diagnoses of UTI, URI, and SSTI were the visits of interest. Demographics, tests, and prescriptions were compared, divided by ED versus outpatient setting using bivariate statistics. Results Between 2006 and 2010, there were an estimated 40.9 million ambulatory visits for UTI, 168.3 million visits for URI, and 34.8 million visits for SSTI; 24% of UTI, 11% of URI, and 33% of SSTI visits were seen in EDs. Across all groups, ED patients were more commonly younger and black and had Medicaid or no insurance. ED patients had more blood tests (54% vs. 22% for UTI, 21% vs. 14% for URI, and 25% vs. 20% for SSTI) and imaging studies (31% vs. 9% for UTI, 27% vs. 8% for URI, and 16% vs. 5% for SSTI). Pain medications were more frequently used in the ED; over one-fifth of UTI and SSTI visits included narcotics. In both settings, greater than 50% of URI visits received antibiotics; more than 40% of UTI ED visits included broad-spectrum fluoroquinolones. Conclusions Emergency departments treated a considerable proportion of U.S. ambulatory infections from 2006 to 2010. Patient factors, including the presence of acute pain and access to care, appear to influence choice of care setting. Observed antibiotic use in both settings suggests a need for optimizing antibiotic use. PMID:24552520

Model for predicting the injury severity score.

PubMed

Hagiwara, Shuichi; Oshima, Kiyohiro; Murata, Masato; Kaneko, Minoru; Aoki, Makoto; Kanbe, Masahiko; Nakamura, Takuro; Ohyama, Yoshio; Tamura, Jun'ichi

2015-07-01

To determine the formula that predicts the injury severity score from parameters that are obtained in the emergency department at arrival. We reviewed the medical records of trauma patients who were transferred to the emergency department of Gunma University Hospital between January 2010 and December 2010. The injury severity score, age, mean blood pressure, heart rate, Glasgow coma scale, hemoglobin, hematocrit, red blood cell count, platelet count, fibrinogen, international normalized ratio of prothrombin time, activated partial thromboplastin time, and fibrin degradation products, were examined in those patients on arrival. To determine the formula that predicts the injury severity score, multiple linear regression analysis was carried out. The injury severity score was set as the dependent variable, and the other parameters were set as candidate objective variables. IBM spss Statistics 20 was used for the statistical analysis. Statistical significance was set at P  < 0.05. To select objective variables, the stepwise method was used. A total of 122 patients were included in this study. The formula for predicting the injury severity score (ISS) was as follows: ISS = 13.252-0.078(mean blood pressure) + 0.12(fibrin degradation products). The P -value of this formula from analysis of variance was <0.001, and the multiple correlation coefficient (R) was 0.739 (R 2  = 0.546). The multiple correlation coefficient adjusted for the degrees of freedom was 0.538. The Durbin-Watson ratio was 2.200. A formula for predicting the injury severity score in trauma patients was developed with ordinary parameters such as fibrin degradation products and mean blood pressure. This formula is useful because we can predict the injury severity score easily in the emergency department.

A Study of the Impact Educational Setting Has on Academic Proficiency of American Indian Students as Measured by the Minnesota Comprehensive Assessment

ERIC Educational Resources Information Center

Hillstrom, Crowley

2013-01-01

The Minnesota Department of Education has collected Minnesota Comprehensive Assessments (MCA) results on every American Indian student who has taken the tests. This information has been made available so communities and parents can assess how their districts, schools, and students are performing based upon MCA proficiency criteria. Prior to this…

Outcome of a Food Observational Study among Low-Income Preschool Children Participating in a Family-Style Meal Setting

ERIC Educational Resources Information Center

Treviño, Roberto P.; Vasquez, Liset; Shaw-Ridley, Mary; Mosley, Desiree; Jechow, Katherine; Piña, Christina

2015-01-01

Introduction: In the United States, one out of every seven low-income children between the ages of 2 and 5 years is at risk for overweight and obesity. Formative research was conducted to determine if preschool children participating in family-style meals consumed the minimum food servings according to U.S. Department of Agriculture dietary…

A Solution to the Small Enrollment Problem in Aerospace Engineering--Self-Paced Materials Used in an Independent Studies Mode.

ERIC Educational Resources Information Center

Fowler, Wallace T.; Watkins, R. D.

With the decline in enrollment in the early 1970's, many aerospace engineering departments had too few students to offer some required courses. At the University of Texas at Austin, a set of personalized system of instruction (PSI) materials for the aircraft performance, stability, and control course was developed. The paper includes a description…

The Rise of Concussions in the Adolescent Population.

