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

PubMed Central

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

2014-01-01

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

RETINAL DISEASES IN A TERTIARY HOSPITAL IN SOUTHERN NIGERIA.

PubMed

Uhumwangho, O M; Itina, E I

2015-01-01

Retinal diseases are an important and common cause of ophthalmic consultation. To determine the pattern of retinal diseases in the ophthalmic department of a tertiary hospital in Southern Nigeria. A retrospective review of the case folders of patients with retinal pathologies seen between 2012 and 2013 was performed. Relevant demographic and clinical data was recorded. Analysis was performed for frequencies, proportions and percentages with the GraphPad Instat Software, Inc. version V2.05a program, San Diego, CA. There were 185 patients made of 94 (50.8%) males and 91 (49.2%) females with a peak age group of 61-70 years, (range 1-85 years) who made consultations for retinal diseases. Age related macular degeneration, 37(15.0%), and macula hole, 10(4.0%), were the common macula pathologies while retinal detachment, 11(4.5%), was the most common condition that required emergency vitreo-retinal surgical intervention. Diabetic retinopathy/maculopathy, 31(12.6%), hypertensive retinopathy 22(8.9%), and retinal vascular occlusion 12(4.8%), were the common retinal vascular diseases found. Bilateral visual impairment (low vision and blindness) from retinal diseases was present in 28(14.4%) persons. The common vitreo-retinal treatment options were use of intravitreal antivascular endothelial growth factors 32(13.0%), laser 16(6.5%), and vitreoretinal surgery in 22(8.9%) eyes. Retinal diseases remain an important cause of ophthalmic consultation and visual loss. Provision of facilities to manage these conditions will improve service delivery and quality of lives of affected patients.

Prospective hospital-based survey of attitudes of Southern women toward surgical treatment of breast cancer.

PubMed

Wei, J P; Sherry, R M; Baisden, B L; Peckel, J; Lala, G

1995-07-01

Breast-conserving surgery is equivalent to total mastectomy in the treatment of breast cancer. The Southern part of the United States has a low rate of breast conservation. We surveyed 300 women: 100 hospital personnel, 100 cancer clinic patients, and 100 non-cancer clinic patients. The women were asked about their attitudes toward breast cancer, surgery preferences, and factors that might influence their decisions. One hundred eighty-nine chose mastectomy as the best operation, 106 women chose lumpectomy, and five women were undecided. There was no difference in mean age, racial distribution, education level, income level, percentage of women who considered themselves Southern women, concerns about breast cancer, recent mammograms, previous breast surgery, previous breast cancer treatment, or acquaintances with breast cancer between the mastectomy and the lumpectomy groups. Women interested in saving the breast were more likely to pick lumpectomy (35 vs. 84%, p = 0.001). A fear of cancer recurrence played a role in the decision (88 vs. 40%, p = 0.001). Fear of radiation therapy (76 vs. 57%, p = 0.002) and of the side effects (80 vs. 63%, p = 0.005) was a significant factor. The choice of surgery for breast cancer is an individual process between a woman and her surgeon. Attitudes and fears regarding cancer recurrence and radiation therapy may make women select mastectomy over lumpectomy.

The efficacy of a neonatal screening programme in decreasing the hospitalization rate of patients with G6PD deficiency in southern Iran.

PubMed

Cohan, Nader; Karimi, Mehran; Khalili, Amir Hossein; Falahzadeh, Mohammad Hossein; Samadi, Behrang; Mahdavi, Mohammad Reza

2010-01-01

To investigate whether a neonatal screening programme for G6PD deficiency has decreased hospitalization for acute haemolytic attack in the Fars province of southern Iran. A total of 850 patients registered with G6PD deficiency were included in the study. Variables including age, sex, time and cause of hospitalization, cause of haemolytic crisis, positive history of blood transfusion, G6PD enzyme deficiency, blood urea nitrogen (BUN) and creatinine were recorded based on a standard questionnaire. All patients were analysed for G6PD enzyme level based on a quantitative test. Five hundred and fifty-three patients were hospitalized before the introduction of the neonatal screening programme (2001-2004) and 297 afterwards (2005-2008). Of those patients hospitalized after the introduction of the screening programme, 237 were wrongly classified as normal and 60 were recorded as having G6PD enzyme deficiency by the neonatal screening programme. The main causes of haemolytic crisis in G6PD-deficient patients were fava bean consumption (88.2%), underlying infection (10.9%) and drugs (0.8%). Our study showed the effectiveness of the neonatal screening programme in decreasing the hospitalization rate.

Malaria and severe anemia over eight years at Gambo Rural Hospital, southern Ethiopia.

PubMed

Barreiro, Pablo; Tiziano, Gebre; Fano, Haji; Yohannes, Tafesse; Gosa, Ashenafi; Reyes, Francisco; Tesfamariam, Abraham; Górgolas, Miguel; Ramos, José M

2017-06-01

Evolution of incident malaria and frequency of anemia were analyzed over eight years in a rural hospital in southern Ethiopia. Capillary blood samples were tested for hemoglobin concentration, and in some instances for malaria parasites, at Gambo Rural General Hospital between January 2007 and September 2014, and the results recorded. Main demographic data were also recorded in subjects with Plasmodium sp. infections. Of a total of 54,493 blood samples taken from 45,096 different patients, 21,723 (39.9%) samples from 19,173 (42.5%) patients were tested for malaria parasites. Malaria was diagnosed in 825 (3.79%, 95% CI 3.55%, 4.06%) instances (58.3% P. vivax and 41.7% P. falciparum; one episode in 575 patients and two episodes in 125 patients). A sustained decrease in yearly incidence of malaria was observed between 2011 (6.1%) and 2014 (2.4%) (p < 0.01). Of all the malaria patients, those with hemoglobin levels less than 8 g/dL, were younger compared to those with levels of 8 g/dL or more (median age of 5 years vs. 18 years; p < 0.01) and more commonly infected with P. falciparum (57.1% vs. 34.8%; p < 0.001). In multivariate analysis, severe anemia (hemoglobin <8 g/dL) in the context of anemia was associated with P falciparum infection (adjusted odd ratio [OR] 2.48, 95% confidence interval [CI] 1.68, 3.65) and younger age (OR 1.06, 95% CI 1.04, 1.07).

Antibiotic susceptibility of Legionella pneumophila strains isolated from hospital water systems in Southern Italy.

PubMed

De Giglio, Osvalda; Napoli, Christian; Lovero, Grazia; Diella, Giusy; Rutigliano, Serafina; Caggiano, Giuseppina; Montagna, Maria Teresa

2015-10-01

The purpose of this study was to describe the susceptibility of environmental strains of Legionella spp. to 10 antimicrobials commonly used for legionellosis therapy. A study of environmental strains could be useful to timely predict the onset of antibiotic resistance in the environment before it is evidenced in clinical specimens. The minimum inhibitory concentrations (MICs) of 100 environmental Legionella pneumophila (Lpn) strains belonging to serogroups (sgs) 1, 6, 8, and 10 were tested using the E-test methodology on buffered charcoal yeast extract agar supplemented with α-ketoglutarate. The most frequent sgs were selected from those obtained during microbiological surveillance conducted in 2014 in a hospital in Southern Italy. The MICs were read after 2 days of incubation at 35 °C in a humidified atmosphere without CO2. All isolates were inhibited by low concentrations of fluoroquinolones and macrolides. Rifampicin was the most active drug against the isolates in vitro. All Lpn isolates were inhibited by the following drugs (in decreasing order of their MICs): doxycycline>tigecycline>cefotaxime. The MICs of azithromycin, ciprofloxacin, levofloxacin, moxifloxacin, and tigecycline were significantly lower for Lpn non-sg 1 than Lpn sg 1 isolates. Susceptibility testing of Legionella strains to appropriate antibiotics should be performed often to evaluate the possible emergence of resistance, to improve the outcomes of patients, and to reduce the direct costs associated with hospitalization. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Social impact of HIV/AIDS on clients attending a teaching hospital in Southern Nigeria.

