21 CFR 207.30 - Updating drug listing information.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Updating drug listing information. 207.30 Section 207.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL REGISTRATION OF PRODUCERS OF DRUGS AND LISTING OF DRUGS IN COMMERCIAL DISTRIBUTION...

21 CFR 207.30 - Updating drug listing information.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Updating drug listing information. 207.30 Section 207.30 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL REGISTRATION OF PRODUCERS OF DRUGS AND LISTING OF DRUGS IN COMMERCIAL DISTRIBUTION...

29 CFR 1904.44 - Retention and updating of old forms.

Code of Federal Regulations, 2010 CFR

2010-07-01

....44 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Transition From the Former Rule § 1904.44 Retention and updating of old forms. You must save your copies of the OSHA 200 and 101...

29 CFR 1904.44 - Retention and updating of old forms.

Code of Federal Regulations, 2011 CFR

2011-07-01

....44 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Transition From the Former Rule § 1904.44 Retention and updating of old forms. You must save your copies of the OSHA 200 and 101...

29 CFR 1904.44 - Retention and updating of old forms.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 5 2012-07-01 2012-07-01 false Retention and updating of old forms. 1904.44 Section 1904.44 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Transition From the Former...

29 CFR 1904.44 - Retention and updating of old forms.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 5 2014-07-01 2014-07-01 false Retention and updating of old forms. 1904.44 Section 1904.44 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Transition From the Former...

An exploratory study of factors influencing resuscitation skills retention and performance among health providers.

PubMed

Curran, Vernon; Fleet, Lisa; Greene, Melanie

2012-01-01

Resuscitation and life support skills training comprises a significant proportion of continuing education programming for health professionals. The purpose of this study was to explore the perceptions and attitudes of certified resuscitation providers toward the retention of resuscitation skills, regular skills updating, and methods for enhancing retention. A mixed-methods, explanatory study design was undertaken utilizing focus groups and an online survey-questionnaire of rural and urban health care providers. Rural providers reported less experience with real codes and lower abilities across a variety of resuscitation areas. Mock codes, practice with an instructor and a team, self-practice with a mannequin, and e-learning were popular methods for skills updating. Aspects of team performance that were felt to influence resuscitation performance included: discrepancies in skill levels, lack of communication, and team leaders not up to date on their skills. Confidence in resuscitation abilities was greatest after one had recently practiced or participated in an update or an effective debriefing session. Lowest confidence was reported when team members did not work well together, there was no clear leader of the resuscitation code, or if team members did not communicate. The study findings highlight the importance of access to update methods for improving providers' confidence and abilities, and the need for emphasis on teamwork training in resuscitation. An eclectic approach combining methods may be the best strategy for addressing the needs of health professionals across various clinical departments and geographic locales. Copyright © 2012 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

National Medical Association

MedlinePlus

... Updates Health Care Reform Policy Letters & Statements Health Information Technology Mazique Symposium Resources Policy Beat Links Contact Us Education About NMA CME Continuing Medical Education CME Mission Statement About William ... Information Appointments Meeting and Delegate Criteria HOD Private Page ...

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

Not Available

Reflecting Secretary O`Leary`s focus on occupational safety and health, the Office of Occupational Safety is pleased to provide you with the latest update to the DOE Interpretations Guide to OSH Standards. This Guide was developed in cooperation with the Occupational Safety and Health Administration, which continued its support during this last revision by facilitating access to the interpretations found on the OSHA Computerized Information System (OCIS). This March 31, 1994 update contains 123 formal interpretation letters written by OSHA. As a result of the unique requests received by the 1-800 Response Line, this update also contains 38 interpretations developed bymore » DOE. This new occupational safety and health information adds still more important guidance to the four volume reference set that you presently have in your possession.« less

Update on Emergency Department Visits Involving Energy Drinks: A Continuing Public Health Concern

MedlinePlus

... concentrated forms of energy drinks, known as energy shots, have become increasingly popular among a wider range ... 3 Marketing analysts reported increasing sales of energy shots in 2011 that were expected to continue through ...

Reexamining organizational configurations: an update, validation, and expansion of the taxonomy of health networks and systems.

PubMed

Dubbs, Nicole L; Bazzoli, Gloria J; Shortell, Stephen M; Kralovec, Peter D

2004-02-01

To (a) assess how the original cluster categories of hospital-led health networks and systems have changed over time; (b) identify any new patterns of cluster configurations; and (c) demonstrate how additional data can be used to refine and enhance the taxonomy measures. DATA SOURCES; 1994 and 1998 American Hospital Association (AHA) Annual Survey of Hospitals. As in the original taxonomy, separate cluster solutions are identified for health networks and health systems by applying three strategic/structural dimensions (differentiation, integration, and centralization) to three components of the health service/product continuum (hospital services, physician arrangements, and provider-based insurance activities). Factor, cluster, and discriminant analyses are used to analyze the 1998 data. Descriptive and comparative methods are used to analyze the updated 1998 taxonomy relative to the original 1994 version. The 1998 cluster categories are similar to the original taxonomy, however, they reveal some new organizational configurations. For the health networks, centralization of product/service lines is occurring more selectively than in the past. For the health systems, participation has grown in and dispersed across a more diverse set of decentralized organizational forms. For both networks and systems, the definition of centralization has changed over time. In its updated form, the taxonomy continues to provide policymakers and practitioners with a descriptive and contextual framework against which to assess organizational programs and policies. There is a need to continue to revisit the taxonomy from time to time because of the persistent evolution of the U.S. health care industry and the consequent shifting of organizational configurations in this arena. There is also value in continuing to move the taxonomy in the direction of refinement/expansion as new opportunities become available.

FOCUSING ON CHILDREN’S INHALATION DOSIMETRY AND HEALTH EFFECTS FOR RISK ASSESSMENT: AN INTRODUCTION

EPA Science Inventory

Substantial effort has been invested in improving children’s health risk assessment in recent years. However, the body of scientific evidence in support of children’s health assessment is constantly advancing requiring continual updating of risk assessment methods. Children’s i...

FOCUSING ON CHILDREN'S INHALATION DOSIMETRY AND HEALTH EFFECTS FOR RISK ASSESSMENT: AN INTRODUCTION (Journal Article)

EPA Science Inventory

Substantial effort has been invested in improving children’s health risk assessment in recent years. However, the body of scientific evidence in support of children’s health assessment is constantly advancing requiring continual updating of risk assessment methods. Children’s i...

Why, when and how to update a meta-ethnography qualitative synthesis.

PubMed

France, Emma F; Wells, Mary; Lang, Heidi; Williams, Brian

2016-03-15

Meta-ethnography is a unique, systematic, qualitative synthesis approach widely used to provide robust evidence on patient and clinician beliefs and experiences and understandings of complex social phenomena. It can make important theoretical and conceptual contributions to health care policy and practice. Since beliefs, experiences, health care contexts and social phenomena change over time, the continued relevance of the findings from meta-ethnographies cannot be assumed. However, there is little guidance on whether, when and how meta-ethnographies should be updated; Cochrane guidance on updating reviews of intervention effectiveness is unlikely to be fully appropriate. This is the first in-depth discussion on updating a meta-ethnography; it explores why, when and how to update a meta-ethnography. Three main methods of updating the analysis and synthesis are examined. Advantages and disadvantages of each method are outlined, relating to the context, purpose, process and output of the update and the nature of the new data available. Recommendations are made for the appropriate use of each method, and a worked example of updating a meta-ethnography is provided. This article makes a unique contribution to this evolving area of meta-ethnography methodology.

Updating the biomedical engineering curriculum: Inclusion of Health Technology Assessment subjects.

PubMed

Martinez Licona, Fabiola; Urbina, Edmundo Gerardo; Azpiroz-Leehan, Joaquin

2010-01-01

This paper describes the work being carried out at Metropolitan Autonomous University (UAM) in Mexico City with regard to the continuous evaluation and updating of the Biomedical Engineering (BME) curriculum. In particular the courses regarded as part of the BME basic branch are reduced and new sets of elective subjects are proposed in order to bring closer the research work at UAM with the subjects in the BME curriculum. Special emphasis is placed on subjects dealing with Health Technology Assessment (HTA) and Health economics, as this branch of the BME discipline is quite promising in Mexico, but there are very few professionals in the field with adequate qualifications.

An Exploratory Study of Factors Influencing Resuscitation Skills Retention and Performance among Health Providers

ERIC Educational Resources Information Center

Curran, Vernon; Fleet, Lisa; Greene, Melanie

2012-01-01

Introduction: Resuscitation and life support skills training comprises a significant proportion of continuing education programming for health professionals. The purpose of this study was to explore the perceptions and attitudes of certified resuscitation providers toward the retention of resuscitation skills, regular skills updating, and methods…

Maquiladora Industry: An Update from the Border. Fulbright-Hays Summer Seminar Abroad Project.

ERIC Educational Resources Information Center

Rodriguez, Angela L.

This research discusses Mexico's maquiladora industry, its employees (mostly women), and how the working conditions and the living environment affect worker health. The paper also explores how the employers, mostly U.S.-owned companies, deny responsibility for worker health, safety, and well-being. This research examines how the continued growth…

A System for Supporting Development and Update of the International Classification of Health Interventions (ICHI).

PubMed

Donada, Marc; Della Mea, Vincenzo; Cumerlato, Megan; Rankin, Nicole; Madden, Richard

2018-01-01

The International Classification of Health Interventions (ICHI) is a member of the WHO Family of International Classifications, being developed to provide a common tool for reporting and analysing health interventions for statistical purposes. A web-based platform for classification development and update has been specifically developed to support the initial development step and then, after final approval, the continuous revision and update of the classification. The platform provides features for classification editing, versioning, comment management and URI identifiers. During the last 12 months it has been used for developing the ICHI Beta version, replacing the previous process based on the exchange of Excel files. At November 2017, 90 users have provided input to the development of the classification, which has resulted in 2913 comments and 2971 changes in the classification, since June 2017. Further work includes the development of an URI API for machine to machine communication, following the model established for ICD-11.

Quality-improvement analytics for intravenous infusion pumps.

PubMed

Skledar, Susan J; Niccolai, Cynthia S; Schilling, Dennis; Costello, Susan; Mininni, Nicolette; Ervin, Kelly; Urban, Alana

2013-04-15

The implementation of a smart-pump continuous quality-improvement (CQI) program across a large health system is described, with an emphasis on key metrics for outcomes analyses and program refinement. Three years ago, the University of Pittsburgh Medical Center health system launched a CQI initiative to help ensure the safe use of 6000 smart pumps in its 14 inpatient facilities. A centralized team led by pharmacists is responsible for the retrieval and interpretation of smart-pump data, which is continuously transmitted to a main server. CQI findings are regularly posted on the health system's interdisciplinary intranet. Monitored metrics include rates of compliance with preprogrammed infusion limits, the top 20 drugs involved in alerts, drugs associated with alert-override rates of ≥90%, numbers of alerts by infusion type, nurse responses to alerts, and alert rate per drug library update. Based on the collected CQI data and site-specific requests, four systemwide updates of the smart-pump drug library were performed during the first 18 months of the program, reducing "nuisance alerts" by about 10% per update cycle and enabling targeted interventions to reduce rapid-infusion errors, other adverse drug events (ADEs), and pump-programming workarounds. Over one 12-month period, bedside alerts prompted nurses to reprogram or cancel continuous infusions an average of 400 times per month, potentially averting i.v. medication ADEs. A smart-pump CQI program is an effective tool for enhancing the safety of i.v. medication administration. The ongoing refinement of the drug library through the development and implementation of key interventions promotes the growth and sustainability of the smart-pump initiative systemwide.

Infectious Diseases Update. Vol. 1. Current Issues in School and Community Health.

ERIC Educational Resources Information Center

Bower, Wilma; And Others

This booklet, designed to provide up-to-date, accurate information, focuses on selected viral diseases that are potentially serious, often not well understood, and periodically in the news media because of their continued impact on school and community health. General information is provided on viral diseases, the immune system, vaccines, and how…

Who will have health insurance in the future? An updated projection.

PubMed

Young, Richard A; DeVoe, Jennifer E

2012-01-01

The passage of the 2010 Patient Protection and Affordable Care Act (PPACA) in the United States put the issues of health care reform and health care costs back in the national spotlight. DeVoe and colleagues previously estimated that the cost of a family health insurance premium would equal the median household income by the year 2025. A slowdown in health care spending tied to the recent economic downturn and the passage of the PPACA occurred after this model was published. In this updated model, we estimate that this threshold will be crossed in 2033, and under favorable assumptions the PPACA may extend this date only to 2037. Continuing to make incremental changes in US health policy will likely not bend the cost curve, which has eluded policy makers for the past 50 years. Private health insurance will become increasingly unaffordable to low-to-middle-income Americans unless major changes are made in the US health care system.

Update: Toxic Shock Syndrome.

ERIC Educational Resources Information Center

Price, James H.

1981-01-01

School health professionals can help reduce the incidence of Toxic Shock Syndrome by suggesting that women not use tampons continuously during menses and that tampons should not be left in place for long periods of time. Tampons should be changed every few hours and used intermittently with pads. (JN)

DOSE RESPONSE MODELING FOR 2, 3, 7, 8-TETRACHLORODIBENZO-P-DIOXIN

EPA Science Inventory

As science continues to appreciate the prevalence and power of dioxins, so it learns more about the harmful effects and effective preventive measures regarding these chemicals. Updating the acclaimed First Edition, Dioxins and Health, Second Edition covers the latest major scient...

Update on the Health Services Research Doctoral Core Competencies.

PubMed

Burgess, James F; Menachemi, Nir; Maciejewski, Matthew L

2018-03-13

To present revised core competencies for doctoral programs in health services research (HSR), modalities to deliver these competencies, and suggested methods for assessing mastery of these competencies. Core competencies were originally developed in 2005, updated (but unpublished) in 2008, modestly updated for a 2016 HSR workforce conference, and revised based on feedback from attendees. Additional feedback was obtained from doctoral program directors, employer/workforce experts and attendees of presentation on these competencies at the AcademyHealth's June 2017 Annual Research Meeting. The current version (V2.1) competencies include the ethical conduct of research, conceptual models, development of research questions, study designs, data measurement and collection methods, statistical methods for analyzing data, professional collaboration, and knowledge dissemination. These competencies represent a core that defines what HSR researchers should master in order to address the complexities of microsystem to macro-system research that HSR entails. There are opportunities to conduct formal evaluation of newer delivery modalities (e.g., flipped classrooms) and to integrate new Learning Health System Researcher Core Competencies, developed by AHRQ, into the HSR core competencies. Core competencies in HSR are a continually evolving work in progress because new research questions arise, new methods are developed, and the trans-disciplinary nature of the field leads to new multidisciplinary and team building needs. © Health Research and Educational Trust.

42 CFR § 512.210 - Included and excluded services.

Code of Federal Regulations, 2010 CFR

2017-10-01

... SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Scope of Episodes...) Certain PBPM payments under models tested under section 1115A of the Act that CMS determines to be... PBPM model payments funded from the Innovation Center appropriation. (c) Updating the exclusion lists...

Update on Multistate Outbreak of Fungal Infections Associated with Contaminated Methylprednisolone Injections, 2012-2014.

PubMed

McCotter, Orion Z; Smith, Rachel M; Westercamp, Mathew; Kerkering, Thomas M; Malani, Anurag N; Latham, Robert; Peglow, Sheree L; Mody, Rajal K; Pappas, Peter G; Chiller, Tom M

2015-10-30

During September 2012, CDC, in collaboration with state and local health departments and the Food and Drug Administration (FDA), investigated a multistate outbreak of fungal meningitis and other infections caused by injections of contaminated methylprednisolone acetate solution (MPA). After this unprecedented outbreak, scientists in the CDC Mycotic Diseases Branch, along with infectious diseases specialists who cared for patients from the outbreak, clinical experts, and public health officials from affected states, have continued to monitor the recovery of affected patients. A long-term follow-up study involving these patients was initiated and is being conducted by the Mycoses Study Group Education and Research Consortium (MSGERC). This update summarizes subsequent information about the current state of the outbreak.

76 FR 63623 - Board of Scientific Counselors, National Center for Environmental Health/Agency for Toxic...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-13

... Nutritional Biomarker Report: transfat analysis; update on ATSDR Science Symposium; update on Camp LeJeune; update on Environmental Health Tracking; presentation on hydraulic fracking; global health updates...

The Center for Devices and Radiological health: an update.

PubMed

Donawa, M

2001-12-01

At a recent medical device conference, Dr. David Feigal, the Director of the Food and Drug Administration (FDA) Center for Devices and Radiological Health (CDRH) stated that one-third of the CDRH staff will retire in five years. This is only one of many challenges that the Center faces.This article discusses key factors shaping current FDA device policies and programmes, the CDRH strategic plan, the continuing importance of the standards programme, and CDRH harmonisation activities.

Expected immunizations and health protection for Hajj and Umrah 2018 -An overview.

PubMed

Al-Tawfiq, Jaffar A; Gautret, Philippe; Memish, Ziad A

2017-09-01

The annual Hajj and Umrah are one of the largest recurring religious mass gatherings across the globe drawing pilgrims from more than 185 countries. The living circumstances and activities of the pilgrims may create an environment for the occurrence and spread of communicable diseases. Each year, the Health authority of the Kingdom of Saudi Arabia, in coordination with international health authorities, updates health requirements for pilgrims. The Hajj for 2017 took place from August 24 to September 5, 2017. Here, we review the expected obligations for immunizations for the 2018 Hajj and Umrah. The Hajj and Umrah vaccine requirements include mandatory vaccinations against yellow fever, quadrivalent meningococcal polysaccharide (every 3 years) or conjugated (every 5 years) vaccines and poliomyelitis vaccine. Influenza vaccine utilizing the 2016 (Southern Hemisphere vaccine to all pilgrims) was recommended but was not obligatory for pilgrims. Ciprofloxacin is required for individuals >12 years excluding pregnant women as chemoprophylaxis to be given at the port of entry for Pilgrims coming from the meningitis belt. With the ongoing outbreaks of measles in Europe, it is recommended that all pilgrims have an updated immunization against vaccine-preventable diseases (diphtheria, tetanus, pertussis, polio, measles and mumps). The mandatory vaccines remain the same with continued vigilance for the development of any new or emerging infectious diseases. Continuing surveillance for Zika virus, cholera and MERS-CoV are ongoing. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Facilitators and Barriers to Nurses’ Participation in Continuing Education Programs: A Mixed Method Explanatory Sequential Study

PubMed Central

Shahhosseini, Zohreh; Hamzehgardeshi, Zeinab

2015-01-01

Background: Since several factors affect nurses’ participation in Continuing Education, and that nurses’ Continuing Education affects patients’ and community health status, it is essential to know facilitators and barriers of participation in Continuing Education programs and plan accordingly. This mixed approach study aimed to investigate the facilitators and barriers of nurses’ participation, to explore nurses’ perception of the most common facilitators and barriers. Methods: An explanatory sequential mixed methods design with follow up explanations variant were used, and it involved collecting quantitative data (361 nurses) first and then explaining the quantitative results with in-depth interviews during a qualitative study. Results: The results showed that the mean score of facilitators to nurses’ participation in Continuing Education was significantly higher than the mean score of barriers (61.99±10.85 versus 51.17±12.83; p<0.001, t=12.23). The highest mean score of facilitators of nurses’ participation in Continuing Education was related to “Update my knowledge”. By reviewing the handwritings in qualitative phase, two main levels of updating information and professional skills were extracted as the most common facilitators and lack of support as the most common barrier to nurses’ participation in continuing education program. Conclusion: According to important role Continuing Education on professional skills, nurse managers should facilitate the nurse’ participation in the Continues Education. PMID:25948439

The facilitators and barriers to nurses' participation in continuing education programs: a mixed method explanatory sequential study.

PubMed

Shahhosseini, Zohreh; Hamzehgardeshi, Zeinab

2014-11-30

Since several factors affect nurses' participation in Continuing Education, and that nurses' Continuing Education affects patients' and community health status, it is essential to know facilitators and barriers of participation in Continuing Education programs and plan accordingly. This mixed approach study aimed to investigate the facilitators and barriers of nurses' participation, to explore nurses' perception of the most common facilitators and barriers. An explanatory sequential mixed methods design with follow up explanations variant were used, and it involved collecting quantitative data (361 nurses) first and then explaining the quantitative results with in-depth interviews during a qualitative study. The results showed that the mean score of facilitators to nurses' participation in Continuing Education was significantly higher than the mean score of barriers (61.99 ± 10.85 versus 51.17 ± 12.83; p<0.001, t=12.23). The highest mean score of facilitators of nurses' participation in Continuing Education was related to "Update my knowledge". By reviewing the handwritings in qualitative phase, two main levels of updating information and professional skills were extracted as the most common facilitators and lack of support as the most common barrier to nurses' participation in continuing education program. According to important role Continuing Education on professional skills, nurse managers should facilitate the nurse' participation in the Continues Education.

Massachusetts health reform: employer coverage from employees' perspective.

PubMed

Long, Sharon K; Stockley, Karen

2009-01-01

The national health reform debate continues to draw on Massachusetts' 2006 reform initiative, with a focus on sustaining employer-sponsored insurance. This study provides an update on employers' responses under health reform in fall 2008, using data from surveys of working-age adults. Results show that concerns about employers' dropping coverage or scaling back benefits under health reform have not been realized. Access to employer coverage has increased, as has the scope and quality of their coverage as assessed by workers. However, premiums and out-of-pocket costs have become more of an issue for employees in small firms.

[The value of using administrative data in public health research: the Continuous Working Life Sample].

PubMed

López, María Andrée; Benavides, Fernando G; Alonso, Jordi; Espallargues, Mireia; Durán, Xavier; Martínez, José Miguel

2014-01-01

The use of administrative data is common practice in public health research. The present field note describes the Continuous Working Life Sample (CWLS) and its use in health research. The CWLS is built on records generated by all contacts with the social security system (work contracts, disability, etc.), plus tax data (monetary gains, income, etc.) and census data (level of education, country of birth, etc.), but does not allow individuals to be identified. The CWLS was started in 2004 with 4% (1.1 million persons) of the total population who were either contributors to or beneficiaries of the social security system. The information on the individuals in the CWLS is updated annually and lost individuals are replaced. This continuous design allows the construction of a cohort with information on working life and financial status and evaluation of their relationship with work disability. Future connection with clinical records would enable analysis of other health-related outcomes. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Integration of On-Line and Off-Line Diagnostic Algorithms for Aircraft Engine Health Management

NASA Technical Reports Server (NTRS)

Kobayashi, Takahisa; Simon, Donald L.

2007-01-01

This paper investigates the integration of on-line and off-line diagnostic algorithms for aircraft gas turbine engines. The on-line diagnostic algorithm is designed for in-flight fault detection. It continuously monitors engine outputs for anomalous signatures induced by faults. The off-line diagnostic algorithm is designed to track engine health degradation over the lifetime of an engine. It estimates engine health degradation periodically over the course of the engine s life. The estimate generated by the off-line algorithm is used to update the on-line algorithm. Through this integration, the on-line algorithm becomes aware of engine health degradation, and its effectiveness to detect faults can be maintained while the engine continues to degrade. The benefit of this integration is investigated in a simulation environment using a nonlinear engine model.

Kids Count Data Book, 2012: State Trends in Child Well-Being

ERIC Educational Resources Information Center

Annie E. Casey Foundation, 2012

2012-01-01

The Annie E. Casey Foundation's 2012 KIDS COUNT[R] Data Book shows both promising progress and discouraging setbacks for the nation's children: While their academic achievement and health improved in most states, their economic well-being continued to decline. This year's Data Book uses an updated index of 16 indicators of child well-being,…

Air Quality in Mexico City: Policies Implemented for its Improvement

NASA Astrophysics Data System (ADS)

Paramo, V.

2007-12-01

Ozone and suspended particles (PM) are two pollutants in the atmosphere of Mexico City Metropolitan Area (MCMA) that still exceed the recommended Mexican health standards. The other criteria pollutants very seldom exceed their corresponding standards. In 2006, the maximum ozone concentrations were above the health standard (0.11 ppm in 1 hour) during 59 percent of the days for an average of 2.2 hours and 130 points of the Air Quality Index (Índice Metropolitano de la Calidad del Aire - IMECA). In contrast, in 1991, 98 percent of the days exceeded the ozone health standard for an average of 6.6 hours and 200 IMECA points. With regards to PM10, in 2006, 80 percent of the sampled concentrations were below the health standard of 120 µg/m3 in 24 hours. However, the annual health standard of 50 µg/m3 is still exceeded. The air quality management in the MCMA is a difficult task due to several adverse factors. The main one is the large population that increased from nearly 15 million in 1992 to more than 18 million at present. As a result, the urban area grows in the adjoined municipalities of the State of Mexico. The vehicular fleet increases also to almost 4 million and the number of industrial facilities is at present 50,000. Consequently, the fuel consumption is very high. The daily energy consumption is estimated to be 44 million liters of equivalent of gasoline. Despite the fact that the air quality has improved in recent years, the related health standards are still exceeded and therefore it is necessary to continue applying the most cost-effective actions to improve the environment quality. Some actions that have contributed most to the reduction of pollutant emissions are the following: Continuous update of the inspection and maintenance program of the vehicular fleet; substitution of the catalytic converters at the end of their useful life; self-regulation of the diesel fleet; use of alternative fuels; update the No-Driving-Day program; establishment of more stringent emission levels of the gasoline fleet; update the detention of pollutant vehicles program; partial exemption of the inspection and maintenance program for cleaner and or highly efficient vehicles; substitution of 3,000 microbuses, 40,000 taxis and 1,200 buses; commissioning of the first Bus Rapid Transit system; implementation of a program for the emissions reduction for the 300 most polluted industrial facilities; and continuous update of the air quality environmental management programs. To continue improving the air quality in the MCMA, the environmental authorities will continue the implementation of the 2002-2010 Air Quality Improvement Program. In 2007 the Green Program was started, this includes those actions that have proven to be effective reduction of pollutant emissions and incorporates new actions for the reduction of local and global pollutant emissions. The most important of these new actions are: substitution of 9,500 microbuses; renewal of all the taxis fleet; commissioning of 10 Bus Rapid Transit lines; commissioning of Line 12 of the underground system; schedules and routes limitations to the cargo fleet; increase 5 percent the number of non-motorized trips (bicycling and walking); regulation of the private public transport passenger stops; requirement of private schools to provide school transport; regulation of non-occupied taxis in circulation; modifications to the circulation of 350 critical crossing points in the city; adoption of intelligent traffic lights systems; complete substitution of the local government vehicle's fleet; implement the inspection and maintenance of the cargo fleet; introduction of low- sulfur diesel, among other measures.

40 CFR 68.190 - Updates.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Updates. 68.190 Section 68.190 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.190 Updates. (a) The owner or operator shall...

40 CFR 68.190 - Updates.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Updates. 68.190 Section 68.190 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.190 Updates. (a) The owner or operator shall...

40 CFR 68.36 - Review and update.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 15 2011-07-01 2011-07-01 false Review and update. 68.36 Section 68.36 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.36 Review and update. (a) The owner or operator shall...

40 CFR 68.36 - Review and update.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 16 2012-07-01 2012-07-01 false Review and update. 68.36 Section 68.36 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.36 Review and update. (a) The owner or operator shall...

40 CFR 68.36 - Review and update.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 16 2013-07-01 2013-07-01 false Review and update. 68.36 Section 68.36 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.36 Review and update. (a) The owner or operator shall...

40 CFR 68.36 - Review and update.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 16 2014-07-01 2014-07-01 false Review and update. 68.36 Section 68.36 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.36 Review and update. (a) The owner or operator shall...

Funding, coverage, and access under Thailand's universal health insurance program: an update after ten years.

PubMed

Damrongplasit, Kannika; Melnick, Glenn

2015-04-01

In 2001, Thailand implemented a universal coverage program by expanding government-funded health coverage to uninsured citizens and limited their out-of-pocket payments to 30 Baht per encounter and, in 2006, eliminated out-of-pocket payments entirely. Prior research covering the early years of the program showed that the program effectively expanded coverage while a more recent paper of the early effects of the program found that improved access from the program led to a reduction in infant mortality. We expand and update previous analyses of the effects of the 30 Baht program on access and out-of-pocket payments. We analyze national survey and governmental budgeting data through 2011 to examine trends in health care financing, coverage and access, including out-of-pocket payments. By 2011, only 1.64 % of the population remained uninsured in Thailand (down from 2.61 % in 2009). While government funding increased 75 % between 2005 and 2010, budgetary requests by health care providers exceeded approved amounts in many years. The 30 Baht program beneficiaries paid zero out-of-pocket payments for both outpatient and inpatient care. Inpatient and outpatient contact rates across all insurance categories fell slightly over time. Overall, the statistical results suggest that the program is continuing to achieve its goals after 10 years of operation. Insurance coverage is now virtually universal, access has been more or less maintained, government funding has continued to grow, though at rates below requested levels and 30 Baht patients are still guaranteed access to care with limited or no out-of-pocket costs. Important issues going forward are the ability of the government to sustain continued funding increases while minimizing cost sharing.

Developing and refining the methods for a 'one-stop shop' for research evidence about health systems.

PubMed

Lavis, John N; Wilson, Michael G; Moat, Kaelan A; Hammill, Amanda C; Boyko, Jennifer A; Grimshaw, Jeremy M; Flottorp, Signe

2015-02-25

Policymakers, stakeholders and researchers have not been able to find research evidence about health systems using an easily understood taxonomy of topics, know when they have conducted a comprehensive search of the many types of research evidence relevant to them, or rapidly identify decision-relevant information in their search results. To address these gaps, we developed an approach to building a 'one-stop shop' for research evidence about health systems. We developed a taxonomy of health system topics and iteratively refined it by drawing on existing categorization schemes and by using it to categorize progressively larger bundles of research evidence. We identified systematic reviews, systematic review protocols, and review-derived products through searches of Medline, hand searches of several databases indexing systematic reviews, hand searches of journals, and continuous scanning of listservs and websites. We developed an approach to providing 'added value' to existing content (e.g., coding systematic reviews according to the countries in which included studies were conducted) and to expanding the types of evidence eligible for inclusion (e.g., economic evaluations and health system descriptions). Lastly, we developed an approach to continuously updating the online one-stop shop in seven supported languages. The taxonomy is organized by governance, financial, and delivery arrangements and by implementation strategies. The 'one-stop shop', called Health Systems Evidence, contains a comprehensive inventory of evidence briefs, overviews of systematic reviews, systematic reviews, systematic review protocols, registered systematic review titles, economic evaluations and costing studies, health reform descriptions and health system descriptions, and many types of added-value coding. It is continuously updated and new content is regularly translated into Arabic, Chinese, English, French, Portuguese, Russian, and Spanish. Policymakers and stakeholders can now easily access and use a wide variety of types of research evidence about health systems to inform decision-making and advocacy. Researchers and research funding agencies can use Health Systems Evidence to identify gaps in the current stock of research evidence and domains that could benefit from primary research, systematic reviews, and review overviews.

[Financial protection in health: updates for Mexico to 2014].

PubMed

Knaul, Felicia Marie; Arreola-Ornelas, Héctor; Méndez-Carniado, Oscar

2016-06-01

Objetive: Document financial protection in health in Mexico up to 2014. We up date the measures of impoverishing and catastrophic health expenditure to 2014, to analyse shifts since the implementation of the System for Social Protection in Health and the Seguro Popular using time series data from the Household Income and Expenditure Survey. Between 2004 and 2014 there has been a continued improvement in levels of financial protection. Excessive expenditure reached its lowest point: -2.0% in 2012 and 2.1% in 2014. Impoverishing expenditure dropped to 1.3% in 2004, compared to 0.5% in 2014, and catastrophic expenditures from 2.7% to 2.1%. The time series of data on financial protection show a clear pattern of improvement between 2000 and 2014 and level off and low levels in 2012 and 2014. Still, levels continue to be relatively high for households in the poorest quintile, in rural areas and with an elderly person.

Hickory decline and mortality: Update on hickory decline research

Treesearch

Jennifer Juzwik; Ji-Huyn Park; Linda Haugen

2010-01-01

Research continued through the 2010 field season on the etiology of hickory decline that is characterized by thinning crowns with small, yellow leaves and hickory bark beetle attack on the upper main stem. This research is part of a larger project initiated in 2006 to assess the distribution and determine the cause(s) of Forest Health Monitoring reported decline and...

APIC position paper: Safe injection, infusion, and medication vial practices in health care.

PubMed

Dolan, Susan A; Arias, Kathleen Meehan; Felizardo, Gwen; Barnes, Sue; Kraska, Susan; Patrick, Marcia; Bumsted, Amelia

2016-07-01

The transmission of bloodborne viruses and other microbial pathogens to patients during routine health care procedures continues to occur because of the use of improper injection, infusion, medication vial, and point-of-care testing practices by health care personnel. These unsafe practices occur in various clinical settings and result in unacceptable and devastating events for patients. This document updates the Association for Professionals in Infection Control and Epidemiology 2010 position paper on safe injection, infusion, and medication vial practices in health care. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

U.S. Department of Energy, Office of Legacy Management Program Update, April-June 2009

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

None

2009-04-01

Welcome to the April-June 2009 issue of the U.S. Department of Energy (DOE) Office of Legacy Management (LM) Program Update. This publication is designed to provide a status of activities within LM. The Legacy Management goals are: (1) Protect human health and the environment through effective and efficient long-term surveillance and maintenance - This goal highlights DOE's responsibility to ensure long-term protection of people, the environment, and the integrity of engineered remedies and monitoring systems. (2) Preserve, protect, and make accessible legacy records and information - This goal recognizes LM's commitment to successfully manage records, information, and archives of legacymore » sites under its authority. (3) Support an effective and efficient work force structured to accomplish Departmental missions and assure continuity of contractor worker pension and medical benefits - This goal recognizes DOE's commitment to its contracted work force and the consistent management of pension and health benefits. As sites continue to close, DOE faces the challenges of managing pension plan and health benefits liability. (4) Manage legacy land and assets, emphasizing protective real and personal property reuse and disposition - This goal recognizes a DOE need for local collaborative management of legacy assets, including coordinating land use planning, personal property disposition to community reuse organizations, and protecting heritage resources (natural, cultural, and historical). (5) Improve program effectiveness through sound management - This goal recognizes that LM's goals cannot be attained efficiently unless the federal and contractor work force is motivated to meet requirements and work toward continuous performance improvement.« less

A 6-year update of the health policy and advocacy priorities of the Society of Behavioral Medicine.

PubMed

Buscemi, Joanna; Bennett, Gary G; Gorin, Sherri Sheinfeld; Pagoto, Sherry L; Sallis, James F; Wilson, Dawn K; Fitzgibbon, Marian L

2017-12-01

Government policy affects virtually every topic of interest to health behavior researchers, from research funding to reimbursement for clinical services to application of evidence to impact health outcomes. This paper provides a 6-year update on the expansion of Society of Behavioral Medicine's (SBM) public policy and advocacy agenda and proposed future directions. SBM's Health Policy Council is responsible for ensuring coordination of the policy-related activities of the Health Policy Committee (HPC), the Civic and Public Engagement Committee (CPEC), and the Scientific and Professional Liaison Council (SPLC). These committees and councils have written letters to Congress, signed onto advocacy letters with hundreds of organizations, and developed and disseminated 15 health policy briefs, the majority of which have been presented to legislative staffers on Capitol Hill. With the assistance of the SPLC, SBM has collaborated on policy efforts with like-minded organizations to increase the impact of the Society's policy work. Moving forward, SBM plans to continue to increase efforts to disseminate policy work more broadly and develop long-term relationships with Congressional staffers. SBM leadership realizes that to remain relevant, demonstrate impact, and advance the role of behavioral medicine, we must advance a policy agenda that reflects our mission of better health through behavior change.

Diagnosis and treatment of endocrine comorbidities in patients with cystic fibrosis.

PubMed

Siwamogsatham, Oranan; Alvarez, Jessica A; Tangpricha, Vin

2014-10-01

The aim of this review is to provide an update on various relevant endocrine aspects of care in adolescents and adults with cystic fibrosis. As life expectancy in cystic fibrosis has continuously improved, endocrine complications have become more apparent. The common endocrine complications include cystic fibrosis related diabetes, cystic fibrosis related bone disease, vitamin D deficiency and poor growth and pubertal development. Thyroid and adrenal disorders have also been reported, although the prevalence appears to be less common. Endocrine diseases are an increasingly recognized complication that has a significant impact on the overall health of individuals with cystic fibrosis. This review summarizes the updated screening and management of endocrine diseases in the cystic fibrosis population.

78 FR 41013 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-09

... [CMS-1450-CN] RIN 0938-AR52 Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting Requirements, and Cost Allocation of Home Health Survey... period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY...

Annual update: drugs, diagnostics and devices.

PubMed

Berardinelli, Candace; Kupecz, Deborah

2003-03-01

As NPs continue to play an important role in health care as administers of prescriptions, the value of reviewing the latest Food and Drug Administration (FDA) approvals for new drugs and devices is immeasurable. In 2002, the FDA approved several new drugs and devices, as well as monitored previously approved drugs for adverse reactions and untoward events. This article provides a brief review of relevant primary care topics.

An Update on Teen Pregnancy.

PubMed

Ahern, Nancy R; Bramlett, Traci

2016-02-01

After years of high teen birth rates, there is currently a decline in U.S. pregnancy and birth rates among teens. Nevertheless, these rates continue to be higher than those of most global counterparts, and psychosocial and physical adversities still occur for pregnant teens and their children. The declining birth rates may be due to teens making better choices about contraceptive use and sexual behaviors. Psychiatric-mental health nurses are in key positions to enhance pregnancy prevention for teens. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 25-28.]. Copyright 2016, SLACK Incorporated.

Progress toward an advanced condition monitoring system for reusable rocket engines

NASA Technical Reports Server (NTRS)

Maram, J.; Barkhoudarian, S.

1987-01-01

A new generation of advanced sensor technologies will allow the direct measurement of critical/degradable rocket engine components' health and the detection of degraded conditions before component deterioration affects engine performance, leading to substantial improvements in reusable engines' operation and maintenance. When combined with a computer-based engine condition-monitoring system, these sensors can furnish a continuously updated data base for the prediction of engine availability and advanced warning of emergent maintenance requirements. Attention is given to the case of a practical turbopump and combustion device diagnostic/prognostic health-monitoring system.

[Maternal discharge: conditions and organization for mothers and newborns returning home. The French National Authority for Health recommendations update].

PubMed

Hascoët, J-M; Petitprez, K

2014-09-01

In light of changes in both medical practices and the organization of medical care, the French National Authority for Health (Haute Autorité de santé, HAS) proposed new recommendations on the discharge of mothers and newborns, updating its 2004 recommendations on early discharge of mothers and newborns. This decision in turn made it necessary to define optimal discharge conditions and accompanying measures for mothers and infants returning home. The problem was approached by adopting the usual HAS methodology for drafting good practice recommendations. This involved establishing a working group bringing together representatives of all medical and care fields related to perinatology as well as patient representatives. This working group submitted draft recommendations, based on updated published references, to a committee. The committee then proposed amendments to the recommendations, which the working group was free to accept or reject. The updated recommendations that emerged from this process apply four essential principles : first, preparing for discharge as early as the prenatal period, ideally during the third trimester of pregnancy, in particular by providing expectant mothers with information on how the discharge will be organized and anticipating problems that might arise; second, ensuring care continuity between hospitalization, discharge to home, and follow-up; third, ensuring optimal conditions for discharge after a maternity stay of 72-96 h for normal delivery or 96-120 h in case of caesarean section (this hospital stay duration allows for neonatal screening); and fourth, defining how mothers and children are to be accompanied during the first postnatal month. In conclusion, these recommendations resulted in an increase in the duration of as well as an improvement in routine newborn surveillance, whether in hospital or after discharge, in what is a critical phase of infant development. They encourage ambulatory postnatal monitoring. The new recommendations ensure continuity of care while taking into account mothers' and couples' wish to take responsibility for organizing their own healthcare. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

75 FR 81138 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-27

... [CMS-1510-CN2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home Health Agencies and Hospices AGENCY... ``Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in...

Update of Continuous-Energy Data for Hydrogen and SiO 2 Thermal Scattering

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

Conlin, Jeremy Lloyd; Parsons, Donald Kent

2017-02-23

The Nuclear Data Team has released updated continuous-energy neutron data files for: 1) hydrogen, and 2) S (α; β) (thermal scattering) on SiO 2. A list of new ZAIDs and the data that is updated (Old ZAID) is given in Table 1. The old data are still accessible, but are not the default.

Status of Insecticide Resistance in Papua New Guinea: An Update from Nation-Wide Monitoring of Anopheles Mosquitoes.

PubMed

Koimbu, Gussy; Czeher, Cyrille; Katusele, Michelle; Sakur, Muker; Kilepak, Lemen; Tandrapah, Anthony; Hetzel, Manuel W; Pulford, Justin; Robinson, Leanne; Karl, Stephan

2018-01-01

Insecticide resistance (IR) monitoring is an important component of vector-borne disease control. The last assessment of IR in Papua New Guinea (PNG) was conducted in 2010. Since then, vector populations have been exposed to higher levels of pyrethroids with the continued nation-wide distribution of insecticide-treated nets. Here, we provide an update on phenotypic IR in four highly malaria-endemic areas of PNG. IR against deltamethrin, lambda-cyhalothrin, and dichlorodiphenyltrichloroethane was assessed using World Health Organization bioassays. A total of 108 bioassays for each insecticide were conducted screening 2,290 adult female anopheline mosquitoes. No phenotypic resistance was observed. Bioassay parameters agreed well with those observed in other studies that used the same assays and insecticides. These results indicate that the three tested insecticides are still universally effective in PNG. Continued IR monitoring (every 1-2 years) in PNG is recommended to detect reduced susceptibility early and adjust guidelines to prevent widespread resistance.

Nonpharmacological Strategies for Patients With Early-Stage Dementia or Mild Cognitive Impairment: A 10-Year Update.

PubMed

Anderson, Joel G; Lopez, Ruth Palan; Rose, Karen M; Specht, Janet K

2017-01-01

As the incidence and prevalence of early-stage Alzheimer's disease and mild cognitive impairment increases worldwide, gerontological researchers continue to examine the efficacy and effectiveness of strategies to help patients and caregivers live with the disease. Although pharmacological treatments remain the focus of much of the research, nonpharmacological strategies and approaches to care continue to gain ground as effective means of improving the health-related quality of life for this patient population. The current commentary summarizes the state of the science based on a series of integrative and systematic reviews undertaken by the International Dementia Scholars Collaborative as a 10-year update to a previous white paper. Selected topics from this previous white paper (e.g., support groups, nutrition, exercise, cognitive training, falls) as well as new topics (e.g., mind-body, advance care planning, driving safety) are discussed, and recommendations for future research are provided. [Res Gerontol Nurs. 2017; 10(1):5-11.]. Copyright 2017, SLACK Incorporated.

New estimates of gaps and transitions in health insurance.

PubMed

Short, Pamela Farley; Graefe, Deborah R; Swartz, Katherine; Uberoi, Namrata

2012-12-01

Changes in individual or family circumstances cause many Americans to experience gaps and transitions in public and private health insurance. Using data from the 2004-2007 Survey of Income and Program Participation, this article updates earlier analyses of insurance gaps and transitions. Eighty-nine million people (one third of nonelderly Americans) were uninsured for at least 1 month during those 4 years. Approximately 23 million lost insurance more than once. The analyses call attention to the continuing instability and insecurity of health insurance, can inform implementation of national reforms, and establish a recent baseline that will be helpful in evaluating the reforms' effects on coverage stability.

Global baby-friendly hospital initiative monitoring data: update and discussion.

PubMed

Labbok, Miriam H

2012-08-01

The World Health Organization (WHO)/UNICEF Baby-Friendly Hospital Initiative (BFHI) was developed to support the implementation of the Ten Steps for Successful Breastfeeding. The purpose of this study is to assess trends in the numbers facilities ever-designated "baby-friendly," to consider uptake of the new WHO/UNICEF BFHI materials, and to consider implications for future breastfeeding support. The national contacts from the 2006-2007 UNICEF BFHI update were recontacted, as were WHO and UNICEF officers worldwide, to ascertain the number of hospitals ever-designated "baby-friendly," presence of a government breastfeeding oversight committee, use of the new BFHI materials and, if yes, use of the new maternity or human immunodeficiency virus (HIV) materials. Seventy countries reporting in 2010-2011 and the updates from an additional 61 reporting in 2006-2007 (n=131, or 66% of the 198 countries) confirm that there are at least 21,328 ever-designated facilities. This is 27.5% of maternities worldwide: 8.5% of those in industrialized countries and 31% in less developed settings. In 2010, government committees were reported by 18 countries, and 34 reported using the new BFHI materials: 14 reported using the maternity care and 11 reported using the HIV materials. Rates of increase in the number of ever-certified "baby-friendly" hospitals vary by region and show some chronological correlation with trends in breastfeeding rates. Although it is not possible to attribute this increase to the BFHI alone, there is ongoing interest in Ten Steps implementation and in BFHI. The continued growth may reflect the dedication of ministries of health and national BFHI groups, as well as increasing recognition that the Ten Steps are effective quality improvement practices that increase breastfeeding and synergize with community interventions and other program efforts. With renewed interest in maternal/neonatal health, revitalization of support for Ten Steps and their effective institutionalization in maternity practices should be considered. Future updates are planned to assess ongoing progress and impact, and ongoing updates from national committees are welcome.

