A Report on New Haven's Library Neighborhood Centers.

ERIC Educational Resources Information Center

Bloss, Meredith

A library neighborhood center is a community built around a branch library, providing the usual branch library functions of self-education and improvement. Four of New Haven's eight branch libraries are designed as library neighborhood centers. The centers are supported by the Ford Foundation, the City of New Haven, the Office of Economic…

The Yale plunger device

NASA Astrophysics Data System (ADS)

Cooper, J. R.; Krücken, R.; Beausang, C. W.; Casten, R. F.; Cata-Danil, G.; Liu, B.; Novak, J. R.; Zamfir, N. V.; Dewald, A.; Peusquens, R.; Tiesler, H.; von Brentano, P.; Barton, C.

1998-04-01

A new plunger device for lifetime experiments using the recoil distance method (RDM) is currently being constructed at Yale. This apparatus will be used for precision lifetime measurements on excited nuclear levels with lifetimes in the picosecond range. The new yale.edu/equipment/plunger.html>Yale plunger is designed for coincidence measurements with all major Ge arrays including Gammasphere. At Yale the plunger will be used in conjunction with the new yale.edu/equipment/yrastball.html>YRAST Ball array (Yale Rochester Array for SpecTroscopy), as well as a variety of auxiliary detectors. It follows the new Cologne plunger in its layout and will employ a new LabView based control system for measurement and stabilization of the target to stopper foil distance. Such a feedback system is crucial for the planned precision lifetime measurements as well as for the measurement of very short level lifetimes around 1 ps. The conceptual design of the plunger as well as the new feedback system will be presented and the planned physics program will be discussed. This work is supported by DOE grant number DE-FG02-91ER40609

Connecticut: New Haven City Government (A Former EPA CARE Project)

EPA Pesticide Factsheets

The City of New Haven is the recipient of a citywide Level II CARE cooperative agreement. The City of New Haven will use CARE funding to expand the existing air toxics initiative into a more comprehensive air, water and land stewardship program.

16. New York, New Haven & Hartford Railroad: Readville Shops. ...

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

16. New York, New Haven & Hartford Railroad: Readville Shops. Readville, Suffolk Co., MA. (Not on NEC). - Northeast Railroad Corridor, Amtrak Route between RI/MA State Line & South Station, Boston, Suffolk County, MA

18. New York, New Haven & Hartford Railroad: Readville Shops. ...

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

18. New York, New Haven & Hartford Railroad: Readville Shops. Readville, Suffolk Co., MA. (Not on NEC). - Northeast Railroad Corridor, Amtrak Route between RI/MA State Line & South Station, Boston, Suffolk County, MA

17. New York, New Haven & Hartford Railroad: Readville Shops ...

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

17. New York, New Haven & Hartford Railroad: Readville Shops with Sprague Street Bridge in background. Readville, Suffolk Co., MA. (Not on NEC). - Northeast Railroad Corridor, Amtrak Route between RI/MA State Line & South Station, Boston, Suffolk County, MA

Richter-Scale Tantrums: New Hope for Exhausted Parents

ERIC Educational Resources Information Center

Brett, Lauri

2009-01-01

Exciting news is emerging that could change the lives of many parents of children and adolescents with autism. Extreme tantrums often "run their lives," according to Dr. Lawrence Scahill, Professor of Nursing and Child Psychiatry at the Yale Child Study Center in New Haven, Connecticut. As the Director of Yale's Research Unit on Pediatric…

78 FR 13479 - Drawbridge Operation Regulation; New Haven Harbor, Quinnipiac and Mill Rivers, CT

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-28

...-AA09 Drawbridge Operation Regulation; New Haven Harbor, Quinnipiac and Mill Rivers, CT AGENCY: Coast... regulations that govern the operation of three bridges across the Quinnipiac and Mill Rivers at New Haven...) entitled ``Drawbridge Operation Regulations New Haven Harbor, Quinnipiac and Mill Rivers,'' in the Federal...

40 CFR 81.26 - Hartford-New Haven-Springfield Interstate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., Milford, New Britain, New Haven, Shelton, Waterbury, West Haven. Townships—Andover, Avon, Beacon Falls..., Holyoke, Northampton, Springfield, Westfield. Townships—Agawam, Amherst, Belchertown, Blandford, Brimfield...

40 CFR 81.26 - Hartford-New Haven-Springfield Interstate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Milford, New Britain, New Haven, Shelton, Waterbury, West Haven. Townships—Andover, Avon, Beacon Falls..., Holyoke, Northampton, Springfield, Westfield. Townships—Agawam, Amherst, Belchertown, Blandford, Brimfield...

Evaluating IAIMS at Yale: information access.

PubMed

Grajek, S E; Calarco, P; Frawley, S J; McKay, J; Miller, P L; Paton, J A; Roderer, N K; Sullivan, J E

1997-01-01

To evaluate use of information resources during the first year of IAIMS implementation at the Yale-New Haven Medical Center. The evaluation asked: (1) Which information resources are being used? (2) Who uses information resources? (3) Where are information resources used? (4) Are multiple sources of information being integrated? Measures included monthly usage data for resources delivered network-wide, in the Medical Library, and in the Hospital; online surveys of library workstation users; an annual survey of a random, stratified sample of Medical Center faculty, postdoctoral trainees, students, nurses, residents, and managerial and professional staff; and user comments. Eighty-three percent of the Medical Center community use networked information resources, and use of resources is increasing. Both status (faculty, student, nurse, etc.) and mission (teaching, research, patient care) affect use of individual resources. Eighty-eight percent of people use computers in more than one location, and increases in usage of traditional library resources such as MEDLINE are due to increased access from outside the Library. Both survey and usage data suggest that people are using multiple resources during the same information seeking session. Almost all of the Medical Center community is using networked information resources in more settings. It is necessary to support increased demand for information access from remote locations and to specific populations, such as nurses. People are integrating information from multiple sources, but true integration within information systems is just beginning. Other institutions are advised to incorporate pragmatic evaluation into their IAIMS activities and to share evaluation results with decision-makers.

New Haven Promise: An Early Look at College Preparation, Access, and Enrollment of New Haven Public School Students (2010-2013). Brief

ERIC Educational Resources Information Center

Gonzalez, Gabriella C.; Bozick, Robert; Daugherty, Lindsay; Scherer, Ethan; Singh, Reema; Suárez, Mónica Jacobo; Ryan, Sarah; Schweig, Jonathan

2013-01-01

In New Haven, stakeholders looking to enhance the city's economic development, attract more residents, reduce crime and incarceration, and improve residents' quality of life embarked on a new scholarship program that seeks to build a college-going culture for local students and the community as an avenue to achieve these goals. Recognizing that…

Evaluating the impact of conflict resolution on urban children's violence-related attitudes and behaviors in New Haven, Connecticut, through a community–academic partnership

PubMed Central

Shuval, Kerem; Pillsbury, Charles A.; Cavanaugh, Brenda; McGruder, La'Rie; McKinney, Christy M.; Massey, Zohar; Groce, Nora E.

2010-01-01

Numerous schools are implementing youth violence prevention interventions aimed at enhancing conflict resolution skills without evaluating their effectiveness. Consequently, we formed a community–academic partnership between a New Haven community-based organization and Yale's School of Public Health and Prevention Research Center to examine the impact of an ongoing conflict resolution curriculum in New Haven elementary schools, which had yet to be evaluated. Throughout the 2007–08 school year, 191 children in three schools participated in a universal conflict resolution intervention. We used a quasi-experimental design to examine the impact of the intervention on participants' likelihood of violence, conflict self-efficacy, hopelessness and hostility. Univariate and multivariable analyses were utilized to evaluate the intervention. The evaluation indicates that the intervention had little positive impact on participants' violence-related attitudes and behavior. The intervention reduced hostility scores significantly in School 1 (P < 0.01; Cohen's d = 0.39) and hopelessness scores in School 3 (P = 0.05, Cohen's d = 0.52); however, the intervention decreased the conflict self-efficacy score in School 2 (P = 0.04; Cohen's d = 0.23) and was unable to significantly change many outcome measures. The intervention's inability to significantly change many outcome measures might be remedied by increasing the duration of the intervention, adding additional facets to the intervention and targeting high-risk children. PMID:20444803

76 FR 18415 - Television Broadcasting Services; New Haven, CT

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-04

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 73 [MB Docket No. 09-123; RM-11546, DA 11-501] Television Broadcasting Services; New Haven, CT AGENCY: Federal Communications Commission. ACTION: Final rule... levels of new interference from other post-transition stations' power increases, and the substitution of...

76 FR 14697 - Amdocs, Inc., Global Support Services, Advertising and Media AT&T Division, New Haven, CT; Notice...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... Support Services, Advertising and Media AT&T Division, New Haven, CT; Notice of Revised Determination on... Amdocs, Inc., Global Support Services, Advertising and Media AT&T Division, New Haven, Connecticut to...: All workers of Amdocs, Inc., Global Support Services, Advertising and Media AT&T Division, New Haven...

Interprofessional student experiences on the HAVEN free clinic leadership board.

PubMed

Scott, Elizabeth Anne; Swartz, Martha K

2015-01-01

In this study, we examined the experiences of students serving on the leadership board of HAVEN - the student-run free clinic of the Yale University health professional schools. Open-ended responses were collected from 18 of the 28 members of the 2011-2012 leadership board through an online survey. Students reported an overall positive experience participating on the board and valued the opportunity to be part of a committed community creating change. The majority of students reported that their time as a board member had improved their attitude towards interprofessional collaboration (78%) and had also fostered their leadership skills (67%). Around two thirds (67%) reported that their experience had positively impacted their future career plans, either reinforcing their desire to work with underserved populations or encouraging them to pursue leadership roles. Based on these data, it is suggested that the HAVEN Free Clinic offers a useful opportunity for students to experience the demands of clinical care leadership while working together in an interprofessional context.

75 FR 1738 - Drawbridge Operation Regulation; New Haven Harbor, Quinnipiac and Mill Rivers, CT

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-13

...-AA09 Drawbridge Operation Regulation; New Haven Harbor, Quinnipiac and Mill Rivers, CT AGENCY: Coast... regulation governing the operation of three bridges across the Quinnipiac and Mill Rivers at New Haven... and 15 feet at mean low water. The Chapel Street Bridge at mile 0.4, across the Mill River has a...

Bridging the Response to Mass Shootings and Urban Violence: Exposure to Violence in New Haven, Connecticut.

PubMed

Santilli, Alycia; O'Connor Duffany, Kathleen; Carroll-Scott, Amy; Thomas, Jordan; Greene, Ann; Arora, Anita; Agnoli, Alicia; Gan, Geliang; Ickovics, Jeannette

2017-03-01

We have described self-reported exposure to gun violence in an urban community of color to inform the movement toward a public health approach to gun violence prevention. The Community Alliance for Research and Engagement at Yale School of Public Health conducted community health needs assessments to document chronic disease prevalence and risk, including exposure to gun violence. We conducted surveys with residents in six low-income neighborhoods in New Haven, Connecticut, using a neighborhood-stratified, population-based sample (n = 1189; weighted sample to represent the neighborhoods, n = 29 675). Exposure to violence is pervasive in these neighborhoods: 73% heard gunshots; many had family members or close friends hurt (29%) or killed (18%) by violent acts. Although all respondents live in low-income neighborhoods, exposure to violence differs by race/ethnicity and social class. Residents of color experienced significantly more violence than did White residents, with a particularly disparate increase among young Black men aged 18 to 34 years. While not ignoring societal costs of horrific mass shootings, we must be clear that a public health approach to gun violence prevention means focusing on the dual epidemic of mass shootings and urban violence.

8. Historic American Buildings Survey Photocopy EAST (FRONT) ELEVATION, OLD ...

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

8. Historic American Buildings Survey Photocopy EAST (FRONT) ELEVATION, OLD PHOTO c. 1860 Restricted: Permission for use must be obtained in writing from Art Library, Yale University, New Haven, Connecticut - Skinner-Trowbridge House, 46 Hillhouse Avenue, New Haven, New Haven County, CT

7. Historic American Buildings Survey Photocopy, August 1951 LATERAL VIEW, ...

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

7. Historic American Buildings Survey Photocopy, August 1951 LATERAL VIEW, EAST FRONT, OLD PHOTOGRAPH c. 1850 Restricted: Permission for use must be obtained in writing from Art Library, Yale University, New Haven, Conn. - Skinner-Trowbridge House, 46 Hillhouse Avenue, New Haven, New Haven County, CT

10. Historic American Buildings Survey Photocopy BASEMENT PLAN, NORTH ELEVATION, ...

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

10. Historic American Buildings Survey Photocopy BASEMENT PLAN, NORTH ELEVATION, ARCHITECT'S ORIGINAL PLAN Restricted: Not to be reproduced without written permission from Beinecke Rare Books Library, Yale University, New Haven, Conn. - John Pitkin Norton House, 52 Hillhouse Avenue, New Haven, New Haven County, CT

12. Historic American Buildings Survey Photocopy CHAMBER PLAN, REAR ELEVATION, ...

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

12. Historic American Buildings Survey Photocopy CHAMBER PLAN, REAR ELEVATION, ARCHITECT'S ORIGINAL PLAN Restricted: Not to be reproduced without written permission from Beinecke Rare Books Library, Yale University, New Haven, Conn. - John Pitkin Norton House, 52 Hillhouse Avenue, New Haven, New Haven County, CT

Behavior and Learning Difficulties in Children of Normal Intelligence Born to Alcoholic Mothers.

ERIC Educational Resources Information Center

Shaywitz, Sally E.; And Others

1980-01-01

Children referred to the Learning Disorders Unit of the Yale-New Haven Hospital were evaluated for indications of prenatal exposure to ethanol. Our results suggest a continuum of teratogenic effects of ethanol on the central nervous system. Journal availability The C. V. Mosby Co., 11830 Westline Industrial Dr., St. Louis, MO 63141. (Author)

11. Historic American Buildings Survey Photocopy PRINCIPAL FLOOR PLAN, SOUTH ...

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

11. Historic American Buildings Survey Photocopy PRINCIPAL FLOOR PLAN, SOUTH SIDE ELEVATION ARCHITECT'S ORIGINAL PLAN Restricted: Not to be reproduced without written permission from Beinecke Rare Books Library, Yale University, New Haven, Connecticut - John Pitkin Norton House, 52 Hillhouse Avenue, New Haven, New Haven County, CT

Applying Community Organizing Principles to Assess Health Needs in New Haven, Connecticut.

PubMed

Santilli, Alycia; Carroll-Scott, Amy; Ickovics, Jeannette R

2016-05-01

The Affordable Care Act added requirements for nonprofit hospitals to conduct community health needs assessments. Guidelines are minimal; however, they require input and representation from the broader community. This call echoes 2 decades of literature on the importance of including community members in all aspects of research design, a tenet of community organizing. We describe a community-engaged research approach to a community health needs assessment in New Haven, Connecticut. We demonstrate that a robust community organizing approach provided unique research benefits: access to residents for data collection, reliable data, leverage for community-driven interventions, and modest improvements in behavioral risk. We make recommendations for future community-engaged efforts and workforce development, which are important for responding to increasing calls for community health needs assessments.

Applying Community Organizing Principles to Assess Health Needs in New Haven, Connecticut

PubMed Central

Carroll-Scott, Amy; Ickovics, Jeannette R.

2016-01-01

The Affordable Care Act added requirements for nonprofit hospitals to conduct community health needs assessments. Guidelines are minimal; however, they require input and representation from the broader community. This call echoes 2 decades of literature on the importance of including community members in all aspects of research design, a tenet of community organizing. We describe a community-engaged research approach to a community health needs assessment in New Haven, Connecticut. We demonstrate that a robust community organizing approach provided unique research benefits: access to residents for data collection, reliable data, leverage for community-driven interventions, and modest improvements in behavioral risk. We make recommendations for future community-engaged efforts and workforce development, which are important for responding to increasing calls for community health needs assessments. PMID:26985599

Preliminary investigation of the effects of sea-level rise on groundwater levels in New Haven, Connecticut

USGS Publications Warehouse

Bjerklie, David M.; Mullaney, John R.; Stone, Janet R.; Skinner, Brian J.; Ramlow, Matthew A.

2012-01-01

New Haven area and from new information on groundwater levels collected during October 2009-June 2010. For the scenario with a 3-ft rise in sea level and no increase in recharge, simulated groundwater levels near the coast rose 3 ft; this increased water level tapered off toward a discharge area at the only nontidal stream in the study area. Simulated stream discharge increased at the nontidal stream because of the increased gradient. Although groundwater levels rose, the simulated difference between the groundwater levels in the aquifer and the increased sea level declined, indicating that the depth to the interface between freshwater and saltwater may possibly decline. Simulated water levels were affected by rise in sea level even in areas where the water table was at 17-24 ft (5.2-7.3 m) above current (2011) sea level. For the scenario with increased recharge, simulated groundwater levels were as much as an additional foot higher at some locations in the study area. The results of this preliminary investigation indicate that groundwater levels in coastal areas can be expected to rise and may rise higher if groundwater recharge also increases. This finding has implications for the disposal of stormwater through infiltration, a low-impact development practice designed to improve water quality and reduce overland peak discharge. Other implications include increased risk of basement flooding and increased groundwater seepage into underground sewer pipes and utility corridors in some areas. These implications will present engineering challenges to New Haven and Yale University. The preliminary model developed for this study can be the starting point for further simulation of future alternative scenarios for sea-level rise and recharge. Further simulations could identify those areas of New Haven where infrastructure may be at greatest risk from rising levels of groundwater. The simulations described in this report have limitations due to the preliminary scope of the work

New Haven, Connecticut: Targeting Low-Income Household Energy Savings (City Energy: From Data to Decisions)

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

Strategic Priorities and Impact Analysis Team, Office of Strategic Programs

This fact sheet "New Haven, Connecticut: Targeting Low-Income Household Energy Savings" explains how the City of New Haven used data from the U.S. Department of Energy's Cities Leading through Energy Analysis and Planning (Cities-LEAP) and the State and Local Energy Data (SLED) programs to inform its city energy planning. It is one of ten fact sheets in the "City Energy: From Data to Decisions" series.

Elite Settlements and Democracy in Latin America: The Dominican Republic and Peru

DTIC Science & Technology

1989-08-01

Social Indicators, volume 2, 3d edition, (New Haven: Yale Wuiversity Press, 1983), pg. 48. UOn a scale from one to seven, one being the greatest...Handbook of Political and Social Indicators, volume 1, 3d edition, (New Haven: Yale University Press, 1983), pg. 209. 107 (12% in 1977) was organized.53...3igarchic sentiment in Peru. Victor Andres Belaunde, Meditaciones Peruanas (Lima: Compaia de Impresiones y Publicidad, Editores, 1932), pg. 199. 192 parties

Transforming an Urban Public School District: Tracking the Progress of New Haven Public Schools' Educational Reforms and the New Haven Promise Scholarship Program. Brief

ERIC Educational Resources Information Center

Gonzalez, Gabriella C.; Bozick, Robert; Daugherty, Lindsay; Scherer, Ethan; Singh, Reema; Suarez, Monica; Ryan, Sarah; Schweig, Jonathan

2014-01-01

New Haven Public Schools (NHPS) is an urban school district in Connecticut serving approximately 21,000 students in 46 schools, with nine high schools. Concerned that only about one-half of its students were meeting state proficiency standards in reading and math tests or graduating within four years of starting high school, NHPS and the City of…

Feasibility of Assessing Public Health Impacts of Air Pollution Reduction Programs on a Local Scale: New Haven Case Study

PubMed Central

Lobdell, Danelle T.; Isakov, Vlad; Baxter, Lisa; Touma, Jawad S.; Smuts, Mary Beth; Özkaynak, Halûk

2011-01-01

Background New approaches to link health surveillance data with environmental and population exposure information are needed to examine the health benefits of risk management decisions. Objective We examined the feasibility of conducting a local assessment of the public health impacts of cumulative air pollution reduction activities from federal, state, local, and voluntary actions in the City of New Haven, Connecticut (USA). Methods Using a hybrid modeling approach that combines regional and local-scale air quality data, we estimated ambient concentrations for multiple air pollutants [e.g., PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter), NOx (nitrogen oxides)] for baseline year 2001 and projected emissions for 2010, 2020, and 2030. We assessed the feasibility of detecting health improvements in relation to reductions in air pollution for 26 different pollutant–health outcome linkages using both sample size and exploratory epidemiological simulations to further inform decision-making needs. Results Model projections suggested decreases (~ 10–60%) in pollutant concentrations, mainly attributable to decreases in pollutants from local sources between 2001 and 2010. Models indicated considerable spatial variability in the concentrations of most pollutants. Sample size analyses supported the feasibility of identifying linkages between reductions in NOx and improvements in all-cause mortality, prevalence of asthma in children and adults, and cardiovascular and respiratory hospitalizations. Conclusion Substantial reductions in air pollution (e.g., ~ 60% for NOx) are needed to detect health impacts of environmental actions using traditional epidemiological study designs in small communities like New Haven. In contrast, exploratory epidemiological simulations suggest that it may be possible to demonstrate the health impacts of PM reductions by predicting intraurban pollution gradients within New Haven using coupled models. PMID:21335318

New Haven Conn. Group Awarded EPA Grant to Help Air and Water Issues

EPA Pesticide Factsheets

A Connecticut organization working to address water and air pollution issues in New Haven was one of three groups in New England to receive an EPA grant award of $30,000 each, to help communities directly address local environmental concerns.

A Light Touch to Learning: Jackie Robinson Middle School, New Haven, Ct.

ERIC Educational Resources Information Center

Progressive Architecture, 1979

1979-01-01

The architectural design of Jackie Robinson Middle School in New Haven, Connecticut, minimizes the school's size by siting it to reveal only one level at its entrance. Extensive use of transparent and translucent materials projects openness and light. (Author/MLF)

2. Photocopy of measured drawing (original drawing in the possession ...

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

2. Photocopy of measured drawing (original drawing in the possession of Beinecke Rare Books Library, Yale University) Henry Austin, architect, 1850 NORTHEAST ELEVATION - Moses Yale Beach House, 86 North Main Street, Wallingford, New Haven County, CT

1. Photocopy of measured drawing (original drawing in the possession ...

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

1. Photocopy of measured drawing (original drawing in the possession of Beinecke Rare Books Library, Yale University) Henry Austin, architect, 1850 SOUTHEAST (FRONT) ELEVATION - Moses Yale Beach House, 86 North Main Street, Wallingford, New Haven County, CT

EPA Enforcement Action Helps Protect Children in New Haven from Lead Paint Hazards

EPA Pesticide Factsheets

An EPA settlement with several affiliated property owners and property management company in New Haven, Conn. requires the company and their affiliates to identify and reduce lead paint hazards in residential rental properties they own.

/sup 7/Be and /sup 210/Pb total deposition fluxes at New Haven, Connecticut and at Bermuda

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

Turekian, K.K.; Benninger, L.K.; Dion, E.P.

1983-06-20

The total deposition fluxes of /sup 210/Pb and /sup 7/Be were determined at New Haven, Connecticut, and Bermuda over approximately the same annual period in 1977-1978. The /sup 210/Pb flux has remained virtually constant at New Haven from 1973 to 1978, the flux in the 1977--1978 period being 1.2 dpm/cm/sup 2//y. The /sup 210/Pb flux at Bermuda is 0.69 dpm/cm/sup 2//y. This lower flux than expected from model calculations is due to the establishment of a blocking high pressure cell during the summer which deflects continental air. The /sup 7/Be fluxes at New Haven and Bermuda are 22.7 and 17.1more » dpm/cm/sup 2//y, values consistent with western North Atlantic oceanic standing crop measurements, but higher than some other estimates. Where the difference cannot be attributed to differences in sampling it is ascribable to regional differences compatible with the oceanic data.« less

33 CFR 100.906 - Grand Haven Coast Guard Festival Waterski Show, Grand Haven, MI.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Grand Haven Coast Guard Festival Waterski Show, Grand Haven, MI. 100.906 Section 100.906 Navigation and Navigable Waters COAST GUARD... Grand Haven Coast Guard Festival Waterski Show, Grand Haven, MI. (a) Regulated Area. All waters of the...

Autonomous Observations of the Upper Ocean Stratification and Velocity Fields About the Seasonally-Retreating Marginal Ice Zone

DTIC Science & Technology

2015-09-30

ITP data is underway on multiple fronts. A few scientific highlights follow: An undergraduate student from VIT University in India, Ratnaksha...Yale University PO Box 208109 New Haven, CT 06520-8109 phone: (203) 432-3167 fax: (203) 432 3134 email: mary-louise.timmermans@yale.edu

33 CFR 165.150 - New Haven Harbor, Quinnipiac River, Mill River.

Code of Federal Regulations, 2010 CFR

2010-07-01

... River, Mill River. 165.150 Section 165.150 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... New Haven Harbor, Quinnipiac River, Mill River. (a) The following is a regulated navigation area: The... 303°T to point D at the west bank of the mouth of the Mill River 41°18′05″ N, 72°54′23″ W thence south...

Did community greening reduce crime? Evidence from New Haven, CT, 1996-2007

Treesearch

Dexter H. Locke; SeungHoon Han; Michelle C. Kondo; Colleen Murphy-Dunning; Mary Cox

2017-01-01

For some volunteers, neighborhood safety is one of the reasons for becoming involved in community greening. For example, many volunteers of the Community Greenspace program at the Urban Resources Initiative in New Haven, Connecticut believe that there is a potential reduction in crime from community greening activities, even though it is not an explicit goal of the...

Segregating Schools: The Foreseeable Consequences of Tuition Tax Credits.

ERIC Educational Resources Information Center

Yale Law Journal, 1979

1979-01-01

Argues that the effect of a proposed tuition tax credit is school segregation, creating serious constitutional objections under the due process clause. A voucher system would avoid these constitutional objections. Available from the Yale Law Journal, 401A Yale Station, New Haven, CT 06520. (Author/IRT)

Safe-haven laws focus on abandoned newborns and their mothers.

PubMed

Kunkel, Katherine A

2007-10-01

In the United States, 47 states have safe-haven laws that allow a mother to relinquish her newborn infant at a hospital emergency department or a manned fire station and maintain her anonymity. In addition to anonymity, immunity from prosecution is given to the mother, provided the relinquished newborn is unharmed and meets the age specified by the state's law. This article describes safe-haven laws and how they developed, barriers to successful use, nursing implications, and the nurse's role in increasing public awareness and influencing legislative policy.

Freedom of Expression at Yale

ERIC Educational Resources Information Center

AAUP Bulletin, 1975

1975-01-01

A report of the Committee on Freedom of Expression at Yale appointed by the president to examine the condition of free expression, peaceful dissent, mutual respect and tolerance at Yale and to draft recommendations for maintenance of those principles. (JT)

Thomas Clap and the Founding of Yale.

ERIC Educational Resources Information Center

Cowley, W. H.

The conflicting statements about Yale's beginning made at various times by President Clap definitively shaped his administration (1740-1766) and also Yale's method of government for more than a century thereafter. During the 90 years following the 1792 reorganization of the Yale Corporation no one seems to have questioned Clap's pronouncements, if…

Man And Woman at Yale

ERIC Educational Resources Information Center

Lever, Janet; Swartz, Pepper

1971-01-01

The authors conclude that the college system inhibits the natural development of relationships because of its goldfish bowl" effect. Yale men may find it doubly hard to be open, yet the people at Yale are generally bright and sensitive and may very well create a uniquely close and natural community. (Author)

The Eighth Data Release Of The Sloan Digital Sky Survey: First Data From SDSS-3

DTIC Science & Technology

2011-04-01

Sunspot, NM 88349, USA 14 Center for Cosmology and Particle Physics, New York University, 4 Washington Place, New York, NY 10003, USA 15 Department of...Park, PA 16802, USA 18 Institute of Cosmology and Gravitation (ICG), Dennis Sciama Building, Burnaby Road, University of Portsmouth, Portsmouth, PO1 3FX... Cosmology , Carnegie Mellon University, Pittsburgh, P.A. 15213, USA 26 Yale Center for Astronomy and Astrophysics, Yale University, New Haven, CT 06520

77 FR 75917 - Drawbridge Operation Regulation; New Haven Harbor, Quinnipiac and Mill Rivers, CT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

...-AA09 Drawbridge Operation Regulation; New Haven Harbor, Quinnipiac and Mill Rivers, CT AGENCY: Coast..., mile 1.3, across the Quinnipiac River, and the Chapel Street Bridge, mile 0.4, across the Mill River..., across the Quinnipiac River, and the Chapel Street Bridge, mile 0.4, across the Mill River, to reduce the...

Campus Community Policing: It All Started with Us...

ERIC Educational Resources Information Center

Margolis, Gary J.; March, Noel C.

2008-01-01

The first police in the United States to embrace the kind of community-focused policing that "modern" law enforcement embraces, and which was extolled by Sir Robert Peel in 1826, were the New Haven, Connecticut police officers hired by Yale University in 1894 to patrol and keep order on campus. Why did Yale not simply rely on the New…

Northeast Corridor Improvement Project Electrification - New Haven, CT to Boston, MA : Draft Environmental Impact Statement. Volume 1.

DOT National Transportation Integrated Search

1993-09-01

The impacts of extending electrification on the National Railroad Passenger Corporation's (Amtrak) Northeast Corridor (NEC) from New Haven, Connecticut to Boston, Massachusetts are of direct concern to the Federal Railroad Administration (FRA). To im...

Elements of progressive patient care in the Yale Health Plan HMO.

PubMed

Pearson, D A; Rowe, D S; Goldberg, B; Seigel, E

1975-01-01

The results of a study of the use of intermediate care beds in the intermediate care facility (ICF) of the Yale Health Plan, a prepaid group practice plan for students and an enrolled non-student population, indicate that the ICF may be a possible model for other health maintenance organizations. The ICF, with 30 beds in active use, is located in the Yale health center. Approximately one-third of the ICF patients would have been admitted to the affiliated short-term general hospital if the ICF did not exist. The plan's medical staff also has the option of transferring patients between the affiliated hospital and the ICF, depending on which institution is most appropriate for the patient's needs. A comparison of the levels of care provided in the ICF with those presented in selected articles from the progressive patient care literature revealed that the ICF is not only providing intermediate care but several other classic elements of progressive patient care -self care, continuing care, minimal care, and partial care.

Elements of progressive patient care in the Yale Health Plan HMO.

PubMed Central

Pearson, D A; Rowe, D S; Goldberg, B; Seigel, E

1975-01-01

The results of a study of the use of intermediate care beds in the intermediate care facility (ICF) of the Yale Health Plan, a prepaid group practice plan for students and an enrolled non-student population, indicate that the ICF may be a possible model for other health maintenance organizations. The ICF, with 30 beds in active use, is located in the Yale health center. Approximately one-third of the ICF patients would have been admitted to the affiliated short-term general hospital if the ICF did not exist. The plan's medical staff also has the option of transferring patients between the affiliated hospital and the ICF, depending on which institution is most appropriate for the patient's needs. A comparison of the levels of care provided in the ICF with those presented in selected articles from the progressive patient care literature revealed that the ICF is not only providing intermediate care but several other classic elements of progressive patient care -self care, continuing care, minimal care, and partial care. PMID:805444

Strategies for Countering Terrorist Safe Havens

DTIC Science & Technology

2014-02-20

within safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to...leadership targeting within safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case ...surrogate forces and pseudo operations—provide viable potential options for USSOF to counter the complex problem of safe havens. Overall, the case

76 FR 5831 - Amdocs, Inc., Global Support Services, Advertising And Media AT&T Division, New Haven...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-02

... Support Services, Advertising And Media AT&T Division, New Haven, Connecticut; Notice of Affirmative... workers and former workers of Amdocs, Inc., Global Support Services, Advertising and Media AT&T Division..., Advertising and Media AT&T Division. The investigation also revealed that the firm is not a Supplier or...

Changing the Guard Slowly: Yale 1963-1975

NASA Astrophysics Data System (ADS)

Trimble, Virginia

2006-12-01

Yale's was the first copy of the Principia to arrive in America, and astronomy was sporadically taught there from the 1740s onward. Perhaps this extended tradition was a contributing factor in the long and somewhat troubled transition from nearly-pure emphasis on "the old astronomy" of positions, proper motions, and such to "the new astronomy" or astrophysics. In an era when many departments were growing rapidly and new astrophysics PhDs were much in demand (even I received 5 offers for 1968-69, though being a small green Martian or female was not thought an advantage then), Yale managed to acquire and rapidly de-accession a remarkable number of folks of great ability, based on their later records. The habit has, perhaps, not yet been entirely overcome. Some details will be explored and some analogies drawn with another institution (Cambridge University), which experienced even greater metamorphic pains. My starting date here is the hiring of Norman Baker and Myron Lecar; the end point the arrival of Beatrice Tinsley; and I may or may not name other names.

Samantha Bench Reese | NREL

Science.gov Websites

, Yale University, New Haven, CT, 2006 B.S. in Engineering and Applied Science, California Institute of (2007-2015) Application Engineer, ZYGO, Middlefield, CT (2004-2007) Senior Analysis Engineer/Product

Level II scour analysis for Bridge 30 (NEWHTH00050030) on Town Highway 5, crossing the New Haven River, New Haven, Vermont

USGS Publications Warehouse

Burns, Ronda L.; Wild, Emily C.

1998-01-01

This report provides the results of a detailed Level II analysis of scour potential at structure NEWHTH00050030 on Town Highway 5 crossing the New Haven River, New Haven, Vermont (figures 1–8). A Level II study is a basic engineering analysis of the site, including a quantitative analysis of stream stability and scour (Federal Highway Administration, 1993). Results of a Level I scour investigation also are included in appendix E of this report. A Level I investigation provides a qualitative geomorphic characterization of the study site. Information on the bridge, gleaned from Vermont Agency of Transportation (VTAOT) files, was compiled prior to conducting Level I and Level II analyses and is found in appendix D.The site is in the Champlain section of the St. Lawrence Valley physiographic province in west-central Vermont. The 115-mi2 drainage area is in a predominantly rural and forested basin. In the vicinity of the study site, the surface cover is pasture on the right bank upstream and downstream of the bridge while the immediate banks have dense woody vegetation. The upstream left bank is also pasture. The downstream left bank is forested.In the study area, the New Haven River has an incised, sinuous channel with a slope of approximately 0.01 ft/ft, an average channel top width of 127 ft and an average bank height of 5 ft. The channel bed material ranges from silt to cobble with a median grain size (D50) of 20.4 mm (0.067 ft). The geomorphic assessment at the time of the Level I and Level II site visit on June 19, 1996, indicated that the reach was laterally unstable. The stream bends through the bridge and impacts the left bank where there is a cut bank and scour hole.The Town Highway 5 crossing of the New Haven River is a 181-ft-long, two-lane bridge consisting of four 45-ft concrete tee-beam spans (Vermont Agency of Transportation, written communication, December 15, 1995). The opening length of the structure parallel to the bridge face is 175.9 ft. The

Portable Television for Recording Emergency Treatment - Phase II

ERIC Educational Resources Information Center

Howze, William C.; Audette, Louis G.

1970-01-01

Describes a study conducted jointly by the Yale University School of Medicine and the City of New Haven on the uses of portable television for the evaluation and improvement of emergency first aid services." (Author/AA)

Health care politics and policy: the business of medicine: a course for physician leaders.

PubMed

Marmor, Theodore Richard

2013-09-01

This article is a condensed and edited version of a speech delivered to the business of medicine: A Course for Physician Leaders symposium presented by Yale-New Haven Hospital and the Medical Directors Leadership Council at Yale University in November 2012 and drawn from Politics, Health, and Health Care: Selected Essays by Theodore R. Marmor and Rudolf Klein [1]. It faithfully reflects the major argument delivered, but it does not include the typical range of citations in a journal article. The material presented here reflects more than 40 years of teaching a course variously described as Political Analysis and Management, Policy and Political Analysis, and The Politics of Policy. The aim of all of these efforts is to inform audiences about the necessity of understanding political conflict in any arena, not least of which is the complex and costly world of medical care.

Safe haven laws as crime control theater.

PubMed

Hammond, Michelle; Miller, Monica K; Griffin, Timothy

2010-07-01

This article examines safe haven laws, which allow parents to legally abandon their infants. The main objective is to determine whether safe haven laws fit the criteria of crime control theater, a term used to describe public policies that produce the appearance, but not the effect, of crime control, and as such are essentially socially constructed "solutions" to socially constructed crime "problems." The analysis will apply the principles of crime control theater to safe haven laws. Specifically, the term crime control theater applies to laws that are reactionary responses to perceived criminal threats and are often widely supported as a way to address the crime in question. Such laws are attractive because they appeal to mythic narratives (i.e., saving an innocent child from a predator); however they are likely ineffective due to the complexity of the crime. These laws can have deleterious effects when policymakers make false claims of success and stunt public discourse (e.g., drawing attention away from more frequent and preventable crimes). This analysis applies these criteria to safe haven laws to determine whether such laws can be classified as crime control theater. Many qualities inherent to crime control theater are present in safe haven laws. For example, the laws are highly publicized, their intentions lack moral ambiguity, rare cases of success legitimize law enforcement and other agencies, and they appeal to the public sense of responsibility in preventing crime. Yet the goal of saving infant lives may be unattainable. These qualities make the effectiveness of the laws questionable and suggest they may be counterproductive. This analysis determined that safe haven laws are socially constructed solutions to the socially constructed problem of child abandonment. Safe haven laws are appropriately classified as crime control theater. It is imperative that further research be conducted to examine the effectiveness and collateral effects of safe haven laws

Resiliency analysis of storm surge for Interstate 95 right-of-way at Long Wharf / New Haven, CT : final report.

DOT National Transportation Integrated Search

2017-03-23

This report focuses on the transportation resiliency of the Long Wharf area in the City of New Haven, CT, : with the aim of identifying resiliency strategies for these transportation assets. The report begins with : reviewing the important transporta...

Fever, petechiae, and pulmonary infiltrates in an immunocompromised Peruvian man.

PubMed Central

Berenson, C. S.; Dobuler, K. J.; Bia, F. J.

1987-01-01

The diagnostic considerations raised by immunocompromised patients with opportunistic infection continue to expand. When such patients harbor latent or persistent infection acquired in a tropical environment, the diagnostic challenge is even greater. The Infectious Disease Service at Yale-New Haven Hospital was asked to see a middle-aged man from Peru with known T-cell lymphoma who had recently completed a course of chemotherapy. He presented to the hospital with fever, petechial skin rash, pulmonary infiltrates, and neutropenia. Ultimately this case illustrated the necessity for careful evaluation of such patients, looking, in particular, for evidence of opportunistic parasitic infection. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 FIG. 5 PMID:3424876

[Yale Food Addiction Scale - review of literature].

PubMed

Magyar, Éva Erzsébet; Csábi, Györgyi; Tényi, Tamás; Tényi, Dalma

Food addiction is a condition presenting with a similar symptomatology to that of drug addiction, with an underlying individual sensitivity and special adaptation to certain foods, being consumed regularly. The concept of food addiction created one of the central issues in addiction research, owing to the pandemic spreading of obesity causing serious public health concerns. Development of an objective, standardized measuring tool of food addiction has become markedly necessary for both research and public health purposes. Literature overview in the fields of food addiction and Yale Food Addiction Scale (1956-2016). For the establishment of food addiction diagnosis, the Yale Food Addiction Scale has become the most widely used method. It is an English questionnaire consisting of 25 questions, having been developed according to the 7 substance use disorder criteria in DSM-IV. The scale provides the possibility of diagnosis establishment, as well as measurement of food addiction severity. Development of the scale has given way to a number of new scientific results. The mean prevalence of food addiction is 19.7%, being more common in women, obese individuals, people >35 years and patients with already established eating disorders (binge eating disorder, bulimia). The most common symptom is the 'persistent desire or repeated unsuccessful attempts to quit'. A positive association has been recognized between food addiction symptomcount and the reward system dysfunction. The Yale Food Addiction Scale is a psychometrically valid, objective and standardized tool, being not only useful in addiction research but also helping in diagnosis establishment in clinical practice.

Promoting Convergence: The Integrated Graduate Program in Physical and Engineering Biology at Yale University, a New Model for Graduate Education

ERIC Educational Resources Information Center

Noble, Dorottya B.; Mochrie, Simon G. J.; O'Hern, Corey S.; Pollard, Thomas D.; Regan, Lynne

2016-01-01

In 2008, we established the Integrated Graduate Program in Physical and Engineering Biology (IGPPEB) at Yale University. Our goal was to create a comprehensive graduate program to train a new generation of scientists who possess a sophisticated understanding of biology and who are capable of applying physical and quantitative methodologies to…

The Changing Landscape of Lung Cancer Research and Treatment

Cancer.gov

Along with the Lung Cancer Social Media (#LCSM) community, the National Cancer Institute will be co-hosting a lively and interactive Google Hangout on Air about the changing landscape of lung cancer research and treatment. During the chat, viewers will have the opportunity to pose questions to a panel of lung cancer experts including NCI's Dr. Shakun Malik, the head of thoracic oncology therapeutics, Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven and David Tom Cooke MD FACS, Head, Section of General Thoracic Surgery University of California, Davis. You can also learn more and follow along on the #LCSM Chat page. The chat will be moderated by lung cancer advocate and #LCSM co-founder, Janet Freeman-Daily. To ask questions of our experts, simply use the #LCSM hashtag during the chat.

Safe Haven.

ERIC Educational Resources Information Center

Bush, Gail

2003-01-01

Discusses school libraries as safe havens for teenagers and considers elements that foster that atmosphere, including the physical environment, lack of judgments, familiarity, leisure, and a welcoming nature. Focuses on the importance of relationships, and taking the time to listen to teens and encourage them. (LRW)

The Anne Frank Haven in an Israeli Kibbutz.

PubMed

Dror, Y

1995-01-01

The Anne Frank Haven, founded in 1956, in the Israeli Kibbutz Sasa provides a unique educational program for coping with muticultural and integration problems. It is a holistic, regional junior and senior high school system within the holistic community of three kibbutzim. The Haven has been the subject of much research into "Moral Development," carried out by Wolins (1969, 1971), and mainly by Kohlberg (1971), his doctoral students Reimer and Snarey and other colleagues. In the seventies and eighties they used the Kibbutz example as a model for the "Just Community" approach. In the early nineties, an Israeli group evaluated the success of the program and its rationale, taking into consideration all the "educational factors" of the community, in the Haven, and in the kibbutzim around it. This article offers a comprehensive picture of the Kohlbergian moral-developmental research at the Anne Frank Haven, including all the relevant references and evaluations of the Haven as a part of the "Just Community" approach. It concludes with a suggestion for another approach--"Community Education" research in the same Haven--as an example of present and future studies in the area of "Moral" and "Values" education.

Strategies for Countering Terrorist Safe Havens

DTIC Science & Technology

2013-12-01

tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to examine these strategies...safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to examine...pseudo operations—provide viable potential options for USSOF to counter the complex problem of safe havens. Overall, the case studies will demonstrate

Improving Ethnic Balance and Intergroup Relations; An Advisory Report to the Board of Education, New Haven Unified School District.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento. Bureau of Intergroup Relations.

Using the findings of a field study and an analysis of school data, this report describes the ethnic and racial distribution of students in the New Haven (California) Unified School District and discusses the availability of educational opportunities and proper intergroup relations for minority-group students. Also, the report examines plant…

Islamic Jihad: Sectarian Factors in Combating Terrorism

DTIC Science & Technology

2015-02-17

Wahhab with the military power of Arabia’s largest and most powerful tribe seemed a perfect recipe for violent fundamentalist revival. Wahhabis...Studies, 2014). Cole, Juan Ricardo and Nikki Keddie, Shi’ism and Social Protest, (New Haven: Yale University Press, 1986). Cook , David, Understanding

Second Chance or No Chance? A Case Study of One Urban Alternative Middle School

ERIC Educational Resources Information Center

Kennedy-Lewis, Brianna L.

2015-01-01

This qualitative case study focuses on a school created to educate expelled students, specifically examining the relationships between educators' beliefs and philosophies and daily school life. At this school, Kelly's ("Last chance high." Yale University Press, New Haven, 1993) competing philosophies of "traditionalism" and…

SOURCES OF INDOOR AIR CONTAMINANTS: CHARACTERIZING EMISSIONS AND HEALTH EFFECTS

EPA Science Inventory

This document consists of the Preface, Chapter 1. Introduction, Chapter 6. Conclusion, and References relating to an October 1990 conference at the John B. Pierce Laboratory and Yale University, New Haven, CT.

The purpose of a May 1985 international conference on indoor s...

33 CFR 117.213 - New Haven Harbor, Quinnipiac and Mill Rivers.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Mill Rivers. 117.213 Section 117.213 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... Haven Harbor, Quinnipiac and Mill Rivers. The draws of the Tomlinson bridge, mile 0.0, the Ferry Street... bridge, mile 0.4 across Mill River, shall operate as follows: (a) The draws shall open on signal; except...

Transactions of the Army Conference on Applied Mathematics and Computing (8th) Held in Ithaca, New York on 19-22 June 1990

DTIC Science & Technology

1991-02-01

Shamos, M I , "Computational Geometry", Ph.D Thesis , Department of Computer Science, Yale University, New Haven CT, 1978. [53] Steiglitz, K., An...431) whose real and imaginary parts are given by 222 mj cos OmJ + Az -mL cos 2 ML + MS Cos 2MS (432) mj sinO 0M cose OM = L sin aML cos ML + m S sin 9...Aequationes Math. 14, 1976, 271-291. 5. Greenwell, C.E., Finite element methods for partial integro-differential equations, Ph.D. Thesis , University of

Safe Haven Laws as "Crime Control Theater"

ERIC Educational Resources Information Center

Hammond, Michelle; Miller, Monica K.; Griffin, Timothy

2010-01-01

Objectives: This article examines safe haven laws, which allow parents to legally abandon their infants. The main objective is to determine whether safe haven laws fit the criteria of "crime control theater", a term used to describe public policies that produce the appearance, but not the effect, of crime control, and as such are essentially…

Northeast Corridor Improvement Project Electrification - New Haven, CT to Boston, MA : Draft Environmental Impact Statement/Report. Volume II: Land use and Regulated Areas

DOT National Transportation Integrated Search

1993-09-01

The impacts of extending electrification on the National Railroad Passenger Corporation's (Amtrak) Northeast Corridor (NEC) from New Haven, Connecticut to Boston, Massachusetts are of direct concern to the Federal Railroad Administration (FRA). To im...

Safe Haven Laws and School Social Work

ERIC Educational Resources Information Center

Kopels, Sandra

2012-01-01

"Safe haven" laws are designed to protect infants from being killed or otherwise harmed. This article examines the safe haven laws from the states that comprise the Midwest School Social Work Council and the variations between these laws regarding the age of the infant, where the infant can be left, who is allowed to leave the infant, whether…

Fear and Trembling at Yale

ERIC Educational Resources Information Center

Graff, Gerald

1977-01-01

Discusses the plight of the contemporary literary critic using as examples, Paul de Man, J. Hillis Miller, Harold Bloom, and Geoffrey Hartman. All four men, among the most learned and talented of contemporary critics, reside at Yale University. (Author/RK)

Alejo Carpentier: Lo real y lo maravilloso en "El Reino de Este Mundo" (Alejo Carpentier: The Real and the Fantastic in "The Rule of the World")

ERIC Educational Resources Information Center

Rodriguez Monegal, Emir

1971-01-01

Special issue dedicated to studies on contemporary Spanish American literature. Paper read at the symposium on Alejo Carpentier organized by Klaus Muller-Bergh at Yale University, New Haven, Connecticut, under the auspices of the Antilles Research Program of the Council for Latin American Studies, on April 17, 1971. (DS)

Pre-freshman enrichment program [University of New Haven

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

NONE

1997-06-01

The Connecticut Pre-Engineering Program, Inc. (CPEP), is a collaboration of school districts, businesses, colleges, universities, government and community organizations whose mission and program efforts are aimed at increasing the pool of African-American, Hispanic, Native-American Indian, Asian American, Women and other under-represented minority students who pursue mathematics, science, engineering and other technological based college study and careers. CPEP provides enrichment programs and activities throughout the year in New Haven. Since 1987, CPEP has sponsored summer enrichment programs designed to motivate and stimulate middle school and high school students to pursue careers in mathematics, science, engineering and other technology related fields. Throughmore » the Summer Enrichment Program, CPEP has been able to better prepare under-represented and urban students with skills that will facilitate their accessing colleges and professionals careers. The essential premise of the program design and academic content is that targeted students must be taught and nurtured as to develop their self-confidence and personal ambitions so that they can seriously plan for and commit to college-level studies. The program stresses multi-disciplinary hands-on science and mathematics experience, group learning and research, and career exploration and academic guidance. Students study under the direction of school teachers and role model undergraduate students. Weekly field trips to industrial sites, science centers and the shoreline are included in this program.« less

Record of decision Northeast Corridor Improvement Project Electrification - New Haven, CT to Boston, MA : final environmental impact statement/report and 4(F) statement.

DOT National Transportation Integrated Search

1995-05-01

This record of decision (ROD) completes the environmental review by the Federal Administration (FRA) of the proposal by the National Railroad Passenger Corporation (Amtrak) to extend electric train operation from New Haven, CT, to Boston, MA. In this...

Wotan’s Workshop: Military Experiments Before the Second World War

DTIC Science & Technology

2002-10-01

1980. Kuenne, Robert E. The Attack Submarine: A study in strategy. New Haven: Yale University Press, 1965. Lanchester, Frederick W. Aircraft in Warfare...little-known Francis Edward Smedley . [8] Typical applications of this phrase appear on pages 35 and 40 of the novel by DiMercurio. [9] Except as otherwise

Colorful Event Lands Off Campus Customers.

ERIC Educational Resources Information Center

Ballard, Richard E.

1978-01-01

To attract suburban, nonstudent customers, the Yale Cooperative Corporation held a Heirloom Discovery Day. Co-op books and materials were sold to customers who came with antique items to be appraised. Donations from the profits were made to the New Haven Symphony and the University Collection of Musical Instruments. (JMD)

At Yale, a Push to Link Academe and Organized Labor.