PubMed

Johnson, Ofonime E

2012-01-01

People living with human immunodeficiency virus and acquired immune deficiency syndrome (PLWHA) face numerous social challenges. The objectives of this study were to assess the level of self-disclosure of status by PLWHA, to describe the level and patterns of stigma and discrimination, if any, experienced by the PLWHA and to assess the effect of sero-positivity on the attitude of friends, family members, health workers, colleagues and community. This was a cross-sectional descriptive study carried out among PLWHA attending the University of Uyo Teaching Hospital, Uyo, Southern Nigeria. Information was obtained using an interviewer-administered semi-structured questionnaire, which was analysed using the Epi 6 software. A total of 331 respondents were interviewed. A majority, 256 (77.3%), of the respondents were within the age range of 25-44 years. A total of 121 (36.6%) PLWHA were single and 151 (46.6%) were married, while the rest were widowed, divorced or separated. A majority, 129 (85.4%), of the married respondents disclosed their status to their spouses and 65 (50.4%) were supportive. Apart from spouses, disclosure to mothers (39.9%) was highest. Most clients (57.7%) did not disclose their status to people outside their immediate families for fear of stigmatization. Up to 111 (80.4%) of the respondents working for others did not disclose their status to their employers. Among those whose status was known, discrimination was reported to be highest among friends (23.2%) and at the workplace (20.2%). Attitudes such as hostility (14.5%), withdrawal (11.7%) and neglect (6.8%) were reported from the private hospitals. Apart from disclosure to spouses, the level of disclosure to others was very low. Those whose status was known mainly received acceptance from their families but faced discriminatory attitudes such as hostility, neglect and withdrawal from friends, colleagues and hospital workers. There is a need for more enlightenment campaigns on HIV/AIDS by

Transport accidents among children and adolescents at the emergency service of a teaching hospital in the southern zone of the city of São Paulo☆☆☆

PubMed Central

Gorios, Carlos; de Souza, Renata Maia; Gerolla, Viviane; Maso, Bruno; Rodrigues, Cintia Leci; Armond, Jane de Eston

2014-01-01

Objective to describe the victim profile and circumstances of transport accidents involving children and adolescents who were attended at a teaching hospital in the southern zone of the city of São Paulo. Methods this was an individual observational case series study among patients up to the age of 19 years who were attended at a hospital in the southern zone of the city of São Paulo, state of São Paulo, Brazil, due to traffic accidents. The files notifying suspected or confirmed cases of violence and accidents (SIVVA files) covering January to December 2012 were analyzed. Results among the 149 cases notified, 64.4% related to males and 35.6% to females. The transport accidents were predominantly among males, irrespective of age. The main injury diagnoses were superficial head trauma (24.8%) followed by multiple non-specified trauma (36.4%), in both sexes. Conclusion transport accidents among children and adolescents occurred more often among males. The main transport accidents among the children and adolescents attended as emergency cases were caused by motor vehicles and motorcycles. Among the accident victims, the largest proportion was attended because of being run over. PMID:26229833

Sleeping porch through french doors off master bedroom (southern unit) ...

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

Sleeping porch through french doors off master bedroom (southern unit) - Fitzsimons General Hospital, Officers' Quarters, West Charlie Kelly Boulevard & South Hutton Street, Southwest Corner, Aurora, Adams County, CO

Significant spread of extensively drug-resistant Acinetobacter baumannii genotypes of clonal complex 92 among intensive care unit patients in a university hospital in southern Iran.

PubMed

Saffari, Fereshteh; Monsen, Tor; Karmostaji, Afsaneh; Azimabad, Fahimeh Bahadori; Widerström, Micael

2017-11-01

Infections associated with Acinetobacter baumannii represent an increasing threat in healthcare settings. Therefore, we investigated the epidemiological relationship between clinical isolates of A. baumannii obtained from patients in a university hospital in Bandar Abbas in southern Iran. Sixty-four consecutive non-duplicate clinical isolates collected during 2014-2015 were subjected to susceptibility testing, clonal relationship analysis using PFGE, multilocus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST), and examined for the presence of carbapenemases and integrons. Almost all A. baumannii isolates were extensively drug-resistant (XDR; 98 %) and carried an OXA carbapenemase gene (blaOXA-23-like; 98 %) and class 1 integrons (48 %). PFGE and MLST analysis identified three major genotypes, all belonging to clonal complex 92 (CC92): sequence type 848 (ST848) (n=23), ST451 (n=16) and ST195 (n=8). CC92 has previously been documented in the hospital setting in northern Iran, and ST195 has been reported in Arab States of the Persian Gulf. These data suggest national and global transmission of A. baumannii CC92. This report demonstrates the occurrence and potential spread of closely related XDR genotypes of A. baumannii CC92 within a university hospital in southern Iran. These genotypes were found in the majority of the investigated isolates, showed high prevalence of blaOXA-23 and integron class 1, and were associated with stay in the intensive care unit. Very few treatment options remain for healthcare-adapted XDR A. baumannii, and hence effective measures are desperately needed to reduce the spread of these strains and resultant infections in the healthcare setting.

Musculoskeletal Problems Among Greek Perioperative Nurses in Regional Hospitals in Southern Peloponnese : Musculoskeletal Problems in Perioperative Nurses.

PubMed

Bakola, Helen; Zyga, Sofia; Stergioulas, Apostolos; Kipreos, George; Panoutsopoulos, George

2017-01-01

The surgery unit is a particularly labor-intensive environment in the hospital. Studies reflect the correlation of labor risk factors for musculoskeletal injuries among nurses but few have investigated the relationship to perioperative nurses. The purpose of this study is the identification and definition of ergonomic risk factors in the operating room and their connection with musculoskeletal disorders in perioperative nurses in regional hospitals in Greece. Forty four Greek perioperative nurses working in regional hospitals in southern Peloponnese participated. Anonymous self-administered questionnaire was used to collect the data, which consisted of three parts (investigating musculoskeletal symptoms, description of work, psychometric evaluation). The analysis was done with the statistical program SPSS.19. Symptoms of musculoskeletal problems emerged. Specifically, 54.4% in the lumbar, 47.7% in the neck, 45.5% in the shoulder, followed by smaller percentages of the hip, knee, elbow and ankle. 6.8% of participants indicated no musculoskeletal symptoms in the last year while 74.9% of those who had symptoms presented them in two or more areas. Activities rated as a major problem among others were the manual handling, tools with weight and vibration etc. 100% of respondents agreed that the work in the surgery unit is demanding and has anxiety. The lack of support from the government (81.8%), combined with the low perioperative nurses (6.8%) having the opportunity to participate in administrative decisions concerning them were related to problems in the organization and management of work. Apart from engineers target factors, a main aim should be the organization of work within the framework of a national policy based on European directives on the protection and promotion of the health and safety of workers.