PubMed

Zhang, Alan L; Sing, David C; Rugg, Caitlin M; Feeley, Brian T; Senter, Carlin

2016-08-01

Concussion injuries have been highlighted to the American public through media and research. While recent studies have shown increased traumatic brain injuries (TBIs) diagnosed in emergency departments across the United States, no studies have evaluated trends in concussion diagnoses across the general US population in various age groups. To evaluate the current incidence and trends in concussions diagnosed across varying age groups and health care settings in a large cross-sectional population. Descriptive epidemiological study. Administrative health records of 8,828,248 members of a large private-payer insurance group in the United States were queried. Patients diagnosed with concussion from years 2007 through 2014 were stratified by year of diagnosis, age group, sex, classification of concussion, and health care setting of diagnosis (eg, emergency department vs physician's office). Chi-square testing was used for statistical analysis. From a cohort of 8,828,248 patients, 43,884 patients were diagnosed with a concussion. Of these patients, 55% were male and over 32% were in the adolescent age group (10-19 years old). The highest incidence of concussion was seen in patients aged 15 to 19 years (16.5/1000 patients), followed by those aged 10 to 14 years (10.5/1000 patients), 20 to 24 years (5.2/1000 patients), and 5 to 9 years (3.5/1000 patients). Overall, there was a 60% increase in concussion incidence from 2007 to 2014. The largest increases were in the 10- to 14-year (143%) and 15- to 19-year (87%) age groups. Based on International Classification of Disease-9th Revision classification, 29% of concussions were associated with some form of loss of consciousness. Finally, 56% of concussions were diagnosed in the emergency department and 29% in a physician's office, with the remainder in urgent care clinics or inpatient settings. The incidence of concussion diagnosed in the general US population is increasing, driven largely by a substantial rise in the adolescent age group. The youth population should be prioritized for ongoing work in concussion education, diagnosis, treatment, and prevention. The rise of concussions in the adolescent age group across the general population is concerning, and clinical efforts to prevent these injuries are needed.

Best strategies to implement clinical pathways in an emergency department setting: study protocol for a cluster randomized controlled trial

PubMed Central

2013-01-01

Background The clinical pathway is a tool that operationalizes best evidence recommendations and clinical practice guidelines in an accessible format for ‘point of care’ management by multidisciplinary health teams in hospital settings. While high-quality, expert-developed clinical pathways have many potential benefits, their impact has been limited by variable implementation strategies and suboptimal research designs. Best strategies for implementing pathways into hospital settings remain unknown. This study will seek to develop and comprehensively evaluate best strategies for effective local implementation of externally developed expert clinical pathways. Design/methods We will develop a theory-based and knowledge user-informed intervention strategy to implement two pediatric clinical pathways: asthma and gastroenteritis. Using a balanced incomplete block design, we will randomize 16 community emergency departments to receive the intervention for one clinical pathway and serve as control for the alternate clinical pathway, thus conducting two cluster randomized controlled trials to evaluate this implementation intervention. A minimization procedure will be used to randomize sites. Intervention sites will receive a tailored strategy to support full clinical pathway implementation. We will evaluate implementation strategy effectiveness through measurement of relevant process and clinical outcomes. The primary process outcome will be the presence of an appropriately completed clinical pathway on the chart for relevant patients. Primary clinical outcomes for each clinical pathway include the following: Asthma—the proportion of asthmatic patients treated appropriately with corticosteroids in the emergency department and at discharge; and Gastroenteritis—the proportion of relevant patients appropriately treated with oral rehydration therapy. Data sources include chart audits, administrative databases, environmental scans, and qualitative interviews. We will also conduct an overall process evaluation to assess the implementation strategy and an economic analysis to evaluate implementation costs and benefits. Discussion This study will contribute to the body of evidence supporting effective strategies for clinical pathway implementation, and ultimately reducing the research to practice gaps by operationalizing best evidence care recommendations through effective use of clinical pathways. Trial registration ClinicalTrials.gov: NCT01815710 PMID:23692634

Patient safety climate in general public hospitals in China: differences associated with department and job type based on a cross-sectional survey

PubMed Central

Zhou, Ping; Bai, Fei; Tang, Hui-qin; Bai, Jie; Li, Min-qi; Xue, Di

2018-01-01

Objective This study analysed differences in the perceived patient safety climate among different working departments and job types in public general hospitals in China. Design Cross-sectional survey. Setting Eighteen tertiary hospitals and 36 secondary hospitals from 10 areas in Shanghai, Hubei Province and Gansu Province, China. Participants Overall, 4753 staff, including physicians, nurses, medical technicians and managers, were recruited from March to June 2015. Main outcome measure The Patient Safety Climate in Healthcare Organisations (PSCHO) tool and the percentages of ‘problematic responses’ (PPRs) were used as outcome measures. Multivariable two-level random intercept models were applied in the analysis. Results A total of 4121 valid questionnaires were collected. Perceptions regarding the patient safety climate varied among departments and job types. Physicians responded with relatively more negative evaluations of ‘organisational resources for safety’, ‘unit recognition and support for safety efforts’, ‘psychological safety’, ‘problem responsiveness’ and overall safety climate. Paediatrics departments, intensive care units, emergency departments and clinical auxiliary departments require more attention. The PPRs for ‘fear of blame and punishment’ were universally significantly high, and the PPRs for ‘fear of shame’ and ‘provision of safe care’ were remarkably high, especially in some departments. Departmental differences across all dimensions and the overall safety climate primarily depended on job type. Conclusions The differences suggest that strategies and measures for improving the patient safety climate should be tailored by working department and job type. PMID:29666125

A prospective observational study to assess the diagnostic accuracy of clinical decision rules for children presenting to emergency departments after head injuries (protocol): the Australasian Paediatric Head Injury Rules Study (APHIRST).