ERIC Educational Resources Information Center

Leatherman, Courtney

1999-01-01

At a recent conference of academics, union organizers, and workers at Yale University (Connecticut) activity and rhetoric focused on reinforcing the ties that bind academe and labor, and particularly on the question, currently before the National Labor Relations Board, of whether Yale graduate students qualify as employees or students. Leaders of…

Using lean methodology to improve productivity in a hospital oncology pharmacy.

PubMed

Sullivan, Peter; Soefje, Scott; Reinhart, David; McGeary, Catherine; Cabie, Eric D

2014-09-01

Quality improvements achieved by a hospital pharmacy through the use of lean methodology to guide i.v. compounding workflow changes are described. The outpatient oncology pharmacy of Yale-New Haven Hospital conducted a quality-improvement initiative to identify and implement workflow changes to support a major expansion of chemotherapy services. Applying concepts of lean methodology (i.e., elimination of non-value-added steps and waste in the production process), the pharmacy team performed a failure mode and effects analysis, workflow mapping, and impact analysis; staff pharmacists and pharmacy technicians identified 38 opportunities to decrease waste and increase efficiency. Three workflow processes (order verification, compounding, and delivery) accounted for 24 of 38 recommendations and were targeted for lean process improvements. The workflow was decreased to 14 steps, eliminating 6 non-value-added steps, and pharmacy staff resources and schedules were realigned with the streamlined workflow. The time required for pharmacist verification of patient-specific oncology orders was decreased by 33%; the time required for product verification was decreased by 52%. The average medication delivery time was decreased by 47%. The results of baseline and postimplementation time trials indicated a decrease in overall turnaround time to about 70 minutes, compared with a baseline time of about 90 minutes. The use of lean methodology to identify non-value-added steps in oncology order processing and the implementation of staff-recommended workflow changes resulted in an overall reduction in the turnaround time per dose. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

An Infrastructure to Advance the Scholarly Work of Staff Nurses

PubMed Central

Parkosewich, Janet A.

2013-01-01

The traditional role of the acute care staff nurse is changing. The new norm establishes an expectation that staff nurses base their practice on best evidence. When evidence is lacking, nurses are charged with using the research process to generate and disseminate new knowledge. This article describes the critical forces behind the transformation of this role and the organizational mission, culture, and capacity required to support practice that is based on science. The vital role of senior nursing leaders, the nurse researcher, and the nursing research committee within the context of a collaborative governance structure is highlighted. Several well-known, evidence-based practice models are presented. Finally, there is a discussion of the infrastructure created by Yale-New Haven Hospital to advance the scholarly work of the nursing staff. PMID:23482435

Chinese-English 2,000 Selected Chinese Common Sayings (Yale Romanization).

ERIC Educational Resources Information Center

Wu, C.K.; Wu, K.S.

Compiled here for the first time in Yale romanization are 2,000 common Chinese sayings, idioms, proverbs, and other figures of speech. The entries are arranged in two series: once in alphabetic order according to the Yale romanization and then again by the stroke-count of the Chinese characters. The romanized entries are accompanied by several…

Interactive radiopharmaceutical facility between Yale Medical Center and Brookhaven National Laboratory. Progress report, October 1976-June 1979

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

Gottschalk, A.

1979-01-01

DOE Contract No. EY-76-S-02-4078 was started in October 1976 to set up an investigative radiochemical facility at the Yale Medical Center which would bridge the gap between current investigation with radionuclides at the Yale School of Medicine and the facilities in the Chemistry Department at the Brookhaven National Laboratory. To facilitate these goals, Dr. Mathew L. Thakur was recruited who joined the Yale University faculty in March of 1977. This report briefly summarizes our research accomplishments through the end of June 1979. These can be broadly classified into three categories: (1) research using indium-111 labelled cellular blood components; (2) developmentmore » of new radiopharmaceuticals; and (3) interaction with Dr. Alfred Wolf and colleagues in the Chemistry Department of Brookhaven National Laboratory.« less

Corrupting Conversations with the Marquis de Sade: On Education, Gender, and Sexuality

ERIC Educational Resources Information Center

Greteman, Adam J.

2016-01-01

In this essay, the author joins a conversation started by Martin ("Reclaiming the conversation: the ideal of the educated woman." Yale University Press, New Haven, 1985) regarding gender and education seeking to extend the conversation to address sexuality. To do so, the author brings a reading of the Marquis de Sade to challenge the…

God and Jerk at Yale

ERIC Educational Resources Information Center

Toor, Rachel

2008-01-01

In this article, the author refutes the arguments forwarded by William Deresiewicz in his much-discussed essay, "The American Scholar." Deresiewicz claimed that his background (as a student at Columbia and a former associate professor of English at Yale) rendered him incapable of a few minutes of small talk with the plumber who came to fix his…

Command and Control of Joint Air Operations. Some Lessons Learned from Four Case Studies of an Enduring Issue

DTIC Science & Technology

1991-01-01

New Zealand Air Force.4 To further complicate matters, General Douglas MacArthur, as Commander Southwest Pacific Area, and the adjoining theater...Army, Marine, and New Zealand officers and the top job was rotated fairly regularly among the services.10 By early 1943 a truly joint staff had...in joint air operations. 2C. Kenneth Allard, Command, Control, and the Common Defense, Yale University Press, New Haven, 1990. The authors strongly

Safe Haven Configurations for Deep Space Transit Habitats

NASA Technical Reports Server (NTRS)

Smitherman, David; Polsgrove, Tara; Rowe, Justin; Simon, Matthew

2017-01-01

Throughout the human space flight program there have been instances where smoke, fire, and pressure loss have occurred onboard space vehicles, putting crews at risk for loss of mission and loss of life. In every instance the mission has been in Low-Earth-Orbit (LEO) with access to multiple volumes that could be used to quickly seal off the damaged module or escape vehicles for a quick return to Earth. For long duration space missions beyond LEO, including Mars transit missions of about 1000 days, the mass penalty for multiple volumes has been a concern as has operating in an environment where a quick return will not be possible. In 2016 a study was done to investigate a variety of dual pressure vessel configurations for habitats that could protect the crew from these hazards. It was found that for a modest increase in total mass it should be possible to provide significant protection for the crew. Several configurations were developed that either had a small safe haven to provide 30-days to recover, or a full duration safe haven using two equal size pressure vessel volumes. The 30-day safe haven was found to be the simplest, yielding the least total mass impact but still with some risk if recovery is not possible during that timeframe. The full duration safe haven was the most massive option but provided the most robust solution. This paper provides information on the various layouts considered in the study and provides a discussion of the findings for implementing a safe haven in future habitat designs.

Growing Pains: Scaling up the Nation's Best Charter Schools. Education Sector Reports

ERIC Educational Resources Information Center

Education Sector, 2009

2009-01-01

Amistad Academy is a bright shining star in public school reform. Founded in 1999 in a renovated warehouse in a blighted New Haven, Connecticut, neighborhood by a group of Yale law school students, the 289-student charter school has won the praise of the last two federal education secretaries. Educators throughout the country have traveled to the…

Probing Nanoscale Ferroelectricity by Ultraviolet Raman Spectroscopy

DTIC Science & Technology

2006-09-15

Breaking the Maya Code (Thames & Hudson, London, rev. ed., 1999), p. 13. 11. S. D. Houston, M. D. Coe, Mexicon 25, 151 (2004). 12. K. A. Taube...in Olmec Art and Archaeology in Mesoamerica, J. E. Clark, M. E. Pye, Eds. (Yale Univ. Press, New Haven, CT, 2000), pp. 75–93. 19. K. H. Basso, N

The future of silviculture research-thoughts from the Yale forestry forum

Treesearch

Sharon T. Friedman; James M. Guldin

2001-01-01

The 1999 Yale Forestry Forum, sponsored by Yale University and the USDA Forest Service, brought together a number of experts in an academic setting to discuss the future of silviculture research in the next century. Four participants in the plenary session outlined three areas that will characterize the future of silviculture research-sustainability, flexibility, and...

Safe Haven Configurations for Deep Space Transit Habitats

NASA Technical Reports Server (NTRS)

Smitherman, David; Polsgrove, Tara; Rowe, Justin; Simon, Matthew

2017-01-01

Throughout the human space flight program there have been instances where systems failures resulting in smoke, fire, and pressure loss have occurred onboard space vehicles, putting crews at risk for loss of mission and loss of life. In most instances the missions have been in Low-Earth-Orbit (LEO) or Earth-Moon vicinity, with access to multiple volumes that could be used to quickly seal off the damaged module or access escape vehicles for return to Earth. For long duration missions beyond LEO, including Mars transit missions of about 1100 days, the mass penalty for multiple volumes and operating in an environment where a quick return will not be possible have been concerns. In 2016, a study was done to investigate a variety of dual pressure vessel configurations for habitats that could protect the crew from these hazards. It was found that with a modest increase in total mass it should be possible to provide significant protection for the crew. Several configurations were considered that either had a small safe haven to provide 30-days to recover, or a full duration safe haven using two equal size pressure vessel volumes. The 30-day safe haven was found to be the simplest, yielding the least total mass impact but still with some risk if recovery is not possible during that timeframe. The full duration safe haven was the most massive option but provided the most robust solution. This paper provides information on the various layouts developed during the study and provides a discussion of the findings for implementing a safe haven in future habitat designs.

History of the Department of Cell Biology at Yale School of Medicine, 1813-2010

PubMed Central

Lentz, Thomas L.

2011-01-01

The Department of Cell Biology at the Yale University School of Medicine was established in 1983. It was preceded by the Section of Cell Biology, which was formed in 1973 when George E. Palade and collaborators came to Yale from the Rockefeller University. Cell Biology at Yale had its origins in the Department of Anatomy that existed from the beginning of classes at the Medical Institution of Yale College in 1813. This article reviews the history of the Department of Anatomy at Yale and its evolution into Cell Biology that began with the introduction of histology into the curriculum in the 1860s. The formation and development of the Section and Department of Cell Biology in the second half of the 20th century to the present time are described. Biographies and research activities of the chairs and key faculty in anatomy and cell biology are provided. PMID:21698037

The Search for a Cold War Grand Strategy: NSC 68 & 162

DTIC Science & Technology

2014-05-22

Robert Dallek, Harry S. Truman (New York: Times Books, 2008); Ernest R. May, American Cold War Strategy (New York: Bedford Books of St. Martin’s Press...Gave the Soviets the Atomic Bomb (New Haven: Yale University Press, 2009), 119. 32Robert C. Williams , Klaus Fuchs, Atom Spy (Cambridge, MA: Harvard...possibilities, including preemptive buying.”52 Dr. Ernest O. Lawrence was the final consultant engaged by the State-Defense Policy Review Group. The

C.-E.A. Winslow Day: Proceedings of the June 3, 1977 Centenary Celebration

PubMed Central

Viseltear, Arthur J.

1977-01-01

Sponsored by Yale University, the City of New Haven, and the John B. Pierce Foundation, the C.-E.A. Winslow Day program consisted of speeches by Mr. Leonard Woodcock, President Emeritus, U.A.W., the Honorable Kenneth Gibson, Mayor of Newark, and Dr. Hector Acuña, Director, Pan American Health Organization; reminiscences of Ira Hiscock, Anna M.R. Lauder Professor Emeritus of Public Health, Mary Elizabeth Tennant, Associate Professor Emeritus of Nursing (Public Health), A. Pharo Gagge, Emeritus Fellow, John B. Pierce Foundation, and Mrs. Harriet Welch, Former President of the VNA of New Haven. The proceedings also included the presentation of gifts and the official C.-E.A. Winslow Day Proclamation. PMID:345631

Organizational Culture Challenges to Interagency and Intelligence Community Communication and Interaction

DTIC Science & Technology

2006-05-31

York: McGraw-Hill, 2003), p 121. 103 Gortner, Mahler, and Nicholson, p 74. 104 Robert B. Denhardt, Theories of Public Organization. (Belmont, CA...Uninformed: Government Secrecy in the 1980’s. New York: Pilgrim Press, 1984. Denhardt, Robert B. Theories of Public Organization. Belmont, CA: Brooks/Cole...Fixing Intelligence: For a More Secure America. New Haven, CT: Yale University Press, 2003. Odom, William E. and Robert Dujarric. America’s Inadvertent

A longitudinal, collaborative, practice-based learning and improvement model to improve post-discharge heart failure outcomes.

PubMed

Anagnostou, Valsamo K; Bailey, Grant; Sze, Edward; Hay, Seonaid; Hyson, Anne; Federman, Daniel G

2014-01-01

Practice-based learning and improvement is one of the Accreditation Council of Graduate Medical Education's core competencies fortrainees. Residencyprograms have grappled with how to accomplish this goal. We describe our institution's unique, longitudinal post-graduate year process and project. West Haven, VA Medical Center. Yale University School of Medicine junior residents on ambulatory electives and faculty preceptor. Longitudinal program aimed to decrease re-admissions for hospitalized patients with congestive heart failure. We feel that our longitudinal project is a novel innovation worthy of further study.

Hubble Space Telescope Astrometry of the Procyon System

DTIC Science & Technology

2015-11-10

Department of Astronomy & Astrophysics, Pennsylvania State University, University Park, PA 16802, USA; heb11@psu.edu 2 Space Telescope Science...Institute, 3700 San Martin Dr., Baltimore, MD 21218, USA 3 Center for Exoplanets and Habitable Worlds, Department of Astronomy & Astrophysics, Pennsylvania...Department of Astronomy , Yale University, Box 208101, New Haven, CT 06520, USA 6 Lunar & Planetary Laboratory, University of Arizona, 1541 E

Low Temperature Physics at Yale in the late 30's through the early 50's

NASA Astrophysics Data System (ADS)

Wheeler, Robert

2006-03-01

The low temperature program at Yale was initiated by C. T. Lane (1904-1991) in the fall of 1937 when he was appointed to the teaching staff as an instructor in the department of Physics. Following his doctorate from McGill in 1929 he investigated the magnetic susceptibilities of ``soft'' metals supported by the National Research Council of Canada, the Commissioners of the 1851 Exhibition and a Sterling Fellowship at Yale. Arranged by Louis McKeehan, with 5000 from the new George Sheffield research fund, he started the construction of a Kapitza type helium liquefier. The machine was largely completed in the fall of 1939, yet liquid helium was not made until early December 1940 due to the need for extensive on line purification of the gas. Returning in 1945 from war research, Lane and Henry A. Fairbank (Ph.D 1944) continued the metals work along with new thrusts into Second Sound , properties of helium^ three impurities in liquid helium and starting in the 50's on rotating He II. In 1933 both Lane and Onsager were awarded Sterling Fellowships, which initiated a stimulating experimental- theoretical exchange continuing until they both retired. The best-known example was the rediscovery at Yale of the deHaas-van Alphen effect, previously observed only in bismuth, in zinc; where upon Onsager and his students provided new insights into our understanding of the Fermi surface of metals. With the development of new instrumentation one observed vast changes in experimental style during this period. The evolution of the production of liquid helium from Lane's device though the Collins machine to the commodity business of today now makes experiments of huge size and importance possible.

The Yale Peabody Museum Mineral Collection: Past, Present, and Future

NASA Astrophysics Data System (ADS)

Nicolescu, S.; Ague, J.

2012-12-01

The beginnings of what became the Yale Peabody Museum (YPM) mineral collection are intimately associated with the emergence of science teaching and scientific research in the US. In 1802 Yale College graduate Benjamin Silliman was offered the first Yale "Chymistry" and Natural History professorship. In order to fulfill his academic duties he needed a mineral collection, but in 1802 only a few specimens were available to him. Through his determined efforts and with the critical support of two Yale College presidents, by 1825 Yale was in possession of what was arguably the best mineral collection in the US. The quality of the scientific education pioneered by Silliman attracted many bright students, including future pillars of 19th century science J. D. Dana, O. C. Marsh and G. J. Brush. Silliman was also the founder of an illustrious mineralogical "dynasty", members of which, starting with his son-in-law J. D. Dana and continuing with son, B. Silliman, Jr. and grandson E. S. Dana, contributed in seminal ways to the development of mineralogy. Having access to specimens collected by the Sillimans, or the many ones described in successive editions of Dana's System of Mineralogy, is a rare privilege. The YPM was founded in 1866 and the mineral collection started by Silliman became part of it. The collection has now grown to some 40,000 specimens, at least 38 of which are type minerals (roughly one percent of all presently known mineral species). Any collection is a valuable asset only if it is "alive" through use and development; hence, further enhancing the holdings of the YPM mineral collection is a continuing effort. Preservation of historic and scientifically relevant specimens is only one of many purposes served by the collection. An important intellectual value resides in the fact that many specimens are from localities lost to anthropogenic activities. The REE and U-Th bearing pegmatites at Barringer Hill, TX are such an example. Barringer Hill has been under the

Cost-effective advertising through TV and newspaper "banner" ads.

PubMed

Gombeski, William R; Taylor, Jan; Krauss, Katie; Medeiros, Clayton

2003-01-01

Banner ads, small strip ads in newspapers used to specifically promote an information piece, were introduced into one newspaper in the Connecticut market in 1999 by Yale-New Haven Hospital (YNHH). Based on their success, the concept was expanded to six additional newspapers in late 2000 and to TV in the summer of 2001. Between 2000-2002, even as the overall marketing/advertising budget declined 30%, switching advertising dollars from image/display ads to banner ads resulted in consumer awareness of YNHH increasing from 29% to 42%. Perception of YNHH as "the advanced medicine" hospital grew from 22% to 40% during the same period. The specific strategic and operational actions generated since the implementation of the program are detailed and the advantages and disadvantages of this banner advertising approach are discussed. Banner ads may offer an alternative approach for organizations to advertise their products and programs.

Data Safe Havens in health research and healthcare.

PubMed

Burton, Paul R; Murtagh, Madeleine J; Boyd, Andy; Williams, James B; Dove, Edward S; Wallace, Susan E; Tassé, Anne-Marie; Little, Julian; Chisholm, Rex L; Gaye, Amadou; Hveem, Kristian; Brookes, Anthony J; Goodwin, Pat; Fistein, Jon; Bobrow, Martin; Knoppers, Bartha M

2015-10-15

The data that put the 'evidence' into 'evidence-based medicine' are central to developments in public health, primary and hospital care. A fundamental challenge is to site such data in repositories that can easily be accessed under appropriate technical and governance controls which are effectively audited and are viewed as trustworthy by diverse stakeholders. This demands socio-technical solutions that may easily become enmeshed in protracted debate and controversy as they encounter the norms, values, expectations and concerns of diverse stakeholders. In this context, the development of what are called 'Data Safe Havens' has been crucial. Unfortunately, the origins and evolution of the term have led to a range of different definitions being assumed by different groups. There is, however, an intuitively meaningful interpretation that is often assumed by those who have not previously encountered the term: a repository in which useful but potentially sensitive data may be kept securely under governance and informatics systems that are fit-for-purpose and appropriately tailored to the nature of the data being maintained, and may be accessed and utilized by legitimate users undertaking work and research contributing to biomedicine, health and/or to ongoing development of healthcare systems. This review explores a fundamental question: 'what are the specific criteria that ought reasonably to be met by a data repository if it is to be seen as consistent with this interpretation and viewed as worthy of being accorded the status of 'Data Safe Haven' by key stakeholders'? We propose 12 such criteria. paul.burton@bristol.ac.uk. © The Author 2015. Published by Oxford University Press.

Intelligence and Law Enforcement: Countering Transnational Threats to the U.S.

DTIC Science & Technology

2001-12-03

K. Johnson, America’s Secret Power: the CIA in a Democratic Society (New York: Oxford University Press , 1989), pp. 133-203. 26 The history of the...gathering on civilians by the military is found in Joan M. Jensen, Army Surveillance in America, 1775-1980 (New Haven: Yale University Press , 1991). 27...103rd Congress, 1st session, Select Committee on Intelligence, The Intelligence Community’s Involvement in the Banca Nazionale del Lavoro (BNL

An interdepartmental Ph.D. program in computational biology and bioinformatics: the Yale perspective.

PubMed

Gerstein, Mark; Greenbaum, Dov; Cheung, Kei; Miller, Perry L

2007-02-01

Computational biology and bioinformatics (CBB), the terms often used interchangeably, represent a rapidly evolving biological discipline. With the clear potential for discovery and innovation, and the need to deal with the deluge of biological data, many academic institutions are committing significant resources to develop CBB research and training programs. Yale formally established an interdepartmental Ph.D. program in CBB in May 2003. This paper describes Yale's program, discussing the scope of the field, the program's goals and curriculum, as well as a number of issues that arose in implementing the program. (Further updated information is available from the program's website, www.cbb.yale.edu.)

Secrecy and Democracy: The Conflict between American Ideals and American Institutions

DTIC Science & Technology

2014-05-22

challenge to the necessity of secrecy are the ideals of transparency and publicity. Modern society, particularly in America , has conceived of...Haven CT: Yale University Press, 2011), 47-54. See also Jeffrey Rosen, The Unwanted Gaze: The Destruction of Privacy in America (New York: Vintage Books...Disappearance of Social Capital in America ,” PS: Political Science and Politics 28, no. 4 (December 1995): 664-683. 36

The On-Line Audit Revisited: Yale University.

ERIC Educational Resources Information Center

Weldon, Albert R., Jr.; And Others

1984-01-01

Yale University's on-line examination of accounting and administrative systems is discussed. Program goals are to review financial management systems at the university to identify weaknesses in internal controls, and to fulfill all audit requirements of federal grants and contracts. After outlining the quarterly audit cycle, advantages of the…

33 CFR 100.903 - Harborfest Dragon Boat Race; South Haven, MI.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Harborfest Dragon Boat Race; South Haven, MI. 100.903 Section 100.903 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... Dragon Boat Race; South Haven, MI. (a) Regulated Area. A regulated area is established to include all...

33 CFR 100.903 - Harborfest Dragon Boat Race; South Haven, MI.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Harborfest Dragon Boat Race; South Haven, MI. 100.903 Section 100.903 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... Dragon Boat Race; South Haven, MI. (a) Regulated Area. A regulated area is established to include all...

33 CFR 100.903 - Harborfest Dragon Boat Race; South Haven, MI.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Harborfest Dragon Boat Race; South Haven, MI. 100.903 Section 100.903 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... Dragon Boat Race; South Haven, MI. (a) Regulated Area. A regulated area is established to include all...

33 CFR 100.903 - Harborfest Dragon Boat Race; South Haven, MI.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Harborfest Dragon Boat Race; South Haven, MI. 100.903 Section 100.903 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... Dragon Boat Race; South Haven, MI. (a) Regulated Area. A regulated area is established to include all...

33 CFR 100.903 - Harborfest Dragon Boat Race; South Haven, MI.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Harborfest Dragon Boat Race; South Haven, MI. 100.903 Section 100.903 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF... Dragon Boat Race; South Haven, MI. (a) Regulated Area. A regulated area is established on the Black River...

Diffuse large cell lymphoma presenting as a sacral mass and lupus anticoagulant.

PubMed

Ediriwickrema, Lilangi S; Zaheer, Wajih

2011-12-01

A 67-year-old gentleman presented to Yale-New Haven Hospital (YNHH) for assessment of a supratherapeutic INR and sacral lesion. Hematologic workup revealed elevated ESR, PT, INR, PTT, and CRP, mixing studies that failed to correct, and a positive Russell Viper Venom Test (RVVT), which confirmed the presence of lupus anticoagulant (LA), a subtype of antiphospholipid syndrome (APA). Pathology of the patient's sacral lesion revealed diffuse large B-cell lymphoma. This case provides insight into the association between APA and lymphoid neoplasm. The patient's unique presentation is in marked contrast to other reports of APA and lymphoid malignancy, which are typically associated with elevated PTT, normal PT, minimal extranodal disease, and potential thrombotic complications. Further, treatment with Rituximab-CHOP chemotherapy led to excellent clinical response with tumor remission and normalization of PT and PTT.

The influence of surgeon personality factors on risk tolerance: a pilot study.

PubMed

Contessa, Jack; Suarez, Luis; Kyriakides, Tassos; Nadzam, Geoffrey

2013-01-01

This study attempts to assess the association between surgeon personality factors (measured by the Myers-Briggs Type Indicator personality inventory (MBTI(®))) and risk tolerance (measured by the Revised Physicians' Reactions to Uncertainty (PRU) and Physician Risk Attitude (PRA) scales). Instrument assessing surgeon personality profile (MBTI) and 2 questionnaires measuring surgeon risk tolerance and risk aversion (PRU and PRA). Saint Raphael campus of Yale New Haven Hospital in New Haven, Connecticut. Twenty categorical surgery residents and 7 surgical core faculty members. The following findings suggest there might be a relationship between surgeon personality factors and risk tolerance. In certain areas of risk assessment, it appears that surgeons with personality factors E (Extravert), T (Thinking), and P (Perception) demonstrated higher tolerance for risk. Conversely, as MBTI(®) dichotomies are complementary, surgeons with personality factors I (Introvert), F (Feeling), and J (Judgment) suggest risk aversion on these same measures. These findings are supported by at least 2 studies outside medicine demonstrating that personality factors E, N, T, and P are associated with risk taking. This preliminary research project represents an initial step in exploring what may be considered a fundamental component in a "successful" surgical personality. © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Promoting convergence: The integrated graduate program in physical and engineering biology at Yale University, a new model for graduate education

PubMed Central

Noble, Dorottya B.; Mochrie, Simon G. J.; O'Hern, Corey S.; Pollard, Thomas D.

2016-01-01

Abstract In 2008, we established the Integrated Graduate Program in Physical and Engineering Biology (IGPPEB) at Yale University. Our goal was to create a comprehensive graduate program to train a new generation of scientists who possess a sophisticated understanding of biology and who are capable of applying physical and quantitative methodologies to solve biological problems. Here we describe the framework of the training program, report on its effectiveness, and also share the insights we gained during its development and implementation. The program features co‐teaching by faculty with complementary specializations, student peer learning, and novel hands‐on courses that facilitate the seamless blending of interdisciplinary research and teaching. It also incorporates enrichment activities to improve communication skills, engage students in science outreach, and foster a cohesive program cohort, all of which promote the development of transferable skills applicable in a variety of careers. The curriculum of the graduate program is integrated with the curricular requirements of several Ph.D.‐granting home programs in the physical, engineering, and biological sciences. Moreover, the wide‐ranging recruiting activities of the IGPPEB serve to enhance the quality and diversity of students entering graduate school at Yale. We also discuss some of the challenges we encountered in establishing and optimizing the program, and describe the institution‐level changes that were catalyzed by the introduction of the new graduate program. The goal of this article is to serve as both an inspiration and as a practical “how to” manual for those who seek to establish similar programs at their own institutions. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(6):537–549, 2016. PMID:27292366

Teaching Students to Teach: A Case Study from the Yale University Art Gallery

ERIC Educational Resources Information Center

Manekin, Elizabeth; Williams, Elizabeth

2015-01-01

The way the Yale University Art Gallery engages students and the adult public has shifted profoundly over time, a change reflected in the evolution of the museum's signature Gallery Guide program. Founded in 1998 as an organic, experimental way to better engage Yale students to give lecture-based tours, it is now a structured, well-articulated…

Innovating in health care management education: development of an accelerated MBA and MPH degree program at Yale.

PubMed

Pettigrew, Melinda M; Forman, Howard P; Pistell, Anne F; Nembhard, Ingrid M

2015-03-01

Increasingly, there is recognition of the need for individuals with expertise in both management and public health to help health care organizations deliver high-quality and cost-effective care. The Yale School of Public Health and Yale School of Management began offering an accelerated Master of Business Administration (MBA) and Master of Public Health (MPH) joint degree program in the summer of 2014. This new program enables students to earn MBA and MPH degrees simultaneously from 2 fully accredited schools in 22 months. Students will graduate with the knowledge and skills needed to become innovative leaders of health care organizations. We discuss the rationale for the program, the developmental process, the curriculum, benefits of the program, and potential challenges.

What Price Sovereignty? The Two Faces of Engagement and the Paradox of Power: A Comparison of the Security and Grand Strategies of the United States and the European Union

DTIC Science & Technology

2012-01-01

Europe. 14 Culture and politics do not change independently. 55 During the post–war occupation of Germany, according to Petra Goedde, the power...15-335. 55 Petra Goedde, GIs and Germans: Culture, Gender, and Foreign Relations, 1945-1949 (New Haven: Yale University Press, 2003), xvii. 56...espousing this view is John Kornblum to Martin Hillenbrand, March 11, 1975, in Martin Hillenbrand Papers, 1975 (Athens: Richard B. Russell Library

Intelligence and Law Enforcement: Countering Transnational Threats to the U.S.

DTIC Science & Technology

2001-12-03

University Press , 1989), pp. 133-203. 26 The history of the much-criticized domestic intelligence gathering is described in U.S. (continued...America, 1775-1980 (New Haven: Yale University Press , 1991). 27 U.S. Congress, 104th Congress, House of Representatives, Permanent Select Committee on...Involvement in the Banca Nazionale del Lavoro (BNL) Affair, Report, S. Prt. 103-12, February 1993, pp. 25-33; also, U.S. Congress, Senate, 102nd

111. Shaws Cove Bridge. New London, New London Co., CT. ...

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

111. Shaws Cove Bridge. New London, New London Co., CT. Sec. 4209, MP 122.65. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

110. Shaws Cove Bridge. New London, New London Co., CT. ...

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

110. Shaws Cove Bridge. New London, New London Co., CT. Sec. 4209, MP 122.65. - Northeast Railroad Corridor, Amtrak Route between New York/Connecticut & Connecticut/Rhode Island State Lines, New Haven, New Haven County, CT

Test-retest reliability of Yale Physical Activity Survey among older Mexican American adults: a pilot investigation.

PubMed

Pennathur, Arunkumar; Magham, Rohini; Contreras, Luis Rene; Dowling, Winifred

2004-01-01

The objective of the work reported in this paper is to assess test-retest reliability of Yale Physical Activity Survey Total Time, Estimated Energy Expenditure, Activity Dimension Indices, and Activities Check-list in older Mexican American men and women. A convenience-based healthy sample of 49 (42 women and 7 men) older Mexican American adults recruited from senior recreation centers aged 68 to 80 years volunteered to participate in this pilot study. Forty-nine older Mexican American adults filled out the Yale Physical Activity Survey for this study. Fifteen (12 women and 3 men) of the 49 volunteers responded twice to the Yale Physical Activity Survey after a 2-week period, and helped assess the test-retest reliability of the Yale Physical Activity Survey. Results indicate that based on a 2-week test-retest administration, the Yale Physical Activity Survey was found to have moderate (rhoI= .424, p < .05) to good reliability (rs = .789, p < .01) for physical activity assessment in older Mexican American adults who responded.

Innovating in Health Care Management Education: Development of an Accelerated MBA and MPH Degree Program at Yale

PubMed Central

Forman, Howard P.; Pistell, Anne F.; Nembhard, Ingrid M.

2015-01-01

Increasingly, there is recognition of the need for individuals with expertise in both management and public health to help health care organizations deliver high-quality and cost-effective care. The Yale School of Public Health and Yale School of Management began offering an accelerated Master of Business Administration (MBA) and Master of Public Health (MPH) joint degree program in the summer of 2014. This new program enables students to earn MBA and MPH degrees simultaneously from 2 fully accredited schools in 22 months. Students will graduate with the knowledge and skills needed to become innovative leaders of health care organizations. We discuss the rationale for the program, the developmental process, the curriculum, benefits of the program, and potential challenges. PMID:25706023

Promoting convergence: The integrated graduate program in physical and engineering biology at Yale University, a new model for graduate education.

PubMed

Noble, Dorottya B; Mochrie, Simon G J; O'Hern, Corey S; Pollard, Thomas D; Regan, Lynne

2016-11-12

In 2008, we established the Integrated Graduate Program in Physical and Engineering Biology (IGPPEB) at Yale University. Our goal was to create a comprehensive graduate program to train a new generation of scientists who possess a sophisticated understanding of biology and who are capable of applying physical and quantitative methodologies to solve biological problems. Here we describe the framework of the training program, report on its effectiveness, and also share the insights we gained during its development and implementation. The program features co-teaching by faculty with complementary specializations, student peer learning, and novel hands-on courses that facilitate the seamless blending of interdisciplinary research and teaching. It also incorporates enrichment activities to improve communication skills, engage students in science outreach, and foster a cohesive program cohort, all of which promote the development of transferable skills applicable in a variety of careers. The curriculum of the graduate program is integrated with the curricular requirements of several Ph.D.-granting home programs in the physical, engineering, and biological sciences. Moreover, the wide-ranging recruiting activities of the IGPPEB serve to enhance the quality and diversity of students entering graduate school at Yale. We also discuss some of the challenges we encountered in establishing and optimizing the program, and describe the institution-level changes that were catalyzed by the introduction of the new graduate program. The goal of this article is to serve as both an inspiration and as a practical "how to" manual for those who seek to establish similar programs at their own institutions. © 2016 by The International Union of Biochemistry and Molecular Biology, 44(6):537-549, 2016. © 2016 The Authors Biochemistry and Molecular Biology Education published by Wiley Periodicals, Inc. on behalf of International Union of Biochemistry and Molecular Biology.

The Language of the Liberal Consensus: John F. Kennedy, Technical Reason, and the "New Economics" at Yale University

ERIC Educational Resources Information Center

Murphy, John W.

2004-01-01

On June 11, 1962, President John F. Kennedy addressed the economy at Yale University. This essay explains the symbolic charge of his economic rhetoric, a persuasive campaign that enjoyed considerable success and marked the first time that a president took explicit responsibility for the nation's economic performance. I argue that the president…

Safe-haven locking device

DOEpatents

Williams, J.V.

1984-04-26

Disclosed is a locking device for eliminating external control of a secured space formed by fixed and movable barriers. The locking device uses externally and internally controlled locksets and a movable strike, operable from the secured side of the movable barrier, to selectively engage either lockset. A disengagement device, for preventing forces from being applied to the lock bolts is also disclosed. In this manner, a secured space can be controlled from the secured side as a safe-haven. 4 figures.

Yale University Library HEA-Title II-C Grant.

ERIC Educational Resources Information Center

Marshman, Donald

This report describes the problems which prompted the Yale University Library to request Higher Education Act (HEA) grants from the federal government, and recounts the accomplishments achieved through the receipt of those grants. HEA funds were given to the Manuscripts and Archives department for the preservation and resurveying of historical…

Diffuse Large Cell Lymphoma Presenting as a Sacral Mass and Lupus Anticoagulant

PubMed Central

Ediriwickrema, Lilangi S.; Zaheer, Wajih

2011-01-01

A 67-year-old gentleman presented to Yale-New Haven Hospital (YNHH) for assessment of a supratherapeutic INR and sacral lesion. Hematologic workup revealed elevated ESR, PT, INR, PTT, and CRP, mixing studies that failed to correct, and a positive Russell Viper Venom Test (RVVT), which confirmed the presence of lupus anticoagulant (LA), a subtype of antiphospholipid syndrome (APA). Pathology of the patient’s sacral lesion revealed diffuse large B-cell lymphoma. This case provides insight into the association between APA and lymphoid neoplasm. The patient’s unique presentation is in marked contrast to other reports of APA and lymphoid malignancy, which are typically associated with elevated PTT, normal PT, minimal extranodal disease, and potential thrombotic complications. Further, treatment with Rituximab-CHOP chemotherapy led to excellent clinical response with tumor remission and normalization of PT and PTT. PMID:22180680

Rethinking Third-Party Intervention into Insurgencies: The Logic of Commitment

DTIC Science & Technology

2010-04-14

Isaiah Wilson III, “Rage Against the Machines: Explaining Outcomes in Counterinsurgency Wars,” International Organization 63, no. 1 (2009): 67-106 and...a chosen goal and it drives people to act consistently because it would be morally wrong, practically inexpedient, or both to do otherwise.49 Thomas ...prospects for future activity by the intervener. 50 Thomas C. Schelling, Arms and Influence (New Haven, CT: Yale University Press, 2009), 49. 51 Ibid., 65-6

Women's Heart Advantage Program: the impact 3 years later.

PubMed

Gombeski, William R; Kramer, R Kyle; Freed, Lisa; Foody, JoAnne; Parkosewich, Janet; Wilson, Tammi; Wack, Jeffery T; D'Onofrio, Gail

2005-01-01

Yale-New Haven Hospital, in partnership with Voluntary Hospital Association (VHA Inc), launched the Women's Heart Advantage program in March 2001. Major program components implemented include (1) a comprehensive initial and ongoing internal communication program; (2) a health promotion initiative including a 24-hour, 7-days-a-week women's heart line staffed by nurses and an Internet health question-and-answer forum; (3) significant ongoing communication with nurses and physicians; (4) a community outreach effort to educate poor and minority women; and (5) an aggressive effort to secure financial partners to underwrite the cost of the program. Before launching the program, a telephone survey of 300 randomly selected New Haven County women ages 40 to 70 years was initiated in January 2001 and repeated in January 2002, 2003, and 2004. Findings include (1) the percentage of women who recognize heart disease as the number-one killer of women their age increased from 26% in 2001 to 59% in 2004, (2) the percentage of women who would call 9-1-1 or go directly to a hospital emergency department increased from 63% in 2002 to 83% in 2004, and (3) the percentage of women aware of recent Women's Heart Advantage program promotion grew from 33% in 2002 to 50% in 2004. Perhaps most importantly, the number of women with heart problems admitted through the hospital's emergency department increased from 1528 per year in 2001 to 1870 per year in 2004 (7.5% annual increase), whereas the number of men with heart problems admitted through the emergency department during the same time period has been relatively low (0.8% annual increase). By linking clinical, public health, and marketing expertise along with finding ways to partner with other organizations, the Women's Heart Advantage program has contributed to remarkable changes in women's awareness, knowledge, and behaviors, suggesting a model for approaching similar health-related problems.

C.-E.A. Winslow and the later years of public health at Yale, 1940-1945.

PubMed Central

Viseltear, A. J.

1987-01-01

This paper is one of a series of papers in which I consider contemporary Yale medical education in general and the Yale Department of Epidemiology and Public Health in particular. It tells of the retirement in 1945 of C.-E.A. Winslow, Professor and Chairman of the Yale Department of Public Health since its inception in 1915; of the committees established by the dean of the School of Medicine and the president of the University, charged with determining the future direction of the department; and of the outcome, which, in 1945, proved favorable to Winslow's public health philosophy in contrast to the medical school's clinical needs and desires. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 PMID:3321724

A century of pathology at Yale: personal reflections.

PubMed Central

Yesner, R.

1998-01-01

This history is largely about the players on the stage of the Yale Pathology Department acting out their roles as observed by the author in over a half century as a member of the department and as associate dean of the medical school. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 PMID:10527367

Havens: Explicit Reliable Memory Regions for HPC Applications

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

Hukerikar, Saurabh; Engelmann, Christian

2016-01-01

Supporting error resilience in future exascale-class supercomputing systems is a critical challenge. Due to transistor scaling trends and increasing memory density, scientific simulations are expected to experience more interruptions caused by transient errors in the system memory. Existing hardware-based detection and recovery techniques will be inadequate to manage the presence of high memory fault rates. In this paper we propose a partial memory protection scheme based on region-based memory management. We define the concept of regions called havens that provide fault protection for program objects. We provide reliability for the regions through a software-based parity protection mechanism. Our approach enablesmore » critical program objects to be placed in these havens. The fault coverage provided by our approach is application agnostic, unlike algorithm-based fault tolerance techniques.« less

Equilibria of a Two-Person Non-Zerosum Noisy Game of Timing,

DTIC Science & Technology

1981-01-01

AD-A097 158 YALE UNIV NEW HAVEN CT COWLES FOUNDATION FOR RESEARC -ETC F/B 12/1 EQUILIBRIA OF A TWO-PERSON ON-ZEROSUN OISY GAME OF TIMING, CUb .JAN al...pubUo zeleale Distribution Unlimited. 1. Introduction Two toothpaste manufacturers are competing for a larger share of the dentifrice market . Each is...successfully capturing a share of the market , if its product hits the stores first. (This is assuming that the toothpaste is being technologically

Acquiring Expertise.

DTIC Science & Technology

1983-01-31

LaBerge and Samuels, 1974): The reading process is too complex to operate completely at the declarative processing level. It can only work well when...1978, 85, 363-394. 44 The Acquisition of Expertise Lesgold Laberge , P. , & Samuels, S. J. Toward a theory of automatic information k - processing in...Menlo Park, CA 94025 Box 11A. Yale Station * New Haven, CT 06520 1 William B. Whitten Bell Laboratories 1 Dr. Albert Stevens 2D-610 Bolt Beranek

Pathogenesis of Dengue Vaccine Viruses in Mosquitoes.

DTIC Science & Technology

1980-01-01

1973). Sabin (1948) showed that attenuated dpngiie, passed through mosquitoes, did not revert to pathogenicity frnr man. -7- Thus even if the vaccine ...AD-A138 518 PATHOGENESIS OF DENGUE VACCINE YIRUSES IN MOSQUITOES 1/ (U) YALE UNIV NEW HAVEN CONN SCHOOL OF MEDICINE B J BEATY ET AL. 9i JAN 80 DRND7...34 ’ UNCLASSIFIED 0{) AD 0Pathogenesis of dengue vaccine viruses in mosquitoes -First Annual Report Barry I. Beaty, Ph.D. Thomas H. G

A US Strategy for Iran (Walker Paper, Number 11)

DTIC Science & Technology

2008-04-01

fpc .state.gov/documents/organization/23591. pdf . Keddie, Nikkie R. Modern Iran. New Haven, CT: Yale University Press, 2006. King , Neil, Jr., and Greg...for Iran. Note . Neil King Jr. and Greg Jaffe, “If Iraq Worsens, Allies See ‘Nightmare’ Case,” Wall Street Journal, 9 January 2007. Chapter 2...Iran’s Perceptions and Patterns—Historic Roots I am Darius the Great King , King of Kings , King of coun- tries containing all kinds of men, King in this

Before Mina Shaughnessy: Basic Writing at Yale, 1920-1960

ERIC Educational Resources Information Center

Ritter, Kelly

2008-01-01

This article examines Yale's "Awkward Squad" of "basic" writers between 1920 and 1960. Using archival materials that illustrate the socioeconomic conditions of this early, "pre-Shaughnessy" site of remedial writing instruction, I argue for a re-definition of "basic" in composition studies using local, institutional values rather than generic…

The Academy on the Firing Line: William F. Buckley, Jr.'s "God and Man at Yale" and the Modern Conservative Critique of Higher Education

ERIC Educational Resources Information Center

Laukaitis, John J.

2013-01-01

In 1951, William F. Buckley, Jr. was a recent alumnus of Yale University and former editor of the "Yale Daily News" when his first major work, "God and Man at Yale: The Superstitions of 'Academic Freedom'," became a controversial polemic that attracted national attention. In his work, Buckley claimed Yale's faculty advanced…

Toward a Revolution in Intelligence Affairs

DTIC Science & Technology

2005-01-01

hard because people overestimate the value of what they have⎯and underestimate the value of what they may gain by giving that up." James Belasco and...Best Truths : Intelligence in the Information Age, New Haven: Yale University Press, 2000, p. 44. 19 collection operations, and analytical methodologies...to CIA DDO James Pavitt, “We have more reporting on the really hard targets than I can remember at any time in my nearly 30 years of agency service.”7

Developing an Instrument for Measuring the Attitudes of Hispanics in the Navy: A Pilot Study.

DTIC Science & Technology

1980-11-01

C _ 085 UNCLASS7IF~ r EO -A NL. Uncassified 4...1945. 1 b ,13 I4 T-Y (0 ~ H .~ 4) ’A I _________________ .9’I:1 * r - V. ii ’a 𔃾- 0I EU .~ "-I I-. T-V Q) c b.0o 4s. > t!3 EU ~ 01 HI 4~) ~ C ) a, VIJ...CONTRACTORS Dr. Clayton P. Alderfer School of Organization and Management Yale University New Haven, CT 06520 Dr. R . Russell Bernard Department

Turkish - American Relations Post 9/11

DTIC Science & Technology

2007-12-01

Döneminde Türk-Amerikan İlişkileri,” Atatürk Araştirma Merkezi Dergisi 38 (1997): 1. 15 Yavuz Güler, “The Relationship between Turkey and USA in the...New Haven, Yale University, December 2000, pp. 315- 17. 16 Ibid, p. 237. 17 Mustafa Kayar, Turk Amerikan Iliskilerinde Irak Sorunu (Istanbul: IQ...Kultur Sanat Yayincilik, 2003), 106. 8 General Harbord visited Mustafa Kemal Ataturk in Sivas in 1919 to fulfill the requirements for conducting a

Peru v. Yale: A Battle Rages over Machu Picchu

ERIC Educational Resources Information Center

Glenn, David

2009-01-01

In early 1916, the legendary Yale University archaeologist Hiram Bingham III completed his third and final expedition in southern Peru. He shipped home 74 boxes of artifacts from Machu Picchu, a spectacular site in the Andes that is believed to have been the last major settlement of the Inca empire. Those boxes were supposed to be on temporary…

Reliability and Validity of the Yale Global Tic Severity Scale

ERIC Educational Resources Information Center

Storch, Eric A.; Murphy, Tanya K.; Geffken, Gary R.; Sajid, Muhammad; Allen, Pam; Roberti, Jonathan W.; Goodman, Wayne K.

2005-01-01

To investigate the reliability and validity of the Yale Global Tic Severity Scale (YGTSS), 28 youth aged 6 to 17 years with Tourette's syndrome (TS) participated in the study. Data included clinician reports of tics and obsessive-compulsive disorder (OCD) severity, parent reports of tics, internalizing and externalizing problems, and child reports…

214. RUSTIC BUS SHELTER, GUARDRAILS AND LAMP POST BELLE HAVEN ...

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

214. RUSTIC BUS SHELTER, GUARDRAILS AND LAMP POST BELLE HAVEN BUS STOP WIDENING, 1932. - George Washington Memorial Parkway, Along Potomac River from McLean to Mount Vernon, VA, Mount Vernon, Fairfax County, VA

The BMC ACCESS project: the development of a medically enhanced safe haven shelter.

PubMed

Lincoln, Alisa; Johnson, Peggy; Espejo, Dennis; Plachta-Elliott, Sara; Lester, Peggy; Shanahan, Christopher; Abbott, Susan; Cabral, Howard; Jamanka, Amber; Delman, Jonathan; Kenny, Patty

2009-10-01

This paper describes the development and implementation of the Boston Medical Center (BMC) Advanced Clinical Capacity for Engagement, Safety, and Services Project. In October 2002, the BMC Division of Psychiatry became the first such entity to open a Safe Haven shelter for people who are chronically homeless, struggling with severe mental illness, and actively substance abusing. The low-demand Safe Haven model targets the most difficult to reach population and serves as a "portal of entry" to the mental health and addiction service systems. In this paper, the process by which this blended funded, multi-level collaboration, consisting of a medical center, state, city, local, and community-based consumer organizations, was created and is maintained, as well as the clinical model of care is described. Lessons learned from creating the Safe Haven Shelter and the development and implementation of the consumer-informed evaluation are discussed as well as implications for future work with this population.

The Yale Kamusi Project: A Swahili-English, English-Swahili Dictionary.

ERIC Educational Resources Information Center

Hinnebusch, Thomas

2001-01-01

Evaluates the strengths and weaknesses of the Yale Online Kamusi project, an electronic Web-based Swahili-English and English-Swahili dictionary. The dictionary is described and checked for comprehensiveness, the adequacy and quality of the glosses and definitions are tested, and a number of recommendations are made to help make it a better and…

Research at Yale in Natural Language Processing. Research Report #84.

ERIC Educational Resources Information Center

Schank, Roger C.

This report summarizes the capabilities of five computer programs at Yale that do automatic natural language processing as of the end of 1976. For each program an introduction to its overall intent is given, followed by the input/output, a short discussion of the research underlying the program, and a prognosis for future development. The programs…

Neutron spectral measurements in an intense photon field associated with a high-energy x-ray radiotherapy machine.

PubMed

Holeman, G R; Price, K W; Friedman, L F; Nath, R

1977-01-01

High-energy x-ray radiotherapy machines in the supermegavoltage region generate complex neutron energy spectra which make an exact evaluation of neutron shielding difficult. Fast neutrons resulting from photonuclear reactions in the x-ray target and collimators undergo successive collisions in the surrounding materials and are moderated by varying amounts. In order to examine the neutron radiation exposures quantitatively, the neutron energy spectra have been measured inside and outside the treatment room of a Sagittaire medical linear accelerator (25-MV x rays) located at Yale-New Haven Hospital. The measurements were made using a Bonner spectrometer consisting of 2-, 3-, 5-, 8-, 10- and 12-in.-diameter polyethylene spheres with 6Li and 7Li thermoluminescent dosimeter (TLD) chips at the centers, in addition to bare and cadmium-covered chips. The individual TLD chips were calibrated for neutron and photon response. The spectrometer was calibrated using a known PuBe spectrum Spectrometer measurements were made at Yale Electron Accelerator Laboratory and results compared with a neutron time-of-flight spectrometer and an activation technique. The agreement between the results from these independent methods is found to be good, except for the measurements in the direct photon beam. Quality factors have been inferred for the neutron fields inside and outside the treatment room. Values of the inferred quality factors fall primarily between 4 and 8, depending on location.

Coordinated Use of Mass Media for the Development and Delivery of Career Education. Final Report. [And A Study of Awareness of and Interest in the Career Education Program in the New Haven Area].

ERIC Educational Resources Information Center

Starch Inra Hooper, Inc., Mamaroneck, NY.

A pilot mass media campaign was conducted in New Haven, Connecticut, to acquaint the public with the concept of career education. For three weeks newspapers, television, and radio devoted time and space to the campaign which focused on one of the following topics each week: the need for planning in career development; career development; career…

Recognition of the Role of the Librarian: Position Classification at Yale.

ERIC Educational Resources Information Center

Siggins, Jack E.

1992-01-01

Reports on a reclassification of jobs across all levels of employment at Yale University and its impact on librarians. Describes the process used in conjunction with consultants, Hewitt Associates, and the resultant changes in career path opportunities and salaries and in market competition. Changes for librarians included salary increases,…

Student nurses experience of a "fairy garden" healing haven garden for sick children.