Workplace violence directed at nursing staff at a general hospital in southern Thailand.

PubMed

Kamchuchat, Chalermrat; Chongsuvivatwong, Virasakdi; Oncheunjit, Suparnee; Yip, Teem Wing; Sangthong, Rassamee

2008-01-01

This study aimed to document the characteristics of workplace violence directed at nursing staff, an issue which has rarely been studied in a developing country. Two study methods, a survey and a key informant interview, were conducted at a general hospital in southern Thailand. A total of 545 out of 594 questionnaires sent were returned for statistical analysis (response rate=91.7%). The 12-month prevalence of violence experience was 38.9% for verbal abuse, 3.1% for physical abuse, and 0.7% for sexual harassment. Psychological consequences including poor relationships with colleagues and family members were the major concerns. Patients and their relatives were the main perpetrators in verbal and physical abuse while co-workers were the main perpetrators in cases of sexual harassment. Common factors to incidents of violence were psychological setting, illness of the perpetrators, miscommunication, and alcohol use. Logistic regression analysis showed younger age to be a personal risk factor. Working in the out-patient unit, trauma and emergency unit, operating room, or medical or surgical unit increased the odds of violence by 80%. Training related to violence prevention and control was found to be effective and decreased the risk of being a victim of violence by 40%. We recommend providing training to high risk groups as a means of controlling workplace violence directed at nursing staff.

Radio advertising increases hospital call center volume by 48%.

PubMed

2006-01-01

Since the fall of 2005, call volume at University of Southern California University Hospital of Los Angeles' call center has increased by nearly 50%. How? The hospital embarked on a long-term radio campaign to promote its presence as a premier academic medical center and to increase patient volume.

Estimating the cost of healthcare delivery in three hospitals in southern ghana.

PubMed

Aboagye, A Q Q; Degboe, A N K; Obuobi, A A D

2010-09-01

The cost burden (called full cost) of providing health services at a referral, a district and a mission hospital in Ghana were determined. Standard cost-finding and cost analysis tools recommended by World Health Organization are used to analyse 2002 and 2003 hospital data. Full cost centre costs were computed by taking into account cash and non-cash expenses and allocating overhead costs to intermediate and final patient care centres. The full costs of running the mission hospital in 2002 and 2003 were US$600,295 and US$758,647 respectively; for the district hospital, the respective costs were US$496,240 and US$487,537; and for the referral hospital, the respective costs were US$1,160,535 and US$1,394,321. Of these, overhead costs ranged between 20% and 42%, while salaries made up between 45% and 60%. Based on healthcare utilization data, in 2003 the estimated cost per outpatient attendance was US$ 2.25 at the mission hospital, US$ 4.51 at the district hospital and US$8.5 at the referral hospital; inpatient day costs were US$ 6.05, US$ 9.95 and US$18.8 at the respective hospitals. User fees charged at service delivery points were generally below cost. However, some service delivery points have the potential to recover their costs. Salaries are the major cost component of the three hospitals. Overhead costs constitute an important part of hospital costs and must be noted in efforts to recover costs. Cost structures are different at different types of hospitals. Unit costs at service delivery points can be estimated and projected into the future.

Medical Errors and Barriers to Reporting in Ten Hospitals in Southern Iran

PubMed Central

Khammarnia, Mohammad; Ravangard, Ramin; Barfar, Eshagh; Setoodehzadeh, Fatemeh

2015-01-01

Background: International research shows that medical errors (MEs) are a major threat to patient safety. The present study aimed to describe MEs and barriers to reporting them in Shiraz public hospitals, Iran. Methods: A cross-sectional, retrospective study was conducted in 10 Shiraz public hospitals in the south of Iran, 2013. Using the standardised checklist of Shiraz University of Medical Sciences (referred to the Clinical Governance Department and recorded documentations) and Uribe questionnaire, we gathered the data in the hospitals. Results: A total of 4379 MEs were recorded in 10 hospitals. The highest frequency (27.1%) was related to systematic errors. Besides, most of the errors had occurred in the largest hospital (54.9%), internal wards (36.3%), and morning shifts (55.0%). The results revealed a significant association between the MEs and wards and hospitals (p < 0.001). Moreover, individual and organisational factors were the barriers to reporting ME in the studied hospitals. Also, a significant correlation was observed between the ME reporting barriers and the participants’ job experiences (p < 0.001). Conclusion: The medical errors were highly frequent in the studied hospitals especially in the larger hospitals, morning shift and in the nursing practice. Moreover, individual and organisational factors were considered as the barriers to reporting MEs. PMID:28729811

Epidemiology Analysis of Streptococcus pyogenes in a Hospital in Southern Taiwan by Use of the Updated emm Cluster Typing System.

PubMed

Chiang-Ni, Chuan; Zheng, Po-Xing; Wang, Shu-Ying; Tsai, Pei-Jane; Chuang, Woei-Jer; Lin, Yee-Shin; Liu, Ching-Chuan; Wu, Jiunn-Jong

2016-01-01

emm typing is the most widely used molecular typing method for the human pathogen Streptococcus pyogenes (group A streptococcus [GAS]). emm typing is based on a small variable region of the emm gene; however, the emm cluster typing system defines GAS types according to the nearly complete sequence of the emm gene. Therefore, emm cluster typing is considered to provide more information regarding the functional and structural properties of M proteins in different emm types of GAS. In the present study, 677 isolates collected between 1994 and 2008 in a hospital in southern Taiwan were analyzed by the emm cluster typing system. emm clusters A-C4, E1, E6, and A-C3 were the most prevalent emm cluster types and accounted for 67.4% of total isolates. emm clusters A-C4 and E1 were associated with noninvasive diseases, whereas E6 was significantly associated with both invasive and noninvasive manifestations. In addition, emm clusters D4, E2, and E3 were significantly associated with invasive manifestations. Furthermore, we found that the functional properties of M protein, including low fibrinogen-binding and high IgG-binding activities, were correlated significantly with invasive manifestations. In summary, the present study provides updated epidemiological information on GAS emm cluster types in southern Taiwan. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Comparison of survival patterns of northern and southern genotypes of the North American tick Ixodes scapularis (Acari: Ixodidae) under northern and southern conditions

USGS Publications Warehouse

Ginsberg, Howard S.; Rulison, Eric L.; Azevedo, Alexandra; Pang, Genevieve C.; Kuczaj, Isis M.; Tsao, Jean I.; LeBrun, Roger A.