PubMed

Babl, Franz E; Lyttle, Mark D; Bressan, Silvia; Borland, Meredith; Phillips, Natalie; Kochar, Amit; Dalziel, Stuart R; Dalton, Sarah; Cheek, John A; Furyk, Jeremy; Gilhotra, Yuri; Neutze, Jocelyn; Ward, Brenton; Donath, Susan; Jachno, Kim; Crowe, Louise; Williams, Amanda; Oakley, Ed

2014-06-13

Head injuries in children are responsible for a large number of emergency department visits. Failure to identify a clinically significant intracranial injury in a timely fashion may result in long term neurodisability and death. Whilst cranial computed tomography (CT) provides rapid and definitive identification of intracranial injuries, it is resource intensive and associated with radiation induced cancer. Evidence based head injury clinical decision rules have been derived to aid physicians in identifying patients at risk of having a clinically significant intracranial injury. Three rules have been identified as being of high quality and accuracy: the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) from Canada, the Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE) from the UK, and the prediction rule for the identification of children at very low risk of clinically important traumatic brain injury developed by the Pediatric Emergency Care Applied Research Network (PECARN) from the USA. This study aims to prospectively validate and compare the performance accuracy of these three clinical decision rules when applied outside the derivation setting. This study is a prospective observational study of children aged 0 to less than 18 years presenting to 10 emergency departments within the Paediatric Research in Emergency Departments International Collaborative (PREDICT) research network in Australia and New Zealand after head injuries of any severity. Predictor variables identified in CATCH, CHALICE and PECARN clinical decision rules will be collected. Patients will be managed as per the treating clinicians at the participating hospitals. All patients not undergoing cranial CT will receive a follow up call 14 to 90 days after the injury. Outcome data collected will include results of cranial CTs (if performed) and details of admission, intubation, neurosurgery and death. The performance accuracy of each of the rules will be assessed using rule specific outcomes and inclusion and exclusion criteria. This study will allow the simultaneous comparative application and validation of three major paediatric head injury clinical decision rules outside their derivation setting. The study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR)- ACTRN12614000463673 (registered 2 May 2014).

Repeat film analysis and its implications for quality assurance in dental radiology: An institutional case study

PubMed Central

Acharya, Shruthi; Pai, Keerthilatha M.; Acharya, Shashidhar

2015-01-01

Context: The goal of any radiologist is to produce the highest quality diagnostic radiographs, while keeping patient exposure as low as reasonably achievable (ALARA). Aims: The aim of this study was to describe the reasons for radiograph rejections through a repeat film analysis in an Indian dental school. Settings and Design: An observational study conducted in the Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal. Materials and Methods: During a 6-month study period, a total of 9,495 intra-oral radiographs and 2339 extraoral radiographs taken in the Radiology Department were subjected to repeat film analysis. Statistical Analysis Used: SPSS Version 16. Descriptive analysis used. Results: The results showed that the repeat rates were 7.1% and 5.86% for intraoral and extraoral radiographs, respectively. Among the causes for errors reported, positioning error (38.7%) was the most common, followed by improper angulations (26.1%), and improper film placement (11.2%) for intra-oral radiographs. The study found that the maximum frequency of repeats among extraoral radiographs was for panoramic radiographs (49%) followed by lateral cephalogram (33%), and paranasal sinus view (14%). It was also observed that repeat rate of intraoral radiographs was highest for internees (44.7%), and undergraduate students (28.2%). Conclusions: The study pointed to a need for more targeted interventions to achieve the goal of keeping patient exposure ALARA in a dental school setting. PMID:26321841

Number of organ dysfunctions predicts mortality in emergency department patients with suspected infection: a multicenter validation study.

PubMed

Jessen, Marie K; Skibsted, Simon; Shapiro, Nathan I

2017-06-01

The aim of this study was to validate the association between number of organ dysfunctions and mortality in emergency department (ED) patients with suspected infection. This study was conducted at two medical care center EDs. The internal validation set was a prospective cohort study conducted in Boston, USA. The external validation set was a retrospective case-control study conducted in Aarhus, Denmark. The study included adult patients (>18 years) with clinically suspected infection. Laboratory results and clinical data were used to assess organ dysfunctions. Inhospital mortality was the outcome measure. Multivariate logistic regression was used to determine the independent mortality odds for number and types of organ dysfunctions. We enrolled 4952 (internal) and 483 (external) patients. The mortality rate significantly increased with increasing number of organ dysfunctions: internal validation: 0 organ dysfunctions: 0.5% mortality, 1: 3.6%, 2: 9.5%, 3: 17%, and 4 or more: 37%; external validation: 2.2, 6.7, 17, 41, and 57% mortality (both P<0.001 for trend). Age-adjusted and comorbidity-adjusted number of organ dysfunctions remained an independent predictor. The effect of specific types of organ dysfunction on mortality was most pronounced for hematologic [odds ratio (OR) 3.3 (95% confidence interval (CI) 2.0-5.4)], metabolic [OR 3.3 (95% CI 2.4-4.6); internal validation], and cardiovascular dysfunctions [OR 14 (95% CI 3.7-50); external validation]. The number of organ dysfunctions predicts sepsis mortality.