76 FR 9502 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-18

... [CMS-1510-F2] RIN 0938-AP88 Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011; Changes in Certification Requirements for Home Health Agencies and Hospices; Correction... set forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: The...

78 FR 27242 - Updated Special Advisory Bulletin on the Effect of Exclusion From Participation in Federal Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

...] Updated Special Advisory Bulletin on the Effect of Exclusion From Participation in Federal Health Care... health care programs by OIG. The updated Special Advisory Bulletin describes the scope and effect of the legal prohibition on payment by Federal health care programs for items or services furnished (1) by an...

Update on the Department of Energy's 1994 plutonium vulnerability assessment for the plutonium finishing plant

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

HERZOG, K.R.

1999-09-01

A review of the environmental, safety, and health vulnerabilities associated with the continued storage of PFP's inventory of plutonium bearing materials and other SNM. This report re-evaluates the five vulnerabilities identified in 1994 at the PFP that are associated with SNM storage. This new evaluation took a more detailed look and applied a risk ranking process to help focus remediation efforts.

Advancing Health Literacy Measurement: A Pathway to Better Health and Health System Performance

PubMed Central

Pleasant, Andrew

2014-01-01

The concept of health literacy initially emerged and continues to gain strength as an approach to improving health status and the performance of health systems. Numerous studies clearly link low levels of education, literacy, and health literacy with poor health, poor health care utilization, increased barriers to care, and early death. However, theoretical understandings and methods of measuring the complex social construct of health literacy have experienced a continual evolution that remains incomplete. As a result, the seemingly most-cited definition of health literacy proposed in the now-decade-old Institute of Medicine report on health literacy is long overdue for updating. Such an effort should engage a broad and diverse set of health literacy researchers, practitioners, and members of the public in creating a definition that can earn broad consensus through validation testing in a rigorous scientific approach. That effort also could produce the basis for a new universally applicable measure of health literacy. Funders, health systems, and policymakers should reconsider their timid approach to health literacy. Although the field and corresponding evidence base are not perfect, health literacy—especially when combined with a focus on prevention and integrative health—is one of the most promising approaches to advancing public health. PMID:25491583

Climate Change and Human Health Impacts in the United States: An Update on the Results of the U.S. National Assessment

PubMed Central

Ebi, Kristie L.; Mills, David M.; Smith, Joel B.; Grambsch, Anne

2006-01-01

The health sector component of the first U.S. National Assessment, published in 2000, synthesized the anticipated health impacts of climate variability and change for five categories of health outcomes: impacts attributable to temperature, extreme weather events (e.g., storms and floods), air pollution, water- and food-borne diseases, and vector- and rodent-borne diseases. The Health Sector Assessment (HSA) concluded that climate variability and change are likely to increase morbidity and mortality risks for several climate-sensitive health outcomes, with the net impact uncertain. The objective of this study was to update the first HSA based on recent publications that address the potential impacts of climate variability and change in the United States for the five health outcome categories. The literature published since the first HSA supports the initial conclusions, with new data refining quantitative exposure–response relationships for several health end points, particularly for extreme heat events and air pollution. The United States continues to have a very high capacity to plan for and respond to climate change, although relatively little progress has been noted in the literature on implementing adaptive strategies and measures. Large knowledge gaps remain, resulting in a substantial need for additional research to improve our understanding of how weather and climate, both directly and indirectly, can influence human health. Filling these knowledge gaps will help better define the potential health impacts of climate change and identify specific public health adaptations to increase resilience. PMID:16966082

Diagnosis and Treatment of Endocrine Co-Morbidities in Patients with Cystic Fibrosis

PubMed Central

Siwamogsatham, Oranan; Alvarez, Jessica

2015-01-01

Purpose of review The aim of this review is to provide an update on various relevant endocrine aspects of care in adolescents and adults with cystic fibrosis (CF). Recent findings As life expectancy in CF has continuously improved, endocrine complications have become more apparent. The common endocrine complications include cystic fibrosis related diabetes (CFRD), cystic fibrosis related bone disease, vitamin D deficiency and poor growth and pubertal development. Thyroid and adrenal disorders have also been reported, although the prevalence appears to be less common. Summary Endocrine diseases are an increasingly recognized complication that has a significant impact on the overall health of individuals with CF. This review summarizes the updated screening and management of endocrine diseases in the CF population. PMID:25105995

42 CFR 414.30 - Conversion factor update.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Conversion factor update. 414.30 Section 414.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Practitioners § 414.30 Conversion factor update. Unless Congress acts in accordance with section 1848(d)(3) of...

42 CFR 414.30 - Conversion factor update.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Conversion factor update. 414.30 Section 414.30 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Practitioners § 414.30 Conversion factor update. Unless Congress acts in accordance with section 1848(d)(3) of...

Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America.

PubMed

Boucher, Helen W; Talbot, George H; Bradley, John S; Edwards, John E; Gilbert, David; Rice, Louis B; Scheld, Michael; Spellberg, Brad; Bartlett, John

2009-01-01

The Infectious Diseases Society of America (IDSA) continues to view with concern the lean pipeline for novel therapeutics to treat drug-resistant infections, especially those caused by gram-negative pathogens. Infections now occur that are resistant to all current antibacterial options. Although the IDSA is encouraged by the prospect of success for some agents currently in preclinical development, there is an urgent, immediate need for new agents with activity against these panresistant organisms. There is no evidence that this need will be met in the foreseeable future. Furthermore, we remain concerned that the infrastructure for discovering and developing new antibacterials continues to stagnate, thereby risking the future pipeline of antibacterial drugs. The IDSA proposed solutions in its 2004 policy report, "Bad Bugs, No Drugs: As Antibiotic R&D Stagnates, a Public Health Crisis Brews," and recently issued a "Call to Action" to provide an update on the scope of the problem and the proposed solutions. A primary objective of these periodic reports is to encourage a community and legislative response to establish greater financial parity between the antimicrobial development and the development of other drugs. Although recent actions of the Food and Drug Administration and the 110th US Congress present a glimmer of hope, significant uncertainly remains. Now, more than ever, it is essential to create a robust and sustainable antibacterial research and development infrastructure--one that can respond to current antibacterial resistance now and anticipate evolving resistance. This challenge requires that industry, academia, the National Institutes of Health, the Food and Drug Administration, the Centers for Disease Control and Prevention, the US Department of Defense, and the new Biomedical Advanced Research and Development Authority at the Department of Health and Human Services work productively together. This report provides an update on potentially effective antibacterial drugs in the late-stage development pipeline, in the hope of encouraging such collaborative action.

Nursing and midwifery regulation and HIV scale-up: establishing a baseline in east, central and southern Africa

PubMed Central

McCarthy, Carey F; Voss, Joachim; Verani, Andre R; Vidot, Peggy; Salmon, Marla E; Riley, Patricia L

2013-01-01

Introduction Shifting HIV treatment tasks from physicians to nurses and midwives is essential to scaling-up HIV services in sub-Saharan Africa. Updating nursing and midwifery regulations to include task shifting and pre-service education reform can help facilitate reaching new HIV targets. Donor-supported initiatives to update nursing and midwifery regulations are increasing. However, there are gaps in our knowledge of current practice and education regulations and a lack of information to target and implement regulation strengthening efforts. We conducted a survey of national nursing and midwifery councils to describe current nursing and midwifery regulations in 13 African countries. Methods A 30-item survey was administered to a convenience sample of 13 national nursing and midwifery regulatory body leaders in attendance at the PEPFAR-supported African Health Profession Regulatory Collaborative meeting in Nairobi, Kenya on 28 February, 2011. The survey contained questions on task shifting and regulations such as registration, licensure, scope of practice, pre-service education accreditation, continuing professional development and use of international guidelines. Survey data were analyzed to present country-level, comparative and regional findings. Results Task shifting to nurses and midwives was reported in 11 of the 13 countries. Eight countries updated their scope of practice within the last five years; only one reported their regulations to reflect task shifting. Countries vary with regard to licensure, pre-service accreditation and continuing professional development regulations in place. There was no consistency in terms of what standards were used to design national practice and education regulations. Discussion Many opportunities exist to assist countries to modernise regulations to incorporate important advancements from task shifting and pre-service reform. Appropriate, revised regulations can help sustain successful health workforce strategies and contribute to further scale-up HIV services and other global health priorities. Conclusions This study provides fundamental information from which to articulate goals and to measure the impact of regulation strengthening efforts. PMID:23531276

A Diversity 3.0 Update: Are We Moving the Needle Enough?

PubMed

Nivet, Marc A

2015-12-01

Five years ago, in a previous Academic Medicine Commentary, the author asserted that the move toward health reform and a more equitable health system required a transformation of more than how we finance, deliver, and evaluate health care. It also required a new role for diversity and inclusion as a solution to our problems, rather than continuing to see it as just another problem to be fixed. In this update, the author assesses the collective progress made by the nation's medical schools and teaching hospitals in integrating diversity into their core strategic activities, as well as highlighting areas for continued improvement.The author identifies five new trends in diversity and inclusion within academic medicine: broader definitions of diversity to include lesbian, gay, bisexual, and transgender people and those who have disabilities; elevated roles for diversity leaders in medical school administration; growing use of a holistic approach to evaluating medical school applicants; recognition of diversity and inclusion as a core marker of excellence; and appreciation of the significance of subpopulations within minority and underrepresented groups.More work remains to be done, but institutional initiatives to foster and prioritize diversity and inclusion coupled with national efforts by organizations such as the Association of American Medical Colleges are working to build the capacity of U.S. medical schools and teaching hospitals to move diversity from a peripheral initiative to a core strategy for improving the education of medical students and, ultimately, the care delivered to all of our nation's people.

Shared decision making in Italy: An updated revision of the current situation.

PubMed

Bottacini, Alessandro; Scalia, Peter; Goss, Claudia

2017-06-01

The aim of this paper is to update the previous review on the state of patient and public participation in healthcare in Italy. Policymakers consider patient involvement an important aspect in health care decisions and encourage patients to actively participate in the clinical interaction. Nevertheless, the term shared decision making (SDM) is still not clearly defined. Patient associations promote patient participation in health care decisions. Several experts attended the latest consensus conference about patient engagement to reach a consensus on the definition of SDM. Research regarding SDM in Italy continues to increase with 17 articles published between 2012 and 2017. Researchers have assessed the variables associated with patient involvement and explored the use of the SDM approach in different medical settings. Despite the dedicated SDM initiative, researchers in Italy recognize room for improvement. Work is needed to reach a common language regarding SDM and its mechanisms to implement this approach at the clinical level. Copyright © 2017. Published by Elsevier GmbH.

Update on Smoking Cessation: E-Cigarettes, Emerging Tobacco Products Trends, and New Technology-Based Interventions.

PubMed

Das, Smita; Tonelli, Makenzie; Ziedonis, Douglas

2016-05-01

Tobacco use disorders (TUDs) continue to be overly represented in patients treated in mental health and addiction treatment settings. It is the most common substance use disorder (SUD) and the leading cause of health disparities and increased morbidity/mortality amongst individuals with a psychiatric disorder. There are seven Food and Drug Administration (FDA) approved medications and excellent evidence-based psychosocial treatment interventions to use in TUD treatment. In the past few years, access to and use of other tobacco or nicotine emerging products are on the rise, including the highly publicized electronic cigarette (e-cigarette). There has also been a proliferation of technology-based interventions to support standard TUD treatment, including mobile apps and web-based interventions. These tools are easily accessed 24/7 to support outpatient treatment. This update will review the emerging products and counter-measure intervention technologies, including how clinicians can integrate these tools and other community-based resources into their practice.

Computer-assisted expert case definition in electronic health records.

PubMed

Walker, Alexander M; Zhou, Xiaofeng; Ananthakrishnan, Ashwin N; Weiss, Lisa S; Shen, Rongjun; Sobel, Rachel E; Bate, Andrew; Reynolds, Robert F

2016-02-01

To describe how computer-assisted presentation of case data can lead experts to infer machine-implementable rules for case definition in electronic health records. As an illustration the technique has been applied to obtain a definition of acute liver dysfunction (ALD) in persons with inflammatory bowel disease (IBD). The technique consists of repeatedly sampling new batches of case candidates from an enriched pool of persons meeting presumed minimal inclusion criteria, classifying the candidates by a machine-implementable candidate rule and by a human expert, and then updating the rule so that it captures new distinctions introduced by the expert. Iteration continues until an update results in an acceptably small number of changes to form a final case definition. The technique was applied to structured data and terms derived by natural language processing from text records in 29,336 adults with IBD. Over three rounds the technique led to rules with increasing predictive value, as the experts identified exceptions, and increasing sensitivity, as the experts identified missing inclusion criteria. In the final rule inclusion and exclusion terms were often keyed to an ALD onset date. When compared against clinical review in an independent test round, the derived final case definition had a sensitivity of 92% and a positive predictive value of 79%. An iterative technique of machine-supported expert review can yield a case definition that accommodates available data, incorporates pre-existing medical knowledge, is transparent and is open to continuous improvement. The expert updates to rules may be informative in themselves. In this limited setting, the final case definition for ALD performed better than previous, published attempts using expert definitions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Epidemiologic update on the dengue situation in the Western Pacific Region, 2011

PubMed Central

Edelstein, Zoe Rebecca; Han, Hwi Kwang; Matsui, Tamano

2013-01-01

Dengue is an emerging vectorborne infectious disease that is a major public health concern in the Asia and the Pacific. Official dengue surveillance data for 2011 provided by ministries of health were summarized as part of routine activities of the World Health Organization Regional Office for the Western Pacific. Based on officially reported surveillance data, dengue continued to show sustained activity in the Western Pacific Region. In 2011, Member States reported a total of 244 855 cases of which 839 died for a case fatality rate of 0.34%. More than 1000 cases were reported each from Cambodia, the Federated States of Micronesia, the Lao People's Democratic Republic, Malaysia, the Philippines, the Marshall Islands, Singapore and Viet Nam. Cambodia, the Federated States of Micronesia and the Marshall Islands reported higher activity relative to 2010. There continues to be great variability among the dengue-endemic countries and areas in the Region in the number of cases and serotype distribution. The continued high notification rate and complex dengue epidemiology in the Region highlight the need for information-sharing on a routine and timely basis. PMID:24015372

Epidemiologic update on the dengue situation in the Western Pacific Region, 2011.

PubMed

Arima, Yuzo; Edelstein, Zoe Rebecca; Han, Hwi Kwang; Matsui, Tamano

2013-01-01

Dengue is an emerging vectorborne infectious disease that is a major public health concern in the Asia and the Pacific. Official dengue surveillance data for 2011 provided by ministries of health were summarized as part of routine activities of the World Health Organization Regional Office for the Western Pacific. Based on officially reported surveillance data, dengue continued to show sustained activity in the Western Pacific Region. In 2011, Member States reported a total of 244,855 cases of which 839 died for a case fatality rate of 0.34%. More than 1000 cases were reported each from Cambodia, the Federated States of Micronesia, the Lao People's Democratic Republic, Malaysia, the Philippines, the Marshall Islands, Singapore and Viet Nam. Cambodia, the Federated States of Micronesia and the Marshall Islands reported higher activity relative to 2010. There continues to be great variability among the dengue-endemic countries and areas in the Region in the number of cases and serotype distribution. The continued high notification rate and complex dengue epidemiology in the Region highlight the need for information-sharing on a routine and timely basis.

Updates and Overview of Spaceflight Medical Support in Russia and Kazakhstan

NASA Technical Reports Server (NTRS)

Chough, Natacha; Pattarini, James; Cole, Richard; Patlach, Robert; Menon, Anil

2017-01-01

This panel presents recent updates to and a comprehensive overview of the operational medical support provided to ISS crewmembers in Star City, Russia and Kazakhstan as part of UTMB/KBRwyle's Human Health & Performance contract. With the current Soyuz training flow, physician support is required for nominal training evolutions involving pressure changes or other potential physical risks detailed in this presentation. In addition, full-time physician presence in Star City helps to address the disparity in access to health care in these relatively remote practice areas, while also developing and maintaining relationships with host nation resources. A unique part of standard training in Russia also involves survival training in both winter and water environments; logistic details and medical impacts of each of these training scenarios will be discussed. Following support of a successful training flow, UTMB/KBRwyle's Star City Medical Support Group (SCMSG) is also responsible for configuring medical packs in support of Soyuz launches and landings; we will present the rationale for current pack contents within the context of specific operational needs. With respect to contingency events, the group will describe their preparedness to respond appropriately by activating both local and global resources as necessary, detailing a specialized subset of the group who continually work and update these assets, given changes in international infrastructure and other impacts.

To Your Health: NLM update transcript - Health and wealth loss

MedlinePlus

... https://medlineplus.gov/podcast/transcript062518.html To Your Health: NLM update Transcript Health and wealth loss : 06/25/2018 To use ... is what's new this week in To Your Health, a consumer health-oriented podcast from NLM, that ...

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

42 CFR 484.225 - Annual update of the unadjusted national prospective 60-day episode payment rate.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Annual update of the unadjusted national... SERVICES Prospective Payment System for Home Health Agencies § 484.225 Annual update of the unadjusted national prospective 60-day episode payment rate. (a) CMS updates the unadjusted national 60-day episode...

South Carolina Cancer Health Equity Consortium: HBCU Student Summer Training Program

DTIC Science & Technology

2016-08-01

Teleconferences were held quarterly with members of the Leadership Team to discuss student recruitment methods . The Associate Directors and Faculty Advisors then...tools such as Facebook have also been useful for engaging the students and opening a venue for communication. Another method we have found useful is...these methods [19] to improve continued student tracking. These multiple tracking strategies will be used to update the table that is included in

40 CFR 68.36 - Review and update.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.36 Review and update. (a) The owner or operator shall... processes, quantities stored or handled, or any other aspect of the stationary source might reasonably be...

Guidelines for the selection of chemical protective clothing. 1991 Update: Performance, availability, and sources of chemical protective clothing

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

Johnson, J.S.; Schwope, A.D.; Goydan, R.

1991-12-31

The selection, acquisition, and use of chemical protective clothing (CPC) at Department of Energy (DOE) facilities require up-to-date data and information on the performance, availability, and sources of such clothing. There are hundreds of types and more than one hundred principal manufacturers of CPC. Information on CPC is published in manufacturers` brochures and the technical literature. These information sources, however, have no standard format or terminology for describing products or the results of product testing. Furthermore, the literature and information is continually changing and growing. Consequently, DOE`s industrial hygienists and safety specialists are frequently confounded in their efforts to providemore » effective CPC to workers, by they in the field, the laboratory, or the plant. In recognition of the many advances and changes that have occurred and of the need to provide current information to its health and safety staff, the DOE has updated and modified the key appendices of the Guidelines/Chemical Protective Clothing. The updates appendices compose the majority of this update document, wherein they are called Sections. Each Section begins with a description of its format, content, abbreviations, units, and links with other Sections, as appropriate.« less

Violence: a priority for public health? (part 2)

PubMed Central

Rutherford, Alison; Zwi, Anthony B; Grove, Natalie J; Butchart, Alexander

2007-01-01

Violence continues to grow as a priority for public health practitioners, particularly as its causes and consequences become better understood and the potential roles for public health are better articulated. This article provides the context to “Violence: a glossary (part 1)” published in the last issue of this journal, and updates some of the data, concepts and population approaches presented in the 2002 World report on violence and health. The paper addresses the following questions: What is the magnitude and global burden of injury from violence? What causes violence? Is resilience important? What is the role for public health? What are the key challenges and opportunities? We aim to engage the general reader and to increase understanding of violence as a potentially preventable issue. PMID:17699529

New Estimates of Gaps and Transitions in Health Insurance

PubMed Central

Short, Pamela Farley; Graefe, Deborah R.; Swartz, Katherine; Uberoi, Namrata

2014-01-01

Changes in individual or family circumstances cause many Americans to experience gaps and transitions in public and private health insurance. Using data from the 2004–2007 Survey of Income and Program Participation, this article updates earlier analyses of insurance gaps and transitions. Eighty-nine million people (one third of non-elderly Americans) were uninsured for at least one month during those four years. Approximately twenty-three million lost insurance more than once. The analyses call attention to the continuing instability and insecurity of health insurance, can inform implementation of national reforms, and establish a recent baseline that will be helpful in evaluating the reforms’ effects on coverage stability. PMID:22833452

NASA Human Health and Performance Center: Open innovation successes and collaborative projects

NASA Astrophysics Data System (ADS)

Richard, Elizabeth E.; Davis, Jeffrey R.

2014-11-01

In May 2007, what was then the Space Life Sciences Directorate published the 2007 Space Life Sciences Strategy for Human Space Exploration, setting the course for development and implementation of new business models and significant advances in external collaboration over the next five years. The strategy was updated on the basis of these accomplishments and reissued as the NASA Human Health and Performance Strategy in 2012, and continues to drive new approaches to innovation for the directorate. This short paper describes the successful execution of the strategy, driving organizational change through open innovation efforts and collaborative projects, including efforts of the NASA Human Health and Performance Center (NHHPC).

Business process modeling in healthcare.

PubMed

Ruiz, Francisco; Garcia, Felix; Calahorra, Luis; Llorente, César; Gonçalves, Luis; Daniel, Christel; Blobel, Bernd

2012-01-01

The importance of the process point of view is not restricted to a specific enterprise sector. In the field of health, as a result of the nature of the service offered, health institutions' processes are also the basis for decision making which is focused on achieving their objective of providing quality medical assistance. In this chapter the application of business process modelling - using the Business Process Modelling Notation (BPMN) standard is described. Main challenges of business process modelling in healthcare are the definition of healthcare processes, the multi-disciplinary nature of healthcare, the flexibility and variability of the activities involved in health care processes, the need of interoperability between multiple information systems, and the continuous updating of scientific knowledge in healthcare.

Dissociable cognitive mechanisms underlying human path integration.

PubMed

Wiener, Jan M; Berthoz, Alain; Wolbers, Thomas

2011-01-01

Path integration is a fundamental mechanism of spatial navigation. In non-human species, it is assumed to be an online process in which a homing vector is updated continuously during an outward journey. In contrast, human path integration has been conceptualized as a configural process in which travelers store working memory representations of path segments, with the computation of a homing vector only occurring when required. To resolve this apparent discrepancy, we tested whether humans can employ different path integration strategies in the same task. Using a triangle completion paradigm, participants were instructed either to continuously update the start position during locomotion (continuous strategy) or to remember the shape of the outbound path and to calculate home vectors on basis of this representation (configural strategy). While overall homing accuracy was superior in the configural condition, participants were quicker to respond during continuous updating, strongly suggesting that homing vectors were computed online. Corroborating these findings, we observed reliable differences in head orientation during the outbound path: when participants applied the continuous updating strategy, the head deviated significantly from straight ahead in direction of the start place, which can be interpreted as a continuous motor expression of the homing vector. Head orientation-a novel online measure for path integration-can thus inform about the underlying updating mechanism already during locomotion. In addition to demonstrating that humans can employ different cognitive strategies during path integration, our two-systems view helps to resolve recent controversies regarding the role of the medial temporal lobe in human path integration.

Proposal for an Update of the Definition and Scope of Behavioral Medicine.

PubMed

Dekker, Joost; Stauder, Adrienne; Penedo, Frank J

2017-02-01

We aim to provide an update of the definition and scope of behavioral medicine in the Charter of ISBM, as the present version was developed more than 25 years ago. We identify issues which need clarification or updating. This leads us to propose an update of the definition and scope of behavioral medicine. Issues in need of clarification or updating include the scope of behavioral medicine (biobehavioral mechanisms, clinical diagnosis and intervention, and prevention and health promotion); research as an essential characteristic of all three areas of behavioral medicine; the application of behavioral medicine; the terminology of behavioral medicine as a multidisciplinary field; and the relationship and distinction between behavioral medicine, mental health, health psychology, and psychosomatic medicine. We propose the following updated definition and scope of behavioral medicine: "Behavioral medicine can be defined as the multidisciplinary field concerned with the development and integration of biomedical and behavioral knowledge relevant to health and disease, and the application of this knowledge to prevention, health promotion, diagnosis, treatment, rehabilitation, and care. The scope of behavioral medicine extends from biobehavioral mechanisms (i.e., the interaction of biomedical processes with psychological, social, societal, cultural, and environmental processes), to clinical diagnosis and intervention, and to public health."

[Welfare State and public health: a relationship that needs to be updated].

PubMed

Benavides, Fernando G; Delclós, Jordi; Serra, Consol

Human health has improved throughout the 20th century, at the same time that the Welfare State was consolidated. This paper explores the current relationship between the welfare state and public health. The essential functions of public health are exercised as part of the State, and currently the main challenge is to ensure that health is protected and promoted through different public policies, including employment. Studies assessing the health effect of different types of welfare state are contradictory, but when the impact of specific policies, such as unemployment benefits, is considered, the results are positive and consistent. However, the current crisis of the Welfare State hampers its continuity, largely due to changes in the labour market, with more flexible and insecure jobs. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

System for Continuous Delivery of MODIS Imagery to Internet Mapping Applications

NASA Technical Reports Server (NTRS)

Plesea, Lucian

2008-01-01

This software represents a complete, unsupervised processing chain that generates a continuously updating global image of the Earth from the most recent available MODIS Level 1B scenes. The software constantly updates a global image of the Earth at 250 m per pixel.

Method of Implementing Digital Phase-Locked Loops

NASA Technical Reports Server (NTRS)

Stephens, Scott A. (Inventor); Thomas, J. Brooks (Inventor)

1997-01-01

In a new formulation for digital phase-locked loops, loop-filter constants are determined from loop roots that can each be selectively placed in the s-plane on the basis of a new set of parameters, each with simple and direct physical meaning in terms of loop noise bandwidth, root-specific decay rate, and root-specific damping. Loops of first to fourth order are treated in the continuous-update approximation (B(sub L)T approaches 0) and in a discrete-update formulation with arbitrary B(sub L)T. Deficiencies of the continuous-update approximation in large-B(sub L)T applications are avoided in the new discrete-update formulation.

Methanol test

MedlinePlus

... Safety and Health. Emergency Response Safety and Health Database. Methanol: systemic agent. Updated May 28, 2015. www. ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

The status of state boards of health in 2010.

PubMed

Fenton, Ginger D

2011-01-01

The objective of the survey was to update information about state boards of health throughout the United States and, based on the results of the survey, to determine how the National Association of Local Boards of Health can serve as a resource to assist state boards in fulfilling their responsibilities and duties. A written survey was developed to collect information about the composition, organizational structure, statutory authority, roles, responsibilities, concerns, and needs of state boards of health. Information specific to state boards of health has not been collected on a routine basis by any organization, therefore the National Association of Local Boards of Health sought to compile current information on these boards that will be maintained and updated on a routine basis. Surveys were mailed to 31 contacts for state boards of health. After follow-up attempts, responses (n = 27) were received from all but four boards for a response rate of 87.1% with one indicating no board. Consumers and physicians were most frequently reported as required members of the boards. Board members were appointed solely by the governor in 21 (80.8%) states. Nine boards (34.6%) indicated an advisory only capacity regarding statutory authority while the others were governing, policy making, or had multiple authorities. Specific responsibilities of all of the boards included, regardless of statutory authority, advising the state chief health officer (84.6%), advising the governor (42.3%), and adopting and enforcing statutes (38.5%). State boards of health have undergone changes and likely will continue to evolve in their role in public health governance as demonstrated by this survey. This repository of current data on state boards of health could be of use to public health researchers, boards of health, and national public health organizations in strengthening public health governance.

40 CFR 1065.309 - Continuous gas analyzer system-response and updating-recording verification-for gas analyzers...

Code of Federal Regulations, 2010 CFR

2010-07-01

... change the system response. (b) Measurement principles. This procedure verifies that the updating and... gas detectors used to generate a continuously combined/compensated concentration measurement signal... verifies that the measurement system meets a minimum response time. For this procedure, ensure that all...

32 CFR 635.24 - Updating the COPS MPRS.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Updating the COPS MPRS. 635.24 Section 635.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND... ensure that every founded offense is reported into the COPS MPRS. Timely and accurate reporting is...

32 CFR 635.24 - Updating the COPS MPRS.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Updating the COPS MPRS. 635.24 Section 635.24 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND... ensure that every founded offense is reported into the COPS MPRS. Timely and accurate reporting is...

Recent and Upcoming Changes to NOAA Marine Forecasts

Science.gov Websites

tropical cyclone forecast products effective on or about June 1, 2018 Updated: Continuing experimental around May 15, 2018 Updated: Continuing experimental status in offshore and high seas gridded forecasts been disestablished Discontinuing experimental text products used in the creation of the Tampa Bay

Integrating Remote Sensing and Disease Surveillance to Forecast Malaria Epidemics

NASA Astrophysics Data System (ADS)

Wimberly, M. C.; Beyane, B.; DeVos, M.; Liu, Y.; Merkord, C. L.; Mihretie, A.

2015-12-01

Advance information about the timing and locations of malaria epidemics can facilitate the targeting of resources for prevention and emergency response. Early detection methods can detect incipient outbreaks by identifying deviations from expected seasonal patterns, whereas early warning approaches typically forecast future malaria risk based on lagged responses to meteorological factors. A critical limiting factor for implementing either of these approaches is the need for timely and consistent acquisition, processing and analysis of both environmental and epidemiological data. To address this need, we have developed EPIDEMIA - an integrated system for surveillance and forecasting of malaria epidemics. The EPIDEMIA system includes a public health interface for uploading and querying weekly surveillance reports as well as algorithms for automatically validating incoming data and updating the epidemiological surveillance database. The newly released EASTWeb 2.0 software application automatically downloads, processes, and summaries remotely-sensed environmental data from multiple earth science data archives. EASTWeb was implemented as a component of the EPIDEMIA system, which combines the environmental monitoring data and epidemiological surveillance data into a unified database that supports both early detection and early warning models. Dynamic linear models implemented with Kalman filtering were used to carry out forecasting and model updating. Preliminary forecasts have been disseminated to public health partners in the Amhara Region of Ethiopia and will be validated and refined as the EPIDEMIA system ingests new data. In addition to continued model development and testing, future work will involve updating the public health interface to provide a broader suite of outbreak alerts and data visualization tools that are useful to our public health partners. The EPIDEMIA system demonstrates a feasible approach to synthesizing the information from epidemiological surveillance systems and remotely-sensed environmental monitoring systems to improve malaria epidemic detection and forecasting.

To Your Health: NLM update transcript - A new way to illustrate health care

MedlinePlus

... NLM update Transcript A new way to illustrate health care : 05/07/2018 To use the sharing features ... to represent both the experiences of patients and health care providers was suggested as a new mass medium ...

76 FR 3637 - Annual Update of the HHS Poverty Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Annual Update of the HHS Poverty... update of the Department of Health and Human Services (HHS) poverty guidelines to account for last... program. For information about poverty figures for immigration forms, the Hill-Burton Uncompensated...

77 FR 4034 - Annual Update of the HHS Poverty Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Annual Update of the HHS Poverty... update of the Department of Health and Human Services (HHS) poverty guidelines to account for last... program. For information about poverty figures for immigration forms, the Hill-Burton Uncompensated...

78 FR 5182 - Annual Update of the HHS Poverty Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Annual Update of the HHS Poverty... update of the Department of Health and Human Services (HHS) poverty guidelines to account for last... program. For information about poverty figures for immigration forms, the Hill-Burton Uncompensated...

[Adult learning, professional autonomy and individual commitment].

PubMed

Pardell-Alentá, H

The concept of 'andragogy' is the basis of the adult education which is different from pedagogy in several aspects, particularly in the autonomy of the adult learner in choosing the educational programmes and the methodologies and sites in where learning occurs. This happens very often in the worksite. The professionals have to learn permanently during their active lives in order to maintain their competence updated. In this sense, continuing education correlates with continuing professional development, which is an attempt to enlarge the traditional domains of continuing education. Continuing education must be clearly differentiated from formal education, which is a requirement for granting professional degrees or titles. Very often it arises from the changing health needs and for this reason is necessary to avoid the institutionalization of continuing education programmes. Professional associations should be actively involved in providing and accrediting continuing education-continuing professional development programmes, because this involvement is an essential component of the professionals' self-regulation in the context of the current medical professionalism ideology.

Dance your way to fitness

MedlinePlus

... team. Editorial update 04-02-18. Related MedlinePlus Health Topics Exercise and Physical Fitness Browse the Encyclopedia A.D. ... of Health and Human Services National Institutes of Health Page last updated: 04 June 2018

NASA Human Health and Performance Center: Open Innovation Successes and Collaborative Projects

NASA Technical Reports Server (NTRS)

Davis, Jeffrey R.; Richard, Elizabeth E.

2014-01-01

In May 2007, what was then the Space Life Sciences Directorate published the 2007 Space Life Sciences Strategy for Human Space Exploration, which resulted in the development and implementation of new business models and significant advances in external collaboration over the next five years. The strategy was updated on the basis of these accomplishments and reissued as the NASA Human Health and Performance Strategy in 2012, and continues to drive new approaches to innovation for the directorate. This short paper describes the open innovation successes and collaborative projects developed over this timeframe, including the efforts of the NASA Human Health and Performance Center (NHHPC), which was established to advance human health and performance innovations for spaceflight and societal benefit via collaboration in new markets.

Alternative Fuels Data Center: Status Update: E25 Dispensers Certified, E15

Science.gov Websites

Alternative Fuels Data Center: Status Update: E25 Dispensers Certified, E15 Warranty Upgraded, and Testing on Ethanol Blends Continues (May 2010) on Facebook Tweet about Alternative Fuels Data Center: Status Update Twitter Bookmark Alternative Fuels Data Center: Status Update: E25 Dispensers Certified, E15 Warranty

Sedentary behaviour and diet across the lifespan: an updated systematic review.

PubMed

Hobbs, Matthew; Pearson, Natalie; Foster, Perry J; Biddle, Stuart J H

2015-09-01

Sedentary behaviour and its association with dietary intake in young people and adults are important topics and were systematically reviewed in 2011. There is a need to update this evidence given the changing nature of sedentary behaviour and continued interest in this field. This review aims to assist researchers in better interpreting the diversity of findings concerning sedentary behaviour and weight status. To provide an update of the associations between sedentary behaviour and dietary intake across the lifespan. Electronic databases searched were MEDLINE, PsychInfo, Cochrane Library, Web of Science and Science Direct for publications between January 2010 and October 2013, thus updating a previous review. Included were observational studies assessing an association between at least one sedentary behaviour and at least one aspect of dietary intake in preschool children (<5 years), school-aged children (6-11 years), adolescents (12-18 years) and adults (>18 years). 27 papers met inclusion criteria (preschool k=3, school-aged children k=9, adolescents k=15, adults k=3). For all three groups of young people, trends were evident for higher levels of sedentary behaviour, especially TV viewing, to be associated with a less healthful diet, such as less fruit and vegetable and greater consumption of energy-dense snacks and sugar sweetened beverages. Data for the three studies with adults were less conclusive. Sedentary behaviour continues to be associated with unhealthy diet in young people in mostly cross-sectional studies. More studies utilising a prospective design are needed to corroborate findings and more studies are needed with adults. 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.

Health promotion strategies for the "Boomer" generation: wellness for the mature worker.

PubMed

Musich, Shirley; McDonald, Timothy; Chapman, Larry S

2009-01-01

Subsequent to World War II some 78 million individuals were birthed by parents striving to return to a normal life. THis group has been labeled the "Baby Boom" generation and as "Boomers" in a short form moniker. This group has continued to dominate the demographics of the U.S. as they move through their life span. Worksite and health plan Wellness efforts need to address some of the unique characteristics and needs of this multi-generational group in order to assure their active engagement in Wellness programming and Wellness-oriented lifestyles. Maturing employees that belong to this group represent a challenge to employers that will require special consideration in physical and psychosocial work arrangements, health management programming and options for updating professional training.

The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel.

PubMed

Williamson, Sean R; Delahunt, Brett; Magi-Galluzzi, Cristina; Algaba, Ferran; Egevad, Lars; Ulbright, Thomas M; Tickoo, Satish K; Srigley, John R; Epstein, Jonathan I; Berney, Daniel M

2017-02-01

Since the last World Health Organization (WHO) classification scheme for tumours of the urinary tract and male genital organs, there have been a number of advances in the understanding, classification, immunohistochemistry and genetics of testicular germ cell tumours. The updated 2016 draft classification was discussed at an International Society of Urological Pathology Consultation on Testicular and Penile Cancer. This review addresses the main updates to germ cell tumour classification. Major changes include a pathogenetically derived classification using germ cell neoplasia in situ (GCNIS) as a new name for the precursor lesion, and the distinction of prepubertal tumours (non-GCNIS-derived) from postpubertal-type tumours (GCNIS-derived), acknowledging the existence of rare benign prepubertal-type teratomas in the postpubertal testis. Spermatocytic tumour is adopted as a replacement for spermatocytic seminoma, to avoid potential confusion with the unrelated usual seminoma. The spectrum of trophoblastic tumours arising in the setting of testicular germ cell tumour continues to expand, to include epithelioid and placental site trophoblastic tumours analogous to those of the gynaecological tract. Currently, reporting of anaplasia (seminoma or spermatocytic tumour) or immaturity (teratoma) is not required, as these do not have demonstrable prognostic importance. In contrast, overgrowth of a teratomatous component (somatic-type malignancy) and sarcomatous change in spermatocytic tumour indicate more aggressive behaviour, and should be reported. © 2016 John Wiley & Sons Ltd.

Continuous Enhancement of Science Teachers' Knowledge and Skills through Scientific Lecturing.

PubMed

Azevedo, Maria-Manuel; Duarte, Sofia

2018-01-01

Due to their importance in transmitting knowledge, teachers can play a crucial role in students' scientific literacy acquisition and motivation to respond to ongoing and future economic and societal challenges. However, to conduct this task effectively, teachers need to continuously improve their knowledge, and for that, a periodic update is mandatory for actualization of scientific knowledge and skills. This work is based on the outcomes of an educational study implemented with science teachers from Portuguese Basic and Secondary schools. We evaluated the effectiveness of a training activity consisting of lectures covering environmental and health sciences conducted by scientists/academic teachers. The outcomes of this educational study were evaluated using a survey with several questions about environmental and health scientific topics. Responses to the survey were analyzed before and after the implementation of the scientific lectures. Our results showed that Basic and Secondary schools teachers' knowledge was greatly improved after the lectures. The teachers under training felt that these scientific lectures have positively impacted their current knowledge and awareness on several up-to-date scientific topics, as well as their teaching methods. This study emphasizes the importance of continuing teacher education concerning knowledge and awareness about health and environmental education.

Ecto- and endoparasites of new world camelids.

PubMed

Ballweber, Lora Rickard

2009-07-01

Parasitism in New World camelids (NWC), which is associated with both ecto- and endoparasites, is a major health concern throughout the world. Clinical disease has been noted as causing severe economic losses; subclinical issues have yet to be addressed. Despite the advances made in the knowledge and understanding of parasites of NWC, old parasites continue to plague producers, and new issues have arisen. This article updates information on the major ecto- and endoparasites of NWC, including diagnostic techniques and issues relative to anthelmintic resistance in nematodes.

RTECS database (on the internet). Online data

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

NONE

The Registry of Toxic Effects of Chemical Substances (RTECS (trademark)) is a database of toxicological information compiled, maintained, and updated by the National Institute for Occupational Safety and Health. The program is mandated by the Occupational Safety and Health Act of 1970. The original edition, known as the `Toxic Substances List,` was published on June 28, 1971, and included toxicologic data for approximately 5,000 chemicals. Since that time, the list has continuously grown and been updated, and its name changed to the current title, `Registry of Toxic Effects of Chemical Substances.` RTECS (trademark) now contains over 133,000 chemicals as NIOSHmore » strives to fulfill the mandate to list `all known toxic substances...and the concentrations at which...toxicity is known to occur.` This database is now available for searching through the Gov. Research-Center (GRC) service. GRC is a single online web-based search service to well known Government databases. Featuring powerful search and retrieval software, GRC is an important research tool. The GRC web site is at http://grc.ntis.gov.« less

Adolescent Health Research Updates: Supplement to the Adolescent Health Plan, Numbers 1-6, December 1996-November 1997.

ERIC Educational Resources Information Center

Schleich, Ley, Ed.

This document contains the first six research updates to "Alaska's Adolescents: A Plan for the Future," a comprehensive 1994 report on adolescent health issues prepared by the multiagency Alaska Adolescent Health Advisory Committee. "The Media and Adolescent Health: Television's Impact on Certain Teen Behaviors" (Elizabeth…

75 FR 53975 - Office of Women's Health Update

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-N-0001] Office of Women's Health Update AGENCY: Food and Drug Administration, HHS. ACTION: Notice of meeting. The Food and Drug Administration (FDA) is announcing the following meeting: Office of Women's Health (OWH...

NONCARCINOGENIC EFFECTS OF CHROMIUM: UPDATE TO HEALTH ASSESSMENT DOCUMENT

EPA Science Inventory

This 1990 document updates the 1984 Health Assessment Document for Chromium by addressing issues regarding noncarcinogenic health effects of chromium: oxidation states and persistence of these states in the environment, sampling and analytical methodology to differentiate these o...

Biosurveillance: A Review and Update

PubMed Central

Kman, Nicholas E.; Bachmann, Daniel J.

2012-01-01

Since the terrorist attacks and anthrax release in 2001, almost $32 billion has been allocated to biodefense and biosurveillance in the USA alone. Surveillance in health care refers to the continual systematic collection, analysis, interpretation, and dissemination of data. When attempting to detect agents of bioterrorism, surveillance can occur in several ways. Syndromic surveillance occurs by monitoring clinical manifestations of certain illnesses. Laboratory surveillance occurs by looking for certain markers or laboratory data, and environmental surveillance is the process by which the ambient air or environment is continually sampled for the presence of biological agents. This paper focuses on the ways by which we detect bioterrorism agents and the effectiveness of these systems. PMID:22242207

Update on Validity of Required Competencies for Worksite Health Professionals

ERIC Educational Resources Information Center

Becker, Craig; Rager, Robin C.; Wright, Fred Egbert

2013-01-01

Background: To improve global health, the workforce capacity of health promotion professionals must be strengthened through the provision of competencies necessary to deliver effective programs. Purpose: This study provides an updated analysis of the validity of the worksite health promotion (WHP) professional competencies developed in 2000 by the…

Safe Surgery Trainer

DTIC Science & Technology

2014-11-15

design, testing, and development. b) Prototype Development – Continue developing SST software, game -flow, and mechanics. Continue developing art...refined learning objectives into measurement outlines. Update IRB submissions, edit usability game play study, and update I/ITSEC IRB. Provide case...minimal or near zero. 9) Related Activities a) Presenting at the Design of Learning Games Community Workshop, at I/ITSEC, Wednesday, Dec 3 rd

A Continuous Square Root in Formation Filter-Swoother with Discrete Data Update

NASA Technical Reports Server (NTRS)

Miller, J. K.

1994-01-01

A differential equation for the square root information matrix is derived and adapted to the problems of filtering and smoothing. The resulting continuous square root information filter (SRIF) performs the mapping of state and process noise by numerical integration of the SRIF matrix and admits data via a discrete least square update.

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 7 2012-04-01 2012-04-01 false Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 7 2013-04-01 2013-04-01 false Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 7 2014-04-01 2014-04-01 false Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

21 CFR 607.30 - Updating blood product listing information.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 7 2011-04-01 2010-04-01 true Updating blood product listing information. 607.30... (CONTINUED) BIOLOGICS ESTABLISHMENT REGISTRATION AND PRODUCT LISTING FOR MANUFACTURERS OF HUMAN BLOOD AND BLOOD PRODUCTS Procedures for Domestic Blood Product Establishments § 607.30 Updating blood product...

Method of implementing digital phase-locked loops

NASA Technical Reports Server (NTRS)

Stephens, Scott A. (Inventor); Thomas, Jess Brooks, Jr. (Inventor)

1993-01-01

In a new formulation for digital phase-locked loops, loop-filter constants are determined from loop roots that can each be selectively placed in the s-plane on the basis of a new set of parameters, each with simple and direct physical meaning in terms of loop noise bandwidth, root-specific decay rate, or root-specific damping. Loops of first to fourth order are treated in the continuous-update approximation (BLT yields 0) and in a discrete-update formulation with arbitrary BLT. Deficiencies of the continuous-update approximation in large-BLT applications are avoided in the new discrete-update formulation. A new method for direct, transient-free acquisition with third- and fourth-order loops can improve the versatility and reliability of acquisition with such loops.