2014-01-01

BackgroundSeveral investigators have reported genetic differences between northern and southern populations of Ixodes scapularis in North America, as well as differences in patterns of disease transmission. Ecological and behavioral correlates of these genetic differences, which might have implications for disease transmission, have not been reported. We compared survival of northern with that of southern genotypes under both northern and southern environmental conditions in laboratory trials.MethodsSubadult I. scapularis from laboratory colonies that originated from adults collected from deer from several sites in the northeastern, north central, and southern U.S. were exposed to controlled conditions in environmental chambers. Northern and southern genotypes were exposed to light:dark and temperature conditions of northern and southern sites with controlled relative humidities, and mortality through time was recorded.ResultsTicks from different geographical locations differed in survival patterns, with larvae from Wisconsin surviving longer than larvae from Massachusetts, South Carolina or Georgia, when held under the same conditions. In another experiment, larvae from Florida survived longer than larvae from Michigan. Therefore, survival patterns of regional genotypes did not follow a simple north–south gradient. The most consistent result was that larvae from all locations generally survived longer under northern conditions than under southern conditions.ConclusionsOur results suggest that conditions in southern North America are less hospitable than in the north to populations of I. scapularis. Southern conditions might have resulted in ecological or behavioral adaptations that contribute to the relative rarity of I. scapularis borne diseases, such as Lyme borreliosis, in the southern compared to the northern United States.

Valuing morbidity effects of wildfire smoke exposure from the 2007 Southern California wildfires

Treesearch

Ikuho Kochi; Patricia A. Champ; John B. Loomis; Geoffrey H. Donovan

2016-01-01

This study estimated the economic costs associated with morbidity from the wildfires that occurred in 2007 in southern California. We used the excess number of hospital admissions and emergency department visits to quantify the morbidity effects and used medical costs to estimate the economic impact. With data from 187 hospital facilities and 140 emergency departments...

Technology penetration of endovascular aortic aneurysm repair in southern California.

PubMed

Shah, Haimesh; Kumar, S Ram; Major, Kevin; Hood, Douglas; Rowe, Vincent; Weaver, Fred A

2006-11-01

Our objective was to investigate the penetration of endovascular abdominal aortic aneurysm repair (EVAR) in the large, diverse health-care market of southern California over 3 years and to study variability in the pattern of distribution of EVAR in southern California counties by analyzing available demographic, geographic, and socioeconomic data from California state health-care databases. Information abstracted from the inpatient hospital discharge data for patients undergoing AAA repair for the years 2001, 2002, and 2003, derived from the Office of Statewide Health Planning and Development, included age, gender, race, hospitals performing EVAR, and payors for the service. Per-capita income (PCI) for the year 1999 and the population size of each county for the respective years were obtained from the U.S. Census Bureau. Data pertaining to members of the Southern California Vascular Surgical Society (SCVSS) serving the southern California region were obtained from the SCVSS membership directory. Data were categorized based on 10 counties in southern California. All the above variables were analyzed using the chi-squared test, with p < 0.05 considered significant. The proportions of EVAR for the years 2001, 2002, and 2003 were 15.4% (n = 409), 20.2% (n = 492), and 25.9% (n = 566), respectively. This is a 67.8% (p < 0.0001) increase in EVAR application in southern California since 2001. However, the proportion of EVAR varied among counties (p < 0.0001), with 457 EVARs performed in Los Angeles County and eight in Imperial County during the study period. EVAR proportion was higher in patients aged > or =65 years (p < 0.0001) and male patients (p < 0.0001). The proportion of EVAR was significantly higher in counties with more than 20 vascular surgeons available (p < 0.0001) and PCI >21,000 US$ (p < 0.0001) and in Medicare, health maintenance organization, preferred provider organization, and private insurance holders (p < 0.0001). There was a trend toward increased

Anaesthesia and hospital links: strengthening healthcare through South-North hospital partnerships.

PubMed

Parry, E H O; Percy, D B

2007-12-01

Health services can respond to the needs of the poorest people in developing countries if those who work in the front line of health care are supported and motivated and if development needs in services and training programmes can be filled. This can be achieved when a Health Link between a southern hospital and/or training school and its northern counterpart is designed to build a disciplined and long-term programme of staff development including the needs of anaesthetic services, which meets the needs identified by the southern partner. Development of anaesthetic practice is best carried out in the context of an institution-wide Health Link where not only the staff and systems involved in anaesthesia but all the essential 'back office' or support services are also supported and developed.

Emergence of sporadic non-clustered cases of hospital-associated listeriosis among immunocompromised adults in southern Taiwan from 1992 to 2013: effect of precipitating immunosuppressive agents.

PubMed

Lee, Chun-Yuan; Tsai, Hung-Chin; Kunin, Calvin M; Lee, Susan Shin-Jung; Wu, Kuan-Sheng; Chen, Yao-Shen

2014-03-19

Sporadic non-clustered hospital-associated listeriosis is an emerging infectious disease in immunocompromised hosts. The current study was designed to determine the impact of long-term and precipitating immunosuppressive agents and underlying diseases on triggering the expression of the disease, and to compare the clinical features and outcome of hospital-associated and community-associated listeriosis. We reviewed the medical records of all patients with Listeria monocytogenes isolated from sterile body sites at a large medical center in southern Taiwan during 1992-2013. Non-clustered cases were defined as those unrelated to any other in time or place. Multivariable regression analysis was used to determine factors associated with prognosis. Thirty-five non-clustered cases of listeriosis were identified. Twelve (34.2%) were hospital-associated, and 23 (65.7%) were community-associated. The 60-day mortality was significantly greater in hospital-associated than in community-associated cases (66.7% vs. 17.4%, p = 0.007). Significantly more hospital-associated than community-associated cases were treated with a precipitating immunosuppressive agent within 4 weeks prior to onset of listeriosis (91.7% vs. 4.3%, respectively p < 0.001). The median period from the start of precipitating immunosuppressive treatment to the onset of listeriosis-related symptoms was 12 days (range, 4-27 days) in 11 of the 12 hospital-associated cases. In the multivariable analysis, APACHE II score >21 (p = 0.04) and receipt of precipitating immunosuppressive therapy (p = 0.02) were independent risk factors for 60-day mortality. Sporadic non-clustered hospital-associated listeriosis needs to be considered in the differential diagnosis of sepsis in immunocompromised patients, particularly in those treated with new or increased doses of immunosuppressive agents.

Emergence of sporadic non-clustered cases of hospital-associated listeriosis among immunocompromised adults in southern Taiwan from 1992 to 2013: effect of precipitating immunosuppressive agents

PubMed Central

2014-01-01

Background Sporadic non-clustered hospital-associated listeriosis is an emerging infectious disease in immunocompromised hosts. The current study was designed to determine the impact of long-term and precipitating immunosuppressive agents and underlying diseases on triggering the expression of the disease, and to compare the clinical features and outcome of hospital-associated and community-associated listeriosis. Methods We reviewed the medical records of all patients with Listeria monocytogenes isolated from sterile body sites at a large medical center in southern Taiwan during 1992–2013. Non-clustered cases were defined as those unrelated to any other in time or place. Multivariable regression analysis was used to determine factors associated with prognosis. Results Thirty-five non-clustered cases of listeriosis were identified. Twelve (34.2%) were hospital-associated, and 23 (65.7%) were community-associated. The 60-day mortality was significantly greater in hospital-associated than in community-associated cases (66.7% vs. 17.4%, p = 0.007). Significantly more hospital-associated than community-associated cases were treated with a precipitating immunosuppressive agent within 4 weeks prior to onset of listeriosis (91.7% vs. 4.3%, respectively p < 0.001). The median period from the start of precipitating immunosuppressive treatment to the onset of listeriosis-related symptoms was 12 days (range, 4–27 days) in 11 of the 12 hospital-associated cases. In the multivariable analysis, APACHE II score >21 (p = 0.04) and receipt of precipitating immunosuppressive therapy (p = 0.02) were independent risk factors for 60-day mortality. Conclusions Sporadic non-clustered hospital-associated listeriosis needs to be considered in the differential diagnosis of sepsis in immunocompromised patients, particularly in those treated with new or increased doses of immunosuppressive agents. PMID:24641498

Assessment of drug use patterns in terms of the WHO patient-care and facility indicators at four hospitals in Southern Ethiopia: a cross-sectional study.