Predicting suicide with the SAD PERSONS scale.

PubMed

Katz, Cara; Randall, Jason R; Sareen, Jitender; Chateau, Dan; Walld, Randy; Leslie, William D; Wang, JianLi; Bolton, James M

2017-09-01

Suicide is a major public health issue, and a priority requirement is accurately identifying high-risk individuals. The SAD PERSONS suicide risk assessment scale is widely implemented in clinical settings despite limited supporting evidence. This article aims to determine the ability of the SAD PERSONS scale (SPS) to predict future suicide in the emergency department. Five thousand four hundred sixty-two consecutive adults were seen by psychiatry consultation teams in two tertiary emergency departments with linkage to population-based administrative data to determine suicide deaths within 6 months, 1, and 5 years. Seventy-seven (1.4%) individuals died by suicide during the study period. When predicting suicide at 12 months, medium- and high-risk scores on SPS had a sensitivity of 49% and a specificity of 60%; the positive and negative predictive values were 0.9 and 99%, respectively. Half of the suicides at both 6- and 12-month intervals were classified as low risk by SPS at index visit. The area under the curve at 12 months for the Modified SPS was 0.59 (95% confidence interval [CI] range 0.51-0.67). High-risk scores (compared to low risk) were significantly associated with death by suicide over the 5-year study period using the SPS (hazard ratio 2.49; 95% CI 1.34-4.61) and modified version (hazard ratio 2.29; 95% CI 1.24-2.29). Although widely used in educational and clinical settings, these findings do not support the use of the SPS and Modified SPS to predict suicide in adults seen by psychiatric services in the emergency department. © 2017 Wiley Periodicals, Inc.

[Peripheral venous catheter use in the emergency department: reducing adverse events in patients and biosafety problems for staff].

PubMed

Tomás Vecina, Santiago; Mozota Duarte, Julián; Ortega Marcos, Miguel; Gracia Ruiz Navarro, María; Borillo, Vicente; San Juan Gago, Leticia; Roqueta Egea, Fermin; Chanovas Borrás, Manuel

2016-01-01

To test a strategy to reduce the rate of adverse events in patients and safety problems for emergency department staff who insert peripheral venous catheters (PVCs). The strategy consisted of training, implementing a protocol, and introducing safety-engineered PVCs. Prospective, multicenter, observational, preauthorization study in patients requiring PVC placement in an emergency department. The study had 2 phases. The first consisted of training, implementing a protocol for using conventional PVCs, and monitoring practice. The second phase introduced safety-engineered PVC sets. The number of adverse events in patients and threats to safety for staff were compared between the 2 phases. A total of 520 patients were included, 180 in the first phase and 340 in the second. We detected breaches in aseptic technique, failure to maintain a sterile field, and improper management of safety equipment and devices. Some practices improved significantly during the second phase. Eighty-six adverse events occurred in the first phase and 52 (15.4%) in the second; the between-phase difference was not statistically significant. The incidence of postinfusion phlebitis was 50% lower in the second phase. Seven splash injuries and 1 accidental puncture occurred with conventional PVCs in the first phase; 2 splash injuries occurred with the safety-engineered PVCs in the second phase (36% decrease, P = .04). Differences were particularly noticeable for short-term PVC placements (P = .02). Combining training, a protocol, and the use of safety-engineered PVC sets offers an effective strategy for improving patient and staff safety.

An analysis of casualties presenting to military emergency departments in Iraq and Afghanistan.

PubMed

Schauer, Steven G; Naylor, Jason F; Oliver, Joshua J; Maddry, Joseph K; April, Michael D

2018-05-02

During the past 17 years of conflict the deployed US military health care system has found new and innovative ways to reduce combat mortality down to the lowest case fatality rate in US history. There is currently a data dearth of emergency department (ED) care delivered in this setting. We seek to describe ED interventions in this setting. We used a series of ED procedure codes to identify subjects within the Department of Defense Trauma Registry from January 2007 to August 2016. During this time, 28,222 met inclusion criteria. The median age of causalities in this dataset was 25 years and most (96.9%) were male, US military (41.3%), and part of Operation Enduring Freedom (66.9%). The majority survived to hospital discharge (95.5%). Most subjects sustained injuries by explosives (55.3%) and gunshot wound (GSW). The majority of subjects had an injury severity score that was considered minor (74.1%), while the preponderance of critically injured casualties sustained injuries by explosive (0.7%). Based on AIS, the most frequently seriously injured body region was the extremities (23.9%). The bulk of administered blood products were packed red blood cells (PRBC, 26.4%). Endotracheal intubation was the most commonly performed critical procedure (11.9%). X-ray (79.9%) was the most frequently performed imaging study. US military personnel comprised the largest proportion of combat casualties and most were injured by explosive. Within this dataset, ED providers most frequently performed endotracheal intubation, administered blood products, and obtained diagnostic imaging studies. Published by Elsevier Inc.