75 FR 45628 - Delayed Update of the HHS Poverty Guidelines for the Remainder of 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Delayed Update of the HHS Poverty...: This notice provides a delayed update of the Department of Health and Human Services (HHS) poverty guidelines for the remainder of 2010, and until the 2011 poverty guidelines are published, which is expected...

77 FR 71179 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-29

... notice provides the updated regional per-diem rates for low-volume mental health providers; the update... beneficiary per-diem cost-share amount for low-volume providers; and, the updated per-diem rates for both full... with high TRICARE volume) and regional-specific rates for psychiatric hospitals and units with low...

Professional activity, information demands, training and updating needs of occupational medicine physicians in Italy: National survey.

PubMed

Persechino, Benedetta; Fontana, Luca; Buresti, Giuliana; Rondinone, Bruna Maria; Laurano, Patrizia; Imbriani, Marcello; Iavicoli, Sergio

2016-01-01

Occupational medicine is a discipline continually evolving in response to technological advances, changes in workplaces and production processes, emergence of new occupational risks and diseases and modifications in regulatory framework for occupational health and safety. Therefore, the recurrent revaluation of professional activity, information demands and education and training needs of occupational physicians is essential in order to identify methodologies and tools that may contribute to improvement of their professional knowledge and competency. In this regard, we conducted the first large-scale national survey of Italian occupational medicine physicians to define their demographic and professional activity and to assess their information demands, training and updating needs. A random sample of occupational physicians, listed in the national register of the Italian Ministry of Health, was selected to complete a voluntary survey. Subjects recruited in this study were asked to complete 3 different sections (personal and professional information, training and updating needs, professional activity and practice characteristics) of a questionnaire for a total of 35 questions. Most of participants were specialized in occupational medicine, worked for a large number of companies and carried out health surveillance on a total number of workers that exceeds 1500. Occupational physicians would like to have a higher training offer towards practical aspects of health surveillance, risks assessment, manual handling of loads, chemical substances and upper limb biomechanical overload. Interestingly, statistically significant differences were observed subdividing the sample into different groups according to the legal requirements to perform the professional activity of occupational physicians in Italy or according to particular aspects of their professional activity. This study has provided interesting findings that may help to guide future discussion on alternative and additional instruments and/or methodologies that may be adopted to implement the quality and effectiveness of occupational medicine practice. Int J Occup Med Environ Health 2016;29(5):837-858. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Current Calibration Efforts and Performance of the HST Space Telescope Imaging Spectrograph: Echelle Flux Calibration, the BAR5 Occulter, and Lamp Lifetimes

NASA Astrophysics Data System (ADS)

Monroe, TalaWanda R.; Aloisi, Alessandra; Debes, John H.; Jedrzejewski, Robert I.; Lockwood, Sean A.; Peeples, Molly S.; Proffitt, Charles R.; Riley, Allyssa; Walborn, Nolan R.

2016-06-01

The variety of operating modes of the Space Telescope Imaging Spectrograph (STIS) on the Hubble Space Telescope (HST) continues to allow STIS users to obtain unique, high quality observations and cutting-edge results 19 years after its installation on HST. STIS is currently the only instrument available to the astronomy community that allows high spectral and spatial resolution spectroscopy in the FUV and NUV, including echelle modes. STIS also supports solar-blind imaging in the FUV. In the optical, STIS provides long-slit, first-order spectra that take advantage of HST's superb spatial resolution, as well as several unique unfiltered coronagraphic modes, which continue to benefit the exoplanet and debris-disk communities. The STIS instrument team monitors the instrument’s health and performance over time to characterize the effects of radiation damage and continued use of the detectors and optical elements. Additionally, the STIS team continues to improve the quality of data products for the user community. We present updates on efforts to improve the echelle flux calibration of overlapping spectral orders due to changes in the grating blaze function since HST Servicing Mission 4, and efforts to push the contrast limit and smallest inner working angle attainable with the coronagraphic BAR5 occulter. We also provide updates on the performance of the STIS calibration lamps, including work to maintain the accuracy of the wavelength calibration for all modes.

Finite element model updating of a prestressed concrete box girder bridge using subproblem approximation

NASA Astrophysics Data System (ADS)

Chen, G. W.; Omenzetter, P.

2016-04-01

This paper presents the implementation of an updating procedure for the finite element model (FEM) of a prestressed concrete continuous box-girder highway off-ramp bridge. Ambient vibration testing was conducted to excite the bridge, assisted by linear chirp sweepings induced by two small electrodynamic shakes deployed to enhance the excitation levels, since the bridge was closed to traffic. The data-driven stochastic subspace identification method was executed to recover the modal properties from measurement data. An initial FEM was developed and correlation between the experimental modal results and their analytical counterparts was studied. Modelling of the pier and abutment bearings was carefully adjusted to reflect the real operational conditions of the bridge. The subproblem approximation method was subsequently utilized to automatically update the FEM. For this purpose, the influences of bearing stiffness, and mass density and Young's modulus of materials were examined as uncertain parameters using sensitivity analysis. The updating objective function was defined based on a summation of squared values of relative errors of natural frequencies between the FEM and experimentation. All the identified modes were used as the target responses with the purpose of putting more constrains for the optimization process and decreasing the number of potentially feasible combinations for parameter changes. The updated FEM of the bridge was able to produce sufficient improvements in natural frequencies in most modes of interest, and can serve for a more precise dynamic response prediction or future investigation of the bridge health.

Republic of the Marshall Islands assessment for a continuing health care professional development program.

PubMed

Langidrik, Justina R; Riklon, Sheldon; Lanwi, Salome; Gunawardane, Kamal; Soe, Tin; Jack, Tom; Balaoing, Grace Ann; Buenconsejo-Lum, Lee E

2007-03-01

In 2003, the University of Hawai'i Department of Family Medicine and Community Health entered a 4-year cooperative agreement with the U.S. Health Resources and Services Administration to establish the "Pacific Association for Clinical Training" (PACT). PACT's goal is to develop effective distance education methods to improve the education and skills of healthcare professionals in the U.S.-Affiliated Pacific Island nations. To determine the situation existing in 2004, one of PACT's first projects was to perform site visits to each jurisdiction, conducting needs assessments through interviews with key health care professionals, hospital administrators, and government officials. This article highlights findings of PACT's assessment of Republic of the Marshall Islands. Meant to establish a baseline for future reference, all data are those collected in 2004/2005 and have not been updated.

10 CFR 72.248 - Safety analysis report updating.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Safety analysis report updating. 72.248 Section 72.248 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR THE INDEPENDENT STORAGE OF... Approval of Spent Fuel Storage Casks § 72.248 Safety analysis report updating. (a) Each certificate holder...

10 CFR 60.24 - Updating of application and environmental impact statement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Updating of application and environmental impact statement. 60.24 Section 60.24 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) DISPOSAL OF HIGH-LEVEL RADIOACTIVE WASTES IN GEOLOGIC REPOSITORIES Licenses License Applications § 60.24 Updating of application and...

29 CFR 4281.43 - Notices of insolvency and annual updates.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 9 2010-07-01 2010-07-01 false Notices of insolvency and annual updates. 4281.43 Section 4281.43 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION INSOLVENCY... MASS WITHDRAWAL Benefit Suspensions § 4281.43 Notices of insolvency and annual updates. (a) Requirement...

10 CFR 61.22 - Updating of application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Updating of application. 61.22 Section 61.22 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.22 Updating of application. (a) The application must be as complete as possible in the light...

10 CFR 61.22 - Updating of application.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 2 2014-01-01 2014-01-01 false Updating of application. 61.22 Section 61.22 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.22 Updating of application. (a) The application must be as complete as possible in the light...

10 CFR 61.22 - Updating of application.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 2 2013-01-01 2013-01-01 false Updating of application. 61.22 Section 61.22 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.22 Updating of application. (a) The application must be as complete as possible in the light...

10 CFR 61.22 - Updating of application.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 2 2011-01-01 2011-01-01 false Updating of application. 61.22 Section 61.22 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.22 Updating of application. (a) The application must be as complete as possible in the light...

10 CFR 61.22 - Updating of application.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 2 2012-01-01 2012-01-01 false Updating of application. 61.22 Section 61.22 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR LAND DISPOSAL OF RADIOACTIVE WASTE Licenses § 61.22 Updating of application. (a) The application must be as complete as possible in the light...

An Agent-Based Data Mining System for Ontology Evolution

NASA Astrophysics Data System (ADS)

Hadzic, Maja; Dillon, Darshan

We have developed an evidence-based mental health ontological model that represents mental health in multiple dimensions. The ongoing addition of new mental health knowledge requires a continual update of the Mental Health Ontology. In this paper, we describe how the ontology evolution can be realized using a multi-agent system in combination with data mining algorithms. We use the TICSA methodology to design this multi-agent system which is composed of four different types of agents: Information agent, Data Warehouse agent, Data Mining agents and Ontology agent. We use UML 2.1 sequence diagrams to model the collaborative nature of the agents and a UML 2.1 composite structure diagram to model the structure of individual agents. The Mental Heath Ontology has the potential to underpin various mental health research experiments of a collaborative nature which are greatly needed in times of increasing mental distress and illness.

77 FR 58143 - Interagency Task Force on Antimicrobial Resistance (ITFAR): An Update of A Public Health Action...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-19

...-2012-0011] Interagency Task Force on Antimicrobial Resistance (ITFAR): An Update of A Public Health...), Department of Health and Human Services (HHS). ACTION: Notice of public meeting and request for comments... Federal agencies in accomplishing activities outlined in ``A Public Health Action Plan to Combat...

Aircraft engine sensor fault diagnostics using an on-line OBEM update method.

PubMed

Liu, Xiaofeng; Xue, Naiyu; Yuan, Ye

2017-01-01

This paper proposed a method to update the on-line health reference baseline of the On-Board Engine Model (OBEM) to maintain the effectiveness of an in-flight aircraft sensor Fault Detection and Isolation (FDI) system, in which a Hybrid Kalman Filter (HKF) was incorporated. Generated from a rapid in-flight engine degradation, a large health condition mismatch between the engine and the OBEM can corrupt the performance of the FDI. Therefore, it is necessary to update the OBEM online when a rapid degradation occurs, but the FDI system will lose estimation accuracy if the estimation and update are running simultaneously. To solve this problem, the health reference baseline for a nonlinear OBEM was updated using the proposed channel controller method. Simulations based on the turbojet engine Linear-Parameter Varying (LPV) model demonstrated the effectiveness of the proposed FDI system in the presence of substantial degradation, and the channel controller can ensure that the update process finishes without interference from a single sensor fault.

Aircraft engine sensor fault diagnostics using an on-line OBEM update method

PubMed Central

Liu, Xiaofeng; Xue, Naiyu; Yuan, Ye

2017-01-01

This paper proposed a method to update the on-line health reference baseline of the On-Board Engine Model (OBEM) to maintain the effectiveness of an in-flight aircraft sensor Fault Detection and Isolation (FDI) system, in which a Hybrid Kalman Filter (HKF) was incorporated. Generated from a rapid in-flight engine degradation, a large health condition mismatch between the engine and the OBEM can corrupt the performance of the FDI. Therefore, it is necessary to update the OBEM online when a rapid degradation occurs, but the FDI system will lose estimation accuracy if the estimation and update are running simultaneously. To solve this problem, the health reference baseline for a nonlinear OBEM was updated using the proposed channel controller method. Simulations based on the turbojet engine Linear-Parameter Varying (LPV) model demonstrated the effectiveness of the proposed FDI system in the presence of substantial degradation, and the channel controller can ensure that the update process finishes without interference from a single sensor fault. PMID:28182692

Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges

PubMed Central

2017-01-01

Infectious diseases are a significant burden on public health and economic stability of societies all over the world. They have for centuries been among the leading causes of death and disability and presented growing challenges to health security and human progress. The threat posed by infectious diseases is further deepened by the continued emergence of new, unrecognized, and old infectious disease epidemics of global impact. Over the past three and half decades at least 30 new infectious agents affecting humans have emerged, most of which are zoonotic and their origins have been shown to correlate significantly with socioeconomic, environmental, and ecological factors. As these factors continue to increase, putting people in increased contact with the disease causing pathogens, there is concern that infectious diseases may continue to present a formidable challenge. Constant awareness and pursuance of effective strategies for controlling infectious diseases and disease emergence thus remain crucial. This review presents current updates on emerging and neglected infectious diseases and highlights the scope, dynamics, and advances in infectious disease management with particular focus on WHO top priority emerging infectious diseases (EIDs) and neglected tropical infectious diseases. PMID:28286767

Emerging and Neglected Infectious Diseases: Insights, Advances, and Challenges.

PubMed

Nii-Trebi, Nicholas Israel

2017-01-01

Infectious diseases are a significant burden on public health and economic stability of societies all over the world. They have for centuries been among the leading causes of death and disability and presented growing challenges to health security and human progress. The threat posed by infectious diseases is further deepened by the continued emergence of new, unrecognized, and old infectious disease epidemics of global impact. Over the past three and half decades at least 30 new infectious agents affecting humans have emerged, most of which are zoonotic and their origins have been shown to correlate significantly with socioeconomic, environmental, and ecological factors. As these factors continue to increase, putting people in increased contact with the disease causing pathogens, there is concern that infectious diseases may continue to present a formidable challenge. Constant awareness and pursuance of effective strategies for controlling infectious diseases and disease emergence thus remain crucial. This review presents current updates on emerging and neglected infectious diseases and highlights the scope, dynamics, and advances in infectious disease management with particular focus on WHO top priority emerging infectious diseases (EIDs) and neglected tropical infectious diseases.

Japanese Encephalitis Surveillance and Immunization - Asia and Western Pacific Regions, 2016.

PubMed

Heffelfinger, James D; Li, Xi; Batmunkh, Nyambat; Grabovac, Varja; Diorditsa, Sergey; Liyanage, Jayantha B; Pattamadilok, Sirima; Bahl, Sunil; Vannice, Kirsten S; Hyde, Terri B; Chu, Susan Y; Fox, Kimberley K; Hills, Susan L; Marfin, Anthony A

2017-06-09

Japanese encephalitis (JE) virus is the most important vaccine-preventable cause of encephalitis in the Asia-Pacific region. The World Health Organization (WHO) recommends integration of JE vaccination into national immunization schedules in all areas where the disease is a public health priority (1). This report updates a previous summary of JE surveillance and immunization programs in Asia and the Western Pacific in 2012 (2). Since 2012, funding for JE immunization has become available through the GAVI Alliance, three JE vaccines have been WHO-prequalified,* and an updated WHO JE vaccine position paper providing guidance on JE vaccines and vaccination strategies has been published (1). Data for this report were obtained from a survey of JE surveillance and immunization practices administered to health officials in countries with JE virus transmission risk, the 2015 WHO/United Nations Children's Fund Joint Reporting Form on Immunization, notes and reports from JE meetings held during 2014-2016, published literature, and websites. In 2016, 22 (92%) of 24 countries with JE virus transmission risk conducted JE surveillance, an increase from 18 (75%) countries in 2012, and 12 (50%) countries had a JE immunization program, compared with 11 (46%) countries in 2012. Strengthened JE surveillance, continued commitment, and adequate resources for JE vaccination should help maintain progress toward prevention and control of JE.

76 FR 12074 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-04

... notice provides the updated regional per-diem rates for low-volume mental health providers; the update... beneficiary per-diem cost-share amount for low-volume providers; and, the updated per-diem rates for both full... psychiatric hospitals and units with low TRICARE volume will have their TRICARE rates for Fiscal Year 2011...

Update: Investigations of West Nile virus infections in recipients of organ transplantation and blood transfusion--Michigan, 2002.

PubMed

2002-10-04

On September 27, 2002, this report was posted on the MMWR website (http://www.cdc.gov/mmwr). CDC, the Food and Drug Administration (FDA), the Health Resources and Services Administration (HRSA), and state and local health departments continue to investigate West Nile virus (WNV) infections in recipients of organ transplantation and blood transfusion. This report summarizes two investigations of Michigan recipients of blood products, one of whom also received a liver transplant. Both persons tested positive for WNV infection after receiving blood products derived from a single blood donation subsequently found to have evidence of WNV. These investigations provide further evidence that WNV is transmitted through blood transfusion.

The xenotropic murine leukemia virus-related retrovirus debate continues at first international workshop.

PubMed

Stoye, Jonathan P; Silverman, Robert H; Boucher, Charles A; Le Grice, Stuart F J

2010-12-22

The 1st International Workshop on Xenotropic Murine Leukemia Virus-Related Retrovirus (XMRV), co-sponsored by the National Institutes of Health, The Department of Health and Human Services and Abbott Diagnostics, was convened on September 7/8, 2010 on the NIH campus, Bethesda, MD. Attracting an international audience of over 200 participants, the 2-day event combined a series of plenary talks with updates on different aspects of XMRV research, addressing basic gammaretrovirus biology, host response, association of XMRV with chronic fatigue syndrome and prostate cancer, assay development and epidemiology. The current status of XMRV research, concerns among the scientific community and suggestions for future actions are summarized in this meeting report.

Data Management for a Climate Data Record in an Evolving Technical Landscape

NASA Astrophysics Data System (ADS)

Moore, K. D.; Walter, J.; Gleason, J. L.

2017-12-01

For nearly twenty years, NASA Langley Research Center's Clouds and the Earth's Radiant Energy System (CERES) Science Team has been producing a suite of data products that forms a persistent climate data record of the Earth's radiant energy budget. Many of the team's physical scientists and key research contributors have been with the team since the launch of the first CERES instrument in 1997. This institutional knowledge is irreplaceable and its longevity and continuity are among the reasons that the team has been so productive. Such legacy involvement, however, can also be a limiting factor. Some CERES scientists-cum-coders might possess skills that were state-of-the-field when they were emerging scientists but may now be outdated with respect to developments in software development best practices and supporting technologies. Both programming languages and processing frameworks have evolved significantly in the past twenty years, and updating one of these factors warrants consideration of updating the other. With the imminent launch of a final CERES instrument and the good health of those in flight, the CERES data record stands to continue far into the future. The CERES Science Team is, therefore, undergoing a re-architecture of its codebase to maintain compatibility with newer data processing platforms and technologies and to leverage modern software development best practices. This necessitates training our staff and consequently presents several challenges, including: Development continues immediately on the next "edition" of research algorithms upon release of the previous edition. How can code be rewritten at the same time that the science algorithms are being updated and integrated? With limited time to devote to training, how can we update the staff's existing skillset without slowing progress or introducing new errors? The CERES Science Team is large and complex, much like the current state of its codebase. How can we identify, in a breadth-wise manner, areas for code improvement across multiple research groups that maintain code with varying semantics but common concepts? In this work, we discuss the successes and pitfalls of this major re-architecture effort and share how we will sustain improvement into the future.

Examining the role of gender in career advancement at the Centers for Disease Control and Prevention.

PubMed

Chen, Zhuo; Roy, Kakoli; Gotway Crawford, Carol A

2010-03-01

During the past decade, efforts to promote gender parity in the healing and public health professions have met with only partial success. We provide a critical update regarding the status of women in the public health profession by exploring gender-related differences in promotion rates at the nation's leading public health agency, the Centers for Disease Control and Prevention (CDC). Using personnel data drawn from CDC, we found that the gender gap in promotion has diminished across time and that this reduction can be attributed to changes in individual characteristics (e.g., higher educational levels and more federal work experience). However, a substantial gap in promotion that cannot be explained by such characteristics has persisted, indicating continuing barriers in women's career advancement.

Examining the Role of Gender in Career Advancement at the Centers for Disease Control and Prevention

PubMed Central

Roy, Kakoli; Gotway Crawford, Carol A.

2010-01-01

During the past decade, efforts to promote gender parity in the healing and public health professions have met with only partial success. We provide a critical update regarding the status of women in the public health profession by exploring gender-related differences in promotion rates at the nation's leading public health agency, the Centers for Disease Control and Prevention (CDC). Using personnel data drawn from CDC, we found that the gender gap in promotion has diminished across time and that this reduction can be attributed to changes in individual characteristics (e.g., higher educational levels and more federal work experience). However, a substantial gap in promotion that cannot be explained by such characteristics has persisted, indicating continuing barriers in women's career advancement. PMID:20075327

Geriatric Education in the Health Professions: Are We Making Progress?

PubMed Central

Bardach, Shoshana H.; Rowles, Graham D.

2012-01-01

Purpose: Relative to the overall population, older adults consume a disproportionally large percentage of health care resources. Despite advocacy and efforts initiated more than 30 years ago, the number of providers with specialized training in geriatrics is still not commensurate with the growing population of older adults. This contribution provides a contemporary update on the status of geriatric education and explores how geriatric coverage is valued, how geriatric competence is defined, and how students are evaluated for geriatric competencies. Design and Methods: Semi-structured interviews were conducted with curriculum representatives from 7 health profession disciplines in a case study of one academic medical center. Findings: Geriatric training varies across health professions’ disciplines. Although participants recognized the unique needs of older patients and valued geriatric coverage, they identified shortage of time in packed curricula, lack of geriatrics-trained educators, absence of financial incentive, and low student demand (resulting from limited exposure to older adults and gerontological stereotyping) as barriers to improving geriatric training. Implications: Progress in including geriatric training within curricula across the health professions continues to lag behind need as a result of the continuing presence of barriers identified several decades ago. There remains an urgent need for institutional commitment to enhance geriatric education as a component of health professions curricula. PMID:22394495

Update on inflation of journal prices: Brandon/Hill list journals and the scientific, technical, and medical publishing market.

PubMed

Schlimgen, Joan B; Kronenfeld, Michael R

2004-07-01

The original study of journal prices, using the "Brandon/ Hill Selected List of Books and Journals for the Small Medical Library," was first published in 1980 and periodically updated. This research continues to measure price increases for these titles for the periods 1996 to 1999 and 1999 to 2002. The 111 journal titles that have appeared in each published list from 1967 to 2001 were included in the study. Institutional subscription price data were gathered for each journal for the years 1996, 1999, and 2002 and were compared to the Consumer Price Index (CPI) for the same years. The average journal price continues to rise significantly and is independent of the CPI. The study found that prices have jumped 51.9% from 1996 to 1999 and 32% from 1999 to 2002, which is consistent with nearly every recent journal price study. The unprecedented rise in journal prices negatively affects the purchasing power of medical libraries. This paper examines the economic and technological pressures on the science, technology, and medical journals market that contribute to high prices and identifies a number of initiatives in the biological and health sciences that utilize alternative models for disseminating scientific research.

Costs And Savings Associated With Community Water Fluoridation In The United States.

PubMed

O'Connell, Joan; Rockell, Jennifer; Ouellet, Judith; Tomar, Scott L; Maas, William

2016-12-01

The most comprehensive study of US community water fluoridation program benefits and costs was published in 2001. This study provides updated estimates using an economic model that includes recent data on program costs, dental caries increments, and dental treatments. In 2013 more than 211 million people had access to fluoridated water through community water systems serving 1,000 or more people. Savings associated with dental caries averted in 2013 as a result of fluoridation were estimated to be $32.19 per capita for this population. Based on 2013 estimated costs ($324 million), net savings (savings minus costs) from fluoridation systems were estimated to be $6,469 million and the estimated return on investment, 20.0. While communities should assess their specific costs for continuing or implementing a fluoridation program, these updated findings indicate that program savings are likely to exceed costs. Project HOPE—The People-to-People Health Foundation, Inc.

SWEIS annual review - CY2002 : a comparison of CY2002 operations to projections included in the site-wide environmental impact statement for continued operation of Sandia National Laboratories/New Mexico.

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

Bayliss, Linda Sue; White, Brenda Bailey; Guerrero, Joseph Vincent

2003-10-01

The SNL/NM CY2002 SWEIS Annual Review discusses changes in facilities and facility operations that have occurred in selected and notable facilities since source data were collected for the SNL/NM SWEIS (DOE/EIS-0281). The following information is presented: {sm_bullet} An updated overview of SNL/NM selected and notable facilities and infrastructure capabilities. {sm_bullet} An overview of SNL/NM environment, safety, and health programs, including summaries of the purpose, operations, activities, hazards, and hazard controls at relevant facilities and risk management methods for SNL/NM. {sm_bullet} Updated base year activities data, together with related inventories, material consumption, emissions, waste, and resource consumption. {sm_bullet} Appendices summarizing activitiesmore » and related hazards at SNL/NM individual special, general, and highbay laboratories, and chemical purchases.« less

An update on radioactive release and exposures after the Fukushima Dai-ichi nuclear disaster

PubMed Central

Mclaughlin, P D; Jones, B; Maher, M M

2012-01-01

On 11 March 2011, the Richter scale 0.9-magnitude Tokohu earthquake and tsunami struck the northeast coast of Japan, resulting in widespread injury and loss of life. Compounding this tragic loss of life, a series of equipment and structural failures at the Fukushima Dai-ichi nuclear power plant (FDNP) resulted in the release of many volatile radioisotopes into the atmosphere. In this update, we detail currently available evidence about the nature of immediate radioactive exposure to FDNP workers and the general population. We contrast the nature of the radioactive exposure at FDNP with that which occurred at the Chernobyl power plant 25 years previously. Prediction of the exact health effects related to the FDNP release is difficult at present and this disaster provides the scientific community with a challenge to help those involved and to continue research that will improve our understanding of the potential complications of radionuclide fallout. PMID:22919005

An update on radioactive release and exposures after the Fukushima Dai-ichi nuclear disaster.

PubMed

McLaughlin, P D; Jones, B; Maher, M M

2012-09-01

On 11 March 2011, the Richter scale 0.9-magnitude Tokohu earthquake and tsunami struck the northeast coast of Japan, resulting in widespread injury and loss of life. Compounding this tragic loss of life, a series of equipment and structural failures at the Fukushima Dai-ichi nuclear power plant (FDNP) resulted in the release of many volatile radioisotopes into the atmosphere. In this update, we detail currently available evidence about the nature of immediate radioactive exposure to FDNP workers and the general population. We contrast the nature of the radioactive exposure at FDNP with that which occurred at the Chernobyl power plant 25 years previously. Prediction of the exact health effects related to the FDNP release is difficult at present and this disaster provides the scientific community with a challenge to help those involved and to continue research that will improve our understanding of the potential complications of radionuclide fallout.

Bioelectrical impedance methods in clinical research: a follow-up to the NIH Technology Assessment Conference.

PubMed

Ellis, K J; Bell, S J; Chertow, G M; Chumlea, W C; Knox, T A; Kotler, D P; Lukaski, H C; Schoeller, D A

1999-01-01

In 1994, the National Institutes of Health (NIH) convened a Technology Assessment Conference "to provide physicians with a responsible assessment of bioelectrical impedance analysis (BIA) technology for body composition measurement." In 1997, Serono Symposia USA, Inc., organized an invited panel of scientists and clinicians, with extensive research and clinical experience with BIA, to provide an update. Panel members presented reviews based on their own work and published studies for the intervening years. Updates were provided on the single and multifrequency BIA methods and models; continued clinical research experiences; efforts toward establishing population reference norms; and the feasibility of establishing guidelines for potential diagnostic use of BIA in a clinical setting. This report provides a summary of the panel's findings including a consensus on several technical and clinical issues related to the research use of BIA, and those areas that are still in need of additional study.

Recurrent urinary tract infection.

PubMed

Epp, Annette; Larochelle, Annick

2010-11-01

to provide an update of the definition, epidemiology, clinical presentation, investigation, treatment, and prevention of recurrent urinary tract infections in women. continuous antibiotic prophylaxis, post-coital antibiotic prophylaxis, and acute self-treatment are all efficient alternatives to prevent recurrent urinary tract infection. Vaginal estrogen and cranberry juice can also be effective prophylaxis alternatives. a search of PubMed and The Cochrane Library for articles published in English identified the most relevant literature. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date restrictions. this update is the consensus of the Sub-Committee on Urogynaecology of the Society of Obstetricians and Gynaecologists of Canada. Recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). recurrent urinary tract infections need careful investigation and can be efficiently treated and prevented. Different prophylaxis options can be selected according to each patient's characteristics.

Medical support of the Sinai Multinational Force and Observers: an update, 2001.

PubMed

Rowe, John R

2003-02-01

The Multinational Force and Observers is an 11-nation coalition force with the mission of peacekeeping in the Sinai. It commenced operations in 1982 and continues today after two decades of successful enforcement of the 1979 Egyptian-Israeli Treaty of Peace. The fielding of a medical support team for this mission was the first effort of its kind for the U.S. Army Medical Department, resulting in a uniquely organized medical unit. A U.S. Army physician heads the medical team, which includes nine other physicians from six different countries. The team provides health care for the 2,500-person coalition in the remote Sinai desert. This writing compares earlier medical support with that of August 2000 through July 2001 and describes medical conditions and problems encountered during the 12-month tour of duty. This article updates two previous articles on the subject published in Military Medicine in 1983 and 1991.

Use of restraints

MedlinePlus

... Commission website. The Comprehensive Accreditation Manual for Hospitals: Human Resources. www.jointcommission.org . Updated January 1, 2015. Accessed October 27, 2017. Review Date 11/20/2017 ... of Health and Human Services National Institutes of Health Page last updated: ...

Updating the definition and role of public health nursing to advance and guide the specialty.

PubMed

Bekemeier, Betty; Walker Linderman, Tessa; Kneipp, Shawn; Zahner, Susan J

2015-01-01

National changes in the context for public health services are influencing the nature of public health nursing practice. Despite this, the document that defines public health nursing as a specialty--The Definition and Role of Public Health Nursing--has remained in wide use since its publication in 1996 without a review or update. With support from the American Public Health Association (APHA) Public Health Nursing Section, a national Task Force, was formed in November 2012 to update the definition of public health nursing, using processes that reflected deliberative democratic principles. A yearlong process was employed that included a modified Delphi technique and various modes of engagement such as online discussion boards, questionnaires, and public comment to review. The resulting 2013 document consisted of a reaffirmation of the one-sentence 1996 definition, while updating supporting documentation to align with the current social, economic, political, and health care context. The 2013 document was strongly endorsed by vote of the APHA Public Health Nursing Section elected leadership. The 2013 definition and document affirm the relevance of a population-focused definition of public health nursing to complex systems addressed in current practice and articulate critical roles of public health nurses (PHN) in these settings. © 2014 Wiley Periodicals, Inc.

Overview of the National Health Educator Competencies Update Project, 1998-2004

ERIC Educational Resources Information Center

Gilmore, Gary David; Olsen, Larry K.; Taub, Alyson; Connell, David

2005-01-01

The National Health Educator Competencies Update Project (CUP), conducted during 1998-2004, addressed what health educators currently do in practice, the degree to which the role definition of the entry-level health educator is still up-to-date, and the validation of advanced-level competencies. A 19-page questionnaire was sent to a representative…

40 CFR 53.9 - Conditions of designation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... continue to do so only so long as updates of the Product Manufacturing Checklist set forth in subpart E of this part are submitted annually. In the event that an annual Checklist update is not received by EPA within 12 months of the date of the last such submitted Checklist or Checklist update, EPA shall notify...

40 CFR 53.9 - Conditions of designation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... FEM may continue to do so only so long as updates of the Product Manufacturing Checklist set forth in subpart E of this part are submitted annually. In the event that an annual Checklist update is not received by EPA within 12 months of the date of the last such submitted Checklist or Checklist update, EPA...

40 CFR 53.9 - Conditions of designation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... FEM may continue to do so only so long as updates of the Product Manufacturing Checklist set forth in subpart E of this part are submitted annually. In the event that an annual Checklist update is not received by EPA within 12 months of the date of the last such submitted Checklist or Checklist update, EPA...

Control of Interference during Working Memory Updating

ERIC Educational Resources Information Center

Szmalec, Arnaud; Verbruggen, Frederick; Vandierendonck, Andre; Kemps, Eva

2011-01-01

The current study examined the nature of the processes underlying working memory updating. In 4 experiments using the n-back paradigm, the authors demonstrate that continuous updating of items in working memory prevents strong binding of those items to their contexts in working memory, and hence leads to an increased susceptibility to proactive…

[The German program for disease management guidelines. Results and perspectives].

PubMed

Ollenschläger, Günter; Kopp, Ina

2007-05-15

The Program for National Disease Management Guidelines (German DM-CPG Program) is a joint initiative of the German Medical Association (umbrella organization of the German Chambers of Physicians), the Association of the Scientific Medical Societies (AWMF), and of the National Association of Statutory Health Insurance Physicians (NASHIP). The program aims at developing, implementing and continuously updating best-practice recommendations for countrywide and regional disease management programs in Germany. Since 2003 twelve national guidelines (topics: asthma, chronic obstructive pulmonary disease, HI (Chronic heart failure), CVD (Chronic coronary heart disease) back pain, depression, several aspects of diabetes) have been produced by use of a standardized procedure in accordance with internationally consented methodologies. For countrywide dissemination and implementation the program uses a wide range of specialist journals, continuous medical education and quality management programs. So far, 36 out of 150 national scientific medical associations, four allied health profession organizations, and twelve national consumer organizations have been participating in the DM-CPG Program. Studies to evaluate the program's effects on health-care providers' behavior and patients' outcomes are under way.

Addressing Children's Oral Health in the New Millennium: Trends in the Dental Workforce

PubMed Central

Mertz, Elizabeth; Mouradian, Wendy

2009-01-01

The Surgeon General's Report on Oral Health (SGROH) and the Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist to population ratio is declining, while mal-distribution of dentists continues for rural and underserved communities. The diversity of the dental workforce has only improved slightly, while the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include: enhanced training in children's oral health for general dentists; expanded scope of practice for allied dental health professionals; new dental practitioners including the dental health aid therapist; and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts and strong partnerships with communities will be needed to effect substantive changes in children's oral health. PMID:19854121

Addressing children's oral health in the new millennium: trends in the dental workforce.

PubMed

Mertz, Elizabeth; Mouradian, Wendy E

2009-01-01

Oral Health in America: A Report of the Surgeon General (SGROH) and National Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity, and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist-to-population ratio is declining while shortages of dentists continue in rural and underserved communities. The diversity of the dental workforce has only improved slightly, and the the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include enhanced training in children's oral health for general dentists, expanded scope of practice for allied dental health professionals, new dental practitioners including the dental health aid therapist, and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts, and strong partnerships with communities will be needed to effect substantive changes in children's oral health.

The EPA Children’s Environmental Health Yearbook Supplement (2000)

EPA Pesticide Factsheets

New projects and updates to some ongoing projects already described in the 1998 Yearbook, including sections on asthma, childhood cancer, developmental/neurological toxicity, pesticides, contaminated water, and updated list of Children's Health Resources.

77 FR 64524 - Advisory Committee on Infant Mortality; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-22

... the Healthy Start Program and Healthy People 2020 infant mortality objectives. Agenda: Topics that will be discussed include the following: HRSA Update; Maternal and Child Health Bureau Update; Healthy Start Program Update; Updates from Partnering Agencies and Organizations; and ACIM's recommendations for...

The role of fMRI in drug development

PubMed Central

Carmichael, Owen; Schwarz, Adam J.; Chatham, Christopher H.; Scott, David; Turner, Jessica A.; Upadhyay, Jaymin; Coimbra, Alexandre; Goodman, James A.; Baumgartner, Richard; English, Brett A.; Apolzan, John W.; Shankapal, Preetham; Hawkins, Keely R.

2017-01-01

Functional magnetic resonance imaging (fMRI) has been known for over a decade to have the potential to greatly enhance the process of developing novel therapeutic drugs for prevalent health conditions. However, the use of fMRI in drug development continues to be relatively limited because of a variety of technical, biological, and strategic barriers that continue to limit progress. Here, we briefly review the roles that fMRI can have in the drug development process and the requirements it must meet to be useful in this setting. We then provide an update on our current understanding of the strengths and limitations of fMRI as a tool for drug developers and recommend activities to enhance its utility. PMID:29154758

Federal employees health benefits acquisition regulation: large provider agreements, subcontracts, and miscellaneous changes. Final rule.

PubMed

2005-06-01

The Office of Personnel Management (OPM) is issuing this final regulation to amend the Federal Employees Health Benefits Acquisition Regulation (FEHBAR). It establishes requirements, including audit, for Federal Employees Health Benefits Program (FEHB) experience-rated carriers' Large Provider Agreements. It also modifies the dollar threshold for review of carriers' subcontract agreements; revises the definitions of Cost or Pricing Data and Experience-rate to reflect mental health parity requirements; updates the contract records retention requirement; updates the FEHB Clause Matrix; and conforms subpart and paragraph references to Federal Acquisition Regulation (FAR) revisions made since we last updated the FEHBAR.

McMaster Optimal Aging Portal: an evidence-based database for geriatrics-focused health professionals.

PubMed

Barbara, Angela M; Dobbins, Maureen; Brian Haynes, R; Iorio, Alfonso; Lavis, John N; Raina, Parminder; Levinson, Anthony J

2017-07-11

The objective of this work was to provide easy access to reliable health information based on good quality research that will help health care professionals to learn what works best for seniors to stay as healthy as possible, manage health conditions and build supportive health systems. This will help meet the demands of our aging population that clinicians provide high quality care for older adults, that public health professionals deliver disease prevention and health promotion strategies across the life span, and that policymakers address the economic and social need to create a robust health system and a healthy society for all ages. The McMaster Optimal Aging Portal's (Portal) professional bibliographic database contains high quality scientific evidence about optimal aging specifically targeted to clinicians, public health professionals and policymakers. The database content comes from three information services: McMaster Premium LiteratUre Service (MacPLUS™), Health Evidence™ and Health Systems Evidence. The Portal is continually updated, freely accessible online, easily searchable, and provides email-based alerts when new records are added. The database is being continually assessed for value, usability and use. A number of improvements are planned, including French language translation of content, increased linkages between related records within the Portal database, and inclusion of additional types of content. While this article focuses on the professional database, the Portal also houses resources for patients, caregivers and the general public, which may also be of interest to geriatric practitioners and researchers.

Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society.

PubMed

Oeffinger, Kevin C; Fontham, Elizabeth T H; Etzioni, Ruth; Herzig, Abbe; Michaelson, James S; Shih, Ya-Chen Tina; Walter, Louise C; Church, Timothy R; Flowers, Christopher R; LaMonte, Samuel J; Wolf, Andrew M D; DeSantis, Carol; Lortet-Tieulent, Joannie; Andrews, Kimberly; Manassaram-Baptiste, Deana; Saslow, Debbie; Smith, Robert A; Brawley, Otis W; Wender, Richard

2015-10-20

Breast cancer is a leading cause of premature mortality among US women. Early detection has been shown to be associated with reduced breast cancer morbidity and mortality. To update the American Cancer Society (ACS) 2003 breast cancer screening guideline for women at average risk for breast cancer. The ACS commissioned a systematic evidence review of the breast cancer screening literature to inform the update and a supplemental analysis of mammography registry data to address questions related to the screening interval. Formulation of recommendations was based on the quality of the evidence and judgment (incorporating values and preferences) about the balance of benefits and harms. Screening mammography in women aged 40 to 69 years is associated with a reduction in breast cancer deaths across a range of study designs, and inferential evidence supports breast cancer screening for women 70 years and older who are in good health. Estimates of the cumulative lifetime risk of false-positive examination results are greater if screening begins at younger ages because of the greater number of mammograms, as well as the higher recall rate in younger women. The quality of the evidence for overdiagnosis is not sufficient to estimate a lifetime risk with confidence. Analysis examining the screening interval demonstrates more favorable tumor characteristics when premenopausal women are screened annually vs biennially. Evidence does not support routine clinical breast examination as a screening method for women at average risk. The ACS recommends that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years (strong recommendation). Women aged 45 to 54 years should be screened annually (qualified recommendation). Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually (qualified recommendation). Women should have the opportunity to begin annual screening between the ages of 40 and 44 years (qualified recommendation). Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer (qualified recommendation). The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age (qualified recommendation). These updated ACS guidelines provide evidence-based recommendations for breast cancer screening for women at average risk of breast cancer. These recommendations should be considered by physicians and women in discussions about breast cancer screening.

Emergency medical kit for commercial airlines: an update.

PubMed

Thibeault, Claude

2002-06-01

As expected, the issue of medical kits for commercial airlines continues to attract attention, especially in light of the recent United States regulation on the subject. As promised in its first recommendation in 1998, the Air Transport Medicine (ATM) Committee has continued to monitor medical kit usage as well as pharmaceutical scientific developments and wishes to propose an update to its 1998 recommendation. Lists of contents are provided for emergency medical kits of two types: 1) those without defibrillator/monitor or monitor; and 2) those with defibrillator/monitor or monitor alone. Follow up and updates on this issue will be an ongoing task of the ATM Committee.

To Your Health: NLM update transcript - Genetic architecture of mental disorders

MedlinePlus

... html To Your Health: NLM update Transcript Genetic architecture of mental disorders : 04/30/2018 To use ... disorders may have a distinctive molecular or genetic architecture that may provide a way to better diagnose ...

Primary healthcare reform in the United Nations Relief and Works Agency for Palestine Refugees in the Near East.

PubMed

Santoro, A; Abu-Rmeileh, N; Khader, A; Seita, A; McKee, M

2016-09-25

Palestinian refugees served by the United Nation Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) are experiencing increasing rates of diagnosis of non-communicable diseases. In response, in 2011 UNRWA initiated an Agency-wide programme of primary healthcare reform, informed by the Chronic Care Model framework. Health services were reorganized following a family-centred approach, with delivery by multidisciplinary family health teams supported by updated technical advice. An inclusive clinical information system, termed e-Health, was implemented to collect a wide range of health information, with a focus on continuity of treatment. UNRWA was able to bring about these wide-ranging changes within its existing resources, reallocating finances, reforming its payment mechanisms, and modernizing its drug-procurement policies. While specific components of UNRWA's primary healthcare reform are showing promising results, additional efforts are needed to empower patients further and to strengthen involvement of the community.

Development of the Updating Executive Function: From 7-Year-Olds to Young Adults

ERIC Educational Resources Information Center

Carriedo, Nuria; Corral, Antonio; Montoro, Pedro R.; Herrero, Laura; Rucián, Mercedes

2016-01-01

Updating information in working memory (WM) is a critical executive function responsible both for continuously replacing outdated information with new relevant data and to suppress or inhibit content that is no longer relevant according to task demands. The goal of the present research is twofold: First, we aimed to study updating development in…

Treatment 2.0: catalyzing the next phase of treatment, care and support.

PubMed

Duncombe, Chris; Ball, Andrew; Passarelli, Carlos; Hirnschall, Gottfried

2013-01-01

This review provides an update on the WHO/UNAIDS Treatment 2.0 strategy by reviewing the documents and technical updates issued under the initiative. Launched in 2010, this global initiative provides a framework for the continued scale-up of access to HIV care and treatment. WHO has prioritized once daily fixed-dose combination as the preferred antiretroviral (ARV) regimen to initiate HIV treatment, paving the way for programmatic simplification, with reduced toxicity and improved adherence. WHO also recommends the use of point-of-care diagnostics, with CD4 cell count technologies being implemented in the field and progress towards improving access to simplified viral load testing. The strategy also seeks mechanisms that can contribute to reducing treatment costs, such as pooled commodity procurement and public health-oriented licensing approaches. Improved service delivery, specifically through decentralization, task shifting, integration and community mobilization also has the potential to reduce costs and improve access. Support to countries has been provided through the timely release of a series of programmatic and technical updates on specific treatment-related topics. The Treatment 2.0 strategy articulates how innovation and greater efficiency can make HIV care and treatment more accessible and affordable, and guide treatment and prevention scale-up.

Fast Updating National Geo-Spatial Databases with High Resolution Imagery: China's Methodology and Experience

NASA Astrophysics Data System (ADS)

Chen, J.; Wang, D.; Zhao, R. L.; Zhang, H.; Liao, A.; Jiu, J.

2014-04-01

Geospatial databases are irreplaceable national treasure of immense importance. Their up-to-dateness referring to its consistency with respect to the real world plays a critical role in its value and applications. The continuous updating of map databases at 1:50,000 scales is a massive and difficult task for larger countries of the size of more than several million's kilometer squares. This paper presents the research and technological development to support the national map updating at 1:50,000 scales in China, including the development of updating models and methods, production tools and systems for large-scale and rapid updating, as well as the design and implementation of the continuous updating workflow. The use of many data sources and the integration of these data to form a high accuracy, quality checked product were required. It had in turn required up to date techniques of image matching, semantic integration, generalization, data base management and conflict resolution. Design and develop specific software tools and packages to support the large-scale updating production with high resolution imagery and large-scale data generalization, such as map generalization, GIS-supported change interpretation from imagery, DEM interpolation, image matching-based orthophoto generation, data control at different levels. A national 1:50,000 databases updating strategy and its production workflow were designed, including a full coverage updating pattern characterized by all element topographic data modeling, change detection in all related areas, and whole process data quality controlling, a series of technical production specifications, and a network of updating production units in different geographic places in the country.

Oral Infections and Pregnancy: Knowledge of Gynecologists/Obstetricians, Midwives and Dentists.