PubMed

Gidebo, Kassa Daka; Summoro, Temesgen Sidamo; Kanche, Zewde Zema; Woticha, Eskinder Wolka

2016-11-10

Patient-centered care is now the goal for virtually all healthcare systems. The aim of this research was to evaluate the patient care quality in regard to drug dispensing in four hospitals in southern Ethiopia namely Wolaita Sodo University teaching and referral hospital (WSUTRH), Tercha zonal hospital (TZH), Sodo Christian hospital (SCH) and Dubo St. Mary's Catholic primary hospital (DSMCPH). A cross sectional study was conducted by using the WHO patient care and facility indicators between September 10 and October 20, 2014. Patients who visited the outpatient departments of the four hospitals were selected by systematic random sampling method and interviewed. In total 384 patients were selected based on a rough estimate of proportion of patients visiting to the four hospitals. Facility indicators including the availability of essential drugs list (EDL), national drug formulary, standard treatment guideline (STG) and key drugs were evaluated. Descriptive statistical calculations were performed using SPSS® version 20.0 software. The mean number of drugs was in the range between 1.9 ± 0.9 to 2.2 ± 2.0. The mean consultation time range was found to be 4.2 ± 1.6 to 4.9 ± 5.0 min whereas the mean dispensing time was ranged from 96.1 ± 52.0 to 152.3 ± 47.6 s. The overall mean number of drug prescribed for the four hospitals was 2.0 ± 1.2 and the mean percentage of medications actually dispensed in the hospitals was thus calculated to be 86.3. The mean percentage of medications clearly labeled was 45.4. Patients who knew their dosage forms accurately were 78.8. Among the four hospitals evaluated only one hospital (25 %) had at least a copy of the Ethiopian essential drug list (EDL), standard treatment guideline for hospitals and drug formulary. The mean availability of key drugs in the hospitals was found to be 65.7 %. The result of the present study indicates that the patient consulting time, medications labeling and availability

Aggressive television ad campaign for Cooper University Hospital features hometown celebrity.

PubMed

2006-01-01

Cooper University Hospital in Camden, NJ, features an extensive ambulatory care network that includes practice sites across eight counties of Southern New Jersey. Recently, the hospital worked with Willing Strategic Advertising to produce an award-winning television advertising campaign endorsed by New Jersey-born TV personality, Kelly Ripa.

Salary survey of the Medical Library Group of Southern California and Arizona.

PubMed Central

Smith, J L; Connolly, B F; Davis, M; Graham, E; Wheeler, S

1984-01-01

The 1982 salary survey of the Medical Library Group of Southern California and Arizona (MLGSCA) indicates that 211 health sciences librarians in Southern California and Arizona earned a mean annual salary of $20,910 for 1982. Data analysis shows a positive correlation between salary and educational level. Other factors found to affect salary were job history, number of positions held, MLA certification, and professional responsibility. Age, gender, and MLA certification did not have a consistent positive correlation with salary. Results indicate that the salaries of hospital librarians are, on the average, roughly comparable to those of academic librarians in Southern California and Arizona. PMID:6743878

Impact of El Niño Southern Oscillation on infectious disease hospitalization risk in the United States.

PubMed

Fisman, David N; Tuite, Ashleigh R; Brown, Kevin A

2016-12-20

Although the global climate is changing at an unprecedented rate, links between weather and infectious disease have received little attention in high income countries. The "El Niño Southern Oscillation" (ENSO) occurs irregularly and is associated with changing temperature and precipitation patterns. We studied the impact of ENSO on infectious diseases in four census regions in the United States. We evaluated infectious diseases requiring hospitalization using the US National Hospital Discharge Survey (1970-2010) and five disease groupings that may undergo epidemiological shifts with changing climate: (i) vector-borne diseases, (ii) pneumonia and influenza, (iii) enteric disease, (iv) zoonotic bacterial disease, and (v) fungal disease. ENSO exposure was based on the Multivariate ENSO Index. Distributed lag models, with adjustment for seasonal oscillation and long-term trends, were used to evaluate the impact of ENSO on disease incidence over lags of up to 12 mo. ENSO was associated more with vector-borne disease [relative risk (RR) 2.96, 95% confidence interval (CI) 1.03-8.48] and less with enteric disease (0.73, 95% CI 0.62-0.87) in the Western region; the increase in vector-borne disease was attributable to increased risk of rickettsioses and tick-borne infectious diseases. By contrast, ENSO was associated with more enteric disease in non-Western regions (RR 1.12, 95% CI 1.02-1.15). The periodic nature of ENSO may make it a useful natural experiment for evaluation of the impact of climatic shifts on infectious disease risk. The impact of ENSO suggests that warmer temperatures and extreme variation in precipitation events influence risks of vector-borne and enteric disease in the United States.

AMONG PREGNANT WOMEN ATTENDING AN ANTENATAL CLINIC AT A RURAL HOSPITAL IN SOUTHERN ETHIOPIA.

PubMed

Deme, Chala; Edao, Beyene; Jaya, Gemedi; Tisiano, Gebre; Fano, Hayi; Alegria, Iñaki; Reyes, Francisco; Gorgolas, Miguel; Ramos, José M

2016-09-01

Antenatal care (ANC) is provided to prevent, diagnose early and treat pregnant women for a variety of diseases. The objective of this study was to determine the seroprevalences of syphilis, human immunodeficiency virus (HIV) and hepatitis B virus (HVB) and asymptomatic urinary tract infections and the prevalence of hypertension and anemia among pregnant women attending the antenatal clinic at Gambo Rural Hospital in southern Ethiopia. The following tests were conducted among study subjects: hemoglobin (Hgb) level, rapid plasma reagin (RPR) for syphilis, anti-HIV antibodies, hepatitis B surface antigen (HBsAg) and urine analysis. A total of 574 pregnant women were included in this study. The mean age of the participants was 25.7 (SD: 4.8) years old; 88.2% were living in urban areas and 11.8% in rural areas. Sixty-seven point two percent of participants began their attended care during the second trimester of their pregnancy. Overall, anemia (Hgb < 11 mg/dl) was present in 8.9% (95% CI: 6.9-11.6): severe anemia (Hgb < 7 mg/dl), moderate anemia (Hgb 7-8.9 mg/dl) and mild anemia (Hgb 9-10.9 mg/dl) were found in 0.5% (95% CI: 0.2-1.5), 0.2% (95% CI: 0.03-0.9) and 8.2% (95% CI: 6.2-10.8). The overall prevalence of hypertension was 1.2% (95% CI: 0.06-2.6). This was significantly higher (p=0.01) in the third trimester (3.2%) than in the second (0.5%) and first (0%) trimesters. The prevalence of preeclampsia, defined by have hypertension and proteinuria, was 0.7% (95% CI: 0.3-1.8). Asymptomatic urinary tract infection (having ≥10 white blood cells /high power field in the urine) was present in 12.7% of participants (95% CI: 10.0-15.5). The RPR test was positive in two patients (0.3%; 95% CI: 0.1-1.3). The prevalences of positive test for HBsAg and HIV-1 were 2.3% (95% CI: 1.3-3.8) and 0.2% (95% CI: 0.03-0.9), respectively. No HIV-2 cases were detected. Our data show relatively low prevalences of anemia, hypertension, urinary tract infection, syphilis, HIV, and hepatitis B