Hospital treatment for fluid overload in the Medicare hemodialysis population.

PubMed

Arneson, Thomas J; Liu, Jiannong; Qiu, Yang; Gilbertson, David T; Foley, Robert N; Collins, Allan J

2010-06-01

Fluid overload in hemodialysis patients sometimes requires emergent dialysis, but the magnitude of this care has not been characterized. This study aimed to estimate the magnitude of fluid overload treatment episodes for the Medicare hemodialysis population in hospital settings, including emergency departments. Point-prevalent hemodialysis patients were identified from the Centers for Medicare and Medicaid Renal Management Information System and Standard Analytical Files. Fluid overload treatment episodes were defined by claims for care in inpatient, hospital observation, or emergency department settings with primary discharge diagnoses of fluid overload, heart failure, or pulmonary edema, and dialysis performed on the day of or after admission. Exclusion criteria included stays >5 days. Cost was defined as total Medicare allowable costs for identified episodes. Associations between patient characteristics and episode occurrence and cost were analyzed. For 25,291 patients (14.3%), 41,699 care episodes occurred over a mean follow-up time of 2 years: 86% inpatient, 9% emergency department, and 5% hospital observation. Heart failure was the primary diagnosis in 83% of episodes, fluid overload in 11%, and pulmonary edema in 6%. Characteristics associated with more frequent events included age <45 years, female sex, African-American race, causes of ESRD other than diabetes, dialysis duration of 1 to 3 years, fewer dialysis sessions per week at baseline, hospitalizations during baseline, and most comorbid conditions. Average cost was $6,372 per episode; total costs were approximately $266 million. Among U.S. hemodialysis patients, fluid overload treatment is common and expensive. Further study is necessary to identify prevention opportunities.

75 FR 5373 - United States Mint

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-02

... DEPARTMENT OF THE TREASURY United States Mint ACTION: Notification of Pricing for 2010 United States Mint Presidential $1 Coin Proof Set. \\TM\\ SUMMARY: The United States Mint is announcing the price of the 2010 United States Mint Presidential $1 Coin Proof Set. The 2010 United States Mint...

28 CFR 2.12 - Initial hearings: Setting presumptive release dates.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Initial hearings: Setting presumptive release dates. 2.12 Section 2.12 Judicial Administration DEPARTMENT OF JUSTICE PAROLE, RELEASE, SUPERVISION AND RECOMMITMENT OF PRISONERS, YOUTH OFFENDERS, AND JUVENILE DELINQUENTS United States Code...

Medicaid: Methods for Setting Nursing Home Rates Should be Improved.

DTIC Science & Technology

1986-05-01

care facility SNF skilled nursing facility Page 7 GAO/HRJD.W626 Medicaid Nursing Home Rate Setting A,, I-?A -WI...consumer price index GNP Gross National Product HCFA Health Care Financing Administration HHS Department of Health and Human Services ICF intermediate

21 CFR 884.5100 - Obstetric anesthesia set.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Obstetric anesthesia set. 884.5100 Section 884.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Therapeutic Devices...

21 CFR 884.5100 - Obstetric anesthesia set.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Obstetric anesthesia set. 884.5100 Section 884.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Therapeutic Devices...

21 CFR 884.5100 - Obstetric anesthesia set.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Obstetric anesthesia set. 884.5100 Section 884.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Therapeutic Devices...

15 CFR 719.1 - Scope and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ENFORCEMENT... proceedings. Section 719.3 of the CWCR sets forth violations of the Chemical Weapons Convention for which the... of the export requirements imposed pursuant to the Chemical Weapons Convention and set forth in the...

15 CFR 719.1 - Scope and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ENFORCEMENT... proceedings. Section 719.3 of the CWCR sets forth violations of the Chemical Weapons Convention for which the... of the export requirements imposed pursuant to the Chemical Weapons Convention and set forth in the...

15 CFR 719.1 - Scope and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ENFORCEMENT... proceedings. Section 719.3 of the CWCR sets forth violations of the Chemical Weapons Convention for which the... of the export requirements imposed pursuant to the Chemical Weapons Convention and set forth in the...

15 CFR 719.1 - Scope and definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ENFORCEMENT... proceedings. Section 719.3 of the CWCR sets forth violations of the Chemical Weapons Convention for which the... of the export requirements imposed pursuant to the Chemical Weapons Convention and set forth in the...