PubMed

van der Riet, Pamela; Jitsacorn, Chaweewan; Junlapeeya, Piyatida; Thursby, Peter

2017-12-01

The concept and philosophy of healing environments in health care is not new and there has been recent research into the experience of nurses and families experience of healing environments producing positive outcomes in relieving stress and improving quality of life. However, there is little in-depth information about student nurse's experience of healing environments in support of patients. To report on the stories of student nurses who participated in formal and informal activities in a healing haven environment called a Fairy Garden (FG) within a hospital in northern Thailand. Their beliefs about the care of sick children in an environment designed to provide educational and recreational activity during hospital care are explored. Narrative inquiry, a qualitative methodology was selected to capture the main threads of the participants' experience. Clandinin's narrative inquiry framework involving the three commonality dimensions of sociality, temporality and place were used in analysing the data. Sixty-two student nurses from a Thai College of Nursing and from an Australian university were interviewed. In this study the place of a FG has been investigated as a non-clinical environment providing sick children with exposure to nature, play activities and spaces to explore. Findings include three main threads: freedom to be a child not a sick child, engaging in care and professionalism, a moment in time of living fantasy. Student nurses in this study had a broader understanding of health care other than the biomedical model. It transformed their learning and opened their eyes to a more holistic approach to humanising care of sick children. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using the red/yellow/green discharge tool to improve the timeliness of hospital discharges.

PubMed

Mathews, Kusum S; Corso, Philip; Bacon, Sandra; Jenq, Grace Y

2014-06-01

As part of Yale-New Haven Hospital (Connecticut)'s Safe Patient Flow Initiative, the physician leadership developed the Red/Yellow/Green (RYG) Discharge Tool, an electronic medical record-based prompt to identify likelihood of patients' next-day discharge: green (very likely), yellow (possibly), and red (unlikely). The tool's purpose was to enhance communication with nursing/care coordination and trigger earlier discharge steps for patients identified as "green" or "yellow." Data on discharge assignments, discharge dates/ times, and team designation were collected for all adult medicine patients discharged in October-December 2009 (Study Period 1) and October-December 2011 (Study Period 2), between which the tool's placement changed from the sign-out note to the daily progress note. In Study Period 1, 75.9% of the patients had discharge assignments, compared with 90.8% in Period 2 (p < .001). The overall 11 A.M. discharge rate improved from 10.4% to 21.2% from 2007 to 2011. "Green" patients were more likely to be discharged before 11 A.M. than "yellow" or "red" patients (p < .001). Patients with RYG assignments discharged by 11 A.M. had a lower length of stay than those without assignments and did not have an associated increased risk of readmission. Discharge prediction accuracy worsened after the change in placement, decreasing from 75.1% to 59.1% for "green" patients (p < .001), and from 34.5% to 29.2% (p < .001) for "yellow" patients. In both periods, hospitalists were more accurate than house staff in discharge predictions, suggesting that education and/or experience may contribute to discharge assignment. The RYG Discharge Tool helped facilitate earlier discharges, but accuracy depends on placement in daily work flow and experience.

Using the Red/Yellow/Green Discharge Tool to Improve the Timeliness of Hospital Discharges

PubMed Central

Mathews, Kusum S.; Corso, Philip; Bacon, Sandra; Jenq, Grace Y.

2015-01-01

Background As part of Yale-New Haven Hospital (Connecticut)’s Safe Patient Flow Initiative, the physician leadership developed the Red/Yellow/Green (RYG) Discharge Tool, an electronic medical record–based prompt to identify likelihood of patients’ next-day discharge: green (very likely), yellow (possibly), and red (unlikely). The tool’s purpose was to enhance communication with nursing/care coordination and trigger earlier discharge steps for patients identified as “green” or “yellow”. Methods Data on discharge assignments, discharge dates/times, and team designation were collected for all adult medicine patients discharged from October – December 2009 (Study Period 1) and October – December 2011 (Study Period 2), between which the tool’s placement changed from the sign-out note to the daily progress note. Results In Study Period 1, 75.9% of the patients had discharge assignments, compared with 90.8% in Period 2 (p < .001). The overall 11 A.M. discharge rate improved from 10.4% to 21.2% from 2007 to 2011. “Green” patients were more likely to be discharged before 11 A.M. than “yellow” or “red” patients (p < .001). Patients with RYG assignments discharged by 11 A.M. had a lower length of stay than those without assignments and did not have an associated increased risk of readmission. Discharge prediction accuracy worsened after the change in placement, decreasing from 75.1% to 59.1% for “green” patients (p < .001), and from 34.5% to 29.2% (p < .001) for “yellow” patients. In both periods, hospitalists were more accurate than housestaff in discharge predictions, suggesting that education and/or experience may contribute to discharge assignment. Conclusions The RYG Discharge Tool helped facilitate earlier discharges, but accuracy depends on placement in daily work flow and experience. PMID:25016672

A Study to Determine if Ethics Committees Should be a Decision-Making and Review Mechanism for Matters Relating to No-Code Orders in the Continental United States Army Medical Department Hospitals with over One Hundred Total Operating Beds

DTIC Science & Technology

1984-08-01

their role in the hospital. The book Megatrends points out that there are six States which set the pace for national trends. One of these is California...care hospitals but two. Again, one must recall what the book Megatrends says about California and national trends. Another key according to this study...Catholic Hospitals," Ethics Committees Newsletter, Vol 1, No. 2, November 1983, p. 2. 7. R. Veatch, Death, PyiLn and the Biological Revolution, New Haven

Controversy over Student's Art Exhibit at Yale Raises Issues of Academic Freedom

ERIC Educational Resources Information Center

Wilson, Robin

2008-01-01

This article describes the controversy surrounding a Yale University art student, Aliza Shvarts, who told the campus newspaper that she had repeatedly inseminated herself artificially and then induced abortions as part of her senior thesis. The controversy has created massive reverberations throughout academe, especially in the already hotly…

Milton C. Winternitz and the Yale Institute of Human Relations: a brief chapter in the history of social medicine.

PubMed Central

Viseltear, A. J.

1984-01-01

This paper considers the antecedent events that led to the development of Yale's Institute of Human Relations, the program of interdisciplinary research and teaching established, and the principal protagonists, James Rowland Angell, President of Yale University, and Milton C. Winternitz, Dean of the School of Medicine, both of whom were committed to the concept that medicine is a social science. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 PMID:6399650

27 CFR 9.72 - Southeastern New England.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... 9.72 Section 9.72 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU... viticultural area is located in the counties of New Haven, New London, and Middlesex in Connecticut; in the... on the “Hartford” U.S.G.S. map in New Haven Harbor; (1) Then north following the Quinnipiac River to...

The Student Trainer Clinical Experience at Lock Haven State College.

ERIC Educational Resources Information Center

Tomasi, David

An integral part of the clinical experience for athletic trainers at Lock Haven State College (Pennsylvania) is training in first aid and learning to evaluate not only sport-related injuries but all injuries. Thorough knowledge is expected of athletic trainers in the areas of cardiopulmonary resuscitation, first aid, and treatment of…

Mass Digitization at Yale University Library: Exposing the Treasures in Our Stacks

ERIC Educational Resources Information Center

Weintraub, Jennifer; Wisner, Melissa

2008-01-01

In September 2007, Yale University Library (YUL) and Microsoft agreed to partner in a large-scale project to digitize 100,000 books from the YUL collections--an ambitious effort that would substantially increase the library's digitized holdings, particularly in the area of its own text collections. YUL has been digitizing materials from its…

Looking Back at Greeley Haven After Opportunity First Drive of 2012

NASA Image and Video Library

2012-05-09

NASA Mars Exploration Rover Opportunity drove about 12 feet 3.67 meters on May 8, 2012, after spending 19 weeks working on the north slope of an outcrop called Greeley Haven while solar power was too low for driving during the Martian winter.

Yale Study: African-American Women Report More Menopause Symptoms than White Women

ERIC Educational Resources Information Center

Black Issues in Higher Education, 2005

2005-01-01

A study of African-American women in menopause shows that while they experience many of the same symptoms as White women, they report more vasomotor symptoms such as dizziness and bloating, according to a study by a Yale School of Nursing researcher. The women reported symptoms common among White women in menopause--hot flashes, irregular…

“I Live by Shooting Hill” – A Qualitative Exploration of Conflict and Violence among Urban Youth in New Haven, Connecticut

PubMed Central

Shuval, Kerem; Massey, Zohar; O Caughy, Margaret; Cavanaugh, Brenda; Pillsbury, Charles A; Groce, Nora

2013-01-01

To elucidate urban youths’ perceptions of conflict and violence we conducted a qualitative study among minority urban youths in New Haven, Connecticut. We utilized the ecological framework to explore the multilevel nature of the findings, and triangulated results with a parallel quantitative study. We found risk factors for violence at multiple levels including lack of interpersonal anger management skills (individual level); parents not physically present in the household (relationship level); residence in crime and gang-ridden neighborhoods (community level); and socioeconomic inequalities between neighborhoods, as reflected by participants’ perception of the inadequacy of neighborhood resources to provide safety (societal level). Neighborhood resources were perceived as sparse, and police were not regarded as a protective factor (sometimes rather as racially discriminatory). Participants’ statements pertaining to feelings of isolation, racism, and violence without strong parental, neighborhood, and school support may impede prosocial attitudes and behaviors throughout adolescence and young adulthood. PMID:22643467

Report of a Mental Health Survey among Chinese International Students at Yale University

ERIC Educational Resources Information Center

Han, Xuesong; Han, Xuemei; Luo, Qianlai; Jacobs, Selby; Jean-Baptiste, Michel

2013-01-01

Objective: To examine the prevalence of depression and anxiety symptoms in Chinese international students, to identify factors that might be associated with these 2 symptom complexes, and to investigate their perception of mental health issues and counseling services. Participants: Chinese students ("N" = 130) at Yale University.…

Workplace violence in hospitals: safe havens no more.

PubMed

Warren, Bryan

2011-01-01

Healthcare presents many security challenges, particularly when it comes to workplace violence prevention. With a staff population that is approximately 80% female, 24-hour operations, numerous points of ingress and egress, and the high tension environment that exists in today's hospitals and urgent care centers, the stage is set for the "perfect storm" of workplace violence, the author points out. He cites statistics that healthcare workers are at a much higher risk of victimization than workers in other industries. The best strategy to prevent workplace violence in the healthcare environment, he says, is to develop a corporate culture that supports respect, open communication, employee involvement and participation and an effective training program.

Mild intraoperative hypothermia reduces free tissue transfer thrombosis.

PubMed

Liu, Yuen-Jong; Hirsch, Brandon P; Shah, Asad A; Reid, Marjorie A; Thomson, J Grant

2011-02-01

Patients undergoing free tissue transfer are particularly susceptible to hypothermia. The goal was to investigate the impact of intraoperative core body temperature on free flap thrombosis. Two hundred twelve cases of free flap reconstruction at Yale-New Haven Hospital between 1992 and 2008 were reviewed. Free flap thrombosis was defined by complete flap necrosis or direct visualization of arterial or venous thrombosis. Temperature measurements were calibrated to bladder temperatures as measured by Foley catheter sensor. Through logistic regression analysis, maximum and minimum intraoperative temperatures were determined to be statistically significant predictors of free flap thrombosis. The optimal temperature was calculated to be 36.2 °C, and maximum intraoperative temperatures between 36.0 °C and 36.4 °C showed lower thrombosis rates than super-warmed patients ( P < 0.03). Therefore, free flap patients should be mildly hypothermic at 36.0 °C to 36.4 °C, compared with normothermia at 37.5 °C, as measured in the bladder. A prospective randomized trial investigating thrombosis rates and intraoperative temperature should be undertaken. © Thieme Medical Publishers.

Yale and the Atomic Bomb Casualty Commission.

PubMed Central

Bowers, J. Z.

1983-01-01

This is a description, based largely on personal discussions, of the contributions of men from the Yale University School of Medicine to the saga of the immediate and long-term studies on the medical effects of the atomic bombs at Hiroshima and Nagasaki. They played key roles in the immediate studies of bomb effects, in the creation of long-term studies of delayed effects, and in elevating the Atomic Bomb Casualty Commission after 1955 to a position of excellence in its studies and relations with the Japanese. The accumulation of the information presented in this paper derives from research for the preparation of the history of the Atomic Bomb Casualty Commission. In 1975, the commission was passed to Japanese leadership as the Radiation Effects Research Foundation. PMID:6349145

Revisiting the environmental Kuznets curve and pollution haven hypotheses: MIKTA sample.

PubMed

Bakirtas, Ibrahim; Cetin, Mumin Atalay

2017-08-01

This study aims to examine the validity of the environmental Kuznets curve (EKC) and pollution haven hypotheses in Mexico, Indonesia, South Korea, Turkey, and Australia (MIKTA) countries from 1982 to 2011 by using a panel vector auto regressive (PVAR) model. Empirical findings imply that the EKC hypothesis is rejected by the MIKTA sample. However, PVAR estimations reveal Granger causality from income level, foreign direct investment (FDI) inward, and energy consumption to CO 2 emissions. Orthogonalized impulse-response functions are derived from PVAR estimations. According to the analysis results, the response of CO 2 emissions to a shock on FDI is positive. These results assert that FDI has a detrimental effect on environmental quality in MIKTA countries which means the pollution haven hypothesis is confirmed by the MIKTA sample. Therefore, MIKTA countries should revise their current economic growth plans to provide sustainable development and also re-organize their legal infrastructure to induce usage of renewable energy sources.

77 FR 77073 - York Haven Power Company, LLC; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

... Company, LLC; Notice of Meeting On Wednesday, January 9, 2013, Commission staff will meet with York Haven Power Company, LLC (applicant) in Washington, DC. The purpose of the meeting is to discuss the required... begin at 10 a.m. at the Federal Energy Regulatory Commission headquarters building located at 888 First...

Development and Psychometric Evaluation of the Yale-Brown Obsessive-Compulsive Scale--Second Edition

ERIC Educational Resources Information Center

Storch, Eric A.; Rasmussen, Steven A.; Price, Lawrence H.; Larson, Michael J.; Murphy, Tanya K.; Goodman, Wayne K.

2010-01-01

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; Goodman, Price, Rasmussen, Mazure, Delgado, et al., 1989) is acknowledged as the gold standard measure of obsessive-compulsive disorder (OCD) symptom severity. A number of areas where the Y-BOCS may benefit from revision have emerged in past psychometric studies of the Severity Scale and Symptom…

Motivational Interviewing to Increase Postdischarge Antibiotic Adherence in Older Adults with Pneumonia.

PubMed

Eyler, Rachel; Shvets, Kristina; Blakely, Michelle L

2016-01-01

To evaluate the impact of a pharmacist-led, motivational interviewing on antibiotic adherence following discharge in older adults with pneumonia. Inpatient medical wards in a large tertiary academic medical center. Older adults diagnosed with pneumonia were enrolled from December 1, 2013, to August 1, 2014, at Yale-New Haven Hospital. Motivational interviewing-a patient-centered method of communication-has gained recognition as a tool that can aid pharmacists in addressing negative health behaviors (e.g., medication adherence, health screenings, substance abuse during counseling sessions). However, the potential role of motivational interviewing in older adults to improve medication adherence during transitions of care is not clear. In this study, in addition to standard discharge care, older adults hospitalized with pneumonia who were randomized to the intervention group received enhanced care: pharmacist-led motivational interviewing. Evaluation of adherence to prescribed antibiotic regimens and patient satisfaction with the motivational interviewing, enhanced-care session. Ultimately, 87% of patients in the intervention group (n = 16) compared with 64% of patients in the control group (n = 14) were adherent to their antibiotic regimens. Patient satisfaction with the motivational interviewing intervention was high. Pharmacist-led motivational interviewing sessions have the potential to positively influence antibiotic adherence rates and patient satisfaction.

At Yale, an Unlikely Champion for "The Building that Won't Go Away"

ERIC Educational Resources Information Center

Biemiller, Lawrence

2008-01-01

It is most surprising that Yale University is spending $126-million to renovate and add to a 1963 Modernist building that almost everyone has hated for decades. Aside from that, the project's champion is a high-society architect whose own career refutes pretty much the whole Modernist design theology. This article talks about the renovation of…

The Anne Frank Haven: A case of an alternative educational program in an integrative Kibbutz setting

NASA Astrophysics Data System (ADS)

Ben-Peretz, Miriam; Giladi, Moshe; Dror, Yuval

1992-01-01

The essential features of the programme of the Anne Frank Haven are the complete integration of children from low SES and different cultural backgrounds with Kibbutz children; a holistic approach to education; and the involvement of the whole community in an "open" residential school. After 33 years, it is argued that the experiment has proved successful in absorbing city-born youth in the Kibbutz, enabling at-risk populations to reach significant academic achievements, and ensuring their continued participation in the dominant culture. The basic integration model consists of "layers" of concentric circles, in dynamic interaction. The innermost circle is the class, the learning community. The Kibbutz community and the foster parents form a supportive, enveloping circle, which enables students to become part of the outer community and to intervene in it. A kind of meta-environment, the inter-Kibbutz partnership and the Israeli educational system, influence the program through decision making and guidance. Some of the principles of the Haven — integration, community involvement, a year's induction for all new students, and open residential settings — could be useful for cultures and societies outside the Kibbutz. The real "secret" of success of an alternative educational program is the dedicated, motivated and highly trained staff.

Public Notice: Winkle Bus Company of West Haven, Inc., CWA-01-2016-0009

EPA Pesticide Factsheets

Notice of Proposed Assessment of Class II Clean Water Act Section 309(g)(2)(B) and 311(b)(6)(B)(ii) Administrative Penalties and Opportunity to Comment for Winkle Bus Company of West Haven, Inc., CWA-01-2016-0009

75 FR 20396 - Yale Industrial Trucks-PGH, Inc. Monroeville, PA; Notice of Negative Determination Regarding...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,634] Yale Industrial Trucks... Industrial Trucks-PGH, Inc., Monroeville, Pennsylvania, was based on the findings that: The subject firm had not shifted abroad forklift truck sales and maintenance services or imported forklift truck sales and...

The Harvard-Yale-Columbia Intensive Summer Studies Program. The Disadvantaged Student in Graduate School.

ERIC Educational Resources Information Center

Stahmer, Harold M.

The Harvard-Yale-Columbia Intensive Summer Studies Program (ISSP) was established in 1965 to prepare students from predominantly black and selected southern white colleges for graduate study in the arts and sciences, law, medicine, and related fields. In 1966, 59% and in 1967, 71% of the ISSP class went on to graduate school. The original plan…

Report of the Yale Conference on the Teaching of English (15th, New Haven, April 11-12, 1969).

ERIC Educational Resources Information Center

Yale Univ., New Haven, CT. Graduate School.

The speeches in this collection on English instruction are by (1) Walker Gibson, who discusses the teaching of responsibility to the young by making them responsible for clear writing; (2) Hart D. Leavitt, who describes the ways in which many possible subjects for composition can be seen in the collection of pictures, "Stop, Look, and Write"; (3)…

Four Children and Yale: The Making of a Human Geneticist

PubMed Central

Rosenberg, Leon E.

2014-01-01

Dr. Leon E. Rosenberg delivered the following presentation as the Grover Powers Lecturer on May 14, 2014, which served as the focal point of his return to his “adult home” as a Visiting Professor in the Department of Pediatrics. Grover F. Powers, MD, was one of the most influential figures in American Pediatrics and certainly the leader who created the modern Department of Pediatrics at Yale when he was recruited in 1921 from Johns Hopkins and then served as its second chairman from 1927 to 1951. Dr. Powers was an astute clinician and compassionate physician and fostered and shaped the careers of countless professors, chairs, and outstanding pediatricians throughout the country. This lectureship has continued yearly since it first honored Dr. Powers in 1956. The selection of Dr. Rosenberg for this honor recognizes his seminal role at Yale and throughout the world in the fostering and cultivating of the field of human genetics. Dr. Rosenberg served as the inaugural Chief of a joint Division of Medical Genetics in the Departments of Pediatrics and Internal Medicine; he became Chair when this attained Departmental status. Then he served as Dean of the Medical School from 1984 to 1991, before he became President of the Pharmaceutical Research Institute at Bristol-Myers Squibb and later Senior Molecular Biologist and Professor at Princeton University, until his recent retirement. Dr. Rosenberg has received numerous honors that include the Borden Award from the American Academy of Pediatrics, the McKusick Leadership Award from the American Society for Human Genetics, and election to the Institute of Medicine and the National Academy of Sciences. PMID:25191153

Course Outlines in Business of the Rumson-Fair Haven Senior Elective Program.

ERIC Educational Resources Information Center

1976

The Rumson-Fair Haven Senior Elective Program was developed and implemented by students, faculty, and administrators over the three-year period from 1971 to 1974. The program offers high school students who complete graduation requirements in the first three years of the four-year program a combination of the following options for the senior year:…

Course Outlines in Science of the Rumson-Fair Haven Senior Elective Program.

ERIC Educational Resources Information Center

1976

The Rumson-Fair Haven Senior Elective Program was developed and implemented by students, faculty, and administrators over the three-year period from 1971 to 1974. The program offers high school students who complete graduation requirements in the first three years of the four-year program a combination of the following options for the senior year:…

Level II scour analysis for Bridge 46 (LINCTH00060046) on Town Highway 6, crossing the New Haven River, Lincoln, Vermont

USGS Publications Warehouse

Wild, Emily C.

1998-01-01

This report provides the results of a detailed Level II analysis of scour potential at structure LINCTH00060046 on Town Highway 6 crossing the New Haven River, Lincoln, Vermont (figures 1–8). A Level II study is a basic engineering analysis of the site, including a quantitative analysis of stream stability and scour (FHWA, 1993). Results of a Level I scour investigation also are included in appendix E of this report. A Level I investigation provides a qualitative geomorphic characterization of the study site. Information on the bridge, gleaned from Vermont Agency of Transportation (VTAOT) files, was compiled prior to conducting Level I and Level II analyses and is found in appendix D. The site is in the Green Mountain section of the New England physiographic province in west-central Vermont. The 45.9-mi2 drainage area is in a predominantly suburban and forested basin. In the vicinity of the study site, the surface cover is forest upstream of the bridge. The downstream right overbank near the bridge is suburban with buildings, homes, lawns, and pavement (less than fifty percent). The downstream left overbank is brushland while the immediate banks have dense woody vegetation. In the study area, the New Haven River has an incised, sinuous channel with a slope of approximately 0.01 ft/ft, an average channel top width of 95 ft and an average bank height of 7 ft. The channel bed material ranges from sand to bedrock with a median grain size (D50) of 120.7 mm (0.396 ft). The geomorphic assessment at the time of the Level I and Level II site visit on June 13, 1996, indicated that the reach was stable. The Town Highway 34 crossing of the New Haven River is a 85-ft-long, two-lane bridge consisting of an 80-foot steel arch truss (Vermont Agency of Transportation, written communication, December 14, 1995). The opening length of the structure parallel to the bridge face is 69 feet. The bridge is supported by vertical, concrete abutments with wingwalls. The channel is skewed

Level II scour analysis for Bridge 44 (LINCTH00330044) on Town Highway 33, crossing the New Haven River, Lincoln, Vermont

USGS Publications Warehouse

Burns, Ronda L.; Wild, Emily C.

1997-01-01

This report provides the results of a detailed Level II analysis of scour potential at structure LINCTH00330044 on Town Highway 33 crossing the New Haven River, Lincoln, Vermont (figures 1–8). A Level II study is a basic engineering analysis of the site, including a quantitative analysis of stream stability and scour (U.S. Department of Transportation, 1993). Results of a Level I scour investigation also are included in Appendix E of this report. A Level I investigation provides a qualitative geomorphic characterization of the study site. Information on the bridge, gleaned from Vermont Agency of Transportation (VTAOT) files, was compiled prior to conducting Level I and Level II analyses and is found in Appendix D.The site is in the Green Mountain section of the New England physiographic province in west-central Vermont. The 6.3-mi2 drainage area is in a predominantly rural and forested basin. In the vicinity of the study site, the surface cover is forest.In the study area, the New Haven River has an incised, sinuous channel with a slope of approximately 0.02 ft/ft, an average channel top width of 56 ft and an average bank height of 6 ft. The channel bed material ranges from gravel to boulder with a median grain size (D50) of 101.9 mm (0.334 ft). The geomorphic assessment at the time of the Level I and Level II site visit on June 10, 1996, indicated that the reach was stable.The Town Highway 33 crossing of the New Haven River is a 33-ft-long, one-lane bridge consisting of one 31-foot timber-beam span (Vermont Agency of Transportation, written communication, December 14, 1995). The opening length of the structure parallel to the bridge face is 29.3 ft. The bridge is supported by vertical, wood-beam crib abutments with wingwalls. The channel is skewed approximately 25 degrees to the opening while the opening-skew-to-roadway is zero degrees.A scour hole 1.0 ft deeper than the mean thalweg depth was observed along the right abutment during the Level I assessment. The

The rural hospital doctors workforce in New Zealand.

PubMed

Lawrenson, Ross A; Nixon, Garry; Steed, Robin H

2011-01-01

The sustainability of New Zealand's rural hospitals has been in question for some years. Increasingly, clinical services have been centralised and specialist staff have moved to bigger centres. As well as clinical services, the governance of these hospitals has shifted, often due to a shortage of vocationally registered medical practitioners available to lead the clinical services. In 2009 the Medical Council of New Zealand (MCNZ) approved a new vocational scope of practice in Rural Hospital Medicine (RHM). The present study was designed to establish the current composition of the rural hospital medical workforce at the introduction of this new scope of practice. This study was a 2009 cross-sectional survey of rural hospitals approved for RHM training by the MCNZ. Hospital managers were surveyed using a mailed questionnaire. All medical practitioners providing medical care in these hospitals in 2009 were identified, and each was mailed an additional questionnaire. In all, 28 rural hospitals and 107 medical practitioners who provided clinical services were identified; 28 responses (100%) were received to the hospital managers' survey and 69 responses (64%) to the doctors' survey. The managers' survey revealed a shortage of medical practitioners and significant use of locum staff. The workforce had a median age of 47 years, was predominantly male (75%) and principally trained overseas (68%), and 54% was vocationally registered. A proportion of the hospitals (35%) did not have a recognised clinical leader or an active process for credentialing new medical staff. The findings were not unexpected but do quantify the shortage of medical practitioners and the governance issues facing small rural hospitals in New Zealand. The scope of RHM has the potential to attract new doctors into practice, providing greater stability and clinical leadership for these important facilities. The study provides a baseline for a future evaluation of the effectiveness of the introduction of

Patterns in benthic populations in the Milford Haven waterway following the 'Sea Empress' oil spill with special reference to amphipods.

PubMed

Nikitik, Christopher C S; Robinson, Andrew W

2003-09-01

The macrobenthic fauna of the Milford Haven Waterway was studied in detail following the 'Sea Empress' oil spill in 1996. Contamination patterns indicated heaviest contamination of sediments by oil to have occurred in the lower reaches of the waterway, although water borne hydrocarbons are likely to have penetrated throughout the Haven. Generally, the communities showed little impact of contamination by oil, although some changes were evident at the population level. A decline in the amphipod fauna was observed throughout the Haven, with the genera Ampelisca and Harpinia and the family Isaeidae particularly affected. This was accompanied by increases in both the diversity and abundance of polychaete populations as opportunist species took advantage of the decline of the amphipod fauna. However, within five years of the spill the amphipod fauna has shown clear signs of recovery. The use of the polychaete/amphipod ratio as an indicator of oil pollution is discussed.

Conjugation in Escherichia coli

PubMed Central

Boyer, Herbert

1966-01-01

Boyer, Herbert (Yale University, New Haven, Conn.). Conjugation in Escherichia coli. J. Bacteriol. 91:1767–1772. 1966.—The sex factor of Escherichia coli K-12 was introduced into an E. coli B/r strain by circumventing the host-controlled modification and restriction incompatibilities known to exist between these closely related strains. The sexual properties of the constructed F+ B strain and its Hfr derivatives were examined. These studies showed that the E. coli strain B/r F+ and Hfr derivatives are similar to the E. coli strain K-12 F+ and Hfr derivatives. However, the site of sex factor integration was found to be dependent on the host genome. PMID:5327905

Reflective Writing for Medical Students on the Surgical Clerkship: Oxymoron or Antidote?

PubMed

Liu, Geoffrey Z; Jawitz, Oliver K; Zheng, Daniel; Gusberg, Richard J; Kim, Anthony W

2016-01-01

Reflective writing has emerged as a solution to declining empathy during clinical training. However, the role for reflective writing has not been studied in a surgical setting. The aim of this proof-of-concept study was to assess receptivity to a reflective-writing intervention among third-year medical students on their surgical clerkship. The reflective-writing intervention was a 1-hour, peer-facilitated writing workshop. This study employed a pre-post-intervention design. Subjects were surveyed on their experience 4 weeks before participation in the intervention and immediately afterwards. Surveys assessed student receptivity to reflective writing as well as self-perceived empathy, writing habits, and communication behaviors using a Likert-response scale. Quantitative responses were analyzed using paired t tests and linear regression. Qualitative responses were analyzed using an iterative consensus model. Yale-New Haven hospital, a tertiary care academic center. All medical students of Yale School of Medicine, rotating on their surgical clerkship during a 9-month period (74 in total) were eligible. In all, 25 students completed this study. The proportion of students desiring more opportunities for reflective writing increased from 32%-64%. The proportion of students receptive to a mandatory writing workshop increased from 16%-40%. These differences were both significant (p = 0.003 and p = 0.001). In all, 88% of students also reported new insight as a result of the workshop. In total, 39% of students reported a more positive impression of the surgical profession after participation. Overall, the workshop was well-received by students and improved student attitudes toward reflective writing and the surgical profession. Larger studies are required to validate the effect of this workshop on objective empathy measures. This study demonstrates how reflective writing can be incorporated into a presurgical curriculum. Copyright © 2015 Association of Program Directors in

Reflective Writing for Medical Students on the Surgical Clerkship: Oxymoron or Antidote?

PubMed Central

Liu, Geoffrey Z; Jawitz, Oliver K; Zheng, Daniel; Gusberg, Richard J; Kim, Anthony W

2017-01-01

Objectives Reflective writing has emerged as a solution to declining empathy during clinical training. However, the role for reflective writing has not been studied in a surgical setting. The aim of this proof-of-concept study was to assess receptivity to a reflective writing intervention among third-year medical students on their surgical clerkship. Study Design The reflective writing intervention was a one hour, peer-facilitated writing workshop. This study employed a pre-post-intervention design. Subjects were surveyed on their experience four weeks prior to participation in the intervention and immediately afterwards. Surveys assessed student receptivity to reflective writing as well as self-perceived empathy, writing habits and communication behaviors using a Likert response scale. Quantitative responses were analyzed using paired t-tests and linear regression. Qualitative responses were analyzed using an iterative consensus model. Setting Yale-New Haven hospital, a tertiary care academic center. Participants All Yale School of Medicine medical students rotating on their surgical clerkship during a 9 month period (74 in total) were eligible. In all, 25 students completed this study. Results The proportion of students desiring more opportunities for reflective writing increased from 32% to 64%. The proportion of students receptive to a mandatory writing workshop increased from 16% to 40%. These differences were both significant (p=0.003 and p = 0.001). 88% of students also reported new insight as a result of the workshop. 39% of students reported a more positive impression of the surgical profession after participation. Conclusion Overall, the workshop was well-received by students and improved student attitudes towards reflective writing and the surgical profession. Larger studies are required to validate the effect of this workshop on objective empathy measures. This study demonstrates how reflective writing can be incorporated into a pre-surgical curriculum

Sign-out snapshot: cross-sectional evaluation of written sign-outs among specialties

PubMed Central

Schoenfeld, Amy R.; Al-Damluji, Mohammed Salim; Horwitz, Leora I.

2013-01-01

Background Sign-out is the process (written, verbal, or both) by which one clinical team transmits information about patients to another team. Poor quality sign-outs are associated with adverse events and delayed treatment. How different specialties approach written sign-outs is unknown. Objective To compare written sign-out practices across specialties and to determine consistency of content, format, and timeliness. Methods The authors evaluated all non-Intensive Care Unit written sign-outs from five inpatient specialties on January 18, 2012, at Yale-New Haven Hospital, focusing on content elements, format style, and whether the sign-outs had been updated within 24 hours. In our institution, all specialties used a single standardized sign-out template, which was built into the electronic medical record. Results The final cohort included 457 sign-outs: 313 medicine, 64 general surgery, 36 pediatrics, 30 obstetrics, and 14 gynecology. Though nearly all sign-outs (96%) had been updated within 24 hours, they frequently lacked key information. Hospital course prevalence ranged from 57% (gynecology) to 100% (pediatrics) (p<0.001). Clinical condition prevalence ranged from 34% (surgery) to 72% (pediatrics) (p=0.005). Conclusion Specialties have varied sign-out practices, and thus structured templates alone do not guarantee inclusion of critical content. Sign-outs across specialties often lacked complex clinical information such clinical condition, anticipatory guidance, and overnight tasks. PMID:23996093

The duty to bring children living in conflict zones to a safe haven

PubMed Central

Schweiger, Gottfried

2016-01-01

ABSTRACT In this paper, I will discuss a children’s rights-based argument for the duty of states, as a joint effort, to establish an effective program to help bring children out of conflict zones, such as parts of Syria, and to a safe haven. Children are among the most vulnerable subjects in violent conflicts who suffer greatly and have their human rights brutally violated as a consequence. Furthermore, children are also a group whose capacities to protect themselves are very limited, while their chance to flee is most often only slim. I will then discuss three counterarguments: the first counterargument would be that, instead of getting the children out of a particular country, it would be better to improve their situation in their home countries. A second counterargument could be that those states, which have such a duty to bring children to a safe haven, would be overburdened by it. Finally, the third counterargument I want to discuss states that such a duty would also demand a military intervention, which could worsen the situation even further. PMID:28690666

Photograph of model projected new hospital building and new landscaping ...

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

Photograph of model projected new hospital building and new landscaping for area north of building 500. Model displayed on the mezzanine level of building 500. - Fitzsimons General Hospital, Bounded by East Colfax to south, Peoria Street to west, Denver City/County & Adams County Line to north, & U.S. Route 255 to east, Aurora, Adams County, CO

Hospital strategic preparedness planning: the new imperative.

PubMed

Ginter, Peter M; Duncan, W Jack; Abdolrasulnia, Maziar

2007-01-01

Strategic preparedness planning is an important new imperative for many hospitals. Strategic preparedness planning goes beyond traditional product/market strategic planning by focusing on disaster prevention, containment, and response roles. Hospitals, because of their unique mission, size, complexity, the types of materials they handle, and the types of patients they encounter, are especially vulnerable to natural and human-initiated disasters. In addition, when disasters occur, hospitals must develop well-conceived first responder (receiver) strategies. This paper argues the case for strategic preparedness planning for hospitals and proposes a process for this relatively new and much needed type of planning.

Extravillous trophoblast invasion in placenta accreta is associated with differential local expression of angiogenic and growth factors: a cross-sectional study.

PubMed

Duzyj, C M; Buhimschi, I A; Laky, C A; Cozzini, G; Zhao, G; Wehrum, M; Buhimschi, C S

2018-02-22

Placenta accreta is clinically associated with maternal uterine scar. Our objective was to investigate the biochemical contribution of maternal scarring to hyperinvasive trophoblast. We hypothesised that trophoblast over-invasion in placenta accreta is associated with aberrant invasion-site signalling of growth and angiogenic factors known to be involved in wound healing and promotion of cell invasion through the epithelial to mesenchymal cellular programme. Cross-sectional series. Yale-New Haven Hospital. Women with histologically confirmed normal and abnormal placentation. Placental invasion site tissue sections were immunostained for endoglin and other angiogenic regulators, and transforming growth factor β (TGFβ) proteins. Maternal serum endoglin, and the vascular endothelial growth factor (VEGF) mediators hypoxia-inducible factor-1α (HIF1α) and endostatin, were assessed using immunoassay. Differences in median H-score by immunostaining and in mean serum level by immunoassay. By immunostaining, placenta accreta samples demonstrated intervillous endoglin shedding and increased trophoblast expression of its cleavage protein matrix metalloproteinase-14. Absent decidual HIF1α and endostatin were observed in areas of VEGF upregulation. TGFβ1 was present in myocytes but not in collagen bundles into which accreta trophoblast invaded. Maternal serum endoglin decreased in praevia and accreta when corrected for gestational age. Angiogenic and growth factors at the placental invasion site are altered in accreta, both by decidual absence and within myometrial scar. We postulate this promotes the invasive phenotype of placenta accreta by activating hyperinvasive trophoblast and by dysregulating placental vascular remodelling. Yale Department of Obstetrics, Gynecology and Reproductive Sciences funds. Placenta accreta histology shows dysregulation of angiogenic and growth factors. © 2018 Royal College of Obstetricians and Gynaecologists.

77 FR 25738 - Notice of Intent To Repatriate Cultural Items: Yale Peabody Museum of Natural History, New Haven, CT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-01

...; two broken pumice stones marked with red ochre; six bone arrowheads; four broken stone pipes; sixteen dentalium and other shell beads; and thirteen small items including ochre, bone carving fragments, and bone...

Geographic List of Prime Contract Awards. Oct 91 - Sep 92. FY92. (San Juan California - Yale New Haven Conn)

DTIC Science & Technology

1993-01-01

414 -4-- - - 4 4 4 4 N Ř I-. I 00(0 if w0 Coto (0(0(0(000woo 0D0(((000(((0000((000(c(DW-I (0 M of4 0001 0 acca " 00 0 0 0 0 00 0 0 00 0 0 0 0 00 - 0...w l" I"r---0 InNC- (00C -.1~00oC I,-0C 0)00> f7 )(NNN,14NNNN( 1I0 o(0-4 tig>- LL- 000o - Nt ý <U- (0 in -J >(0o In4. 0y) 44 xaCp000000 CL if I(00-4...007 W10 M 1 )-4 -TM f7 - -400 "d N"t, -If N 4 40( N -4NC .4 -4040)0N0040- -ION N l 4-4 in 0 -4 ൏ NIO it xo - 0 NI0 I 0. 1 0 00 -4-4 NOCIA0 -4o N-I -4N

YALE NATURAL RADIOCARBON MEASUREMENTS. PART VI

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

Stuiver, M.; Deevey, E.S.

1961-01-01

Most of the measurements made since publication of Yale V are included; some measurements, such as a series collected in Greenland, are withneld pending additional information or field work that will make better interpretations possible. In addition to radiocarbon dates of geologic and/or archaeologic interest, recent assays are given of C/sup 14/ in lake waters and other lacustrine materials, now normalized for C/sup 13/ content. The newly accepted convention is followed in expressing normalized C/sup 14/ values as DELTA = delta C/sup 14/ (2 delta C/sup 13/ + 50)STAl + ( delta C/sup 14//1000)! where DELTA is the per milmore » deviation of the C/sup 14/ if the sample from any contemporary standard (whether organic or a carbonate) after correction of sample and/or standard for real age, for the Suess effect, for normal isotopic fractionation, and for deviations of C/sup 14/ content of the age- and pollution- corrected l9th-century wood standard from that of 95% of the NBS oxalic acid standard; delta C/sup 14/ is the measured deviation from 95% of the NBS standard, and delta C/sup 13/ is the deviation from the NBS limestone standard, both in per mil. These assays are variously affected by artificial C/sup 14/ resulting from nuclear tests. (auth)« less

Nothing Virtual About it: An Emerging Safe Haven for an Adaptive Enemy

DTIC Science & Technology

2010-12-02

TERRORISTS May Allah bless you lions of the front, for by Allah, the fruits of your combined efforts-- sound, video, and text—are more severe for the...insurgencies, as demonstrated in the Soviet-Afghan War and many other conflicts exists and for many insurgencies perhaps is its operational center of...who have limited geographical safe havens, the Internet is becoming of equal or greater importance if not their center of gravity. The Birth of Al

Employing U.S. Navy Hospital Ships in Support of Soft Power Projection

DTIC Science & Technology

2011-03-24

the employment of hard power such as military engagements in multiple countries that support non-state actors and terrorists. One way to stem the...The United State‟s seeming decline in foreign policy can be directly attributed to the employment of hard power such as military engagements in...the Vietnam conflict, the USS REPOSE (AH-16) and USS SANCTUARY (AH-17), Haven class hospital ships, provided significant support to combat units

A Crash Course in Science Radio Reporting

NASA Astrophysics Data System (ADS)

Schielke, Erika

2009-12-01

This past summer, 5 weeks after defending my doctoral dissertation, I traded my lab bench and field sampling gear for a radio reporter's recorder and a microphone, and I headed west. As a graduate student at Yale University in New Haven, Conn., I had seen great science going on all around me, but the public was unaware of most of it. Having dabbled in science writing while finishing my Ph.D. in ecology and evolutionary biology, I was looking for ways to gain more experience in science communication and even had been considering pursuing a career in science reporting. Then a remarkable opportunity opened up that took me to Greeley, Colo., covering science stories at KUNC, a National Public Radio affiliate, for 10 weeks this past summer.

Combating Terrorism: U.S. Government Strategies and Efforts to Deny Terrorists Safe Haven

DTIC Science & Technology

2011-06-03

havens—such as activities funded through State’s Peacekeeping Operations and State-funded DHS training to combat money laundering and bulk cash...Management, Committee on Homeland Security House of Representatives COMBATING TERRORISM U.S. Government Strategies and Efforts to Deny Terrorists... Combating Terrorism: U.S. Government Strategies and Efforts to Deny Terrorists Safe Haven 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT

Combating Terrorism: U.S. Government Should Improve Its Reporting on Terrorist Safe Havens

DTIC Science & Technology

2011-06-01

Ecuador , Panama, Peru, and Venezuela) Trans-Sahara (Algeria, Mali, Mauritania, and Niger) Somalia Southern Philippines Yemen Northern Iraq...the east.” Colombia Border Region (Venezuela, Ecuador , Peru, Panama, and Brazil) “Columbia’s borders with Venezuela, Ecuador , Peru, Panama, and...assistance. This appeared to be less so in Brazil and Peru where potential safe havens were addressed by stronger government responses. Ecuador and Panama

Campaign supports new name for TX hospital. Effort expands children's hospital's image and increases awareness.

PubMed

2007-01-01

For years, the North Texas Hospital for Children at Medical City in Dallas struggled with its brand awareness. It's long-winded name was largely unknown among the city's 1.2 million residents. The hospital needed a new name and it needed one fast. The year 2005 proved to be both a burden and an opportunity for the 311-bed pediatric hospital. It survived a legal battle with a local competitor for the right to use the word "children's" in its name, created a new identity, and launched a three-year branding initiative to introduce its new name: Medical City Children's Hospital.

No safe haven: locations of harassment and bullying victimization in middle schools.

PubMed

Perkins, H Wesley; Perkins, Jessica M; Craig, David W

2014-12-01

Given that adolescent bullying victimization is a significant concern for secondary education and adolescent development, identifying school contexts in which victimization is most likely to occur is salient. An anonymous online survey assessed the prevalence of being harassed or bullied in various locations within 20 middle schools (grades 5-9) in New Jersey and New York (N = 10,668). Seven types of bullying-related victimization (teased in an unfriendly way, called hurtful names, physically abused, excluded from a group to hurt feelings, belongings taken/damaged, threatened to be hurt, and negative rumors spread) were examined in 7 locations where each type of victimization could occur (classroom, lunchroom, hallways, gym, playground, bus, or bathroom). Prevalence of victimization types ranged from 4% to 38% depending on location. Prevalence of overall victimization was equal or greater in classrooms compared with other school locations (highest prevalence rates in hallways, classrooms, and lunchrooms), regardless of school demographic characteristics. Victimization in classrooms compared with other school settings was most highly associated with feelings of being unsafe. Vigilant attention to bullying is needed across all school environments and especially in the classroom context, which may mistakenly be perceived as a more protected area. Indeed, middle school classrooms are not safe havens. © 2014, American School Health Association.

Renovating Charity Hospital or building a new hospital in post-Katrina New Orleans: economic rationale versus political will.

PubMed

Leleu, Hervé; Moises, James; Valdmanis, Vivian Grace

2013-02-01

Since September 2005, Charity Hospital of New Orleans has been closed due to Hurricane Katrina. A debate following the closing arose about whether this public hospital should be renovated or a new medical center affiliated with the Louisiana State University should be built. Using academic literature, government statistics, and popular press reports, we describe the economic implications that support the view that Charity Hospital should have been renovated. We also address why this policy was not pursued by demonstrating the influence politics and individual stakeholders (specifically, Louisiana State University) had on the eventual policy pursued. In this commentary we also note the political identity movement away from public-sector provision of services to private-sector interests.

How medical ethical principles are applied in treatment with artificial insemination by donors (AID) in Hunan, China: effective practice at the Reproductive and Genetic Hospital of CITIC-Xiangya

PubMed Central

Li, L; Lu, G

2005-01-01

This paper investigates the efficiency of application of medical ethics principles in the practice of artificial insemination by donors (AID) in China, in a culture characterised by traditional ethical values and disapproval of AID. The paper presents the ethical approach to AID treatment as established by the Reproduction and Genetics Hospital of CITIC-Xiangya (CITIC Hunan-Yale Approach) in the central southern area of China against the social ethical background of China and describes its general features. The CITIC-Xiangya Approach facilitates the implementation of ethical relations between clinicians and patients participating in AID treatment procedures in Hunan-Yale. PMID:15923480

An Epidemiologic Study on Ageing and Dysphagia in the Acute Care Geriatric-Hospitalized Population: A Replication and Continuation Study.

PubMed

Leder, Steven B; Suiter, Debra M; Agogo, George O; Cooney, Leo M

2016-10-01

United States census data project dramatic increases in the geriatric population ageing demographics by 2060 with concomitant health-care consequences. The purpose of this replication and continuation study was to collect new 2014 demographic data relative to ageing, swallow evaluation referral rates, and oral feeding status in geriatric-hospitalized patients for comparison with published data from 2000 to 2007. This was a planned data acquisition study of consecutive hospitalized patients referred for swallow assessments. Swallow evaluation referral rates for 2014 were described according to inpatient discharges, age range 60-105 years grouped by decade, gender, admitting diagnostic category, results of swallow evaluations, and oral feeding status. Determination of aspiration risk status was made with the Yale Swallow Protocol and diagnosis of dysphagia made with fiberoptic endoscopic evaluation of swallowing (FEES). There were 1348 referrals and 961 patients ≥60 years of age participated. Overall swallow evaluation referral rates increased an average of 63 % between the comparison years 2007 and 2014 with consistent increases corresponding to the decades, i.e., 60-69 (46 %), 70-79 (68 %), 80-89 (53 %), and 90+ (222 %). A total of 75 % of participants resumed oral alimentation and oral medications. Swallow evaluation referral rates increased by 63 % for 60-90+ year-old acute care geriatric-hospitalized participants despite only a 23 % increase in inpatient discharges for the years 2007 versus 2014. This corroborated previously reported increases for individual years from 2000 to 2007. For timely, safe, and successful initiation of oral alimentation, it is important to perform a reliable swallow screen for aspiration risk assessment with the Yale Swallow Protocol and, if failed, instrumental testing with FEES. More dysphagia specialists are needed through 2060 and beyond due to projections of continued population ageing resulting in ever increasing

77 FR 47331 - Regulated Navigation Area-New Haven Harbor, Quinnipiac River, Mill River, New Haven, CT; Pearl...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-08

... Harbor Memorial Bridge (Interstate 95) Construction AGENCY: Coast Guard, DHS. ACTION: Notice of proposed... needed during construction of the new Pearl Harbor Memorial Bridge, and which could be needed at other... Department, U. S. Coast Guard Sector Long Island Sound, (203) 468-4544, [email protected] ; or...

Training of residents in laparoscopic tubal sterilization: Long-term failure rates

PubMed Central

Rackow, Beth W.; Rhee, Maria C.; Taylor, Hugh S.

2011-01-01

Objectives Laparoscopic tubal sterilization with bipolar coagulation is a common and effective method of contraception, and a procedure much used to teach laparoscopic surgical skills to Obstetrics and Gynaecology residents (trainees); but it has an inherent risk of failure. This study investigated the long-term failure rate of this procedure when performed by Obstetrics and Gynaecology residents on women treated in their teaching clinics. Methods From 1991 to 1994, Obstetrics and Gynaecology residents carried out 386 laparoscopic tubal sterilizations with bipolar coagulation at Yale-New Haven Hospital. Six to nine years after the procedure, the women concerned were contacted by telephone and data were collected about sterilization failure. Results Two failures of laparoscopic tubal sterilization with bipolar coagulation were identified: an ectopic pregnancy and a spontaneous abortion. For this time period, the long-term sterilization failure rate was 1.9% (0–4.4%). Conclusions The long-term sterilization failure rate for laparoscopic tubal sterilization with bipolar coagulation performed by residents is comparable to the results of prior studies. These findings can be used to properly counsel women at a teaching clinic about the risks of sterilization failure with this procedure, and attest to the adequacy of residents’ training and supervision. PMID:18465476

Coronary surgery for unstable angina pectoris. Incidence and mortality of perioperative myocardial infarction.

PubMed Central

Langou, R A; Wiles, J C; Cohen, L S

1978-01-01

The incidence of perioperative myocardial infarction determined by electrocardiogram was examined in 123 consecutive patients having only coronary artery bypass grafting for unstable angina pectoris, at Yale-New Haven Hospital from January 1974 to June 1975. The incidence of myocardial infarction and its mortality were correlated with clinical, haemodynamic, anatomical, and operative factors. Myocardial infarction occurred in 18% of all patients (22/123); 15 inferior, 6 anterior, and 1 anterolateral wall. Three factors appeared to be related to the occurrence of myocardial infarction: left main coronary artery disease (LMCD), (47%, 7/15), increased left ventricular end-diastolic pressure (LVEDP), (27%, 14/52), and cardiopulmonary bypass time more than 60 minutes (24%, 21/88). The mortality of perioperative myocardial infarcation was 13.6% (3/22), while for patients without perioperative myocardial infarction the mortality was 2% (2/101). The overall operative mortality was 4% (5/123). The risk of perioperative myocardial infarction is significantly increased by left main coronary artery disease, increased left ventricular end-diastolic pressure, and cardiopulmonary bypass time more than 60 minutes, in patients undergoing coronary artery surgery for unstable angina pectoris. The mortality of perioperative myocardial infarction is high (13.6%) in patients with unstable angina. PMID:308374

77 FR 67563 - Regulated Navigation Area-New Haven Harbor, Quinnipiac River, Mill River, New Haven, CT; Pearl...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-13

...; Pearl Harbor Memorial Bridge (Interstate 95) Construction AGENCY: Coast Guard, DHS. ACTION: Final rule... construction of the new Pearl Harbor Memorial Bridge, and which could be needed at other times as well. This..., call or email Petty Officer Joseph Graun, Prevention Department, U.S. Coast Guard Sector Long Island...