PubMed

Boutigny, Hervé; de Moegen, Marie-Laure; Egea, Luc; Badran, Zahi; Boschin, François; Delcourt-Debruyne, Elisabeth; Soueidan, Assem

2016-01-01

To establish an inventory of knowledge, attitudes and daily pratice of dental and medical practitioners in France regarding oral health care and its relationship to pregnancy, particularly to preterm delivery and low birth-weight infants. A questionnaire was distributed to health-care professionals (n= 460), consisting of 100 prenatal care practitioners (obstetricians, midwives) and 360 dentists, about their knowledge of oral alterations during pregnancy, the possible association between periodontal disorders and preterm/low birth weight, and their conduct toward their patients. Bleeding gums and pregnancy gingivitis were the oral manifestations most often cited by all the practitioners. In contrast, prenatal care practitioners were unaware of epulis and a greater percentage of them than dentists believed caries risk to increase during pregnancy. The most adverse pregnancy outcomes cited were risk of premature delivery and chorioamniotis. Only dentists had received initial training on pregnancy complications. Finally, all health professionals point out the lack of continuing education on this topic. The present results underline the need for a better initial professional education and continuing education regarding pregnancy and oral health conditions and emphasise the need to update the guidelines in health care practices for pregnant women for a more effective prevention of risk-related adverse pregnancy outcomes, such as pre-term birth or pre-eclampsia.

World Health Organization Ranking of Antimicrobials According to Their Importance in Human Medicine: A Critical Step for Developing Risk Management Strategies to Control Antimicrobial Resistance From Food Animal Production.

PubMed

Collignon, Peter C; Conly, John M; Andremont, Antoine; McEwen, Scott A; Aidara-Kane, Awa; Agerso, Yvonne; Andremont, Antoine; Collignon, Peter; Conly, John; Dang Ninh, Tran; Donado-Godoy, Pilar; Fedorka-Cray, Paula; Fernandez, Heriberto; Galas, Marcelo; Irwin, Rebecca; Karp, Beth; Matar, Gassan; McDermott, Patrick; McEwen, Scott; Mitema, Eric; Reid-Smith, Richard; Scott, H Morgan; Singh, Ruby; DeWaal, Caroline Smith; Stelling, John; Toleman, Mark; Watanabe, Haruo; Woo, Gun-Jo

2016-10-15

Antimicrobial use in food animals selects for antimicrobial resistance in bacteria, which can spread to people. Reducing use of antimicrobials-particularly those deemed to be critically important for human medicine-in food production animals continues to be an important step for preserving the benefits of these antimicrobials for people. The World Health Organization ranking of antimicrobials according to their relative importance in human medicine was recently updated. Antimicrobials considered the highest priority among the critically important antimicrobials were quinolones, third- and fourth-generation cephalosporins, macrolides and ketolides, and glycopeptides. The updated ranking allows stakeholders in the agriculture sector and regulatory agencies to focus risk management efforts on drugs used in food animals that are the most important to human medicine. In particular, the current large-scale use of fluoroquinolones, macrolides, and third-generation cephalosporins and any potential use of glycopeptides and carbapenems need to be addressed urgently. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Accomplishments Under the Airport Improvement Program. Fiscal year 1987.

DTIC Science & Technology

1987-01-01

APRON PORTLAND INTERNATIONAL JETPORT (PRIMARY) 17 $312,300 INSTALL RUNWAY LIGHTING SYSTEM 1B $1,481,738 EXTENDAPRON PRESQUE ISLE 06 $99,000 RECONSTRUCT...LOCATION AND PROJECT FEDERAL NAME OF AIRPORT NUMBER FUNDS DESCRIPTION OF WORK o PENNSYLVANIA S4 $198,000 CONDUCT STATE SYSTEM PLAN UPDATE COMMONWEALTH...OF PENNSYLVANIA (CONTINUOUS) (SYSTEM PLAN) R5 $200,000 CONDUCT REGIONAL SYSTEM PLAN UPDATE DELAWARE VALLEY REGION (CONTINUOUS) (SYSTEM PLAN) RS

Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

PubMed

2016-11-03

This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

Barrio Adentro and the reduction of health inequalities in Venezuela: an appraisal of the first years.

PubMed

Armada, Francisco; Muntaner, Caries; Chung, Haejoo; Williams-Brennan, Leslie; Benach, Joan

2009-01-01

This article presents an update on the characteristics and performance of Venezuela's Bolivarian health care system, Barrio Adentro (Inside the Neighborhood). During its first five years of existence, Barrio Adentro has improved access and utilization of health services by reaching approximately 17 million impoverished and middle-class citizens all over Venezuela. This was achieved in approximately two years and provides an example of an immense "South-South" cooperation and participatory democracy in health care. Popular participation was achieved with the Comités de Salud (health committees) and more recently with the Consejos Comunales (community councils), while mostly Cuban physicians provided medical care. Examination of a few epidemiological indicators for the years 2004 and 2005 of Barrio Adentro reveals the positive impact of this health care program, in particular its primary care component, Barrio Adentro I. Continued political commitment and realistic evaluations are needed to sustain and improve Barrio Adentro, especially its primary care services.

To Your Health: NLM update transcript - Rebuilding public trust in science

MedlinePlus

... Health: NLM update Transcript Rebuilding public trust in science : 04/16/2018 To use the sharing features ... to counter the public's misunderstanding and mistrust of science, suggests one of the U.S.' leading research officials ...

Life sciences.

PubMed

Martin-Brennan, Cindy; Joshi, Jitendra

2003-12-01

Space life sciences research activities are reviewed for 2003. Many life sciences experiments were lost with the tragic loss of STS-107. Life sciences experiments continue to fly as small payloads to the International Space Station (ISS) via the Russian Progress vehicle. Health-related studies continue with the Martian Radiation Environment Experiment (MARIE) aboard the Odyssey spacecraft, collecting data on the radiation environment in Mars orbit. NASA Ames increased nanotechnology research in all areas, including fundamental biology, bioastronautics, life support systems, and homeland security. Plant research efforts continued at NASA Kennedy, testing candidate crops for ISS. Research included plant growth studies at different light intensities, varying carbon dioxide concentrations, and different growth media. Education and outreach efforts included development of a NASA/USDA program called Space Agriculture in the Classroom. Canada sponsored a project called Tomatosphere, with classrooms across North America exposing seeds to simulated Mars environment for growth studies. NASA's Office of Biological and Physical Research released an updated strategic research plan.

Device SEE Susceptibility Update: 1996-1998

NASA Technical Reports Server (NTRS)

Coss, J. R.; Miyahira, T. F.; Swift, G. M.

1998-01-01

This eighth Compendium continues the previous work of Nichols, et al, on single event effects (SEE) first published in 1985. Because the compendium has grown so voluminous, this update only presents data not publised in previous compendia.

To Your Health: NLM update transcript - Breast cancer treatment sans chemotherapy?

MedlinePlus

... transcript061118.html To Your Health: NLM update Transcript Breast cancer treatment sans chemotherapy? : 06/11/2018 To use ... 50 with a midrange or modest risk of breast cancer safely may skip chemotherapy as part of their ...

75 FR 2515 - TRICARE, Formerly Known as the Civilian Health and Medical Program of the Uniformed Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

...: This notice provides the updated regional per diem rates for low volume mental health providers; the... beneficiary per-diem cost-share amount for low-volume providers; and the updated per- [[Page 2516

Update of the Dutch manual for costing studies in health care

PubMed Central

Kanters, Tim A.; Bouwmans, Clazien A. M.; van der Linden, Naomi; Tan, Siok Swan; Hakkaart-van Roijen, Leona

2017-01-01

Objectives Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version. Methods An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute. Results The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1) costs within the health care sector; 2) patient and family costs; and 3) costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added. Conclusions The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines. PMID:29121647

Update of the Dutch manual for costing studies in health care.

PubMed

Kanters, Tim A; Bouwmans, Clazien A M; van der Linden, Naomi; Tan, Siok Swan; Hakkaart-van Roijen, Leona

2017-01-01

Dutch health economic guidelines include a costing manual, which describes preferred research methodology for costing studies and reference prices to ensure high quality studies and comparability between study outcomes. This paper describes the most important revisions of the costing manual compared to the previous version. An online survey was sent out to potential users of the costing manual to identify topics for improvement. The costing manual was aligned with contemporary health economic guidelines. All methodology sections and parameter values needed for costing studies, particularly reference prices, were updated. An expert panel of health economists was consulted several times during the review process. The revised manual was reviewed by two members of the expert panel and by reviewers of the Dutch Health Care Institute. The majority of survey respondents was satisfied with content and usability of the existing costing manual. Respondents recommended updating reference prices and adding some particular commonly needed reference prices. Costs categories were adjusted to the international standard: 1) costs within the health care sector; 2) patient and family costs; and 3) costs in other sectors. Reference prices were updated to reflect 2014 values. The methodology chapter was rewritten to match the requirements of the costing manual and preferences of the users. Reference prices for nursing days of specific wards, for diagnostic procedures and nurse practitioners were added. The usability of the costing manual was increased and parameter values were updated. The costing manual became integrated in the new health economic guidelines.

Monitoring the elimination of human African trypanosomiasis: Update to 2014

PubMed Central

Priotto, Gerardo; Paone, Massimo; Diarra, Abdoulaye; Grout, Lise; Mattioli, Raffaele C.; Argaw, Daniel

2017-01-01

Background The World Health Organization (WHO) has targeted the elimination of Human African trypanosomiasis (HAT) ‘as a public health problem’ by 2020. The selected indicators of elimination should be monitored every two years, and we provide here a comprehensive update to 2014. The monitoring system is underpinned by the Atlas of HAT. Results With 3,797 reported cases in 2014, the corresponding milestone (5,000 cases) was surpassed, and the 2020 global target of ‘fewer than 2,000 reported cases per year’ seems within reach. The areas where HAT is still a public health problem (i.e. > 1 HAT reported case per 10,000 people per year) have halved in less than a decade, and in 2014 they corresponded to 350 thousand km2. The number and potential coverage of fixed health facilities offering diagnosis and treatment for HAT has expanded, and approximately 1,000 are now operating in 23 endemic countries. The observed trends are supported by sustained surveillance and improved reporting. Discussion HAT elimination appears to be on track. For gambiense HAT, still accounting for the vast majority of reported cases, progress continues unabated in a context of sustained intensity of screening activities. For rhodesiense HAT, a slow-down was observed in the last few years. Looking beyond the 2020 target, innovative tools and approaches will be increasingly needed. Coordination, through the WHO network for HAT elimination, will remain crucial to overcome the foreseeable and unforeseeable challenges that an elimination process will inevitably pose. PMID:28531222

Serial and Parallel Processes in Working Memory after Practice

ERIC Educational Resources Information Center

Oberauer, Klaus; Bialkova, Svetlana

2011-01-01

Six young adults practiced for 36 sessions on a working-memory updating task in which 2 digits and 2 spatial positions were continuously updated. Participants either did 1 updating operation at a time, or attempted 1 numerical and 1 spatial operation at the same time. In contrast to previous research using the same paradigm with a single digit and…

Losing the rose tinted glasses: neural substrates of unbiased belief updating in depression

PubMed Central

Garrett, Neil; Sharot, Tali; Faulkner, Paul; Korn, Christoph W.; Roiser, Jonathan P.; Dolan, Raymond J.

2014-01-01

Recent evidence suggests that a state of good mental health is associated with biased processing of information that supports a positively skewed view of the future. Depression, on the other hand, is associated with unbiased processing of such information. Here, we use brain imaging in conjunction with a belief update task administered to clinically depressed patients and healthy controls to characterize brain activity that supports unbiased belief updating in clinically depressed individuals. Our results reveal that unbiased belief updating in depression is mediated by strong neural coding of estimation errors in response to both good news (in left inferior frontal gyrus and bilateral superior frontal gyrus) and bad news (in right inferior parietal lobule and right inferior frontal gyrus) regarding the future. In contrast, intact mental health was linked to a relatively attenuated neural coding of bad news about the future. These findings identify a neural substrate mediating the breakdown of biased updating in major depression disorder, which may be essential for mental health. PMID:25221492

New Opportunities to Support Student Health under ESSA. Policy Update. Vol. 23, No. 15

ERIC Educational Resources Information Center

Fobbs, Erima; Mays, Alexandra; Rayburn, Jack

2016-01-01

A growing body of research links student health and academic achievement. The Every Student Succeeds Act (ESSA) recognizes this and calls on states to support student health and wellness and ensure safe, supportive learning environments. This National Association of State Boards of Education (NASBE) Policy Update explains how states can take…

Industry Update: the latest developments in therapeutic delivery.

PubMed

Steinbach, Oliver C

2013-05-01

The present industry update covers the period 2-28 February 2013, with information sourced from company press releases, regulatory and patent agencies, as well as from scientific literature. With the US presidential inauguration in January, the inevitable 'fiscal cliff' and with the healthcare reform taking shape, there are many challenges ahead for the world's largest healthcare market. Healthcare providers are preparing for the 'accountable care organizations' paradigm shift and it has been reported that the pharmaceutical industry is low in public perception; only 'for-profit' health insurers rank lower according to a survey recently published. Although in 2012 one could still observe a decline in the overall number of drug delivery partnering deals announced, there has been a slight recovery, thus, meaning a repeat of the lows of 2011 have not been witnessed. The experts expect a reversed trend in 2013 as larger companies seek to refill pipelines with new candidates and drug-delivery solutions. There is a lot of emphasis on altered oral delivery profiles to provide patient compliance. This is indicated by the recent licensing deals, such as that between Radius Health Inc. and 3M, TissueGen and Biomedical Structures, and new financing rounds of companies, such as SKL, Catalent and BioActiva. Injectable technology, including needle-free delivery, continues to be prevalent in deals, such as those between Clearside and Kala until compelling alternatives to the delivery of biologicals are available. Alternative routes of administration, such as nasal, buccal (Kala), sublingual (Stallergenes) see growing interest; however, bioavailability and reproducible dosing will continue to be a challenge in the foreseeable future.

Living systematic review: 1. Introduction-the why, what, when, and how.

PubMed

Elliott, Julian H; Synnot, Anneliese; Turner, Tari; Simmonds, Mark; Akl, Elie A; McDonald, Steve; Salanti, Georgia; Meerpohl, Joerg; MacLehose, Harriet; Hilton, John; Tovey, David; Shemilt, Ian; Thomas, James

2017-11-01

Systematic reviews are difficult to keep up to date, but failure to do so leads to a decay in review currency, accuracy, and utility. We are developing a novel approach to systematic review updating termed "Living systematic review" (LSR): systematic reviews that are continually updated, incorporating relevant new evidence as it becomes available. LSRs may be particularly important in fields where research evidence is emerging rapidly, current evidence is uncertain, and new research may change policy or practice decisions. We hypothesize that a continual approach to updating will achieve greater currency and validity, and increase the benefits to end users, with feasible resource requirements over time. Copyright © 2017 Elsevier Inc. All rights reserved.

World Health Organization treatment guidelines for drug-resistant tuberculosis, 2016 update

PubMed Central

Schünemann, Holger J.; Harausz, Elizabeth; González-Angulo, Licé; Lienhardt, Christian; Jaramillo, Ernesto; Weyer, Karin

2017-01-01

Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9–12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016. The composition of longer regimens for patients ineligible for the shorter regimen was modified. A first-ever meta-analysis of individual paediatric patient data allowed treatment recommendations for childhood MDR/RR-TB to be made. Delamanid is now also recommended in patients aged 6–17 years. Partial lung resection is a recommended option in MDR/RR-TB care. The 2016 revision highlighted the continued shortage of high-quality evidence and implementation research, and reiterated the need for clinical trials and best-practice studies to improve MDR/RR-TB patient treatment outcomes and strengthen policy. PMID:28331043

Expanded Benefits for Humanity from the International Space Station

NASA Technical Reports Server (NTRS)

Rai, Amelia; Robinson, Julie A.; Tate-Brown, Judy; Buckley, Nicole; Zell, Martin; Tasaki, Kazuyuki; Karabadzhak, Georgy; Sorokin, Igor V.; Pignataro, Salvatore

2016-01-01

In 2012, the International Space Station (ISS) partnership published the updated International Space Station Benefits for Humanity, 2nd edition, a compilation of stories about the many benefits being realized in the areas of human health, Earth observations and disaster response, and global education. This compilation has recently been revised to include updated statistics on the impacts of the benefits, and new benefits that have developed since the first publication. Two new sections have also been added to the book, economic development of space and innovative technology. This paper will summarize the updates on behalf of the ISS Program Science Forum, made up of senior science representatives across the international partnership. The new section on "Economic Development of Space" highlights case studies from public-private partnerships that are leading to a new economy in low earth orbit (LEO). Businesses provide both transportation to the ISS as well as some research facilities and services. These relationships promote a paradigm shift of government-funded, contractor-provided goods and services to commercially-provided goods purchased by government agencies. Other examples include commercial firms spending research and development dollars to conduct investigations on ISS and commercial service providers selling services directly to ISS users. This section provides examples of ISS as a test bed for new business relationships, and illustrates successful partnerships. The second new section, Innovative Technology, merges technology demonstration and physical science findings that promise to return Earth benefits through continued research. Robotic refueling concepts for life extensions of costly satellites in geo-synchronous orbit have applications to robotics in industry on Earth. Flame behavior experiments reveal insight into how fuel burns in microgravity leading to the possibility of improving engine efficiency on Earth. Nanostructures and smart fluids are examples of materials improvements that are being developed using data from ISS. The publication also expands the benefits of research results in human health, environmental change and disaster response and in education activities developed to capture student imaginations in support of science, technology, engineering and mathematics, or STEM, education internationally. Applications to human health of the knowledge gained on ISS continues to grow and improve healthcare technologies and our understanding of human physiology. Distinct benefits return to Earth from the only orbiting multi-disciplinary laboratory of its kind. The ISS is a stepping stone for future space exploration by providing findings that develop LEO and improve life on our planet.

Expanded benefits for humanity from the International Space Station

NASA Astrophysics Data System (ADS)

Rai, Amelia; Robinson, Julie A.; Tate-Brown, Judy; Buckley, Nicole; Zell, Martin; Tasaki, Kazuyuki; Karabadzhak, Georgy; Sorokin, Igor V.; Pignataro, Salvatore

2016-09-01

In 2012, the International Space Station (ISS) (Fig. 1) partnership published the updated International Space Station Benefits for Humanity[1], a compilation of stories about the many benefits being realized in the areas of human health, Earth observations and disaster response, and global education. This compilation has recently been revised to include updated statistics on the impacts of the benefits, and new benefits that have developed since the first publication. Two new sections have also been added to the book, economic development of space and innovative technology. This paper will summarize the updates on behalf of the ISS Program Science Forum, made up of senior science representatives across the international partnership. The new section on "Economic Development of Space" highlights case studies from public-private partnerships that are leading to a new economy in low earth orbit (LEO). Businesses provide both transportation to the ISS as well as some research facilities and services. These relationships promote a paradigm shift of government-funded, contractor-provided goods and services to commercially-provided goods purchased by government agencies. Other examples include commercial firms spending research and development dollars to conduct investigations on ISS and commercial service providers selling services directly to ISS users. This section provides examples of ISS as a test bed for new business relationships, and illustrates successful partnerships. The second new section, "Innovative Technology," merges technology demonstration and physical science findings that promise to return Earth benefits through continued research. Robotic refueling concepts for life extensions of costly satellites in geo-synchronous orbit have applications to robotics in industry on Earth. Flame behavior experiments reveal insight into how fuel burns in microgravity leading to the possibility of improving engine efficiency on Earth. Nanostructures and smart fluids are examples of materials improvements that are being developed using data from ISS. The publication also expands the benefits of research results in human health, environmental change and disaster response and in education activities developed to capture student imaginations in support of science, technology, engineering and mathematics, or STEM, education internationally. Applications to human health of the knowledge gained on ISS continue to grow and improve healthcare technologies and our understanding of human physiology. Distinct benefits return to Earth from the only orbiting multi-disciplinary laboratory of its kind. The ISS is a stepping stone for future space exploration by providing findings that develop LEO and improve life on our planet.

Multiplicative Forests for Continuous-Time Processes

PubMed Central

Weiss, Jeremy C.; Natarajan, Sriraam; Page, David

2013-01-01

Learning temporal dependencies between variables over continuous time is an important and challenging task. Continuous-time Bayesian networks effectively model such processes but are limited by the number of conditional intensity matrices, which grows exponentially in the number of parents per variable. We develop a partition-based representation using regression trees and forests whose parameter spaces grow linearly in the number of node splits. Using a multiplicative assumption we show how to update the forest likelihood in closed form, producing efficient model updates. Our results show multiplicative forests can be learned from few temporal trajectories with large gains in performance and scalability. PMID:25284967

Multiplicative Forests for Continuous-Time Processes.

PubMed

Weiss, Jeremy C; Natarajan, Sriraam; Page, David

2012-01-01

Learning temporal dependencies between variables over continuous time is an important and challenging task. Continuous-time Bayesian networks effectively model such processes but are limited by the number of conditional intensity matrices, which grows exponentially in the number of parents per variable. We develop a partition-based representation using regression trees and forests whose parameter spaces grow linearly in the number of node splits. Using a multiplicative assumption we show how to update the forest likelihood in closed form, producing efficient model updates. Our results show multiplicative forests can be learned from few temporal trajectories with large gains in performance and scalability.

Medicare program; home health prospective payment system rate update for calendar year 2011; changes in certification requirements for home health agencies and hospices. Final rule.

PubMed

2010-11-17

This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy. In addition, this rule revises the home health agency (HHA) capitalization requirements. This rule further adds clarifying language to the "skilled services" section. The rule finalizes a 3.79 percent reduction to rates for CY 2011 to account for changes in case-mix, which are unrelated to real changes in patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face encounters with providers related to home health and hospice care.

MedlinePlus E-mail Updates | NIH MedlinePlus the Magazine

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... of this page please turn Javascript on. MedlinePlus E-mail Updates Past Issues / Spring - Summer 2010 Table ... in health and medicine? Sign up for MedlinePlus e-mail updates, and you'll receive alerts whenever ...

Development of the updating executive function: From 7-year-olds to young adults.

PubMed

Carriedo, Nuria; Corral, Antonio; Montoro, Pedro R; Herrero, Laura; Rucián, Mercedes

2016-04-01

Updating information in working memory (WM) is a critical executive function responsible both for continuously replacing outdated information with new relevant data and to suppress or inhibit content that is no longer relevant according to task demands. The goal of the present research is twofold: First, we aimed to study updating development in 548 participants of 4 different age ranges--7-, 11-, and 15-year-olds and young adults--using the updating task devised by R. De Beni and P. Palladino (2004), which allows differentiating maintenance and inhibition processes. Second, we attempted to determine the relation between these processes across development as well as the differentiation among different types of inhibition processes tapped by this task. Results showed that there was an improvement of memory performance with age along with an upgrading of inhibitory efficiency. However, whereas in memory performance, a progressive increase was observed until the age of 15 years followed by stabilization, in inhibition, a continuous progressive increase was observed until young adulthood. Importantly, results showed that development of the different inhibitory mechanisms does not progress equally. All the groups committed more errors related to inefficient suppression mechanisms in WM than errors related to control of long-term memory interference. Principal component analysis showed that updating implies different subprocesses: active maintenance/suppression of information in WM and control of proactive interference. Developmental trajectories showed that the maintenance/suppression of information in the WM component continues to develop far beyond adolescence but that proactive interference control is responsible for variations in updating across development. (c) 2016 APA, all rights reserved).

78 FR 79009 - Proposed Information Collection; Radiation Sampling and Exposure Records (Pertains to Underground...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-27

...The Department of Labor, as part of its continuing effort to reduce paperwork and respondent burden, conducts a pre-clearance consultation program to provide the general public and Federal agencies with an opportunity to comment on proposed and continuing collections of information in accordance with the Paperwork Reduction Act of 1995, 44 U.S.C. 3506(c)(2)(A). This program helps to assure that requested data can be provided in the desired format, reporting burden (time and financial resources) is minimized, collection instruments are clearly understood, and the impact of collection requirements on respondents can be properly assessed. Currently, the Mine Safety and Health Administration (MSHA) is soliciting comments concerning the proposed information collection for updating Radiation Sampling and Exposure Records.

Psychologists conducting Psychotherapy in 2012: current practices and historical trends among Division 29 members.

PubMed

Norcross, John C; Rogan, Jessica D

2013-12-01

This study updates three similar investigations conducted in 1981, 1991, and 2001 on APA Division of Psychotherapy members in order to paint a contemporary portrait of psychologists conducting psychotherapy and to chronicle historical trends among Division 29 members. Four hundred twenty-eight psychologists (43% response) completed a questionnaire in 2012 regarding their demographic characteristics, professional activities, theoretical orientations, employment settings, and career experiences. The results point to an increasingly female and aging membership, which continues to be employed primarily in private practices and universities. Psychodynamic (27%), integrative (25%), and cognitive (17%) orientations continue to prevail. Professional activities have remained quite similar across the past 30 years with the exception of declines in projective testing and growth in neuropsychological and health testing. Training and career satisfactions remain high as well.

Current Continuing Professional Education Practice among Malaysian Nurses

PubMed Central

Chong, Mei Chan; Francis, Karen; Cooper, Simon; Abdullah, Khatijah Lim

2014-01-01

Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses' (RNs) needs and not simply organizational requirements. PMID:24523961

Integrating malaria surveillance with climate data for outbreak detection and forecasting: the EPIDEMIA system.

PubMed

Merkord, Christopher L; Liu, Yi; Mihretie, Abere; Gebrehiwot, Teklehaymanot; Awoke, Worku; Bayabil, Estifanos; Henebry, Geoffrey M; Kassa, Gebeyaw T; Lake, Mastewal; Wimberly, Michael C

2017-02-23

Early indication of an emerging malaria epidemic can provide an opportunity for proactive interventions. Challenges to the identification of nascent malaria epidemics include obtaining recent epidemiological surveillance data, spatially and temporally harmonizing this information with timely data on environmental precursors, applying models for early detection and early warning, and communicating results to public health officials. Automated web-based informatics systems can provide a solution to these problems, but their implementation in real-world settings has been limited. The Epidemic Prognosis Incorporating Disease and Environmental Monitoring for Integrated Assessment (EPIDEMIA) computer system was designed and implemented to integrate disease surveillance with environmental monitoring in support of operational malaria forecasting in the Amhara region of Ethiopia. A co-design workshop was held with computer scientists, epidemiological modelers, and public health partners to develop an initial list of system requirements. Subsequent updates to the system were based on feedback obtained from system evaluation workshops and assessments conducted by a steering committee of users in the public health sector. The system integrated epidemiological data uploaded weekly by the Amhara Regional Health Bureau with remotely-sensed environmental data freely available from online archives. Environmental data were acquired and processed automatically by the EASTWeb software program. Additional software was developed to implement a public health interface for data upload and download, harmonize the epidemiological and environmental data into a unified database, automatically update time series forecasting models, and generate formatted reports. Reporting features included district-level control charts and maps summarizing epidemiological indicators of emerging malaria outbreaks, environmental risk factors, and forecasts of future malaria risk. Successful implementation and use of EPIDEMIA is an important step forward in the use of epidemiological and environmental informatics systems for malaria surveillance. Developing software to automate the workflow steps while remaining robust to continual changes in the input data streams was a key technical challenge. Continual stakeholder involvement throughout design, implementation, and operation has created a strong enabling environment that will facilitate the ongoing development, application, and testing of the system.

Maintaining health insurance during a recession: likely COBRA eligibility: an updated analysis using the Commonwealth Fund 2007 Biennial Health Insurance Survey.

PubMed

Doty, Michelle; Rustgi, Sheila D; Schoen, Cathy; Collins, Sara R

2009-01-01

As the U.S. economic downturn continues and job losses mount, more working Americans are likely to lose access to affordable health benefits subsidized by their employers. Analysis of the 2007 Commonwealth Fund Biennial Health Insurance Survey finds that two of three working adults would be eligible to extend job-based coverage, under the 1985 Consolidated Omnibus Budget Reconciliation Act (COBRA) if they became unemployed. Under COBRA, however, unemployed workers would have to pay four to six times their current contribution at a time of sharply reduced income. In fact, the latest national figures indicate that, because of high premiums, only 9 percent of unemployed workers have COBRA coverage. Substantial financial assistance of 75 percent to 85 percent of premiums could help laid-off workers maintain coverage. In addition, expansion of Medicaid and the State Children's Health Insurance Program would benefit low-income, laid-off workers and their families who are ineligible for COBRA.

Responding rapidly to FDA drug withdrawals: design and application of a new approach for a consumer health website.

PubMed

Embi, Peter J; Acharya, Prasad; McCuistion, Mark; Kishman, Charles P; Haag, Doris; Marine, Stephen

2006-09-06

Information about drug withdrawals may not reach patients in a timely manner, and this could result in adverse events. Increasingly, the public turns to consumer health websites for health information, but such sites may not update their content for days or weeks following important events like Food and Drug Administration (FDA) drug withdrawal actions. There is no recognized standard for how quickly consumer health websites should respond to such events, and reports addressing this issue are lacking. The objective of this study was to develop and implement an approach to enhance the efficiency with which a consumer health website (NetWellness.org) responds to FDA drug withdrawal actions. Evaluation of the current approach used by NetWellness staff to update content affected by FDA action revealed a slow process driven by the goal of performing thorough and comprehensive review and editing. To achieve our desired goal of accurately updating affected content within 24 hours of FDA action, we developed a strategy that included rapid updating of affected Web pages with warning boxes and hyperlinks to the information about the withdrawal. With the next FDA withdrawal event, that of valdecoxib (Bextra) on April 7, 2005, we applied this new approach, observed the time and resource requirements, and monitored the rate at which consumers viewed the updated information to gauge its potential impact. Application of the new approach allowed one person to modify the affected Web pages in less than 1 hour and within 18 hours of the FDA announcement. Using the old strategy, response to a similar event, the withdrawal of rofecoxib (Vioxx) 6 months earlier, had taken over 3 weeks and the efforts of several personnel. Updated valdecoxib content received 188 hits within the first month and 4285 hits within 1 year. Rapid updating of a consumer health website's content in response to an FDA drug withdrawal event was easily accomplished by applying the approach described. This allowed consumers to view accurate information regarding the withdrawn drug much sooner than would otherwise have been the case. Given that consumers increasingly turn to websites for their health information, adoption of a rapid response standard for important health events like FDA drug withdrawals should be considered by the consumer health informatics community.

IRIS TOXICOLOGICAL REVIEW AND SUMMARY DOCUMENTS FOR BERYLLIUM AND COMPOUNDS

EPA Science Inventory

EPA's assessment of the noncancer health effects and carcinogenic potential of Beryllium was added to the IRIS database in 1998. The IRIS program is updating the IRIS assessment for Beryllium. This update will incorporate health effects information published since the last assess...

78 FR 17679 - Implementation of the Updated American Veterinary Medical Association Guidelines for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Implementation of the Updated American Veterinary Medical Association Guidelines for the Euthanasia of Animals: 2013 Edition...) awardee institutions on implementation of the American Veterinary Medical Association (AVMA) Guidelines...

75 FR 70371 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

...This final rule sets forth an update to the Home Health Prospective Payment System (HH PPS) rates, including: the national standardized 60-day episode rates, the national per-visit rates, the nonroutine medical supply (NRS) conversion factors, and the low utilization payment amount (LUPA) add-on payment amounts, under the Medicare prospective payment system for HHAs effective January 1, 2011. This rule also updates the wage index used under the HH PPS and, in accordance with the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), updates the HH PPS outlier policy. In addition, this rule revises the home health agency (HHA) capitalization requirements. This rule further adds clarifying language to the ``skilled services'' section. The rule finalizes a 3.79 percent reduction to rates for CY 2011 to account for changes in case-mix, which are unrelated to real changes in patient acuity. Finally, this rule incorporates new legislative requirements regarding face-to-face encounters with providers related to home health and hospice care.

Test and analysis procedures for updating math models of Space Shuttle payloads

NASA Technical Reports Server (NTRS)

Craig, Roy R., Jr.

1991-01-01

Over the next decade or more, the Space Shuttle will continue to be the primary transportation system for delivering payloads to Earth orbit. Although a number of payloads have already been successfully carried by the Space Shuttle in the payload bay of the Orbiter vehicle, there continues to be a need for evaluation of the procedures used for verifying and updating the math models of the payloads. The verified payload math models is combined with an Orbiter math model for the coupled-loads analysis, which is required before any payload can fly. Several test procedures were employed for obtaining data for use in verifying payload math models and for carrying out the updating of the payload math models. Research was directed at the evaluation of test/update procedures for use in the verification of Space Shuttle payload math models. The following research tasks are summarized: (1) a study of free-interface test procedures; (2) a literature survey and evaluation of model update procedures; and (3) the design and construction of a laboratory payload simulator.

Update on inflation of journal prices: Brandon/Hill list journals and the scientific, technical, and medical publishing market*

PubMed Central

Schlimgen, Joan B.; Kronenfeld, Michael R.

2004-01-01

Objective: The original study of journal prices, using the “Brandon/ Hill Selected List of Books and Journals for the Small Medical Library,” was first published in 1980 and periodically updated. This research continues to measure price increases for these titles for the periods 1996 to 1999 and 1999 to 2002. Methodology: The 111 journal titles that have appeared in each published list from 1967 to 2001 were included in the study. Institutional subscription price data were gathered for each journal for the years 1996, 1999, and 2002 and were compared to the Consumer Price Index (CPI) for the same years. Results: The average journal price continues to rise significantly and is independent of the CPI. The study found that prices have jumped 51.9% from 1996 to 1999 and 32% from 1999 to 2002, which is consistent with nearly every recent journal price study. Conclusion: The unprecedented rise in journal prices negatively affects the purchasing power of medical libraries. This paper examines the economic and technological pressures on the science, technology, and medical journals market that contribute to high prices and identifies a number of initiatives in the biological and health sciences that utilize alternative models for disseminating scientific research. PMID:15243636

Updated Priorities Among Effective Clinical Preventive Services

PubMed Central

Maciosek, Michael V.; LaFrance, Amy B.; Dehmer, Steven P.; McGree, Dana A.; Flottemesch, Thomas J.; Xu, Zack; Solberg, Leif I.

2017-01-01

PURPOSE The Patient Protection and Affordable Care Act’s provisions for first-dollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services. METHODS We assessed the potential impact of 28 evidence-based clinical preventive services in terms of their cost-effectiveness and clinically preventable burden, as measured by quality-adjusted life years (QALYs) saved. Each service received 1 to 5 points on each of the 2 measures—cost-effectiveness and clinically preventable burden—for a total score ranging from 2 to 10. New microsimulation models were used to provide updated estimates of 12 of these services. Priorities for improving delivery rates were established by comparing the ranking with what is known of current delivery rates nationally. RESULTS The 3 highest-ranking services, each with a total score of 10, are immunizing children, counseling to prevent tobacco initiation among youth, and tobacco-use screening and brief intervention to encourage cessation among adults. Greatest population health improvement could be obtained from increasing utilization of clinical preventive services that address tobacco use, obesity-related behaviors, and alcohol misuse, as well as colorectal cancer screening and influenza vaccinations. CONCLUSIONS This study identifies high-priority preventive services and should help decision makers select which services to emphasize in quality-improvement initiatives. PMID:28376457

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine HIV pre-exposure prophylaxis: clinical guidelines. Update April 2018.

PubMed

Wright, Edwina; Grulich, Andrew; Roy, Katy; Boyd, Mark; Cornelisse, Vincent; Russell, Darren; O'Donnell, Darryl; Whittaker, Bill; Crooks, Levinia; Zablotska, Iryna

2018-04-01

Daily use of coformulated tenofovir and emtricitabine for HIV pre-exposure prophylaxis (PrEP) by populations at high risk of HIV infection is now recommended in guidelines from the United States, Europe and Australia and globally through the 2015 WHO guidelines. These 2017 Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine's (ASHM) PrEP Guidelines are an updated adaptation of the 2014 US Centers for Disease Control's PrEP guidelines and are designed to: •Support the prescription of PrEP using forms of coformulated tenofovir and emtricitabine that have been registered in Australia by the Therapeutic Goods Administration and other bioequivalent generic drugs that are available in Australia through self-importation, private prescription or Australian PrEP clinical trials•Assist clinicians in the evaluation of patients who are seeking PrEP•Assist clinicians in commencing and monitoring patients on PrEP including PrEP dosing schedules, management of side-effects and toxicity, use of PrEP in pregnancy and in chronic hepatitis B infection and how to cease PrEP Daily PrEP with co-formulated tenofovir and emtricitabine, used continuously or for shorter periods of time, is recommended in these guidelines as a key HIV-prevention option for men who have sex with men (MSM), transgender men and women, heterosexual men and women, and people who inject drugs (PWID) at substantial risk of HIV acquisition. These guidelines were updated in April 2018 and include changes to the recommendations regarding the choice of daily or on-demand PrEP.

An Update on Ethanol Production and Utilization in Thailand

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

Bloyd, Cary N.

Thailand has continued to promote domestic biofuel utilization. Production and consumption of biofuel in Thailand have continued to increase at a fast rate due to aggressive policies of the Thai government in reducing foreign oil import and increasing domestic renewable energy utilization. This paper focuses on ethanol production and consumption, and the use of gasohol in Thailand. The paper is an update on the previous paper--Biofuel Infrastructure Development and Utilization in Thailand--in August 2008.

IRIS Toxicological Review of Benzo[a]pyrene (Final Report) ...

EPA Pesticide Factsheets

EPA has finalized the Integrated Risk Information System (IRIS) assessment of benzo[a]pyrene. This assessment addresses the potential cancer and noncancer human health effects from long-term exposure to benzo[a]pyrene. Now final, this assessment will update the toxicological information on benzo[a]pyrene posted in 1987. EPA’s program and regional offices may use this assessment to inform decisions to protect human health. EPA is undertaking an update of the Integrated Risk Information System (IRIS) health assessment for benzo[a]pyrene (BaP). The outcome of this project is an updated Toxicological Review and IRIS Summary for BaP that will be entered into the IRIS database.

Capital update factor: a new era approaches.

PubMed

Grimaldi, P L

1993-02-01

The Health Care Financing Administration (HCFA) has constructed a preliminary model of a new capital update method which is consistent with the framework being developed to refine the update method for PPS operating costs. HCFA's eventual goal is to develop a single update framework for operating and capital costs. Initial results suggest that adopting the new capital update method would reduce capital payments substantially, which might intensify creditor's concerns about extending loans to hospitals.

Announcement: Guidance for U.S. Laboratory Testing for Zika Virus Infection: Implications for Health Care Providers.

PubMed

2016-11-25

CDC has released updated guidance online for U.S. laboratory testing for Zika virus infection. The guidance is available at https://www.cdc.gov/zika/laboratories/lab-guidance.html. Frequently asked questions are addressed at https://www.cdc.gov/zika/laboratories/lab-guidance-faq.html. This guidance updates recommendations for testing of specimens by U.S. laboratories for possible Zika virus infection. Major updates to the guidance with clinical implications for health care providers include the following.

IRIS TOXICOLOGICAL REVIEW AND SUMMARY DOCUMENTS FOR 1,2,3-TRICHLOROPROPANE

EPA Science Inventory

EPA's assessment of the noncancer health effects and carcinogenic potential of 1,2,3-trichloropropane (TCP) was added to the IRIS database in 1990. The IRIS program is updating the IRIS assessment for TCP. This update will incorporate health effects information published since t...

Guideline on terminology and definitions of updating clinical guidelines: The Updating Glossary.

PubMed

Martínez García, Laura; Pardo-Hernández, Hector; Sanabria, Andrea Juliana; Alonso-Coello, Pablo; Penman, Katrina; McFarlane, Emma

2018-03-01

The Guidelines International Network (G-I-N) Updating Guidelines Working Group launched an initiative to develop a glossary (the Updating Glossary) with domains, terms, definitions, and synonyms related to updating of clinical guidelines (CGs). The steering committee developed an initial list of domains, terms, definitions, and synonyms through brainstorming and discussion. The panel members participated in three rounds of feedback to discuss, refine, and clarify the proposed terms, definitions, and synonyms. Finally, the panel members were surveyed to assess their level of agreement regarding the glossary. Eighteen terms were identified and defined: (1) continuous updating, (2) decision to update, (3) fixed updating, (4) full updating, (5) impact of the new evidence, (6) partial updating, (7) prioritization process, (8) reporting process, (9) signal for an update, (10) surveillance process, (11) time of validity, (12) timeframe, (13) tools and resources, (14) up to date, (15) update cycle, (16) update unit, (17) updated version, and (18) updating strategy. Consensus was reached for all terms, definitions, and synonyms (median agreement scores ≥ 6); except for one term. The G-I-N Updating Guidelines Working Group assembled the Updating Glossary to facilitate and improve the knowledge exchange among CGs developers, researchers, and users. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of GRCh38 and de novo haploid genome assemblies demonstrates the enduring quality of the reference assembly

PubMed Central

Schneider, Valerie A.; Graves-Lindsay, Tina; Howe, Kerstin; Bouk, Nathan; Chen, Hsiu-Chuan; Kitts, Paul A.; Murphy, Terence D.; Pruitt, Kim D.; Thibaud-Nissen, Françoise; Albracht, Derek; Fulton, Robert S.; Kremitzki, Milinn; Magrini, Vincent; Markovic, Chris; McGrath, Sean; Steinberg, Karyn Meltz; Auger, Kate; Chow, William; Collins, Joanna; Harden, Glenn; Hubbard, Timothy; Pelan, Sarah; Simpson, Jared T.; Threadgold, Glen; Torrance, James; Wood, Jonathan M.; Clarke, Laura; Koren, Sergey; Boitano, Matthew; Peluso, Paul; Li, Heng; Chin, Chen-Shan; Phillippy, Adam M.; Durbin, Richard; Wilson, Richard K.; Flicek, Paul; Eichler, Evan E.; Church, Deanna M.

2017-01-01

The human reference genome assembly plays a central role in nearly all aspects of today's basic and clinical research. GRCh38 is the first coordinate-changing assembly update since 2009; it reflects the resolution of roughly 1000 issues and encompasses modifications ranging from thousands of single base changes to megabase-scale path reorganizations, gap closures, and localization of previously orphaned sequences. We developed a new approach to sequence generation for targeted base updates and used data from new genome mapping technologies and single haplotype resources to identify and resolve larger assembly issues. For the first time, the reference assembly contains sequence-based representations for the centromeres. We also expanded the number of alternate loci to create a reference that provides a more robust representation of human population variation. We demonstrate that the updates render the reference an improved annotation substrate, alter read alignments in unchanged regions, and impact variant interpretation at clinically relevant loci. We additionally evaluated a collection of new de novo long-read haploid assemblies and conclude that although the new assemblies compare favorably to the reference with respect to continuity, error rate, and gene completeness, the reference still provides the best representation for complex genomic regions and coding sequences. We assert that the collected updates in GRCh38 make the newer assembly a more robust substrate for comprehensive analyses that will promote our understanding of human biology and advance our efforts to improve health. PMID:28396521

Performance Analysis of Inter-Domain Handoff Scheme Based on Virtual Layer in PMIPv6 Networks for IP-Based Internet of Things.

PubMed

Cho, Chulhee; Choi, Jae-Young; Jeong, Jongpil; Chung, Tai-Myoung

2017-01-01

Lately, we see that Internet of things (IoT) is introduced in medical services for global connection among patients, sensors, and all nearby things. The principal purpose of this global connection is to provide context awareness for the purpose of bringing convenience to a patient's life and more effectively implementing clinical processes. In health care, monitoring of biosignals of a patient has to be continuously performed while the patient moves inside and outside the hospital. Also, to monitor the accurate location and biosignals of the patient, appropriate mobility management is necessary to maintain connection between the patient and the hospital network. In this paper, a binding update scheme on PMIPv6, which reduces signal traffic during location updates by Virtual LMA (VLMA) on the top original Local Mobility Anchor (LMA) Domain, is proposed to reduce the total cost. If a Mobile Node (MN) moves to a Mobile Access Gateway (MAG)-located boundary of an adjacent LMA domain, the MN changes itself into a virtual mode, and this movement will be assumed to be a part of the VLMA domain. In the proposed scheme, MAGs eliminate global binding updates for MNs between LMA domains and significantly reduce the packet loss and latency by eliminating the handoff between LMAs. In conclusion, the performance analysis results show that the proposed scheme improves performance significantly versus PMIPv6 and HMIPv6 in terms of the binding update rate per user and average handoff latency.

Update on international adoption: focus on Russia.

PubMed

McGuinness, Teena M; Robinson, Cheryl Broadus

2011-06-01

American families will continue to adopt children from foreign countries; the desire to have a child transcends national boundaries. Sadly, not all adoptions have happy outcomes. A recent and well-reported incident involved an American mother, who, exasperated with her adopted son's severe behavioral problems, returned him to Russia, alone, on an aircraft. Other tragic reports involve internationally adopted children who have died at the hands of their American parents. This article provides an overview of the consequences of institutionalization as a risk factor for behavioral health of children; implications for nursing care of adoptive families follow. Copyright 2011, SLACK Incorporated.