15 CFR 719.1 - Scope and definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE CHEMICAL WEAPONS CONVENTION REGULATIONS ENFORCEMENT... proceedings. Section 719.3 of the CWCR sets forth violations of the Chemical Weapons Convention for which the... of the export requirements imposed pursuant to the Chemical Weapons Convention and set forth in the...

Where Is Obesity Prevention on the Map? Distribution and Predictors of Local Health Department Prevention Activities in Relation to County-Level Obesity Prevalence in the US

PubMed Central

Stamatakis, Katherine A.; Leatherdale, Scott T.; Marx, Christine; Yan, Yan; Colditz, Graham A.; Brownson, Ross C.

2013-01-01

Context The system of local health departments (LHD) in the US has potential to advance a locally-oriented public health response in obesity control and reduce geographic disparities. However, the extent to which obesity prevention programs correspond to local obesity levels is unknown. Objective This study examines the extent to which LHDs across the US have responded to local levels of obesity by examining the association between jurisdiction level obesity prevalence and the existence of obesity prevention programs. Design Data on LHD organizational characteristics from the Profile Study of Local Health Departments and county-level estimates of obesity from the Behavioral Risk Factor Surveillance System were analyzed (n=2,300). Since local public health systems are nested within state infrastructure, multilevel models were used to examine the relationship between county-level obesity prevalence and LHD obesity prevention programming and to assess the impact of state-level clustering. Setting 2,300 local health department jurisdictions defined with respect to county boundaries Participants Practitioners in local health departments who responded to the 2005 Profile Study of Local Health Departments. Main Outcome Measures Likelihood of having obesity prevention activities and association with area-level obesity prevalence Results The existence of obesity prevention activities was not associated with prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering. Conclusions This paper identified a gap in the local public health response to the obesity epidemic and underscores the importance of multilevel modeling in examining predictors of LHD performance. PMID:22836530

Assailant Identity and Self-Reported Nondisclosure of Military Sexual Trauma in Partnered Women Veterans.

PubMed

Blais, Rebecca K; Brignone, Emily; Fargo, Jamison D; Galbreath, Nathan W; Gundlapalli, Adi V

2017-10-09

Department of Veterans Affairs estimates of military sexual trauma (MST) suggest 27% of female veterans have experienced MST. However, Department of Defense data (Department of Defense, 2014) show that a subgroup of active-duty women do not report sexual assaults to a military authority, suggesting barriers to disclosure exist among military samples. No study of female veterans has examined rates of nondisclosure among those with previous screens for MST; these data could inform screening efforts and establishment of safe havens for candid disclosures. Using an explanatory sequential mixed-methods survey, a history of MST, and postservice MST disclosures during screening and their associations with demographic, assault, and screening-setting characteristics were evaluated in 359 female veterans. Open-ended responses regarding barriers to disclosure were analyzed using editing analysis style. Eighty-one percent (n = 289) reported MST. Of these, 50% (n = 143) reported a prior screening and 25% (n = 35) reported they did not disclose their true MST status. Veterans who experienced MST by a unit-member assailant were significantly less likely to disclose (adjusted odds ratio = 4.75, 95% confidence interval = 1.20-18.30). Disclosure barriers included stigma, experiential avoidance, and discomfort with the screening setting. Creative interventions to reduce nondisclosure among female veterans, with specific attention to those assaulted by a unit member, are urgently needed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

[Detection and classification of medication errors at Joan XXIII University Hospital].

PubMed

Jornet Montaña, S; Canadell Vilarrasa, L; Calabuig Mũoz, M; Riera Sendra, G; Vuelta Arce, M; Bardají Ruiz, A; Gallart Mora, M J

2004-01-01

Medication errors are multifactorial and multidisciplinary, and may originate in processes such as drug prescription, transcription, dispensation, preparation and administration. The goal of this work was to measure the incidence of detectable medication errors that arise within a unit dose drug distribution and control system, from drug prescription to drug administration, by means of an observational method confined to the Pharmacy Department, as well as a voluntary, anonymous report system. The acceptance of this voluntary report system's implementation was also assessed. A prospective descriptive study was conducted. Data collection was performed at the Pharmacy Department from a review of prescribed medical orders, a review of pharmaceutical transcriptions, a review of dispensed medication and a review of medication returned in unit dose medication carts. A voluntary, anonymous report system centralized in the Pharmacy Department was also set up to detect medication errors. Prescription errors were the most frequent (1.12%), closely followed by dispensation errors (1.04%). Transcription errors (0.42%) and administration errors (0.69%) had the lowest overall incidence. Voluntary report involved only 4.25% of all detected errors, whereas unit dose medication cart review contributed the most to error detection. Recognizing the incidence and types of medication errors that occur in a health-care setting allows us to analyze their causes and effect changes in different stages of the process in order to ensure maximal patient safety.

Overcoming Barriers to the Use of Osteopathic Manipulation Techniques in the Emergency Department

PubMed Central

Roberge, Raymond J.; Roberge, Marc R.