Medical necessity for the hospitalization of the abused and neglected child. American Academy of Pediatrics. Committee on Hospital Care and Committee on Child Abuse and Neglect.

PubMed

1998-04-01

The child suspected of being abused or neglected demands prompt evaluation in a protective environment where knowledgeable consultants are readily available. In communities without specialized centers for the care of abused children, the hospital inpatient unit becomes an appropriate setting for their initial management. Medical, psychosocial, and legal concerns may be assessed expeditiously while the child is housed in a safe haven awaiting final disposition by child protective services. The American Academy of Pediatrics recommends that hospitalization of abused and neglected children, when medically indicated or for their protection/diagnosis when there are no specialized facilities in the community for their care, should be viewed as medically necessary by both health professionals and third-party payors.

NewYork-Presbyterian Hospital: translating innovation into practice.

PubMed

Johnson, Trudy; Currie, Gail; Keill, Patricia; Corwin, Steven J; Pardes, Herbert; Cooper, Mary Reich

2005-10-01

NewYork-Presbyterian (NYP) Hospital, a 2,242-bed not-for-profit academic medical center, was formed by a merger of The New York Hospital and The Presbyterian Hospital in the City of New York. It is also the flagship for the NewYork-Presbyterian Healthcare System, with 37 acute care facilities and 18 others. The hospital embeds safety in the culture through strategic initiatives and enhances service and efficiency using Six Sigma and other techniques to drive adoption of improvements. Goals are selected in alignment with the annual strategic initiatives, which are chosen on the basis of satisfaction surveys, patient and family complaints, community advisory groups, and performance measures, among other sources. A new business intelligence system enables online, dynamic analysis of performance results, replacing static paper reports. Advanced features in the clinical information systems include computerized physician order entry; interactive clinical alerts for decision support; a real-time infection control tracking system; and a clinical data warehouse supporting data mining and analysis for quality improvement, decision making, and education. To achieve clinical, service, and operational excellence, NYP focuses on all Institute of Medicine quality aims.

The Yale Craving Scale: Development and psychometric properties.

PubMed

Rojewski, Alana M; Morean, Meghan E; Toll, Benjamin A; McKee, Sherry A; Krishnan-Sarin, Suchitra; Green, Barry G; Bartoshuk, Linda M; O'Malley, Stephanie S

2015-09-01

The current study presents a psychometric evaluation of the Yale Craving Scale (YCS), a novel measure of craving for cigarettes and alcohol, respectively. The YCS is the first craving measure to use a generalized Labeled Magnitude Scale (gLMS) as the scoring format, which facilitates between-group comparisons of subjective craving and eliminates ceiling effects by assessing the full range of imaginable sensation intensities. Psychometric evaluations of the YCS for use with cigarettes (YCS Smoking) and alcohol (YCS Drinking) included assessments of latent factor structure, internal consistency, ceiling effects, and test-criterion relationships. Study samples included 493 treatment-seeking smokers and 213 heavy drinkers. Factor analyses of the 5-item YCS Smoking and Drinking scores confirmed a 1-factor scale. The YCS Smoking and Drinking scores evidenced: (1) good internal consistency, (2) scalar measurement invariance within several subgroups (e.g., smoking/drinking status; nicotine/alcohol dependence), (3) convergent relationships with extant craving measures, and (4) concurrent relationships with smoking/drinking outcomes. These results suggest that the YCS represents a psychometrically sound scale for assessing smoking and drinking urges in dependent populations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Hospital emergency surge capacity: an empiric New York statewide study.

PubMed

Kanter, Robert K; Moran, John R

2007-09-01

National policy for emergency preparedness calls for hospitals to accommodate surges of 500 new patients per million population in a disaster, but published studies have not evaluated the ability of existing resources to meet these goals. We describe typical statewide and regional hospital occupancy and patterns of variation in occupancy and estimate the ability of hospitals to accommodate new inpatients. Daily hospital occupancy for each hospital was calculated according to admission date and length of stay for each patient during the study period. Occupancy was expressed as the count of occupied beds. Peak hospital capacity was defined as the 95th percentile highest occupancy at each facility. Data obtained from the New York Statewide Planning and Research Cooperative System were analyzed for 1996 to 2002. Patients were classified as children (0 to 14 years, excluding newborns) or adults. Vacant hospital beds per million age-specific population were determined as the difference between peak capacity and average occupancy. In New York State, 242 hospitals cared for a peak capacity of 2,707 children and 46,613 adults. Occupancy averaged 60% of the peak for children and 82% for adults, allowing an average statewide capacity for a surge of 268 new pediatric and 555 adult patients for each million age-specific population. After the September 11, 2001, attacks, in the New York City region, a discretionary modification of admissions and discharges resulted in an 11% reduction from the expected occupancy for children and adults. Typically, there are not enough vacant hospital beds available to serve 500 children per million population. Modified standards of hospital care to expand capacity may be necessary to serve children in a mass-casualty event.

Experts: despite time constraints, motivational interviewing techniques can have lasting impact on drinkers, drug abusers.

PubMed

2013-04-01

Researchers have found that the Brief Negotiation Interview (BNI), a tool developed at Yale School of Medicine in New Haven, CT, can curb harmful drinking in patients when the tool is used with these patients in the emergency setting. Further, by using the same motivational interviewing techniques employed in the tool, experts say providers can help patients curb other harmful behaviors as well. The BNI consists of a series of questions that take about seven minutes to discuss with patients. The tool prompts patients to come up with their own reasons for changing harmful behaviors. To implement the BNI, emergency providers need training and constant reinforcement. Ideally, experts say the motivational interviewing techniques employed in the BNI need to become routine to have a lasting impact on patient care.

Sensitivity of the Modified Children's Yale-Brown Obsessive Compulsive Scale to Detect Change: Results from Two Multi-Site Trials

ERIC Educational Resources Information Center

Scahill, Lawrence; Sukhodolsky, Denis G.; Anderberg, Emily; Dimitropoulos, Anastasia; Dziura, James; Aman, Michael G.; McCracken, James; Tierney, Elaine; Hallett, Victoria; Katz, Karol; Vitiello, Benedetto; McDougle, Christopher

2016-01-01

Repetitive behavior is a core feature of autism spectrum disorder. We used 8-week data from two federally funded, multi-site, randomized trials with risperidone conducted by the Research Units on Pediatric Psychopharmacology Autism Network to evaluate the sensitivity of the Children's Yale-Brown Obsessive Compulsive Scale modified for autism…

Food Addiction and Bulimia Nervosa: New Data Based on the Yale Food Addiction Scale 2.0.

PubMed

de Vries, Sarah-Kristin; Meule, Adrian

2016-11-01

Previous research on 'food addiction' as measured with the Yale Food Addiction Scale (YFAS) showed a large overlap between addiction-like eating and bulimia nervosa. Most recently, a revised version of the YFAS has been developed according to the changes made in the diagnostic criteria for substance use disorder in the Diagnostic and Statistical Manual of Mental Disorders fifth edition. The current study examined prevalence and correlates of the YFAS2.0 in individuals with bulimia (n = 115) and controls (n = 341). Ninety-six per cent of participants with bulimia and 14% of controls received a YFAS2.0 diagnosis. A higher number of YFAS2.0 symptoms was associated with lower interoceptive awareness, higher depressiveness, and higher impulsivity in both groups. However, a higher number of YFAS2.0 symptoms was associated with higher body mass and weight suppression in controls only and not in participants with bulimia. The current study is the first to show a large overlap between bulimia and 'food addiction' as measured with the YFAS2.0, replicating and extending findings from studies, which used the previous version of the YFAS. Compensatory weight control behaviours in individuals with bulimia likely alleviate the association between addiction-like eating and higher body mass. Thus, the large overlap between bulimia and 'food addiction' should be taken into consideration when examining the role of addiction-like eating in weight gain and obesity. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

26. 'CITY HOSPITAL, BLACKWELL'S ISLAND.' (Source: New York City Department ...

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

26. 'CITY HOSPITAL, BLACKWELL'S ISLAND.' (Source: New York City Department of Public Finance, Real Estate Owned by the City of New York under Jurisdiction of the Department of Public Charities, 1909.) - Island Hospital, Roosevelt Island, New York County, NY

Mechanisms for nonprofit hospitals to acquire new equipment.

PubMed

Cotora, C

1985-01-01

The expense of new technologies and current high costs of capital financing have combined to encourage hospitals to acquire the use of new equipment by having a group of private investors purchase the equipment and make it available for use by the hospital. However, tax exempt healthcare providers are inhibited from pursuing this alternative because of current Internal Revenue Service policies prohibiting Investment Tax Credit (ITC) for property used by tax exempt organizations. This article discusses some approaches a nonprofit hospital and a group of potential investors can take to enable the investors to claim ITC.

A new "P" for hospital marketing?

PubMed

Hill, R C

1988-01-01

The rather abrupt introduction of payors to hospitals and vice versa that started a few years ago has now settled down into a learning situation. To be price competitive in the health insurance marketplace, the payor must obtain full contractual performance in price, administrative and utilization review areas. Hospitals need the patients that payors can refer, but there is only a minimal understanding of how the health insurance industry operates both internally and in the marketplace. By selecting payors and soliciting those selected, hospitals have an excellent chance to accomplish their patient and revenue goals while payors have the opportunity to determine the effectiveness of their various programs to help meet their goals. By making a little effort, hospitals can accomplish a lot by adding this new "P" to their marketing mix.

Reliability generalization study of the Yale-Brown Obsessive-Compulsive Scale for children and adolescents.

PubMed

López-Pina, José Antonio; Sánchez-Meca, Julio; López-López, José Antonio; Marín-Martínez, Fulgencio; Núñez-Núñez, Rosa Ma; Rosa-Alcázar, Ana I; Gómez-Conesa, Antonia; Ferrer-Requena, Josefa

2015-01-01

The Yale-Brown Obsessive-Compulsive Scale for children and adolescents (CY-BOCS) is a frequently applied test to assess obsessive-compulsive symptoms. We conducted a reliability generalization meta-analysis on the CY-BOCS to estimate the average reliability, search for reliability moderators, and propose a predictive model that researchers and clinicians can use to estimate the expected reliability of the CY-BOCS scores. A total of 47 studies reporting a reliability coefficient with the data at hand were included in the meta-analysis. The results showed good reliability and a large variability associated to the standard deviation of total scores and sample size.

Anticipating Terrorist Safe Havens from Instability Induced Conflict

NASA Astrophysics Data System (ADS)

Shearer, Robert; Marvin, Brett

This chapter presents recent methods developed at the Center for Army Analysis to classify patterns of nation-state instability that lead to conflict. The ungoverned areas endemic to failed nation-states provide terrorist organizations with safe havens from which to plan and execute terrorist attacks. Identification of those states at risk for instability induced conflict should help to facilitate effective counter terrorism policy planning efforts. Nation-states that experience instability induced conflict are similar in that they share common instability factors that make them susceptible to experiencing conflict. We utilize standard pattern classification algorithms to identify these patterns. First, we identify features (political, military, economic and social) that capture the instability of a nation-state. Second, we forecast the future levels of these features for each nation-state. Third, we classify each future state’s conflict potential based upon the conflict level of those states in the past most similar to the future state.

Long-term behavior of aortic intramural hematomas and penetrating ulcers.

PubMed

Chou, Alan S; Ziganshin, Bulat A; Charilaou, Paris; Tranquilli, Maryann; Rizzo, John A; Elefteriades, John A

2016-02-01

For intramural hematoma and penetrating atherosclerotic ulcer, long-term behavior and treatment are controversial. This study evaluates the long-term behavior of intramural hematoma and penetrating atherosclerotic ulcer, including radiologic follow-up and survival analysis. Between 1995 and 2014, 108 patients (mean age, 70.8 ± 10 years; 56% female) presented with intramural hematoma or penetrating atherosclerotic ulcer to Yale-New Haven Hospital (New Haven, Conn). We reviewed the medical records, radiology, and online mortality databases. Ten of 55 patients (18%) with intramural hematoma and 17 of 53 patients (32%) with penetrating atherosclerotic ulcer had rupture state symptoms on admission, both greater than type A (8%) or type B dissection (4%) (P < .001). No branch vascular occlusion occurred. For patients with intramural hematoma with follow-up imaging, 8 of 14 (57%) worsened (mean follow-up, 9.4 months) and 6 (43%) underwent late surgery. For patients with penetrating atherosclerotic ulcer with follow-up imaging, 6 of 20 (30%) worsened and underwent late surgery, and 11 (55%) showed no change (mean follow-up, 34.3 months). Overall survivals were 77%, 70%, 58%, and 33% at 1, 3, 5, and 10 years, respectively. No operative deaths occurred for patients with nonrupture state. Patients with penetrating atherosclerotic ulcer with initial surgical treatment had better long-term survival than patients treated medically (P = .037). In the intramural hematoma group, no such difference was observed (P = .10). At presentation, the incidence of early rupture of intramural hematoma and penetrating atherosclerotic ulcer was higher than for typical dissection. For branch vessels, intramural hematoma never occludes branch arteries. On imaging follow-up, patients with intramural hematoma and penetrating atherosclerotic ulcer rarely improved, with late surgery commonly needed. Better survival was observed for the initial surgical management of patients with penetrating

Preliminary validation of the Yale Food Addiction Scale.

PubMed

Gearhardt, Ashley N; Corbin, William R; Brownell, Kelly D

2009-04-01

Previous research has found similarities between addiction to psychoactive substances and excessive food consumption. Further exploration is needed to evaluate the concept of "food addiction," as there is currently a lack of psychometrically validated measurement tools in this area. The current study represents a preliminary exploration of the Yale Food Addiction Scale (YFAS), designed to identify those exhibiting signs of addiction towards certain types of foods (e.g., high fat and high sugar). Survey data were collected from 353 respondents from a stratified random sample of young adults. In addition to the YFAS, the survey assessed eating pathology, alcohol consumption and other health behaviors. The YFAS exhibited adequate internal reliability, and showed good convergent validity with measures of similar constructs and good discriminant validity relative to related but dissimilar constructs. Additionally, the YFAS predicted binge-eating behavior above and beyond existing measures of eating pathology, demonstrating incremental validity. The YFAS is a sound tool for identifying eating patterns that are similar to behaviors seen in classic areas of addiction. Further evaluation of the scale is needed, especially due to a low response rate of 24.5% and a non-clinical sample, but confirmation of the reliability and validity of the scale has the potential to facilitate empirical research on the concept of "food addiction".

New tax law hobbles tax-exempt hospitals.

PubMed

Goldblatt, S J

1982-03-01

The Economic Recovery Tax Act of 1981 left tax-exempt hospitals at a significant disadvantage in the competition for capital. Although the new law's accelerated depreciation schedules and liberalized investment tax credits contain some marginal benefits for tax-exempt hospitals, these benefits are probably more than offset by the impact of the law on charitable giving.

VizieR Online Data Catalog: Yale Trigonometric Parallaxes Preliminary (van Altena+ 1991)

NASA Astrophysics Data System (ADS)

van Altena, W. F.; Lee, J. T.; Hoffleit, D.

1995-10-01

The preliminary edition of the General Catalogue of Trigonometric Stellar Parallaxes, containing 15349 parallaxes for 7879 stars, has been prepared at the Yale University Observatory. In this edition 1480 stars have been added to those contained in the previous edition of the catalog by Jenkins (1952, 1963). This relatively small increase in the number of stars is more than compensated for by the increased accuracy of the newer trigonometric parallaxes. The authors have attempted to include here all trigonometric parallaxes made available to them by March 1991 and will provide for each listed parallax in the final version the reference to its source of publication. For each star it lists the equatorial coordinates for B1900 and the secular variation for 100 years, the proper motion in x and y, the weighted average absolute parallax and its standard error, the number of parallax observations, the quality of interagreement among the different values, the visual magnitude, and various cross identifications with other catalogs. The B1900 equinox has been maintained to avoid assigning yet another star number. Ancillary information, including UBV photometry, MK spectral types, data on the variability and binary nature of the stars, orbits when available, and miscellaneous information to aid in determining the reliability of the data, will be listed in the final version. The relative parallaxes are corrected to absolute parallax using newly computed corrections that are based on an improved model of the galaxy. An analysis of the resulting absolute parallaxes has been made to study the accidental and systematic errors of the parallaxes. The results of that investigation are used to arrive at a weighting system for the catalog, which then yields weighted absolute parallaxes for each star. The weighting system is still under investigation; therefore, the weighted parallaxes may change a bit in the final version. Printed copies of the catalog will be available from the Yale

Strategic planning--a plan for excellence for South Haven Health System.

PubMed

Urbanski, Joanne; Baskel, Maureen; Martelli, Mary

2011-01-01

South Haven Health System has developed an innovative approach to strategic planning. The key to success of this process has been the multidisciplinary involvement of all stakeholders from the first planning session through the final formation of a strategic plan with measurable objectives for each goal. The process utilizes a Conversation Café method for identifying opportunities and establishing goals, Strategic Oversight Teams to address each goal and a Champion for implementation of each objective. Progress is measured quarterly by Strategic Oversight Team report cards. Transparency of communication within the organization and the sharing of information move the plan forward. The feedback from participant evaluations has been overwhelmingly positive. They are involved and excited.

Proposed regs address new hospital tax-exemption requirements.

PubMed

Speizman, Richard A; Moore, V A; Mitchell, Alexandra O

2013-03-01

Proposed regulations set forth detailed rules for implementing the new tax-exemption requirements of Section 501(r) of the Internal Revenue Code for not-for-profit organizations operating hospital facilities. The proposed regulations provide guidance on the written financial assistance policies (FAPs) that hospital facilities are required to establish. The regulations propose methodologies for determining the amounts that a hospital facility can charge FAP-eligible individuals for emergency and other medically necessary care. They prescribe procedures that hospital facilities would be required to follow before engaging in extraordinary collection actions against an individual.

HCA Richmond Hospitals' new marketing strategy a winning plan.

PubMed

Rees, Tom

2003-01-01

HCA Richmond Hospitals, a five-hospital system in Richmond, Va., is positioning itself as a winner in a highly competitive, healthcare-saturated market since overhauling is marketing strategy a little over a year ago. The marketing strategy enables individual hospital to target their own unique constituencies. "Understanding the intricate marketing dynamics of hospital systems is today of critical importance and equal complexity," said Tony Bejamin, principal of Oxygen Advertising Inc., New York, the agency that remodeled HCA Richmond Hospitals' marketing strategy.

Developing a career advancement program.

PubMed

Pinette, Shirley L

2003-01-01

managers in the department of diagnostic imaging at Yale-New Haven Hospital in New Haven, Conn., to develop a Career Ladder for all diagnostic imaging staff members, called the Career Advancement Program (CAP). The process has been time consuming and has required intense discussion and debate. The draft plan is for one CAP with multiple tracks to be used by all staff, both technical and support. A copy of the draft plan is included in this article.

Yale High Energy Physics Research: Precision Studies of Reactor Antineutrinos

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

Heeger, Karsten M.

2014-09-13

This report presents experimental research at the intensity frontier of particle physics with particular focus on the study of reactor antineutrinos and the precision measurement of neutrino oscillations. The experimental neutrino physics group of Professor Heeger and Senior Scientist Band at Yale University has had leading responsibilities in the construction and operation of the Daya Bay Reactor Antineutrino Experiment and made critical contributions to the discovery of non-zeromore » $$\\theta_{13}$$. Heeger and Band led the Daya Bay detector management team and are now overseeing the operations of the antineutrino detectors. Postdoctoral researchers and students in this group have made leading contributions to the Daya Bay analysis including the prediction of the reactor antineutrino flux and spectrum, the analysis of the oscillation signal, and the precision determination of the target mass yielding unprecedented precision in the relative detector uncertainty. Heeger's group is now leading an R\\&D effort towards a short-baseline oscillation experiment, called PROSPECT, at a US research reactor and the development of antineutrino detectors with advanced background discrimination.« less

Managing chronic back pain: impact of an interdisciplinary team approach.

PubMed

Flavell, H A; Carrafa, G P; Thomas, C H; Disler, P B

1996-09-02

To evaluate the effectiveness of a six-week outpatient program in pain management for patients with chronic back pain. Retrospective review. Rehabilitation Clinical Business Unit, Essendon campus of the Royal Melbourne Hospital. 138 consecutive patients who participated in the unit's Chronic Back Pain Programme between 1991 and 1993. Multidisciplinary program that promoted pain management rather than "cure", with two six-hour group sessions per week for six weeks. Patient assessments before the program and at program completion and at three months' follow-up, with the West Haven-Yale Multidimensional Pain Inventory (WHYMPI) and a four-minute walk test. At program completion, the WHYMPI showed significant decreases in the amount pain interfered with life and significant increases in patient sense of control and activity level. However, severity of pain remained the same. All these effects were maintained three months later. A brief outpatient program was effective in improving pain management in a group of chronic back pain sufferers. This seems a useful and relatively inexpensive option in managing this problematic group of patients.

Social responsibility: a new paradigm of hospital governance?

PubMed

Brandão, Cristina; Rego, Guilhermina; Duarte, Ivone; Nunes, Rui

2013-12-01

Changes in modern societies originate the perception that ethical behaviour is essential in organization's practices especially in the way they deal with aspects such as human rights. These issues are usually under the umbrella of the concept of social responsibility. Recently the Report of the International Bioethics Committee of UNESCO on Social Responsibility and Health has addressed this concept of social responsibility in the context of health care delivery suggesting a new paradigm in hospital governance. The objective of this paper is to address the issue of corporate social responsibility in health care, namely in the hospital setting, emphasising the special governance arrangements of such complex organisations and to evaluate if new models of hospital management (entrepreneurism) will need robust mechanisms of corporate governance to fulfil its social responsiveness. The scope of this responsible behaviour requires hospitals to fulfil its social and market objectives, in accordance to the law and general ethical standards. Social responsibility includes aspects like abstention of harm to the environment or the protection of the interests of all the stakeholders enrolled in the deliverance of health care. In conclusion, adequate corporate governance and corporate strategy are the gold standard of social responsibility. In a competitive market hospital governance will be optimised if the organization culture is reframed to meet stakeholders' demands for unequivocal assurances on ethical behaviour. Health care organizations should abide to this new governance approach that is to create organisation value through performance, conformance and responsibility.

Container barge feeder service study : Bridgeport, New Haven, New London, Norwich

DOT National Transportation Integrated Search

2001-03-01

The Connecticut Department of Transportation (ConnDOT) has conducted this study to determine the need and opportunity for establishing a Container Barge Feeder Service along Long Island Sound between the Port of New York and New Jersey (NY&NJ) and th...

The Probability of Neonatal Respiratory Distress Syndrome as a Function of Gestational Age and Lecithin/Sphingomyelin Ratio

PubMed Central

St. Clair, Caryn; Norwitz, Errol R.; Woensdregt, Karlijn; Cackovic, Michael; Shaw, Julia A.; Malkus, Herbert; Ehrenkranz, Richard A.; Illuzzi, Jessica L.

2011-01-01

We sought to define the risk of neonatal respiratory distress syndrome (RDS) as a function of both lecithin/sphingomyelin (L/S) ratio and gestational age. Amniotic fluid L/S ratio data were collected from consecutive women undergoing amniocentesis for fetal lung maturity at Yale-New Haven Hospital from January 1998 to December 2004. Women were included in the study if they delivered a live-born, singleton, nonanomalous infant within 72 hours of amniocentesis. The probability of RDS was modeled using multivariate logistic regression with L/S ratio and gestational age as predictors. A total of 210 mother-neonate pairs (8 RDS, 202 non-RDS) met criteria for analysis. Both gestational age and L/S ratio were independent predictors of RDS. A probability of RDS of 3% or less was noted at an L/S ratio cutoff of ≥3.4 at 34 weeks, ≥2.6 at 36 weeks, ≥1.6 at 38 weeks, and ≥1.2 at term. Under 34 weeks of gestation, the prevalence of RDS was so high that a probability of 3% or less was not observed by this model. These data describe a means of stratifying the probability of neonatal RDS using both gestational age and the L/S ratio and may aid in clinical decision making concerning the timing of delivery. PMID:18773379

Outreach: the western New York Hospital Library Services Program, 1985-1989.

PubMed Central

Birkinbine, L A; Bertuca, C A

1991-01-01

The Hospital Library Services Program (HLSP) in western New York, during the period covered by its first five-year plan, 1984-1989, is recounted and described. This ongoing program is funded annually by a New York State grant and hospital participation fees. It is designed to support access to biomedical information for health care professionals through a grant program for hospitals with staffed libraries and a circuit program for hospitals without library staffing or without libraries. Hospitals participating in the grant program contribute funds and receive grants for collection development. Hospitals participating in the circuit program pay a participation fee and receive regularly scheduled, documented, circuit librarian visits; a collection development grant; and a grant for contract library services. The program contracts with the State University of New York at Buffalo's (UB) Health Sciences Library to provide computerized literature searches; interlibrary loan (ILL) of journal articles, books, and audiovisuals; and ILL referrals. PMID:1958912

Predictors for Unplanned Hospitalization of New Home Care Clients.

PubMed

Rönneikkö, Jukka K; Mäkelä, Matti; Jämsen, Esa R; Huhtala, Heini; Finne-Soveri, Harriet; Noro, Anja; Valvanne, Jaakko N

2017-02-01

To identify factors predicting unplanned hospitalization of new home care clients using the Resident Assessment Instrument for Home Care (RAI-HC). A register-based study based on RAI-HC assessments and nationwide hospital discharge records. Municipal home care services in Finland. New Finnish home care clients aged 63 and older (N = 15,700). Information from home care clients' first RAI-HC assessment was connected to information regarding their first hospitalization over 1 year of follow-up. Multivariate regression analyses were used to evaluate the independent risk factors for hospitalization. Forty-three percent (n = 6,812) of participants were hospitalized at least once. The strongest independent risk factors were hospitalization during the year preceding the RAI-HC assessment (odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.87-2.16), aged 90 and older (OR = 1.69, 95% CI = 1.48-1.92), renal insufficiency (OR = 1.44, 95% CI = 1.22-1.69) and using 10 or more drugs (OR = 1.41, 95% CI = 1.26-1.58). Other independent risk factors were male sex, previous emergency department visits or other acute outpatient care use, daily urinary incontinence, fecal incontinence, history of falls, cognitive impairment, chronic skin ulcer, pain, unstable health status, housing-related problems, and poor self-rated health. Parkinson's disease, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, and cancer were independent prognostic indicators. A body mass index of 24 kg/m 2 or greater and the client's own belief that functional capacity could improve had a protective role. Assessing new home care clients using the RAI-HC reveals modifiable risk factors for unplanned hospitalization. Systematic assessment by a multidisciplinary team at the beginning of the service and targeting modifiable risk factors could reduce the risk of unplanned hospitalization. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics

An Evaluation of the Italian Version of the Yale Food Addiction Scale in Obese Adult Inpatients Engaged in a 1-Month-Weight-Loss Treatment.

PubMed

Ceccarini, Martina; Manzoni, Gian Mauro; Castelnuovo, Gianluca; Molinari, Enrico

2015-11-01

Addiction is a compulsive need for and use of a specific substance leading to a habit, tolerance, and psychophysiological symptoms. Excessive food consumption is similar to that of substance addiction. Some individuals who have trouble losing weight display addictive eating symptoms. To investigate food addiction in a sample of obese adults referred to hospital for a 1-month-weight-loss treatment. The Italian version of the Yale Food Addiction Scale (YFAS-16) was used as a screening tool in 88 obese inpatients. The construct validity of the YFAS-16 was assessed by testing its correlations with measures of binge eating (Binge Eating Scale), impulsiveness (Barratt Impulsiveness Scale), and emotional dysregulation (Difficulties in Emotion Regulation Scale). 34.1% of our sample was diagnosed with YFAS food addiction. Such diagnosis was also supported by strong associations between FA and psychological and behavioral features, typically descriptive of classic addiction. Patients who endorsed the YFAS-16 criteria for food addiction (FA) had significantly higher binge eating levels, greater emotional dysregulation, and nonacceptance of negative feelings; they lacked goal-oriented behavior, had little impulse control, had difficulty in emotion recognition, and attentional impulsivity; and they were unable to concentrate and lacked inhibitory control behavior, unlike participants who did not meet the FA criteria. Further research is needed to support the reliability of the YFAS-16. This measure has the potential to be applied in epidemiological research, estimating the prevalence of FA within the Italian population and to assess new treatments' efficacy for obese patients with food addiction symptoms seeking weight-loss treatments.

Four children and Yale: the making of a human geneticist: the Grover Powers lecture 2014.

PubMed

Rosenberg, Leon E

2014-09-01

Dr. Leon E. Rosenberg delivered the following presentation as the Grover Powers Lecturer on May 14, 2014, which served as the focal point of his return to his "adult home" as a Visiting Professor in the Department of Pediatrics. Grover F. Powers, MD, was one of the most influential figures in American Pediatrics and certainly the leader who created the modern Department of Pediatrics at Yale when he was recruited in 1921 from Johns Hopkins and then served as its second chairman from 1927 to 1951. Dr. Powers was an astute clinician and compassionate physician and fostered and shaped the careers of countless professors, chairs, and outstanding pediatricians throughout the country. This lectureship has continued yearly since it first honored Dr. Powers in 1956. The selection of Dr. Rosenberg for this honor recognizes his seminal role at Yale and throughout the world in the fostering and cultivating of the field of human genetics. Dr. Rosenberg served as the inaugural Chief of a joint Division of Medical Genetics in the Departments of Pediatrics and Internal Medicine; he became Chair when this attained Departmental status. Then he served as Dean of the Medical School from 1984 to 1991, before he became President of the Pharmaceutical Research Institute at Bristol-Myers Squibb and later Senior Molecular Biologist and Professor at Princeton University, until his recent retirement. Dr. Rosenberg has received numerous honors that include the Borden Award from the American Academy of Pediatrics, the McKusick Leadership Award from the American Society for Human Genetics, and election to the Institute of Medicine and the National Academy of Sciences.

Project ASPIRE: Incorporating Integrative Medicine Into Residency Training

PubMed Central

Nawaz, Haq; Via, Christina M.; Ali, Ather; Rosenberger, Lisa D.

2016-01-01

Griffin Hospital, a community hospital affiliated with Yale School of Public Health and Yale School of Medicine, received Health Resources and Services Administration funding to strengthen and improve its combined internal medicine and general preventive medicine residency program by incorporating an integrative medicine curriculum. The purpose of project ASPIRE (Advancing Skills of Preventive medicine residents through Integrative medicine Education, Research and Evaluation) was to create, implement, and evaluate a needs-based, innovative training curriculum in integrative medicine. Through this robust new training, the authors aimed to produce preventive medicine-trained physicians with competencies in integrative medicine to collaboratively work with other integrative medicine practitioners in interdisciplinary teams to provide holistic, patient-centered care. The multifaceted collaborative curriculum was composed of didactics, grand rounds, journal club, objective structured clinical examinations, and two new practicum rotations in integrative medicine. The new practicum rotations included block rotations at the Integrative Medicine Center at Griffin Hospital and the Yale Stress Center. Between 2012 and 2014, three cohorts participated in the curriculum; two of these cohorts included three advanced preventive medicine residents each and the fourth included four residents. Project faculty conducted 14 lectures and journal clubs, and two grand rounds. Six of the ten participating residents (60%) completed integrative medicine clinical rotations. Residents’ attitudes toward integrative medicine were evaluated through self-assessment using the Complementary, Alternative, and Integrative Medicine Attitudes Questionnaire; data were analyzed in 2015. This article describes the results of this prospective observational study based on single-institution experience over the course of the 2-year project period. PMID:26477907

Preliminary validation of the Yale Food Addiction Scale for children.

PubMed

Gearhardt, Ashley N; Roberto, Christina A; Seamans, Marissa J; Corbin, William R; Brownell, Kelly D

2013-12-01

Evidence is growing that an addictive process may play a role in problematic eating behavior. The majority of research on this topic has examined the concept of "food addiction" solely in adult samples. If certain foods have addictive potential, children may be impacted as much as (or more) than adults due to psychological and neurobiological vulnerabilities at younger developmental stages. In the current study, we developed a measure of food addiction in children that reflects the diagnostic indicators of addiction. The content and reading level of the Yale Food Addiction Scale (YFAS) was altered to be appropriate for children (YFAS-C). The YFAS-C and other eating-related measures were administered to study participants to examine the validity and reliability of the YFAS-C. 75 children were recruited from the community ranging from lean to obese. The validation of the YFAC-C provides preliminary support for its convergent validity with like constructs and incremental validity in predicting body mass index. Internal consistency was adequate given the small number of items on the scale. The YFAS-C appears to be a helpful tool for identifying addictive-like eating in children. © 2013.

Implementing Legislation to Improve Hospital Support of Breastfeeding, New York State, 2009-2013.

PubMed

Dennison, Barbara A; Hawke, Bethany A; Ruberto, Rachael A; Gregg, Deborah J

2015-07-30

Increasing breastfeeding is a public health priority supported by strong evidence. In 2009, New York passed Public Health Law § 2505-a, requiring that hospitals support the World Health Organization's (WHO's) recommended "Ten Steps for Successful Breastfeeding" (Ten Steps). This legislation strengthened and codified existing New York State's hospital perinatal regulations. The purpose of this study was to assess hospital policy compliance with New York laws and regulations related to breastfeeding. In 2009, 2011, and 2013, we collected written breastfeeding policies from 129 New York hospitals that provided maternity services. A policy review tool was developed to quantify compliance with the 28 components of breastfeeding support specified in New York Codes, Rules, and Regulations and the new legislation. In 2010 and 2012, hospitals received individual feedback from the New York State Department of Health, which informed hospitals in 2012 that formal regulatory enforcement, including potential fines, would be implemented for noncompliance. The number of components included in hospital policies increased from a mean of 10.4 in 2009, to 16.8 in 2011, and to 27.1 in 2013) (P < .001); a greater increase occurred from 2011 through 2013 than from 2009 through 2011 (P < .001). The percentage of hospitals with fully compliant policies increased from 0% in 2009, to 5% in 2011, and to 75% in 2013 (P < .001), and the percentage that included all WHO's 10 steps increased from 0% to 9% to 87%, respectively (P < .001). Although legislation or regulations requiring certain practices are important, monitoring with enforcement accelerates, and may be necessary for, full implementation. Future research is needed to evaluate the impact of improved hospital breastfeeding policies on breastfeeding outcomes in New York.

A new hospital library: a marketing opportunity.

PubMed Central

Walker, M E

1995-01-01

A new or remodeled library presents a unique marketing opportunity for the hospital librarian. Furthermore, a well-designed library markets itself through its convenience, attractiveness, and ease of use. A marketing approach to library planning takes into account needs of users and of library staff and considers the librarian's relations with the architect as well as with hospital employees. This paper describes ways to combine library planning with marketing techniques and specifies aspects of the library that contribute to its good image. PMID:7581190

A new kind of hospital magazine. Holy Name Hospital reaches Bergen County coffee tables.

PubMed

Botvin, Judith D

2002-01-01

Holy Name Hospital, Bergen County, N.J., mails its new magazine to 135,000 upscale homes, hoping to cause some defection from the heavy competition. The new publication retains the popular HealthWatch newsletter name, wrapping it in a slick package of consumer articles and ads.

The Yale-Brown Obsessive Compulsive Scale: A Reliability Generalization Meta-Analysis.

PubMed

López-Pina, José Antonio; Sánchez-Meca, Julio; López-López, José Antonio; Marín-Martínez, Fulgencio; Núñez-Núñez, Rosa Maria; Rosa-Alcázar, Ana I; Gómez-Conesa, Antonia; Ferrer-Requena, Josefa

2015-10-01

The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the most frequently applied test to assess obsessive compulsive symptoms. We conducted a reliability generalization meta-analysis on the Y-BOCS to estimate the average reliability, examine the variability among the reliability estimates, search for moderators, and propose a predictive model that researchers and clinicians can use to estimate the expected reliability of the Y-BOCS. We included studies where the Y-BOCS was applied to a sample of adults and reliability estimate was reported. Out of the 11,490 references located, 144 studies met the selection criteria. For the total scale, the mean reliability was 0.866 for coefficients alpha, 0.848 for test-retest correlations, and 0.922 for intraclass correlations. The moderator analyses led to a predictive model where the standard deviation of the total test and the target population (clinical vs. nonclinical) explained 38.6% of the total variability among coefficients alpha. Finally, clinical implications of the results are discussed. © The Author(s) 2014.

Status update. Hospitals are finding ways to use the social media revolution to raise money, engage patients and connect with their communities.

PubMed

Galloro, Vince

2011-03-14

As the social media revolution being built around Facebook, Twitter and YouTube has taken hold, hospitals haven't been left behind. Many see it as a vital part of communicating with their community. "We're really getting to the point where, if you want to be visible on the Internet, you have to be visible on social media," says Ed Bennett, left, of the University of Maryland Medical Center.

Changes in hospital competitive strategy: a new medical arms race?

PubMed

Devers, Kelly J; Brewster, Linda R; Casalino, Lawrence P

2003-02-01

To describe changes in hospitals' competitive strategies, specifically the relative emphasis placed on strategies for competing along price and nonprice (i.e., service, amenities, perceived quality) dimensions, and the reasons for any observed shifts. This study uses data gathered through the Community Tracking Study site visits, a longitudinal study of a nationally representative sample of 12 U.S. communities. Research teams visited each of these communities every two years since 1996 and conducted between 50 to 90 semistructured interviews. Additional information on hospital competition and strategy was gathered from secondary data. We found that hospitals' strategic emphasis changed significantly between 1996-1997 and 2000-2001. In the mid-1990s, hospitals primarily competed on price through "wholesale" strategies (i.e., providing services attractive to managed care plans). By 2000-2001, nonprice competition was becoming increasingly important and hospitals were reviving "retail" strategies (i.e., providing services attractive to individual physicians and the patients they serve). Three major factors explain this shift in hospital strategy: less than anticipated selective contracting and capitated payment; the freeing up of hospital resources previously devoted to horizontal and vertical integration strategies; and, the emergence and growth of new competitors. Renewed emphasis on nonprice competition and retail strategies, and the service mimicking and one-upmanship that result, suggest that a new medical arms race is emerging. However, there are important differences between the medical arms race today and the one that occurred in the 1970s and early 1980s: the hospital market is more concentrated and price competition remains relatively important. The development of a new medical arms race has significant research and policy implications.

Adopting new medical technologies in Russian hospitals: what causes inefficiency? (qualitative study).

PubMed

Shishkin, Sergey; Zasimova, Liudmila

2018-01-01

The adoption of new medical technologies often generates losses in efficiency associated with the excess or insufficient acquisition of new equipment, an inappropriate choice (in terms of economic and clinical parameters) of medical equipment, and its poor use. Russia is a good example for exploring the problem of the ineffective adoption of new medical technologies due to the massive public investment in new equipment for medical institutions in 2006-2013. This study examines the procurement of new technologies in Russian hospitals to find the main causes of inefficiency. The research strategy was based on in-depth semistructured interviews with representatives of prominent actors (regional health care authorities, hospital executives, senior physicians). The main result is that inefficiencies arise from the contradiction between hospitals' and authorities' motivation for acquiring new technologies: hospitals tend to adopt technologies which bring benefits to their department heads and physicians and minimize maintenance and servicing costs, while the authorities' main concern is the initial cost of the technology.

Closing forensic psychiatric hospitals in Italy: a new revolution begins?

PubMed

Barbui, Corrado; Saraceno, Benedetto

2015-06-01

On 30 May 2014 the Italian Parliament approved a new law regarding forensic psychiatric hospitals. Forensic psychiatric hospitals are facilities that admit individuals who have committed a criminal offence but lack criminal responsibility because of a mental disorder and are deemed as dangerous to public safety. Here we report the key aspects of the new legislation together with some critical considerations. © The Royal College of Psychiatrists 2015.

An inquiry into good hospital governance: A New Zealand-Czech comparison

PubMed Central

Ditzel, Elizabeth; Štrach, Pavel; Pirozek, Petr

2006-01-01

Background This paper contributes to research in health systems literature by examining the role of health boards in hospital governance. Health care ranks among the largest public sectors in OECD countries. Efficient governance of hospitals requires the responsible and effective use of funds, professional management and competent governing structures. In this study hospital governance practice in two health care systems – Czech Republic and New Zealand – is compared and contrasted. These countries were chosen as both, even though they are geographically distant, have a universal right to 'free' health care provided by the state and each has experienced periods of political change and ensuing economic restructuring. Ongoing change has provided the impetus for policy reform in their public hospital governance systems. Methods Two comparative case studies are presented. They define key similarities and differences between the two countries' health care systems. Each public hospital governance system is critically analysed and discussed in light of D W Taylor's nine principles of 'good governance'. Results While some similarities were found to exist, the key difference between the two countries is that while many forms of 'ad hoc' hospital governance exist in Czech hospitals, public hospitals in New Zealand are governed in a 'collegiate' way by elected District Health Boards. These findings are discussed in relation to each of the suggested nine principles utilized by Taylor. Conclusion This comparative case analysis demonstrates that although the New Zealand and Czech Republic health systems appear to show a large degree of convergence, their approaches to public hospital governance differ on several counts. Some of the principles of 'good governance' existed in the Czech hospitals and many were practiced in New Zealand. It would appear that the governance styles have evolved from particular historical circumstances to meet each country's specific requirements

Quashing ownership: health reform law bans new physician-owned hospitals.

PubMed

Ortolon, Ken

2010-08-01

With nearly 70 Texas hospitals with some type of physician investment, the state is a national leader in the physician-owned hospital industry. And, members of that industry say it has been good for patients. But the health system reform law Congress passed earlier this year slams the door on new physician-owned hospitals by prohibiting them from obtaining a Medicare provider number.

Going Beyond Compliance: A Strategic Framework for Promoting Information Security in Hospitals.

PubMed

Zandona, David J; Thompson, Jon M

In the past decade, public and private organizations have experienced a significant and alarming rise in the number of data breaches. Across all sectors, there seems to be no safe haven for the protection of information. In the health care industry, the trend is even worse. Information security is at an unbelievable low point, and it is unlikely that government oversight can fix this issue. Health care organizations have ramped up their approaches to addressing the problem; however, these initiatives are often incremental rather than transformational. Hospitals need an overall organization-wide strategy to prevent breaches from occurring and to minimize effects if they do occur. This article provides an analysis of the literature related to health information security and offers a suggested strategy for hospital administrators to follow in order to create a more secure environment for patient health information.

New Technologies to Assist Training in Hospitality Sector

ERIC Educational Resources Information Center

Balta, Sabah

2007-01-01

Hospitality sector needs new technological training tools, which can assist to improve sector employees' skills and services quality. The sector might be more interactive when these technological training tools used on the job-training program. This study addresses to issue of illumination of new technologic tools that enforce training in which…

Changes in Hospital Competitive Strategy: A New Medical Arms Race?

PubMed Central

Devers, Kelly J; Brewster, Linda R; Casalino, Lawrence P

2003-01-01

Objective To describe changes in hospitals' competitive strategies, specifically the relative emphasis placed on strategies for competing along price and nonprice (i.e., service, amenities, perceived quality) dimensions, and the reasons for any observed shifts. Methods This study uses data gathered through the Community Tracking Study site visits, a longitudinal study of a nationally representative sample of 12 U.S. communities. Research teams visited each of these communities every two years since 1996 and conducted between 50 to 90 semistructured interviews. Additional information on hospital competition and strategy was gathered from secondary data. Principal Findings We found that hospitals' strategic emphasis changed significantly between 1996–1997 and 2000–2001. In the mid-1990s, hospitals primarily competed on price through “wholesale” strategies (i.e., providing services attractive to managed care plans). By 2000–2001, nonprice competition was becoming increasingly important and hospitals were reviving “retail” strategies (i.e., providing services attractive to individual physicians and the patients they serve). Three major factors explain this shift in hospital strategy: less than anticipated selective contracting and capitated payment; the freeing up of hospital resources previously devoted to horizontal and vertical integration strategies; and, the emergence and growth of new competitors. Conclusion Renewed emphasis on nonprice competition and retail strategies, and the service mimicking and one-upmanship that result, suggest that a new medical arms race is emerging. However, there are important differences between the medical arms race today and the one that occurred in the 1970s and early 1980s: the hospital market is more concentrated and price competition remains relatively important. The development of a new medical arms race has significant research and policy implications. PMID:12650375

The Connecticut Mental Health Center: Celebrating 50 Years of a Successful Partnership Between the State and Yale University.

PubMed

Steiner, Jeanne L; Anez-Nava, Luis; Baranoski, Madelon; Cole, Robert; Davidson, Larry; Delphin-Rittmon, Miriam; Dike, Charles; DiLeo, Paul J; Duman, Ronald S; Kirk, Thomas; Krystal, John; Malison, Robert T; Rohrbaugh, Robert M; Sernyak, Michael J; Srihari, Vinod; Styron, Thomas; Tebes, Jacob K; Woods, Scott; Zonana, Howard; Jacobs, Selby C

2016-12-01

September 28, 2016, marked the 50th anniversary of the Connecticut Mental Health Center, a state-owned and state-operated joint venture between the state and Yale University built and sustained with federal, state, and university funds. Collaboration across these entities has produced a wide array of clinical, educational, and research initiatives, a few of which are described in this column. The missions of clinical care, research, and education remain the foundation for an organization that serves 5,000 individuals each year who are poor and who experience serious mental illnesses and substance use disorders.

New Orleans Charity Hospital--your trauma center at work.

PubMed

Stockinger, Zsolt T; Holloway, Vicki L; McSwain, Norman E; Thomas, Dwayne; Fontenot, Cathi; Hunt, John P; Mederos, Eileen; Hewitt, Robert L

2004-01-01

The Medical Center of Louisiana at New Orleans-Charity Hospital stands with pride as one of only two level I trauma centers in the state and one of the largest trauma centers in the United States, seeing over 4,000 trauma patients per year. Despite perennial funding issues, Charity Hospital's Emergency Department treated almost 200,000 patients in 2003. This brief report gives an overview of the emergency- and trauma-related services provided by Charity Hospital and underscores its value as a critical asset to healthcare in the Louisiana.

2016 Federal Green Challenge Award Winners in the New England Region

EPA Pesticide Factsheets

In the New England region, the 2016 Federal Green Challenge award winners are the Manchester Veterans Affairs (VA) Medical Center, West Haven VA Medical Campus, and the U.S. Naval Undersea Warfare Center..

Impacts of Hospital Budget Limits in Rochester, New York

PubMed Central

Friedman, Bernard; Wong, Herbert S.

1995-01-01

During 1980-87, eight hospitals in the Rochester, New York area participated in an experimental program to limit total revenue. This article analyzes: increase of costs for Rochester hospitals; trends for inputs and compensation; and cash flow margins. Real expense per case grew annually by about 3 percent less in Rochester. However, after 1984, Medicare prospective payment had an effect of similar size outside Rochester. Some capital inputs to hospital care were restrained, as were wages and particularly benefits. The program did not generally raise or stabilize hospital revenue margins, while the ratio of cash flow to debt trended down. Financial stringency of this program relative to alternatives may have contributed to its end. PMID:10151889

Impacts of hospital budget limits in Rochester, New York.

PubMed

Friedman, B; Wong, H S

1995-01-01

During 1980-87, eight hospitals in the Rochester, New York area participated in an experimental program to limit total revenue. This article analyzes: increase of costs for Rochester hospitals; trends for inputs and compensation; and cash flow margins. Real expense per case grew annually by about 3 percent less in Rochester. However, after 1984, Medicare prospective payment had an effect of similar size outside Rochester. Some capital inputs to hospital care were restrained, as were wages and particularly benefits. The program did not generally raise or stabilize hospital revenue margins, while the ratio of cash flow to debt trended down. Financial stringency of this program relative to alternatives may have contributed to its end.

A new casemix adjustment index for hospital mortality among patients with congestive heart failure.

PubMed

Polanczyk, C A; Rohde, L E; Philbin, E A; Di Salvo, T G

1998-10-01

Comparative analysis of hospital outcomes requires reliable adjustment for casemix. Although congestive heart failure is one of the most common indications for hospitalization, congestive heart failure casemix adjustment has not been widely studied. The purposes of this study were (1) to describe and validate a new congestive heart failure-specific casemix adjustment index to predict in-hospital mortality and (2) to compare its performance to the Charlson comorbidity index. Data from all 4,608 admissions to the Massachusetts General Hospital from January 1990 to July 1996 with a principal ICD-9-CM discharge diagnosis of congestive heart failure were evaluated. Massachusetts General Hospital patients were randomly divided in a derivation and a validation set. By logistic regression, odds ratios for in-hospital death were computed and weights were assigned to construct a new predictive index in the derivation set. The performance of the index was tested in an internal Massachusetts General Hospital validation set and in a non-Massachusetts General Hospital external validation set incorporating data from all 1995 New York state hospital discharges with a primary discharge diagnosis of congestive heart failure. Overall in-hospital mortality was 6.4%. Based on the new index, patients were assigned to six categories with incrementally increasing hospital mortality rates ranging from 0.5% to 31%. By logistic regression, "c" statistics of the congestive heart failure-specific index (0.83 and 0.78, derivation and validation set) were significantly superior to the Charlson index (0.66). Similar incrementally increasing hospital mortality rates were observed in the New York database with the congestive heart failure-specific index ("c" statistics 0.75). In an administrative database, this congestive heart failure-specific index may be a more adequate casemix adjustment tool to predict hospital mortality in patients hospitalized for congestive heart failure.

The Department of Obstetrics and Gynecology at Yale: the first one hundred fifty years, from Nathan Smith to Lee Buxton.

PubMed Central

Kohorn, E. I.