The prevalence of trichomoniasis and associated factors among women treated at a university hospital in southern Brazil

PubMed Central

2017-01-01

Background Trichomoniasis is the most prevalent non-viral sexually transmitted disease (STD) in the world; however, it remains a neglected parasitic disease. This study aimed to determine the prevalence of trichomoniasis and its associated epidemiological factors among women treated at a hospital in southern Brazil. Methodology/Principal findings A cross-sectional study was performed to determine the prevalence of this infection in women treated at Hospital Universitário (HU) in Rio Grande, Rio Grande do Sul, Brazil, between January 2012 and January 2015. This study consisted a self-administered questionnaire regarding demographic, clinical, and behavioural data and a molecular diagnosis with polymerase chain reaction (PCR) using the TVK3/7 primer set, which was confirmed with sequence analysis. Of the 345 women surveyed, the overall prevalence of Trichomonas vaginalis (T. vaginalis) was 4.1% (14/345). The prevalence rates were 5.9% among pregnant women, 8.5% among HIV-positive women, and 10.1% among HIV-positive pregnant women. The rates for groups with other significant demographic and clinical features were as follows: 6.6% among women with white skin, 12.3% among women with an income below the minimum monthly wage, 7.4% among women with a vaginal pH greater than or equal to 4.6, and 7.9% among women with a comorbid STD. The multivariate analysis confirmed that pregnant women who were HIV-positive (p = 0.001) and had low incomes (p = 0.026) were the most likely to have this infection. Conclusions A multivariate analysis confirmed that HIV-positive pregnant women with low incomes were the participants most likely to have trichomoniasis. These results are important because this Brazilian region presents a high prevalence of HIV-1 subtype C, which is associated with greater transmissibility. Additionally, low family income reveals a socioeconomic fragility that might favour the transmission of this STD. PMID:28346531

Rocky mountain spotted fever hospitalizations among American Indians.

PubMed

Demma, Linda J; Holman, Robert C; Mikosz, Christina A; Curns, Aaron T; Swerdlow, David L; Paisano, Edna L; Cheek, James E

2006-09-01

To describe the epidemiology of Rocky Mountain spotted fever (RMSF) among American Indians/Alaska Natives (AI/ANs), we conducted a retrospective analysis of hospitalization records with an RMSF diagnosis using Indian Health Service (IHS) hospital discharge data for calendar years 1980-2003. A total of 261 RMSF hospitalizations were reported among AIs, for an average annual hospitalization rate of 1.21 per 100,000 persons; two deaths were reported (0.8%). Most hospitalizations (88.5%) occurred in the Southern Plains region, where the rate was 4.23 per 100,000 persons. Children 1-4 years of age had the highest age-specific hospitalization rate of 2.50 per 100,000 persons. The overall annual RMSF hospitalization rate declined during the study period. Understanding the epidemiology of RMSF among AI/ANs and educating IHS/tribal physicians on the diagnosis of tick-borne diseases remain important for the prompt treatment of RMSF and the reduction of the disease occurrence among AI/ANs, particularly in high-risk areas.

Radon Levels in Indoor Environments of the University Hospital in Bari-Apulia Region Southern Italy

PubMed Central

Fucilli, Fulvio; Cavone, Domenica; De Maria, Luigi; Birtolo, Francesco; Ferri, Giovanni Maria; Soleo, Leonardo

2018-01-01

Since 1988, the International Agency for Research on Cancer (IARC) has classified radon among the compounds for which there is scientific evidence of carcinogenicity for humans (group 1). The World Health Organization (WHO) recommends a reference radon level between 100 and 300 Bq/m3 for homes. The objective of this study is to measure the radon concentrations in 401 workplaces, different from the patient rooms, in 28 different buildings of the university hospital in Bari (Apulia region, Southern Italy) to evaluate the exposure of health care workers. Radon environmental sampling is performed over two consecutive six-month periods via the use of passive dosimeters of the CR-39 type. We find an average annual radon concentration expressed as median value of 48.0 Bq/m3 (range 6.5–388.0 Bq/m3) with a significant difference between the two six-month periods (median value: February/July 41.0 Bq/m3 vs. August/January 55.0 Bq/m3). An average concentration of radon lower than the WHO reference level (100 Bq/m3) is detected in 76.1% of monitored environments, while higher than 300 Bq/m3 only in the 0.9%. Most workplaces report radon concentrations within the WHO reference level, therefore, the risk to workers’ health deriving from occupational exposure to radon can be considered to be low. Nevertheless, the goal is to achieve near-zero exposures to protect workers’ health. PMID:29642436

The relationship of respiratory and cardiovascular hospital admissions to the southern California wildfires of 2003.

PubMed

Delfino, R J; Brummel, S; Wu, J; Stern, H; Ostro, B; Lipsett, M; Winer, A; Street, D H; Zhang, L; Tjoa, T; Gillen, D L

2009-03-01

There is limited information on the public health impact of wildfires. The relationship of cardiorespiratory hospital admissions (n = 40 856) to wildfire-related particulate matter (PM(2.5)) during catastrophic wildfires in southern California in October 2003 was evaluated. Zip code level PM(2.5) concentrations were estimated using spatial interpolations from measured PM(2.5), light extinction, meteorological conditions, and smoke information from MODIS satellite images at 250 m resolution. Generalised estimating equations for Poisson data were used to assess the relationship between daily admissions and PM(2.5), adjusted for weather, fungal spores (associated with asthma), weekend, zip code-level population and sociodemographics. Associations of 2-day average PM(2.5) with respiratory admissions were stronger during than before or after the fires. Average increases of 70 microg/m(3) PM(2.5) during heavy smoke conditions compared with PM(2.5) in the pre-wildfire period were associated with 34% increases in asthma admissions. The strongest wildfire-related PM(2.5) associations were for people ages 65-99 years (10.1% increase per 10 microg/m(3) PM(2.5), 95% CI 3.0% to 17.8%) and ages 0-4 years (8.3%, 95% CI 2.2% to 14.9%) followed by ages 20-64 years (4.1%, 95% CI -0.5% to 9.0%). There were no PM(2.5)-asthma associations in children ages 5-18 years, although their admission rates significantly increased after the fires. Per 10 microg/m(3) wildfire-related PM(2.5), acute bronchitis admissions across all ages increased by 9.6% (95% CI 1.8% to 17.9%), chronic obstructive pulmonary disease admissions for ages 20-64 years by 6.9% (95% CI 0.9% to 13.1%), and pneumonia admissions for ages 5-18 years by 6.4% (95% CI -1.0% to 14.2%). Acute bronchitis and pneumonia admissions also increased after the fires. There was limited evidence of a small impact of wildfire-related PM(2.5) on cardiovascular admissions. Wildfire-related PM(2.5) led to increased respiratory hospital