Leprosy: a glossary.

PubMed

Virmond, Marcos; Grzybowski, Andrzej; Virmond, Luiza

2015-01-01

Leprosy continues to afflict residents from a number of countries in Africa, South America, and southeast Asia, despite the marked reduction in the number of cases of leprosy worldwide, after the introduction of the multidrug regimens as recommended by the World Health Organization (WHO-MDT). With the increasing immigration of individuals from risk areas to Europe and the United States, knowledge of the basic concepts of leprosy would be helpful to clinicians caring for immigrants in nonendemic areas. We present a comprehensive, updated, and critical glossary of the most relevant terms related to leprosy. Copyright © 2015. Published by Elsevier Inc.

Aeromedical Disposition and Waiver Consideration for ISS Crewmembers

NASA Technical Reports Server (NTRS)

Taddeo, Terrance

2012-01-01

Aeromedical certification of astronauts and cosmonauts traveling to the International Space Station is a multi?-tiered process that involv es standards agreed to by the partner agencies, and participation by the individual agency aeromedical boards and a multilateral space medi cine board. Medical standards are updated continually by a multilater al working group. The boards operate by consensus and strive to achie ve effective decision making through experience, medical judgment, medical evidence and risk modeling. The aim of the certification process is to minimize the risk to the ISS program of loss of mission object ives due to human health issues.

Eliminating Inappropriate Telemetry Monitoring: An Evidence-Based Implementation Guide.

PubMed

Yeow, Raymond Y; Strohbehn, Garth W; Kagan, Calvin M; Petrilli, Christopher M; Krishnan, Jamuna K; Edholm, Karli; Sussman, L Scott; Blanck, Jaime F; Popa, Remus I; Pahwa, Amit K

2018-06-04

In-hospital continuous electrocardiographic monitoring, commonly referred to as telemetry, has allowed for rapid recognition of life-threatening conditions, including complex arrhythmias and myocardial ischemia. However, inappropriate use can lead to unnecessary downstream testing from "false alarms," which in turn affects clinician efficiency and increases health care costs without benefiting patients. For these reasons, the Society of Hospital Medicine's Choosing Wisely campaign recommended use of a protocol-driven discontinuation of telemetry. The American Heart Association (AHA) developed a set of Practice Standards for the appropriate use of telemetry monitoring in 2004, which they updated in 2017. Unfortunately, the AHA Practice Standards have not been widely adopted-with as many as 43% of monitored patients lacking a recommended indication for monitoring. Thus, we created an overview discussing the safety and efficacy of incorporating the AHA Practice Standards and a review of studies highlighting their successful incorporation within patient care workflow. We conclude by outlining an "implementation blueprint" for health system professionals and administrators seeking to change their institution's culture of telemetry use. As the health care landscape continues to shift, enacting high-value initiatives that improve patient safety and efficiency of care will be critical.

Disease burden attributed to alcohol: How methodological advances in the Global Burden of Disease 2013 study have changed the estimates in Sweden.

PubMed

Kellerborg, Klas; Danielsson, Anna-Karin; Allebeck, Peter; Coates, Matthew M; Agardh, Emilie

2016-08-01

The Global Burden of Disease (GBD) study continuously refines its estimates as new data and methods become available. In the latest iteration of the study, GBD 2013, changes were made related to the disease burden attributed to alcohol. The aim of this study was to briefly present these changes and to compare the disease burden attributed to alcohol in Swedish men and women in 2010 using previous and updated methods. In the GBD study, the contribution of alcohol to the burden of disease is estimated by theoretically assessing how much of the disease burden can be avoided by reducing the consumption of alcohol to zero. The updated methods mainly consider improved measurements of alcohol consumption, including less severe alcohol dependence, assigning the most severe injuries and removing the protective effect of drinking on cardiovascular diseases if combined with binge drinking. The overall disease burden attributed to alcohol in 2010 increased by 14% when using the updated methods. Women accounted for this overall increase, mainly because the updated methods led to an overall higher alcohol consumption in women. By contrast, the overall burden decreased in men, one reason being the lower overall alcohol consumption with the new methods. In men, the inclusion of less severe alcohol dependence resulted in a large decrease in the alcohol attributed disease burden. This was, however, evened out to a great extent by the increase in cardiovascular disease and injuries. CONCLUSIONS WHEN USING THE UPDATED GBD METHODS, THE OVERALL DISEASE BURDEN ATTRIBUTED TO ALCOHOL INCREASED IN WOMEN, BUT NOT IN MEN. © 2016 the Nordic Societies of Public Health.

Updates in the management of stable chronic obstructive pulmonary disease.

PubMed

Narsingam, Saiprasad; Bozarth, Andrew L; Abdeljalil, Asem

2015-01-01

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease state characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory process. It is increasingly recognized as a major public health problem, affecting more than 20 million adults in the US. It is also recognized as a leading cause of hospitalizations and is the fourth leading cause of death in the US. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) operates to promote evidence-based management of COPD, increase awareness and encourage research. In 2011, GOLD published a consensus report detailing evidence-based management strategies for COPD, which were last updated in 2015. In recent years, newer strategies and a growing number of new pharmacologic agents to treat symptoms of COPD have also been introduced and show promise in improving the management of COPD. We aim to provide an evidence-based review of the available and upcoming pharmacologic and non-pharmacologic treatment options for stable COPD, with continued emphasis on evidence-based management.

NIEHS/FDA CLARITY-BPA research program update.

PubMed

Heindel, Jerrold J; Newbold, Retha R; Bucher, John R; Camacho, Luísa; Delclos, K Barry; Lewis, Sherry M; Vanlandingham, Michelle; Churchwell, Mona I; Twaddle, Nathan C; McLellen, Michelle; Chidambaram, Mani; Bryant, Matthew; Woodling, Kellie; Gamboa da Costa, Gonçalo; Ferguson, Sherry A; Flaws, Jodi; Howard, Paul C; Walker, Nigel J; Zoeller, R Thomas; Fostel, Jennifer; Favaro, Carolyn; Schug, Thaddeus T

2015-12-01

Bisphenol A (BPA) is a chemical used in the production of numerous consumer products resulting in potential daily human exposure to this chemical. The FDA previously evaluated the body of BPA toxicology data and determined that BPA is safe at current exposure levels. Although consistent with the assessment of some other regulatory agencies around the world, this determination of BPA safety continues to be debated in scientific and popular publications, resulting in conflicting messages to the public. Thus, the National Toxicology Program (NTP), National Institute of Environmental Health Sciences (NIEHS), and U.S. Food and Drug Administration (FDA) developed a consortium-based research program to link more effectively a variety of hypothesis-based research investigations and guideline-compliant safety testing with BPA. This collaboration is known as the Consortium Linking Academic and Regulatory Insights on BPA Toxicity (CLARITY-BPA). This paper provides a detailed description of the conduct of the study and a midterm update on progress of the CLARITY-BPA research program. Published by Elsevier Inc.

NIEHS/FDA CLARITY-BPA research program update

PubMed Central

Heindel, Jerrold J.; Newbold, Retha R.; Bucher, John R.; Camacho, Luísa; Delclos, K. Barry; Lewis, Sherry M.; Vanlandingham, Michelle; Churchwell, Mona I.; Twaddle, Nathan C.; McLellen, Michelle; Chidambaram, Mani; Bryant, Matthew; Woodling, Kellie; Gamboa da Costa, Gonçalo; Ferguson, Sherry A.; Flaws, Jodi; Howard, Paul C.; Walker, Nigel J.; Zoeller, R. Thomas; Fostel, Jennifer; Favaro, Carolyn; Schug, Thaddeus T.

2016-01-01

Bisphenol A (BPA) is a chemical used in the production of numerous consumer products resulting in potential daily human exposure to this chemical. The FDA previously evaluated the body of BPA toxicology data and determined that BPA is safe at current exposure levels. Although consistent with the assessment of some other regulatory agencies around the world, this determination of BPA safety continues to be debated in scientific and popular publications, resulting in conflicting messages to the public. Thus, the National Toxicology Program (NTP), National Institute of Environmental Health Sciences (NIEHS), and U.S Food and Drug Administration (FDA) developed a consortium-based research program to link more effectively a variety of hypothesis-based research investigations and guideline-compliant safety testing with BPA. This collaboration is known as the Consortium Linking Academic and Regulatory Insights on BPA Toxicity (CLARITY-BPA). This paper provides a detailed description of the conduct of the study and a midterm update on progress of the CLARITY-BPA research program. PMID:26232693

No. 250-Recurrent Urinary Tract Infection.

PubMed

Epp, Annette; Larochelle, Annick

2017-10-01

To provide an update of the definition, epidemiology, clinical presentation, investigation, treatment, and prevention of recurrent urinary tract infections in women. Continuous antibiotic prophylaxis, post-coital antibiotic prophylaxis, and acute self-treatment are all efficient alternatives to prevent recurrent urinary tract infection. Vaginal estrogen and cranberry juice can also be effective prophylaxis alternatives. A search of PubMed and The Cochrane Library for articles published in English identified the most relevant literature. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date restrictions. This update is the consensus of the Sub-Committee on Urogynaecology of the Society of Obstetricians and Gynaecologists of Canada. Recommendations were made according to the guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1). Recurrent urinary tract infections need careful investigation and can be efficiently treated and prevented. Different prophylaxis options can be selected according to each patient's characteristics. Copyright © 2017. Published by Elsevier Inc.

Leishmania and its quest for iron: An update and overview.

PubMed

Zaidi, Amir; Singh, Krishn Pratap; Ali, Vahab

2017-01-01

Parasites of genus Leishmania are the causative agents of complex neglected diseases called leishmaniasis and continue to be a significant health concern globally. Iron is a vital nutritional requirement for virtually all organisms, including pathogenic trypanosomatid parasites, and plays a crucial role in many facets of cellular metabolism as a cofactor of several enzymes. Iron acquisition is essential for the survival of parasites. Yet parasites are also vulnerable to the toxicity of iron and reactive oxygen species. The aim of this review is to provide an update on the current knowledge about iron acquisition and usage by Leishmania species. We have also discussed about host strategy to modulate iron availability and the strategies deployed by Leishmania parasites to overcome iron withholding defences and thus favour parasite growth within host macrophages. Since iron plays central roles in the host's response and parasite metabolism, a comprehensive understanding of the iron metabolism is beneficial to identify potential viable therapeutic opportunities against leishmaniasis. Copyright © 2016 Elsevier B.V. All rights reserved.

Perspectives on current tumor-node-metastasis (TNM) staging of cancers of the colon and rectum.

PubMed

Hu, Huankai; Krasinskas, Alyssa; Willis, Joseph

2011-08-01

Improvements in classifications of cancers based on discovery and validation of important histopathological parameters and new molecular markers continue unabated. Though still not perfect, recent updates of classification schemes in gastrointestinal oncology by the American Joint Commission on Cancer (tumor-node-metastasis [TNM] staging) and the World Health Organization further stratify patients and guide optimization of treatment strategies and better predict patient outcomes. These updates recognize the heterogeneity of patient populations with significant subgrouping of each tumor stage and use of tumor deposits to significantly "up-stage" some cancers; change staging parameters for subsets of IIIB and IIIC cancers; and introduce of several new subtypes of colon carcinomas. By the nature of the process, recent discoveries that are important to improving even routine standards of patient care, especially new advances in molecular medicine, are not incorporated into these systems. Nonetheless, these classifications significantly advance clinical standards and are welcome enhancements to our current methods of cancer reporting. Copyright © 2011 Elsevier Inc. All rights reserved.

78 FR 24666 - Updates to the List of Plant Inspection Stations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... plant material imported for plant breeding and research programs. The Plant Germplasm Inspection Station... DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service 7 CFR Part 319 [Docket No. APHIS-2012-0099] Updates to the List of Plant Inspection Stations AGENCY: Animal and Plant Health...

Proposed reporting model update creates dialogue between FASB and not-for-profits.

PubMed

Mosrie, Norman C

2016-04-01

Seeing a need to refresh the current guidelines, the Financial Accounting Standards Board (FASB) proposed an update to the financial accounting and reporting model for not-for-profit entities. In a response to solicited feedback, the board is now revisiting its proposed update and has set forth a plan to finalize its new guidelines. The FASB continues to solicit and respond to feedback as the process progresses.

Disclosure and Fit Capability of the Filtering Facepiece Respirator.

PubMed

Lofgren, Don J

2018-05-01

The filtering facepiece air-purifying respirator is annually purchased in the tens of millions and widely used for worker protection from harmful airborne particulates. The workplace consumers of this safety product, i.e., employers, workers, and safety and health professionals, have assurances of its effectiveness through the respirator certification and disclosure requirements of the National Institute for Occupational Safety and Health. However, the certification of a critical performance requirement has been missing for the approved filtering facepiece respirator since 1995: fit capability. Without this certification, consumers continue to be at risk of purchasing a respirator model that may fit a small percentage of the intended users. This commentary updates and expands an earlier one by this author, addresses the consequences of poorly fitting certified models on the market and lack of disclosure, and calls for further action by National Institute for Occupational Safety and Health to meet the needs and expectations of the consumer.

HIV testing updates and challenges: when regulatory caution and public health imperatives collide.

PubMed

Branson, Bernard M

2015-03-01

Numerous improvements in HIV testing technology led recently to the first revision of recommendations for diagnostic laboratory testing in the USA in 25 years. Developments in HIV testing continue to produce tests that identify HIV infection earlier with faster turnaround times for test results. These play an important role in identifying HIV infection during the highly infectious acute phase, which has implication for both patient management and public health interventions to control the spread of HIV. Access to these developments, however, is often delayed by the regulatory apparatus for approval and oversight of HIV testing in the USA. This article summarizes recent developments in HIV diagnostic testing technology, outlines their implications for clinical management and public health, describes current systems of regulatory oversight for HIV testing in the USA, and proposes alternatives that could expedite access to improved tests as they become available.

Updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12).

PubMed

Selim, Alfredo J; Rogers, William; Fleishman, John A; Qian, Shirley X; Fincke, Benjamin G; Rothendler, James A; Kazis, Lewis E

2009-02-01

The purpose of this project was to develop an updated U.S. population standard for the Veterans RAND 12-item Health Survey (VR-12). We used a well-defined and nationally representative sample of the U.S. population from 52,425 responses to the Medical Expenditure Panel Survey (MEPS) collected between 2000 and 2002. We applied modified regression estimates to update the non-proprietary 1990 scoring algorithms. We applied the updated standard to the Medicare Health Outcomes Survey (HOS) to compute the VR-12 physical (PCS((MEPS standard))) and mental (MCS((MEPS standard))) component summaries based on the MEPS. We compared these scores to PCS and MCS based on the 1990 U.S. population standard. Using the updated U.S. population standard, the average VR-12 PCS((MEPS standard)) and MCS((MEPS standard)) scores in the Medicare HOS were 39.82 (standard deviation [SD] = 12.2) and 50.08 (SD = 11.4), respectively. For the same Medicare HOS, the average PCS and MCS scores based on the 1990 standard were 1.40 points higher and 0.99 points lower in comparison to VR-12 PCS and MCS, respectively. Changes in the U.S. population between 1990 and today make the old standard obsolete for the VR-12, so the updated standard developed here is widely available to serve as such a contemporary standard for future applications for health-related quality of life (HRQoL) assessments.

Monitoring the compliance of the academic enterprise with the Fair Labor Standards Act

PubMed Central

Bankston, Adriana; McDowell, Gary S.

2017-01-01

Background: On December 1, 2016, the Fair Labor Standards Act (FLSA) was due to be updated by the U.S. Department of Labor. Key changes included an increase in the salary threshold for exemption from overtime for working more than 40 hours per week, and indexing the salary level so that it is updated automatically every 3 years. This was predicted to have a profound effect on academe as postdoctoral researchers were mostly paid at a salary below the new threshold. On November 22, 2016, an injunction was granted nationwide, delaying implementation of the updates, which were finally struck down entirely on August 31, 2017. Here we review the key changes to the FLSA, how they came about, and how the postdoctoral population was affected. Methods: We describe recent data collection efforts to uncover what institutions with postdocs were doing to comply with the FLSA. Results: Our data showed that 57% of institutions checked (containing 41% of the estimated postdoctoral workforce in science, engineering and health) had not decided or had no public decision available one month prior to implementation, and only 35.5% of institutions were planning to raise salaries to the new minimum. After the injunction, a number of institutions and the NIH continued with their plans to raise salaries. Overall, despite the removal of a federal mandate, approximately 60% of postdocs are at institutions whose policy is to raise salaries. Conclusions: Our data show uncertainty in postdoctoral salaries in the U.S. prior to implementation of the FLSA ruling. In addition, while some institutions did suspend plans to raise postdoctoral salaries after the injunction, many continued with the raise. The implementation of postdoctoral salary raises may be inconsistent, however, as the legal minimum is still $23,660. PMID:27990268

Rocky Mountain Research Station: 2008 Strategic Framework Update

Treesearch

Lane Eskew

2009-01-01

The Rocky Mountain Research Station's 2008 Strategic Framework Update is an addendum to the 2003 RMRS Strategic Framework. It focuses on critical natural resources research topics over the next five to 10 years when we will see continued, if not accelerated, socioeconomic and...

41 CFR 102-37.405 - How often must a SASP update donee eligibility records?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION PERSONAL PROPERTY 37-DONATION OF SURPLUS PERSONAL PROPERTY Donations to Public Agencies, Service Educational Activities.... Annually, you must update files for nonprofit organizations whose eligibility depends on annual...

41 CFR 102-37.405 - How often must a SASP update donee eligibility records?

Code of Federal Regulations, 2011 CFR

2011-01-01

... Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION PERSONAL PROPERTY 37-DONATION OF SURPLUS PERSONAL PROPERTY Donations to Public Agencies, Service Educational Activities.... Annually, you must update files for nonprofit organizations whose eligibility depends on annual...

Issues Facing Pharmacy Leaders in 2015: Suggestions for Pharmacy Strategic Planning

PubMed Central

Weber, Robert J.

2015-01-01

Issues facing pharmacy leaders in 2015 include practice model growth and the role of pharmacy students, clinical privileging of health-system pharmacists and provider status, medication error prevention, and specialty pharmacy services. The goal of this article is to provide practical approaches to 4 issues facing pharmacy leaders in 2015 to help them focus their department’s goals. This article will address (1) advances in the pharmacy practice model initiative and the role of pharmacy students, (2) the current thinking of pharmacists being granted clinical privileges in health systems, (3) updates on preventing harmful medication errors, and (4) the growth of specialty pharmacy services. The sample template of a strategic plan may be used by a pharmacy department in 2015 in an effort to continue developing patient-centered pharmacy services. PMID:25717212

Continuing Training in Firms and Trainer Development in Germany.

ERIC Educational Resources Information Center

Rieleit, Birgit; Selke, Reinhard

German legislation contains provisions on both initial and further vocational training. Three types of continuing training are distinguished: retraining, updating training, and upgrading training. Industries contribute the largest share of funding and participants to continuing training. In-company continuing training differs greatly according to…

A cross-sectional study of facilitators and barriers of Iranian nurses' participation in continuing education programs.

PubMed

Hamzehgardeshi, Zeinab; Shahhosseini, Zohreh

2013-12-27

Continuing education is one of the modern strategies to maintain and elevate knowledge and professional skills of nurses which in turn elevate the health status of society. Since several factors affect nurses' participation in continuing education, it's essential to know promoters and obstacles in this issue and plan accordingly. In this cross-sectional study, 361 Iranian nurses who were recruited by convenience sampling method completed an anonymous, self-administered questionnaire from October 2012 to April 2013. Topics covered the participants' attitudes towards facilitators and barriers of their participation in continuing education. Mean and standard deviation of participants ' age were 37.14±7.58 years and 93.94% were female. The maximum score of facilitators and barriers to nurses' participation in continuing education were related to "Update my knowledge" and "Work commitments" respectively. The results showed among Iranian nurses, the mean score of personal and structural barriers was significantly higher than the mean score of interpersonal ones (F=2122.66, p<0.001). Results highlight policy makers and nursing managers' role on improving the accessibility to provided continuing education programs by enforcement of facilitators and reducing barriers focusing on the personal and structural barriers.

Cardiovascular Update: Risk, Guidelines, and Recommendations.

PubMed

Pearson, Tamera

2015-09-01

This article provides an update of the current status of cardiovascular disease (CVD) in the United States, including a brief review of the underlying pathophysiology and epidemiology. This article presents a discussion of the latest American Heart Association guidelines that introduce the concept of promoting ideal cardiovascular health, defined by seven identified metrics. Specific CVD risk factors and utilization of the 10-year CVD event prediction calculator are discussed. In addition, current management recommendations of health-related conditions that increase risk for CVD, such as hypertension and hypercholesterolemia, are provided. Finally, a discussion of detailed evidence-based lifestyle recommendations to promote cardiovascular health and reduce CVD risks concludes the update. © 2015 The Author(s).

HCV Health Policy Developments in Response to the National Viral Hepatitis Action Plan: A Brief Update.

PubMed

Guo, Yuqi; Sims, Omar T

2017-02-17

Hepatitis C virus (HCV) kills 366,000 people worldwide and 17,000 people in the United States each year. In 2011, the U.S. Department of Health and Human Services (HHS) published a national viral hepatitis action plan to control and combat HCV in the United States. This article provides a brief update of HCV health policy developments that have emerged since publication of HHS's national viral hepatitis action plan and concludes with a discussion of the public health impact of these recent HCV health policy developments.

Project update: evaluating the community health legacy of WWI chemical weapons testing.

PubMed

Fox, Mary A

2014-10-01

The Spring Valley community of Washington, District of Columbia, was built on the site of a World War I chemical weapons lab where testing activities had distributed arsenic to surface soil and waste disposal had resulted in localized subsurface contamination. In previous work, findings were suggestive of potential site-related health issues, although no evidence of cancer clustering was found. In follow-up, we updated the community health assessment and explored time trends for several arsenic-related cancers. Health indicators continue to be very good in Spring Valley. For all major causes of mortality, Spring Valley rates were lower than United States (US) rates with most substantially lower (20-80 %); rates for heart diseases, Alzheimer's, and essential hypertension and related kidney disease were only slightly lower than US rates (3-8 %). Incidence and mortality rates for the selected cancers in the Spring Valley area were lower than US rates. Small non-statistically significant increasing time trends were observed in Spring Valley for incidence of two arsenic-related cancers: bladder and lung and bronchus. A moderate statistically significant increasing rate trend was observed for lung and bronchus cancer mortality in Spring Valley (p < 0.01). Lung and bronchus cancer mortality rates were also increasing in the Chevy Chase community, the local comparison area closely matched to Spring Valley on important demographic variables, suggesting that the observed increases may not be site-related. A full profile of common cancer site rates and trends for both study areas was suggested to better understand the rate trend findings but no epidemiological study was recommended.

Pandemic influenza A (H1N1) 2009 vaccine: an update.

PubMed

Goel, M K; Goel, M; Khanna, P; Mittal, K

2011-01-01

The world witnessed a the first influenza pandemic in this century and fourth overall since first flu pandemic was reported during the World War I. The past experiences with influenza viruses and this pandemic of H1N1 place a consider-able strain on health services and resulted in serious illnesses and a large number of deaths. Develop-ing countries were declared more likely to be at risk from the pandemic effects, as they faced the dual problem of highly vulnerable populations and limited resources to respond H1N1. The public health experts agreed that vaccination is the most effective ways to mitigate the negative effects of the pandemic. The vaccines for H1N1 virus have been used in over 40 countries and administered to over 200 million people helped in a great way and on August 10, 2010, World Health Organization (WHO) announced H1N1 to be in postpandemic period. But based on knowledge about past pandemics, the H1N1 (2009) virus is expected to continue to circulate as a seasonal virus and may undergo some agenic-variation. As WHO strongly recommends vaccination, vigilance for regular updating of the composition of influenza vaccines, based on an assessment of the future impact of circulating viruses along with safety surveillance of the vaccines is necessary. This review has been done to take a stock of the currently available H1N1 vaccines and their possible use as public health intervention in the postpandemic period.

Wireless data collection system for travel time estimation and traffic performance evaluation.

DOT National Transportation Integrated Search

2010-09-01

Having accurate and continually updated travel time and other performance data for the road and highway system has many benefits. From the perspective of the road users, having real-time updates on travel times will permit better travel and route pla...

Medicare program; FY 2014 hospice wage index and payment rate update; hospice quality reporting requirements; and updates on payment reform. final rule.

PubMed

2013-08-07

This final rule updates the hospice payment rates and the wage index for fiscal year (FY) 2014, and continues the phase out of the wage index budget neutrality adjustment factor (BNAF). Including the FY 2014 15 percent BNAF reduction, the total 5 year cumulative BNAF reduction in FY 2014 will be 70 percent. The BNAF phase-out will continue with successive 15 percent reductions in FY 2015 and FY 2016. This final rule also clarifies how hospices are to report diagnoses on hospice claims, and provides updates to the public on hospice payment reform. Additionally, this final rule changes the requirements for the hospice quality reporting program by discontinuing currently reported measures and implementing a Hospice Item Set with seven National Quality Forum (NFQ) endorsed measures beginning July 1, 2014, as proposed. Finally, this final rule will implement the hospice Experience of Care Survey on January 1, 2015, as proposed.

75 FR 82030 - Board of Scientific Counselors, National Center for Health Statistics (BSC, NCHS)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-29

... to be Discussed: The agenda will include welcome remarks by the Director, NCHS; an update on the Health Indicators Warehouse; an update on program reviews; and an open session for comments from the... the presenter. Written comments should not exceed five single-spaced typedpages in length and must be...

77 FR 24720 - Board of Scientific Counselors, National Center for Environmental Health/Agency for Toxic...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-25

... Investigations; update on the Advisory Committee on Childhood Lead Poisoning Prevention; and updates by the BSC... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of.... L. 92-463), the Centers for Disease Control and Prevention (CDC), announces the following meeting of...

Insurance Financing Increased For Mental Health Conditions But Not For Substance Use Disorders, 1986-2014.

PubMed

Mark, Tami L; Yee, Tracy; Levit, Katharine R; Camacho-Cook, Jessica; Cutler, Eli; Carroll, Christopher D

2016-06-01

This study updates previous estimates of US spending on mental health and substance use disorders through 2014. The results reveal that the long-term trend of greater insurance financing of mental health care continued in recent years. The share of total mental health treatment expenditures financed by private insurance, Medicare, and Medicaid increased from 44 percent in 1986 to 68 percent in 2014. In contrast, the share of spending for substance use disorder treatment financed by private insurance, Medicare, and Medicaid was 45 percent in 1986 and 46 percent in 2014. From 2004 to 2013, a growing percentage of adults received mental health treatment (12.6 percent and 14.6 percent, respectively), albeit only because of the increased use of psychiatric medications. In the same period, only 1.2-1.3 percent of adults received substance use disorder treatment in inpatient, outpatient, or residential settings, although the use of medications to treat substance use disorders increased rapidly. Project HOPE—The People-to-People Health Foundation, Inc.

HIV testing in Europe: Evaluating the impact, added value, relevance and usability of the European Centre for Disease Prevention and Control (ECDC)'s 2010 HIV testing guidance.

PubMed

Sullivan, Ann K; Sperle, Ida; Raben, Dorthe; Amato-Gauci, Andrew J; Lundgren, Jens Dilling; Yazdanpanah, Yazdan; Jakobsen, Stine Finne; Tavoschi, Lara

2017-11-01

An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015-January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance. Data sources were two surveys: one for the primary target audience (health policymakers and decision makers, national programme managers and ECDC official contact points in the European Union/European Economic Area (EU/EEA) countries and one for a broader target audience (clinicians, civil society organisations and international public health agencies); two moderated focus group discussions  (17 participants each); webpage access data; a literature citation review; and an expert consultation (18 participants) to discuss the evaluation findings. Twenty-three of 28 primary target audience and 31 of 51 broader target audience respondents indicated the guidance was the most relevant when compared with other international guidance. Primary target audience respondents in 11 of 23 countries reported that they had used the guidance in development, monitoring and/or evaluation of their national HIV testing policy, guidelines, programme and/or strategy, and 29 of 51 of the broader target audience respondents reported having used the guidance in their work. Both the primary and broader target audience considered it important or very important to have an EU/EEA-level HIV testing guidance (23/28 and 46/51, respectively). The guidance has been widely used to develop policies, guidelines, programmes and strategies in the EU/EEA and should be regularly updated due to continuous developments in the field in order to continue to serve as an important reference guidance in the region.

HIV testing in Europe: Evaluating the impact, added value, relevance and usability of the European Centre for Disease Prevention and Control (ECDC)’s 2010 HIV testing guidance

PubMed Central

Sullivan, Ann K; Sperle, Ida; Raben, Dorthe; Amato-Gauci, Andrew J; Lundgren, Jens Dilling; Yazdanpanah, Yazdan; Jakobsen, Stine Finne; Tavoschi, Lara

2017-01-01

Background: An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015–January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance. Methods: Data sources were two surveys: one for the primary target audience (health policymakers and decision makers, national programme managers and ECDC official contact points in the European Union/European Economic Area (EU/EEA) countries and one for a broader target audience (clinicians, civil society organisations and international public health agencies); two moderated focus group discussions  (17 participants each); webpage access data; a literature citation review; and an expert consultation (18 participants) to discuss the evaluation findings. Results: Twenty-three of 28 primary target audience and 31 of 51 broader target audience respondents indicated the guidance was the most relevant when compared with other international guidance. Primary target audience respondents in 11 of 23 countries reported that they had used the guidance in development, monitoring and/or evaluation of their national HIV testing policy, guidelines, programme and/or strategy, and 29 of 51 of the broader target audience respondents reported having used the guidance in their work. Both the primary and broader target audience considered it important or very important to have an EU/EEA-level HIV testing guidance (23/28 and 46/51, respectively). Conclusion: The guidance has been widely used to develop policies, guidelines, programmes and strategies in the EU/EEA and should be regularly updated due to continuous developments in the field in order to continue to serve as an important reference guidance in the region. PMID:29208158

Landsat-7 ETM+ Radiometric Calibration Status

NASA Technical Reports Server (NTRS)

Barsi, Julia A.; Markham, Brian L.; Czapla-Myers, Jeffrey S.; Helder, Dennis L.; Hook, Simon J.; Schott, John R; Haque, Md. Obaidul

2016-01-01

Now in its 17th year of operation, the Enhanced Thematic Mapper + (ETM+), on board the Landsat-7 satellite, continues to systematically acquire imagery of the Earth to add to the 40+ year archive of Landsat data. Characterization of the ETM+ on-orbit radiometric performance has been on-going since its launch in 1999. The radiometric calibration of the reflective bands is still monitored using on-board calibration devices, though the Pseudo-Invariant Calibration Sites (PICS) method has proven to be an effect tool as well. The calibration gains were updated in April 2013 based primarily on PICS results, which corrected for a change of as much as -0.2%/year degradation in the worst case bands. A new comparison with the SADE database of PICS results indicates no additional degradation in the updated calibration. PICS data are still being tracked though the recent trends are not well understood. The thermal band calibration was updated last in October 2013 based on a continued calibration effort by NASA/Jet Propulsion Lab and Rochester Institute of Technology. The update accounted for a 0.31 W/sq m/ sr/micron bias error. The updated lifetime trend is now stable to within + 0.4K.

America's Children and the Environment, Third Edition ...

EPA Pesticide Factsheets

America's Children and the Environment is the U.S. EPA's report of children's environmental health indicators. Two editions of the report have been published, in 2000 and 2003, and a website is maintained with updated values for the indicators. The new Third Edition of America's Children and the Environment incorporates updates and revisions to previous content as well as several new indicators. America's Children and the Environment is the U.S. EPA's report of children's environmental health indicators. Two editions of the report have been published, in 2000 and 2003, and a website is maintained with updated values for the indicators. The new Third Edition of America's Children and the Environment incorporates updates and revisions to previous content as well as several new indicators.

A process for updating a philosophy of education statement.

PubMed

Gambescia, Stephen F

2013-01-01

Most health education specialists have been introduced to the idea of having a philosophy of education statement. Although some in the field have been writing about this career development exercise, little has been written about the process of developing one's philosophy of education statement. This brief essay explains a sample process health education specialists can use to create or update their philosophy of education statement. The author gives a firsthand account of a systematic, disciplined, intellectually liberating, and reflective approach to articulating one's philosophy of education statement, by considering the writings of select intellectual giants who have acted on human experience, thought, and practice in education. A philosophy of education statement should be useful to any health education specialist regardless of type of work, site, position in the organization, population served, or health topic. The resultant updated and precisely written statement serves to sharpen a health education specialist's future role as a health educator, as well as contribute to his or her journey in lifelong learning.

Update on implementation of GHS in Korea and revision of Industrial Safety and Health Act in relation to GHS.

PubMed

Yu, Il Je; Kim, Dong Suk; Lim, Cheol Hong; Choi, Jung Yun; Lee, Je Bong; Chung, Ok-Sun; Kwon, Kyungok; Yum, Young Na; Kim, Jeongho; Kuk, Won-Kwen; Kim, Kyun

2007-12-01

To implement the globally harmonized system of classification and labelling of chemicals (GHS) in Korea, an inter-ministerial GHS committee, involving 8 ministries and an expert working group composed of 9 experts from relevant organizations and one private consultant, have made some progress towards implementation by 2008. As such, the first revision of the official Korean translated version of the GHS in accordance with the GHS purple book revision 1 in 2005, including annexes, started in August, 2006, was completed in December, 2006. The Ministry of Labor also finally revised the Industrial Safety and Health Act (ISHA) relating to the GHS and the detailed notification was announced on Dec 12, 2006 and became effective immediately. The revised ISHA will allow continued use of the existing hazard communication system until Jun 30, 2008. Other revisions of chemical-related regulations will follow soon to facilitate the implementation of the GHS by 2008. Besides, inter-ministerial collaborative efforts on harmonizing regulations and disseminating the GHS in Korea will continue to avoid any confusion or duplication and for the effective use of resources.

Cardiovascular Effects of Exposure to Cigarette Smoke and Electronic Cigarettes: Clinical Perspectives From the Prevention of Cardiovascular Disease Section Leadership Council and Early Career Councils of the American College of Cardiology.

PubMed

Morris, Pamela B; Ference, Brian A; Jahangir, Eiman; Feldman, Dmitriy N; Ryan, John J; Bahrami, Hossein; El-Chami, Mikhael F; Bhakta, Shyam; Winchester, David E; Al-Mallah, Mouaz H; Sanchez Shields, Monica; Deedwania, Prakash; Mehta, Laxmi S; Phan, Binh An P; Benowitz, Neal L

2015-09-22

Cardiovascular morbidity and mortality as a result of inhaled tobacco products continues to be a global healthcare crisis, particularly in low- and middle-income nations lacking the infrastructure to develop and implement effective public health policies limiting tobacco use. Following initiation of public awareness campaigns 50 years ago in the United States, considerable success has been achieved in reducing the prevalence of cigarette smoking and exposure to secondhand smoke. However, there has been a slowing of cessation rates in the United States during recent years, possibly caused by high residual addiction or fatigue from cessation messaging. Furthermore, tobacco products have continued to evolve faster than the scientific understanding of their biological effects. This review considers selected updates on the genetics and epigenetics of smoking behavior and associated cardiovascular risk, mechanisms of atherogenesis and thrombosis, clinical effects of smoking and benefits of cessation, and potential impact of electronic cigarettes on cardiovascular health. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

10 CFR 72.70 - Safety analysis report updating.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Safety analysis report updating. 72.70 Section 72.70 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) LICENSING REQUIREMENTS FOR THE INDEPENDENT STORAGE OF SPENT NUCLEAR FUEL, HIGH-LEVEL RADIOACTIVE WASTE, AND REACTOR-RELATED GREATER THAN CLASS C WASTE Records...

A History of the Teratology Society -With Updates 2000-2010

EPA Science Inventory

Background: The 49-year history of the Teratology Society is reviewed. An abbreviated history is outlined in table form, along with listings of the Warkany Lectures, the Continuing Education Courses, and officers of the Society. The original article was updated to include the yea...

Mental health system funding of cognitive enhancement interventions for schizophrenia: summary and update of the New York Office of Mental Health expert panel and stakeholder meeting.

PubMed

McGurk, Susan R; Mueser, Kim T; Covell, Nancy H; Cicerone, Keith D; Drake, Robert E; Silverstein, Steven M; Medialia, Alice; Myers, Robert; Bellack, Alan S; Bell, Morris D; Essock, Susan M

2013-09-01

A growing research literature indicates that cognitive enhancement (CE) interventions for people with schizophrenia can improve cognitive functioning and may benefit psychosocial functioning (e.g., competitive employment, quality of social relationships). Debate continues regarding the strength of evidence for CE and related policy implications, such as the appropriateness of funding CE services. This paper summarizes and updates a meeting of experts and stakeholders convened in 2008 by the New York Office of Mental Health to review evidence on the impact of CE for people with schizophrenia and other serious mental illnesses, and addresses whether the evidence base for CE interventions is sufficient to warrant funding. Specific recommendations based on the extant literature are provided regarding the structure and components of CE programs that should be present in order to improve cognitive and psychosocial outcomes and therefore merit consideration of funding. These recommendations may serve as a starting point in developing standards for CE programs. Establishing evidence-based practice standards for implementing CE interventions for people with serious mental illnesses may facilitate dissemination of programs that have the greatest potential for improving individuals' functional outcomes while minimizing incremental costs associated with providing CE services. Important open questions include how the performance of CE programs should be monitored and which individuals might be expected to benefit from CE as evidenced by improved functioning in their everyday lives. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

World Health Organization treatment guidelines for drug-resistant tuberculosis, 2016 update.

PubMed

Falzon, Dennis; Schünemann, Holger J; Harausz, Elizabeth; González-Angulo, Licé; Lienhardt, Christian; Jaramillo, Ernesto; Weyer, Karin

2017-03-01

Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9-12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016. The composition of longer regimens for patients ineligible for the shorter regimen was modified. A first-ever meta-analysis of individual paediatric patient data allowed treatment recommendations for childhood MDR/RR-TB to be made. Delamanid is now also recommended in patients aged 6-17 years. Partial lung resection is a recommended option in MDR/RR-TB care. The 2016 revision highlighted the continued shortage of high-quality evidence and implementation research, and reiterated the need for clinical trials and best-practice studies to improve MDR/RR-TB patient treatment outcomes and strengthen policy. The content of this work is copyright of the authors or their employers. Design and branding are copyright ©ERS 2017.

High-performance sport, marijuana, and cannabimimetics.

PubMed

Hilderbrand, Richard L

2011-11-01

The prohibition on use of cannabinoids in sporting competitions has been widely debated and continues to be a contentious issue. Information continues to accumulate on the adverse health effects of smoked marijuana and the decrement of performance caused by the use of cannabinoids. The objective of this article is to provide an overview of cannabinoids and cannabimimetics that directly or indirectly impact sport, the rules of sport, and performance of the athlete. This article reviews some of the history of marijuana in Olympic and Collegiate sport, summarizes the guidelines by which a substance is added to the World Anti-Doping Agency Prohibited List, and updates information on the pharmacologic effects of cannabinoids and their mechanism of action. The recently marketed cannabimimetics Spice and K2 are included in the discussion as they activate the same receptors as are activated by THC. The article also provides a view as to why the World Anti-Doping Agency prohibits cannabinoid or cannabimimetic use incompetition and should continue to do so.

Frequency Response Function Based Damage Identification for Aerospace Structures

NASA Astrophysics Data System (ADS)

Oliver, Joseph Acton

Structural health monitoring technologies continue to be pursued for aerospace structures in the interests of increased safety and, when combined with health prognosis, efficiency in life-cycle management. The current dissertation develops and validates damage identification technology as a critical component for structural health monitoring of aerospace structures and, in particular, composite unmanned aerial vehicles. The primary innovation is a statistical least-squares damage identification algorithm based in concepts of parameter estimation and model update. The algorithm uses frequency response function based residual force vectors derived from distributed vibration measurements to update a structural finite element model through statistically weighted least-squares minimization producing location and quantification of the damage, estimation uncertainty, and an updated model. Advantages compared to other approaches include robust applicability to systems which are heavily damped, large, and noisy, with a relatively low number of distributed measurement points compared to the number of analytical degrees-of-freedom of an associated analytical structural model (e.g., modal finite element model). Motivation, research objectives, and a dissertation summary are discussed in Chapter 1 followed by a literature review in Chapter 2. Chapter 3 gives background theory and the damage identification algorithm derivation followed by a study of fundamental algorithm behavior on a two degree-of-freedom mass-spring system with generalized damping. Chapter 4 investigates the impact of noise then successfully proves the algorithm against competing methods using an analytical eight degree-of-freedom mass-spring system with non-proportional structural damping. Chapter 5 extends use of the algorithm to finite element models, including solutions for numerical issues, approaches for modeling damping approximately in reduced coordinates, and analytical validation using a composite sandwich plate model. Chapter 6 presents the final extension to experimental systems-including methods for initial baseline correlation and data reduction-and validates the algorithm on an experimental composite plate with impact damage. The final chapter deviates from development and validation of the primary algorithm to discuss development of an experimental scaled-wing test bed as part of a collaborative effort for developing structural health monitoring and prognosis technology. The dissertation concludes with an overview of technical conclusions and recommendations for future work.

Genomics and Health Impact Update

MedlinePlus

... Antimicrobial Resistance Detection/ Diagnosis Epidemiology/ Outbreaks/ Transmission Antimicrobials/ Vaccines/ Interventions Host-Microbe Interactions Updates on Specific Diseases Alzheimer’s Disease Autism Blood Diseases Breast Cancer Cancer Cardiomyopathy Colorectal Cancer ...

76 FR 53137 - Board of Scientific Counselors, National Center for Health Statistics, (BSC, NCHS)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

... Regulation, Subpart 101-20.301, all persons entering in or on Federal controlled property and their packages... Discussed: The agenda will include welcome remarks by the Director, NCHS; update on the Health Indicators Warehouse; update on program reviews; discussion of the NHANES program, plans for the NHIS for 2012 and...

An ontology of and roadmap for mHealth research.

PubMed

Cameron, Joshua D; Ramaprasad, Arkalgud; Syn, Thant

2017-04-01

Mobile health or mHealth research has been growing exponentially in recent years. However, the research on mHealth has been ad-hoc and selective without a clear definition of the mHealth domain. Without a roadmap for research we may not realize the full potential of mHealth. In this paper, we present an ontological framework to define the mHealth domain and illuminate a roadmap. We present an ontology of mHealth. The ontology is developed by systematically deconstructing the domain into its primary dimensions and elements. We map the extent research on mHealth in 2014 onto the ontology and highlight the bright, light, and blind/blank spots which represent the emphasis of mHealth research. The emphases of mHealth research in 2014 are very uneven. There are a few bright spots and many light spots. The research predominantly focuses on individuals' use of mobile devices and applications to capture or obtain health-related data mostly to improve quality of care through mobile intervention. We argue that the emphases can be balanced in the roadmap for mHealth research. The ontological mapping plays an integral role in developing and maintaining the roadmap which can be updated periodically to continuously assess and guide mHealth research. Copyright © 2017 Elsevier B.V. All rights reserved.

Comprehensive Environmental Informatics System (CEIS) Integrating Crew and Vehicle Environmental Health

NASA Technical Reports Server (NTRS)

Nall, Mark E.

2006-01-01

Integrated Vehicle Health Management (IVHM) systems have been pursued as highly integrated systems that include smart sensors, diagnostic and prognostics software for assessments of real-time and life-cycle vehicle health information. Inclusive to such a system is the requirement to monitor the environmental health within the vehicle and the occupants of the vehicle. In this regard an enterprise approach to informatics is used to develop a methodology entitled, Comprehensive Environmental Informatics System (CEIS). The hardware and software technologies integrated into this system will be embedded in the vehicle subsystems, and maintenance operations, to provide both real-time and life-cycle health information of the environment within the vehicle cabin and of its occupants. This comprehensive information database will enable informed decision making and logistics management. One key element of the CEIS is interoperability for data acquisition and archive between environment and human system monitoring. With comprehensive components the data acquired in this system will use model based reasoning systems for subsystem and system level managers, advanced on-board and ground-based mission and maintenance planners to assess system functionality. Knowledge databases of the vehicle health state will be continuously updated and reported for critical failure modes, and routinely updated and reported for life cycle condition trending. Sufficient intelligence, including evidence-based engineering practices which are analogous to evidencebased medicine practices, will be included in the CEIS to result in more rapid recognition of off-nominal operation to enable quicker corrective actions. This will result from better information (rather than just data) for improved crew/operator situational awareness, which will produce significant vehicle and crew safety improvements, as well as increasing the chance for mission success, future mission planning as well as training. Other benefits include improved reliability, increase safety in operations and cost of operations. The cost benefits stem from significantly reduced processing and operations manpower, predictive maintenance for systems and subjects. The improvements in vehicle functionality and cost will result from increased prognostic and diagnostic capability due to the detailed total human exploration system health knowledge from CEIS. A collateral benefit is that there will be closer observations of the vehicle occupants as wrist watch sized devices are worn for continuous health monitoring. Additional database acquisition will stem from activities in countermeasure practices to ensure peak performance capability by occupants of the vehicle. The CEIS will provide data from advanced sensing technologies and informatics modeling which will be useful in problem troubleshooting, and improving NASA s awareness of systems during operation.