1993-01-01

The persons who directed the academic teaching of women's health at Yale Medical School are presented by biographical sketches recounting their achievements and some of the difficulties they encountered. Three who provided particular catalysis were Nathan Smith, Herbert Thoms, and Lee Buxton. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 PMID:8303913

Implementing Legislation to Improve Hospital Support of Breastfeeding, New York State, 2009–2013

PubMed Central

Hawke, Bethany A.; Ruberto, Rachael A.; Gregg, Deborah J.

2015-01-01

Introduction Increasing breastfeeding is a public health priority supported by strong evidence. In 2009, New York passed Public Health Law § 2505–a, requiring that hospitals support the World Health Organization’s (WHO’s) recommended “Ten Steps for Successful Breastfeeding” (Ten Steps). This legislation strengthened and codified existing New York State’s hospital perinatal regulations. The purpose of this study was to assess hospital policy compliance with New York laws and regulations related to breastfeeding. Methods In 2009, 2011, and 2013, we collected written breastfeeding policies from 129 New York hospitals that provided maternity services. A policy review tool was developed to quantify compliance with the 28 components of breastfeeding support specified in New York Codes, Rules, and Regulations and the new legislation. In 2010 and 2012, hospitals received individual feedback from the New York State Department of Health, which informed hospitals in 2012 that formal regulatory enforcement, including potential fines, would be implemented for noncompliance. Results The number of components included in hospital policies increased from a mean of 10.4 in 2009, to 16.8 in 2011, and to 27.1 in 2013) (P < .001); a greater increase occurred from 2011 through 2013 than from 2009 through 2011 (P < .001). The percentage of hospitals with fully compliant policies increased from 0% in 2009, to 5% in 2011, and to 75% in 2013 (P < .001), and the percentage that included all WHO’s 10 steps increased from 0% to 9% to 87%, respectively (P < .001). Conclusion Although legislation or regulations requiring certain practices are important, monitoring with enforcement accelerates, and may be necessary for, full implementation. Future research is needed to evaluate the impact of improved hospital breastfeeding policies on breastfeeding outcomes in New York. PMID:26226069

Can patient safety indicators monitor medical and surgical care at New Zealand public hospitals?

PubMed

Hider, Phil; Parker, Karl; von Randow, Martin; Milne, Barry; Lay-Yee, Roy; Davis, Peter

2014-11-07

Increasing interest has focused on the safety of hospital care. The AusPSIs are a set of indicators developed from Australian administrative data to reliably identify inpatient adverse events in hospitals. The main aim of this study was to explore the application of the AHRQ/AusPSIs to New Zealand administrative hospital data related to medical and surgical care. Variation over time and across hospitals were also considered for a subset of the more common indicators. AHRQ/AusPSIs were adapted for use with New Zealand National Minimum Dataset administrative data for the period 2001-9. Crude positive event rates for each of the 16 indicators were assessed across New Zealand public hospitals. Variation over time for six more common indicators is presented using statistical control charts. Variation between hospitals was explored using rates adjusted for differences in patient variables including age, sex, ethnicity, rurality of residence, NZDep score and comorbidities. The AHRQ/AusPSIs were applied to New Zealand administrative hospital data and some 99,366 admissions were associated with a positive indicator event. However rates for some indicators were low (<1% of denominator admissions). Over the study period considerable variation in the rate of positive events was evident for the six most common indicators. Likewise there was substantial variation between hospitals in relation to risk adjusted positive event rates Patient safety indicators can be applied to New Zealand administrative hospital data. While infrequent rates hinder the use of some of the indicators, several could now be readily employed as warning flags to help monitor rates of adverse events at particular hospitals. In conjunction with other established or emerging tools, such as audit and trigger tools, the PSIs are now available to promote ongoing quality improvement activities in New Zealand hospitals.

Responses to prospective payment by rural New Mexico hospitals.

PubMed

Smith, H L; Piland, N F; Phillipp, A M

1991-12-01

A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed.

Responses to prospective payment by rural New Mexico hospitals.

PubMed Central

Smith, H L; Piland, N F; Phillipp, A M

1991-01-01

A cross-sectional study is used to determine how rural New Mexico hospitals altered service diversification, inpatient service emphasis, and service promotion during Medicare's prospective payment system (PPS) transition and posttransition phases. Results suggest that the hospitals implemented distinct strategies in response to PPS. The posttransition strategies were examined for their association with improved revenue and utilization indicators. Few of the service diversification and promotional strategies were consistent predictors of performance. Emphasis on fine-tuning inpatient services was the most promising predictor of higher utilization and revenue measures. The implications for other rural hospitals are discussed. PMID:1743969

Report of a mental health survey among Chinese international students at Yale University.

PubMed

Han, Xuesong; Han, Xuemei; Luo, Qianlai; Jacobs, Selby; Jean-Baptiste, Michel

2013-01-01

To examine the prevalence of depression and anxiety symptoms in Chinese international students, to identify factors that might be associated with these 2 symptom complexes, and to investigate their perception of mental health issues and counseling services. Chinese students (N = 130) at Yale University. Participants completed an anonymous online survey in fall 2009. Forty-five percent reported symptoms of depression, and 29% reported symptoms of anxiety. A self-evaluation of poor current health, a poor relationship with one's advisor, and a low exercise regimen were associated with a higher prevalence of depression and anxiety symptoms. Twenty-seven percent of responders were not aware of the availability of mental health and counseling services on campus. This study suggests that efforts should be made to improve the relationship between students and their advisors and to enhance the awareness of and the accessibility to mental health and counseling services to improve the mental health of Chinese international students.

Hospital inpatient prospective payment system: incorporating new technology.

PubMed

Durthaler, Jeffrey M; Miller, Alicia

2003-11-01

New technologies in the impatient prospective payment system are discussed. On December 21, 2000, Congress passed Public Law 106-554 that includes a requirement to establish a mechanism to more expeditiously incorporate the costs and establish qualifying criteria for payment of new services and technologies into the hospital inpatient prospective payment system. The final ruling of this law states that a new service or technology must demonstrate substantial improvement, be inadequately paid under the DRG system, and be "new." The intent of these criteria is to identify new technologies that offer substantial improvement over existing technologies and to provide supplemental payment that encourages physicians and hospitals to utilize the new technology. In November 2001, drotrecogin alfa (activated) received fast-track FDA approval because of the robust findings from the PROWESS trial. Drotrecogin alfa (activated) is the first agent proven to reduce mortality in patients suffering from severe sepsis associated with acute organ dysfunction who are at a high risk of death (i.e., APACHE II score > 24). In August 2002, drotrecogin alfa (activated) was one of four such new technologies and the first agent approved for new technology payment under the prospective payment system (PPS). This decision offers confidence that the PPS is effectively striving to incorporate new medical services and technologies at a pace similar to that of innovation. Providers may receive up to $3400 in additional reimbursement when drotrecogin alfa (activated) is administered in the Medicare population. Pharmacy and patient accounting personnel should develop a collaborative process to identify, document, and capture this new source of payment.

An occurence records database of Irregular Echinoids (Echinodermata: Echinoidea) in Mexico.

PubMed

Martínez-Melo, Alejandra; Solís-Marín, Francisco Alonso; Buitrón-Sánchez, Blanca Estela; Laguarda-Figueras, Alfredo

2016-01-01

Research on echinoderms in Mexico began in the late nineteenth century. We present a dataset that includes the taxonomic and geographic information of irregular echinoids from Mexico, housed in four collections: 1) Colección Nacional de Equinodermos "Ma. Elena Caso Muñoz" from the Instituto de Ciencias del Mar y Limnología (ICML), Universidad Nacional Autónoma de México (UNAM); 2) Invertebrate Zoology Collection, Smithsonian Museum of Natural History, Washington, D.C., United States of America (USA); 3) Invertebrate Collection, Museum of Comparative Zoology, University of Harvard, Boston, Massachusetts, USA and 4) Invertebrate Zoology, Peabody Museum, Yale University, New Haven, Connecticut, USA. A total of six orders, 17 families, 35 genera and 68 species are reported, 37 distributed in the Pacific coast and 31 in the Atlantic coast, none of them was found in both coasts. The most diverse region is the Gulf of California (S=32); the most diverse order is Spatangoida with 31 species reported in mexican waters.

Appreciated abroad, depreciated at home. The career of a radiochemist in Norway: Ellen Gleditsch (1879-1968).

PubMed

Lykknes, Annette; Kvittingen, Lise; Børresen, Anne Kristine

2004-12-01

Ellen Gleditsch (1879-1968) became Norway's first authority on radioactivity and the country's second female full professor. From her many years abroad--in Marie Curie's laboratory in Paris and at Yale University in New Haven with Bertram Boltram--she became internationally acknowledged and developed an extensive personal and scientific network. In the Norwegian scientific community she was, however, less appreciated, and her appointment as a professor in 1929 caused controversy. Despite the recommendation of the expert committee, her predecessor and his allies spread the view that Gleditsch was a diligent but outdated researcher with little scientific promise-a view that apparently persists in the Norwegian chemical community today. In addition to her scientific work, Gleditsch acquired political influence by joining the International Federation of University Women in 1920; she later became the president of both the Norwegian section and the worldwide organization. She worked in particular to establish scholarships enabling women to go abroad.

Hospitalization Rates Among People With HIV/AIDS in New York City, 2013.

PubMed

Lazar, Rachael; Kersanske, Laura; Xia, Qiang; Daskalakis, Demetre; Braunstein, Sarah L

2017-08-01

Hospitalizations are an important indicator of healthcare quality and access for people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). This study assesses hospitalization rates among people with HIV/AIDS in New York City. We performed a deterministic match between people in the New York City HIV surveillance registry alive as of 1 January 2013 and diagnosed with HIV as of 31 December 2013 and patient-level inpatient hospitalization records during 2013. Event-level data were analyzed to determine characteristics of and reasons for hospitalizations. Primary diagnoses were classified using the International Classification of Diseases, Ninth Revision, Clinical Modification. We estimated hospitalization rates as the number of hospitalizations per 100 person-years for all causes, AIDS-defining illnesses, and non-AIDS-defining infections. Nearly one-fifth of hospitalizations were attributed to non-AIDS-defining infections, whereas AIDS-defining illness diagnoses were infrequent (3.6% of hospitalizations). Other common causes were cardiovascular (10.9%) and substance use (9.8%). The estimated all-cause hospitalization rate was 36.7 per 100 person-years. Higher all-cause hospitalization rates were observed among females (46.8 per 100 person-years), Black and Latino/Hispanic people (41.8 and 39.5 per 100 person-years, respectively), people living in high-poverty neighborhoods (47.4 per 100 person-years), and people with a history of injection drug use (74.9 per 100 person-years). The estimated AIDS-defining illness and non-AIDS-defining infection hospitalization rates were 1.3 and 7.2 per 100 person-years, respectively. People with HIV in New York City were frequently hospitalized. While AIDS-defining illnesses were relatively rare, non-AIDS-defining infection hospitalizations were more common. Disparities in hospitalization rates indicate a need for targeted improved primary care and comorbid disease management. © The Author 2017

Harvey Cushing and the battle of Boston common: military medical preparedness for world war one.

PubMed

Rutkow, Eric; Rutkow, Ira

2010-07-01

To explore the events and people that shaped Harvey Cushing, one of the nation's leading surgeons, into a political actor as he rallied support for the issue of military medical preparedness for World War One. In a little remembered episode of American medical history, for 2 years before the nation's formal entry into World War One in April 1917, Harvey Cushing attempted to garner political and professional support for the idea of military medical preparedness. His efforts, including the proposed construction of a functioning Base Hospital on Boston Common, sparked controversy in a public that was torn between maintaining neutrality and going to war. An analysis of Harvey Cushing's unpublished letters, manuscripts, and papers located at the Yale University School of Medicine, New Haven, CT. While Harvey Cushing's crusade for military medical preparedness failed to win over the local public, it helped convince national military leaders that the civilian medical community was ready to assist in the war. This, in turn, laid the foundation for much of the American medical establishment's success on the battlefields of World War One. The disagreement surrounding the Battle of Boston Common, as Harvey Cushing had labeled the debate, reveals both how, even at the brink of war, ideas formulated on the war front could not be translated to the home front, and how early military medical preparedness, although national in character, was commanded by only a few select voices.

Building new university hospital--what citizens know and policy makers should be aware of.

PubMed

Oresković, S; Letica, S; Mastilica, M; Babić-Bosanac, S; Civljak, M; Bozicević, I; Borovecki, A

2002-12-01

Survey of citizens' attitudes in the process of strategic decision making is one of the most important methods for determining health care priorities. We describe the results of a survey carried out in December 2001, with an aim to collect and analyze the attitudes of the citizens and health care professionals toward the possibilities and strategies of construction of the University Hospital in Blato, Zagreb. The first referendum on the construction of the new hospital was conducted among Zagreb citizens in 1982, when they agreed that the new University Hospital was much needed. Zagreb citizens confirmed once again their attitudes toward and opinions on the need to continue the construction of new hospital in the city outskirts. By 1992, when the construction of the hospital was halted due to insufficient financial means, Zagreb citizens had already invested over 150 epsilon million in the project. It is interesting that today, 89.4% of the citizens and 74.5% of physicians agree that the new hospital building should be completed. Also, 66.7% of the citizens and 88% of physicians think that this hospital should be a University hospital that could offer the most complex treatments and medical education. To finish the construction of the new hospital further 200 epsilon million needs to be invested. Survey showed that 71% of citizens and 82.2% of physicians think that funds should be raised from some form of credit or budget rather than by special local tax, additional tax or voluntary tax. This project will significantly determine the future of hospital and health care system in Croatia due to its capacities in terms of space, technology, and staff. Before the decision to continue with the new hospital construction be made, the expected future needs, demands, and supply of the health care services in hospital sector in Zagreb and Croatia should be provided using SWOT analysis for each of existing the facilities.

New name can sharpen a hospital's image--or diffuse checkered past.

PubMed

Burns, J

1992-06-22

Hospitals change their names for a variety of reasons. Some seek a new identity that conveys a wider range of services; others need a new moniker as a result of a merger; still others hope a change can help the facility erase past problems. Whatever the case may be, a hospital's decision to change its name has evolved from a mere technical formality to a competitive, and often costly, marketing strategy.

Integrating new practices: a qualitative study of how hospital innovations become routine.

PubMed

Brewster, Amanda L; Curry, Leslie A; Cherlin, Emily J; Talbert-Slagle, Kristina; Horwitz, Leora I; Bradley, Elizabeth H

2015-12-05

Hospital quality improvement efforts absorb substantial time and resources, but many innovations fail to integrate into organizational routines, undermining the potential to sustain the new practices. Despite a well-developed literature on the initial implementation of new practices, we have limited knowledge about the mechanisms by which integration occurs. We conducted a qualitative study using a purposive sample of hospitals that participated in the State Action on Avoidable Rehospitalizations (STAAR) initiative, a collaborative to reduce hospital readmissions that encouraged members to adopt new practices. We selected hospitals where risk-standardized readmission rates (RSRR) had improved (n = 7) or deteriorated (n = 3) over the course of the first 2 years of the STAAR initiative (2010-2011 to 2011-2012) and interviewed a range of staff at each site (90 total). We recruited hospitals until reaching theoretical saturation. The constant comparative method was used to conduct coding and identification of key themes. When innovations were successfully integrated, participants consistently reported that a small number of key staff held the innovation in place for as long as a year while more permanent integrating mechanisms began to work. Depending on characteristics of the innovation, one of three categories of integrating mechanisms eventually took over the role of holding new practices in place. Innovations that proved intrinsically rewarding to the staff, by making their jobs easier or more gratifying, became integrated through shifts in attitudes and norms over time. Innovations for which the staff did not perceive benefits to themselves were integrated through revised performance standards if the innovation involved complex tasks and through automation if the innovation involved simple tasks. Hospitals have an opportunity to promote the integration of new practices by planning for the extended effort required to hold a new practice in place while

Data Safe Havens and Trust: Toward a Common Understanding of Trusted Research Platforms for Governing Secure and Ethical Health Research

PubMed Central

Nicholls, Jacqueline; Dobbs, Christine; Sethi, Nayha; Cunningham, James; Ainsworth, John; Heaven, Martin; Peacock, Trevor; Peacock, Anthony; Jones, Kerina; Laurie, Graeme; Kalra, Dipak

2016-01-01

In parallel with the advances in big data-driven clinical research, the data safe haven concept has evolved over the last decade. It has led to the development of a framework to support the secure handling of health care information used for clinical research that balances compliance with legal and regulatory controls and ethical requirements while engaging with the public as a partner in its governance. We describe the evolution of 4 separately developed clinical research platforms into services throughout the United Kingdom-wide Farr Institute and their common deployment features in practice. The Farr Institute is a case study from which we propose a common definition of data safe havens as trusted platforms for clinical academic research. We use this common definition to discuss the challenges and dilemmas faced by the clinical academic research community, to help promote a consistent understanding of them and how they might best be handled in practice. We conclude by questioning whether the common definition represents a safe and trustworthy model for conducting clinical research that can stand the test of time and ongoing technical advances while paying heed to evolving public and professional concerns. PMID:27329087

13. View north within enclosure between old and new sections ...

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

13. View north within enclosure between old and new sections of Armory Street Pump House. Object at is a muffler and exhaust stack for the turbine powered stand-by generator unit. - Lake Whitney Water Filtration Plant, Armory Street Pumphouse, North side of Armory Street between Edgehill Road & Whitney Avenue, Hamden, New Haven County, CT

Hospital sector choice and support for public hospital care in New Zealand: Results from a labeled discrete choice survey.

PubMed

Brown, Paul; Panattoni, Laura; Cameron, Linda; Knox, Stephanie; Ashton, Toni; Tenbensel, Tim; Windsor, John

2015-09-01

This study uses a discrete choice experiment (DCE) to measure patients' preferences for public and private hospital care in New Zealand. A labeled DCE was administered to 583 members of the general public, with the choice between a public and private hospital for a non-urgent surgery. The results suggest that cost of surgery, waiting times for surgery, option to select a surgeon, convenience, and conditions of the hospital ward are important considerations for patients. The most important determinant of hospital choice was whether it was a public or private hospital, with respondents far more likely to choose a public hospital than a private hospital. The results have implications for government policy toward using private hospitals to clear waiting lists in public hospitals, with these results suggesting the public might not be indifferent to policies that treat private hospitals as substitutes for public hospitals. Copyright © 2015 Elsevier B.V. All rights reserved.

Has price competition changed hospital revenues and expenses in New York?

PubMed

Zwanziger, Jack; Mooney, Cathleen

2005-01-01

This study analyzes the factors that influenced hospital expenses and revenues prior to and following the enactment of the New York State Health Care Reform Act of 1996 (HCRA)-the period from 1994-1999. HCRA was expected to encourage price competition which in turn was anticipated to lower hospital revenues and expenses. We measured the differential effects on hospital revenues and expenses in markets with varying degrees of competition. We also measured the relationship between hospital revenues and expenses and the increased concentration resulting from the formation of local hospital systems. We found that revenues and expenses both grew more slowly for hospitals located in more competitive markets; hospital systems that increased concentration tended to have higher revenues. In the short run at least, price competition induced by HCRA did constrain both hospital expense and revenue growth, although the increase in hospital mergers countered this trend.

INTERIOR OF BOILER BUILDING, FIRST LEVEL, EAST SIDE, SHOWING STEAMDRIVEN ...

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

INTERIOR OF BOILER BUILDING, FIRST LEVEL, EAST SIDE, SHOWING STEAM-DRIVEN PISTON PUMPS FOR FUEL OIL, CAMERA FACING EAST. - New Haven Rail Yard, Central Steam Plant and Oil Storage, Vicinity of Union Avenue, New Haven, New Haven County, CT

A PUBLIC, K-SELECTED, OPTICAL-TO-NEAR-INFRARED CATALOG OF THE EXTENDED CHANDRA DEEP FIELD SOUTH (ECDFS) FROM THE MULTIWAVELENGTH SURVEY BY YALE-CHILE (MUSYC)

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

Taylor, Edward N.; Franx, Marijn; Quadri, Ryan F.

2009-08-01

We present a new, K-selected, optical-to-near infrared photometric catalog of the Extended Chandra Deep Field South (ECDFS), making it publicly available to the astronomical community.{sup 22}Imaging and spectroscopy data and catalogs are freely available through the MUSYC Public Data Release webpage: http://www.astro.yale.edu/MUSYC/. The data set is founded on publicly available imaging, supplemented by original z'JK imaging data collected as part of the MUltiwavelength Survey by Yale-Chile (MUSYC). The final photometric catalog consists of photometry derived from UU {sub 38} BVRIz'JK imaging covering the full 1/2 x 1/2 square circ of the ECDFS, plus H-band photometry for approximately 80% of themore » field. The 5{sigma} flux limit for point sources is K{sup (AB)}{sub tot}= 22.0. This is also the nominal completeness and reliability limit of the catalog: the empirical completeness for 21.75 < K < 22.00 is {approx}>85%. We have verified the quality of the catalog through both internal consistency checks, and comparisons to other existing and publicly available catalogs. As well as the photometric catalog, we also present catalogs of photometric redshifts and rest-frame photometry derived from the 10-band photometry. We have collected robust spectroscopic redshift determinations from published sources for 1966 galaxies in the catalog. Based on these sources, we have achieved a (1{sigma}) photometric redshift accuracy of {delta}z/(1 + z) = 0.036, with an outlier fraction of 7.8%. Most of these outliers are X-ray sources. Finally, we describe and release a utility for interpolating rest-frame photometry from observed spectral energy distributions, dubbed InterRest.{sup 23}InterRest is available via http://www.strw.leidenuniv.nl/{approx}ent/InterRest. Documentation and a complete walkthrough can be found at the same address.« less

Charity Hospital: from the beginning to either a new beginning or the end.

PubMed

Hoover, Eddie L

2007-05-01

Through epidemics, wars, hurricanes, pirates and politics, Charity Hospital has served the indigent population of New Orleans and Louisiana since May 10, 1736 as the second oldest continuing public hospital in the country following Bellevue in New York City, which opened six weeks earlier on March 31, 1736. The first Charity facility was financed by the estate of boat builder Jean Louis, whose will recorded, "a sale shall be made of all that remains, which, together with my small lot, I bequeath to serve in perpetuity to the founding of a hospital for the sick of the City of New Orleans...".

Rates of Hospitalization for Dehydration Following Hurricane Sandy in New Jersey.

PubMed

Swerdel, Joel N; Rhoads, George G; Cosgrove, Nora M; Kostis, John B

2016-04-01

Hurricane Sandy, one of the most destructive natural disasters in New Jersey history, made landfall on October 29, 2012. Prolonged loss of electrical power and extensive infrastructure damage restricted access for many to food and water. We examined the rate of dehydration in New Jersey residents after Hurricane Sandy. We obtained data from 2008 to 2012 from the Myocardial Infarction Data Acquisition System (MIDAS), a repository of in-patient records from nonfederal New Jersey hospitals (N=517,355). Patients with dehydration had ICD-9-CM discharge diagnosis codes for dehydration, volume depletion, and/or hypovolemia. We used log-linear modeling to estimate the change in in-patient hospitalizations for dehydration comparing 2 weeks after Sandy with the same period in the previous 4 years (2008-2011). In-patient hospitalizations for dehydration were 66% higher after Sandy than in 2008-2011 (rate ratio [RR]: 1.66; 95% confidence interval [CI]: 1.50, 1.84). Hospitalizations for dehydration in patients over 65 years of age increased by nearly 80% after Sandy compared with 2008-2011 (RR: 1.79; 95% CI: 1.58, 2.02). Sandy was associated with a marked increase in hospitalizations for dehydration. Reducing the rate of dehydration following extreme weather events is an important public health concern that needs to be addressed, especially in those over 65 years of age.

OVERVIEW OF CENTRAL HEATING PLANT, WITH OIL STORAGE ON LEFT, ...

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

OVERVIEW OF CENTRAL HEATING PLANT, WITH OIL STORAGE ON LEFT, BOILER BUILDING ON RIGHT, SOUTH AND EAST ELEVATIONS, CAMERA FACING NORTH. - New Haven Rail Yard, Central Steam Plant and Oil Storage, Vicinity of Union Avenue, New Haven, New Haven County, CT

Dissecting the Yale-Brown Obsessive-Compulsive Scale severity scale to understand the routes for symptomatic improvement in obsessive-compulsive disorder.

PubMed

Costa, Daniel L da Conceição; Barbosa, Veronica S; Requena, Guaraci; Shavitt, Roseli G; Pereira, Carlos A de Bragança; Diniz, Juliana B

2017-10-01

We aimed to investigate which items of the Yale-Brown Obsessive-Compulsive Severity Scale best discriminate the reduction in total scores in obsessive-compulsive disorder patients after 4 and 12 weeks of pharmacological treatment. Data from 112 obsessive-compulsive disorder patients who received fluoxetine (⩽80 mg/day) for 12 weeks were included. Improvement indices were built for each Yale-Brown Obsessive-Compulsive Severity Scale item at two timeframes: from baseline to week 4 and from baseline to week 12. Indices for each item were correlated with the total scores for obsessions and compulsions and then ranked by correlation coefficient. A correlation coefficient ⩾0.7 was used to identify items that contributed significantly to reducing obsessive-compulsive disorder severity. At week 4, the distress items reached the threshold of 0.7 for improvement on the obsession and compulsion subscales although, contrary to our expectations, there was greater improvement in the control items than in the distress items. At week 12, there was greater improvement in the time, interference, and control items than in the distress items. The use of fluoxetine led first to reductions in distress and increases in control over symptoms before affecting the time spent on, and interference from, obsessions and compulsions. Resistance did not correlate with overall improvement. Understanding the pathway of improvement with pharmacological treatment in obsessive-compulsive disorder may provide clues about how to optimize the effects of medication.

'McMurdo' Panorama from Spirit's 'Winter Haven'

NASA Technical Reports Server (NTRS)

2006-01-01

the Web shortly to augment this McMurdo panorama view.

This beautiful scene reveals a tremendous amount of detail in Spirit's surroundings. Many dark, porous-textured volcanic rocks can be seen around the rover, including many on Low Ridge. Two rocks to the right of center, brighter and smoother-looking in this image and more reflective in infrared observations by Spirit's miniature thermal emission spectrometer, are thought to be meteorites. On the right, 'Husband Hill' on the horizon, the rippled 'El Dorado' sand dune field near the base of that hill, and lighter-toned 'Home Plate' below the dunes provide context for Spirit's travels since mid-2005. Left of center, tracks and a trench dug by Spirit's right-front wheel, which no longer rotates, have exposed bright underlying material. This bright material is evidence of sulfur-rich salty minerals in the subsurface, which may provide clues about the watery past of this part of Gusev Crater.

Spirit has stayed busy at Winter Haven during the past six months even without driving. In addition to acquiring this spectacular panorama, the rover team has also acquired significant new assessments of the elemental chemistry and mineralogy of rocks and soil targets within reach of the rover's arm. The team plans soon to have Spirit drive to a very nearby spot on Low Ridge to access different rock and soil samples while maintaining a good solar panel tilt toward the sun for the rest of the Martian winter.

Despite the long span of time needed for acquiring this 360-degree view -- a few images at a time every few sols over a total of 119 sols because the available power was so low -- the lighting and color remain remarkably uniform across the mosaic. This fact attests to the repeatability of wintertime sols on Mars in the southern hemisphere. This is the time of year when Mars is farthest from the sun, so there is much less dust storm and dust devil activity than at other times of the year.

This is an

[The anaesthesia and critical care specialty and new hospital management in France: an inquiry in university and general hospitals].

PubMed

Fusciardi, J; Remérand, F; Landais, A; Brodeur, J; Journois, D; Laffon, M

2010-03-01

To know: (1) how French public services of anaesthesia and critical care (ACC) have applied the new principles of hospital management and (2) whether or not it has impacted the different components of ACC. National questionnaire at the end of 2008, i.e., after 2 years of new hospital management. Heads of ACC services in general (GH) and university hospitals (UH). Eighteen closed questions and open opinions analyzed. Comparisons of percentages (Chi(2) - Yates): linear correlation. Percentages of responses were 70% (n=51) for UH and 37% (n=146) for GH. The new management principles were mainly applied. The different clinical and academic components of the ACC specialty (ACC, emergency medicine, pain management) mainly remained associated in UH. In GH, the new management induced constant and various changes. They were mainly judged as defeating the object of the ACC speciality in GH, especially in those of lower and mild sizes. The general tendency is that the ACC specialty was able to maintain the family ties of its different components in the UH. However, this principle was not a cornerstone of the new management in the GH. Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.

Soil sedimentology at Gusev Crater from Columbia Memorial Station to Winter Haven

USGS Publications Warehouse

Cabrol, N.A.; Herkenhoff, K. E.; Greeley, R.; Grin, E.A.; Schroder, C.; d'Uston, C.; Weitz, C.; Yingst, R.A.; Cohen, B. A.; Moore, J.; Knudson, A.; Franklin, B.; Anderson, R.C.; Li, R.

2008-01-01

A total of 3140 individual particles were examined in 31 soils along Spirit's traverse. Their size, shape, and texture were quantified and classified. They represent a unique record of 3 years of sedimentologic exploration from landing to sol 1085 covering the Plains Unit to Winter Haven where Spirit spent the Martian winter of 2006. Samples in the Plains Unit and Columbia Hills appear as reflecting contrasting textural domains. One is heterogeneous, with a continuum of angular-to-round particles of fine sand to pebble sizes that are generally dust covered and locally cemented in place. The second shows the effect of a dominant and ongoing dynamic aeolian process that redistributes a uniform population of medium-size sand. The texture of particles observed in the samples at Gusev Crater results from volcanic, aeolian, impact, and water-related processes. Copyright 2008 by the American Geophysical Union.

New Tools for Measuring and Improving Patient Safety in Canadian Hospitals.

PubMed

D'Silva, Jennifer; Amuah, Joseph Emmanuel; Sovran, Vanessa; MacLaurin, Anne; Rodgers, Jennifer; Johnson, Tracy; Leeb, Kira; Kossey, Sandi

2017-01-01

The Canadian Institute for Health Information (CIHI) and the Canadian Patient Safety Institute (CPSI) have collaborated on a new measure of patient safety, along with a resource of evidence-informed practices. This measure captures four broad categories of harm in acute care hospitals, consisting of 31 clinical groups selected by clinicians. Analysis showed that harm was experienced in 1 of 18 hospital stays in Canada in 2014ߝ2015 and that no single category accounted for the majority of harmful events. Although CIHI and CPSI continue to work with hospitals and experts to further refine the methodology, the measure and associated Improvement Resource are useful new tools for monitoring and identifying harm, and have the potential to improve patient safety.

LIFENET hospitals (India): developing new services' case study.

PubMed

Rahman, Zillur; Qureshi, M N

2008-01-01

Indian healthcare is in the process of offering a plethora of services to customers hailing largely from India and from neighboring countries. The Indian hospital sector consists of private "nursing homes" and government and charitable missionary hospitals. Government and missionary hospitals determine their charges according to patients' income levels and treat poor patients freely. Nursing homes charged higher, market-determined rates. They offer services in just a few medical specialties, owned and operated by physicians who worked with them. Nursing homes cannot afford the latest medical technology, but they provide more intimate settings than government hospitals. This case study aims to demonstrate the various strategic options available to a for-profit hospital, in an emerging economy with a burgeoning middle-class population and how it can choose which services that it can best offer to its target population. Diagnosing and treating complex ailments in nursing homes could be a time-consuming and expensive proposition as visits to several nursing homes with different specialties may be necessary. This paper demonstrates how an hospital can develop new customer-oriented services and eliminate the hassle for patients needing to run around different healthcare outlets even for minor ailments. The paper finds that large government hospitals generally have better facilities than nursing homes, but they were widely believed to provide poor-quality care. They failed to keep up with advanced equipment, train their technicians adequately and did not publicize their capabilities to doctors who might refer patients. Many missionary and charitable hospitals were undercapitalized and did not offer all services. These conditions left an unsatisfied demand for high-quality medical care. In 1983, LIFENET opened in Madras, becoming the first comprehensive, for-profit hospital in India. LIFENET, invested in a cardiology laboratory and clinics with capacity to diagnose heart

Collective response to public health emergencies and large-scale disasters: putting hospitals at the core of community resilience.

PubMed

Paturas, James L; Smith, Deborah; Smith, Stewart; Albanese, Joseph

2010-07-01

Healthcare organisations are a critical part of a community's resilience and play a prominent role as the backbone of medical response to natural and manmade disasters. The importance of healthcare organisations, in particular hospitals, to remain operational extends beyond the necessity to sustain uninterrupted medical services for the community, in the aftermath of a large-scale disaster. Hospitals are viewed as safe havens where affected individuals go for shelter, food, water and psychosocial assistance, as well as to obtain information about missing family members or learn of impending dangers related to the incident. The ability of hospitals to respond effectively to high-consequence incidents producing a massive arrival of patients that disrupt daily operations requires surge capacity and capability. The activation of hospital emergency support functions provides an approach by which hospitals manage a short-term shortfall of hospital personnel through the reallocation of hospital employees, thereby obviating the reliance on external qualified volunteers for surge capacity and capability. Recent revisions to the Joint Commission's hospital emergency preparedness standard have impelled healthcare facilities to participate actively in community-wide planning, rather than confining planning exclusively to a single healthcare facility, in order to harmonise disaster management strategies and effectively coordinate the allocation of community resources and expertise across all local response agencies.

"I Have Sickle Cell Disease, But Sickle Cell Doesn't Have Me" | NIH MedlinePlus the Magazine

MedlinePlus

... May 2009, and it has really changed my life. I haven't had a hospital admission in 13 months, and my blood numbers are wonderful. My doctor is totally pleased with it. I haven't had any negative side effects from the medicine. On staying healthy: It's much ...

The Epidemiology of Hospitalized Postpartum Depression in New York State, 1995–2004

PubMed Central

Savitz, David A.; Stein, Cheryl R.; Ye, Fen; Kellerman, Lisa; Silverman, Michael

2011-01-01

Purpose The purpose of this study is to describe the patterns of hospitalization for depression in the year following delivery in relation to social, demographic, and behavioral characteristics. Methods Data on fetal deliveries were linked to hospitalizations for depression over the subsequent year in order to describe the frequency and patterns of hospitalized postpartum depression among 2,355,886 deliveries in New York State from 1995 – 2004. We identified “definite postpartum depression” based on ICD codes indicative of “mental disorders specific to pregnancy,” and “possible postpartum depression” by ICD codes for hospitalization with any depressive disorders. Results In New York State, we identified 1,363 women (5.8 per 10,000) who were hospitalized with definite postpartum depression, and 6,041 women (25.6 per 10,000) with possible postpartum depression, with lower risks in the New York City area. Postpartum depression was more common in later years and among mothers who were older, Black, smokers, lacking private insurance, and with multiple gestations, and was rarer among Asians. For possible postpartum depression, socioeconomic gradients were enhanced. Conclusions Risk of hospitalized postpartum depression is strongly associated with socioeconomic deprivation and varies markedly by ethnicity, with direct implications for screening and health services, also providing suggestions for etiologic studies. PMID:21549277

Census Cities experiment in urban change detection. [mapping of land use changes in San Francisco, Washington D.C., Phoenix, Tucson, Boston, New Haven, Cedar Rapids, and Pontiac

NASA Technical Reports Server (NTRS)

Wray, J. R. (Principal Investigator); Milazzo, V. A.

1974-01-01

The author has identified the following significant results. Mapping of 1970 and 1972 land use from high-flight photography has been completed for all test sites: San Francisco, Washington, Phoenix, Tucson, Boston, New Haven, Cedar Rapids, and Pontiac. Area analysis of 1970 and 1972 land use has been completed for each of the mandatory urban areas. All 44 sections of the 1970 land use maps of the San Francisco test site have been officially released through USGS Open File at 1:62,500. Five thousand copies of the Washington one-sheet color 1970 land use map, census tract map, and point line identification map are being printed by USGS Publication Division. ERTS-1 imagery for each of the eight test sites is being received and analyzed. Color infrared photo enlargements at 1:100,000 of ERTS-1 MSS images of Phoenix taken on October 16, 1972 and May 2, 1973 are being analyzed to determine to what level land use and land use changes can be identified and to what extent the ERTS-1 imagery can be used in updating the 1970 aircraft photo-derived land use data base. Work is proceeding on the analysis of ERTS-1 imagery by computer manipulation of ERTS-1 MSS data in digital format. ERTS-1 CCT maps at 1:24,000 are being analyzed for two dates over Washington and Phoenix. Anniversary tape sets have been received at Purdue LARS for some additional urban test sites.

An Intervention to Increase Availability of Healthy Foods and Beverages in New York City Hospitals: The Healthy Hospital Food Initiative, 2010-2014.

PubMed

Moran, Alyssa; Krepp, Erica M; Johnson Curtis, Christine; Lederer, Ashley

2016-06-09

Hospitals serve millions of meals and snacks each year; however, hospital food is often unhealthy. Hospitals are ideal settings for modeling healthy eating, but few programs have sought to improve nutrition in all venues where food is served. The New York City Department of Health and Mental Hygiene created the Healthy Hospital Food Initiative (HHFI) to improve the healthfulness of food served in hospitals. The HHFI built on prior work implementing mandatory nutrition standards for patient meals and vending in public hospitals. Public hospitals joined the HHFI by voluntarily adopting standards for cafeterias and cafés. Private hospitals joined by implementing nutrition standards for patient meals, food and beverage vending machines, and cafeterias and cafés. Hospitals were recruited from 2010 through 2014 and provided technical assistance from health department staff. Implementation in each of the 4 areas was monitored through on-site assessments and menu review. Twenty-eight hospital cafeterias and cafés were evaluated at baseline and at the end of the HHFI to assess changes. Sixteen public hospitals and 24 private hospitals joined the HHFI. Most (n = 18) private hospitals implemented standards in at least 2 areas. In cafeterias, most hospitals introduced a healthy value meal (n = 19), removed unhealthy items from the entrance and checkout (n = 18), increased whole grains to at least half of all grains served (n = 17), and reduced calories in pastries and desserts (n = 15). Most New York City hospitals joined the HHFI and voluntarily adopted rigorous nutrition standards. Partnerships between hospitals and local government are feasible and can lead to significant improvements in hospital food environments.

A comprehensive obstetric patient safety program reduces liability claims and payments.

PubMed

Pettker, Christian M; Thung, Stephen F; Lipkind, Heather S; Illuzzi, Jessica L; Buhimschi, Catalin S; Raab, Cheryl A; Copel, Joshua A; Lockwood, Charles J; Funai, Edmund F

2014-10-01

Begun in 2003, the Yale-New Haven Hospital comprehensive obstetric safety program consisted of measures to standardize care, improve teamwork and communication, and optimize oversight and quality review. Prior publications have demonstrated improvements in adverse outcomes and safety culture associated with this program. In this analysis, we aimed to assess the impact of this program on liability claims and payments at a single institution. We reviewed liability claims at a single, tertiary-care, teaching hospital for two 5-year periods (1998-2002 and 2003-2007), before and after implementing the safety program. Connecticut statute of limitations for professional malpractice is 36 months from injury. Claims/events were classified by event-year and payments were adjusted for inflation. We analyzed data for trends as well as differences between periods before and after implementation. Forty-four claims were filed during the 10-year study period. Annual cases per 1000 deliveries decreased significantly over the study period (P < .01). Claims (30 vs 14) and payments ($50.7 million vs $2.9 million) decreased in the 5-years after program inception. Compared with before program inception, median annual claims dropped from 1.31 to 0.64 (P = .02), and median annual payments per 1000 deliveries decreased from $1,141,638 to $63,470 (P < .01). Even estimating the monetary awards for the 2 remaining open cases using the median payments for the surrounding 5 years, a reduction in the median monetary amount per case resulting in payment to the claimant was also statistically significant ($632,262 vs $216,815, P = .046). In contrast, the Connecticut insurance market experienced a stable number of claims and markedly increased cost per claim during the same period. We conclude that an obstetric safety initiative can improve liability claims exposure and reduce liability payments. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparison of Two Types of Meditation on Patients' Psychosocial Responses During Radiation Therapy for Head and Neck Cancer.

PubMed

Boxleitner, Gisela; Jolie, Shelley; Shaffer, Dana; Pasacreta, Nicholas; Bai, Mei; McCorkle, Ruth

2017-05-01

Radiation treatment for head and neck cancer introduces adaptive demands and subjects patients to significant and unique psychosocial challenges. There is growing evidence that meditation is useful in lessening anxiety and depression in cancer patients. This study compared the effects of two types of meditation training on the psychological responses of patients with head and neck cancer during radiation therapy. Randomized clinical trial. Smilow Cancer Hospital at Yale New Haven. A total of 29 patients with head and neck cancers were recruited and 28 patients were followed during their radiation therapy over 12 weeks. Depending on their group assignment, patients were taught one of two standardized meditations: meditation with a coach or self-meditation with a CD. Patient psychosocial responses were defined as anxiety, depression, and emotional distress and were measured by the Hospital and Anxiety Depression Scale (HADS) and the Emotional Distress Thermometer. Measures were self-reported and collected by the nurse manager at baseline and 6 and 12 weeks during the patient's scheduled weekly visit. No significant mean differences were found between the two meditation groups on all three outcomes: anxiety, depression, and emotional distress. Patients in both the meditation with a coach and self-meditation with a CD groups reported less distress from baseline and at 6 and 12 weeks, as evidenced by the HADS anxiety scale. This study demonstrated two equally effective meditation techniques that can be implemented with patients experiencing high stress during radiation treatments in any health care setting to decrease patient anxiety, depression, and emotional distress. The data established self-meditation with a CD as a more cost-effective alternative to meditation with a coach, which requires intensive training and time commitment for patients.

Grade pending: lessons for hospital quality reporting from the New York City restaurant sanitation inspection program.

PubMed

Ryan, Andrew M; Detsky, Allan S

2015-02-01

Public quality reporting programs have been widely implemented in hospitals in an effort to improve quality and safety. One such program is Hospital Compare, Medicare's national quality reporting program for US hospitals. The New York City sanitary grade inspection program is a parallel effort for restaurants. The aims of Hospital Compare and the New York City sanitary inspection program are fundamentally similar: to address a common market failure resulting from consumers' lack of information on quality and safety. However, by displaying easily understandable information at the point of service, the New York City sanitary inspection program is better designed to encourage informed consumer decision making. We argue that this program holds important lessons for public quality reporting of US hospitals. © 2014 Society of Hospital Medicine.

[The effects of a new model of hospital management on undergraduate teaching of urology].

PubMed

Bogado S, Justo; Bogado C, Mariana; López C, Ilse; Rosselot J, Eduardo

2010-04-01

Since January 2005, a new model for hospital coordinated assistance was implanted in Chile, denominated Self Managed Hospitals in net, to improve resource use effectiveness and efficiency. This new design changed health care and teaching models. To analyze, understand and to reflect on how teachers and students of the Urology Unit of the Eastern Campus of the Faculty of Medicine in the University of Chile, perceive learning in this new hospital scenario. A qualitative methodology was used, including semi-structured interviews to chief teachers and focal groups of teachers and students. Also, a written structured questionnaire was answered by a group of 5th year students and interns. University teachers perceive that undergraduate learning is affected in the new hospital scenario. Students think that they have less opportunities to directly interact with patients, and therefore have fewer possibilities to take medical histories, perform physical examinations, and fewer occasions to discuss cases with their tutors. The new health system that runs hospitals under a network could jeopardize undergraduate teaching. This is the case for the Urology Service at Hospital and the corresponding Department of Specialties, where the dominant perception of teachers and a number of students is that their clinical learning is endangered by these innovations. To obtain the learning objectives of the undergraduate program in this subject, reorientation of their ambulatory practice and derivation skills must be rationally elaborated to improve students accomplishment.

13. Photocopy of drawing (original in AMTRAK Engineering Department), Boston ...

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

13. Photocopy of drawing (original in AMTRAK Engineering Department), Boston Bridge Works, Inc., March 8, 1912 N. Y. N. H. & H. R. R. BRIDGE #214 SHORE LINE DIV. DETAILS OF SIDEWALK BKTS, SHOES, ROLLERS, ETC. - Ferry Street Railroad Bridge, Ferry Street over New Haven Railroad, New Haven, New Haven County, CT

Transmission of vocational skills between experienced and new hospital workers.

PubMed

Thébault, Jeanne; Gaudart, Corinne; Cloutier, Esther; Volkoff, Serge

2012-01-01

This article presents the results of a study currently underway looking at the transmission of vocational skills between health care workers in a French hospital. The aim was to show that health care workers, in addition to their work with patients, also have to incorporate the transmission of vocational skills into their daily activities. Thirteen transmission situations were observed and analyzed by means of an activity-focused ergonomic work analysis, with the aim of reporting on this "invisible work". The population studied was composed of nurses and the nursing assistants from three different units in one hospital. The results show that the work required to integrate and supervise new staff members is left to the discretion of health care workers. This means they are constantly required to arbitrate on both an individual and collective basis between providing health care for patients and supporting new members of staff. The content of the transmission goes beyond the prescribed tasks and technical knowledge, as staff members also pass on their professional strategies (individual and collective), rules of practice and ethical considerations. Supervising students also offers experienced workers the opportunity to share their professional practices. This study highlights the issues arising from this transmission activity for the experienced workers, new workers, patients and the hospital.

The key to health services in Turkey: new perspectives on leadership and hospital management.

PubMed

Sahin, Alper A

2014-01-01

Health services are one of the most important criteria for making a country function. Turkey has mobilized all of its resources to provide high-quality, easily accessible and patient-friendly services for its population. To achieve this aim, the Turkish health care system has been undergoing a significant transformation through its Health Transformation Programme begun in 2005. The reforms focus on the introduction of a general health insurance system, changing hospital health services, improvements in hospital management and transformational leadership skills. Firstly, all state-run hospitals in the country were merged under the same umbrella, giving millions of people covered by the national security agency access to all of these hospitals. Secondly, all drugs and medical equipment used by patients were made free of charge. Thanks to these developments, hospitals were modernized, and this modernization process in the health sector is still continuing swiftly. On the other hand, for Turkish hospitals to survive, they need to modernize further and become closer to European models, and produce new leaders with new paradigms. In this new and changing health system, hospital leaders and executive officers should be visionaries and strategists advising when to change direction. Following this doctrine, most Turkish hospitals are now run by two top executives: the hospital manager and the chief executive officer who is in charge of business functions. These executives should clearly be the leaders of high-quality, health care organizations.

6. South View of Whitneyville in Hamden, 1836 by John ...

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

6. South View of Whitneyville in Hamden, 1836 by John Warner Barber Photocopied from John Warner Barber, Connecticut Historical Collections (New Haven, 1856), p. 220. 'The engraving... shows the appearance of the little village of Whitneyville, as seen from a few rods south, on the New Haven road.' (Barber, p. 219). The right fork, with Ithiel Town's truss, carries the New Haven & Hartford Turnpike, the left the Cheshire Turnpike. The factory is on the right, the village on the left. - Eli Whitney Armory, West of Whitney Avenue, Armory Street Vicinity, Hamden, New Haven County, CT

Building new hospitals: a UK infection control perspective.

PubMed

Stockley, J M; Constantine, C E; Orr, K E

2006-03-01

Infection control input is vital throughout the planning, design and building stages of a new hospital project, and must continue through the commissioning (and decommissioning) process, evaluation and putting the facility into full clinical service. Many hospitals continue to experience problems months or years after occupying the new premises; some of these could have been avoided by infection control involvement earlier in the project. The importance of infection control must be recognized by the chief executive of the hospital trust and project teams overseeing the development. Clinical user groups and contractors must also be made aware of infection control issues. It is vital that good working relationships are built up between the infection control team (ICT) and all these parties. ICTs need the authority to influence the process. This may require their specific recognition by the Private Finance Initiative National Unit, the Department of Health or other relevant authorities. ICTs need training in how to read design plans, how to write effective specifications, and in other areas with which they may be unfamiliar. The importance of documentation and record keeping is paramount. External or independent validation of processes should be available, particularly in commissioning processes. Building design in relation to infection control needs stricter national regulations, allowing ICTs to focus on more local usage issues. Further research is needed to provide evidence regarding the relationship between building design and the prevalence of infection.

Use of hospital-based ambulatory care in New York City's Health Manpower Shortage Areas.

PubMed Central

Stager, D F; Krasner, M I; Goodwin, E J

1987-01-01

The development of a comprehensive data base for hospital-based ambulatory care has made possible the accurate determination of each community's use of hospitals in New York City and permits a reliable estimation of all ambulatory care received by residents of Health Manpower Shortage Areas (HMSAs). In spite of the city's abundant supply of private practitioners and widespread Medicaid coverage, residents of HMSAs in New York City are heavily dependent on hospital-based ambulatory care. Contrary to commonly held notions, however, HMSA residents do not appear to overuse hospital-based ambulatory care. Rather, that use appears to be quite modest, given their poorer health status. PMID:3101118

New CPT codes: hospital, consultation, emergency and nursing facility services.

PubMed

Zuber, T J; Henley, D E

1992-03-01

New evaluation and management codes were created by the Current Procedural Terminology (CPT) Editorial Panel to ensure more accurate and consistent reporting of physician services. The new hospital inpatient codes describe three levels of service for both initial and subsequent care. Critical care services are reported according to the total time spent by a physician providing constant attention to a critically ill patient. Consultation codes are divided into four categories: office/outpatient, initial inpatient, follow-up inpatient and confirmatory. Emergency department services for both new and established patients are limited to five codes. In 1992, nursing facility services are described with either comprehensive-assessment codes or subsequent-care codes. Hospital discharge services may be reported in addition to the comprehensive nursing facility assessment. Since the 1992 CPT book will list only the new codes, and since all insurance carriers will not be using these codes in 1992, physicians are encouraged to keep their 1991 code books and contact their local insurance carriers to determine which codes will be used.