Leprosy in a University Hospital in Southern Brazil*

PubMed Central

de Lima, Adma Silva; Pinto, Karin Cristine; Bona, Míryan Priscilla Santos; de Mattos, Suelen Mayara Lopes; Hoffmann, Marina Portiolli; Mulinari-Brenner, Fabiane Andrade; Ottoboni, Vanessa Cristhine Dallolmo

2015-01-01

BACKGROUND Leprosy is an infectious disease that may lead to irreversible nerve damage, compromising patient's quality of life and leading to loss of working years. OBJECTIVES To evaluate the epidemiological profile of patients followed at a University Hospital. MATERIALS AND METHODS This is a retrospective observational study, based on a review of medical records. We studied the clinical and epidemiological features of patients with leprosy monitored at the Hospital de Clínicas of the Federal University of Paraná between January 2005 and January 2010. RESULTS The mean age was 47.51, while 35.94% of patients were aged 41-60. The male:female rate was 1.8:1. The most prevalent occupations were: retired, students or rural workers. Patients came mainly from Curitiba or nearby areas, but there were also patients from the countryside. The mean diagnostic delay was 24.57 months. Multibacillary forms prevailed, with the lepromatous variety being the most common, closely followed by the borderline type. Neural enlargement was found in more than 50% of the patients and 48.44% of them developed reactional states. Hemolysis was the most commonly detected drug side effect. Initial functional evaluation was possible in 70% of patients, 55% of whom had disabilities upon diagnosis. The most prevalent associated disease was hypertension. CONCLUSIONS This study showed an important diagnostic delay and a high rate of sequelae in this specific population. Brazil is one of the few remaining countries that has not yet eradicated leprosy and it is important to improve health policies in order to prevent sequelae and achieve eradication. PMID:26560210

Examining for any impact of climate change on the association between seasonality and hospitalization for mania.

PubMed

Parker, Gordon B; Hadzi-Pavlovic, Dusan; Graham, Rebecca K

2017-01-15

Studies have established higher rates of hospitalization for mania in spring and summer and posit various explanatory climatic variables. As the earth's climate is changing, we pursue whether this is reflected in the yearly seasonal variation in hospitalizations for mania. This would be indicated by the presence of secular changes in both the hospitalization seasonal pattern and climatic variables, and associations between both variable sets. Data were obtained for 21,882 individuals hospitalized to psychiatric hospitals in the Australian state of New South Wales (NSW) over a 14-year period (2000-2014) with ICD-diagnosed mania - and with NSW population figures and salient climatic variables collected for the same period. Regression analyses were conducted to examine the predictive value of climate variables on hospital admissions. Data quantified a peak for manic admissions in spring of the southern hemisphere, in the months of October and November. There was a significant linear increase in manic admissions (0.5%/year) over the 14-year time period, with significant variation across years. In terms of climatic variables, there was a significant linear trend over the interval for solar radiation, although the trend indicated a decrease rather than an increase. Seasonal variation in admissions was most closely associated with two climate variables - evaporation in the current month and temperature in the previous month. Hospitalization rates do not necessarily provide an accurate estimate of the onset of manic episodes and findings may be limited to the southern hemisphere, or New South Wales. While overall findings do not support the hypothesis that climate change is leading to a higher seasonal impact for manic hospital admissions in the southern hemisphere, analyses identified two climate/weather variables - evaporation and temperature - that may account for the yearly spring excess. Copyright © 2016 Elsevier B.V. All rights reserved.

Are the nation's hospitals facing a capital crisis?

PubMed

Johnsson, J

1990-07-20

Are hospitals facing a capital crisis? Wall Street is taking a long, hard look at hospitals' bottom lines--and many analysts don't like what they see. Hospitals' increasing reliance on long-term debt, lower debt-service coverage ratios, and weakening performance indicators all signal a potentially volatile situation for some sectors of the field. Which hospitals are at risk? Experts point to hospitals in Southern California and New York. But others say that hospitals in moderate-size cities with 250 beds and $40 million or more in long-term debt are vulnerable. However, 40 percent of the 600 CEOs who responded to our Hamilton/KSA survey agree that the continued erosion of reimbursement will require a government bailout similar to the savings and loan industry. "A great deal depends on public policy," says Darrel Brownell, executive vice-president and chief financial officer, Memorial Health Services, a two-hospital system based in Long Beach, CA. "The government has the ability to maintain the industry in a stable condition, or it has the ability to force it into a bailout situation."

Prevalence of impaired memory in hospitalized adults and associations with in-hospital sleep loss.

PubMed

Calev, Hila; Spampinato, Lisa M; Press, Valerie G; Meltzer, David O; Arora, Vineet M

2015-07-01

Effective inpatient teaching requires intact patient memory, but studies suggest hospitalized adults may have memory deficits. Sleep loss among inpatients could contribute to memory impairment. To assess memory in older hospitalized adults, and to test the association between sleep quantity, sleep quality, and memory, in order to identify a possible contributor to memory deficits in these patients. Prospective cohort study. General medicine and hematology/oncology inpatient wards. Fifty-nine hospitalized adults at least 50 years of age with no diagnosed sleep disorder. Immediate memory and memory after a 24-hour delay were assessed using a word recall and word recognition task from the University of Southern California Repeatable Episodic Memory Test. A vignette-based memory task was piloted as an alternative test more closely resembling discharge instructions. Sleep duration and efficiency overnight in the hospital were measured using actigraphy. Mean immediate recall was 3.8 words out of 15 (standard deviation = 2.1). Forty-nine percent of subjects had poor memory, defined as immediate recall score of 3 or lower. Median immediate recognition was 11 words out of 15 (interquartile range [IQR] = 9-13). Median delayed recall score was 1 word, and median delayed recognition was 10 words (IQR = 8-12). In-hospital sleep duration and efficiency were not significantly associated with memory. The medical vignette score was correlated with immediate recall (r = 0.49, P < 0.01). About half of the inpatients studied had poor memory while in the hospital, signaling that hospitalization might not be an ideal teachable moment. In-hospital sleep was not associated with memory scores. © 2015 Society of Hospital Medicine.

The relationship of respiratory and cardiovascular hospital admissions to the southern California wildfires of 2003

PubMed Central

Delfino, R J; Brummel, S; Wu, J; Stern, H; Ostro, B; Lipsett, M; Winer, A; Street, D H; Zhang, L; Tjoa, T; Gillen, D L