Continuous flow measurements using ultrasonic velocity meters - an update

USGS Publications Warehouse

Oltmann, Rick

1995-01-01

An article in the summer 1993 Newsletter described USGS work to continously monitor tidal flows in the delta using ultrasonic velocity meters.  This article updates progress since 1993, including new installations, results of data analysis, damage during this year's high flows, and the status of each site.

40 CFR 1065.202 - Data updating, recording, and control.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... 1065.202 Section 1065.202 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS ENGINE-TESTING PROCEDURES Measurement Instruments § 1065.202 Data updating, recording... Intake-air or raw-exhaust flow rate N/A 1 Hz means. § 1065.530, § 1065.545 Dilution air if actively...

40 CFR 1065.202 - Data updating, recording, and control.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... 1065.202 Section 1065.202 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS ENGINE-TESTING PROCEDURES Measurement Instruments § 1065.202 Data updating, recording...; § 1065.545 Intake-air or raw-exhaust flow rate 1 Hz means. § 1065.530; § 1065.545 Dilution air flow if...

40 CFR 1065.202 - Data updating, recording, and control.

Code of Federal Regulations, 2012 CFR

2012-07-01

.... 1065.202 Section 1065.202 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS ENGINE-TESTING PROCEDURES Measurement Instruments § 1065.202 Data updating, recording... Intake-air or raw-exhaust flow rate N/A 1 Hz means. § 1065.530, § 1065.545 Dilution air if actively...

40 CFR 1065.202 - Data updating, recording, and control.

Code of Federal Regulations, 2013 CFR

2013-07-01

.... 1065.202 Section 1065.202 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS ENGINE-TESTING PROCEDURES Measurement Instruments § 1065.202 Data updating, recording... Intake-air or raw-exhaust flow rate N/A 1 Hz means. § 1065.530, § 1065.545 Dilution air if actively...

76 FR 16285 - Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-23

... Plan to update the Commission's human health and aquatic life stream quality objectives (also called... DELAWARE RIVER BASIN COMMISSION 18 CFR Part 410 Amendments to the Water Quality Regulations, Water Code and Comprehensive Plan To Update Water Quality Criteria for Toxic Pollutants in the Delaware...

75 FR 3911 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-25

...: The Advisory Board was established under the Energy Employees Occupational Illness Compensation... employees at any Department of Energy facility who were exposed to radiation but for whom it is not feasible... Labor (DOL) Program Update; Department of Energy (DOE) Program Update; OCAS Science Update; Special...

Evaluation of GRCh38 and de novo haploid genome assemblies demonstrates the enduring quality of the reference assembly.

PubMed

Schneider, Valerie A; Graves-Lindsay, Tina; Howe, Kerstin; Bouk, Nathan; Chen, Hsiu-Chuan; Kitts, Paul A; Murphy, Terence D; Pruitt, Kim D; Thibaud-Nissen, Françoise; Albracht, Derek; Fulton, Robert S; Kremitzki, Milinn; Magrini, Vincent; Markovic, Chris; McGrath, Sean; Steinberg, Karyn Meltz; Auger, Kate; Chow, William; Collins, Joanna; Harden, Glenn; Hubbard, Timothy; Pelan, Sarah; Simpson, Jared T; Threadgold, Glen; Torrance, James; Wood, Jonathan M; Clarke, Laura; Koren, Sergey; Boitano, Matthew; Peluso, Paul; Li, Heng; Chin, Chen-Shan; Phillippy, Adam M; Durbin, Richard; Wilson, Richard K; Flicek, Paul; Eichler, Evan E; Church, Deanna M

2017-05-01

The human reference genome assembly plays a central role in nearly all aspects of today's basic and clinical research. GRCh38 is the first coordinate-changing assembly update since 2009; it reflects the resolution of roughly 1000 issues and encompasses modifications ranging from thousands of single base changes to megabase-scale path reorganizations, gap closures, and localization of previously orphaned sequences. We developed a new approach to sequence generation for targeted base updates and used data from new genome mapping technologies and single haplotype resources to identify and resolve larger assembly issues. For the first time, the reference assembly contains sequence-based representations for the centromeres. We also expanded the number of alternate loci to create a reference that provides a more robust representation of human population variation. We demonstrate that the updates render the reference an improved annotation substrate, alter read alignments in unchanged regions, and impact variant interpretation at clinically relevant loci. We additionally evaluated a collection of new de novo long-read haploid assemblies and conclude that although the new assemblies compare favorably to the reference with respect to continuity, error rate, and gene completeness, the reference still provides the best representation for complex genomic regions and coding sequences. We assert that the collected updates in GRCh38 make the newer assembly a more robust substrate for comprehensive analyses that will promote our understanding of human biology and advance our efforts to improve health. © 2017 Schneider et al.; Published by Cold Spring Harbor Laboratory Press.

Performance Analysis of Inter-Domain Handoff Scheme Based on Virtual Layer in PMIPv6 Networks for IP-Based Internet of Things

PubMed Central

Choi, Jae-Young; Jeong, Jongpil; Chung, Tai-Myoung

2017-01-01

Lately, we see that Internet of things (IoT) is introduced in medical services for global connection among patients, sensors, and all nearby things. The principal purpose of this global connection is to provide context awareness for the purpose of bringing convenience to a patient’s life and more effectively implementing clinical processes. In health care, monitoring of biosignals of a patient has to be continuously performed while the patient moves inside and outside the hospital. Also, to monitor the accurate location and biosignals of the patient, appropriate mobility management is necessary to maintain connection between the patient and the hospital network. In this paper, a binding update scheme on PMIPv6, which reduces signal traffic during location updates by Virtual LMA (VLMA) on the top original Local Mobility Anchor (LMA) Domain, is proposed to reduce the total cost. If a Mobile Node (MN) moves to a Mobile Access Gateway (MAG)-located boundary of an adjacent LMA domain, the MN changes itself into a virtual mode, and this movement will be assumed to be a part of the VLMA domain. In the proposed scheme, MAGs eliminate global binding updates for MNs between LMA domains and significantly reduce the packet loss and latency by eliminating the handoff between LMAs. In conclusion, the performance analysis results show that the proposed scheme improves performance significantly versus PMIPv6 and HMIPv6 in terms of the binding update rate per user and average handoff latency. PMID:28129355

40 CFR 141.520 - Is my system subject to the updated watershed control requirements?

Code of Federal Regulations, 2010 CFR

2010-07-01

... AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People Additional Watershed Control...

40 CFR 141.520 - Is my system subject to the updated watershed control requirements?

Code of Federal Regulations, 2011 CFR

2011-07-01

... AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People Additional Watershed Control...

40 CFR 141.520 - Is my system subject to the updated watershed control requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

... AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People Additional Watershed Control...

40 CFR 141.520 - Is my system subject to the updated watershed control requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People Additional Watershed Control...

40 CFR 141.520 - Is my system subject to the updated watershed control requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000 People Additional Watershed Control...

Solar ultraviolet radiation, vitamin D and skin cancer surveillance in organ transplant recipients (OTRs): an update.

PubMed

Reichrath, Jörg

2014-01-01

During the last decades, the annual numbers of performed solid organ transplants have continuously increased world-wide. Solid organ transplant recipients (OTR) have a greater risk to develop malignancies, with skin cancer representing the most common neoplasia. Additionally, OTRs in general develop a more aggressive form of malignancies. In consequence, dermatologic surveillance is of high importance for OTRs and these patients represent an increasing and significant challenge to clinicians including dermatologists. In OTRs, patient and organ survival have increased considerably and continuously over the past two decades as a result of better immunosuppressive regimens and better posttransplant care. Great progress has been made in our understanding that individual immunosuppressive regiments differ in their effect on skin cancer risk in OTRs, and that effects of individual immunosuppressive regiments on skin cancer risk depend on various other factors including viral infections. Since sunlight is the major source of vitamin D for most humans, OTRs, who have to protect themselves consequently against solar or artificial UV radiation, are at high risk of developing vitamin D deficiency. Vitamin D deficiency is not only associated with increased risk for metabolic bone disease, but with other severe health problems including various types of malignancies. As a consequence, screening for and treatment of vitamin D deficiency is warranted in OTRs. In this review, we give an update on our present understanding of skin cancer surveillance in OTRs.

Nomenclature updates resulting from the evolution of avian influenza A(H5) virus clades 2.1.3.2a, 2.2.1, and 2.3.4 during 2013-2014.

PubMed

Smith, Gavin J D; Donis, Ruben O

2015-09-01

The A/goose/Guangdong/1/96-like hemagglutinin (HA) genes of highly pathogenic avian influenza (HPAI) A(H5) viruses have continued to rapidly evolve since the most recent update to the H5 clade nomenclature by the WHO/OIE/FAO H5N1 Evolution Working Group. New clades diverging beyond established boundaries need to be identified and designated accordingly. Hemagglutinin sequences deposited in publicly accessible databases up to December 31, 2014, were analyzed by phylogenetic and average pairwise distance methods to identify new clades that merit nomenclature changes. Three new clade designations were recommended based on division of clade 2·1·3·2a (Indonesia), 2·2·1 (Egypt), and 2·3·4 (widespread detection in Asia, Europe, and North America) that includes newly emergent HPAI virus subtypes H5N2, H5N3, H5N5, H5N6, and H5N8. Continued global surveillance for HPAI A(H5) viruses in all host species and timely reporting of sequence data will be critical to quickly identify new clades and assess their potential impact on human and animal health. © 2015 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Streptococcus suis infection

PubMed Central

Feng, Youjun; Zhang, Huimin; Wu, Zuowei; Wang, Shihua; Cao, Min; Hu, Dan; Wang, Changjun

2014-01-01

Streptococcus suis (S. suis) is a family of pathogenic gram-positive bacterial strains that represents a primary health problem in the swine industry worldwide. S. suis is also an emerging zoonotic pathogen that causes severe human infections clinically featuring with varied diseases/syndromes (such as meningitis, septicemia, and arthritis). Over the past few decades, continued efforts have made significant progress toward better understanding this zoonotic infectious entity, contributing in part to the elucidation of the molecular mechanism underlying its high pathogenicity. This review is aimed at presenting an updated overview of this pathogen from the perspective of molecular epidemiology, clinical diagnosis and typing, virulence mechanism, and protective antigens contributing to its zoonosis. PMID:24667807

The Global Health Dimensions of Asbestos and Asbestos-Related Diseases.

PubMed

Takahashi, Ken; Landrigan, Philip J

2016-01-01

The Collegium Ramazzini (CR) reaffirms its long-standing position that responsible public health action is to ban all extraction and use of asbestos, including chrysotile. This current statement updates earlier statements by the CR with a focus on global health dimensions of asbestos and asbestos-related diseases (ARDs). The ARD epidemic will likely not peak for at least a decade in most industrialized countries and for several decades in industrializing countries. Asbestos and ARDs will continue to present challenges in the arena of occupational medicine and public health, as well as in clinical research and practice, and have thus emerged as a global health issue. Industrialized countries that have already gone through the transition to an asbestos ban have learned lessons and acquired know-how and capacity that could be of great value if deployed in industrializing countries embarking on the transition. The accumulated wealth of experience and technologies in industrialized countries should thus be shared internationally through global campaigns to eliminate ARDs. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

[Work and health: Two social rights].

PubMed

García Blanco, Lucía

2015-01-01

Work and health are two concepts whose formulation varies from one society to another depending on unique and temporal appreciation. Updating them to our time involves the challenge to understand their construction as part of consuming organized societies. Political and social processes during the last decades must be analyzed, and so must be the worker subject as a psychophysics unit. Health, as well, ought to be considered a universal right, from where to focus and understand pathological social behaviors impacting the workplace. The subject's social dimension and the health-work relationship are dynamic. And keeping this dynamic involves to continuously review principles, norms and regulations which need to fit reality, and specific communication and language modes, as well as working conditions and environmental aspects. These processes must be considered as taking part in Argentina's social imaginary worth highlighting: a shift in how the State's role is considered, the public policy's sense, the importance of working in a complementary and interdisciplinary way, redesigning the concept of health through the broadening of those under the State's care and considering and building the workplace as a healthy space.

An update on zolpidem abuse and dependence.

PubMed

Victorri-Vigneau, Caroline; Gérardin, Marie; Rousselet, Morgane; Guerlais, Marylène; Grall-Bronnec, Marie; Jolliet, Pascale

2014-01-01

In 2004, the health authorities (French National Agency for Medicines and Health Products Safety-ANSM) modified the summary of zolpidem characteristics. Particularly it now includes the sentence "a pharmacodependence may materialize." The current article aims to show that despite this modification, zolpidem continues to be associated with problematic drug use, as the official system (Center for Evaluation and Information on Pharmacodependence-Addictovigilance network) providing information on the abuse and dependence potential of drugs informs us. The authors reviewed the literature on this topic and analyzed French data from zolpidem's postmarketing period that were collected by the Addictovigilance network from 2003 to 2010. Postmarketing data and the 30 case reports yielded from the literature review highlight a significant dependence and abuse potential for zolpidem. This survey led to propose in stronger additional rules in France to try to mitigate the abuse potential of zolpidem.

BI-RADS update.

PubMed

Mercado, Cecilia L

2014-05-01

The updated American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) has been newly released. This article summarizes the changes and updates that have been made to BI-RADS. The goal of the revised edition continues to be the same: to improve clarification in image interpretation, maintain reporting standardization, and simplify the monitoring of outcomes. The new BI-RADS also introduces new terminology to provide a more universal lexicon across all 3 imaging modalities. Copyright © 2014 Elsevier Inc. All rights reserved.

Red Hill Updates

EPA Pesticide Factsheets

This and other periodic updates are intended to keep the public informed on major progress being made to protect public health and the environment at the Red Hill Underground Fuel Storage Facility in Hawaii.

Model documentation for relations between continuous real-time and discrete water-quality constituents in Cheney Reservoir near Cheney, Kansas, 2001--2009

USGS Publications Warehouse

Stone, Mandy L.; Graham, Jennifer L.; Gatotho, Jackline W.

2013-01-01

Cheney Reservoir, located in south-central Kansas, is one of the primary water supplies for the city of Wichita, Kansas. The U.S. Geological Survey has operated a continuous real-time water-quality monitoring station in Cheney Reservoir since 2001; continuously measured physicochemical properties include specific conductance, pH, water temperature, dissolved oxygen, turbidity, fluorescence (wavelength range 650 to 700 nanometers; estimate of total chlorophyll), and reservoir elevation. Discrete water-quality samples were collected during 2001 through 2009 and analyzed for sediment, nutrients, taste-and-odor compounds, cyanotoxins, phytoplankton community composition, actinomycetes bacteria, and other water-quality measures. Regression models were developed to establish relations between discretely sampled constituent concentrations and continuously measured physicochemical properties to compute concentrations of constituents that are not easily measured in real time. The water-quality information in this report is important to the city of Wichita because it allows quantification and characterization of potential constituents of concern in Cheney Reservoir. This report updates linear regression models published in 2006 that were based on data collected during 2001 through 2003. The update uses discrete and continuous data collected during May 2001 through December 2009. Updated models to compute dissolved solids, sodium, chloride, and suspended solids were similar to previously published models. However, several other updated models changed substantially from previously published models. In addition to updating relations that were previously developed, models also were developed for four new constituents, including magnesium, dissolved phosphorus, actinomycetes bacteria, and the cyanotoxin microcystin. In addition, a conversion factor of 0.74 was established to convert the Yellow Springs Instruments (YSI) model 6026 turbidity sensor measurements to the newer YSI model 6136 sensor at the Cheney Reservoir site. Because a high percentage of geosmin and microcystin data were below analytical detection thresholds (censored data), multiple logistic regression was used to develop models that best explained the probability of geosmin and microcystin concentrations exceeding relevant thresholds. The geosmin and microcystin models are particularly important because geosmin is a taste-and-odor compound and microcystin is a cyanotoxin.

77 FR 7594 - Advisory Committee on Infant Mortality; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-13

... Infant Mortality (ACIM). Dates and Times: March 8, 2012, 8:30 a.m.-6 p.m.; March 9, 2012, 8:30 a.m.-3 p.m... mortality and improving the health status of infants and pregnant women; and factors affecting the continuum...; a Maternal and Child Health Bureau (MCHB) update; an update from the Committee's four workgroups...

Worksite Wellness Media Report Research Update 1988. Worksite Wellness Series.

ERIC Educational Resources Information Center

Behrens, Ruth; Weiss, Joanne

This report is the 15th in a series of updates on worksite health promotion activities in the United States. The first section summarizes the results of three recent surveys: a study of the extent of worksite wellness activities in the United States (funded by the Office of Disease Prevention and Health Promotion); a 1986 Harris poll of Americans…

75 FR 43235 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2011...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

... comment period. 3. By express or overnight mail. You may send written comments to the following address... approximately 3 weeks after publication of a document, at the headquarters of the Centers for Medicare... 2. Regulatory Update 3. Statutory Update 4. Outlier Cap 5. Loss Sharing Ratio and Fixed Dollar Ratio...

Problems Related to Alcohol, Other Drugs, and Violence among Military Students. Prevention Update

ERIC Educational Resources Information Center

Higher Education Center for Alcohol, Drug Abuse, and Violence Prevention, 2011

2011-01-01

According to a Research Update from the National Institute on Drug Abuse, ongoing operations in Iraq and Afghanistan "continue to strain military personnel, returning veterans, and their families. Some have experienced long and multiple deployments, combat exposure, and physical injuries, as well as post-traumatic stress disorder (PTSD) and…

Everyday Mathematics®. What Works Clearinghouse Intervention Report. Updated November 2015

ERIC Educational Resources Information Center

What Works Clearinghouse, 2015

2015-01-01

The "Everyday Mathematics®" curriculum aims to provide students in prekindergarten through grade 6 with multiple opportunities to learn math concepts and practice skills. Since the release of the WWC's 2010 Everyday Mathematics report, the curriculum continues to be widely used and evaluated. This updated review includes 30 studies that…

76 FR 50669 - Safety Zones; Eleventh Coast Guard District Annual Fireworks Events

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-16

... occurring, add new unlisted annual fireworks events to the regulations, and standardize the format for all... to be added. In addition, information for those events that continue to occur has changed in some... sections will be updated or added as follows: update with current information existing events, add...

Construction and Updating of Event Models in Auditory Event Processing

ERIC Educational Resources Information Center

Huff, Markus; Maurer, Annika E.; Brich, Irina; Pagenkopf, Anne; Wickelmaier, Florian; Papenmeier, Frank

2018-01-01

Humans segment the continuous stream of sensory information into distinct events at points of change. Between 2 events, humans perceive an event boundary. Present theories propose changes in the sensory information to trigger updating processes of the present event model. Increased encoding effort finally leads to a memory benefit at event…

78 FR 12267 - Approval and Promulgation of Air Quality Implementation Plans; Charlotte, Raleigh/Durham and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

... maintenance plan update is for the Charlotte, Raleigh/Durham and Winston-Salem carbon monoxide (CO) maintenance areas. Specifically, the State submitted a limited maintenance plan update for CO, showing continued attainment of the 8-hour CO National Ambient Air Quality Standard for the Charlotte, Raleigh...

Copyright Updates for K-12 Librarians

ERIC Educational Resources Information Center

Johnson, Wendell G.

2016-01-01

Copyright concerns continue to bedevil K-12 librarians, who are often called upon to act as the copyright officers in public schools. This article describes recent copyright developments of concern to these librarians in three areas: a recent court case involving a university library, pending legislation supported by ALA, and a regulatory update.…

Landsat-7 ETM+ radiometric calibration status

USGS Publications Warehouse

Barsi, Julia A.; Markham, Brian L.; Czapla-Myers, J. S.; Helder, Dennis L.; Hook, Simon; Schott, John R.; Haque, Md. Obaidul

2016-01-01

Now in its 17th year of operation, the Enhanced Thematic Mapper + (ETM+), on board the Landsat-7 satellite, continues to systematically acquire imagery of the Earth to add to the 40+ year archive of Landsat data. Characterization of the ETM+ on-orbit radiometric performance has been on-going since its launch in 1999. The radiometric calibration of the reflective bands is still monitored using on-board calibration devices, though the Pseudo-Invariant Calibration Sites (PICS) method has proven to be an effective tool as well. The calibration gains were updated in April 2013 based primarily on PICS results, which corrected for a change of as much as -0.2%/year degradation in the worst case bands. A new comparison with the SADE database of PICS results indicates no additional degradation in the updated calibration. PICS data are still being tracked though the recent trends are not well understood. The thermal band calibration was updated last in October 2013 based on a continued calibration effort by NASA/Jet Propulsion Lab and Rochester Institute of Technology. The update accounted for a 0.036 W/m2 sr μm or 0.26K at 300K bias error. The updated lifetime trend is now stable to within +/- 0.4K.

The Diabetes Initiative of South Carolina Celebrates Over 20 Years of Professional Diabetes Education.

PubMed

Hermayer, Kathie L

2016-04-01

Diabetes is a major public health problem in South Carolina; however, the Diabetes Initiative of South Carolina (DSC) provides a realistic mechanism to address issues on a statewide basis. The Diabetes Center of Excellence in the DSC provides oversight for developing and supervising professional education programs for health care workers of all types in South Carolina to increase their knowledge and ability to care for people with diabetes. The DSC has developed many programs for the education of a variety of health professionals about diabetes and its complications. The DSC has sponsored 21 Annual Diabetes Fall Symposia for primary health care professionals featuring education regarding many aspects of diabetes mellitus. The intent of the program is to enhance the lifelong learning process of physicians, advanced practice providers, nurses, pharmacists, dietitians, laboratorians and other health care professionals, by providing educational opportunities and to advance the quality and safety of patient care. The symposium is an annual 2-day statewide program that supplies both a comprehensive diabetes management update to all primary care professionals and an opportunity for attendees to obtain continuing education credits at a low cost. The overarching goal of the DSC is that the programs it sponsors and the development of new targeted initiatives will lead to continuous improvements in the care of people at risk and with diabetes along with a decrease in morbidity, mortality and costs of diabetes and its complications in South Carolina and elsewhere. Published by Elsevier Inc.

Knowledge structure representation and automated updates in intelligent information management systems

NASA Technical Reports Server (NTRS)

Corey, Stephen; Carnahan, Richard S., Jr.

1990-01-01

A continuing effort to apply rapid prototyping and Artificial Intelligence techniques to problems associated with projected Space Station-era information management systems is examined. In particular, timely updating of the various databases and knowledge structures within the proposed intelligent information management system (IIMS) is critical to support decision making processes. Because of the significantly large amounts of data entering the IIMS on a daily basis, information updates will need to be automatically performed with some systems requiring that data be incorporated and made available to users within a few hours. Meeting these demands depends first, on the design and implementation of information structures that are easily modified and expanded, and second, on the incorporation of intelligent automated update techniques that will allow meaningful information relationships to be established. Potential techniques are studied for developing such an automated update capability and IIMS update requirements are examined in light of results obtained from the IIMS prototyping effort.

Personalised physical exercise regime for chronic patients through a wearable ICT platform.

PubMed

Angelidis, Pantelis A

2010-01-01

Today's state of the art in exercise physiology, professional athletics and sports practice in general clearly shows that the best results depend on the personalisation and continuous update of the recommendations provided to an athlete training, a sports lover or a person whose medical condition demands regular physical exercise. The vital signs information gathered in telemonitoring systems can be better evaluated and exploited if processed along with data from the subject's electronic health records, training history and performance statistics. In this context, the current paper intends to exploit modern smart miniaturised systems and advanced information systems towards the development of an infrastructure for continuous, non-invasive acquisition and advanced processing of vital signs information. In particular, it will look into wearable electronics embedded in textile capable of performing regular or exceptional measurements of vital physiological parameters and communicating them to an application server for further processing.

Type 2 Diabetes in Youth: New Lessons from the SEARCH Study.

PubMed

Jensen, Elizabeth T; Dabelea, Dana

2018-05-08

The purpose of this review is to provide an update on the recent body of evidence emerging for type 2 diabetes as identified through the SEARCH for Diabetes in Youth study. This body of evidence illustrates that type 2 diabetes continues to increase in incidence, although this increase may be partially attributable to increased surveillance. Disease management is influenced by the transition from adolescent to adult care and psychosocial factors may also contribute. This evidence also describes a high prevalence of disease-associated complications and comorbidities. Risk factors for cardiovascular disease are also highly prevalent. The SEARCH for Diabetes in Youth study continues to inform our understanding of the descriptive epidemiology and natural history of type 2 diabetes in youth. As the cohort matures, new opportunities emerge for building on our understanding of how youth-onset type 2 diabetes impacts future health.

Towards a more transparent HTA process in Poland: new Polish HTA methodological guidelines

PubMed Central

Lach, Krzysztof; Dziwisz, Michal; Rémuzat, Cécile; Toumi, Mondher

2017-01-01

ABSTRACT Introduction: Health technology assessment (HTA) in Poland supports reimbursement decisions via the Polish HTA Agency (AOTMiT), whose guidelines were updated in 2016. Methods: We identified key changes introduced by the update and, before guideline publication, analysed discrepancies between AOTMiT assessments and the submitting marketing authorisation holders (MAHs) to elucidate the context of the update. We compared the clarity and detail of the new guidelines versus those of the UK’s National Institute for Health and Care Excellence (NICE). Results: The update specified more precise requirements for items such as indirect comparison or input data for economic modelling. Agency–MAH discrepancies relating to the subjects of the HTA update were found in 14.6% of published documents. The new Polish HTA guidelines were as clear and detailed as NICE’s on topics such as assessing quality of evidence and economic modelling, but were less informative when describing (for example) pairwise meta-analysis. Conclusions: The Polish HTA guidelines update demonstrates lessons learned from internal and external experiences. The new guidelines adhere more closely to UK HTA standards, being clearer and more informative. While the update is expected to reduce Agency–MAH discrepancies, there remain areas for development, such as providing templates to aid HTA submissions. PMID:28804603

Low-flow frequency and flow duration of selected South Carolina streams in the Pee Dee River basin through March 2007

USGS Publications Warehouse

Feaster, Toby D.; Guimaraes, Wladmir B.

2009-01-01

Part of the mission of the South Carolina Department of Health and Environmental Control and the South Carolina Department of Natural Resources is to protect and preserve South Carolina's water resources. Doing so requires an ongoing understanding of streamflow characteristics of the rivers and streams in South Carolina. A particular need is information concerning the low-flow characteristics of streams; this information is especially important for effectively managing the State's water resources during critical flow periods such as the severe drought that occurred between 1998 and 2002 and the most recent drought that occurred between 2006 and 2009. In 2008, the U.S. Geological Survey, in cooperation with the South Carolina Department of Health and Environmental Control, initiated a study to update low-flow statistics at continuous-record streamgaging stations operated by the U.S. Geological Survey in South Carolina. Under this agreement, the low-flow characteristics at continuous-record streamgaging stations will be updated in a systematic manner during the monitoring and assessment of the eight major basins in South Carolina as defined and grouped according to the South Carolina Department of Health and Environmental Control's Watershed Water Quality Management Strategy. Depending on the length of record available at the continuous-record streamgaging stations, low-flow frequency characteristics are estimated for annual minimum 1-, 3-, 7-, 14-, 30-, 60-, and 90-day average flows with recurrence intervals of 2, 5, 10, 20, 30, and 50 years. Low-flow statistics are presented for 18 streamgaging stations in the Pee Dee River basin. In addition, daily flow durations for the 5-, 10-, 25-, 50-, 75-, 90-, and 95-percent probability of exceedance also are presented for the stations. The low-flow characteristics were computed from records available through March 31, 2007. The last systematic update of low-flow characteristics in South Carolina occurred more than 20 years ago and included data through March 1987. Of the 17 streamgaging stations included in this study, 15 had low-flow characteristics that were published in previous U.S. Geological Survey reports. A comparison of the low-flow characteristic for the minimum average flow for a 7-consecutive-day period with a 10-year recurrence interval from this study with the most recently published values indicated that 10 of the 15 streamgaging stations had values that were within ±25 percent of each other. Nine of the 15 streamgaging stations had negative percentage differences indicating the low-flow statistic had decreased since the previous study, 4 streamgaging stations had positive percent differences indicating that the low-flow statistic had increased since the previous study, and 2 streamgaging stations had a zero percent difference indicating no change since the previous study. The low-flow characteristics are influenced by length of record, hydrologic regime under which the record was collected, techniques used to do the analysis, and other changes that may have occurred in the watershed.

Therapeutic potential of medicinal marijuana: an educational primer for health care professionals.

PubMed

Mouhamed, Yara; Vishnyakov, Andrey; Qorri, Bessi; Sambi, Manpreet; Frank, Sm Signy; Nowierski, Catherine; Lamba, Anmol; Bhatti, Umrao; Szewczuk, Myron R

2018-01-01

With the proposed Canadian July 2018 legalization of marijuana through the Cannabis Act, a thorough critical analysis of the current trials on the efficacy of medicinal marijuana (MM) as a treatment option is necessary. This review is particularly important for primary care physicians whose patients may be interested in using MM as an alternative therapy. In response to increased interest in MM, Health Canada released a document in 2013 for general practitioners (GPs) as an educational tool on the efficacy of MM in treating some chronic and acute conditions. Although additional studies have filled in some of the gaps since the release of the Health Canada document, conflicting and inconclusive results continue to pose a challenge for physicians. This review aims to supplement the Health Canada document by providing physicians with a critical yet concise update on the recent advancements made regarding the efficacy of MM as a potential therapeutic option. An update to the literature of 2013 is important given the upcoming changes in legislation on the use of marijuana. Also, we briefly highlight the current recommendations provided by Canadian medical colleges on the parameters that need to be considered prior to authorizing MM use, routes of administration as well as a general overview of the endocannabinoid system as it pertains to cannabis. Lastly, we outline the appropriate medical conditions for which the authorization of MM may present as a practical alternative option in improving patient outcomes as well as individual considerations of which GPs should be mindful. The purpose of this paper is to offer physicians an educational tool that provides a necessary, evidence-based analysis of the therapeutic potential of MM and to ensure physicians are making decisions on the therapeutic use of MM in good faith.

Therapeutic potential of medicinal marijuana: an educational primer for health care professionals

PubMed Central

Frank, SM Signy; Nowierski, Catherine; Lamba, Anmol; Bhatti, Umrao; Szewczuk, Myron R

2018-01-01

With the proposed Canadian July 2018 legalization of marijuana through the Cannabis Act, a thorough critical analysis of the current trials on the efficacy of medicinal marijuana (MM) as a treatment option is necessary. This review is particularly important for primary care physicians whose patients may be interested in using MM as an alternative therapy. In response to increased interest in MM, Health Canada released a document in 2013 for general practitioners (GPs) as an educational tool on the efficacy of MM in treating some chronic and acute conditions. Although additional studies have filled in some of the gaps since the release of the Health Canada document, conflicting and inconclusive results continue to pose a challenge for physicians. This review aims to supplement the Health Canada document by providing physicians with a critical yet concise update on the recent advancements made regarding the efficacy of MM as a potential therapeutic option. An update to the literature of 2013 is important given the upcoming changes in legislation on the use of marijuana. Also, we briefly highlight the current recommendations provided by Canadian medical colleges on the parameters that need to be considered prior to authorizing MM use, routes of administration as well as a general overview of the endocannabinoid system as it pertains to cannabis. Lastly, we outline the appropriate medical conditions for which the authorization of MM may present as a practical alternative option in improving patient outcomes as well as individual considerations of which GPs should be mindful. The purpose of this paper is to offer physicians an educational tool that provides a necessary, evidence-based analysis of the therapeutic potential of MM and to ensure physicians are making decisions on the therapeutic use of MM in good faith. PMID:29928146

Assessment and revision of clinical pharmacy practice internet web sites.

PubMed

Edwards, Krystal L; Salvo, Marissa C; Ward, Kristina E; Attridge, Russell T; Kiser, Katie; Pinner, Nathan A; Gallegos, Patrick J; Kesteloot, Lori Lynn; Hylton, Ann; Bookstaver, P Brandon

2014-02-01

Health care professionals, trainees, and patients use the Internet extensively. Editable Web sites may contain inaccurate, incomplete, and/or outdated information that may mislead the public's perception of the topic. To evaluate the editable, online descriptions of clinical pharmacy and pharmacist and attempt to improve their accuracy. The authors identified key areas within clinical pharmacy to evaluate for accuracy and appropriateness on the Internet. Current descriptions that were reviewed on public domain Web sites included: (1) clinical pharmacy and the clinical pharmacist, (2) pharmacy education, (3) clinical pharmacy and development and provision for reimbursement, (4) clinical pharmacists and advanced specialty certifications/training opportunities, (5) pharmacists and advocacy, and (6) clinical pharmacists and interdisciplinary/interprofessional content. The authors assessed each content area to determine accuracy and prioritized the need for updating, when applicable, to achieve consistency in descriptions and relevancy. The authors found that Wikipedia, a public domain that allows users to update, was consistently the most common Web site produced in search results. The authors' evaluation resulted in the creation or revision of 14 Wikipedia Web pages. However, rejection of 3 proposed newly created Web pages affected the authors' ability to address identified content areas with deficiencies and/or inaccuracies. Through assessing and updating editable Web sites, the authors strengthened the online representation of clinical pharmacy in a clear, cohesive, and accurate manner. However, ongoing assessments of the Internet are continually needed to ensure accuracy and appropriateness.

Email Updates

MedlinePlus

... MedlinePlus GO GO About MedlinePlus Site Map FAQs Customer Support Health Topics Drugs & Supplements Videos & Tools Español ... spam" or "junk." About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

Zika Virus Update: More on an Emerging Arboviral Disease in the Western Hemisphere.

PubMed

Vest, Kelly G

2017-04-01

Zika virus has captivated the world with its quick spread throughout the Western Hemisphere. Increased emphasis has been placed on the infection of pregnant women and subsequent adverse and severe effects in the developing fetus and newborn. This article supplements a previous article and provides updated information on new and evolving evidence that strengthens the association between Zika virus and unique congenital and neurologic diseases, updates what is known about the epidemiology of the disease, and provides new and updated material for primary care providers as they counsel patients who may be exposed or infected. With the extent of disease spread, it is expected that Zika virus will become endemic to the Western Hemisphere and will change the public health parameters and approach in this area of the world. (Disaster Med Public Health Preparedness. 2017;11:163-167).

mHealthMon: toward energy-efficient and distributed mobile health monitoring using parallel offloading.

PubMed

Ahnn, Jong Hoon; Potkonjak, Miodrag

2013-10-01

Although mobile health monitoring where mobile sensors continuously gather, process, and update sensor readings (e.g. vital signals) from patient's sensors is emerging, little effort has been investigated in an energy-efficient management of sensor information gathering and processing. Mobile health monitoring with the focus of energy consumption may instead be holistically analyzed and systematically designed as a global solution to optimization subproblems. This paper presents an attempt to decompose the very complex mobile health monitoring system whose layer in the system corresponds to decomposed subproblems, and interfaces between them are quantified as functions of the optimization variables in order to orchestrate the subproblems. We propose a distributed and energy-saving mobile health platform, called mHealthMon where mobile users publish/access sensor data via a cloud computing-based distributed P2P overlay network. The key objective is to satisfy the mobile health monitoring application's quality of service requirements by modeling each subsystem: mobile clients with medical sensors, wireless network medium, and distributed cloud services. By simulations based on experimental data, we present the proposed system can achieve up to 10.1 times more energy-efficient and 20.2 times faster compared to a standalone mobile health monitoring application, in various mobile health monitoring scenarios applying a realistic mobility model.

ADHD and behavioral disorders: Assessment, management, and an update from DSM-5.

PubMed

Austerman, Joseph

2015-11-01

Behavioral disorders in pediatric patients--primarily attention deficit hyperactivity disorder (ADHD)--pose a clinical challenge for health care providers to accurately assess, diagnose, and treat. In 2013, updated diagnostic criteria for behavioral disorders were published, including ADHD and a new diagnostic entity: disruptive mood dysregulation disorder. Revised criteria for ADHD includes oldest age for occurrence of symptoms, need for symptoms to be present in more than one setting, and requirement for number of symptoms in those aged 17 and older. Assessment of ADHD relies primarily on the clinical interview, including the medical and social history, along with the aid of objective measures. The clinical course of ADHD is chronic with symptom onset occurring well before adolescence. Most patients have symptoms that continue into adolescence, and some into adulthood. Many patients with ADHD have comorbid disorders such as depression, disruptive behavior disorders, or substance abuse, which need to be addressed first in the treatment plan. Treatment of ADHD relies on a combination of psychopharmacologic, academic, and behavioral interventions, which produce response rates up to 80%. Copyright © 2015 Cleveland Clinic.

Thalassemia

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The 7Q10 in South Carolina water-quality regulation: Nearly fifty years later

USGS Publications Warehouse

Feaster, Toby D.; Cantrell, Wade M.

2010-01-01

The annual minimum 7-day average streamflow with a 10-year recurrence interval, often referred to as the 7Q10, has a long history of being an important low-flow statistic used in water-quality management in South Carolina as evidenced by its adoption into South Carolina law in 1967. State agencies, such as the South Carolina Department of Health and Environmental Control and the South Carolina Department of Natural Resources, use such lowflow statistics to determine Wasteload Allocations for National Pollutant Discharge Elimination System discharges, develop Total Maximum Daily Loads for streams, prepare the State Water Plan, and restrict the quantity of water that can be transferred out of basin. The U.S. Geological Survey, working cooperatively with the South Carolina Department of Health and Environmental Control, is updating low-flow statistics at continuous-record streamflow gages in South Carolina on a basin-by-basin approach. Such statistics are influenced by length of record and hydrologic conditions under which the record was collected. Statewide low-flow statistics in South Carolina were last updated in 1987. Since that time several droughts have occurred with the most severe occurring from 1998-2002 and the most recent occurring from 2006-2009. The low-flow statistics for the Pee Dee River basin were the first to be completed in this ongoing investigation.

Land and Water Use Characteristics and Human Health Input Parameters for use in Environmental Dosimetry and Risk Assessments at the Savannah River Site. 2016 Update

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

Jannik, G. Tim; Hartman, Larry; Stagich, Brooke

Operations at the Savannah River Site (SRS) result in releases of small amounts of radioactive materials to the atmosphere and to the Savannah River. For regulatory compliance purposes, potential offsite radiological doses are estimated annually using computer models that follow U.S. Nuclear Regulatory Commission (NRC) regulatory guides. Within the regulatory guides, default values are provided for many of the dose model parameters, but the use of applicant site-specific values is encouraged. Detailed surveys of land-use and water-use parameters were conducted in 1991 and 2010. They are being updated in this report. These parameters include local characteristics of meat, milk andmore » vegetable production; river recreational activities; and meat, milk and vegetable consumption rates, as well as other human usage parameters required in the SRS dosimetry models. In addition, the preferred elemental bioaccumulation factors and transfer factors (to be used in human health exposure calculations at SRS) are documented. The intent of this report is to establish a standardized source for these parameters that is up to date with existing data, and that is maintained via review of future-issued national references (to evaluate the need for changes as new information is released). These reviews will continue to be added to this document by revision.« less

Land and Water Use Characteristics and Human Health Input Parameters for use in Environmental Dosimetry and Risk Assessments at the Savannah River Site 2017 Update

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

Jannik, T.; Stagich, B.

Operations at the Savannah River Site (SRS) result in releases of relatively small amounts of radioactive materials to the atmosphere and to the Savannah River. For regulatory compliance purposes, potential offsite radiological doses are estimated annually using computer models that follow U.S. Nuclear Regulatory Commission (NRC) regulatory guides. Within the regulatory guides, default values are provided for many of the dose model parameters, but the use of site-specific values is encouraged. Detailed surveys of land-use and water-use parameters were conducted in 1991, 2008, 2010, and 2016 and are being concurred with or updated in this report. These parameters include localmore » characteristics of meat, milk, and vegetable production; river recreational activities; and meat, milk, and vegetable consumption rates, as well as other human usage parameters required in the SRS dosimetry models. In addition, the preferred elemental bioaccumulation factors and transfer factors (to be used in human health exposure calculations at SRS) are documented. The intent of this report is to establish a standardized source for these parameters that is up to date with existing data, and that is maintained via review of future-issued national references (to evaluate the need for changes as new information is released). These reviews will continue to be added to this document by revision.« less

Environmental Regulatory Update Table, January/February 1995

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

Houlberg, L.M.; Hawkins, G.T.; Bock, R.E.

1995-03-01

The Environmental Regulatory Update Table provides information on regulatory initiatives impacting environmental, health, and safety management responsibilities. the table is updated bi-monthly with information from the Federal Register and other sources, including direct contact with regulatory agencies. Each table entry provides a chronological record of the rulemaking process for that initiative with an abstract and a projection of further action.

76 FR 40987 - Medicare Program; Home Health Prospective Payment System Rate Update for Calendar Year 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... comments to be received before the close of the comment period. 3. By express or overnight mail. You may... they are received, generally beginning approximately 3 weeks after publication of a document, at the.... Background 2. Regulatory Update 3. Statutory Update 4. Loss-Sharing Ratio and Fixed Dollar Loss (FDL) Ratio 5...

Tobacco Control and Treatment for the Pediatric Clinician: Practice, Policy, and Research Updates.

PubMed

Jenssen, Brian P; Wilson, Karen M

2017-04-01

Tobacco use is the leading cause of preventable death in the United States, and exposure to tobacco smoke harms children from conception forward. There is no safe level of tobacco exposure. Although overall smoking rates have declined, the advent of new products, such as electronic cigarettes, threatens to perpetuate nicotine addiction without clear health benefits. In addition to reviewing traditional and new tobacco products, we discuss the unique role that pediatricians should play in tobacco treatment and control efforts. New policies and technologies can empower pediatric clinicians and pediatric health care systems to help parent smokers quit, and new policies outside of the health care setting might help prevent smoking initiation as well as improve cessation treatments. Future research is needed to continue to study the consequences of tobacco use exposure as well as the best ways to help patients and parents stop tobacco use. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Continuing Education and Social Conscience.

ERIC Educational Resources Information Center

Smith, L. L.

Public education has both political, or social, and personal, or self-improvement objectives; in addition it provides much of the moral quality of a democratic society. Each function--personal, political, and moral--has special significance for continuing education. Adults continue their education to update their job skills or to seek satisfaction…

Designing Continuous Professional Development Programmes for Teachers: A Literature Review

ERIC Educational Resources Information Center

Luneta, K.

2012-01-01

Continuous professional development is essential for upgrading and updating teachers because the rate of social and educational change makes pre-service training an inadequate basis for long term professional competence. The design of these continuous professional development programmes must be informed by an effective needs analysis that…

40 CFR 141.521 - What updated watershed control requirements must my unfiltered system implement to continue to...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000... oocysts in the source water. Your system's watershed control program must, for Cryptosporidium: (a...

40 CFR 141.521 - What updated watershed control requirements must my unfiltered system implement to continue to...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000... oocysts in the source water. Your system's watershed control program must, for Cryptosporidium: (a...

40 CFR 141.521 - What updated watershed control requirements must my unfiltered system implement to continue to...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000... oocysts in the source water. Your system's watershed control program must, for Cryptosporidium: (a...

40 CFR 141.521 - What updated watershed control requirements must my unfiltered system implement to continue to...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Enhanced Filtration and Disinfection-Systems Serving Fewer Than 10,000... oocysts in the source water. Your system's watershed control program must, for Cryptosporidium: (a...

Methods for computing water-quality loads at sites in the U.S. Geological Survey National Water Quality Network

USGS Publications Warehouse

Lee, Casey J.; Murphy, Jennifer C.; Crawford, Charles G.; Deacon, Jeffrey R.

2017-10-24

The U.S. Geological Survey publishes information on concentrations and loads of water-quality constituents at 111 sites across the United States as part of the U.S. Geological Survey National Water Quality Network (NWQN). This report details historical and updated methods for computing water-quality loads at NWQN sites. The primary updates to historical load estimation methods include (1) an adaptation to methods for computing loads to the Gulf of Mexico; (2) the inclusion of loads computed using the Weighted Regressions on Time, Discharge, and Season (WRTDS) method; and (3) the inclusion of loads computed using continuous water-quality data. Loads computed using WRTDS and continuous water-quality data are provided along with those computed using historical methods. Various aspects of method updates are evaluated in this report to help users of water-quality loading data determine which estimation methods best suit their particular application.

An update on childhood bone health: mineral accrual, assessment and treatment.