An Intervention to Increase Availability of Healthy Foods and Beverages in New York City Hospitals: The Healthy Hospital Food Initiative, 2010–2014

PubMed Central

Krepp, Erica M.; Johnson Curtis, Christine; Lederer, Ashley

2016-01-01

Background Hospitals serve millions of meals and snacks each year; however, hospital food is often unhealthy. Hospitals are ideal settings for modeling healthy eating, but few programs have sought to improve nutrition in all venues where food is served. Community Context The New York City Department of Health and Mental Hygiene created the Healthy Hospital Food Initiative (HHFI) to improve the healthfulness of food served in hospitals. The HHFI built on prior work implementing mandatory nutrition standards for patient meals and vending in public hospitals. Public hospitals joined the HHFI by voluntarily adopting standards for cafeterias and cafés. Private hospitals joined by implementing nutrition standards for patient meals, food and beverage vending machines, and cafeterias and cafés. Methods Hospitals were recruited from 2010 through 2014 and provided technical assistance from health department staff. Implementation in each of the 4 areas was monitored through on-site assessments and menu review. Twenty-eight hospital cafeterias and cafés were evaluated at baseline and at the end of the HHFI to assess changes. Outcome Sixteen public hospitals and 24 private hospitals joined the HHFI. Most (n = 18) private hospitals implemented standards in at least 2 areas. In cafeterias, most hospitals introduced a healthy value meal (n = 19), removed unhealthy items from the entrance and checkout (n = 18), increased whole grains to at least half of all grains served (n = 17), and reduced calories in pastries and desserts (n = 15). Interpretation Most New York City hospitals joined the HHFI and voluntarily adopted rigorous nutrition standards. Partnerships between hospitals and local government are feasible and can lead to significant improvements in hospital food environments. PMID:27281392

Implementation of a pharmacist career ladder program.

PubMed

Heavner, Mojdeh S; Tichy, Eric M; Yazdi, Marina

2016-10-01

The implementation and outcomes of a pharmacist career ladder program (PCLP) at a tertiary care, academic medical center are described. A PCLP was developed at Yale-New Haven Hospital to guide career development, motivate staff to perform beyond their daily tasks and responsibilities, and recognize and retain high performers through professional advancement. The PCLP advancement criteria include specific requirements for excellence in five categories: level of training and experience, pharmacy practice, drug information, education and scholarship, and leadership. The PCLP is designed with four distinct tiers: clinical pharmacist, clinical pharmacist II, clinical pharmacy specialist, and clinical pharmacy specialist II. The specific criteria are increasingly challenging to achieve when moving up the ladder. Pharmacists may apply voluntarily each year for advancement. A PCLP review committee consisting of pharmacist peers and managers meets annually to discuss and vote on career advancement decisions. Since PCLP implementation, we have observed an increasing success rate for advancement (50% in 2013, 85% in 2014, and 100% in 2015) and a considerable increase in pharmacist participation in clinical and process improvement projects, as well as intervention and medication-use variance documentation. The implementation of a PCLP at a tertiary care, academic medical center provided an opportunity for frontline pharmacists to advance professionally and increased their participation and leadership in clinical and process improvement projects and drug-use policy and medication safety initiatives; the program also increased the number of pharmacists with specialty board certification and peer-reviewed publications. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Optimism, Symptom Distress, Illness Appraisal, and Coping in Patients With Advanced-Stage Cancer Diagnoses Undergoing Chemotherapy Treatment.

PubMed

Sumpio, Catherine; Jeon, Sangchoon; Northouse, Laurel L; Knobf, M Tish

2017-05-01

To explore the relationships between optimism, self-efficacy, symptom distress, treatment complexity, illness appraisal, coping, and mood disturbance in patients with advanced-stage cancer.
. Cross-sectional study.
. Smilow Cancer Hospital at Yale New Haven in Connecticut, an outpatient comprehensive cancer center.
. A convenience sample of 121 adult patients with stages III-IV cancer undergoing active chemotherapy.
. Participants completed common self-report questionnaires to measure variables. Treatment hours and visits were calculated from data retrieved from medical record review. Mediation and path analysis were conducted to identify direct and indirect pathways from the significant antecedent variables to mood disturbance.
. Dispositional optimism, self-efficacy, social support, treatment complexity, symptom distress, illness appraisal, coping, and mood disturbance.
. Greater optimism and self-efficacy were associated with less negative illness appraisal, less avoidant coping, and decreased mood disturbance. Conversely, greater symptom distress was associated with greater negative illness appraisal, greater avoidant coping, and greater mood disturbance. In the final model, optimism and symptom distress had direct and indirect effects on mood disturbance. Indirect effects were partially mediated by illness appraisal.
. Mood disturbance resulted from an interaction of disease stressors, personal resources, and cognitive appraisal of illness. Avoidant coping was associated with greater disturbed mood, but neither avoidant nor active coping had a significant effect on mood in the multivariate model. 
. Illness appraisal, coping style, and symptom distress are important targets for intervention. Optimism is a beneficial trait and should be included, along with coping style, in comprehensive nursing assessments of patients with cancer.

New roles: professional staff sharing between a hospital and an academic library.

PubMed

Just, Melissa L

2003-01-01

Childrens Hospital Los Angeles is a pediatric hospital and research institute affiliated with the Keck School of Medicine of the University of Southern California (USC). Historically, the library at Childrens Hospital was staffed by a hospital-employed librarian. In 1999, the library position was outsourced to USC's Norris Medical Library. The new position is staffed by a librarian who divides her time equally between two locations: the Childrens Hospital Library and the Norris Medical Library. This staff sharing arrangement has three primary goals: increase the collaboration between the libraries; improve access to resources and library staff expertise; and provide faster document delivery service to the Childrens Hospital library. This paper presents the details of the position, and addresses the pros and cons for both libraries and the librarian.

Temperature dependence of the Haven ratio in silver beta-alumina

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

Kim, K. K.; Chandrashekhar, G. V.; Chen, W. K.

Measurements of Ag diffusivity (D) and ionic conductivity (sigma) have been made on the same single crystals of silver beta-alumina with composition 1.23 Ag/sub 2/0.11 Al/sub 2/O/sub 3/. The D values were obtained from the cation exchange rate of radiotracer /sup 110/Ag in molten AgNO/sub 3/ over 210/sup 0/ C approx. 400/sup 0/C. The sigma measurements were made using an impedance bridge with sputtered silver electrodes at a frequency of 3 x 10/sup 5/ Hz over R.T approx. 450/sup 0/C. Both D and sigma can be expressed in a simple Arrhenius form as: D = 1.47 x 10/sup -4/(cm/sup 2//sec)more » exp (-4.05(Kcal/mol)/RT); sigmaT = 1.58 x 10/sup 3/(ohm/sup -1/cm/sup -1/K) exp (-3.77(Kcal/mol)/RT). The Haven ratio varies from 0.51 at 200/sup 0/C to 0.56 at 400/sup 0/C. The magnitude of these values is very close to the theoretical value of 0.6 for interstitialcy mechanism. The temperature dependence is strikingly similar to the case of sodium beta-alumina.« less

[The Explore of the Security Strategy Model in Hospital Mobile Clinic New Mode].

PubMed

Li, Ke; Xia, Yong; Wang, Wei

2016-03-01

The paper elaborates and analyzes the current status of mobile hospital information security, then puts forward a security new model of the mobile treatment, then its architecture and solutions is elaborated. The use of this model makes the overall security level of hospital information to be further improved and enhanced, it has a positive signifi cance to promote the overal hospital management level.

Anesthesia for cesarean delivery in the Czech Republic: a 2011 national survey.

PubMed

Stourac, Petr; Blaha, Jan; Klozova, Radka; Noskova, Pavlina; Seidlova, Dagmar; Brozova, Lucie; Jarkovsky, Jiri

2015-06-01

The purpose of this national survey was to determine current anesthesia practices for cesarean delivery in the Czech Republic. In November 2011, we invited all departments of obstetric anesthesia in the Czech Republic to participate in a prospective study to monitor consecutive peripartum obstetric anesthesia procedures. Data were recorded online in the TrialDB database (Yale University, New Haven, CT). The response rate was 51% (49 of 97 departments); participating centers represented 60% of all births in the country during the study period. There were 1943 cases of peripartum anesthesia care, of which 1166 cases (60%) were anesthesia for cesarean delivery. Estimates were weighted based on population distribution of cesarean delivery among types of participating centers. Neuraxial anesthesia was used in 55.6% (95% confidence interval [CI], 52.8%-58.5%); the distribution of anesthesia techniques differed among type of participating center. The rate of neuraxial anesthesia in university hospitals was 55.6% (95% CI, 51.5%-59.6%), 32.4% (95% CI, 26.4%-39.0%) in regional hospitals, and 60.7% (95% CI, 55.2%-66.0%) in local hospitals. The reasons for cesarean delivery under general anesthesia were emergency procedure (67%), refusal of neuraxial blockade by parturient (30%), failure of neuraxial anesthesia (6%), and preoperative administration of low-molecular-weight heparin (3%). Postcesarean analgesia was primarily provided by systemic opioid (66%) and nonopioid analgesics (61%), solely or in combination. Epidural postoperative analgesia was used in 14% of cases. Compared with national neuraxial anesthesia rate data published in the 1990s (6.7% in 1993), there has been an upward trend in the use of neuraxial anesthesia for cesarean delivery during the 21st century (40.5% in 2000) in the Czech Republic. The rate of neuraxial anesthesia use for cesarean delivery has increased in the Czech Republic in the last 2 decades. However, the current rate of general anesthesia is

Managing the Alert Process at NewYork-Presbyterian Hospital

PubMed Central

Kuperman, Gilad J; Diamente, Rosanna; Khatu, Vrinda; Chan-Kraushar, Terri; Stetson, Pete; Boyer, Aurelia; Cooper, Mary

2005-01-01

Clinical decision support can improve the quality of care, but requires substantial knowledge management activities. At NewYork-Presbyterian Hospital in New York City, we have implemented a formal alert management process whereby only hospital committees and departments can request alerts. An explicit requestor, who will help resolve the details of the alert logic and the alert message must be identified. Alerts must be requested in writing using a structured alert request form. Alert requests are reviewed by the Alert Committee and then forwarded to the Information Systems department for a software development estimate. The model required that clinical committees and departments become more actively involved in the development of alerts than had previously been necessary. In the 12 months following implementation, 10 alert requests were received. The model has been well received. A lot of the knowledge engineering work has been distributed and burden has been removed from scarce medical informatics resources. PMID:16779073

'McMurdo' Panorama from Spirit's 'Winter Haven' (False Color)

NASA Technical Reports Server (NTRS)

2006-01-01

the panorama, and that image will be released on the Web shortly to augment this McMurdo panorama view.

This beautiful scene reveals a tremendous amount of detail in Spirit's surroundings. Many dark, porous-textured volcanic rocks can be seen around the rover, including many on Low Ridge. Two rocks to the right of center, brighter and smoother-looking in this image and more reflective in infrared observations by Spirit's miniature thermal emission spectrometer, are thought to be meteorites. On the right, 'Husband Hill' on the horizon, the rippled 'El Dorado' sand dune field near the base of that hill, and lighter-toned 'Home Plate' below the dunes provide context for Spirit's travels since mid-2005. Left of center, tracks and a trench dug by Spirit's right-front wheel, which no longer rotates, have exposed bright underlying material. This bright material is evidence of sulfur-rich salty minerals in the subsurface, which may provide clues about the watery past of this part of Gusev Crater.

Spirit has stayed busy at Winter Haven during the past six months even without driving. In addition to acquiring this spectacular panorama, the rover team has also acquired significant new assessments of the elemental chemistry and mineralogy of rocks and soil targets within reach of the rover's arm. The team plans soon to have Spirit drive to a very nearby spot on Low Ridge to access different rock and soil samples while maintaining a good solar panel tilt toward the sun for the rest of the Martian winter.

Despite the long span of time needed for acquiring this 360-degree view -- a few images at a time every few sols over a total of 119 sols because the available power was so low -- the lighting and color remain remarkably uniform across the mosaic. This fact attests to the repeatability of wintertime sols on Mars in the southern hemisphere. This is the time of year when Mars is farthest from the sun, so there is much less dust storm and dust devil activity than at

'McMurdo' Panorama from Spirit's 'Winter Haven' (Stereo)

NASA Technical Reports Server (NTRS)

2006-01-01

processing and mosaicking of those final pieces of the panorama, and that image will be released on the Web shortly to augment this McMurdo panorama view.

This beautiful scene reveals a tremendous amount of detail in Spirit's surroundings. Many dark, porous-textured volcanic rocks can be seen around the rover, including many on Low Ridge. Two rocks to the right of center, brighter and smoother-looking in this image and more reflective in infrared observations by Spirit's miniature thermal emission spectrometer, are thought to be meteorites. On the right, 'Husband Hill' on the horizon, the rippled 'El Dorado' sand dune field near the base of that hill, and lighter-toned 'Home Plate' below the dunes provide context for Spirit's travels since mid-2005. Left of center, tracks and a trench dug by Spirit's right-front wheel, which no longer rotates, have exposed bright underlying material. This bright material is evidence of sulfur-rich salty minerals in the subsurface, which may provide clues about the watery past of this part of Gusev Crater.

Spirit has stayed busy at Winter Haven during the past six months even without driving. In addition to acquiring this spectacular panorama, the rover team has also acquired significant new assessments of the elemental chemistry and mineralogy of rocks and soil targets within reach of the rover's arm. The team plans soon to have Spirit drive to a very nearby spot on Low Ridge to access different rock and soil samples while maintaining a good solar panel tilt toward the sun for the rest of the Martian winter.

Despite the long span of time needed for acquiring this 360-degree view -- a few images at a time every few sols over a total of 119 sols because the available power was so low -- the lighting and color remain remarkably uniform across the mosaic. This fact attests to the repeatability of wintertime sols on Mars in the southern hemisphere. This is the time of year when Mars is farthest from the sun, so there is much less

77 FR 68800 - Connecticut; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-16

... Connecticut have been designated as adversely affected by this major disaster: Fairfield, Middlesex, New Haven... within New London County for Individual Assistance. Fairfield, Middlesex, New Haven, and New London...

Development of the Modified Yale Food Addiction Scale Version 2.0.

PubMed

Schulte, Erica M; Gearhardt, Ashley N

2017-07-01

The Yale Food Addiction Scale (YFAS) operationalizes indicators of addictive-like eating, originally based on the Diagnostic and Statistical Manual of Mental Disorders 4th edition Text Revision (DSM-IV-TR) criteria for substance-use disorders. The YFAS has multiple adaptations, including a briefer scale (mYFAS). Recently, the YFAS 2.0 was developed to reflect changes to diagnostic criteria in the DSM-5. The current study developed a briefer version of the YFAS 2.0 (mYFAS 2.0) using the participant sample from the YFAS 2.0 validation paper (n = 536). Then, in an independent sample recruited from Mechanical Turk, 213 participants completed the mYFAS 2.0, YFAS 2.0, and measures of eating-related constructs in order to evaluate the psychometric properties of the mYFAS 2.0, relative to the YFAS 2.0. The mYFAS 2.0 and YFAS 2.0 performed similarly on indexes of reliability, convergent validity with related constructs (e.g. weight cycling), discriminant validity with distinct measures (e.g. dietary restraint) and incremental validity evidenced by associations with frequency of binge eating beyond a measure of disinhibited eating. The mYFAS 2.0 may be an appropriate choice for studies prioritizing specificity when assessing for addictive-like eating or when a briefer measurement of food addiction is needed. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Telemedicine at the top of the world: the 1998 and 1999 Everest extreme expeditions.

PubMed

Angood, P B; Satava, R; Doarn, C; Merrell, R

2000-01-01

The National Aeronautics and Space Administration (NASA) initially established a Commercial Space Center (CSC) in the Department of Surgery at Yale University School of Medicine to further develop and evaluate technologies in information systems, telecommunications applied to medicine, and physiologic sensors. The CSC is known as the Medical Informatics and Technology Applications Consortium (MITAC). The overall purpose for this NASA program is to leverage technology, innovation, and resources from industry and academia through collaborative partnerships. The Yale-NASA CSC/MITAC organized the Everest Extreme Expeditions (E3) for the spring Himalayan climbing seasons in the years 1998 and 1999. The primary mission was to deliver advanced medical support with global telemedicine capabilities to one of the world's most remote and hostile settings--Mount Everest. The purpose was both humanitarian (providing medical support) and scientific (conducting medical and technology research). The Yale team provided medical care for the Everest Base Camp community; conducted validation experiments for several types of advanced medical technologies in this remote, hostile environment; and performed real-time monitoring of selected climbers, while also assessing the basic science of altitude physiology. Additionally, the teams conducted outreach medical care to the citizens of Nepal and provided several educational forums for a variety of medical and nonmedical personnel--including school-age children. As part of the project's mission, the E3 medical teams at both Nepal and New Haven were on a 24-hour emergency call system to deliver medical care in the event of a crisis. Unlike most of the teams at Everest, the mission of E3 was not to climb the 29,028-foot mountain the Nepalese call Sagarmatha ("Sky Head"). The mountain served as an extreme testing ground for telemedicine. The lessons learned from this testbed are reviewed here and further clarify the abilities to provide better

The financial impact of hospitals on the local economy--2 new factors.

PubMed

Rotarius, Timothy; Liberman, Aaron

2014-01-01

This research effort presents a descriptive analysis of the financial impact that several hospitals have on their local economy. An earlier study published by the authors included 3 distinct, yet overlapping components of financial impact: (1) the hospital system as a major health care provider, (2) the hospital system as a large employer, and (3) the hospital system as an entity whose employees contribute greatly to their local community. This new study added additional financial impact factors: (4) the hospital system as an organization committed to major construction projects in pursuit of its health services mission, and (5) the hospital system as an entity that pays taxes to government agencies. The inextricable relationship of these 5 categories both increases and enhances the impact of the hospital system on the local region. The results of this updated and expanded analysis suggest strongly that the hospital system represents 1 of the primary contributors to the economy of the region. The hospital system adds $3 billion to the $28 billion local economy, which means that the hospital system and its employees are responsible for 10.7% of the total economic prowess of the region.

[Quality control at the Istituto di Anatomia e Istologia patologica at the Università di Bologna].

PubMed

Alampi, G; Baroni, R; Berti, E; Ceccarelli, C; Dina, R; Eusebi, V; Giangaspero, F; Grigioni, F W; Lecce, S; Losi, L

1994-04-01

The growing importance in medical practice of a standardized diagnosis in cyto- and histopathology and the recent recommendations for the adoption of standardized schemes for quality control in anatomic pathology by International Committees stimulated the medical staff of the Institute of Anatomic Pathology of the University of Bologna to adopt a pertinent method. The method used by the Department of Pathology of the Yale University (New Haven, Connecticut, USA) was chosen. A Committee for the quality control was appointed and two kinds of controls were set up: an External Quality Assessment (review of the difficult cases by external experts, slide seminars) and an Internal Quality Assessment performed by the members of the Committee on the diagnostic and laboratory routine of the Institute. Such a survey is periodically monitored during the monthly meetings of the Committee and described in the monthly reports. The present paper illustrates the method adopted and the preliminary results obtained in order to stimulate the discussion of such a critical theme in contemporary Anatomic Pathology at a national level.

Inpatient antibiotic consumption in a regional secondary hospital in New Zealand.

PubMed

Hopkins, C J

2014-02-01

Reporting of antibiotic consumption in hospitals is a crucial component of antibiotic stewardship, but data from Australasian secondary hospitals are scarce. The hypothesis of this audit is that antibiotic consumption in secondary hospitals would be lower than in tertiary centres. The study aims to present the first published audit of antibiotic consumption from a secondary hospital in New Zealand compared with two tertiary centres. Hospital population-level data were retrospectively accessed to identify all systemic antibiotics dispensed to adult inpatients at Taranaki District Health Board during 2011. Consumption was calculated in defined daily doses per 100 inpatient-days and per 100 admissions, stratified by drug class. Comparison was against published data from two tertiary centres. Total consumption was lower, but that of high-risk antibiotic classes was higher than both tertiary centres. The relative consumption of lincosamides was 4.0 and 2.6 times higher than the two tertiary centres, with an associated 14% incidence of Clostridium difficile associated diarrhoea within 3 months. Our secondary hospital appears to consume the wrong types of antibiotic rather than too much. Data from all Australasian hospitals, stratified by clinical service area and hospital level, are required for clinically relevant benchmarking. © 2014 The Author; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

Black/white differences in very low birth weight neonatal mortality rates among New York City hospitals.

PubMed

Howell, Elizabeth A; Hebert, Paul; Chatterjee, Samprit; Kleinman, Lawrence C; Chassin, Mark R

2008-03-01

We sought to determine whether differences in the hospitals at which black and white infants are born contribute to black/white disparities in very low birth weight neonatal mortality rates in New York City. We performed a population-based cohort study using New York City vital statistics records on all live births and deaths of infants weighing 500 to 1499 g who were born in 45 hospitals between January 1, 1996, and December 31, 2001 (N = 11 781). We measured very low birth weight risk-adjusted neonatal mortality rates for each New York City hospital and assessed differences in the distributions of non-Hispanic black and non-Hispanic white very low birth weight births among these hospitals. Risk-adjusted neonatal mortality rates for very low birth weight infants in New York City hospitals ranged from 9.6 to 27.2 deaths per 1000 births. White very low birth weight infants were more likely to be born in the lowest mortality tertile of hospitals (49%), compared with black very low birth weight infants (29%). We estimated that, if black women delivered in the same hospitals as white women, then black very low birth weight mortality rates would be reduced by 6.7 deaths per 1000 very low birth weight births, removing 34.5% of the black/white disparity in very low birth weight neonatal mortality rates in New York City. Volume of very low birth weight deliveries was modestly associated with very low birth weight mortality rates but explained little of the racial disparity. Black very low birth weight infants more likely to be born in New York City hospitals with higher risk-adjusted neonatal mortality rates than were very low birth weight infants, contributing substantially to black-white disparities.

Development of the Yale Food Addiction Scale Version 2.0.

PubMed

Gearhardt, Ashley N; Corbin, William R; Brownell, Kelly D

2016-02-01

Parallels in biological, psychological, and behavioral systems have led to the hypothesis that an addictive process may contribute to problematic eating. The Yale Food Addiction Scale (YFAS) was developed to provide a validated measure of addictive-like eating behavior based upon the diagnostic criteria for substance dependence. Recently, the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) was released, which included significant changes to the substance-related and addictive disorders (SRAD) section. In the current study, the YFAS 2.0 was developed to maintain consistency with the current diagnostic understanding of addiction and to improve the psychometric properties of the original YFAS. In a sample of 550 participants, 14.6% met criteria for food addiction. The YFAS 2.0 demonstrated good internal consistency, as well as convergent, discriminant, and incremental validity. Elevated scores on the YFAS 2.0 were associated with higher rates of obesity and more severe pathological eating (e.g., binge eating). The YFAS 2.0 also appeared to capture a related, but unique construct relative to traditional eating disorders. In a separate sample of 209 participants, the YFAS and YFAS 2.0 were directly compared. Both versions of the YFAS were similarly associated with elevated body mass index, binge eating, and weight cycling. However, exceeding the food addiction threshold was more strongly associated with obesity for the YFAS 2.0 than the original YFAS. Thus, the YFAS 2.0 appears to by a psychometrically sound measure that reflects the current diagnostic understanding of addiction to further investigate the potential role of an addictive process in problematic eating behavior. (c) 2016 APA, all rights reserved).

Preventable in-hospital medical injury under the "no fault" system in New Zealand

PubMed Central

Davis, P; Lay-Yee, R; Briant, R; Scott, A

2003-01-01

Objectives: To describe the pattern of preventable in-hospital medical injury under the "no fault" system and to assess the level of serious preventable patient harm. Design: Cross sectional survey using a two stage retrospective assessment of medical records conducted by structured implicit review. Setting: General hospitals with over 100 beds providing acute care in New Zealand. Participants: A sample of 6579 patients admitted in 1998 to 13 hospitals selected by stratified systematic list sample. Main outcome measures: Occurrence, preventability, and impact of adverse events. Results: Over 5% of admissions were associated with a preventable in-hospital event, of which nearly half had an element of systems failure. The elderly, ethnic minority groups, and particular clinical areas were at higher risk. The chances of a patient experiencing a serious preventable adverse event subsequent to hospital admission were just under 1%, a figure close to published results from comparable studies under tort. On average, these events required an additional 4 weeks in hospital. System related issues of protocol use and development, communication, and organisation, as well as requirements for consultation and education, were pre-eminent. Conclusions: The risk of serious preventable in-hospital medical injury for patients in New Zealand, a well established "no fault" jurisdiction, is within the range reported in comparable investigations under tort. PMID:12897357

[The application of new technologies to hospital pharmacy in Spain].

PubMed

Bermejo Vicedo, T; Pérez Menéndez Conde, C; Alvarez, Ana; Codina, Carlos; Delgado, Olga; Herranz, Ana; Hidalgo Correas, Francisco; Martín, Isabel; Martínez, Julio; Luis Poveda, José; Queralt Gorgas, María; Sanjurjo Sáez, María

2007-01-01

To describe the degree of introduction of new technologies in the medication use process in pharmacy services in Spain. A descriptive study via a survey into the degree of introduction of computer systems for: management, computerized physician order entry (CPOE), automated unit dose drug dispensing, preparation of parenteral nutrition solutions, recording drug administration, pharmaceutical care and foreseen improvements. The survey was sent by electronic mail to the heads of the pharmacy services of 207 hospitals throughout Spain. Response index: 82 hospitals (38.6%). 29 hospitals (36.7%) have a modular management system, 24 (30.4%) an integrated one and 34 (44.9%) a modular-integrated one. CPOE is utilised in 17 (22.4%). According to the size of the hospital, between 17.9 and 26.7% of unit dose dispensing is done online with a management software; between 5.1 and 33.3% of unit dose dispensing is automated. Automation of unit dose dispensing centred in the pharmacy service varies between 10 and 33.3%. Between 13.2 and 35.7% of automated in-ward dispensing systems are utilised. Administration records are kept manually on a computerised sheet at 23 (31.5%) of the hospitals; at 4 (5.4%) on CPOE and 7 (9.5%) online on the integral management programme and 4 (5.4%) on specific nursing softwares. Sixty-three per cent foresee the implementation of improvements in the short to medium term. The introduction of new technologies is being developed in Spain aiming to improve the safety and management of drugs, and there is a trend towards increasing their deployment in the near future. It is hoped that their fomentation could help to bring about process reengineering within pharmacy services in order to increase the time available for devotion to pharmaceutical care.

13. Site plan, 1900 Photocopied from a blueprint, 'Appraisal of ...

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

13. Site plan, 1900 Photocopied from a blueprint, 'Appraisal of Water Power and Real Estate at Whitneyville, 1900,' New Haven Water Company, 100 Crown Street, New Haven, Connecticut. Shows the Whitney Arms Company as it existed for much of the period 1860-1904. Compare with photo CT-2-10. - Eli Whitney Armory, West of Whitney Avenue, Armory Street Vicinity, Hamden, New Haven County, CT

50. Photocopy of photograph (original negative is property of the ...

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

50. Photocopy of photograph (original negative is property of the Central Connecticut Regional Water Authority and preserved in their archives at 90 Sargent Drive, New Haven, Connecticut 06511-5966), photographer unknown, circa 1959. The sand washer designed by New Haven Water Company. - Lake Whitney Water Filtration Plant, Filtration Plant, South side of Armory Street between Edgehill Road & Whitney Avenue, Hamden, New Haven County, CT

The impact of New Public Management on efficiency: an analysis of Madrid's hospitals.

PubMed

Alonso, José M; Clifton, Judith; Díaz-Fuentes, Daniel

2015-03-01

Madrid has recently become the site of one of the most controversial cases of public healthcare reform in the European Union. Despite the fact that the introduction of New Public Management (NPM) into Madrid hospitals has been vigorous, little scholarship has been done to test whether NPM actually led to technical efficiency. This paper is one of the first attempts to do so. We deploy a bootstrapped data envelopment analysis to compare efficiency scores in traditionally managed hospitals and those operating with new management formulas. We do not find evidence that NPM hospitals are more efficient than traditionally managed ones. Moreover, our results suggest that what actually matters may be the management itself, rather than the management model. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

17. Interior view, top floor, original bathroom and lockers, looking ...

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

17. Interior view, top floor, original bathroom and lockers, looking east. - New York, New Haven, & Hartford Railroad, Shell Interlocking Tower, New Haven Milepost 16, approximately 100 feel east of New Rochelle Junction, New Rochelle, Westchester County, NY

New Brunswick hospital system reorganization: a formula for success.

PubMed

McGeorge, R K; Giberson, S

1994-01-01

Propelled by a staggering burden of national and provincial debt, Canada has been overtaken by reform of its health system. New Brunswick's regionalization of hospital services has been a fascinating experience in health care reform, and many of its characteristics have now been emulated by other provinces. The approach has been bold, challenging and exciting.

7. OBLIQUE VIEW, HOME SIGNAL, WESTBOUND ON CATENARY BRIDGE 518 ...

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

7. OBLIQUE VIEW, HOME SIGNAL, WESTBOUND ON CATENARY BRIDGE 518 - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

Diminishing availability of trial of labor after cesarean delivery in New Mexico hospitals.

PubMed

Leeman, Lawrence M; Beagle, Melissa; Espey, Eve; Ogburn, Tony; Skipper, Betty

2013-08-01

To examine the availability of trial of labor after cesarean delivery (TOLAC) in New Mexico from 1998 to 2012 and maternity care providers' perception of barriers to TOLAC. Hospital maternity unit directors were surveyed regarding TOLAC availability from 1998 to 2012. Maternity care providers (obstetrician-gynecologists, certified nurse-midwives, and family medicine physicians) were surveyed in 2008 regarding resources and barriers to providing TOLAC and emergency cesarean delivery. Trial of labor after cesarean delivery was available in 100% of counties with maternity care units in 1998 (22/22); by 2008, availability decreased to 32% (7/22). After changes in national guidelines, availability increased slightly to 9 of 22 (41%) in 2012. Barriers to TOLAC included anesthesia availability (88%), hospital and medical malpractice policies (80%), malpractice cost (69%), and obstetric surgeon availability (59%). In hospitals without TOLAC services, 73% of maternity care providers indicated a surgeon could be present in the hospital within 20 minutes of the emergency delivery decision; only 43% indicated obstetric anesthesia personnel could be present within 20 minutes (P<.001). Availability of TOLAC in New Mexico has decreased dramatically. Policy changes are needed to support TOLAC access in rural and community hospitals. III.

Analysis of Recorded Biomedical Book and Journal Use in the Yale Medical Library Part I: Date and Subject Relations*

PubMed Central

Stangl, Peter; Kilgour, Frederick G.

1967-01-01

Analysis of book and journal circulation is based on cancelled charge slips collected over a one-year period in the Yale Medical Library. About two-fifths of material circulated were monographs. Books and journals in seven subject fields provided over half of the circulation. Approximately two-thirds of both books and journals used had been published during the most recent nine years. A subject-by-subject examination of the ratio of books to journals circulating revealed that, in subjects where proportionally more journals than books were taken out of the Library, books were of more recent imprint dates than were journals, contrary to the overall pattern. Date distribution of books and journals by subject was also studied. Results are illustrated with graphs and tables. PMID:6041834

Nameless, New Haven, and Nicholls

ERIC Educational Resources Information Center

Kurland, Jordan E.

2008-01-01

This article presents three recent American Association of University Professors (AAUP) cases that involved the dismissal of a senior non-tenure-track member of the faculty. The most recent case resulted in the investigating committee's report on Nicholls State University, a regional public institution in Louisiana. Preceding Nicholls was an…

A comparison of medical students' perceptions of their initial basic clinical training placements in 'new' and established teaching hospitals.

PubMed

Mathers, Jonathan; Parry, Jayne; Scully, Edward; Popovic, Celia

2006-05-01

This study has examined students' perceptions of the factors influencing learning during initial hospital placements and whether differences in perceived experiences were evident between students attending new and established teaching hospitals. Five focus groups were conducted with Year III students at the University of Birmingham Medical School (UBMS): three with students attending three established teaching hospitals and two with students attached to a new teaching hospital (designated as part of the UBMS expansion programme). Extensive variation in student perception of hospital experiences was evident at the level of teaching hospital, teaching firm and individual teacher. Emergent themes were split into two main categories: 'students' perceptions of teaching and the teaching environment' and 'the new hospital learner'. Themes emerging that related to variation in student experience included the amount of structured teaching, enthusiasm of teachers, grade of teachers, specialty of designated firms and the number of students. The new teaching hospital was generally looked upon favourably by students in comparison to established teaching hospitals. Many of the factors influencing student experience relate to themes grouped under the 'new hospital learner', describing the period of adjustment experienced by students during their first encounter with this new learning environment. Interventions to improve student experience might be aimed at organisations and individuals delivering teaching. However, factors contributing to the student experience, such as the competing demand to teaching of heavy clinical workloads, are outside the scope of medical school intervention. In the absence of fundamental change, mechanisms to equip students with 'survival skills' as self-directed hospital learners should also be considered.

8. North elevation of electric relay station showing electrical cable ...

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

8. North elevation of electric relay station showing electrical cable connection to tower. - New York, New Haven, & Hartford Railroad, Shell Interlocking Tower, New Haven Milepost 16, approximately 100 feel east of New Rochelle Junction, New Rochelle, Westchester County, NY

The Development and Validation of the Bergen-Yale Sex Addiction Scale With a Large National Sample.

PubMed

Andreassen, Cecilie S; Pallesen, Ståle; Griffiths, Mark D; Torsheim, Torbjørn; Sinha, Rajita

2018-01-01

The view that problematic excessive sexual behavior ("sex addiction") is a form of behavioral addiction has gained more credence in recent years, but there is still considerable controversy regarding operationalization of the concept. Furthermore, most previous studies have relied on small clinical samples. The present study presents a new method for assessing sex addiction-the Bergen-Yale Sex Addiction Scale (BYSAS)-based on established addiction components (i.e., salience/craving, mood modification, tolerance, withdrawal, conflict/problems, and relapse/loss of control). Using a cross-sectional survey, the BYSAS was administered to a broad national sample of 23,533 Norwegian adults [aged 16-88 years; mean (± SD ) age = 35.8 ± 13.3 years], together with validated measures of the Big Five personality traits, narcissism, self-esteem, and a measure of sexual addictive behavior. Both an exploratory and a confirmatory factor analysis (RMSEA = 0.046, CFI = 0.998, TLI = 0.996) supported a one-factor solution, although a local dependence between two items (Items 1 and 2) was detected. Furthermore, the scale had good internal consistency (Cronbach's α = 0.83). The BYSAS correlated significantly with the reference scale ( r = 0.52), and demonstrated similar patterns of convergent and discriminant validity. The BYSAS was positively related to extroversion, neuroticism, intellect/imagination, and narcissism, and negatively related to conscientiousness, agreeableness, and self-esteem. High scores on the BYSAS were more prevalent among those who were men, single, of younger age, and with higher education. The BYSAS is a brief, and psychometrically reliable and valid measure for assessing sex addiction. However, further validation of the BYSAS is needed in other countries and contexts.

The Development and Validation of the Bergen–Yale Sex Addiction Scale With a Large National Sample

PubMed Central

Andreassen, Cecilie S.; Pallesen, Ståle; Griffiths, Mark D.; Torsheim, Torbjørn; Sinha, Rajita

2018-01-01

The view that problematic excessive sexual behavior (“sex addiction”) is a form of behavioral addiction has gained more credence in recent years, but there is still considerable controversy regarding operationalization of the concept. Furthermore, most previous studies have relied on small clinical samples. The present study presents a new method for assessing sex addiction—the Bergen–Yale Sex Addiction Scale (BYSAS)—based on established addiction components (i.e., salience/craving, mood modification, tolerance, withdrawal, conflict/problems, and relapse/loss of control). Using a cross-sectional survey, the BYSAS was administered to a broad national sample of 23,533 Norwegian adults [aged 16–88 years; mean (± SD) age = 35.8 ± 13.3 years], together with validated measures of the Big Five personality traits, narcissism, self-esteem, and a measure of sexual addictive behavior. Both an exploratory and a confirmatory factor analysis (RMSEA = 0.046, CFI = 0.998, TLI = 0.996) supported a one-factor solution, although a local dependence between two items (Items 1 and 2) was detected. Furthermore, the scale had good internal consistency (Cronbach's α = 0.83). The BYSAS correlated significantly with the reference scale (r = 0.52), and demonstrated similar patterns of convergent and discriminant validity. The BYSAS was positively related to extroversion, neuroticism, intellect/imagination, and narcissism, and negatively related to conscientiousness, agreeableness, and self-esteem. High scores on the BYSAS were more prevalent among those who were men, single, of younger age, and with higher education. The BYSAS is a brief, and psychometrically reliable and valid measure for assessing sex addiction. However, further validation of the BYSAS is needed in other countries and contexts. PMID:29568277

35. END VIEW, INTERIOR, SHOWING SWITCHING LEVERS, BERK SWITCH TOWER, ...

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

35. END VIEW, INTERIOR, SHOWING SWITCHING LEVERS, BERK SWITCH TOWER, SOUTH NORWALK - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

37. OBLIQUE VIEW, INTERIOR, BERK SWITCH TOWER, SOUTH NORWALK, SHOWING ...

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

37. OBLIQUE VIEW, INTERIOR, BERK SWITCH TOWER, SOUTH NORWALK, SHOWING SWITCHING LEVERS - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

Changes in patient satisfaction related to hospital renovation: experience with a new clinical building.

PubMed

Siddiqui, Zishan K; Zuccarelli, Rebecca; Durkin, Nowella; Wu, Albert W; Brotman, Daniel J

2015-03-01

There is an increasing trend toward designing hospitals with patient-centered features like reduced noise, improved natural light, visitor friendly facilities, well-decorated rooms, and hotel-like amenities. It has also been suggested that because patients cannot reliably distinguish positive experiences with the physical environment from positive experience with care, an improved hospital environment leads to higher satisfaction with physicians, nursing, food service, housekeeping, and higher overall satisfaction. To characterize changes in patient satisfaction that occurred when clinical services (comprised of stable nursing, physician, and unit teams) were relocated to a new clinical building with patient-centered features. We hypothesized that new building features would positively impact provider, ancillary staff, and overall satisfaction, as well as improved satisfaction with the facility. Natural experiment utilizing a pre-post design with concurrent controls. Academic tertiary care hospital. We included all patients discharged from 12 clinical units that relocated to the new clinical building who returned surveys in the 7.5-month period following the move. Premove baseline data were captured from the year prior to the move. Patients on unmoved clinical units who returned satisfaction surveys served as concurrent controls. Patient-centered design features incorporated into the new clinical building. All patients during the baseline period and control patients during the study period were located in usual patient rooms with standard hospital amenities. The primary outcome was satisfaction scores on the Press Ganey and Hospital Consumer Assessment of Healthcare Providers and Systems survey, dichotomized at highest category versus lower categories. We performed logistic regression to identify predictors of "top-box" scores. The move was associated with improved room- and visitor-related satisfaction without significant improvement in satisfaction with clinical

42. INTERIOR VIEW, GREEN SWITCH TOWER, COS COB, SHOWING DETAIL ...

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

42. INTERIOR VIEW, GREEN SWITCH TOWER, COS COB, SHOWING DETAIL OF SWITCH LEVERS - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

Letters of credit getting more expensive.

PubMed

Nemes, J

1991-09-02

Hospital executives who haven't been in the market recently for a new or renewed letter of credit will find it a more expensive way to back their variable-rate debt. Annual fees are surging, for reasons ranging from an international banking agreement that goes into effect next year to more conservative fee structures being instituted because of bad loans made by some banks in the past decade.

Falls in hospital and new placement in a nursing home among older people hospitalized with acute illness.

PubMed

Basic, David; Hartwell, Tabitha J

2015-01-01

To examine the association between falls in hospital and new placement in a nursing home among older people hospitalized with acute illness. This prospective cohort study of 2,945 consecutive patients discharged alive from an acute geriatric medicine service used multivariate logistic regression to model the association between one or more falls and nursing home placement (primary analysis). Secondary analyses stratified falls by injury and occurrence of multiple falls. Demographic, medical, and frailty measures were considered in adjusted models. The mean age of all patients was 82.8±7.6 years and 94% were admitted through the emergency department. During a median length of stay (LOS) of 11 days, 257 (8.7%) patients had a fall. Of these, 66 (25.7%) sustained an injury and 53 (20.6%) had two or more falls. Compared with nonfallers, fallers were more likely to be placed in a nursing home (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.37-3.00), after adjustment for age, sex, frailty, and selected medical variables (including dementia and delirium). Patients without injury (OR: 1.83, 95% CI: 1.17-2.85) and those with injury (OR: 2.35, 95% CI: 1.15-4.77) were also more likely to be placed. Patients who fell had a longer LOS (median 19 days vs 10 days; P<0.001). This study of older people in acute care shows that falls in the hospital are significantly associated with new placement in a nursing home. Given the predominantly negative experiences and the financial costs associated with placement in a nursing home, fall prevention should be a high priority in older people hospitalized with acute illness.

Minimization of Hypoglycemia as an Adverse Event During Insulin Infusion: Further Refinement of the Yale Protocol.

PubMed

Marvin, Michael R; Inzucchi, Silvio E; Besterman, Brian J

2016-08-01

The management of hyperglycemia in the intensive care unit has been a controversial topic for more than a decade, with target ranges varying from 80-110 mg/dL to <200 mg/dL. Multiple insulin infusion protocols exist, including several computerized protocols, which have attempted to achieve these targets. Importantly, compliance with these protocols has not been a focus of clinical studies. GlucoCare™, a Food and Drug Administration (FDA)-cleared insulin-dosing calculator, was originally designed based on the Yale Insulin Infusion Protocol to target 100-140 mg/dL and has undergone several modifications to reduce hypoglycemia. The original Yale protocol was modified from 100-140 mg/dL to a range of 120-140 mg/dL (GlucoCare 120-140) and then to 140 mg/dL (GlucoCare 140, not a range but a single blood glucose [BG] level target) in an iterative and evidence-based manner to eliminate hypoglycemia <70 mg/dL. The final modification [GlucoCare 140(B)] includes the addition of bolus insulin "midprotocol" during an insulin infusion to reduce peak insulin rates for insulin-resistant patients. This study examined the results of these protocol modifications and evaluated the role of compliance with the protocol in the incidence of hypoglycemia <70 mg/dL. Protocol modifications resulted in mean BG levels of 133.4, 136.4, 143.8, and 146.4 mg/dL and hypoglycemic BG readings <70 mg/dL of 0.998%, 0.367%, 0.256%, and 0.04% for the 100-140, 120-140, 140, and 140(B) protocols, respectively (P < 0.001). Adherence to the glucose check interval significantly reduced the incidence of hypoglycemia (P < 0.001). Protocol modifications led to a reduction in peak insulin infusion rates (P < 0.001) and the need for dextrose-containing boluses (P < 0.001). This study demonstrates that refinements in protocol design can improve glucose control in critically ill patients and that the use of GlucoCare 140(B) can eliminate all significant hypoglycemia while

New York hospital group striving for brand recognition. HealthStar Network.

PubMed

Herreria, J

1998-01-01

HealthStar Network established a new concept in its eastern market--a group of hospitals forming one association. Marketers of HealthStar are conducting a branding campaign to distinguish individual expertise under one umbrella company.

36. INTERIOR VIEW, BERK SWITCH TOWER, SOUTH NORWALK, SHOWING SWITCHING ...

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

36. INTERIOR VIEW, BERK SWITCH TOWER, SOUTH NORWALK, SHOWING SWITCHING LEVERS FROM OPERATOR'S POSITION - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

The Case for Case-Mix: A New Construct for Hospital Management

PubMed Central

Plomann, Marilyn Peacock; Garzino, Fred R.

1981-01-01

Case-mix is a useful methodology for health care management, planning and control. It provides managers with a powerful tool by providing a framework for relating resource consumption profiles with specific treatment patterns. In the long run, it will assist hospital planners in analyzing the demands which different classes of patients bring to the hospital. Decisions concerning capital financing, facilities planning, new services, and the medical and financial implications of physician activities are more efficiently analyzed within a case-mix framework. In the near term, inventory management, staffing policies and the on-going need for the astute management of cash flow will be postively and decisively affected by the use of case-mix measures. The benefits derived from a case-mix system are not limited to hospitals possessing sophisticated management information systems. The case-mix methodology also provides a useful tool for hospitals with less advanced data processing systems and management practices in applying a variety of management science techniques to their planning and control activities.

Trends in hospitalization for community-associated methicillin-resistant Staphylococcus aureus in New York City, 1997-2006: data from New York State's Statewide Planning and Research Cooperative System.

PubMed

Farr, Amanda M; Aden, Brandon; Weiss, Don; Nash, Denis; Marx, Melissa A

2012-07-01

To describe trends in hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in New York City over 10 years and to explore the demographics and comorbidities of patients hospitalized with CA-MRSA infections. Retrospective analysis of hospital discharges from New York State's Statewide Planning and Research Cooperative System database from 1997 to 2006. All patients greater than 1 year of age admitted to New York hospitals with diagnosis codes indicating MRSA who met the criteria for CA-MRSA on the basis of admission information and comorbidities. We determined hospitalization rates and compared demographics and comorbidities of patients hospitalized with CA-MRSA versus those hospitalized with all other non-MRSA diagnoses by multivariable logistic regression. Of 18,226 hospitalizations with an MRSA diagnosis over 10 years, 3,579 (20%) were classified as community-associated. The CA-MRSA hospitalization rate increased from 1.47 to 10.65 per 100,000 people overall from 1997 to 2006. Relative to non-MRSA hospitalizations, men, children, Bronx and Manhattan residents, the homeless, patients with human immunodeficiency virus (HIV) infection, and persons with diabetes had higher adjusted odds of CA-MRSA hospitalization. The CA-MRSA hospitalization rate appeared to increase between 1997 and 2006 in New York City, with residents of the Bronx and Manhattan, men, and persons with HIV infection or diabetes at increased odds of hospitalization with CA-MRSA. Further studies are needed to explore how changes in MRSA incidence, access to care, and other factors may have impacted these rates.

Holy Cross Hospital draws more customers for bariatric services through new ad campaign.

PubMed

2006-01-01

In 2003, the bariatric program at Holy Cross Hospital was looking to boost its business. With the help of J. O'Connor & Matthews, Inc., an advertising and marketing firm, the hospital used a new strategy: an ad campaign focused around a one-hour info session about the procedure hosted by doctors, nurses, and former bariatric patients.

Designing new collaborative learning spaces in clinical environments: experiences from a children's hospital in Australia.

PubMed

Bines, Julie E; Jamieson, Peter

2013-09-01

Hospitals are complex places that provide a rich learning environment for students, staff, patients and their families, professional groups and the community. The "new" Royal Children's Hospital opened in late 2011. Its mission is focused on improving health and well-being of children and adolescents through leadership in healthcare, research and education. Addressing the need to create "responsive learning environments" aligned with the shift to student-centred pedagogy, two distinct learning environments were developed within the new Royal Children's Hospital; (i) a dedicated education precinct providing a suite of physical environments to promote a more active, collaborative and social learning experience for education and training programs conducted on the Royal Children's Hospital campus and (ii) a suite of learning spaces embedded within clinical areas so that learning becomes an integral part of the daily activities of this busy Hospital environment. The aim of this article is to present the overarching educational principles that lead the design of these learning spaces and describe the opportunities and obstacles encountered in the development of collaborative learning spaces within a large hospital development.

Outreach Realty Servicing, LLC Information Sheet

EPA Pesticide Factsheets

Outreach Realty Servicing, LLC (the Company) is located in New Haven, Connecticut. The settlement involves renovation activities conducted at property constructed prior to 1978, located in New Haven, Connecticut.

41. INTERIOR VIEW, GREEN SWITCH TOWER, COS COB, SHOWING SWITCH ...

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

41. INTERIOR VIEW, GREEN SWITCH TOWER, COS COB, SHOWING SWITCH LEVER ASSEMBLAGE AND DISPLAY BOARD - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

45. EXTERIOR VIEW, GREEN SWITCH TOLWER, COS COB, SHOWING BARS ...

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

45. EXTERIOR VIEW, GREEN SWITCH TOLWER, COS COB, SHOWING BARS AND PIPES LEADING TO SWITCHES - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

43. OBLIQUE VIEW, GREEN SWITCH TOWER, COS COB, SHOWING SWITCH ...

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

43. OBLIQUE VIEW, GREEN SWITCH TOWER, COS COB, SHOWING SWITCH LEVER ASSEMBLAGE AND DISPLAY BOARD - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

40. EXTERIOR VIEW, BERK SWITCH TOWER, SOUTH NORWALK, SHOWING FRONT ...

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

40. EXTERIOR VIEW, BERK SWITCH TOWER, SOUTH NORWALK, SHOWING FRONT ELEVATION AND PIPES LEADING TO SWITCHES - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

6. Historic American Buildings Survey Photocopy, 1964 FRONT (EAST) ELEVATION, ...

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

6. Historic American Buildings Survey Photocopy, 1964 FRONT (EAST) ELEVATION, 1860 DRAWING Courtesy of Miss C. Rachel Trowbridge - Skinner-Trowbridge House, 46 Hillhouse Avenue, New Haven, New Haven County, CT

Diffusion patterns of new anti-diabetic drugs into hospitals in Taiwan: the case of Thiazolidinediones for diabetes

PubMed Central

2011-01-01

Background Diffusion of new drugs in the health care market affects patients' access to new treatment options and health care expenditures. We examined how a new drug class for diabetes mellitus, thiazolidinediones (TZDs), diffused in the health care market in Taiwan. Methods Assuming that monthly hospital prescriptions of TZDs could serve as a micro-market to perform drug penetration studies, we retrieved monthly TZD prescription data for 580 hospitals in Taiwan from Taiwan's National Health Insurance Research Database for the period between March 1, 2001 and December 31, 2005. Three diffusion parameters, time to adoption, speed of penetration (monthly growth on prescriptions), and peak penetration (maximum monthly prescription) were evaluated. Cox proportional hazards model and quantile regressions were estimated for analyses on the diffusion parameters. Results Prior hospital-level pharmaceutical prescription concentration significantly deterred the adoption of the new drug class (HR: 0.02, 95%CI = 0.01 to 0.04). Adoption of TZDs was slower in district hospitals (HR = 0.43, 95%CI = 0.24 to 0.75) than medical centers and faster in non-profit hospitals than public hospitals (HR = 1.79, 95%CI = 1.23 to 2.61). Quantile regression showed that penetration speed was associated with a hospital's prior anti-diabetic prescriptions (25%Q: 18.29; 50%Q: 25.57; 75%Q: 30.97). Higher peaks were found in hospitals that had adopted TZD early (25%Q: -40.33; 50%Q: -38.65; 75%Q: -32.29) and in hospitals in which the drugs penetrated more quickly (25%Q: 16.53; 50%Q: 24.91; 75%Q: 31.50). Conclusions Medical centers began to prescribe TZDs earlier, and they prescribed more TZDs at a faster pace. The TZD diffusion patterns varied among hospitals depending accreditation level, ownership type, and prescription volume of Anti-diabetic drugs. PMID:21281475

Use of Nutrition Standards to Improve Nutritional Quality of Hospital Patient Meals: Findings from New York City's Healthy Hospital Food Initiative.