2009-01-01

Background: Osteopathic Manipulation Techniques (OMT) have been shown to be effective therapeutic modalities in various clinical settings, but appear to be underutilized in the emergency department (ED) setting. Objective: To examine barriers to the use of OMT in the ED and provide suggestions to ameliorate these barriers. Methods: Literature review Results: While the medical literature cites numerous obstacles to the use of OMT in the ED setting, most can be positively addressed through education, careful planning, and ongoing research into use of these techniques. Recent prospective clinical trials of OMT have demonstrated the utility of these modalities. Conclusion: Osteopathic Manipulation Techniques are useful therapeutic modalities that could be utilized to a greater degree in the ED. As the number of osteopathic emergency physicians increases, the opportunity to employ these techniques should increase. PMID:19718381

19 CFR 181.95 - Oral discussion of issues.

Code of Federal Regulations, 2013 CFR

2013-04-01

... in the Customs file in the matter a written record setting forth any and all additional information... 19 Customs Duties 2 2013-04-01 2013-04-01 false Oral discussion of issues. 181.95 Section 181.95 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

19 CFR 177.4 - Oral discussion of issues.

Code of Federal Regulations, 2012 CFR

2012-04-01

... in the Customs Service file in the matter a written record setting forth any and all additional... 19 Customs Duties 2 2012-04-01 2012-04-01 false Oral discussion of issues. 177.4 Section 177.4 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

19 CFR 181.95 - Oral discussion of issues.

Code of Federal Regulations, 2014 CFR

2014-04-01

... in the Customs file in the matter a written record setting forth any and all additional information... 19 Customs Duties 2 2014-04-01 2014-04-01 false Oral discussion of issues. 181.95 Section 181.95 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

19 CFR 177.4 - Oral discussion of issues.

Code of Federal Regulations, 2011 CFR

2011-04-01

... in the Customs Service file in the matter a written record setting forth any and all additional... 19 Customs Duties 2 2011-04-01 2011-04-01 false Oral discussion of issues. 177.4 Section 177.4 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

19 CFR 177.4 - Oral discussion of issues.

Code of Federal Regulations, 2014 CFR

2014-04-01

... in the Customs Service file in the matter a written record setting forth any and all additional... 19 Customs Duties 2 2014-04-01 2014-04-01 false Oral discussion of issues. 177.4 Section 177.4 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

19 CFR 181.95 - Oral discussion of issues.

Code of Federal Regulations, 2012 CFR

2012-04-01

... in the Customs file in the matter a written record setting forth any and all additional information... 19 Customs Duties 2 2012-04-01 2012-04-01 false Oral discussion of issues. 181.95 Section 181.95 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

19 CFR 181.95 - Oral discussion of issues.

Code of Federal Regulations, 2011 CFR

2011-04-01

... in the Customs file in the matter a written record setting forth any and all additional information... 19 Customs Duties 2 2011-04-01 2011-04-01 false Oral discussion of issues. 181.95 Section 181.95 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

19 CFR 177.4 - Oral discussion of issues.

Code of Federal Regulations, 2010 CFR

2010-04-01

... in the Customs Service file in the matter a written record setting forth any and all additional... 19 Customs Duties 2 2010-04-01 2010-04-01 false Oral discussion of issues. 177.4 Section 177.4 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

19 CFR 177.4 - Oral discussion of issues.

Code of Federal Regulations, 2013 CFR

2013-04-01

... in the Customs Service file in the matter a written record setting forth any and all additional... 19 Customs Duties 2 2013-04-01 2013-04-01 false Oral discussion of issues. 177.4 Section 177.4 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE...

41 CFR 109-1.100-50 - Scope of subpart.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false Scope of subpart. 109-1... Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS GENERAL 1-INTRODUCTION 1.1-Regulation System § 109-1.100-50 Scope of subpart. This subpart sets forth the Department of Energy (DOE...

41 CFR 109-1.100-50 - Scope of subpart.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false Scope of subpart. 109-1... Regulations System (Continued) DEPARTMENT OF ENERGY PROPERTY MANAGEMENT REGULATIONS GENERAL 1-INTRODUCTION 1.1-Regulation System § 109-1.100-50 Scope of subpart. This subpart sets forth the Department of Energy (DOE...