PubMed

Sopher, Aviva B; Fennoy, Ilene; Oberfield, Sharon E

2015-02-01

To update the reader's knowledge about the factors that influence bone mineral accrual and to review the advances in the assessment of bone health and treatment of bone disorders. Maternal vitamin D status influences neonatal calcium levels, bone mineral density (BMD) and bone size. In turn, BMD z-score tends to track in childhood. These factors highlight the importance of bone health as early as fetal life. Dual-energy x-ray absorptiometry is the mainstay of clinical bone health assessment in this population because of the availability of appropriate reference data. Recently, more information has become available about the assessment and treatment of bone disease in chronically ill pediatric patients. Bone health must become a health focus starting prenatally in order to maximize peak bone mass and to prevent osteoporosis-related bone disease in adulthood. Vitamin D, calcium and weight-bearing activity are the factors of key importance throughout childhood in achieving optimal bone health as BMD z-score tracks through childhood and into adulthood. Recent updates of the International Society for Clinical Densitometry focus on the appropriate use of dual-energy x-ray absorptiometry in children of all ages, including children with chronic disease, and on the treatment of pediatric bone disease.

[Risk-sharing schemes: a new paradigm in adopting innovative pharmaceuticals].

PubMed

Hammerman, Ariel; Greenberg, Dan

2012-06-01

In recent years, spending on prescription drugs contributes substantially to the continuous growth in health expenditure in most Western countries. This increase in spending is influenced by both a rise in the use of existing drugs and by the adoption of new and expensive drugs. Risk-sharing agreements between pharmaceutical companies and health insurers have emerged as insurers began to deny reimbursement of expensive innovative treatments with unfavorable cost-effectiveness ratios. This occurred in cases where the expected budgetary impact was too high or when the long-term effectiveness was questionable. Risk sharing agreements serve the interests of both the insurers and the drug manufacturers. Pharmaceutical companies' interests are to dispel the uncertainties encountered by the health insurers white deciding on drug reimbursement. The insurers are interested in these agreements in order to reduce the budgetary risk while allowing their patients access to innovative drugs. Currently, only a few risk sharing agreements have been implemented, and the scientific literature on such schemes is still sparse. Since the health insurers' interest is to develop mechanisms that will contain health costs, without affecting the insured, it appears that this trend will continue to emerge. It is also likely that the adoption of similar mechanisms in the Israeli National List of Health Services updating process, would improve the accuracy of early estimates of the budgetary impact, and the actual use of the new technologies would be close to early estimates. This article reviews the principles of risk-sharing schemes and issues involved in the actual implementation of such agreements.

IRIS Toxicological Review and Summary Documents for N ...

EPA Pesticide Factsheets

EPA's assessment of the noncancer health effects and carcinogenic potential of n-hexane was last prepared and added to the IRIS data base in 1990. The IRIS program is updating the IRIS assessment for n-hexane; this update will incorporate health effects information published since the last assessment was prepared as well as new risk assessment methods. The IRIS assessment for n-hexane will consist of a Toxicological Review and IRIS Summary. The Toxicological Review is a critical review of the physicochemical and toxicokinetic properties of the chemical and its toxicity in humans and experimental systems. The assessment will present reference values for noncancer effects of n-hexane (RfD and RfC) and a cancer assessment, where supported by available data. The Toxicological Review and IRIS Summary will be subject to internal peer consultation, Agency review, and external scientific peer review. EPA is undertaking an update of the Integrated Risk Information System (IRIS) health assessment for n-hexane. The outcome of this project is an updated Toxicological Review and IRIS Summary for n-Hexane that will be entered into the IRIS database. IRIS is an EPA data base containing Agency scientific positions on potential adverse human health effects that may result from chronic (or lifetime) exposure to chemicals in the environment. IRIS contains chemical-specific summaries of qualitative and quantitative health information in support of two steps of the risk assessment

Six Tips for College Health and Safety

MedlinePlus

... Emergency Preparedness & Response Environmental Health Healthy Living Injury, Violence & Safety Life Stages & Populations Travelers’ Health Workplace Safety & Health Features Media Sign up for Features Get Email Updates To ...

Learning Difficulties and Ethnicity: Updating a Framework for Action

ERIC Educational Resources Information Center

Poxton, Richard

2012-01-01

This update of the Framework for Action highlights the continuing relevance of its message as well as those raised by Valuing People Now. People with learning difficulties and their families from Black and minority ethnic (BME) communities have been highlighted as a priority group by Valuing People since 2001 and remain a priority for better…

78 FR 47336 - Privacy Act of 1974; Computer Matching Program Between the Department of Housing and Urban...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-05

... provides an updated cost/benefit analysis providing an assessment of the benefits attained by HUD through... the scope of the existing computer matching program to now include the updated cost/ benefit analysis... change, and find a continued favorable examination of benefit/cost results; and (2) All parties certify...

Complex Span versus Updating Tasks of Working Memory: The Gap Is Not that Deep

ERIC Educational Resources Information Center

Schmiedek, Florian; Hildebrandt, Andrea; Lovden, Martin; Wilhelm, Oliver; Lindenberger, Ulman

2009-01-01

How to best measure working memory capacity is an issue of ongoing debate. Besides established complex span tasks, which combine short-term memory demands with generally unrelated secondary tasks, there exists a set of paradigms characterized by continuous and simultaneous updating of several items in working memory, such as the n-back, memory…

Stop Ticks

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Prevent Shingles

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Preventing Suicide

MedlinePlus

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Data Resource Profile: Cross-national and cross-study sociodemographic and health-related harmonized domains from SAGE plus ELSA, HRS and SHARE (SAGE+, Wave 1)

PubMed Central

Minicuci, Nadia; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

2016-01-01

Four longitudinal studies were included in this rigorous harmonization process: the Study on global AGEing and adult health (SAGE); English Longitudinal Study on Ageing (ELSA); US Health and Retirement Study (HRS); and Survey of Health, Ageing and Retirement in Europe (SHARE). An ex-post harmonized process was applied to nine health-related thematic domains (socio-demographic and economic, health states, overall self-report of health and mental state, health examinations, physical and mental performance tests, risk factors, chronic conditions, social network and subjective well-being) for data from the 2004 wave of each study. Large samples of adults aged 50 years and older were available from each study: SAGE, n = 18 886; ELSA, n = 9181; HRS, n = 19 303; and SHARE, n = 29 917. The microdata, along with further details about the harmonization process and all metadata, are available through the World Health Organization (WHO) data archive at [http://apps.who.int/healthinfo/systems/surveydata/index.php/catalog]. Further information and enquiries can be made to [sagesurvey@who.int] or the corresponding author. The data resource will continue to be updated with data across additional waves of these surveys and new waves. PMID:27794522

Medicare home health payment reform may jeopardize access for clinically complex and socially vulnerable patients.

PubMed

Rosati, Robert J; Russell, David; Peng, Timothy; Brickner, Carlin; Kurowski, Daniel; Christopher, Mary Ann; Sheehan, Kathleen M

2014-06-01

The Affordable Care Act directed Medicare to update its home health prospective payment system to reflect more recent data on costs and use of services-an exercise known as rebasing. As a result, the Centers for Medicare and Medicaid Services will reduce home health payments 3.5 percent per year in the period 2014-17. To determine the impact that these reductions could have on beneficiaries using home health care, we examined the Medicare reimbursement margins and the use of services in a national sample of 96,621 episodes of care provided by twenty-six not-for-profit home health agencies in 2011. We found that patients with clinically complex conditions and social vulnerability factors, such as living alone, had substantially higher service delivery costs than other home health patients. Thus, the socially vulnerable patients with complex conditions represent less profit-lower-to-negative Medicare margins-for home health agencies. This financial disincentive could reduce such patients' access to care as Medicare payments decline. Policy makers should consider the unique characteristics of these patients and ensure their continued access to Medicare's home health services when planning rebasing and future adjustments to the prospective payment system. Project HOPE—The People-to-People Health Foundation, Inc.

Nurse turnover: a literature review - an update.

PubMed

Hayes, Laureen J; O'Brien-Pallas, Linda; Duffield, Christine; Shamian, Judith; Buchan, James; Hughes, Frances; Laschinger, Heather K Spence; North, Nicola

2012-07-01

Concerns related to the complex issue of nursing turnover continue to challenge healthcare leaders in every sector of health care. Voluntary nurse turnover is shown to be influenced by a myriad of inter-related factors, and there is increasing evidence of its negative effects on nurses, patients and health care organizations. The objectives were to conduct a comprehensive review of the related literature to examine recent findings related to the issue of nursing turnover and its causes and consequences, and to identify on methodological challenges and the implications of new evidence for future studies. A comprehensive search of the recent literature related to nursing turnover was undertaken to summarize findings published in the past six years. Electronic databases: MEDLINE, CINAHL and PubMed, reference lists of journal publications. Keyword searches were conducted for publications published 2006 or later that examined turnover or turnover intention in employee populations of registered or practical/enrolled or assistant nurses working in the hospital, long-term or community care areas. Literature findings are presented using an integrative approach and a table format to report individual studies. From about 330 citations or abstracts that were initially scanned for content relevance, 68 studies were included in this summary review. The predominance of studies continues to focus on determinants of nurse turnover in acute care settings. Recent studies offer insight into generational factors that should be considered in strategies to promote stable staffing in healthcare organizations. Nursing turnover continues to present serious challenges at all levels of health care. Longitudinal research is needed to produce new evidence of the relationships between nurse turnover and related costs, and the impact on patients and the health care team. Copyright © 2011 Elsevier Ltd. All rights reserved.

Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update from the American Cancer Society

PubMed Central

Oeffinger, Kevin C.; Fontham, Elizabeth T. H.; Etzioni, Ruth; Herzig, Abbe; Michaelson, James S.; Shih, Ya-Chen Tina; Walter, Louise C.; Church, Timothy R.; Flowers, Christopher R.; LaMonte, Samuel J.; Wolf, Andrew M. D.; DeSantis, Carol; Lortet-Tieulent, Joannie; Andrews, Kimberly; Manassaram-Baptiste, Deana; Saslow, Debbie; Smith, Robert A.; Brawley, Otis W.; Wender, Richard

2016-01-01

Importance Breast cancer is a leading cause of premature mortality among U.S. women. Early detection has been shown to be associated with reduced breast cancer morbidity and mortality. This report updates the American Cancer Society (ACS) 2003 breast cancer screening guideline for women at average risk for breast cancer. Process The ACS commissioned a systematic evidence review of the breast cancer screening literature to inform the update, and a supplemental analysis of mammography registry data to address questions related to the screening interval. Formulation of recommendations was based on the quality of the evidence and judgment (incorporating values and preferences) about the balance of benefits and harms. Evidence Synthesis Mammography screening in women aged 40–69 years is associated with a reduction in breast cancer deaths across a range of study designs, and inferential evidence supports breast cancer screening in women who are age 70 years and older and are in good health. Estimates of the cumulative lifetime risk of false positive exams are greater if screening begins at younger ages due to the greater number of mammograms, as well as the higher recall rate in younger women. The quality of the evidence for overdiagnosis is not sufficient to estimate a lifetime risk with confidence. Analysis examining the screening interval demonstrates more favorable tumor characteristics when premenopausal women are screened annually vs. biennially. Evidence does not support routine clinical breast examination as a screening method for average risk women. Recommendations The ACS recommends that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years (strong recommendation). Women who are ages 45 to 54 years should be screened annually (qualified recommendation). Women who are age 55 years and older should transition to biennial screening or have the opportunity to continue screening annually (qualified recommendation). Women should have the opportunity to begin annual screening between the ages of 40 and 44 years (qualified recommendation). Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or more (qualified recommendation). The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age (qualified recommendation). PMID:26501536

Wash Your Hands

MedlinePlus

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Avoid Mosquito Bites

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Oysters and Vibriosis

MedlinePlus

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Position of the American Dietetic Association: Promoting and supporting breastfeeding.

PubMed

James, Delores C S; Dobson, Brenda

2005-05-01

It is the position of the American Dietetic Association (ADA) that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Breastfeeding is also a public health strategy for improving infant and child health survival, improving maternal morbidity, controlling health care costs, and conserving natural resources. ADA emphasizes the essential role of dietetics professionals in promoting and supporting breastfeeding by providing up-to-date, practical information to pregnant and postpartum women, involving family and friends in breastfeeding education and counseling, removing institutional barriers to breastfeeding, collaborating with community organizations and others who promote and support breastfeeding, and advocating for policies that position breastfeeding as the norm for infant feeding. ADA also emphasizes its own role by providing up-to-date information to the public, encouraging empirical research, providing continuing education opportunities, providing cultural sensitivity and cultural competence training to dietetics professionals, and encouraging universities to review and update undergraduate and graduate training programs.

A method for estimating cost savings for population health management programs.

PubMed

Murphy, Shannon M E; McGready, John; Griswold, Michael E; Sylvia, Martha L

2013-04-01

To develop a quasi-experimental method for estimating Population Health Management (PHM) program savings that mitigates common sources of confounding, supports regular updates for continued program monitoring, and estimates model precision. Administrative, program, and claims records from January 2005 through June 2009. Data are aggregated by member and month. Study participants include chronically ill adult commercial health plan members. The intervention group consists of members currently enrolled in PHM, stratified by intensity level. Comparison groups include (1) members never enrolled, and (2) PHM participants not currently enrolled. Mixed model smoothing is employed to regress monthly medical costs on time (in months), a history of PHM enrollment, and monthly program enrollment by intensity level. Comparison group trends are used to estimate expected costs for intervention members. Savings are realized when PHM participants' costs are lower than expected. This method mitigates many of the limitations faced using traditional pre-post models for estimating PHM savings in an observational setting, supports replication for ongoing monitoring, and performs basic statistical inference. This method provides payers with a confident basis for making investment decisions. © Health Research and Educational Trust.

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

PubMed Central

Van der Wees, Philip J; Hendriks, Erik JM; Custers, Jan WH; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-01-01

Background Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Method Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Results Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. Conclusion As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program. PMID:18036215

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy.

PubMed

Van der Wees, Philip J; Hendriks, Erik J M; Custers, Jan W H; Burgers, Jako S; Dekker, Joost; de Bie, Rob A

2007-11-23

Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on a standardized program. New developments in the field of guideline research raised the need to evaluate and update the KNGF guideline program. Purpose of this study is to compare different guideline development programs and review the KNGF guideline program for physical therapy in the Netherlands, in order to update the program. Six international guideline development programs were selected, and the 23 criteria of the AGREE Instrument were used to evaluate the guideline programs. Information about the programs was retrieved from published handbooks of the organizations. Also, the Dutch program for guideline development in physical therapy was evaluated using the AGREE criteria. Further comparison the six guideline programs was carried out using the following elements of the guideline development processes: Structure and organization; Preparation and initiation; Development; Validation; Dissemination and implementation; Evaluation and update. Compliance with the AGREE criteria of the guideline programs was high. Four programs addressed 22 AGREE criteria, and two programs addressed 20 AGREE criteria. The previous Dutch program for guideline development in physical therapy lacked in compliance with the AGREE criteria, meeting only 13 criteria. Further comparison showed that all guideline programs perform systematic literature searches to identify the available evidence. Recommendations are formulated and graded, based on evidence and other relevant factors. It is not clear how decisions in the development process are made. In particular, the process of translating evidence into practice recommendations can be improved. As a result of international developments and consensus, the described processes for developing clinical practice guidelines have much in common. The AGREE criteria are common basis for the development of guidelines, although it is not clear how final decisions are made. Detailed comparison of the different guideline programs was used for updating the Dutch program. As a result the updated KNGF program complied with 22 AGREE criteria. International discussion is continuing and will be used for further improvement of the program.

E-Cigarettes and Young People: A Public Health Concern

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Family History Collection Practices: National Survey of Pediatric Primary Care Providers.

PubMed

Tarini, Beth A; Gornick, Michele C; Zikmund-Fisher, Brian J; Saal, Howard M; Edmondson, Laurie; Uhlmann, Wendy R

2018-05-01

While family history (FH) collection is a core responsibility of pediatric primary care providers (PCPs), few details about this practice are known. We surveyed a random national sample of 1200 pediatricians and family medicine physicians about FH collection practices. A total of 86% of respondents (n = 289 pediatricians; n = 152 family medicine physicians) indicated that they collect a FH "always" or "most of the time" with 77% reporting collection at the first visit, regardless of whether it is a health maintenance or problem-focused visit. Less than half ask about relatives other than parents, siblings, or grandparents (36.3%). Among respondents, 42% routinely update the FH at every health maintenance visit while 6% updated FH at every visit. Pediatric PCPs use a variety of methods to collect a FH that is limited in scope and variably updated. Our results suggest that interventions are needed to help pediatric PCPs collect a systematic, efficient, and updated FH.

[Google Flu Trends--the initial application of big data in public health].

PubMed

Zou, Xiaohui; Zhu, Wenfei; Yang, Lei; Shu, Yuelong

2015-06-01

Google Flu Trends (GFT) was the first application of big data in the public health field. GFT was open online in 2009 and attracted worldwide attention immediately. However, GFT failed catching the 2009 pandemic H1N1 and kept overestimating the intensity of influenza-like illness in the 2012-2014 season in the United States. GFT model has been updated for three times since 2009, making its prediction bias controlled. Here, we summarized the mechanism GFT worked, the strategy GFT used to update, and its influence on public health.

Update on Chinese American Childhood Obesity Prevalence in New York City.

PubMed

Au, Loretta; Lau, Jennifer D; Chao, Eda; Tse, Raymond; Elbaar, Laminasti

2017-09-15

Prevalence of overweight and obesity was measured in 12,275 Chinese American children and adolescents, ages 2-19, who were patients at a large federally qualified health center in 2015. Demographic characteristics sex, age, and birthplace were further stratified to explore disaggregated prevalence. Comparison of this 2015 cohort to an ethnically similar study cohort from the same health center in 2004 showed that the overall prevalence in overweight and obesity dropped to 21% from previously recorded 24%. US Born school-aged males continue to have the highest prevalence of overweight and obesity at 36%. School-aged children have higher odds of being overweight or obese (OR 1.61, P < 0.001; OR 1.99, P < 0.001) compared to adolescents. Although the foreign-born females had the lowest prevalence of overweight and obesity (12%), they were the only group in 2015 to have increased prevalence in overweight and obesity since 2004 (by 5.8%).

The World Hypertension League: where now and where to in salt reduction

PubMed Central

Lackland, Daniel T.; Lisheng, Liu; Zhang, Xin-Hua; Nilsson, Peter M.; Niebylski, Mark L.

2015-01-01

High dietary salt is a leading risk for death and disability largely by causing increased blood pressure. Other associated health risks include gastric and renal cell cancers, osteoporosis, renal stones, and increased disease activity in multiple sclerosis, headache, increased body fat and Meniere’s disease. The World Hypertension League (WHL) has prioritized advocacy for salt reduction. WHL resources and actions include a non-governmental organization policy statement, dietary salt fact sheet, development of standardized nomenclature, call for quality research, collaboration in a weekly salt science update, development of a process to set recommended dietary salt research standards and regular literature reviews, development of adoptable power point slide sets to support WHL positions and resources, and critic of weak research studies on dietary salt. The WHL plans to continue to work with multiple governmental and non-governmental organizations to promote dietary salt reduction towards the World Health Organization (WHO) recommendations. PMID:26090335

Occupational safety and health education under the lifelong learning framework in Serbia.

PubMed

Macuzic, Ivan; Giagloglou, Eva; Djapan, Marko; Todorovic, Petar; Jeremic, Branislav

2016-12-01

Serbia is aligning with European Union requirements and the occupational safety and health (OSH) administration is one of the most representative sectors of this alignment. Many efforts were made in this field, by introducing new laws and regulations, but it turned out to be insufficient. OSH professionals need to renovate and strengthen their knowledge in accordance with continuous, updated and improved OSH standards and regulation. Lifelong learning (LLL) programmes can contribute to forming professionals who are always up to date. This paper presents an implemented LLL programme, over the duration of two academic years, dedicated to OSH professionals, and investigates whether this programme will be helpful and accepted by professionals. The results from the study show that the given LLL programme had indeed a positive influence on the professional careers of the participants and that the LLL presents the future trend in OSH education.

Implementation of electronic medical records requires more than new software: Lessons on integrating and managing health technologies from Mbarara, Uganda.

PubMed

Madore, Amy; Rosenberg, Julie; Muyindike, Winnie R; Bangsberg, David R; Bwana, Mwebesa B; Martin, Jeffrey N; Kanyesigye, Michael; Weintraub, Rebecca

2015-12-01

Implementation lessons: • Technology alone does not necessarily lead to improvement in health service delivery, in contrast to the common assumption that advanced technology goes hand in hand with progress. • Implementation of electronic medical record (EMR) systems is a complex, resource-intensive process that, in addition to software, hardware, and human resource investments, requires careful planning, change management skills, adaptability, and continuous engagement of stakeholders. • Research requirements and goals must be balanced with service delivery needs when determining how much information is essential to collect and who should be interfacing with the EMR system. • EMR systems require ongoing monitoring and regular updates to ensure they are responsive to evolving clinical use cases and research questions. • High-quality data and analyses are essential for EMRs to deliver value to providers, researchers, and patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

PubMed

2017-11-07

This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

IMMUNISATION TRAINING NEEDS IN MALAWI.

PubMed

Tsega, A Y; Hausi, H T; Steinglass, R; Chirwa, G Z

2014-09-01

The Malawi Ministry of Health (MOH) and its immunisation partners conducted a training needs assessment in May 2013 to assess the current status of immunisation training programmemes in health training institutions, to identify unmet training needs, and to recommend possible solutions for training of health workers on a regular basis. A cross-sectional, descriptive study. Health training institutions in Malawi, a developing country that does not regularly update its curricula to include new vaccines and management tools, nor train healthcare workers on a regular basis. Researchers interviewed Malawi's central immunisation manager, three zonal immunisation officers, six district officers, 12 health facility immunisation coordinators, and eight principals of training institutions. All health training institutions in Malawi include immunisation in their preservice training curricula. However, the curriculum is not regularly updated; thus, the graduates are not well equipped to provide quality services. In addition, the duration of the training curriculum is inadequate, and in-service training sessions for managers and service providers are conducted only on an ad hoc basis. All levels of Malawi's health system have not met sufficient training needs for providing immunisations, and the health training institutions teach their students with outdated materials. It is recommended that the training institutions update their training curricula regularly and the service providers are trained on a regular basis.

Chicken and Food Poisoning

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Autism: Why Act Early?

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Medication Use during Pregnancy

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Learn About Cronobacter Infection

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Bleeding Disorders in Women

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Pregnant? Don't Smoke!

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Home Canning and Botulism

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Advanced Environmental Monitoring and Control Program: Technology Development Requirements

NASA Technical Reports Server (NTRS)

Jan, Darrell (Editor); Seshan, Panchalam (Editor); Ganapathi, Gani (Editor); Schmidt, Gregory (Editor); Doarn, Charles (Editor)

1996-01-01

Human missions in space, from the International Space Station on towards potential human exploration of the moon, Mars and beyond into the solar system, will require advanced systems to maintain an environment that supports human life. These systems will have to recycle air and water for many months or years at a time, and avoid harmful chemical or microbial contamination. NASA's Advanced Environmental Monitoring and Control program has the mission of providing future spacecraft with advanced, integrated networks of microminiaturized sensors to accurately determine and control the physical, chemical and biological environment of the crew living areas. This document sets out the current state of knowledge for requirements for monitoring the crew environment, based on (1) crew health, and (2) life support monitoring systems. Both areas are updated continuously through research and space mission experience. The technologies developed must meet the needs of future life support systems and of crew health monitoring. These technologies must be inexpensive and lightweight, and use few resources. Using these requirements to continue to push the state of the art in miniaturized sensor and control systems will produce revolutionary technologies to enable detailed knowledge of the crew environment.

40 CFR 130.1 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS WATER QUALITY PLANNING..., interstate, areawide and regional and local CWA water quality planning and management activities undertaken on or after February 11, 1985 including all updates and continuing certifications for approved Water...

Breast milk breaks new boundaries.

PubMed

Hilton, Sioned

2012-01-01

It is widely understood that breast milk is best for babies, but groundbreaking research continues to be conducted by the world's leading researchers to ensure we have the most recent knowledge to help breastfeeding mothers and give health professionals up to date guidance. This article provides a report from the recent International Breastfeeding and Lactation Symposium, hosted by Medela, touching on some of the key findings that were presented. This year's symposium revealed some exciting news for the breastfeeding world and here our reporter gives us a snap shot of the three most significant updates: further understanding of stem cells in breast milk, findings that have unlocked the power of human milk and insights into medication and breast milk.

Update on cutaneous tuberculosis*

PubMed Central

Dias, Maria Fernanda Reis Gavazzoni; Bernardes Filho, Fred; Quaresma, Maria Victória; do Nascimento, Leninha Valério; Nery, José Augusto da Costa; Azulay, David Rubem

2014-01-01

Tuberculosis continues to draw special attention from health care professionals and society in general. Cutaneous tuberculosis is an infection caused by M. tuberculosis complex, M. bovis and bacillus Calmette-Guérin. Depending on individual immunity, environmental factors and the type of inoculum, it may present varied clinical and evolutionary aspects. Patients with HIV and those using immunobiological drugs are more prone to infection, which is a great concern in centers where the disease is considered endemic. This paper aims to review the current situation of cutaneous tuberculosis in light of this new scenario, highlighting the emergence of new and more specific methods of diagnosis, and the molecular and cellular mechanisms that regulate the parasite-host interaction. PMID:25387498

Update in women's health.

PubMed

Ganschow, Pamela S; Jacobs, Elizabeth A; Mackinnon, Jennifer; Charney, Pamela

2009-06-01

The aim of this clinical update is to summarize articles and guidelines published in the last year with the potential to change current clinical practice as it relates to women's health. We used two independent search strategies to identify articles relevant to women's health published between March 1, 2007 and February 29, 2008. First, we reviewed the Cochrane Database of Systematic Reviews and journal indices from the ACP Journal Club, Annals of Internal Medicine, Archives of Internal Medicine, British Medical Journal, Circulation, Diabetes, JAMA, JGIM, Journal of Women's Health, Lancet, NEJM, Obstetrics and Gynecology, and Women's Health Journal Watch. Second, we performed a MEDLINE search using the medical subject heading term "sex factors." The authors, who all have clinical and/or research experience in the area of women's health, reviewed all article titles, abstracts, and, when indicated, full publications. We excluded articles related to obstetrical aspects of women's health focusing on those relevant to general internists. We had two acceptance criteria, scientific rigor and potential to impact women's health. We also identified new and/or updated women's health guidelines released during the same time period. We identified over 250 publications with potential relevance to women's health. Forty-six articles were selected for presentation as part of the Clinical Update, and nine were selected for a more detailed discussion in this paper. Evidence-based women's health guidelines are listed in Table 1. Table 1 Important Women's Health Guidelines in 2007-2008: New or Updated Topic Issuing organization Updated recommendations and comments Mammography screening in women 40-4917 ACP Individualized risk assessment and informed decision making should be used to guide decisions about mammography screening in this age group. To aid in the risk assessment, a discussion of the risk factors, which if present in a woman in her 40s increases her risk to above that of an average 50-year-old woman, is provided in the guidelines. In addition, available risk prediction models, such as the NIH Web site calculator (http://www.cancer.gov/bcrisktool/) can also be used to estimate quantitative breast cancer risk. This model was updated in 2008 with race-specific data for calculating risk in African-American women.18 The harms and benefits of mammography should be discussed and incorporated along with a woman's preferences and breast cancer risk profile into the decision on when to begin screening. If a woman decides to forgo mammography, the decision should be readdressed every 1 to 2 years. STD screening guidelines19 USPSTF and CDC Routine screening for this infection is now recommended for ALL sexually active women age 24 and under, based on the recent high prevalence estimates for chlamydia It is not recommended for women (pregnant or nonpregnant) age 25 and older, unless they are at increased risk for infection. STD treatment guidelines20 CDC Flouroquinolones are NO longer recommended for treatment of N. gonorrhea, due to increasing resistance (as high as 15% of isolates in 2006). For uncomplicated infections, treatment of gonorrhea should be initiated with ceftriaxone 125 mg IM or cefixime 400 mg PO and co-treatment for chlamydia infection (unless ruled out with testing). Recent estimates demonstrate that almost 50% of persons with gonorrhea have concomitant chlamydia infection21. STD = sexually transmitted disease, NIH = National Institutes of Health, ACP = American College of Physicians, USPSTF = United States Prevention Services Task Force, CDC = Centers for Disease Control.

Advancing the framework for considering the effects of climate change on worker safety and health.

PubMed

Schulte, P A; Bhattacharya, A; Butler, C R; Chun, H K; Jacklitsch, B; Jacobs, T; Kiefer, M; Lincoln, J; Pendergrass, S; Shire, J; Watson, J; Wagner, G R

2016-11-01

In 2009, a preliminary framework for how climate change could affect worker safety and health was described. That framework was based on a literature search from 1988-2008 that supported seven categories of climate-related occupational hazards: (1) increased ambient temperature; (2) air pollution; (3) ultraviolet radiation exposure; (4) extreme weather; (5) vector-borne diseases and expanded habitats; (6) industrial transitions and emerging industries; and (7) changes in the built environment. This article reviews the published literature from 2008-2014 in each of the seven categories. Additionally, three new topics related to occupational safety and health are considered: mental health effects, economic burden, and potential worker safety and health impacts associated with the nascent field of climate intervention (geoengineering). Beyond updating the literature, this article also identifies key priorities for action to better characterize and understand how occupational safety and health may be associated with climate change events and ensure that worker health and safety issues are anticipated, recognized, evaluated, and mitigated. These key priorities include research, surveillance, risk assessment, risk management, and policy development. Strong evidence indicates that climate change will continue to present occupational safety and health hazards, and this framework may be a useful tool for preventing adverse effects to workers.

Advancing the framework for considering the effects of climate change on worker safety and health

PubMed Central

Schulte, P.A.; Bhattacharya, A.; Butler, C.R.; Chun, H.K.; Jacklitsch, B.; Jacobs, T.; Kiefer, M.; Lincoln, J.; Pendergrass, S.; Shire, J.; Watson, J.; Wagner, G.R.

2016-01-01

ABSTRACT In 2009, a preliminary framework for how climate change could affect worker safety and health was described. That framework was based on a literature search from 1988–2008 that supported seven categories of climate-related occupational hazards: (1) increased ambient temperature; (2) air pollution; (3) ultraviolet radiation exposure; (4) extreme weather; (5) vector-borne diseases and expanded habitats; (6) industrial transitions and emerging industries; and (7) changes in the built environment. This article reviews the published literature from 2008–2014 in each of the seven categories. Additionally, three new topics related to occupational safety and health are considered: mental health effects, economic burden, and potential worker safety and health impacts associated with the nascent field of climate intervention (geoengineering). Beyond updating the literature, this article also identifies key priorities for action to better characterize and understand how occupational safety and health may be associated with climate change events and ensure that worker health and safety issues are anticipated, recognized, evaluated, and mitigated. These key priorities include research, surveillance, risk assessment, risk management, and policy development. Strong evidence indicates that climate change will continue to present occupational safety and health hazards, and this framework may be a useful tool for preventing adverse effects to workers. PMID:27115294

Instruments for measuring mental health recovery: a systematic review.

PubMed

Sklar, Marisa; Groessl, Erik J; O'Connell, Maria; Davidson, Larry; Aarons, Gregory A

2013-12-01

Persons in recovery, providers, and policymakers alike are advocating for recovery-oriented mental health care, with the promotion of recovery becoming a prominent feature of mental health policy in the United States and internationally. One step toward creating a recovery-oriented system of care is to use recovery-oriented outcome measures. Numerous instruments have been developed to assess progress towards mental health recovery. This review identifies instruments of mental health recovery and evaluates the appropriateness of their use including their psychometric properties, ease of administration, and service-user involvement in their development. A literature search using the Medline and Psych-INFO databases was conducted, identifying 21 instruments for potential inclusion in this review, of which thirteen met inclusion criteria. Results suggest only three instruments (25%) have had their psychometric properties assessed in three or more unique samples of participants. Ease of administration varied between instruments, and for the majority of instruments, development included service user involvement. This review updates and expands previous reviews of instruments to assess mental health recovery. As mental health care continues to transform to a recovery-oriented model of service delivery, this review may facilitate selection of appropriate assessments of mental health recovery for systems to use in evaluating and improving the care they provide. © 2013.

40 CFR 141.521 - What updated watershed control requirements must my unfiltered system implement to continue to...

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Identify watershed characteristics and activities which may have an adverse effect on source water quality; and (b) Monitor the occurrence of activities which may have an adverse effect on source water quality. ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL...

76 FR 76892 - Updated Statements of Legal Authority To Reflect Continuation of Emergency Declared in Executive...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-09

... chemical weapons and the means of delivering such weapons. That emergency has been continued in effect... November 4, 2010, Continuation of Emergency Regarding Weapons of Mass Destruction, with citations to the... recordkeeping requirements, Terrorism. 15 CFR Part 745 Administrative practice and procedure, Chemicals, Exports...

Trust in health Websites: a survey among Norwegian Internet users.

PubMed

Rosenvinge, Jan H; Laugerud, Stein; Hjortdahl, Per

2003-01-01

Whether consumers feel able to trust the information presented on a health-related Website is as important a quality criterion as more objective criteria. We investigated whether trust was related to five aspects of health Websites: the involvement of health professionals, a facility for interactive communication, information about those responsible for the site, a picture of those responsible for the site, and the impression of site update frequency. A polling agency invited, by email, a sample of 600 Norwegian users of e-health information to participate in the study and 476 subjects did so (a 79% response rate), by completing a questionnaire online. Their mean age was 41 years and 53% were female. All five aspects of health Websites were related to the trust placed in the site but they were not consistently related to gender or age. Trust in Websites that were frequently updated was related to being a frequent e-health user, while those who trusted interactive e-health sites were low-frequency users who tended to order drugs and health products from the sites. The probability of taking action as a result of e-health information was related to the frequency of visits to health Websites but not to the five aspects of them investigated in relation to trust. However, respondents who trusted sites that were perceived as being frequently updated and to have health professionals involved were more likely to be frequent users of e-health information.

Lupus among Asians and Hispanics

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Prevent the Spread of Norovirus

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Are You Getting Enough Sleep?

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Take Care with Pet Reptiles

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Hand, Foot and Mouth Disease

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Carbon Monoxide (CO) Poisoning Prevention

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Helping Children with Congenital CMV

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Standards of care for occupational asthma: an update.

PubMed

Fishwick, David; Barber, Christopher Michael; Bradshaw, Lisa M; Ayres, Jon G; Barraclough, Richard; Burge, Sherwood; Corne, Jonathan M; Cullinan, Paul; Frank, Timothy Laszlo; Hendrick, David; Hoyle, Jennifer; Curran, Andrew D; Niven, Robert; Pickering, Tony; Reid, Peter; Robertson, Alastair; Stenton, Chris; Warburton, Christopher J; Nicholson, Paul J

2012-03-01

The British Thoracic Society (BTS) Standards of Care (SoC) Committee produced a standard of care for occupational asthma (OA) in 2008, based on a systematic evidence review performed in 2004 by the British Occupational Health Research Foundation (BOHRF). BOHRF updated the evidence base from 2004-2009 in 2010. This article summarises the changes in evidence and is aimed at physicians, nurses and other healthcare professionals in primary and secondary care, occupational health and public health and at employers, workers and their health, safety and other representatives. Various recommendations and evidence ratings have changed in the management of asthma that may have an occupational cause.

Zirconium: biomedical and nephrological applications.

PubMed

Lee, David B N; Roberts, Martin; Bluchel, Christian G; Odell, Ross A

2010-01-01

Recent years have witnessed a rapid increase in the use of zirconium (Zr)-containing compounds in artificial internal organs. Examples include dental implants and other restorative practices, total knee and hip replacement, and middle-ear ossicular chain reconstruction. In nephrological practice, Zr-containing sorbents have been used in hemofiltration, hemodialysis, peritoneal dialysis, and in the design and construction of wearable artificial kidneys. Zr compounds continue to be widely and extensively used in deodorant and antiperspirant preparations. In the public health arena, Zr compounds have been studied or used in controlling phosphorus pollution and in the reclamation of poison and bacteria-contaminated water. Experimental and clinical studies support the general consensus that Zr compounds are biocompatible and exhibit low toxicity. Reports on possible Zr-associated adverse reactions are rare and, in general, have not rigorously established a cause-and-effect relationship. Although publications on the use of Zr compounds have continued to increase in recent years, reports on Zr toxicity have virtually disappeared from the medical literature. Nevertheless, familiarity with, and continued vigilant monitoring of, the use of these compounds are warranted. This article provides an updated review on the biomedical use of Zr compounds.

Continuing challenges in influenza

PubMed Central

Webster, Robert G.; Govorkova, Elena A.

2014-01-01

Influenza is an acute respiratory disease in mammals and domestic poultry that emerges from zoonotic reservoirs in aquatic birds and bats. Although influenza viruses are among the most intensively studied pathogens, existing control options require further improvement. Influenza vaccines must be regularly updated because of continuous antigenic drift and sporadic antigenic shifts in the viral surface glycoproteins. Currently, influenza therapeutics are limited to neuraminidase inhibitors; novel drugs and vaccine approaches are therefore urgently needed. Advances in vaccinology and structural analysis have revealed common antigenic epitopes on hemagglutinins across all influenza viruses and suggest that a universal influenza vaccine is possible. In addition, various immunomodulatory agents and signaling pathway inhibitors are undergoing preclinical development. Continuing challenges in influenza include the emergence of pandemic H1N1 influenza in 2009, human infections with avian H7N9 influenza in 2013, and sporadic human cases of highly pathogenic avian H5N1 influenza. Here, we review the challenges facing influenza scientists and veterinary and human public health officials; we also discuss the exciting possibility of achieving the ultimate goal of controlling influenza’s ability to change its antigenicity. PMID:24891213

Interprofessional education: effects on professional practice and healthcare outcomes (update).

PubMed

Reeves, Scott; Perrier, Laure; Goldman, Joanne; Freeth, Della; Zwarenstein, Merrick

2013-03-28

The delivery of effective, high-quality patient care is a complex activity. It demands health and social care professionals collaborate in an effective manner. Research continues to suggest that collaboration between these professionals can be problematic. Interprofessional education (IPE) offers a possible way to improve interprofessional collaboration and patient care. To assess the effectiveness of IPE interventions compared to separate, profession-specific education interventions; and to assess the effectiveness of IPE interventions compared to no education intervention. For this update we searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE and CINAHL, for the years 2006 to 2011. We also handsearched the Journal of Interprofessional Care (2006 to 2011), reference lists of all included studies, the proceedings of leading IPE conferences, and websites of IPE organisations. Randomised controlled trials (RCTs), controlled before and after (CBA) studies and interrupted time series (ITS) studies of IPE interventions that reported objectively measured or self reported (validated instrument) patient/client or healthcare process outcomes. At least two review authors independently assessed the eligibility of potentially relevant studies. For included studies, at least two review authors extracted data and assessed study quality. A meta-analysis of study outcomes was not possible due to heterogeneity in study designs and outcome measures. Consequently, the results are presented in a narrative format. This update located nine new studies, which were added to the six studies from our last update in 2008. This review now includes 15 studies (eight RCTs, five CBA and two ITS studies). All of these studies measured the effectiveness of IPE interventions compared to no educational intervention. Seven studies indicated that IPE produced positive outcomes in the following areas: diabetes care, emergency department culture and patient satisfaction; collaborative team behaviour and reduction of clinical error rates for emergency department teams; collaborative team behaviour in operating rooms; management of care delivered in cases of domestic violence; and mental health practitioner competencies related to the delivery of patient care. In addition, four of the studies reported mixed outcomes (positive and neutral) and four studies reported that the IPE interventions had no impact on either professional practice or patient care. This updated review reports on 15 studies that met the inclusion criteria (nine studies from this update and six studies from the 2008 update). Although these studies reported some positive outcomes, due to the small number of studies and the heterogeneity of interventions and outcome measures, it is not possible to draw generalisable inferences about the key elements of IPE and its effectiveness. To improve the quality of evidence relating to IPE and patient outcomes or healthcare process outcomes, the following three gaps will need to be filled: first, studies that assess the effectiveness of IPE interventions compared to separate, profession-specific interventions; second, RCT, CBA or ITS studies with qualitative strands examining processes relating to the IPE and practice changes; third, cost-benefit analyses.

Dealing with ADHD: What You Need to Know

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The Deceit Continues: An Updated Literature Review of Munchausen Syndrome By Proxy.

ERIC Educational Resources Information Center

Sheridan, Mary S.

2003-01-01

This updated review of the literature on Munchausen Syndrome by Proxy (MBSP) analyzes 451 cases from 154 medical and psychosocial journal articles. Typical victims were usually 4 years of age or under; 6% were dead, and 7.3% suffered long-term or permanent injury. Twenty-five percent of siblings were dead. Mothers were perpetrators in 76.5% of…

The Fiscal Impact of the Milwaukee Parental Choice Program: 2009 Update. SCDP Milwaukee Evaluation Report #7

ERIC Educational Resources Information Center

Costrell, Robert M.

2009-01-01

In February 2008, the School Choice Demonstration Project (SCDP) issued its first report on the fiscal impact of the Milwaukee Parental Choice Program (MPCP) on taxpayers in Milwaukee and the state of Wisconsin. There are two reasons to update the 2008 report. First, the figures will naturally change with the continuing growth of the voucher…

Focus on Teacher Pay and Incentives: Recent Legislative Actions and Update on Salary Averages. Challenge to Lead

ERIC Educational Resources Information Center

Gaines; Gale F.

2007-01-01

Teacher pay continues to be a hot issue for states, particularly since it is likely the largest expenditure in education budgets. This paper summarizes the latest on average salaries in the Southern Regional Education Board (SREB) states, including an update on recent incentive pay programs, pilot projects, and other legislative actions that…

40 CFR 1065.309 - Continuous gas analyzer system-response and updating-recording verification-for gas analyzers...

Code of Federal Regulations, 2012 CFR

2012-07-01

... for water removed from the sample done in post-processing according to § 1065.659 and it does not... initial installation (i.e., test cell commissioning) and after any modifications to the system that would... concentration is updated and recorded at an appropriate frequency to prevent loss of information. This test also...

40 CFR 1065.309 - Continuous gas analyzer system-response and updating-recording verification-for gas analyzers...

Code of Federal Regulations, 2011 CFR

2011-07-01

... for water removed from the sample done in post-processing according to § 1065.659 and it does not... initial installation (i.e., test cell commissioning) and after any modifications to the system that would... concentration is updated and recorded at an appropriate frequency to prevent loss of information. This test also...

Changing Habits of Practice

PubMed Central

Bowen, Judith L; Salerno, Stephen M; Chamberlain, John K; Eckstrom, Elizabeth; Chen, Helen L; Brandenburg, Suzanne

2005-01-01

Purpose The majority of health care, both for acute and chronic conditions, is delivered in the ambulatory setting. Despite repeated proposals for change, the majority of internal medicine residency training still occurs in the inpatient setting. Substantial changes in ambulatory education are needed to correct the current imbalance. To assist educators and policy makers in this process, this paper reviews the literature on ambulatory education and makes recommendations for change. Methods The authors searched the Medline, Psychlit, and ERIC databases from 2000 to 2004 for studies that focused specifically on curriculum, teaching, and evaluation of internal medicine residents in the ambulatory setting to update previous reviews. Studies had to contain primary data and were reviewed for methodological rigor and relevance. Results Fifty-five studies met criteria for review. Thirty-five of the studies focused on specific curricular areas and 11 on ambulatory teaching methods. Five involved evaluating performance and 4 focused on structural issues. No study evaluated the overall effectiveness of ambulatory training or investigated the effects of current resident continuity clinic microsystems on education. Conclusion This updated review continues to identify key deficiencies in ambulatory training curriculum and faculty skills. The authors make several recommendations: (1) Make training in the ambulatory setting a priority. (2) Address systems problems in practice environments. (3) Create learning experiences appropriate to the resident's level of development. (4) Teach and evaluate in the examination room. (5) Expand subspecialty-based training to the ambulatory setting. (6) Make faculty development a priority. (7) Create and fund multiinstitutional educational research consortia. PMID:16423112

Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update.

PubMed

Sarin, S K; Kumar, M; Lau, G K; Abbas, Z; Chan, H L Y; Chen, C J; Chen, D S; Chen, H L; Chen, P J; Chien, R N; Dokmeci, A K; Gane, Ed; Hou, J L; Jafri, W; Jia, J; Kim, J H; Lai, C L; Lee, H C; Lim, S G; Liu, C J; Locarnini, S; Al Mahtab, M; Mohamed, R; Omata, M; Park, J; Piratvisuth, T; Sharma, B C; Sollano, J; Wang, F S; Wei, L; Yuen, M F; Zheng, S S; Kao, J H

2016-01-01

Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.