PubMed

Moran, Alyssa; Lederer, Ashley; Johnson Curtis, Christine

2015-11-01

Most hospital patient meals are considered regular-diet meals; these meals are not required to meet comprehensive nutrition standards for a healthy diet. Although programs exist to improve nutrition in hospital food, the focus is on retail settings such as vending machines and cafeterias vs patient meals. New York City's Healthy Hospital Food Initiative (HHFI) provides nutrition standards for regular-diet meals that hospitals can adopt, in addition to retail standards. This study was undertaken to describe regular-diet patient menus before and after implementation of the HHFI nutrition standards. The study involved pre- and post- menu change analyses of hospitals participating in the HHFI between 2010 and 2014. Eight New York City hospitals, selected based on voluntary participation in the HHFI, were included in the analyses. Nutritional content of regular-diet menus were compared with the HHFI nutrition standards. Nutrient analysis and exact Wilcoxon signed-rank tests were used for the analysis of the data. At baseline, no regular-diet menu met all HHFI standards, and most exceeded the daily limits for percentage of calories from fat (n=5), percentage of calories from saturated fat (n=5), and milligrams of sodium (n=6), and they did not meet the minimum grams of fiber (n=7). Hospitals met all key nutrient standards after implementation, increasing fiber (25%, P<0.01) and decreasing sodium (-19%, P<0.05), percentage of calories from fat (-24%, P<0.01), and percentage of calories from saturated fat (-21%, P<0.05). A significant increase was seen in fresh fruit servings (667%, P<0.05) and decreases in full-fat and reduced-fat milk servings (-100%, P<0.05), refined grain servings (-35%, P<0.05), and frequency of desserts (-92%, P<0.05). Regular diet menus did not comply with the HHFI nutrition standards at baseline. Using the HHFI framework, hospitals significantly improved the nutritional quality of regular-diet patient menus. The standards were applied across

8. VIEW, LOOKING SOUTHEAST, SHOWING DETAIL OF RANGE 3 TARGET ...

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

8. VIEW, LOOKING SOUTHEAST, SHOWING DETAIL OF RANGE 3 TARGET END, Interior - Winchester Repeating Arms Company, Tract K Shooting Range, 125 Munson Street (rear section), New Haven, New Haven County, CT

6. VIEW, LOOKING SOUTHEAST, SHOWING DETAIL OF RANGE 1 TARGET ...

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

6. VIEW, LOOKING SOUTHEAST, SHOWING DETAIL OF RANGE 1 TARGET END, Interior - Winchester Repeating Arms Company, Tract K Shooting Range, 125 Munson Street (rear section), New Haven, New Haven County, CT

44. EXTERIOR VIEW, GREEN SWITCH TOWER, COS COB, SHOWING BARS ...

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

44. EXTERIOR VIEW, GREEN SWITCH TOWER, COS COB, SHOWING BARS LINKING SWITCH LEVERS AND PIPES LEADING TO SWITCHES - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

New indicators based on personnel cost for management efficiency in a hospital.

PubMed

Nakagawa, Yoshiaki; Yoshihara, Hiroyuki; Nakagawa, Yoshinobu

2011-08-01

A simple and fair benchmarking system or financial indicators for use on the clinical department level have been lacking to evaluate the management efficiency and activity of each clinical department or division of a hospital. New financial indicators have therefore been developed based on personnel costs. Indicator 1: The ratio of marginal profit after personnel cost per personnel cost (RMP). Indicator 2: The ratio of investment (=indirect cost) per personnel cost (RIP). The difference between RMP and RIP demonstrates the operation profit in US Dollars for personnel cost (OPP). A turning point in profitability similar to the break-even point (BEP) and break-even ratio (BER) could be also defined by the combination of the RMP and RIP. The merits of these two indicators are not only the ability to indicate the relationship between the medical profit and the investments in the hospital, but also the capability to demonstrate such indicators as BEP, BER and OPP on a single graph. The two indicators were applied to the hospitals in the National Hospital Organization and to the clinical department in one hospital. Using these two indicators, it was possible to evaluate the management efficiency and medical activity not only in the whole hospital but also in each department and DPC/DRG group. This will be of use to a manager of a hospital in checking the management efficiency of his/her hospital despite the variations among hospitals, departments and divisions.

A "New" Approach to Local Labor Market Analysis: A Feasibility Study.

ERIC Educational Resources Information Center

Goldfarb, Robert; Hamermesh, Daniel

This report describes research on the New Haven labor market carried out during the summer and fall of 1969 and the spring of 1970. The aims of the research were to develop further the theoretical approach to micro-labor economics in a local labor market and to test the feasibility of collecting data from local firms which could be used to test…

Out of the frying pan: New York City hospitals in an age of deregulation.

PubMed

Salit, Sharon; Fass, Steven; Nowak, Mark

2002-01-01

For several decades New York City hospitals had been distinguished by their tightly regulated environment, chronically weak finances, high occupancy rates, teaching intensity, dependency on public payers, low managed care penetration, and minimal merger activity. Then in the late 1990s a rapid convergence of forces--the Balanced Budget Act, managed care growth, state deregulation of commercial rates, escalating costs, and plunging hospital occupancy rates--threw the city's hospital industry into turmoil. In this paper we describe this period of turbulent change that has left most of the city's safety-net and small community hospitals near bankruptcy.

How a new 'public plan' could affect hospitals' finances and private insurance premiums.

PubMed

Dobson, Allen; DaVanzo, Joan E; El-Gamil, Audrey M; Berger, Gregory

2009-01-01

Two key health reform bills in the House of Representatives and Senate include the option of a "public plan" as an additional source of health coverage. At least initially, the plan would primarily be structured to cover many of the uninsured and those who now have individual coverage. Because it is possible, and perhaps even likely, that this new public payer would pay less than private payers for the same services, such a plan could negatively affect hospital margins. Hospitals may attempt to recoup losses by shifting costs to private payers. We outline the financial pressures that hospitals and private payers could experience under various assumptions. High uninsured enrollment in a public plan would bolster hospital margins; however, this effect is reversed if the privately insured enter a public plan in large proportions, potentially stressing the hospital industry and increasing private insurance premiums.

38. INTERIOR VIEW, BERK SWITCH TOWER, SOUTH NORWALK, SHOWING COMPLETE ...

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

38. INTERIOR VIEW, BERK SWITCH TOWER, SOUTH NORWALK, SHOWING COMPLETE SWITCH LEVER ASSEMBLAGE AND DISPLAY BOARD ON FRONT WALL - New York, New Haven & Hartford Railroad, Automatic Signalization System, Long Island Sound shoreline between Stamford & New Haven, Stamford, Fairfield County, CT

Incidence of hypocalcemia in patients receiving denosumab for prevention of skeletal-related events in bone metastasis.

PubMed

Yerram, Prakirthi; Kansagra, Shraddha; Abdelghany, Osama

2017-04-01

Background Denosumab therapy is commonly used for the prevention of skeletal-related events in patients with bone metastasis. However, a common side effect of denosumab is hypocalcemia. Objective The aim of the study is to determine the incidence of hypocalcemia in patients receiving denosumab for prevention of skeletal-related events in bone metastasis and evaluate risk factors for developing hypocalcemia. Methods This was a retrospective medication use evaluation reviewing the incidence of hypocalcemia in patients receiving outpatient denosumab for prevention of skeletal-related events at Yale-New Haven Hospital. Additionally, various risk factors were reviewed to determine their risk of developing hypocalcemia. Results As per Common Terminology Criteria for Adverse Events v4.03, of the 106 patients included in the study population, 37 (35%) patients had an incidence of hypocalcemia within 30 days of denosumab administration. Fourteen patients (13.2%) had an incidence of grade 1, 13 patients (12.3%) had an incidence of grade 2 hypocalcemia, and 7 patients (6.6%) had an incidence of grade 3 hypocalcemia. Grade 4 hypocalcemia occurred in three (2.8%) patients. Calcium supplementation did not decrease the risk of developing hypocalcemia. Patients who had one or more episodes of acute kidney insufficiency were at a higher risk of developing hypocalcemia (odds ratio = 7.5 (95% confidence interval = 1.8-36.3), p = 0.001). Conclusion This study found that the overall incidence of hypocalcemia and severe hypocalcemia was higher than reported in clinical trials. Additionally, calcium supplementation did not have an effect on incidence of hypocalcemia, while patients who experienced acute kidney insufficiency while on denosumab had a higher likelihood of developing hypocalcemia.

Time for a new budget allocation model for hospital care in Stockholm?

PubMed

Andersson, Per-Åke; Bruce, Daniel; Walander, Anders; Viberg, Inga

2011-03-01

In Stockholm County Council (SLL), budgets for hospital care have been allocated to geographically responsible authorities for a long time. This hospital care includes all publicly financed specialist care, also privately owned hospitals, except private practitioner care. The old needs-index model, a 6D capitation matrix based on demography and socio-economy, was generated on linked individual data for 1994-96. In this paper the power of the old allocation model is evaluated by the use of new data for 2006. The analysis shows that most of the socioeconomic variables have lost their descriptive power in 10 years. Using a methodical search we also find an improved need-based allocation model for hospital care using the new data for 2006. By focusing on costly diagnoses, where the descriptive power has increased between 1996 and 2006, and by using some new socioeconomic variables, and by relying on birth and death prognoses, we are able to generate a matrix model with much higher coefficients-of-determinations in 1 year predictions. In addition, a more careful modelling of multi-morbidity, part-of-the-year inhabitants, episode definition and cost transformation is developed. The area-level cost residuals of registered versus predicted costs show stable signs over the years, indicating unexplained systematics. For the reduction of the residuals, accepting proven inpatient diagnoses but not the full costs, a mixed capitation/fee-for-service strategy is discussed. Once equivalent (e.g. full-year) observations are determined, the link between background and consumption is not on individual-level but on cell-level, as in current resource allocation studies in the United Kingdom.

Validation of the French Version of the DSM-5 Yale Food Addiction Scale in a Nonclinical Sample

PubMed Central

Courtois, Robert; Gearhardt, Ashley N.; Gaillard, Philippe; Journiac, Kevin; Cathelain, Sarah; Réveillère, Christian; Ballon, Nicolas

2016-01-01

Objective: The Yale Food Addiction Scale (YFAS) is the only questionnaire that assesses food addiction (FA) based on substance dependence criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, Text Revision. Following recent updating of addiction criteria, a new DSM-5 version (YFAS 2.0) has been developed. Our study tested the psychometric properties of the French YFAS 2.0 in a nonclinical population. Method: We assessed 330 nonclinical participants for FA (French YFAS 2.0), eating behaviour, and eating disorder (Binge Eating Scale, Emotional Overeating Questionnaire, Three-Factor Eating Questionnaire-R18, Questionnaire on Eating and Weight Patterns-Revised, Eating Disorder Diagnostic Scale). We tested the scale’s factor structure (confirmatory factor analysis based on 11 diagnostic criteria), internal consistency, and construct and incremental validity. Results: Prevalence of FA was 8.2%. Our results supported a 1-factor structure similar to the US version. In both its diagnostic and symptom count versions, the YFAS 2.0 had good internal consistency (Kuder-Richardson alpha was 0.83) and was associated with body mass index (BMI), binge eating, uncontrolled and emotional eating, binge eating disorder, and cognitive restraint. FA predicted BMI above and beyond binge eating frequency. Females had a higher prevalence of FA than males but not more FA symptoms. Conclusions: We validated a psychometrically sound French version of the YFAS 2.0 in a nonclinical population, in both its symptom count and diagnostic versions. Future studies should investigate psychometric properties of this questionnaire in clinical populations potentially at risk for FA (that is, patients with obesity, diabetes, hypertension, or other metabolic syndrome risk factors). PMID:28212499

Validation of the French Version of the DSM-5 Yale Food Addiction Scale in a Nonclinical Sample.

PubMed

Brunault, Paul; Courtois, Robert; Gearhardt, Ashley N; Gaillard, Philippe; Journiac, Kevin; Cathelain, Sarah; Réveillère, Christian; Ballon, Nicolas

2017-03-01

The Yale Food Addiction Scale (YFAS) is the only questionnaire that assesses food addiction (FA) based on substance dependence criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, Text Revision. Following recent updating of addiction criteria, a new DSM-5 version (YFAS 2.0) has been developed. Our study tested the psychometric properties of the French YFAS 2.0 in a nonclinical population. We assessed 330 nonclinical participants for FA (French YFAS 2.0), eating behaviour, and eating disorder (Binge Eating Scale, Emotional Overeating Questionnaire, Three-Factor Eating Questionnaire-R18, Questionnaire on Eating and Weight Patterns-Revised, Eating Disorder Diagnostic Scale). We tested the scale's factor structure (confirmatory factor analysis based on 11 diagnostic criteria), internal consistency, and construct and incremental validity. Prevalence of FA was 8.2%. Our results supported a 1-factor structure similar to the US version. In both its diagnostic and symptom count versions, the YFAS 2.0 had good internal consistency (Kuder-Richardson alpha was 0.83) and was associated with body mass index (BMI), binge eating, uncontrolled and emotional eating, binge eating disorder, and cognitive restraint. FA predicted BMI above and beyond binge eating frequency. Females had a higher prevalence of FA than males but not more FA symptoms. We validated a psychometrically sound French version of the YFAS 2.0 in a nonclinical population, in both its symptom count and diagnostic versions. Future studies should investigate psychometric properties of this questionnaire in clinical populations potentially at risk for FA (that is, patients with obesity, diabetes, hypertension, or other metabolic syndrome risk factors).

Nursing structures in New Zealand public hospitals: current configurations.

PubMed

Hughes, Kerri-Ann; Carryer, Jennifer Barbara

2011-02-01

This article reports research reviewing the configuration of nursing leadership in New Zealand public hospitals. It represents an analysis of Phase 1 of a larger study. Leadership in nursing is critical if the profession is to meet the challenges of health services in the 21st century. The research focuses on how leadership in public hospitals is structured at a strategic level. The preliminary summary of findings of this phase of the research show that reporting lines between directors of nursing (DON) and the chief executive officer (CEO) are not always direct, and organizational charts and nursing structures are not readily aligned. Clear financial or budget holding reporting lines by nursing leadership are not easily identified, or are professional and operational accountability lines clearly defined. From 15 total responses received, the organizations are structured differently both organizationally and in the nursing structures.

Financing care for the uninsured: the dilemma vexes New Jersey hospitals and payers.

PubMed

Wells, E V

1996-05-01

New Jersey's diverse constituencies and special interest groups don't usually agree on a public policy issue. However, almost everyone in the public policy arena agrees that hospitals should treat people who show up in emergency departments with problems requiring medical attention. For over a decade, Garden State policymakers, payers, and providers have faced the dilemma of excess demand on hospitals that treat the uninsured. This demand has risen due to increasing health care costs, development of costly technology, state deregulation of hospital payments, and employers' reluctance to insure workers and their families coupled with a mobile workforce holding part-time and seasonal jobs. The fiscal solvency of inner-city hospitals is threatened yet the problem continues to elude resolution.

Pike International, LLC et al. Information Sheet

EPA Pesticide Factsheets

Pike International LLC, et al. (the Company) is located in New Haven, Connecticut. The Complaint involves the lease of, and renovation activities conducted at, property constructed prior to 1978, located in New Haven, Connecticut.

Managing prices for hospital pharmaceuticals: a successful strategy for New Zealand?

PubMed

Tordoff, June M; Norris, Pauline T; Reith, David M

2005-01-01

In 2002, as part of a National Hospital Pharmaceutical Strategy, the New Zealand (NZ) government agency PHARMAC commenced a 3-year period of negotiating prices for 90% of hospital pharmaceuticals on behalf of all NZ public hospitals. The present study was undertaken to determine the effects of this first year of "pooled procurement." Using price changes and volume data for each of their top 150 pharmaceutical items, chief pharmacists at 11 public hospitals calculated projected cost savings for the financial year July 2003 to June 2004. Researchers calculated total projected savings for all 11 hospitals, and for three types of hospitals. Estimates of projected savings were made for all 29 major public hospitals by using savings per bed and savings per bed-day. A sensitivity analysis was undertaken. Items showing savings were categorized by using the Anatomical Therapeutic Chemical classification system. For the 11 hospitals, the top 150 items comprised 612 different items. Projected savings for 2003 to 2004 were NZ dollar 2,652,814, NZ dollar 658,984, and NZ dollar 127,952 for tertiary, secondary, and rural/special hospitals, respectively. Percentage savings as a median (range) of the total top 150 expenditure were: tertiary 5.28% (3.09-16.05%), secondary 7.41% (4.67-12.85%), and rural/special 9.55% (6.27-10.09%). For all 29 hospitals, estimated projected savings were NZ dollar 5,234,919 (NZ dollar 3,304,606-NZ dollar 8,044,482) by savings per bed, and NZ dollar 5,255,781 (NZ dollar 2,936,850-NZ dollar 8,693,239) by savings per bed-day. The main contributors to savings were: agents for infections, the nervous system, musculoskeletal system, and blood/blood-forming organs. The first year of pooled procurement under the National Hospital Pharmaceutical Strategy (2002-2003) has resulted in moderate savings. For all 29 major public hospitals, savings of around NZ dollar 5.2 million (dollar 2.9 million-dollar 8.7 million) or 3.7% were projected for 2003 to 2004. Longer

THE IMPACT OF MEASURES OF SOCIOECONOMIC STATUS ON HOSPITAL PROFILING IN NEW YORK CITY

PubMed Central

Blum, Alexander B.; Egorova, Natalia N.; Sosunov, Eugene A.; Gelijns, Annetine C.; DuPree, Erin; Moskowitz, Alan J.; Federman, Alex D.; Ascheim, Deborah D.; Keyhani, Salomeh

2014-01-01

Background Current 30-day readmission models used by the Center for Medicare and Medicaid Services for the purpose of hospital-level comparisons lack measures of socioeconomic status (SES). We examined whether the inclusion of a SES measure in 30-day congestive heart failure (CHF) readmission models changed hospital risk standardized readmission rates (RSRR) in New York City (NYC) hospitals. Methods and Results Using a Centers for Medicare & Medicaid Services (CMS)-like model we estimated 30-day hospital-level RSRR by adjusting for age, gender and comorbid conditions. Next, we examined how hospital RSRRs changed relative to the New York City mean with inclusion of the Agency for Healthcare Research and Quality (AHRQ) validated SES index score. In a secondary analysis, we examined whether inclusion of the AHRQ SES Index score in 30-day readmission models disproportionately impacted the RSRR of minority-serving hospitals. Higher AHRQ SES scores, indicators of higher socioeconomic status, were associated with lower odds, 0.99, of 30-day readmission (p< 0.019). The addition of the AHRQ SES index did not change the model’s C statistic (0.63). After adjustment for the AHRQ SES index, one hospital changed status from “worse than the NYC average” to “no different than the NYC average”. After adjustment for the AHRQ SES index, one NYC minority-serving hospital was re-classified from “worse” to “no different than average”. Conclusions While patients with higher SES were less likely to be admitted, the impact of SES on readmission was very small. In NYC, inclusion of the AHRQ SES score in a CMS based model did not impact hospital-level profiling based on 30-day readmission. PMID:24823956

State University of New York Stony Brook University Hospital: Selected Expenditure Controls. Report 92-S-66.

ERIC Educational Resources Information Center

New York State Office of the Comptroller, Albany. Div. of Management Audit.

An audit was done of selected expenditure controls at the State University of New York (SUNY) at Stony Brook University Hospital particularly payroll costs and procurement practices. The Hospital reported an operating loss of $24 million in 1992. The audit reviewed Hospital management and staff and applicable policies and procedures as well as…

Old patterns, new meaning: the 1845 hospital of Bezm-i Alem in Istanbul.

PubMed

Shefer, Miri

2005-01-01

This paper discusses the history of an 1845 Ottoman hospital founded by Bezm-i Alem, mother of the reigning sultan Abdülmecit I (reigned 1839-1856), embedded in the medical and political contexts of the Middle East in the nineteenth century. The main focus of this paper is the Ottoman discourse of modernization, which identified progress with modernization and westernization and induced a belief in the positive character of progress, with a high degree of optimism regarding the success of the process. The Bezm-i Alem hospital illustrates the medical reality of the 19th century, reconstructed through Ottoman eyes rather than from the perspective of foreigners with their own agenda and biases. In many respects it continued previous medical traditions; other aspects reveal brand new developments in Ottoman medicine and hospital management. Ottoman medical reality was one of coexistence and rivalry: traditional conceptions of medicine and health were believed and practiced side-by-side with new western-like concepts and techniques.

New-Onset Heart Failure and Mortality in Hospital Survivors of Sepsis-Related Left Ventricular Dysfunction.

PubMed

Vallabhajosyula, Saraschandra; Jentzer, Jacob C; Geske, Jeffrey B; Kumar, Mukesh; Sakhuja, Ankit; Singhal, Akhil; Poterucha, Joseph T; Kashani, Kianoush; Murphy, Joseph G; Gajic, Ognjen; Kashyap, Rahul

2018-02-01

The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 who underwent echocardiography within 72 h of admission to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II. Primary composite outcome included new hospitalization for acute decompensated heart failure and all-cause mortality at 2-year follow-up. Secondary outcomes included persistent LV dysfunction, and hospital mortality and length of stay. During this 8-year period, 434 patients with 206 (48%) patients having LV dysfunction were included. The two groups had similar baseline characteristics, but those with LV dysfunction had worse function as demonstrated by worse LV ejection fraction, cardiac index, and LV diastolic dysfunction. In the 331 hospital survivors, new-onset acute decompensated heart failure hospitalization did not differ between the two cohorts (15% vs. 11%). The primary composite outcome was comparable at 2-year follow-up between the groups with and without LV dysfunction (P = 0.24). Persistent LV dysfunction was noted in 28% hospital survivors on follow-up echocardiography. Other secondary outcomes were similar between the two groups. In patients with severe sepsis and septic shock, the presence of new-onset LV dysfunction did not increase the risk of long-term adverse heart failure outcomes.

Effect of cause-of-death training on agreement between hospital discharge diagnoses and cause of death reported, inpatient hospital deaths, New York City, 2008-2010.

PubMed

Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio; Madsen, Ann

2015-01-15

Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions should employ similar interventions to

Application of the new ESPEN definition of malnutrition in geriatric diabetic patients during hospitalization: A multicentric study.

PubMed

Sanz-París, Alejandro; Gómez-Candela, Carmen; Martín-Palmero, Ángela; García-Almeida, José M; Burgos-Pelaez, Rosa; Matía-Martin, Pilar; Arbones-Mainar, Jose M

2016-12-01

The European Society for Clinical Nutrition and Metabolism (ESPEN) recently provided new diagnosis criteria of malnutrition and called to confirm those criteria in specific populations. The aims of our study were 1) to determine the prevalence of malnutrition according to the new ESPEN definition in elder hospitalized diabetic patients, and 2) to evaluate whether this new diagnosis of malnutrition predicted clinical outcomes in these patients. 1014 hospitalized diabetic patients (≥65 years) from 35 hospitals in Spain were screened for being at risk of malnutrition using the short version of the Mini Nutritional Assessment. Subsequently, at risk individuals were considered malnourished if they met at least one of the two options: 1) body mass index (BMI) < 18.5 kg/m 2 , or 2) unintentional weight loss >5% of their body weight with reduced BMI (<20 kg/m 2 in subjects younger than 70 years or <22 kg/m 2 in subjects older than 70 years). The new ESPEN definition, with MNA-SF as initial screening, identified 68 malnourished geriatric individuals with diabetes (6.73% of the cohort). Additionally, malnutrition lengthened the hospital stay, increased 2.7 times the odds of dying in hospital, and decreased to one third the odds of being discharged home. Our study confirms that the new ESPEN definition for the diagnosis of malnutrition is a reliable tool that is capable of predicting clinical outcomes in a large population of elder hospitalized individuals with diabetes. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Development of a short version of the modified Yale Preoperative Anxiety Scale.

PubMed

Jenkins, Brooke N; Fortier, Michelle A; Kaplan, Sherrie H; Mayes, Linda C; Kain, Zeev N

2014-09-01

The modified Yale Preoperative Anxiety Scale (mYPAS) is the current "criterion standard" for assessing child anxiety during induction of anesthesia and has been used in >100 studies. This observational instrument covers 5 items and is typically administered at 4 perioperative time points. Application of this complex instrument in busy operating room (OR) settings, however, presents a challenge. In this investigation, we examined whether the instrument could be modified and made easier to use in OR settings. This study used qualitative methods, principal component analyses, Cronbach αs, and effect sizes to create the mYPAS-Short Form (mYPAS-SF) and reduce time points of assessment. Data were obtained from multiple patients (N = 3798; Mage = 5.63) who were recruited in previous investigations using the mYPAS over the past 15 years. After qualitative analysis, the "use of parent" item was eliminated due to content overlap with other items. The reduced item set accounted for 82% or more of the variance in child anxiety and produced the Cronbach α of at least 0.92. To reduce the number of time points of assessment, a minimum Cohen d effect size criterion of 0.48 change in mYPAS score across time points was used. This led to eliminating the walk to the OR and entrance to the OR time points. Reducing the mYPAS to 4 items, creating the mYPAS-SF that can be administered at 2 time points, retained the accuracy of the measure while allowing the instrument to be more easily used in clinical research settings.

Access to new cardiovascular therapies in Canadian hospitals: a national survey of the formulary process.

PubMed

Shalansky, Stephen J; Virk, Roohina; Ackman, Margaret; Jackevicius, Cynthia; Kertland, Heather; Tsuyuki, Ross; Humphries, Karin

2003-02-01

Access to new therapies in hospitals depends upon both clinical trial evidence and local Pharmacy and Therapeutics (P&T) committee approval. The process of formulary evaluation by P&T committees is not well-understood. To describe the formulary decision-making process in Canadian hospitals for cardiovascular medications recently made available on the Canadian market. Postal survey of hospital pharmacy directors in all Canadian hospitals with more than 50 beds. Target drugs included abciximab, enoxaparin, dalteparin, clopidogrel, eptifibatide and tirofiban. Of 428 surveys mailed, responses were received from 164 P&T committees representing 350 hospitals for an effective response rate of 82%. While physicians make up the largest proportion of committee membership, pharmacists play an influential role. Information most commonly cited as influencing formulary decisions included published clinical trials (97%), regional guidelines (90%), pharmacoeconomic data (84%), decisions at peer hospitals (73%) and local opinion leaders (60%). However, this information was often not required on formulary applications. Approval timelines varied widely for target medications but there were no regional, hospital or P&T committee characteristics that were independent predictors of early formulary application or approval. There is wide variability in the time taken for Canadian institutions to adopt new cardiovascular therapies, which is not explained by regional, hospital or P&T committee characteristics. Standardization of the formulary application and evaluation processes, including sharing of information amongst institutions, would lead to broader understanding of the applicable issues, more objectivity and improved efficiency.

Estimating the Hospital Delivery Costs Associated With Severe Maternal Morbidity in New York City, 2008-2012.

PubMed

Howland, Renata E; Angley, Meghan; Won, Sang Hee; Wilcox, Wendy; Searing, Hannah; Tsao, Tsu-Yu

2018-02-01

To quantify the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries over a 5-year period in New York City adjusting for other sociodemographic and clinical factors. We conducted a population-based cross-sectional study using linked birth certificates and hospital discharge data for New York City deliveries from 2008 to 2012. Severe maternal morbidity was defined using a published algorithm of International Classification of Diseases, 9 Revision, Clinical Modification disease and procedure codes. Hospital costs were estimated by converting hospital charges using factors specific to each year and hospital and to each diagnosis. These estimates approximate what it costs the hospital to provide services (excluding professional fees) and were used in all subsequent analyses. To estimate adjusted mean costs associated with severe maternal morbidity, we used multivariable regression models with a log link, gamma distribution, robust standard errors, and hospital fixed effects, controlling for age, race and ethnicity, neighborhood poverty, primary payer, number of deliveries, method of delivery, comorbidities, and year. We used the adjusted mean cost to determine the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries from 2008 to 2012. Approximately 2.3% (n=13,502) of all New York City delivery hospitalizations were complicated by severe maternal morbidity. Compared with nonsevere maternal morbidity deliveries, these hospitalizations were clinically complicated, required more and intensive clinical services, and had a longer stay in the hospital. The average cost of delivery with severe maternal morbidity was $14,442 (95% CI $14,128-14,756), compared with $7,289 (95% CI $7,276-7,302) among deliveries without severe maternal morbidity. After adjusting for other factors, the difference between deliveries

A new framework for assessing hospital crisis management based on resilience engineering approach.

PubMed

Shirali, Gh A; Azadian, Sh; Saki, A

2016-06-14

In recent years, an increasing number of natural and man-made disasters have exposed many people and properties to various disasters. This has resulted in approximately 75,000 deaths worldwide every year due to disasters. Crisis management is becoming increasingly important to cope effectively with the magnitude and potential damage resulting from disasters. Hospitals, as the final point in the rescue chain, have a key role in the crisis management and need to be resilient against disasters. The purpose of this paper is to present a new framework for assessing the crisis management based on resilience principles in hospital infrastructure of a developing country. A questionnaire was developed and completed by 310 staff (nurses and managers) of eight hospitals in Iran. The findings indicate that the eight hospitals included in the study have moderate conditions in general, while hospitals X3, X4, and X7 have poor conditions in the crisis management. Consequently, it seems that the crisis management system was not resilient in all these hospitals in general. Using resilience engineering in assessing crisis management can improve and develop the ability of the hospitals' management to cope with any type of disaster.

Accuracy of injury coding under ICD‐9 for New Zealand public hospital discharges

PubMed Central

Langley, J; Stephenson, S; Thorpe, C; Davie, G

2006-01-01

Objective To determine the level of accuracy in coding for injury principal diagnosis and the first external cause code for public hospital discharges in New Zealand and determine how these levels vary by hospital size. Method A simple random sample of 1800 discharges was selected from the period 1996–98 inclusive. Records were obtained from hospitals and an accredited coder coded the discharge independently of the codes already recorded in the national database. Results Five percent of the principal diagnoses, 18% of the first four digits of the E‐codes, and 8% of the location codes (5th digit of the E‐code), were incorrect. There were no substantive differences in the level of incorrect coding between large and small hospitals. Conclusions Users of New Zealand public hospital discharge data can have a high degree of confidence in the injury diagnoses coded under ICD‐9‐CM‐A. A similar degree of confidence is warranted for E‐coding at the group level (for example, fall), but not, in general, at higher levels of specificity (for example, type of fall). For those countries continuing to use ICD‐9 the study provides insight into potential problems of coding and thus guidance on where the focus of coder training should be placed. For those countries that have historical data coded according to ICD‐9 it suggests that some specific injury and external cause incidence estimates may need to be treated with more caution. PMID:16461421

21. Historic view looking northeast from tracks of Shell Interlocking ...

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

21. Historic view looking northeast from tracks of Shell Interlocking Tower after construction, 1909. Photographic copy of photograph published in Railway Age Gazette, February 4, 1910. - New York, New Haven, & Hartford Railroad, Shell Interlocking Tower, New Haven Milepost 16, approximately 100 feel east of New Rochelle Junction, New Rochelle, Westchester County, NY

The determination of nutritional requirements for Safe Haven Food Supply System (emergency/survival foods)

NASA Technical Reports Server (NTRS)

Ahmed, Selina

1987-01-01

The Space Station Safe Haven Food System must sustain 8 crew members under emergency conditions for 45 days. Emergency Survival Foods are defined as a nutritionally balanced collection of high density food and beverages selected to provide for the survival of Space Station flight crews in contingency situations. Since storage volume is limited, the foods should be highly concentrated. A careful study of different research findings regarding starvation and calorie restricted diets indicates that a minimum nutritional need close to RDA is an important factor for sustaining an individual's life in a stressful environment. Fat, protein, and carbohydrates are 3 energy producing nutrients which play a vital role in the growth and maintenance process of human life. A lower intake of protein can minimize the water intake, but it causes a negative nitrogen balance and a lower performance level. Other macro and micro nutrients are also required for nutritional interrelationships to metabolize the other 3 nutrients to their optimum level. The various options for longer duration than 45 days are under investigation.

76 FR 12 - Drawbridge Operation Regulations; New Haven Harbor, Quinnipiac and Mill Rivers, New Haven, CT

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-03

... to keep one lift span closed to facilitate scheduled bridge maintenance. DATES: This deviation is... temporary deviation the Ferry Street Bridge may keep one lift span in the closed position from 8 a.m. on... January 13, 2011. One lift span shall remain operational at all times. In accordance with 33 CFR 117.35(e...

Physician-hospital relationships: from historical failures to successful "new kids on the block".

PubMed

Payton, Bruce

2012-01-01

Trends in healthcare reveal that increasing numbers of physicians prefer to work directly with hospitals-whether through employment models, new or revived partnership structures, or other such "deals". Meanwhile, hospital executives are vigorously seeking ways to create win-win arrangements that satisfy both parties-models that will ensure medical coverage for the hospital, along with revenue gains and cost savings when possible. Add to this a competitive environment, physician shortages, and high regulatory activity and healthcare reform, and the path to clinical, operational, and financial viability in the context of a hospital/physician partnership can be a challenging one. Models such as The physician enterprise and co-management agreements are gaining popularity, each with distinct benefits. With market forces dynamically changing, along with accountable care, it is time for hospitals, health systems, and physicians to prioritize their partnering relationships, a strategy that is now key to achieving success in the future...and that's a trend that's likely to continue far into the years ahead.

Best practices: Use of an administrative review committee at New Hampshire Hospital to mitigate risk with high-profile patients.

PubMed

de Nesnera, Alexander; Folks, David G

2010-07-01

An increasing number of patients manifesting violent and aggressive behaviors are treated at New Hampshire Hospital. Over the past ten years, the volume of referrals on an involuntary emergency petition has increased 70%. New Hampshire Hospital has successfully initiated its Administrative Review Committee, which confers a risk management process to mitigate potential liability for the hospital and treating clinicians for these high-risk patients. This best practice is viewed as helpful by clinicians and by the hospital's legal counsel. Hospitals treating similar high-risk patients may also benefit from developing a similar committee and risk management process.

The unsafe haven: Eating disorders as attachment relationships.

PubMed

Forsén Mantilla, Emma; Clinton, David; Birgegård, Andreas

2018-05-21

' anxiety and ambivalence about change, seen from an attachment perspective. In treatment, it may be important to explore alternative safe havens and secure bases to the ED, such as interpersonal relationships and activities. © 2018 The British Psychological Society.

Evaluation of new antimicrobials for the hospital formulary. Policies restricting antibiotic use in hospitals.

PubMed

Pujol, Miquel; Delgado, Olga; Puigventós, Francesc; Corzo, Juan E; Cercenado, Emilia; Martínez, José Antonio

2013-09-01

In Spain, the inclusion of new antibiotics in hospital formularies is performed by the Infection Policy Committee or the Pharmacy and Therapeutic Committee, although now the decision is moving to a regional level. Criteria for the evaluation of new drugs include efficacy, safety and cost. For antimicrobial drugs evaluation it is necessary to consider local sensibility and impact in bacterial resistance to determinate the therapeutic positioning. There is compelling evidence that the use of antibiotics is associated with increasing bacterial resistance, and a great number of antibiotics are used incorrectly. In order to decrease the inappropriate use of antibiotics, several approaches have been proposed. Limiting the use of antimicrobials through formulary restrictions, often aimed at drugs with a specific resistance profile, shows benefits in improving antimicrobial susceptibilities and decreasing colonization by drug-resistant organisms. However, the restriction of one agent may result in the increased utilization of other agents. By using antibiotic cycling, the amount of antibiotics is maintained below the threshold where bacterial resistance develops, thus preserving highly efficient antibiotics. Unfortunately, cumulative evidence to date suggests that antibiotic cycling has limited efficacy in preventing antibiotic resistance. Finally, although there is still little clinical evidence available on antibiotic heterogeneity, the use of most of the existing antimicrobial classes could limit the emergence of resistance. This review summarizes information regarding antibiotic evaluation and available restrictive strategies to limit the use of antibiotics at hospitals with the aim of curtailing increasing antibiotic resistance. Copyright © 2013 Elsevier España, S.L. All rights reserved.

78 FR 61958 - New England Hydropower Company, LLC; Notice of Preliminary Permit Application Accepted for Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-08

... located on Quinnipiac River, near the city of Meriden, in New Haven County, Connecticut. The sole purpose...' express permission. The proposed project would consist of the following: (1) An existing 25-foot-high, 430-foot-long earth embankment dam with four low-level, sluice gates and a 242-foot-long concrete spillway...

Is the corporate transformation of hospitals creating a new hybrid health care space? A case study of the impact of co-location of public and private hospitals in Australia.

PubMed

Brown, Laurie; Barnett, J Ross

2004-01-01

A common feature of health reforms in western nations has been the transformation or (re)construction of health and health care as both a commodity and product. In the hospital sector, this transformation has become increasingly evident in the growth of for-profit involvement in service delivery. Investor-owned hospitals are now prominent providers of hospital care in Australia. This paper examines the changing nature of health care space through the changing portrayal and meaning of hospitals as represented by and encoded in the built environment. Public hospitals once occupied 'pride of place'. In contrast, up to the early 1980s, the private sector was seen as a cottage industry. However, increased levels of state subsidisation and government incentives and pro-market policies, combined with market-based opportunities for profit generation, have seen the emergence of large private hospital chains with a new corporate image to hospital care and the blurring of 'public' and 'private'. A significant factor in the reconstruction of hospital space in Australia has been the co-location of private and public hospitals. Co-location is a popular strategy proffered by State governments and one that has been quickly acted on by corporate providers. Using Mayne Health Ltd, Australia's largest for-profit hospital chain, and four specific case studies, this paper explores four variants of co-location. Each of these examples represent a different public and private hospital space. The growth of for-profit hospital chains signifies a new phase in the delivery of health care in Australia but also importantly the creation of a new hybridised 'health care' space. This space is neither private nor public but a reflection of the economic, political and social processes underlying this transformation.

10. General view of site showing south side of Shell ...

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

10. General view of site showing south side of Shell Interlocking Tower and slope of railroad bed. View to north from unpaved service road extending from Bartels Place. - New York, New Haven, & Hartford Railroad, Shell Interlocking Tower, New Haven Milepost 16, approximately 100 feel east of New Rochelle Junction, New Rochelle, Westchester County, NY

Operating a wide-area high-availability collaborative remote observing system for classically-scheduled observations at the W. M. Keck Observatory

NASA Astrophysics Data System (ADS)

Kibrick, Robert I.; Wirth, Gregory D.; Allen, Steven L.; Deich, William T. S.; Goodrich, Robert W.; Lanclos, Kyle; Lyke, James E.

2011-03-01

For over a decade, the W. M. Keck Observatory's two 10-meter telescopes have been operated remotely from its Waimea headquarters. Over the last 9 years, WMKO remote observing has expanded to allow observing teams at dedicated sites located across California to observe via the Internet either in collaboration with colleagues in Waimea or entirely from California; this capability was extended to Swinburne University in Melbourne, Australia in 2010 and to Yale University in New Haven, Connecticut in early 2011. All Keck facility science instruments are currently supported. Observers distributed between as many as four sites can collaborate in the interactive operation of each instrument by means of shared VNC desktops and multipoint video and/or telephone conferencing. Automated routers at primary remote observing sites ensure continued connectivity during Internet outages. Each Keck remote observing facility is similarly equipped and configured so observers have the same operating environment. This architecture provides observers the flexibility to conduct observations from the location best suited to their needs and to adapt to last-minute changes. It also enhances the ability of off-site technical staff to provide remote support.

Framing Samuel See: the discursive detritus of the moral panic over the "double epidemic" of methamphetamines and HIV among gay men.

PubMed

Gideonse, Theodore K

2016-02-01

After being arrested for violating a restraining order against his husband, on November 24, 2013, Yale professor Samuel See died while in lockup at the Union Avenue Detention Center in New Haven, Connecticut. The death received media attention around the world, with readers arguing online about whether See's death was caused by police misconduct, as his friends and colleagues charged in interviews and during a well-publicised march and protest. When an autopsy revealed that he had died from a methamphetamine-induced heart attack, online commentary changed dramatically, with See's many supporters rhetorically abandoning him and others describing him as a stereotype of the gay meth addict who deserved his fate. In this article, I argue that this shift in the interpretation and meaning of See's death can be traced to the discursive structures left by the moral panic about crystal meth in the United States (1996-2008), which comprised within it a secondary moral panic about crystal meth in the gay community and its connection to the spread of HIV and a possible super-strain (2005-2008). Copyright © 2015 Elsevier B.V. All rights reserved.

Framing Samuel See: the discursive detritus of the moral panic over the “double epidemic” of methamphetamines and HIV among gay men

PubMed Central

Gideonse, Theodore K.

2018-01-01

After being arrested for violating a restraining order against his husband, on November 24, 2013, Yale professor Samuel See died while in lockup at the Union Avenue Detention Center in New Haven, Connecticut. The death received media attention around the world, with readers arguing online about whether See’s death was caused by police misconduct, as his friends and colleagues charged in interviews and during a well-publicised march and protest. When an autopsy revealed that he had died from a methamphetamine-induced heart attack, online commentary changed dramatically, with See’s many supporters rhetorically abandoning him and others describing him as a stereotype of the gay meth addict who deserved his fate. In this article, I argue that this shift in the interpretation and meaning of See’s death can be traced to the discursive structures left by the moral panic about crystal meth in the United States (1996–2008), which comprised within it a secondary moral panic about crystal meth in the gay community and its connection to the spread of HIV and a possible super-strain (2005–2008). PMID:26826730

Prevention of hospital-onset Clostridium difficile infection in the New York metropolitan region using a collaborative intervention model.

PubMed

Koll, Brian S; Ruiz, Rafael E; Calfee, David P; Jalon, Hillary S; Stricof, Rachel L; Adams, Audrey; Smith, Barbara A; Shin, Gina; Gase, Kathleen; Woods, Maria K; Sirtalan, Ismail

2014-01-01

The incidence, severity, and associated costs of Clostridium difficile (C. difficile) infection (CDI) have dramatically increased in hospitals over the past decade, indicating an urgent need for strategies to prevent transmission of C. difficile. This article describes a multifaceted collaborative approach to reduce hospital-onset CDI rates in 35 acute care hospitals in the New York metropolitan region. Hospitals participated in a comprehensive CDI reduction intervention and formed interdisciplinary teams to coordinate their efforts. Standardized clinical infection prevention and environmental cleaning protocols were implemented and monitored using checklists. Monthly data reports were provided to hospitals for facility-specific performance evaluation and comparison to aggregate data from all participants. Hospitals also participated in monthly teleconferences to review data and highlight successes, challenges, and strategies to reduce CDI. Incidence of hospital-onset CDI per 10,000 patient days was the primary outcome measure. Additionally, the incidence of nonhospital-associated, community-onset, hospital-associated, and recurrent CDIs were measured. The use of a collaborative model to implement a multifaceted infection prevention strategy was temporally associated with a significant reduction in hospital-onset CDI rates in participating New York metropolitan regional hospitals. © 2013 National Association for Healthcare Quality.

Effect of Cause-of-Death Training on Agreement Between Hospital Discharge Diagnoses and Cause of Death Reported, Inpatient Hospital Deaths, New York City, 2008–2010

PubMed Central

Ong, Paulina; Gambatese, Melissa; Begier, Elizabeth; Zimmerman, Regina; Soto, Antonio

2015-01-01

Introduction Accurate cause-of-death reporting is required for mortality data to validly inform public health programming and evaluation. Research demonstrates overreporting of heart disease on New York City death certificates. We describe changes in reported causes of death following a New York City health department training conducted in 2009 to improve accuracy of cause-of-death reporting at 8 hospitals. The objective of our study was to assess the degree to which death certificates citing heart disease as cause of death agreed with hospital discharge data and the degree to which training improved accuracy of reporting. Methods We analyzed 74,373 death certificates for 2008 through 2010 that were linked with hospital discharge records for New York City inpatient deaths and calculated the proportion of discordant deaths, that is, death certificates reporting an underlying cause of heart disease with no corresponding discharge record diagnosis. We also summarized top principal diagnoses among discordant reports and calculated the proportion of inpatient deaths reporting sepsis, a condition underreported in New York City, to assess whether documentation practices changed in response to clarifications made during the intervention. Results Citywide discordance between death certificates and discharge data decreased from 14.9% in 2008 to 9.6% in 2010 (P < .001), driven by a decrease in discordance at intervention hospitals (20.2% in 2008 to 8.9% in 2010; P < .001). At intervention hospitals, reporting of sepsis increased from 3.7% of inpatient deaths in 2008 to 20.6% in 2010 (P < .001). Conclusion Overreporting of heart disease as cause of death declined at intervention hospitals, driving a citywide decline, and sepsis reporting practices changed in accordance with health department training. Researchers should consider the effect of overreporting and data-quality changes when analyzing New York City heart disease mortality trends. Other vital records jurisdictions

'McMurdo' Panorama from Spirit's 'Winter Haven' (Color Stereo)

NASA Technical Reports Server (NTRS)

2006-01-01

, highest-fidelity view of Mars acquired from either rover. Additional photo coverage of the parts of the rover deck not shown here was completed on sol 980 (Oct. 5 , 2006). The team is completing the processing and mosaicking of those final pieces of the panorama, and that image will be released on the Web shortly to augment this McMurdo panorama view.

This beautiful scene reveals a tremendous amount of detail in Spirit's surroundings. Many dark, porous-textured volcanic rocks can be seen around the rover, including many on Low Ridge. Two rocks to the right of center, brighter and smoother-looking in this image and more reflective in infrared observations by Spirit's miniature thermal emission spectrometer, are thought to be meteorites. On the right, 'Husband Hill' on the horizon, the rippled 'El Dorado' sand dune field near the base of that hill, and lighter-toned 'Home Plate' below the dunes provide context for Spirit's travels since mid-2005. Left of center, tracks and a trench dug by Spirit's right-front wheel, which no longer rotates, have exposed bright underlying material. This bright material is evidence of sulfur-rich salty minerals in the subsurface, which may provide clues about the watery past of this part of Gusev Crater.

Spirit has stayed busy at Winter Haven during the past six months even without driving. In addition to acquiring this spectacular panorama, the rover team has also acquired significant new assessments of the elemental chemistry and mineralogy of rocks and soil targets within reach of the rover's arm. The team plans soon to have Spirit drive to a very nearby spot on Low Ridge to access different rock and soil samples while maintaining a good solar panel tilt toward the sun for the rest of the Martian winter.

Despite the long span of time needed for acquiring this 360-degree view -- a few images at a time every few sols over a total of 119 sols because the available power was so low -- the lighting and color remain remarkably

Pharmaceutical penetration of new drug and pharmaceutical market structure in Taiwan: hospital-level prescription of thiazolidinediones for diabetes.

PubMed

Tsai, Yi-Wen; Wen, Yu-Wen; Huang, Weng-Foung; Kuo, Ken N; Chen, Pei-Fen; Shih, Hsin-Wei; Lee, Yue-Chune

2010-06-01

This study used Taiwan's National Health Insurance claim database (years 2000-2005) to examine how thiazolidinediones (TZD), a new class of drugs for diabetes, penetrated into Taiwan's hospitals, and its association with the concentration of all diabetes drugs at the hospital level. We collected 72 monthly summaries of diabetes prescriptions from all hospitals in Taiwan. Hospital-level pharmaceutical concentration was measured by penetration of TZD, defined as monthly market share of TZD in each hospital. Concentration of diabetes drugs was measured by Herfindahl-Hirschman indices. We found a negative association (coefficient = -0.3610) between TZD penetration and concentration of diabetes drug but a positive association between penetration of TZD and the volume of prescribed diabetes drugs (coefficient = 0.4088). In conclusion, hospital characteristics and volume of services determined the concentration of pharmaceuticals at the institution level, reflecting the heterogeneous competition between pharmaceutical companies within each hospital. Institution-level pharmaceutical concentration influences the adoption and penetration of new drugs.

9. Detail of electrical cables from relay station to upper ...

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

9. Detail of electrical cables from relay station to upper floor of tower. Note the penetrations in the wall, right of center where cables formerly passed into the control room. - New York, New Haven, & Hartford Railroad, Shell Interlocking Tower, New Haven Milepost 16, approximately 100 feel east of New Rochelle Junction, New Rochelle, Westchester County, NY

[New methods of treatment applied in the hospital of Sochi during the Great Patriotic War].

PubMed

Artiukhov, S A

2013-05-01

During the Great Patriotic War 1941-1945 Sochi was turned into the largest hospital base in the south of the USSR. All told, 335 thousand wonded and seriously ill soldiers were treated in the hospitals of Sochi. During the war physicians applied many new, including, early unknown medical methods of treatment. Poor provision with medical equipment, instruments, bandages and medicines was made up for using of local resources. Adoption of new treatment methods based on the use of local medicines allowed the Sochi's physicians to save many lives during the war.

New integrated information system for pusan national university hospital.

PubMed

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

2011-03-01

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

Let him not be alone: perspectives of older British South Asian minority ethnic patients on dying in acute hospitals.