Alternative Fuels Data Center: Utah's Clean Fuels and Vehicle Technology

Science.gov Websites

vehicles, infrastructure, and equipment. As an agency of Utah's Department of Environmental Quality, DAQ legislation that created the fund typically sets forth other important provisions related to funding and , or a combination of the two. Enabling legislation also gives a state agency or department the

Child Maltreatment and Onset of Emergency Department Presentations for Suicide-Related Behaviors

ERIC Educational Resources Information Center

Rhodes, Anne E.; Boyle, Michael H.; Bethell, Jennifer; Wekerle, Christine; Goodman, Deborah; Tonmyr, Lil; Leslie, Bruce; Lam, Kelvin; Manion, Ian

2012-01-01

Objectives: To determine whether the rates of a first presentation to the emergency department (ED) for suicide-related behavior (SRB) are higher among children/youth permanently removed from their parental home because of substantiated maltreatment than their peers. To describe the health care settings accessed by these children/youth before a…

U.G. Government Technology Information Locator

DTIC Science & Technology

1998-04-01

National Science Foundation (NSF); the United States Department of Agriculture (USDA); and the Department of Commerce (DOC)-plus eight other government S&T resources. It is intended as a starter set to help users locate U.S. government technology information. For convenience, it uses Internet addresses, e-mail addresses, and telephone numbers. The Appendix contains a

The President's Report on Occupational Safety and Health.

ERIC Educational Resources Information Center

Department of Health, Education, and Welfare, Washington, DC.

This report describes what has been done to implement the Occupational Safety and Health Act of 1970 during its first year of operation. The report examines the responsibilities of the Department of Labor for setting safety and health standards and also explores the activities of the Department of Health, Education, and Welfare in research and…

32 CFR 701.5 - Policy.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Policy. 701.5 Section 701.5 National Defense... THE PUBLIC Department of the Navy Freedom of Information Act (FOIA) Program § 701.5 Policy. (a) Compliance with the FOIA. DON policy is to comply with the FOIA as set forth in the Department of Defense's...

7 CFR 505.3 - Fees for paper copying, duplicating, and reproduction of materials in library collections.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of materials in library collections. 505.3 Section 505.3 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL AGRICULTURAL LIBRARY... in library collections. (a) Photocopy reproduction of paper copy will be set as a flat fee of $13.00...

7 CFR 505.3 - Fees for paper copying, duplicating, and reproduction of materials in library collections.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of materials in library collections. 505.3 Section 505.3 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL AGRICULTURAL LIBRARY... in library collections. (a) Photocopy reproduction of paper copy will be set as a flat fee of $13.00...

7 CFR 505.3 - Fees for paper copying, duplicating, and reproduction of materials in library collections.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of materials in library collections. 505.3 Section 505.3 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE NATIONAL AGRICULTURAL LIBRARY... in library collections. (a) Photocopy reproduction of paper copy will be set as a flat fee of $13.00...

Winning performance improvement strategies--linking documentation and accounts receivable.

PubMed

Braden, J H; Swadley, D

1996-01-01

When the HIM department at The University of Texas Medical Branch set out to improve documentation and accounts receivable management, it established a plan that encompassed a broad spectrum of data management process changes. The department examined and acknowledged the deficiencies in data management processes and used performance improvement tools to achieve successful results.

10 CFR 862.4 - Prohibitions and penalties.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Prohibitions and penalties. 862.4 Section 862.4 Energy DEPARTMENT OF ENERGY RESTRICTIONS ON AIRCRAFT LANDING AND AIR DELIVERY AT DEPARTMENT OF ENERGY NUCLEAR SITES... imposition of criminal penalties set forth in sections 223 and 229 of the Atomic Energy Act, as amended (42 U...

Making Departments Distinctive: The Continuous Quality Improvement (CQI) Mindset.

ERIC Educational Resources Information Center

Chambliss, Catherine

The Continuous Quality Improvement (CQI) approach has provided many corporations with a tool for adapting to ongoing shifts in demands and resources, and it can offer academic settings similar assistance. CQI offers a mechanism for building a collaborative process that can help departments define their unique strengths and cultivate a distinctive…

The relationship between the forensic nurse in the emergency department and law enforcement officials.

PubMed

Pasqualone, Georgia A

2015-01-01

This article describes the need for a collaborative relationship between the advanced practice forensic nurse in the emergency department and critical care settings with law enforcement officials. The relationship is necessary when working with victims and/or perpetrators in the context of the 27 categories of forensic patients.

77 FR 54572 - President's Advisory Commission on Asian Americans and Pacific Islanders

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... DEPARTMENT OF EDUCATION President's Advisory Commission on Asian Americans and Pacific Islanders... Education. ACTION: Notice of an open meeting. SUMMARY: This notice sets forth the schedule and agenda of the... attend. DATES: September 28, 2012. Time: 8:30 a.m.-5:00 p.m. EDT. ADDRESSES: U.S. Department of Education...

Health Education in the Department of Defense Dependents Schools: An Internationalizing Experience.

ERIC Educational Resources Information Center

Sponberg, Janalee L.; And Others

1983-01-01

The Department of Defense Dependents Schools system provides a unique educational experience for thousands of military and civilian independents living in foreign countries. Health education in this international setting provides a social and cultural experience which is not readily found at home in the United States. (Authors/CJ)

42 CFR 137.205 - Will this voluntary uniform data set reporting activity be required of all Self-Governance Tribes...

Code of Federal Regulations, 2010 CFR

2010-10-01

....205 Section 137.205 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational... resources, hardware, software, and technical assistance to the Self-Governance Tribes to facilitate data...