Evaluation of Online Information Sources on Alien Species in Europe: The Need of Harmonization and Integration

NASA Astrophysics Data System (ADS)

Gatto, Francesca; Katsanevakis, Stelios; Vandekerkhove, Jochen; Zenetos, Argyro; Cardoso, Ana Cristina

2013-06-01

Europe is severely affected by alien invasions, which impact biodiversity, ecosystem services, economy, and human health. A large number of national, regional, and global online databases provide information on the distribution, pathways of introduction, and impacts of alien species. The sufficiency and efficiency of the current online information systems to assist the European policy on alien species was investigated by a comparative analysis of occurrence data across 43 online databases. Large differences among databases were found which are partially explained by variations in their taxonomical, environmental, and geographical scopes but also by the variable efforts for continuous updates and by inconsistencies on the definition of "alien" or "invasive" species. No single database covered all European environments, countries, and taxonomic groups. In many European countries national databases do not exist, which greatly affects the quality of reported information. To be operational and useful to scientists, managers, and policy makers, online information systems need to be regularly updated through continuous monitoring on a country or regional level. We propose the creation of a network of online interoperable web services through which information in distributed resources can be accessed, aggregated and then used for reporting and further analysis at different geographical and political scales, as an efficient approach to increase the accessibility of information. Harmonization, standardization, conformity on international standards for nomenclature, and agreement on common definitions of alien and invasive species are among the necessary prerequisites.

Salivary immunoassays to investigate potential exposure to ...

EPA Pesticide Factsheets

This presentation provides an update to an ongoing collaboration with Inter American University of Puerto Rico. The goal of this study is to investigate public health benefits that result from implementation of low cost, sustainable filtration technologies in remote, rural communities in Puerto Rico. To present an update to an ongoing collaborative project with Inter American University of Puerto Rico which investigates the health benefits that may result from installation of community level water filtration systems.

Center for Disease Control's Diethylstilbestrol Update: a case for effective operationalization of messaging in social marketing practice.

PubMed

Mattson, Marifran; Basu, Ambar

2010-07-01

The Center for Disease Control's (CDC) Diethylstilbestrol (DES) Update, a campaign to educate people who may have been exposed to the drug DES, is framed on the premises of the social marketing model, namely formative research, audience segmentation, product, price, placement, promotion, and campaign evaluation. More than that, the campaign takes a critical step in extending the social marketing paradigm by highlighting the need to situate the messaging process at the heart of any health communication campaign. This article uses CDC's DES Update as a case study to illustrate an application of a message development tool within social marketing. This tool promotes the operationalization of messaging within health campaigns. Ultimately, the goal of this project is to extend the social marketing model and provide useful theoretical guidance to health campaign practitioners on how to accomplish stellar communication within a social marketing campaign.

Need yellow fever vaccine? Plan ahead

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Drowsy Driving: Asleep at the Wheel

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Prevent Type 2 Diabetes in Kids

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Help Protect Babies from Whooping Cough

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Test Your Knowledge of Spina Bifida

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Protect Your Child from Rotavirus Disease

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Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States.

PubMed

Biggs, Holly M; Behravesh, Casey Barton; Bradley, Kristy K; Dahlgren, F Scott; Drexler, Naomi A; Dumler, J Stephen; Folk, Scott M; Kato, Cecilia Y; Lash, R Ryan; Levin, Michael L; Massung, Robert F; Nadelman, Robert B; Nicholson, William L; Paddock, Christopher D; Pritt, Bobbi S; Traeger, Marc S

2016-05-13

Tickborne rickettsial diseases continue to cause severe illness and death in otherwise healthy adults and children, despite the availability of low-cost, effective antibacterial therapy. Recognition early in the clinical course is critical because this is the period when antibacterial therapy is most effective. Early signs and symptoms of these illnesses are nonspecific or mimic other illnesses, which can make diagnosis challenging. Previously undescribed tickborne rickettsial diseases continue to be recognized, and since 2004, three additional agents have been described as causes of human disease in the United States: Rickettsia parkeri, Ehrlichia muris-like agent, and Rickettsia species 364D. This report updates the 2006 CDC recommendations on the diagnosis and management of tickborne rickettsial diseases in the United States and includes information on the practical aspects of epidemiology, clinical assessment, treatment, laboratory diagnosis, and prevention of tickborne rickettsial diseases. The CDC Rickettsial Zoonoses Branch, in consultation with external clinical and academic specialists and public health professionals, developed this report to assist health care providers and public health professionals to 1) recognize key epidemiologic features and clinical manifestations of tickborne rickettsial diseases, 2) recognize that doxycycline is the treatment of choice for suspected tickborne rickettsial diseases in adults and children, 3) understand that early empiric antibacterial therapy can prevent severe disease and death, 4) request the appropriate confirmatory diagnostic tests and understand their usefulness and limitations, and 5) report probable and confirmed cases of tickborne rickettsial diseases to public health authorities.

Barriers to Electronic Health Record Adoption: a Systematic Literature Review.

PubMed

Kruse, Clemens Scott; Kristof, Caitlin; Jones, Beau; Mitchell, Erica; Martinez, Angelica

2016-12-01

Federal efforts and local initiatives to increase adoption and use of electronic health records (EHRs) continue, particularly since the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act. Roughly one in four hospitals not adopted even a basic EHR system. A review of the barriers may help in understanding the factors deterring certain healthcare organizations from implementation. We wanted to assemble an updated and comprehensive list of adoption barriers of EHR systems in the United States. Authors searched CINAHL, MEDLINE, and Google Scholar, and accepted only articles relevant to our primary objective. Reviewers independently assessed the works highlighted by our search and selected several for review. Through multiple consensus meetings, authors tapered articles to a final selection most germane to the topic (n = 27). Each article was thoroughly examined by multiple authors in order to achieve greater validity. Authors identified 39 barriers to EHR adoption within the literature selected for the review. These barriers appeared 125 times in the literature; the most frequently mentioned barriers were regarding cost, technical concerns, technical support, and resistance to change. Despite federal and local incentives, the initial cost of adopting an EHR is a common existing barrier. The other most commonly mentioned barriers include technical support, technical concerns, and maintenance/ongoing costs. Policy makers should consider incentives that continue to reduce implementation cost, possibly aimed more directly at organizations that are known to have lower adoption rates, such as small hospitals in rural areas.

Vibrio Pathogens: A Public Health Concern in Rural Water Resources in Sub-Saharan Africa.

PubMed

Osunla, Charles A; Okoh, Anthony I

2017-10-07

Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the continuous discovery of novel species. The main route of transmission of Vibrio pathogens to man is through drinking of contaminated water and consumption inadequately cooked aquatic food products. In sub-Saharan Africa and much of the developing world, some rural dwellers use freshwater resources such as rivers for domestic activities, bathing, and cultural and religious purposes. This review describes the impact of inadequately treated sewage effluents on the receiving freshwater resources and the associated risk to the rural dwellers that depends on the water. Vibrio infections remain a threat to public health. In the last decade, Vibrio disease outbreaks have created alertness on the personal, economic, and public health uncertainties associated with the impact of contaminated water in the aquatic environment of sub-Saharan Africa. In this review, we carried out an overview of Vibrio pathogens in rural water resources in Sub-Saharan Africa and the implication of Vibrio pathogens on public health. Continuous monitoring of Vibrio pathogens among environmental freshwater and treated effluents is expected to help reduce the risk associated with the early detection of sources of infection, and also aid our understanding of the natural ecology and evolution of Vibrio pathogens.

Vibrio Pathogens: A Public Health Concern in Rural Water Resources in Sub-Saharan Africa

PubMed Central

Osunla, Charles A.

2017-01-01

Members of the Vibrio genus are autochthonous inhabitants of aquatic environments and play vital roles in sustaining the aquatic milieu. The genus comprises about 100 species, which are mostly of marine or freshwater origin, and their classification is frequently updated due to the continuous discovery of novel species. The main route of transmission of Vibrio pathogens to man is through drinking of contaminated water and consumption inadequately cooked aquatic food products. In sub-Saharan Africa and much of the developing world, some rural dwellers use freshwater resources such as rivers for domestic activities, bathing, and cultural and religious purposes. This review describes the impact of inadequately treated sewage effluents on the receiving freshwater resources and the associated risk to the rural dwellers that depends on the water. Vibrio infections remain a threat to public health. In the last decade, Vibrio disease outbreaks have created alertness on the personal, economic, and public health uncertainties associated with the impact of contaminated water in the aquatic environment of sub-Saharan Africa. In this review, we carried out an overview of Vibrio pathogens in rural water resources in Sub-Saharan Africa and the implication of Vibrio pathogens on public health. Continuous monitoring of Vibrio pathogens among environmental freshwater and treated effluents is expected to help reduce the risk associated with the early detection of sources of infection, and also aid our understanding of the natural ecology and evolution of Vibrio pathogens. PMID:28991153

Incentive Program Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Provider-Based Status of Indian Health Service and Tribal Facilities and Organizations; Costs Reporting and Provider Requirements; Agreement Termination Notices. Final rule.

PubMed

2017-08-14

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2018. Some of these changes implement certain statutory provisions contained in the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, the 21st Century Cures Act, and other legislation. We also are making changes relating to the provider-based status of Indian Health Service (IHS) and Tribal facilities and organizations and to the low-volume hospital payment adjustment for hospitals operated by the IHS or a Tribe. In addition, we are providing the market basket update that will apply to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2018. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2018. In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific Medicare providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities). We also are establishing new requirements or revising existing requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. We also are making changes relating to transparency of accrediting organization survey reports and plans of correction of providers and suppliers; electronic signature and electronic submission of the Certification and Settlement Summary page of the Medicare cost reports; and clarification of provider disposal of assets.

Physicians’ duty to recontact and update genetic advice

PubMed Central

Stevens, Yvonne A; Senner, Grant D; Marchant, Gary E

2017-01-01

This perspective addresses whether physicians have a duty to recontact former or current patients to update clinical advice based on newly discovered genomic information. Genetic information is unique compared with other medical data in that the underlying data do not appreciably change during the patients’ lifetime, but the clinical significance of that information will continue to evolve. Based on relevant case law and guidelines, there is no general, established legal duty for physicians to affirmatively recontact former or current patients to update clinical advice based on newly discovered genetic information. However, integration of genomics into clinical practice is advancing quickly, and there may be limited, specific situations where a physician may have a duty to provide updated genetic information. PMID:29158769

TOPEX Radar Altimeter Engineering Assessment Report. Update: Launch to January 1, 1997

NASA Technical Reports Server (NTRS)

Hancock, D. W., III; Hayne, G. S.; Brooks, R. L.; Lee, J. E.; Lockwood, D. W.

1997-01-01

The initial TOPEX Mission Radar Altimeter Engineering Assessment Report, in February 1994, presented performance results for the NASA Radar Altimeter on the TOPEX/POSEIDON spacecraft, from its launch in August 1992 to February 1994. There have been supplemental Engineering Assessment Reports, issued in March 1995 and again in May 1996, which updated the performance results through the end of calendar years 1994 and 1995, respectively. This supplement updates the altimeter performance to the end of calendar year 1996, and describes significant events that occurred during 1996. As the performance data base has expanded, and as analysis tools and techniques continue to evolve, the longer-term trends of the altimeter data have become more apparent. The updated findings are presented here.

Pneumonia Can Be Prevented -- Vaccines Can Help

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Protect Your Baby from Group B Strep!

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Don't Let Glaucoma Steal Your Sight!

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Rubella: Make Sure Your Child Gets Vaccinated

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Worried Your Sore Throat May Be Strep?

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Scarlet Fever: A Group A Streptococcal Infection

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Tips to Prevent Illness from Clostridium Perfringens

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Avionics Tether Operations Control

NASA Technical Reports Server (NTRS)

Glaese, John R.

2001-01-01

The activities described in this Final Report were authorized and performed under Purchase Order Number H32835D, issued as part of NASA contract number NAS8-00114. The period of performance of this PO was from March 1 to September 30, 2001. The primary work activity was the continued development and updating of the tether dynamic simulation tools GTOSS (Generalized Tethered Object System Simulation) and TSSIM (Tethered Satellite System) and use of these and other tools in the analysis of various tether dynamics problems. Several updated versions of GTOSS were delivered during the period of performance by the author of the simulation, Lang Associates' David Lang. These updates had mainly to do with updated documentation and an updated coordinate system definition to the J2000 standards. This Final Report is organized by the months in which the activities described were performed. The following sections review the Statement of Work (SOW) and activities performed to satisfy it.

Reducing resistance to polio immunisation with free health camps and Bluetooth messaging: An update from Kaduna, Northern, Nigeria.

PubMed

Birukila, Gerida; Babale, Sufiyan M; Epstein, Helen; Gugong, Victor; Anger, Robert; Corkum, Melissa; Jehoshaphat Nebanat, Albarka; Musoke, Fredrick; Alabi, Olaniran

2017-01-01

Since 1997, the Global Polio Eradication Initiative has sponsored regular door-to-door polio immunisation campaigns in northern Nigeria. On 30 July 2015, the country was finally declared poliofree, a hard won success. At various times, polio eradication has been threatened by rumours and community tensions. For example, in 2003, local Imams, traditional leaders and politicians declared a polio campaign boycott, due to the concerns about the safety of the polio vaccine. Although the campaigns resumed in 2004, many parents continued to refuse vaccination because of the persistence of rumours of vaccine contamination, and anger about the poor state of health services for conditions other than polio. To address this, UNICEF and Nigerian Government partners piloted two interventions: (1) mobile 'health camps' to provide ambulatory care for conditions other than polio and (2) an audiovisual clip about vaccine safety and other health issues, shareable on multimedia mobile phones via Bluetooth pairing. The mobile phone survey found that Bluetooth compatible messages could rapidly spread behavioural health messages in low-literacy communities. The health camps roughly doubled polio vaccine uptake in the urban ward where it was piloted. This suggests that polio eradication would have been accelerated by improving primary health care services.

A practitioner-driven research agenda for syndromic surveillance

DOE PAGES

Hopkins, Richard S.; Gunn, Julia; Berezowski, John; ...

2017-05-02

The objective here is to obtain feedback and seek future directions for an ISDS initiative to establish and update research questions in Informatics, Analytics,Communications, and Systems Research with the greatest perceived impact for improving surveillance practice.Introduction Over the past fifteen years, syndromic surveillance (SyS) has evolved from a set of ad hoc methods used mostly in post-disaster settings, then expanded with broad support and development because of bioterrorism concerns, and subsequently evolved to a mature technology that runs continuously to detect and monitor a wide range of health issues. Continued enhancements needed to meet the challenges of novel health threatsmore » with increasingly complex information sources will require technical advances focused on day-to-day public health needs.Since its formation in 2005, the International Society for Disease Surveillance (ISDS) has sought to clarify and coordinate global priorities in surveillance research. As part of a practitioner-driven initiative to identify current research priorities in SyS, ISDS polled its members about capabilities needed by SyS practitioners that could be improved as a result of research efforts. A taskforce of the ISDS Research Committee, consisting of national and global subject matter experts (SMEs) in SyS and ISDS professional staff, carried out the project. This panel will discuss the results and the preferred means to determine and communicate priorities in the future.« less

A practitioner-driven research agenda for syndromic surveillance

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

Hopkins, Richard S.; Gunn, Julia; Berezowski, John

The objective here is to obtain feedback and seek future directions for an ISDS initiative to establish and update research questions in Informatics, Analytics,Communications, and Systems Research with the greatest perceived impact for improving surveillance practice.Introduction Over the past fifteen years, syndromic surveillance (SyS) has evolved from a set of ad hoc methods used mostly in post-disaster settings, then expanded with broad support and development because of bioterrorism concerns, and subsequently evolved to a mature technology that runs continuously to detect and monitor a wide range of health issues. Continued enhancements needed to meet the challenges of novel health threatsmore » with increasingly complex information sources will require technical advances focused on day-to-day public health needs.Since its formation in 2005, the International Society for Disease Surveillance (ISDS) has sought to clarify and coordinate global priorities in surveillance research. As part of a practitioner-driven initiative to identify current research priorities in SyS, ISDS polled its members about capabilities needed by SyS practitioners that could be improved as a result of research efforts. A taskforce of the ISDS Research Committee, consisting of national and global subject matter experts (SMEs) in SyS and ISDS professional staff, carried out the project. This panel will discuss the results and the preferred means to determine and communicate priorities in the future.« less

Health Topics: MedlinePlus

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Updated recommendations on the use of hydroxychloroquine in dermatologic practice.

PubMed

Fernandez, Anthony P

2017-06-01

Hydroxychloroquine has unique immunomodulatory properties and an attractive adverse effect profile. Over the past 10 years, research has led to significant updates in clinical recommendations concerning the optimal use of hydroxychloroquine and monitoring of patients taking it. We discuss updated recommendations concerning hydroxychloroquine daily dosing, retinopathy screening, serologic monitoring, use in smokers, use in pregnant women, and adverse effect risk and monitoring. This review can hopefully serve as an aid to dermatologists and help ensure they continue using hydroxychloroquine safely and effectively. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Be Food Safe: Protect Yourself from Food Poisoning

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Measles: Make Sure Your Child Is Fully Immunized

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Prepare for Diabetes Care in Heat and Emergencies

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Don't Let Measles Be Your Travel Souvenir

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48 CFR 1318.270 - Emergency acquisition flexibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Procurement Executive. (b) Continuity of Operations Plan. Each Contracting Activity shall have an updated Continuity of Operations Plan, in place designating emergency personnel with warrant levels. (c) Management... appropriate management controls are established and maintained to support the use of the increased thresholds...

New Developments in Breast Cancer Screening and Treatment.

PubMed

Tilstra, Sarah; McNeil, Melissa

2017-01-01

The clinical update serves as a brief review of recently published, high-impact, and potentially practice-changing journal articles summarized for our readers. In this clinical update, we selected top recent articles regarding breast health that may change the clinical practice of women's health providers. We identified articles by reviewing high-impact medical and women's health journals as well as national practice guidelines. Three of our articles are dedicated to the rapid changes in breast cancer screening. With regard to breast cancer treatment, we focused on two articles that impact who we treat with traditional aggressive regimens.

Update on vaccine-derived polioviruses - worldwide, July 2012-December 2013.

PubMed

Diop, Ousmane M; Burns, Cara C; Wassilak, Steven G; Kew, Olen M

2014-03-21

In 1988, the World Health Assembly resolved to eradicate poliomyelitis worldwide. One of the main tools used in polio eradication efforts has been live, attenuated oral poliovirus vaccine (OPV), an inexpensive vaccine easily administered by trained volunteers. OPV might require several doses to induce immunity, but then it provides long-term protection against paralytic disease through durable humoral immunity. Rare cases of vaccine-associated paralytic poliomyelitis can occur among immunologically normal OPV recipients, their contacts, and persons who are immunodeficient. In addition, vaccine-derived polioviruses (VDPVs) can emerge in areas with low OPV coverage to cause polio outbreaks and can replicate for years in persons who have primary, B-cell immunodeficiencies. This report updates previous surveillance summaries and describes VDPVs detected worldwide during July 2012-December 2013. Those include a new circulating VDPV (cVDPV) outbreak identified in Pakistan in 2012, with spread to Afghanistan; an outbreak in Afghanistan previously identified in 2009 that continued into 2013; a new outbreak in Chad that spread to Cameroon, Niger, and northeastern Nigeria; and an outbreak that began in Somalia in 2008 that continued and spread to Kenya in 2013. A large outbreak in Nigeria that was identified in 2005 was nearly stopped by the end of 2013. Additionally, 10 newly identified persons in eight countries were found to excrete immunodeficiency-associated VDPVs (iVDPVs), and VDPVs were found among immunocompetent persons and environmental samples in 13 countries. Because the majority of VDPV isolates are type 2, the World Health Organization has developed a plan for coordinated worldwide replacement of trivalent OPV (tOPV) with bivalent OPV (bOPV; types 1 and 3) by 2016, preceded by introduction of at least 1 dose of inactivated poliovirus vaccine (IPV) containing all three poliovirus serotypes into routine immunization schedules worldwide to ensure high population immunity to all polioviruses.

"Blueprint version 2.0": updating public health surveillance for the 21st century.

PubMed

Smith, Perry F; Hadler, James L; Stanbury, Martha; Rolfs, Robert T; Hopkins, Richard S

2013-01-01

Rapid changes to the United States public health system challenge the current strategic approach to surveillance. During 2011, the Council of State and Territorial Epidemiologists convened national experts to reassess public health surveillance in the United States and update surveillance strategies that were published in a 1996 report and endorsed by the Council of State and Territorial Epidemiologists. Although surveillance goals, historical influences, and most methods have not changed, surveillance is being transformed by 3 influences: public health information and preparedness as national security issues; new information technologies; and health care reform. Each offers opportunities for surveillance, but each also presents challenges that public health epidemiologists can best meet by rigorously applying surveillance evaluation concepts, engaging in national standardization activities driven by electronic technologies and health care reform, and ensuring an adequately trained epidemiology workforce.

2014 Edition Release 2 Electronic Health Record (EHR) certification criteria and the ONC HIT Certification Program; regulatory flexibilities, improvements, and enhanced health information exchange. Final rule.

PubMed

2014-09-11

This final rule introduces regulatory flexibilities and general improvements for certification to the 2014 Edition EHR certification criteria (2014 Edition). It also codifies a few revisions and updates to the ONC HIT Certification Program for certification to the 2014 Edition and future editions of certification criteria as well as makes administrative updates to the Code of Federal Regulations.

40 CFR 600.314-86 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for comparable automobiles. 600.314-86 Section 600.314-86 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR...

40 CFR 600.314-01 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economies for comparable automobiles. 600.314-01 Section 600.314-01 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR...

40 CFR 600.314-08 - Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Updating label values, annual fuel cost, Gas Guzzler Tax, and range of fuel economy for comparable automobiles. 600.314-08 Section 600.314-08 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) ENERGY POLICY FUEL ECONOMY AND CARBON-RELATED EXHAUST EMISSIONS OF MOTOR...

Building a Grad Nation: Progress and Challenge in Ending the High School Dropout Epidemic. Annual Update, 2012

ERIC Educational Resources Information Center

Balfanz, Robert; Bridgeland, John M.; Bruce, Mary; Fox, Joanna Hornig

2012-01-01

In 2010, the authors shared a Civic Marshall Plan to create a Grad Nation. Through that first report and subsequent update, they saw hopeful signs of progress in boosting high school graduation rates in communities across the country. This 2012 report shows that high school graduation rates continue to improve nationally and across many states and…

Chickenpox Can Be Serious. Protect Yourself and Your Child.

MedlinePlus

... Emergency Preparedness & Response Environmental Health Healthy Living Injury, Violence & Safety Life Stages & Populations Travelers’ Health Workplace Safety & Health Features Media Sign up for Features Get Email Updates To ...

US Adults Drink 17 Billion Binge Drinks a Year

MedlinePlus

... Emergency Preparedness & Response Environmental Health Healthy Living Injury, Violence & Safety Life Stages & Populations Travelers’ Health Workplace Safety & Health Features Media Sign up for Features Get Email Updates To ...

Tuberculosis: Learn the Signs and Symptoms of TB Disease

MedlinePlus

... Emergency Preparedness & Response Environmental Health Healthy Living Injury, Violence & Safety Life Stages & Populations Travelers’ Health Workplace Safety & Health Features Media Sign up for Features Get Email Updates To ...

Necrotizing Fasciitis: A Rare Disease, Especially for the Healthy

MedlinePlus

... Emergency Preparedness & Response Environmental Health Healthy Living Injury, Violence & Safety Life Stages & Populations Travelers’ Health Workplace Safety & Health Features Media Sign up for Features Get Email Updates To ...

Update of the Mexican College of Rheumatology guidelines for the pharmacologic treatment of rheumatoid arthritis.

PubMed

Cardiel, Mario H; Díaz-Borjón, Alejandro; Vázquez del Mercado Espinosa, Mónica; Gámez-Nava, Jorge Iván; Barile Fabris, Leonor A; Pacheco Tena, César; Silveira Torre, Luis H; Pascual Ramos, Virginia; Goycochea Robles, María Victoria; Aguilar Arreola, Jorge Enrique; González Díaz, Verónica; Alvarez Nemegyei, José; González-López, Laura del Carmen; Salazar Páramo, Mario; Portela Hernández, Margarita; Castro Colín, Zully; Xibillé Friedman, Daniel Xavier; Alvarez Hernández, Everardo; Casasola Vargas, Julio; Cortés Hernández, Miguel; Flores-Alvarado, Diana E; Martínez Martínez, Laura A; Vega-Morales, David; Flores-Suárez, Luis Felipe; Medrano Ramírez, Gabriel; Barrera Cruz, Antonio; García González, Adolfo; López López, Susana Marisela; Rosete Reyes, Alejandra; Espinosa Morales, Rolando

2014-01-01

The pharmacologic management of rheumatoid arthritis has progressed substantially over the past years. It is therefore desirable that existing information be periodically updated. There are several published international guidelines for the treatment of rheumatoid arthritis that hardly adapt to the Mexican health system because of its limited healthcare resources. Hence, it is imperative to unify the existing recommendations and to incorporate them to a set of clinical, updated recommendations; the Mexican College of Rheumatology developed these recommendations in order to offer an integral management approach of rheumatoid arthritis according to the resources of the Mexican health system. To review, update and improve the available evidence within clinical practice guidelines on the pharmacological management of rheumatoid arthritis and produce a set of recommendations adapted to the Mexican health system, according to evidence available through December 2012. The working group was composed of 30 trained and experienced rheumatologists with a high quality of clinical knowledge and judgment. Recommendations were based on the highest quality evidence from the previously established treatment guidelines, meta-analysis and controlled clinical trials for the adult population with rheumatoid arthritis. During the conformation of this document, each working group settled the existing evidence from the different topics according to their experience. Finally, all the evidence and decisions were unified into a single document, treatment algorithm and drug standardization tables. This update of the Mexican Guidelines for the Pharmacologic Treatment of Rheumatoid Arthritis provides the highest quality information available at the time the working group undertook this review and contextualizes its use for the complex Mexican health system. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Transitions: A Guide to Teens Getting Older and Changing Health Care Providers

MedlinePlus

... Transitions: A Guide to Getting Older and Changing Health Care Providers (HCP’s) Posted under Health Guides . Updated 11 ... can help me plan my transition to adult health care? Your pediatrician or other health care provider Your ...

Continuous-time adaptive critics.

PubMed

Hanselmann, Thomas; Noakes, Lyle; Zaknich, Anthony

2007-05-01

A continuous-time formulation of an adaptive critic design (ACD) is investigated. Connections to the discrete case are made, where backpropagation through time (BPTT) and real-time recurrent learning (RTRL) are prevalent. Practical benefits are that this framework fits in well with plant descriptions given by differential equations and that any standard integration routine with adaptive step-size does an adaptive sampling for free. A second-order actor adaptation using Newton's method is established for fast actor convergence for a general plant and critic. Also, a fast critic update for concurrent actor-critic training is introduced to immediately apply necessary adjustments of critic parameters induced by actor updates to keep the Bellman optimality correct to first-order approximation after actor changes. Thus, critic and actor updates may be performed at the same time until some substantial error build up in the Bellman optimality or temporal difference equation, when a traditional critic training needs to be performed and then another interval of concurrent actor-critic training may resume.

The Update of the Mexican Health Care Formulary and Supply Catalog in the Context of the Health Technology Assessment.

PubMed

Ríos, Pedro Rizo; Rivera, Aurora González; Oropeza, Itzel Rivas; Ramírez, Odette Campos

2014-12-01

One of the instruments Mexico has available for the optimization of resources specifically allocated to health technologies is the Health Care Formulary and Supply Catalog (Cuadro Básico y Catálogo de Insumos del Sector Salud [CBCISS]). The aim of the CBCISS is to collaborate in the optimization of public resources through the use of technologies (supplies) that have proven their safety, therapeutic efficacy, and efficiency. The importance of the CBCISS lies in the fact that all public institutions within the National Health System must use only the established technologies it contains. The implementation of strategies that strengthen the CBCISS update process allows it to be thought of as an essential regulatory tool for the introduction of health technologies, with relevant contributions to the proper selection of cost-effective interventions. It ensures that each supply included on the list meets the criteria sufficient and necessary to ensure efficacy, safety, effectiveness, and, of course, efficiency, as evidence supporting the selection of suitable technologies. The General Health Council (Consejo de Salubridad General [CSG]) is a collegial body of constitutional origin that-in accordance with its authority-prepares, updates, publishes, and distributes the CBCISS. To perform these activities, the CSG has the CBCISS Inter-institutional Commission. The CBCISS update is performed through the processes of inclusion, modification, and exclusion of supplies approved by the Interior Commission. The CBCISS update process consists of three stages: the first stage involves a test that leads to the acceptance or inadmissibility of the requests, and the other two focus on an in-depth evaluation for the ruling. This article describes the experience of health technology assessment in Mexico, presents the achievements and outlines the improvements in the process of submission of new health technologies, and presents a preliminary analysis of the submissions evaluated until December 2012. During the analysis period, 394 submissions were received. After confirming compliance with the requirements, 59.9% of the submissions passed to the next stage of the process, technology assessment. In the third stage, the committee approved 44.9% of the submissions evaluated. The improvements established in the country in terms of health technology assessment allowed choosing the technologies that give more value for money in a context of public health institutions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Human Health Water Quality Criteria and Methods for Toxics

EPA Pesticide Factsheets

Documents pertaining to Human Health Water Quality Criteria and Methods for Toxins. Includes 2015 Update for Water Quality Criteria, 2002 National Recommended Human Health Criteria, and 2000 EPA Methodology.

Continuous Professional Development along the Continuum of Lifelong Learning.

ERIC Educational Resources Information Center

Ryan, Jane

2003-01-01

Of 300 surveyed, responses from 94 nurses, 38 occupational therapists, and 50 physical therapists indicated that professional knowledge was a prime motivation for continuing professional development, followed by updating qualifications, increasing the status of the profession, and demonstrating professional competence. No differences were observed…

32 CFR 223.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Purpose. 223.1 Section 223.1 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS DOD UNCLASSIFIED CONTROLLED NUCLEAR INFORMATION (UCNI) § 223.1 Purpose. This part: (a) Updates policies, assigns...

32 CFR 223.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Purpose. 223.1 Section 223.1 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS DOD UNCLASSIFIED CONTROLLED NUCLEAR INFORMATION (UCNI) § 223.1 Purpose. This part: (a) Updates policies, assigns...

32 CFR 318.1 - Reissuance and purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) PRIVACY PROGRAM DEFENSE THREAT REDUCTION AGENCY PRIVACY PROGRAM § 318.1 Reissuance and purpose. (a) This part updates the policies, responsibilities, and procedures of the DTRA Privacy Program under the Privacy Act...

Personal technology use by U.S. military service members and veterans: an update.

PubMed

Bush, Nigel E; Wheeler, William M

2015-04-01

Although personal electronic devices, such as mobile phones, computers, and tablets, increasingly are being leveraged as vehicles for health in the civilian world, almost nothing is known about personal technology use in the U.S. military. In 2012 we conducted a unique survey of personal technologies used by U.S. military service members. However, with the rapidly growing sophistication of personal technology and changes in consumer habits, that knowledge must be continuously updated to be useful. Accordingly, we recently surveyed new samples of active duty service members, National Guard and Reserve, and veterans. We collected data by online surveys in 2013 from 239 active, inactive, and former service members. Online surveys were completed in-person via laptop computers at a large military installation and remotely via Web-based surveys posted on the Army Knowledge Online Web site and on a Defense Center Facebook social media channel. We measured high rates of personal technology use by service members at home across popular electronic media. The most dramatic change since our earlier survey was the tremendous increase in mobile phone use at home for a wide variety of purposes. Participants also reported moderate non-work uses of computers and tablets while on recent deployment to Iraq and Afghanistan, but almost no mobile phone use, ostensibly because of military restrictions in the war zone. These latest results will enable researchers and technology developers target their efforts on the most promising and popular technologies for psychological health in the military.

How can managers in the hospital in the home units help to balance technology and physician-patient knowledge?

PubMed

Cepeda-Carrión, Gabriel; Cegarra-Navarro, Juan Gabriel; Martínez-Caro, Eva; Eldridge, Stephen

2011-10-01

With the passing of time, knowledge like other resources can become obsolete. Thus, people in a healthcare system need to update their knowledge in order to keep pace with the ongoing changes in their operational environment. Information technology continually provides a great amount of new knowledge which can lead to healthcare professionals becoming overloaded with knowledge. This overloading can be alleviated by a process of unlearning which enables the professional to retain just the relevant and critical knowledge required to improve the quality of service provided by them. This paper shows some of the tools and methods that Hospital-in-the-Home Units (HHUs) have used to update the physician-patient knowledge and the technology knowledge of the HHUs' personnel. A survey study was carried out in the HHU in Spanish health system in 2010. Fifty-five doctors and 62 nurses belonging to 44 HHUs. None. Three hypotheses are presented and supported, which suggest that technology and physician-patient knowledge is related to the unlearning context and the unlearning context impacts positively on the quality of health services provided. The key benefits of the unlearning context for the quality of service provided in HHUs are clear: it enables them to identify and replace poor practices and also avoids the reinvention of the wheel (e.g.: by minimizing unnecessary work caused by the use of poor methods) and it reduces costs through better productivity and efficiency (improving services to patients).

Codeine and Tramadol Can Cause Breathing Problems for Children

MedlinePlus

... the FDA’s Consumer Updates page , which features the latest on all FDA-regulated products. April 20, 2017 back to top ... in Consumer Updates Animal & Veterinary Children's Health Cosmetics Dietary Supplements Drugs Food Medical Devices Nutrition Radiation-Emitting Products Tobacco Products Vaccines, Blood & ...

Changes in Exercise Data Management

NASA Technical Reports Server (NTRS)

Buxton, R. E.; Kalogera, K. L.; Hanson, A. M.

2018-01-01

The suite of exercise hardware aboard the International Space Station (ISS) generates an immense amount of data. The data collected from the treadmill, cycle ergometer, and resistance strength training hardware are basic exercise parameters (time, heart rate, speed, load, etc.). The raw data are post processed in the laboratory and more detailed parameters are calculated from each exercise data file. Updates have recently been made to how this valuable data are stored, adding an additional level of data security, increasing data accessibility, and resulting in overall increased efficiency of medical report delivery. Questions regarding exercise performance or how exercise may influence other variables of crew health frequently arise within the crew health care community. Inquiries over the health of the exercise hardware often need quick analysis and response to ensure the exercise system is operable on a continuous basis. Consolidating all of the exercise system data in a single repository enables a quick response to both the medical and engineering communities. A SQL server database is currently in use, and provides a secure location for all of the exercise data starting at ISS Expedition 1 - current day. The database has been structured to update derived metrics automatically, making analysis and reporting available within minutes of dropping the inflight data it into the database. Commercial tools were evaluated to help aggregate and visualize data from the SQL database. The Tableau software provides manageable interface, which has improved the laboratory's output time of crew reports by 67%. Expansion of the SQL database to be inclusive of additional medical requirement metrics, addition of 'app-like' tools for mobile visualization, and collaborative use (e.g. operational support teams, research groups, and International Partners) of the data system is currently being explored.

Data Resource Profile: Cross-national and cross-study sociodemographic and health-related harmonized domains from SAGE plus ELSA, HRS and SHARE (SAGE+, Wave 1).

PubMed

Minicuci, Nadia; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

2016-10-01

Four longitudinal studies were included in this rigorous harmonization process: the Study on global AGEing and adult health (SAGE); English Longitudinal Study on Ageing (ELSA); US Health and Retirement Study (HRS); and Survey of Health, Ageing and Retirement in Europe (SHARE). An ex-post harmonized process was applied to nine health-related thematic domains (socio-demographic and economic, health states, overall self-report of health and mental state, health examinations, physical and mental performance tests, risk factors, chronic conditions, social network and subjective well-being) for data from the 2004 wave of each study. Large samples of adults aged 50 years and older were available from each study: SAGE, n = 18 886; ELSA, n = 9181; HRS, n = 19 303; and SHARE, n = 29 917. The microdata, along with further details about the harmonization process and all metadata, are available through the World Health Organization (WHO) data archive at [http://apps.who.int/healthinfo/systems/surveydata/index.php/catalog]. Further information and enquiries can be made to [sagesurvey@who.int] or the corresponding author. The data resource will continue to be updated with data across additional waves of these surveys and new waves. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Leasing as a Source of Finance by the Major US Airlines: Hidden Debt and its Changes Over Time

NASA Technical Reports Server (NTRS)

Gritta, Richard D.; Lippman, Ellen J.

2003-01-01

This paper updates prior research on aircraft leasing and contrasts the findings of current data with prior results. Usage of leases by air carriers is a means to lessen the impact of financial obligations from fleet purchases. The study revisits two previous studies, one in 1969 and one in 1991, which is analyzed the incidence of leases by major air carriers. The current study updates these past studies to consider air carriers current usage of leases. Additionally, since operating leases are not reflected in the balance sheets of airlines, operating lease information was capitalized using a present value of future operating lease payments. Then, financial debt burden ratios were computed to determine the impact from the capitalization of lease information. The usage of operating leases increased, significantly from the first study to the 1991 study, and this trend continues. The incidence of leasing, the classification of leases as operating, and the percentage of operating leases to total fleet have all increased for the majority of the airlines reviewed. When operating lease data were capitalized, debt ratios weakened, providing further evidence of deterioration in the financial health of air carriers.

Measuring estrogens in women, men, and children: Recent advances 2012-2017.

PubMed

Smy, Laura; Straseski, Joely

2018-05-22

The measurement of estrogens is important for diagnosing and monitoring the health of women, men, and children. For example, for postmenopausal women or women undergoing treatment for breast cancer with aromatase inhibitors, the measurement of extremely low concentrations of estrogens in serum, especially estradiol, is problematic but essential for proper medical care. Achieving superb analytical sensitivity and specificity has been and continues to be a challenge for the clinical laboratory, but is a challenge that is being taken seriously. Focusing on publications from 2012 to 2017, this review will provide an overview of recent research in the development of methods to accurately and precisely measure estrogens, including a variety of estrogen metabolites. Additionally, the latest in clinical research involving estrogen measurement in women, men, and children will be presented to provide an update on the association of estrogens with diseases or conditions such as breast cancer, precocious puberty, infertility, and pregnancy. This research update will provide context as to why estrogen measurement is important and why laboratories are working hard to support the recommendations made by the Endocrine Society regarding estrogen measurement. Copyright © 2018 Elsevier Inc. All rights reserved.

Non-medical prescribing in New Zealand: an overview of prescribing rights, service delivery models and training.

PubMed

Raghunandan, Rakhee; Tordoff, June; Smith, Alesha

2017-11-01

In this paper, we aim to provide an updated source of information for nonmedical prescribing (NMP) in New Zealand (NZ). A variety of NZ sources were used to collect data: legislation, policy documents and information from professional and regulatory organizations, and education providers. In NZ, the legal categories for prescribers include authorized, designated, and delegated prescribers. Authorized prescribers include dentists, midwives, nurse practitioners, and optometrist prescribers. Designated prescribers include pharmacist prescribers, registered nurse prescribers, and dietitian prescribers. There are no delegated prescribers in NZ at this time. There is variation in the regulation, educational programmes and prescribing competencies used by the different prescribing health professionals involved in NMP in NZ. This update collates relevant information relating to NMP in NZ into one consolidated document and provides policy makers with a current overview of prescribing rights, service delivery models, training requirements, and prescribing competencies used for NMP in NZ. As NMP in NZ continues to expand and evolve, this paper will form a baseline for future NMP research in NZ. NZ needs to develop overarching NMP policy to enable consistency in the various aspects of NMP, thereby delivering a safe and sustainable NMP service in NZ.

Update in geriatrics: What geriatric oncology can learn from general geriatric research.

PubMed

Hamaker, Marije E; Prins, Meike; van Huis, Lieke H

2018-01-29

Life expectancy has been steadily increasing for decades and this trend is likely to continue in coming years. In fact, there is more than a 50% probability that by 2030 female life expectancy could break the 90 year barrier, with more than half of the expected gains due to enhanced longevity above the age of 65 years. The resultant aging of societies means that health care will be faced with a rising number of increasingly older patients, who are also likely to have higher levels of multimorbidity. Most issues regarding assessment, prognostication and, management of older patients are not unique to geriatric oncology and thus there is opportunity to learn from progress in other fields. The purpose of this paper is to provide an update on research, reviews, and debate in general geriatrics that may be relevant to clinicians and researchers active in geriatric oncology. The selection of topics was based on a general search of the table of contents of widely read geriatrics and internal medicine journals, and includes geriatric co-management, improving research for older patients, caregiver issues, eliciting patient preferences, and shared-decision making. Copyright © 2018 Elsevier Inc. All rights reserved.

DOE Radiation Research Program is floundering - NAS

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

Lobsenz, G.

1994-04-20

The Energy Department's radiation health effects research program is floundering in a morass of administrative confusion due to an ill-considered 1990 joint management agreement between DOE and the Health and Human Services Department, a National Academy of Sciences panel says. The NAS panel said the [open quotes]administrative difficulties[close quotes] created by the DOE-HHS agreement appear to be [open quotes]stifling creativity and efficiency within DOE's Epidemiology Research Program, delaying the completion and publication of research.[close quotes] The panel also expressed concern that DOE has failed to adequately fund or staff its health research office, and that the department had no mastermore » research plan to identify research needs or set forth uniform, scientifically rigorous data collection procedures. The panel said DOE's lack of commitment was particularly evident in its failure to set up an effective health surveillance program for its nuclear work force. In addition, the panel said DOE had fallen short on promises to create a comprehensive computer bank of health research data that would be continually updated with new information gleaned from an ongoing worker surveillance program. While recommending enhancements, the NAS panel emphasized that DOE's health research program would not be able to function effectively until the department revamped its joint management agreement with HHS.« less

Comparison of two optimization algorithms for fuzzy finite element model updating for damage detection in a wind turbine blade

NASA Astrophysics Data System (ADS)

Turnbull, Heather; Omenzetter, Piotr

2018-03-01

vDifficulties associated with current health monitoring and inspection practices combined with harsh, often remote, operational environments of wind turbines highlight the requirement for a non-destructive evaluation system capable of remotely monitoring the current structural state of turbine blades. This research adopted a physics based structural health monitoring methodology through calibration of a finite element model using inverse techniques. A 2.36m blade from a 5kW turbine was used as an experimental specimen, with operational modal analysis techniques utilised to realize the modal properties of the system. Modelling the experimental responses as fuzzy numbers using the sub-level technique, uncertainty in the response parameters was propagated back through the model and into the updating parameters. Initially, experimental responses of the blade were obtained, with a numerical model of the blade created and updated. Deterministic updating was carried out through formulation and minimisation of a deterministic objective function using both firefly algorithm and virus optimisation algorithm. Uncertainty in experimental responses were modelled using triangular membership functions, allowing membership functions of updating parameters (Young's modulus and shear modulus) to be obtained. Firefly algorithm and virus optimisation algorithm were again utilised, however, this time in the solution of fuzzy objective functions. This enabled uncertainty associated with updating parameters to be quantified. Varying damage location and severity was simulated experimentally through addition of small masses to the structure intended to cause a structural alteration. A damaged model was created, modelling four variable magnitude nonstructural masses at predefined points and updated to provide a deterministic damage prediction and information in relation to the parameters uncertainty via fuzzy updating.

A Study of Reasons for Participation in Continuing Professional Education in the U.S. Nuclear Power Industry

ERIC Educational Resources Information Center

McCamey, Randy B.

2003-01-01

The need for workers in the U.S. nuclear power industry to continually update their knowledge, skills, and abilities is critical to the safe and reliable operation of the country's nuclear power facilities. To improve their skills, knowledge, and abilities, many professionals in the nuclear power industry participate in continuing professional…

An application of the Continuous Opinions and Discrete Actions (CODA) model to adolescent smoking initiation.

PubMed

Sun, Ruoyan; Mendez, David

2017-01-01

We investigated the impact of peers' opinions on the smoking initiation process among adolescents. We applied the Continuous Opinions and Discrete Actions (CODA) model to study how social interactions change adolescents' opinions and behaviors about smoking. Through agent-based modeling (ABM), we simulated a population of 2500 adolescents and compared smoking prevalence to data from 9 cohorts of adolescents in the National Survey on Drug Use and Health (NSDUH) from year 2001 till 2014. Our model adjusts well for NSDUH data according to pseudo R2 values, which are at least 96%. Optimal parameter values indicate that adolescents exhibit imitator characteristics with regard to smoking opinions. The imitator characteristics suggests that teenagers tend to update their opinions consistently according to what others do, and these opinions later translate into smoking behaviors. As a result, peer influence from social networks plays a big role in the smoking initiation process and should be an important driver in policy formulation.

Body Odor (For Young Men)

MedlinePlus

... Sexual Health Medical Conditions Nutrition & Fitness Emotional Health Body Odor Posted under Health Guides . Updated 23 March 2017. + ... every guy has to deal with. What causes body odor? During puberty, your sweat glands become much more ...