PubMed

Venkatasalu, Munikumar Ramasamy

2017-09-02

To investigate older British South Asians' views on dying at acute hospitals. Older people, including those from ethnic minorities prefer 'home as a haven' for their last days of life; however, they are more likely to die in hospital. Constructive grounded theory was used as a methodological approach that informed data collection to data analysis. Open meetings with 11 local South Asian community organisations enabled the researchers to recruit a total of 55 older South Asians in this study. Data were collected using gender-based focus groups (n=5) and in-depth, semi-structured interviews (n=29). Transcripts were analysed using Nvivo 9. Three key themes were identified: 'mistrust', 'let him not be alone' and 'family as a protective shield'. The theme 'mistrust' is explored through examination of beliefs, attitudes and expectations about 'hospital' as a place in the care of the dying. The theme of 'let him not be alone' draws the family's preferences and concerns in relation to leaving their older dying relative alone in the hospital. The final theme of 'family as a protective shield' describes the element of family care as a protective shield for their older one to have peaceful end-of-life care moments in the hospital. Allowing older relatives to die in hospital seems to evoke feelings of missed filial responsibilities and guilt among family carers among older ethnic minorities. The presence of cultural paranoia and mistrust often led minorities to experience sub-standard end-of-life care in acute hospitals.

Adoption and hospital admission in Port Moresby, Papua New Guinea.

PubMed

Pameh, Wendy; Ripa, Paulus; Vince, John; Mueller, Ivo

2002-10-01

We report a study of adopted children admitted to the children's wards of Port Moresby General Hospital, Papua New Guinea over a 5-month period in 2000. The proportion of hospitalized children known to be adopted was almost three times that in the children's outpatients department. Gastroenteritis and neonatal sepsis were more common causes of admission in adopted children than in the general paediatric hospital population. Admitted adopted children were lighter and shorter than the controls with no difference in weight-for-height, suggesting that stunting is the predominant nutritional problem among adopted children. These differences were even more marked in children with diagnoses other than gastroenteritis. Thirty-three (82.5 per cent) of the adopted children had ever been bottle fed compared with 11 (13.75 per cent) of the controls (p = 0.029). Twelve (30 per cent) children had been adopted because of neglect or abandonment. The biological mothers of seven of these children had died, and two children had been bought for cash. Biological mothers were more likely than the adoptive or control mothers to be single and less than 20 years of age. Knowledge of formal adoption procedures was very poor. The present study therefore shows that adoption in Papua New Guinea is not without risk and it is important that adoption should be recognized as having the potential for serious adverse effects on the child's well-being, especially since adoption is likely to become even more prevalent as the HIV epidemic continues. Consideration needs to be given to protection of the rights of children at high risk of adoption.

Psychosocial work factors in new or recurrent injuries among hospital workers: a prospective study.

PubMed

Lee, Soo-Jeong; You, Doohee; Gillen, Marion; Blanc, Paul D

2015-11-01

Accumulating evidence suggests an important role for psychosocial work factors in injury, but little is known about the interaction between psychosocial factors and previous injury experience on subsequent injury risk. We examined the relationships between psychosocial work factors and new or recurrent injury among hospital workers. We studied 492 hospital workers including 116 cases with baseline injury and 376 injury-free referents at baseline over follow-up. Job strain, total support, effort-reward imbalance, overcommitment, and musculoskeletal injury at baseline were examined in logistic regression models as predictors of new or recurrent injury experienced during a 2-year follow-up period. The overall cumulative incidence of injury over follow-up was 35.6 % (51.7 % for re-injury among baseline injury cases; 30.6 % for new injury among referents). Significantly increased risks with baseline job strain (OR 1.26; 95 % CI 1.02-1.55) and effort-reward imbalance (OR 1.42; 95 % CI 1.12-1.81) were observed for injury only among the referents. Overcommitment was associated with increased risk of injury only among the cases (OR 1.58; 95 % CI 1.05-2.39). The effects of psychosocial work factors on new or recurrent injury risk appear to differ by previous injury experience, suggesting the need for differing preventive strategies in hospital workers.

New hospital payment systems: comparing medical strategies in The Netherlands, Germany and England.

PubMed

van Essen, Anne Marije

2009-01-01

This paper seeks to identify different medical strategies adopted in relation to the new hospital payment systems in Germany, The Netherlands and England and analyse how the medical strategies have impacted on the emergence of these New Public Management policy tools between 2002 and 2007. A comparative approach is applied. In addition to secondary sources, the study uses publications in professional journals, official publications of the (national) physician organisations and a (non-random) expert questionnaire to obtain the views of the medical corporate bodies in the three countries. The results reveal differences in the medical strategies in the three countries that point towards the significance of institutional and interest configurations. The Dutch corporate medical body was most willing to solve the conflict, while the German and English corporate medical bodies seem to be keen to use a strategy of confrontation. The differences in medical strategies also impact on the ways in which hospital payment systems have emerged in the three countries. Further research is necessary to study the medical strategies in healthcare reforms from a broader perspective, for instance by including other countries. The paper gives insights into the interplay between the medical profession and the government in the context of new managerial governance practices in the hospital sector. It adds to the scholarly debates about the role of the medical profession in health policy-making.

Hospital response to the legalization of abortion in New York State: an analysis of program innovation.

PubMed

Miller, J

1979-12-01

The reorientation of hospital services in the state of New York to accommodate women's constitutional right to elective abortion was investigated. Market and resource constraints, the social orientations of the organization, and the values of physicians were examined in the effort to evaluate hospital response between 1971 and 1973. Analysis indicates that program innovation in obstetrical and gynecological services to include elective abortion was inhibited by economic factors that generally determined the feasibility of diverting finite resources to a new service and social orientations and values that determined the compatibility of elective abortions with the dominant values underlying hospital operations. The reform of New York abortion statutes and the subsequent ruling by the Supreme Court reiterating the right of women to terminate pregnancy failed to standardize the delivery of health care so that individual rights to service could be obtained everywhere in the state. The social changes ultimately realized through legislative and judicial action were essentially conditional upon the responsiveness of local health care providers. Legal action that failed to specifically address the administrative role of hospitals in social change qualified local access and could not be completely effective in legitimizing the redefinition of abortion in society.

New roles & responsibilities of hospital biomedical engineering.

PubMed

Frisch, P H; Stone, B; Booth, P; Lui, W

2014-01-01

Over the last decade the changing healthcare environment has required hospitals and specifically Biomedical Engineering to critically evaluate, optimize and adapt their operations. The focus is now on new technologies, changes to the environment of care, support requirements and financial constraints. Memorial Sloan Kettering Cancer Center (MSKCC), an NIH-designated comprehensive cancer center, has been transitioning to an increasing outpatient care environment. This transition is driving an increase in-patient acuity coupled with the need for added urgency of support and response time. New technologies, regulatory requirements and financial constraints have impacted operating budgets and in some cases, resulted in a reduction in staffing. Specific initiatives, such as the Joint Commission's National Patient Safety Goals, requirements for an electronic medical record, meaningful use and ICD10 have caused institutions to reevaluate their operations and processes including requiring Biomedical Engineering to manage new technologies, integrations and changes in the electromagnetic environment, while optimizing operational workflow and resource utilization. This paper addresses the new and expanding responsibilities and approach of Biomedical Engineering organizations, specifically at MSKCC. It is suggested that our experience may be a template for other organizations facing similar problems. Increasing support is necessary for Medical Software - Medical Device Data Systems in the evolving wireless environment, including RTLS and RFID. It will be necessary to evaluate the potential impact on the growing electromagnetic environment, on connectivity resulting in the need for dynamic and interactive testing and the growing demand to establish new and needed operational synergies with Information Technology operations and other operational groups within the institution, such as nursing, facilities management, central supply, and the user departments.

Respiratory hospitalizations in association with fine PM and its components in New York State.

PubMed

Jones, Rena R; Hogrefe, Christian; Fitzgerald, Edward F; Hwang, Syni-An; Özkaynak, Halûk; Garcia, Valerie C; Lin, Shao

2015-05-01

Despite observed geographic and temporal variation in particulate matter (PM)-related health morbidities, only a small number of epidemiologic studies have evaluated the relation between PM2.5 chemical constituents and respiratory disease. Most assessments are limited by inadequate spatial and temporal resolution of ambient PM measurements and/or by their approaches to examine the role of specific PM components on health outcomes. In a case-crossover analysis using daily average ambient PM2.5 total mass and species estimates derived from the Community Multiscale Air Quality (CMAQ) model and available observations, we examined the association between the chemical components of PM (including elemental and organic carbon, sulfate, nitrate, ammonium, and other remaining) and respiratory hospitalizations in New York State. We evaluated relationships between levels (low, medium, high) of PM constituent mass fractions, and assessed modification of the PM2.5-hospitalization association via models stratified by mass fractions of both primary and secondary PM components. In our results, average daily PM2.5 concentrations in New York State were generally lower than the 24-hr average National Ambient Air Quality Standard (NAAQS). Year-round analyses showed statistically significant positive associations between respiratory hospitalizations and PM2.5 total mass, sulfate, nitrate, and ammonium concentrations at multiple exposure lags (0.5-2.0% per interquartile range [IQR] increase). Primarily in the summer months, the greatest associations with respiratory hospitalizations were observed per IQR increase in the secondary species sulfate and ammonium concentrations at lags of 1-4 days (1.0-2.0%). Although there were subtle differences in associations observed between mass fraction tertiles, there was no strong evidence to support modification of the PM2.5-respiratory disease association by a particular constituent. We conclude that ambient concentrations of PM2.5 and secondary

Sediment contaminant surveillance in Milford Haven Waterway.

PubMed

Little, D I; Bullimore, B; Galperin, Y; Langston, W J

2016-01-01

Sediment contaminants were monitored in Milford Haven Waterway (MHW) since 1978 (hydrocarbons) and 1982 (metals), with the aim of providing surveillance of environmental quality in one of the UK's busiest oil and gas ports. This aim is particularly important during and after large-scale investment in liquefied natural gas (LNG) facilities. However, the methods inevitably have changed over the years, compounding the difficulties of coordinating sampling and analytical programmes. After a review by the MHW Environmental Surveillance Group (MHWESG), sediment hydrocarbon chemistry was investigated in detail in 2010. Natural Resources Wales (NRW) contributed their MHW data for 2007 and 2012, collected to assess the condition of the Special Area of Conservation (SAC) designated under the European Union Habitats Directive. Datasets during 2007-2012 have thus been more comparable. The results showed conclusively that a MHW-wide peak in concentrations of sediment polycyclic aromatic hydrocarbons (PAHs), metals and other contaminants occurred in late 2007. This was corroborated by independent annual monitoring at one centrally located station with peaks in early 2008 and 2011. The spatial and temporal patterns of recovery from the 2007 peak, shown by MHW-wide surveys in 2010 and 2012, indicate several probable causes of contaminant trends, as follows: atmospheric deposition, catchment runoff, sediment resuspension from dredging, and construction of two LNG terminals and a power station. Adverse biological effects predictable in 2007 using international sediment quality guidelines were independently tested by data from monitoring schemes of more than a decade duration in MHW (starfish, limpets) and in the wider SAC (grey seals). Although not proving cause and effect, many of these potential biological receptors showed a simultaneous negative response to the elevated 2007 contamination following intense dredging activity in 2006. Wetland bird counts were typically at a peak in

[Strategics of medical centers and regional hospitals in response to new labour insurance fee schedule].

PubMed

Wang, S C; Sheen, P C; Ko, Y C

1993-02-01

The purpose of this paper is to evaluate the medical centers and regional hospitals, strategic response to the implementation of new labour insurance fee schedule. This survey selects fifty-one medical centers and regional hospitals, with the response rate of 92.73%. This questionnaire was developed and evaluated by the authors and mailed to the questionnaire response by hospital's director or relative department director. We have selected Shortell et al. (1985) theory as the framework for evaluating and explaining hospital response to regulation environment (ex: change in the reimbursement system) at institutional-level response (ex: hospital association activity aimed at influencing regulation), managerial-level response (ex: increased physician participation in hospital-wide decision making; starting or expanding a planning department) and technical-level response (ex: shared clinical services such as lab., X-ray, pharmacy). The result found that hospitals with the characteristics as non-public ownership, medical centers, bigger size, and more administrative staff are more inclined to adopt institutional-level response. And a technical-level response occurs to hospital when market competibility becomes more intense which leads to higher reimbursement resource dependency.

Access to hospital interpreter services for limited English proficient patients in New Jersey: a statewide evaluation.

PubMed

Flores, Glenn; Torres, Sylvia; Holmes, Linda Janet; Salas-Lopez, Debbie; Youdelman, Mara K; Tomany-Korman, Sandra C

2008-05-01

We surveyed New Jersey (NJ) hospitals to assess current language services and identify policy recommendations on meeting limited English proficiency (LEP) patients' needs. Survey with 37 questions regarding hospital/patient features, interpreter services, and resources/policies needed to provide quality interpreter services. Sixty-seven hospitals responded (55% response rate). Most NJ hospitals have no interpreter services department, 80% provide no staff training on working with interpreters, 31% lack multilingual signs, and 19% offer no written translation services. Only 3% of hospitals have full-time interpreters, a ratio of 1 interpreter:240,748 LEP NJ residents. Most hospitals stated third-party reimbursement for interpreters would be beneficial, by reducing costs, adding interpreters, meeting population growth, and improving communication. Most NJ hospitals have no full-time interpreters, interpreter services department, or staff training on working with interpreters, and deficiencies exist in hospital signage and translation services. Most NJ hospitals stated third-party reimbursement for interpreter services would be beneficial.

Washington Hospital Center defends its position. Changing situation calls for a new approach.

PubMed

Botvin, J D

2000-01-01

Washington Hospital Center, in the nation's capital, found cardiac care, its leading source of revenue, challenged by new contenders. This launched an aggressive campaign directly at patients, encouraging them to use WHC's diagnostic testing services.

34. VIEW SOUTHEAST, WEST ABUTMENT OF OPERATING MACHINERY LARGE ...

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

34. VIEW SOUTHEAST, WEST ABUTMENT OF OPERATING MACHINERY - LARGE GEAR AT LEFT CENTER IS 'D' - REFER TO STRAUSS SHEETS #15 AND #18 FOR POWER TRAIN RELATIONSHIPS - Tomlinson Bridge, Spanning Quinnipiac River at Forbes Street (U.S. Route 1), New Haven, New Haven County, CT

Variation in Formula Supplementation of Breastfed Newborn Infants in New York Hospitals.

PubMed

Nguyen, Trang; Dennison, Barbara A; Fan, Wei; Xu, Changning; Birkhead, Guthrie S

2017-07-01

We examined the variation between 126 New York hospitals in formula supplementation among breastfed infants after adjusting for socioeconomic, maternal, and infant factors and stratifying by level of perinatal care. We used 2014 birth certificate data for 160 911 breastfed infants to calculate hospital-specific formula supplementation percentages by using multivariable hierarchical logistic regression models. Formula supplementation percentages varied widely among hospitals, from 2.3% to 98.3%, and was lower among level 1 hospitals (18.2%) than higher-level hospitals (50.6%-57.0%). Significant disparities in supplementation were noted for race and ethnicity (adjusted odds ratios [aORs] were 1.54-2.05 for African Americans, 1.85-2.74 for Asian Americans, and 1.25-2.16 for Hispanics, compared with whites), maternal education (aORs were 2.01-2.95 for ≤12th grade, 1.74-1.85 for high school or general education development, and 1.18-1.28 for some college or a college degree, compared with a Master's degree), and insurance coverage (aOR was 1.27-1.60 for Medicaid insurance versus other). Formula supplementation was higher among mothers who smoked, had a cesarean delivery, or diabetes. At all 4 levels of perinatal care, there were exemplar hospitals that met the HealthyPeople 2020 supplementation goal of ≤14.2%. After adjusting for individual risk factors, the hospital-specific, risk-adjusted supplemental formula percentages still revealed a wide variation. A better understanding of the exemplar hospitals could inform future efforts to improve maternity care practices and breastfeeding support to reduce unnecessary formula supplementation, reduce disparities, increase exclusive breastfeeding and breastfeeding duration, and improve maternal and child health outcomes. Copyright © 2017 by the American Academy of Pediatrics.

A multicenter examination and strategic revisions of the Yale Global Tic Severity Scale.

PubMed

McGuire, Joseph F; Piacentini, John; Storch, Eric A; Murphy, Tanya K; Ricketts, Emily J; Woods, Douglas W; Walkup, John W; Peterson, Alan L; Wilhelm, Sabine; Lewin, Adam B; McCracken, James T; Leckman, James F; Scahill, Lawrence

2018-05-08

To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS) scores to inform modification of the measure. This cross-sectional study included 617 participants with a tic disorder (516 children and 101 adults), who completed an age-appropriate diagnostic interview and the YGTSS to evaluate tic symptom severity. The distributions of scores on YGTSS dimensions were evaluated for normality and skewness. For dimensions that were skewed across motor and phonic tics, a modified Delphi consensus process was used to revise selected anchor points. Children and adults had similar clinical characteristics, including tic symptom severity. All participants were examined together. Strong internal consistency was identified for the YGTSS Motor Tic score (α = 0.80), YGTSS Phonic Tic score (α = 0.87), and YGTSS Total Tic score (α = 0.82). The YGTSS Total Tic and Impairment scores exhibited relatively normal distributions. Several subscales and individual item scales departed from a normal distribution. Higher scores were more often used on the Motor Tic Number, Frequency, and Intensity dimensions and the Phonic Tic Frequency dimension. By contrast, lower scores were more often used on Motor Tic Complexity and Interference, and Phonic Tic Number, Intensity, Complexity, and Interference. The YGTSS exhibits good internal consistency across children and adults. The parallel findings across Motor and Phonic Frequency, Complexity, and Interference dimensions prompted minor revisions to the anchor point description to promote use of the full range of scores in each dimension. Specific minor revisions to the YGTSS Phonic Tic Symptom Checklist were also proposed. © 2018 American Academy of Neurology.

The new wave of hospital consolidation.

PubMed

Goldstein, Lisa

2012-04-01

Reimbursement challenges, spiraling healthcare costs, and a slow economic recovery are driving the latest wave of hospital consolidation. Health insurance companies and provider systems are forming partnerships in the consolidation field with the goal of reducing healthcare costs and improving quality. The "cost" of the acquisition may include debt and other obligations of the acquired hospital, such as pension liabilities, along with a multiyear capital commitment.

The contribution of geography to black/white differences in the use of low neonatal mortality hospitals in New York City.

PubMed

Hebert, Paul L; Chassin, Mark R; Howell, Elizabeth A

2011-02-01

Racial differences in the use of high-quality hospital care contribute to racial disparities in mortality for very low birth weight (VLBW) neonates. We explored the role that geographic distribution of hospitals plays in the racial disparity in the use of top-tier hospitals by mothers of VLBW neonates in New York City. Retrospective analysis of Vital Statistics and administrative databases. VLBW deliveries in New York City from 1996 to 2001 to non-Hispanic Black (n = 4947) and non-Hispanic White (n = 1615) mothers. Black mothers were less likely to deliver in a top-tier hospitals (White = 44%, Black = 28%; P < 0.001) and top-tier hospitals were less likely to be located in Black mothers' neighborhoods (White = 40%, Black = 33%; P < 0.001). Distance, however, did not contribute to the disparity in use of top-tier hospitals. Non-Hispanic Black mothers lived marginally closer to a top-tier hospital than non-Hispanic White mothers (0.65 miles closer; P < 0.001), and mothers of both the races often bypassed their neighborhood hospital (Black = 62% bypassed, White = 71%; P < 0.001). Inattention to recommended prenatal behaviors was associated with using a closer hospital, suggesting that geographic proximity was most important to mothers of vulnerable neonates. Purported measures of hospital quality such as Neonatal Intensive Care Unit level and volume were more strongly associated with use of hospital for White mothers than for Black mothers. The influence of geography on the use of top-tier hospitals for mothers of VLBW neonates is complex. Other personal and hospital characteristics, not just distance or geography, also influenced hospital use in New York City.

The effect of the global financial crisis on preventable hospitalizations among the homeless in New York State.

PubMed

White, Brandi; Ellis, Charles; Jones, Walter; Moran, William; Simpson, Kit

2018-04-01

Objective Periods of economic instability may increase preventable hospitalizations because of increased barriers to accessing primary care. For underserved populations such as the homeless, these barriers may be more pronounced due to limited resources in the health care safety net. This study examined the impact of the global financial crisis of 2007-2008 on access to care for the homeless in New York State. Methods Hospitalizations for ambulatory care sensitive conditions (ACSCs) were used as a proxy measure for primary care access. Admissions for ACSCs were identified in the New York State Inpatient Database from 2006 to 2012. Hospitalization rates for ACSCs were calculated for the homeless and nonhomeless. Multivariable linear regression was used to investigate the impact of the financial crisis on hospitalization rates for ACSCs. Results The findings indicate that during the financial crisis, homeless adults had significantly higher preventable hospitalizations than nonhomeless adults, and the uninsured homeless had significantly higher preventable hospitalizations when compared to other homeless subgroups. After the financial crisis, preventable hospitalizations for the homeless stabilized but remained at higher rates than those for the nonhomeless. Conclusions These findings are important to developing health policies designed to provide effective care for underserved population such as the homeless.

Palliative care need and management in the acute hospital setting: a census of one New Zealand Hospital

PubMed Central

2013-01-01

Background Improving palliative care management in acute hospital settings has been identified as a priority internationally. The aim of this study was to establish the proportion of inpatients within one acute hospital in New Zealand who meet prognostic criteria for palliative care need and explore key aspects of their management. Methods A prospective survey of adult hospital inpatients (n = 501) was undertaken. Case notes were examined for evidence that the patient might be in their last year of life according to Gold Standards Framework (GSF) prognostic indicator criteria. For patients who met GSF criteria, clinical and socio-demographic information were recorded. Results Ninety-nine inpatients met GSF criteria, representing 19.8% of the total census population. The patients’ average age was 70 years; 47% had a primary diagnosis of cancer. Two thirds had died within 6 months of their admission. Seventy-eight of the 99 cases demonstrated evidence that a palliative approach to care had been adopted; however documentation of discussion about goals of care was very limited and only one patient had evidence of an advance care plan. Conclusion One fifth of hospital inpatients met criteria for palliative care need, the majority of whom were aged >70 years. Whilst over three quarters were concluded to be receiving care in line with a palliative care approach, very little documented evidence of discussion with patients and families regarding end of life issues was evident. Future research needs to explore how best to support ‘generalist’ palliative care providers in initiating, and appropriately recording, such discussions. PMID:23537092

Evaluating the Impact of Policies to Regulate Involuntary Out-of-Network Charges on New Jersey Hospitals.

PubMed

Mattke, Soeren; White, Chapin; Hanson, Mark; Kotzias, Virginia I

2017-01-01

Policymakers must balance the complex and sometimes conflicting objectives of ensuring access to care, limiting the financial burden on patients, and controlling overall costs. States differ in how they handle involuntary out-of-network charges-i.e., payment for care when a patient does not have the option of selecting a hospital in his or her health plan's network. New Jersey's current regulations emphasize patient protection, in that patients are only responsible for the portion of the cost that they would have incurred for in-network care, and health plans must pay the remainder of the provider's charges. This policy is seen as contentious by health plans, who argue that they have been made responsible for paying whatever charges a hospital submits, and proposals to limit payments for involuntary out-of-network care are being debated in the state legislature. This study seeks to inform the current debate (as of October 2016) by analyzing the role of out-of-network payments in New Jersey hospitals' financial performance and simulating the effect of policies to limit charges for involuntary out-of-network care. The authors' estimates suggest that implementing New Jersey Bill A1952, which proposes a limit of between 90 and 200 percent of Medicare rates for involuntary out-of-network hospital care, would have reduced payments for hospital care by commercial plans by between 6 and 10 percent during 2010 through 2014. Assuming no change in operating expenses and no recoupment of lost out-of-network revenues, the cap would have led to an operating loss at between 48 and 70 percent of hospitals.

33. EAST ABUTMENT, VIEW NORTHEAST OF OPERATING MACHINERY SMALL ...

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

33. EAST ABUTMENT, VIEW NORTHEAST OF OPERATING MACHINERY - SMALL GEAR IS IDENTIFIED AS 'C' - LARGE GEAR IS 'B' REFER TO GEARING DIAGRAMS - STRAUSS SHEET #15 FOR POWER TRAIN RELATIONSHIPS - Tomlinson Bridge, Spanning Quinnipiac River at Forbes Street (U.S. Route 1), New Haven, New Haven County, CT

35. VIEW SOUTHEAST, WEST ABUTMENT OF OPERATING MACHINERY BASCULE ...

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

35. VIEW SOUTHEAST, WEST ABUTMENT OF OPERATING MACHINERY - BASCULE LEAF RAISED - LARGE GEAR AT LEFT CENTER IS 'D' - REFER TO STRAUSS SHEETS #15 AND #18 FOR POWER TRAIN RELATIONSHIPS - Tomlinson Bridge, Spanning Quinnipiac River at Forbes Street (U.S. Route 1), New Haven, New Haven County, CT

CONFIRMATORY SURVEY OF THE DEFENSE LOGISTICS AGENCY, DEFENSE NATIONAL STOCKPILE CENTER NEW HAVEN DEPOT, NEW HAVEN, INDIANA

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

E.M. Harpenau

2010-02-19

The objectives of the radiological confirmatory survey were to collect adequate radiological data for use in evaluating the radiological condition of NHD land areas, warehouses, and support buildings. The data generated from the confirmatory survey activities were used to evaluate the results of the Final Status Survey Report (FSSR) submitted by Cabrera Services (Cabrera 2009). Cabrera has stated that all radioactive materials have been removed and that remediation of the open land areas and structure surfaces was complete, and that the NHD meets the criteria for unrestricted use.

A New Approach to Hospital Cost Functions and Some Issues in Revenue Regulation

PubMed Central

Friedman, Bernard; Pauly, Mark V.

1983-01-01

An important aspect of hospital revenue regulation at the State level is the use of retroactive allowances for changes in the volume of service. Arguments favoring non-proportional allowances have been based on statistical studies of marginal cost, together with concerns about fairness toward non-profit enterprises or concerns about various inflationary biases in hospital management. This article attempts to review and clarify the regulatory issues and choices, with the aid of new econometric work that explicitly allows for the effects of transitory as well as expected demand changes on hospital expense. The present analysis is also novel in treating length of stay as an endogenous variable in cost functions. We analyzed cost variation for a panel of over 800 hospitals that reported monthly to Hospital Administrative Services between 1973 and 1978. The central results are that marginal cost of unexpected admissions is about half of average cost, while marginal cost of forecasted admissions is about equal to average cost. We obtained relatively low estimates of the cost of an “empty bed.” The study tends to support proportional volume allowances in revenue regulation programs, with perhaps a residual role for selective case review. PMID:10309853

Use, trends, and impacts of nurse overtime in New York hospitals, 1995--2000

NASA Astrophysics Data System (ADS)

Berney, Barbara L.

Over the last several years, nurses and their advocates have expressed concern about heavy use of overtime (OT) in hospitals and claimed that it undermines the quality of nursing care. Some hospital managers view OT as an important staffing and scheduling tool. This study examines trends in the use of nurse overtime and its effects on several nurse-sensitive patient outcomes. Previous studies have demonstrated a relationship between several patient outcomes and nurse staffing levels, but little is known about the impact of nurse overtime on patient outcomes. Using staffing and discharge data covering 1995 to 2000 from 160 acute general hospitals in New York State, this study examines hospital characteristics that are associated with the use of OT. These characteristics include size, location, RN unionization, hospital ownership and teaching status. The study examines trends in the use of OT. Finally, it uses multivariate regression to analyze the relationship between OT and the rates of six nurse-sensitive patient outcomes and mortality. Significant differences were observed in the use of OT by hospital ownership and by union status. Government hospitals used less OT than non-government hospitals. Non-union hospitals used slightly less OT than hospitals with unionized nurses. As total RN hours and straight (non-OT) hours per acute inpatient day increased, OT decreased. OT use as a percent of total inpatient RN hours increased significantly over the study period from 3.9% to 5.5%. Trends varied by hospital characteristic. This dissertation finds little evidence for an association between nurse OT and patient outcomes. One reason may be that the administrative data used track OT use and adverse events for whole years. Since OT use is episodic, data that examine the occurrence of adverse events during periods of heavy nurse overtime may be more sensitive to the impact of OT. That hospitals vary dramatically in their OT use and that some categories of hospitals (e

Does a chest x-ray alter the management of new patients attending a geriatric day hospital?

PubMed

Logan, J A; Vallance, R; Williams, B O; Paul, H

1997-01-01

Studies have suggested that routine chest x-ray is never indicated but all new attenders at our day hospitals have a chest x-ray carried out. Our aim was to determine if this investigation altered the clinical management of patients and to try to select those patients in whom a chest x-ray is indicated. A prospective study was carried out over a 7 month period from February to September 1995. All new patients had cardiorespiratory symptoms/signs documented and a management plan made. A chest x-ray was then carried out and change in management as a result of the x-ray report noted. Knightswood and Drumchapel Geriatric Day Hospitals, West Glasgow University NHS Trust. All new Day Hospital attenders. Of 207 new Day Hospital attenders, 53 had no clinical indication for a chest x-ray and although 70% had an abnormal film in no case was patient management changed as a result of this. A chest x-ray was indicated in 154 patients and of these 114 (74%) had an abnormal film with a resultant change in management in 23 patients (this comprised either a change in drug treatment or a further investigation.) Of those whose management was changed as a result of the x-ray report 61% had respiratory symptoms. We would recommend that chest x-ray should be performed in those patients who have a clear clinical indication and that the diagnostic yield is highest in the presence of respiratory symptoms or signs.

Development of the breastfeeding quality improvement in hospitals learning collaborative in New York state.

PubMed

Fitzpatrick, Eileen; Dennison, Barbara A; Welge, Sara Bonam; Hisgen, Stephanie; Boyce, Patricia Simino; Waniewski, Patricia A

2013-06-01

Exclusive breastfeeding is a public health priority. A strong body of evidence links maternity care practices, based on the Ten Steps to Successful Breastfeeding, to increased breastfeeding initiation, duration and exclusivity. Despite having written breastfeeding policies, New York (NY) hospitals vary widely in reported maternity care practices and in prevalence rates of breastfeeding, especially exclusive breastfeeding, during the birth hospitalization. To improve hospital maternity care practices, breastfeeding support, and the percentage of infants exclusively breastfeeding, the NY State Department of Health developed the Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative. The BQIH Learning Collaborative was the first to use the Institute for Health Care Improvement's Breakthrough Series methodology to specifically focus on increasing hospital breastfeeding support. The evidence-based maternity care practices from the Ten Steps to Successful Breastfeeding provided the basis for the Change Package and Data Measurement Plan. The present article describes the development of the BQIH Learning Collaborative. The engagement of breastfeeding experts, partners, and stakeholders in refining the Learning Collaborative design and content, in defining the strategies and interventions (Change Package) that drive hospital systems change, and in developing the Data Measurement Plan to assess progress in meeting the Learning Collaborative goals and hospital aims is illustrated. The BQIH Learning Collaborative is a model program that was implemented in a group of NY hospitals with plans to spread to additional hospitals in NY and across the country.

9. Town of Hamden, 1868 Map detail photocopied from F. ...

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

9. Town of Hamden, 1868 Map detail photocopied from F. W. Beers, et al., Atlas of New Haven County, Connecticut (New York, 1868), p. 25. Shows the newly created Lake Whitney and, one quarter mile south of the armory, a 'Rifle Factory.' - Eli Whitney Armory, West of Whitney Avenue, Armory Street Vicinity, Hamden, New Haven County, CT

Prevalence of malignant hyperthermia diagnosis in hospital discharge records in California, Florida, New York, and Wisconsin.

PubMed

Lu, Zhen; Rosenberg, Henry; Li, Guohua

2017-06-01

Malignant hyperthermia (MH) is a rare yet potentially fatal pharmacogenetic disorder triggered by exposure to inhalational anesthetics and the depolarizing neuromuscular blocking agent succinylcholine. Epidemiologic data on the geographic variation in MH prevalence is scant. The objective of this study is to examine the prevalence of recorded MH diagnosis in patients discharged from hospitals in four states in the United States. Observational study. Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) for California (2011), Florida (2011), New York (2012) and Wisconsin (2012). A total of 164 hospital discharges that had a recorded diagnosis of MH using the International Classification of Disease, 9th Revision, Clinical Modification code 995.86. MH prevalence was assessed by patient demographic and clinical characteristics. The prevalence of MH per 100,000 hospital discharges ranged from 1.23 (95% Confidence Interval [CI], 0.80-1.66) in New York to 1.91 (95% CI, 1.48-2.34) in California, and the prevalence of MH per 100,000 surgical discharges ranged from 1.47 (95% CI, 0.93-2.02) in New York to 2.86 (95% CI, 2.00-3.71) in Florida. The prevalence of MH in male patients was more than twice the prevalence in female patients. Of the 164 patients with MH diagnosis, 11% were dead on discharge. There exists a modest variation in the prevalence of recorded MH diagnosis in hospital discharges in California, Florida, New York and Wisconsin. Epidemiologic patterns of MH diagnosis in hospital discharges appear to be similar across the four states. Further research is needed to better understand the geographic variation and contributing factors of MH in different populations. Copyright © 2017 Elsevier Inc. All rights reserved.

Results of a Targeted Screening Program for Congenital Cytomegalovirus Infection in Infants Who Fail Newborn Hearing Screening.

PubMed

Vancor, Emily; Shapiro, Eugene D; Loyal, Jaspreet

2018-01-24

Congenital cytomegalovirus (CMV) infection is a major cause of sensorineural hearing loss. By law, newborns in Connecticut who fail newborn hearing screening are tested for infection with CMV. This targeted screening is controversial, because most children with congenital CMV infection are asymptomatic, and CMV-related hearing loss can have a delayed onset. Our hospital uses a saliva polymerase chain reaction (PCR) assay (confirmed by a urine PCR assay) to detect CMV. Here, we report the results of the first year of our screening program. We reviewed the medical records of newborns in the Yale New Haven Health System who failed the newborn hearing screening test between January 1 and December 31, 2016. Of 10964 newborns, 171 failed newborn hearing screening, and 3 of these newborns had positive saliva CMV PCR test results. Of these 3 newborns, 2 had positive results on the confirmatory test (for 1 of them the confirmatory test was not performed until the infant was 10 weeks old), and 1 had a negative result on the confirmatory test. Three additional newborns with congenital CMV infection were tested because of clinical indications (1 for ventriculomegaly on prenatal ultrasound and 2 for CMV infection of the mother). Results of audiology follow-up were available for 149 (87.1%) of the 171 newborns who failed newborn hearing screening; 127 (85.2%) had normal results. Our targeted screening program for congenital CMV infection had a low yield. Consideration should be given to other strategies for identifying children at risk of hearing loss as a result of congenital CMV infection. © The Author(s) 2018. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparison of valvar and right ventricular function following transcatheter and surgical pulmonary valve replacement.

PubMed

Li, Wendy F; Pollard, Heidi; Karimi, Mohsen; Asnes, Jeremy D; Hellenbrand, William E; Shabanova, Veronika; Weismann, Constance G

2018-01-01

Trans-catheter (TC) pulmonary valve replacement (PVR) has become common practice for patients with right ventricular outflow tract obstruction (RVOTO) and/or pulmonic insufficiency (PI). Our aim was to compare PVR and right ventricular (RV) function of patients who received TC vs surgical PVR. Retrospective review of echocardiograms obtained at three time points: before, immediately after PVR, and most recent. Sixty-two patients (median age 19 years, median follow-up 25 months) following TC (N = 32) or surgical (N = 30) PVR at Yale-New Haven Hospital were included. Pulmonary valve and right ventricular function before, immediately after, and most recently after PVR. At baseline, the TC group had predominant RVOTO (74% vs 10%, P < .001), and moderate-severe PI was less common (61% vs 100%, P < .001). Immediate post-procedural PVR function was good throughout. At last follow-up, the TC group had preserved valve function, but the surgical group did not (moderate RVOTO: 6% vs 41%, P < .001; >mild PI: 0% vs 24%, P = .003). Patients younger than 17 years at surgical PVR had the highest risk of developing PVR dysfunction, while PVR function in follow-up was similar in adults. Looking at RV size and function, both groups had a decline in RV size following PVR. However, while RV function remained stable in the TC group, there was a transient postoperative decline in the surgical group. TC PVR in patients age <17 years is associated with better PVR function in follow-up compared to surgical valves. There was a transient decline in RV function following surgical but not TC PVR. TC PVR should therefore be the first choice in children who are considered for PVR, whenever possible. © 2017 Wiley Periodicals, Inc.

Best practices: The Administrative Review Committee at New Hampshire Hospital: a one-year follow-up.

PubMed

de Nesnera, Alexander; Folks, David G

2012-06-01

New Hampshire Hospital implemented an Administrative Review Committee (ARC), a best practice that provides a risk management process to mitigate potential liability for the hospital and clinicians treating high-profile, high-risk patients. This column reports on the first year of the ARC's operation, during which the committee reviewed 206 patients. The authors describe four patient groups and their distinguishing characteristics. The ARC is accepted by clinicians as an important venue to present high-risk clinical cases and to obtain risk management guidance and consultation. The committee has become an integral part of the hospital culture.

The prevalence of food addiction as assessed by the Yale Food Addiction Scale: a systematic review.

PubMed

Pursey, Kirrilly M; Stanwell, Peter; Gearhardt, Ashley N; Collins, Clare E; Burrows, Tracy L

2014-10-21

Obesity is a global issue and it has been suggested that an addiction to certain foods could be a factor contributing to overeating and subsequent obesity. Only one tool, the Yale Food Addiction Scale (YFAS) has been developed to specifically assess food addiction. This review aimed to determine the prevalence of food addiction diagnosis and symptom scores, as assessed by the YFAS. Published studies to July 2014 were included if they reported the YFAS diagnosis or symptom score and were published in the English language. Twenty-five studies were identified including a total of 196,211 predominantly female, overweight/obese participants (60%). Using meta-analysis, the weighted mean prevalence of YFAS food addiction diagnosis was 19.9%. Food addiction (FA) diagnosis was found to be higher in adults aged >35 years, females, and overweight/obese participants. Additionally, YFAS diagnosis and symptom score was higher in clinical samples compared to non-clinical counterparts. YFAS outcomes were related to a range of other eating behavior measures and anthropometrics. Further research is required to explore YFAS outcomes across a broader spectrum of ages, other types of eating disorders and in conjunction with weight loss interventions to confirm the efficacy of the tool to assess for the presence of FA.

The Prevalence of Food Addiction as Assessed by the Yale Food Addiction Scale: A Systematic Review

PubMed Central

Pursey, Kirrilly M.; Stanwell, Peter; Gearhardt, Ashley N.; Collins, Clare E.; Burrows, Tracy L.

2014-01-01

Obesity is a global issue and it has been suggested that an addiction to certain foods could be a factor contributing to overeating and subsequent obesity. Only one tool, the Yale Food Addiction Scale (YFAS) has been developed to specifically assess food addiction. This review aimed to determine the prevalence of food addiction diagnosis and symptom scores, as assessed by the YFAS. Published studies to July 2014 were included if they reported the YFAS diagnosis or symptom score and were published in the English language. Twenty-five studies were identified including a total of 196,211 predominantly female, overweight/obese participants (60%). Using meta-analysis, the weighted mean prevalence of YFAS food addiction diagnosis was 19.9%. Food addiction (FA) diagnosis was found to be higher in adults aged >35 years, females, and overweight/obese participants. Additionally, YFAS diagnosis and symptom score was higher in clinical samples compared to non-clinical counterparts. YFAS outcomes were related to a range of other eating behavior measures and anthropometrics. Further research is required to explore YFAS outcomes across a broader spectrum of ages, other types of eating disorders and in conjunction with weight loss interventions to confirm the efficacy of the tool to assess for the presence of FA. PMID:25338274

Specialty hospital market proliferation: Strategic implications for general hospitals.

PubMed

Al-Amin, Mona; Zinn, Jacqueline; Rosko, Michael D; Aaronson, William

2010-01-01

Since the early 1990s, specialty hospitals have been continuously increasing in number. A moratorium was passed in 2003 that prohibited physicians' referrals of Medicare patients to newly established specialty hospitals if the physician has ownership stakes in the hospital. Although this moratorium expired in effect in 2007, many are still demanding that the government pass new policies to discourage the proliferation of specialty hospitals. This study aimed at examining the regulatory and environmental forces that influence specialty hospitals founding rate. Specifically, we use the resource partitioning theory to investigate the relationship between general hospitals closure rates and the market entry of specialty hospitals. This study will help managers of general hospitals in their strategic thinking and planning. We rely on secondary data resources, which include the American Hospital Association, Area Resource file, census, and Center for Medicare and Medicaid Services data, to perform a longitudinal analysis of the founding rate of specialty hospital in the 48 states. Specifically, we use the negative binomial generalized estimating equation approach available through Stata 9.0 to study the effect of general hospitals closure rate and environmental variables on the proliferation of specialty hospitals. Specialty hospitals founding rate seems to be significantly related to general hospitals closure rates. Moreover, results indicate that economic, supply, regulatory, and financial conditions determine the founding rate of specialty hospitals in different states. The results from this study indicate that the closure of general hospitals creates market conditions that encourage the market entry of specialized health care delivery forms such as specialty hospitals. Managers of surviving general hospitals have to view the closure of other general hospitals not just as an opportunity to increase market share but also as a threat of competition from new forms of

[What is new in 2016 for the specialist in hospital internal medicine?

PubMed

Mraihi, Hamza; Chevaux, Fabienne; Castoni, Julien; Aebischer, Oriane; Christou, Foetini; Jaccard, Evrim; Benmachiche, Malik; Tasheva, Plamena; Giroud, Sabine; Kraege, Vanessa; Lamy, Olivier

2017-01-18

The year 2016 was rich in significant advances in all areas of internal medicine. Many of them have an impact on our daily practice in general internal medicine. From the treatment of NSTEMI in population older than 80, to new sepsis and septic shock criteria to antidotes of new oral anticoagulants, this selection offers to the readers a brief overview of the major advances. The chief residents in the Service of internal medicine of the Lausanne University hospital are pleased to share their readings.

27 CFR 9.122 - Western Connecticut Highlands.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Highlands. 9.122 Section 9.122 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE... (Litchfield-Hartford-New Haven County line); (6) The boundary then travels approximately 7 miles west along the Litchfield-New Haven County line to Connecticut Route #8 at Waterville in the Town of Waterbury...

Designated Stroke Center Status and Hospital Characteristics as Predictors of In-Hospital Mortality among Hemorrhagic Stroke Patients in New York, 2008-2012.

PubMed

Gatollari, Hajere J; Colello, Anna; Eisenberg, Bonnie; Brissette, Ian; Luna, Jorge; Elkind, Mitchell S V; Willey, Joshua Z

2017-01-01

Although designated stroke centers (DSCs) improve the quality of care and clinical outcomes for ischemic stroke patients, less is known about the benefits of DSCs for patients with intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH). Compared to non-DSCs, hospitals with the DSC status have lower in-hospital mortality rates for hemorrhagic stroke patients. We believed these effects would sustain over a period of time after adjusting for hospital-level characteristics, including hospital size, urban location, and teaching status. We evaluated ICH (International Classification of Diseases, Ninth Revision; ICD-9: 431) and SAH (ICD-9: 430) hospitalizations documented in the 2008-2012 New York State Department of Health Statewide Planning and Research Cooperative System inpatient sample database. Generalized estimating equation logistic regression was used to evaluate the association between DSC status and in-hospital mortality. We calculated ORs and 95% CIs adjusted for clustering of patients within facilities, other hospital characteristics, and individual level characteristics. Planned secondary analyses explored other hospital characteristics associated with in-hospital mortality. In 6,352 ICH and 3,369 SAH patients in the study sample, in-hospital mortality was higher among those with ICH compared to SAH (23.7 vs. 18.5%). Unadjusted analyses revealed that DSC status was related with reduced mortality for both ICH (OR 0.7, 95% CI 0.5-0.8) and SAH patients (OR 0.4, 95% CI 0.3-0.7). DSC remained a significant predictor of lower in-hospital mortality for SAH patients (OR 0.6, 95% CI 0.3-0.9) but not for ICH patients (OR 0.8, 95% CI 0.6-1.0) after adjusting for patient demographic characteristics, comorbidities, hospital size, teaching status and location. Admission to a DSC was independently associated with reduced in-hospital mortality for SAH patients but not for those with ICH. Other patient and hospital characteristics may explain the benefits of DSC

Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State.

PubMed

Campbell, Lauren; Li, Yue

2018-02-01

Hospital care costs are high while quality varies across hospitals. Patient satisfaction may be associated with better clinical quality, and social media ratings may offer another opportunity to measure patient satisfaction with care. To test if Facebook user ratings of hospitals are associated with existing measures of patient satisfaction, cost and quality. Data were obtained from Centers for Medicare and Medicaid Services Hospital Compare, the Hospital Inpatient Prospective Payment System impact files and the Area Health Resource File for 2015. Information from hospitals' Facebook pages was collected in July 2016. Multivariate linear regression was used to test if there is an association between Facebook user ratings (star rating and adjusted number of 'likes') and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction measures, the 30-day all-cause readmission rate, and the Medicare spending per beneficiary (MSPB) ratio. One hundred and thirty-six acute care hospitals in New York State in 2015. An increase in the Facebook star rating is associated with significant increases in 21/23 HCAHPS measures (p≤0.003). An increase in the adjusted number of 'likes' is associated with very small increases in 3/23 HCAHPS measures (p<0.05). Facebook user ratings are not associated with the 30-day all-cause readmission rate or the Medicare spending per beneficiary ratio. Results demonstrate an association between HCAHPS patient satisfaction measures and Facebook star ratings. Adjusted number of 'likes' may not be a useful measure of patient satisfaction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Case Outcomes in a Communication-and-Resolution Program in New York Hospitals.

PubMed

Mello, Michelle M; Greenberg, Yelena; Senecal, Susan K; Cohn, Janet S

2016-12-01

To determine case outcomes in a communication-and-resolution program (CRP) implemented to respond to adverse events in general surgery. Five acute-care hospitals in New York City. Following CRP implementation, hospitals recorded information about each CRP event for 22 months. Risk managers prospectively collected data in collaboration with representatives from the hospital's insurer. External researchers administered an online satisfaction survey to clinicians involved in CRP events. Among 125 CRP cases, disclosure conversations were carried out in 92 percent, explanations were conveyed in 88 percent, and apologies were offered in 72.8 percent. Three quarters of events did not involve substandard care. Compensation offers beyond bill waivers were deemed appropriate in 9 of 30 of cases in which substandard care caused harm and communicated in six such cases. In 44 percent of cases, hospitals identified steps that could be taken to improve safety. Clinicians had low awareness of the workings of the CRP, but high satisfaction with their experiences. The bulk of CRPs' work is in investigating and communicating about events not caused by substandard care. These CRPs were quite successful in handling such events, but less consistent in offering compensation in cases involving substandard care. © Health Research and Educational Trust.

Short Hospitalization system: a new way of interpreting day surgery care.

PubMed

Rago, Rocco; Franceschini, Francesca; Tomassini, Carlo R

2016-01-01

Today's poorer income on the one hand and the more and more unbearable costs on the other, call for solutions to maintain public health through proper and collective care. We need to think of a new dimension of health, to found a modern and innovative approach, which can combine the respect of healthcare rights with the optimization of resources. Worldwide, franchises serving millions of people every year succeed in limiting operating costs and still offer a service and a quality equal to single businesses. Let's imagine every single Day Surgery Unit (DSU), within its own hospital, as a single trade: starting a process of centralized management and subsequent affiliation with other DSUs, they would increase their healthcare offer by means of solid organization, efficiency and foresight that with a strong focus on innovation and continuous updating, thus increasing its range of consumers and containing management costs. The Short Hospitalization System (SHS) is the proposed project, which is not only a type of hospitalization which is different from the ordinary, but also an innovative clinical-organizational model, with an important economic impact, where the management and maximization of the different hospital flows (care, professional, logistical, information), as well as the ability to implement strategies to anticipate them are crucial. The expected benefits are both clinically and socially relevant. Among them: 1) best practice build up; 2) lower impact on daily habits and increased patient satisfaction; 3) reduction of social and health expenditure.

The next pandemic: anticipating an overwhelmed health care system.

PubMed

Duley, Mary Grace Keating

2005-10-01

In September 2005, an overview of current health care system planning efforts was presented to the audience at the Yale University Ethics Symposium on Avian and Pandemic Influenza. The speaker, also the author of this article, provided the audience with a summary of what was being undertaken with the use of federal preparedness funds to improve the overall infrastructure of the health care system. All of Connecticut's 31 acute care hospitals, the Veteran's Administration Hospital in West Haven, Hospital for Special Care, Gaylord Rehabilitation Hospital, Natchaug Psychiatric Hospital, and the state's 13 Community Health Centers are currently recipients of federal preparedness funds. Federal funding for this planning comes from Health Resources and Services Administration, Department of Health and Human Service's National Bioterrorism Hospital Preparedness Program. This article outlines the planning activities around pandemic influenza that the state's health care system partners started in 2004-2005 and also those they are currently participating in or will be participating in the next 12 to 15 months. The article highlights the key objectives and strategies that health care facilities will be using in this planning. There are four major objectives that each health care facility's Emergency Operations Plan must address. They are: increasing bed availability, developing strategies to deal with the potential staffing shortages, developing strategies for dealing with potential critical equipment and pharmaceutical shortages, and, lastly, the implementation of education, training and communication strategies for their health care workers and the public they serve. These plans, and all the activities needed to operationalize the plans, such as education, training, drills, and exercises, will include their key partners, i.e., local health departments, local emergency management, police, fire, and Emergency Medical Services. This article will describe this work plan in

New evidence on hospital profitability by payer group and the effects of payer generosity.

PubMed

Friedman, Bernard; Sood, Neeraj; Engstrom, Kelly; McKenzie, Diane

2004-09-01

This study provides (a) new estimates of U.S. hospital profitability by payer group, controlling for hospital characteristics, and (b) evidence about the intensity of care for particular diseases associated with the generosity of the patient's payer and other payers at the same hospital. The conceptual framework is a variant of the well-known model of a local monopolist selling in a segmented market. Effects of two kinds of regulation are considered. The data are taken from hospital accounting reports in four states in FY2000, and detailed discharge summaries from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality. The profitability of inpatient care for privately insured patients was found to be about 4% less than for Medicare, but 14% higher than for Medicaid and only 9% higher than for self-pay patients. We found significant direct associations but not external effects of payer generosity on the intensity of care.