2014-01-01

Objective There is limited information on the public health impact of wildfires. The relationship of cardiorespiratory hospital admissions (n = 40 856) to wildfire-related particulate matter (PM2.5) during catastrophic wildfires in southern California in October 2003 was evaluated. Methods Zip code level PM2.5 concentrations were estimated using spatial interpolations from measured PM2.5, light extinction, meteorological conditions, and smoke information from MODIS satellite images at 250 m resolution. Generalised estimating equations for Poisson data were used to assess the relationship between daily admissions and PM2.5, adjusted for weather, fungal spores (associated with asthma), weekend, zip code-level population and sociodemographics. Results Associations of 2-day average PM2.5 with respiratory admissions were stronger during than before or after the fires. Average increases of 70 μg/m3 PM2.5 during heavy smoke conditions compared with PM2.5 in the pre-wildfire period were associated with 34% increases in asthma admissions. The strongest wildfire-related PM2.5 associations were for people ages 65– 99 years (10.1% increase per 10 μg/m3 PM2.5, 95% CI 3.0% to 17.8%) and ages 0–4 years (8.3%, 95% CI 2.2% to 14.9%) followed by ages 20–64 years (4.1%, 95% CI 20.5% to 9.0%). There were no PM2.5–asthma associations in children ages 5–18 years, although their admission rates significantly increased after the fires. Per 10 μg/m3 wildfire-related PM2.5, acute bronchitis admissions across all ages increased by 9.6% (95% CI 1.8% to 17.9%), chronic obstructive pulmonary disease admissions for ages 20–64 years by 6.9% (95% CI 0.9% to 13.1%), and pneumonia admissions for ages 5–18 years by 6.4% (95% CI 21.0% to 14.2%). Acute bronchitis and pneumonia admissions also increased after the fires. There was limited evidence of a small impact of wildfire-related PM2.5 on cardiovascular admissions. Conclusions Wildfire-related PM2.5 led to increased respiratory

Hospital readmissions after spontaneous intracerebral hemorrhage in Southern Portugal.

PubMed

Nzwalo, Hipólito; Nogueira, Jerina; Guilherme, Patrícia; Abreu, Pedro; Félix, Catarina; Ferreira, Fátima; Ramalhete, Sara; Marreiros, Ana; Tatlisumak, Turgut; Thomassen, Lars; Logallo, Nicola

2018-06-01

Spontaneous intracerebral hemorrhage (SICH) survivors are at risk of hospital readmissions. Data on readmissions after SICH is scarce. We aimed to study the frequency and predictors of readmissions after SICH in Algarve, Portugal. Retrospective study of a community representative cohort of SICH survivors (2009-2015). The first unplanned readmission in the first year after discharge was the outcome. Cox regression analysis was performed to identify predictors of 1-year readmission. Of the 357 SICH survivors followed, 116 (32.5%) were readmitted within the first-year. Sixty-seven (18.8%) of the survivors were early readmitted (<90 days), corresponding to 57.8% or all readmissions. Common causes were pneumonia, endocrine/nutritional/metabolic and cardiovascular complications. The risk of readmission was increased by prior to index SICH history of ≥ 3 previous emergency department visits (hazards ratio (HR) = 2.663 (1.770-4.007); P < 0.001), pneumonia during index hospitalization (HR = 2.910 (1.844-4.592); P < 0.001) and reduced in patients discharge home (HR = 0.681 (0.366-0.976); P = 0.048). The rate of readmissions after SICH is high, predictors are identifiable and causes are potentially preventable. Improvement of care can potentially reduce this burden. Copyright © 2018 Elsevier B.V. All rights reserved.

Reemergence of Dengue in Southern Texas, 2013.

PubMed

Thomas, Dana L; Santiago, Gilberto A; Abeyta, Roman; Hinojosa, Steven; Torres-Velasquez, Brenda; Adam, Jessica K; Evert, Nicole; Caraballo, Elba; Hunsperger, Elizabeth; Muñoz-Jordán, Jorge L; Smith, Brian; Banicki, Alison; Tomashek, Kay M; Gaul, Linda; Sharp, Tyler M

2016-06-01

During a dengue epidemic in northern Mexico, enhanced surveillance identified 53 laboratory-positive cases in southern Texas; 26 (49%) patients acquired the infection locally, and 29 (55%) were hospitalized. Of 83 patient specimens that were initially IgM negative according to ELISA performed at a commercial laboratory, 14 (17%) were dengue virus positive by real-time reverse transcription PCR performed at the Centers for Disease Control and Prevention. Dengue virus types 1 and 3 were identified, and molecular phylogenetic analysis demonstrated close identity with viruses that had recently circulated in Mexico and Central America. Of 51 household members of 22 dengue case-patients who participated in household investigations, 6 (12%) had been recently infected with a dengue virus and reported no recent travel, suggesting intrahousehold transmission. One household member reported having a recent illness consistent with dengue. This outbreak reinforces emergence of dengue in southern Texas, particularly when incidence is high in northern Mexico.

Reemergence of Dengue in Southern Texas, 2013

PubMed Central

Thomas, Dana L.; Santiago, Gilberto A.; Abeyta, Roman; Hinojosa, Steven; Torres-Velasquez, Brenda; Adam, Jessica K.; Evert, Nicole; Caraballo, Elba; Hunsperger, Elizabeth; Muñoz-Jordán, Jorge L.; Smith, Brian; Banicki, Alison; Tomashek, Kay M.; Gaul, Linda

2016-01-01

During a dengue epidemic in northern Mexico, enhanced surveillance identified 53 laboratory-positive cases in southern Texas; 26 (49%) patients acquired the infection locally, and 29 (55%) were hospitalized. Of 83 patient specimens that were initially IgM negative according to ELISA performed at a commercial laboratory, 14 (17%) were dengue virus positive by real-time reverse transcription PCR performed at the Centers for Disease Control and Prevention. Dengue virus types 1 and 3 were identified, and molecular phylogenetic analysis demonstrated close identity with viruses that had recently circulated in Mexico and Central America. Of 51 household members of 22 dengue case-patients who participated in household investigations, 6 (12%) had been recently infected with a dengue virus and reported no recent travel, suggesting intrahousehold transmission. One household member reported having a recent illness consistent with dengue. This outbreak reinforces emergence of dengue in southern Texas, particularly when incidence is high in northern Mexico. PMID:27191223

Hantavirus pulmonary syndrome, Southern Chile, 1995-2012.

PubMed

Riquelme, Raúl; Rioseco, María Luisa; Bastidas, Lorena; Trincado, Daniela; Riquelme, Mauricio; Loyola, Hugo; Valdivieso, Francisca

2015-04-01

Hantavirus is endemic to the Region de Los Lagos in southern Chile; its incidence is 8.5 times higher in the communes of the Andean area than in the rest of the region. We analyzed the epidemiologic aspects of the 103 cases diagnosed by serology and the clinical aspects of 80 hospitalized patients during 1995-2012. Cases in this region clearly predominated during winter, whereas in the rest of the country, they occur mostly during summer. Mild, moderate, and severe disease was observed, and the case-fatality rate was 32%. Shock caused death in 75% of those cases; high respiratory frequency and elevated creatinine plasma level were independent factors associated with death. Early clinical suspicion, especially in rural areas, should prompt urgent transfer to a hospital with an intensive care unit and might help decrease the high case-fatality rate.

Different profile of intestinal protozoa and helminthic infections among patients with diarrhoea according to age attending a rural hospital in southern Ethiopia.

PubMed

Ramos, Jose M; Rodríguez-Valero, Natalia; Tisiano, Gabriel; Fano, Haji; Yohannes, Tafese; Gosa, Ashenafi; Fruttero, Enza; Reyes, Francisco; Górgolas, Miguel

2014-06-01

The aim of this study was to analyze the association of intestinal parasitic diseases with age and gender in patients with diarrhea attending a rural hospital in southern Ethiopia in the period 2007-2012. A total of 32,191 stool examination was performed in patients who presented with diarrhea. The overall prevalence of intestinal parasites in the present study was 26.5%. Predominant parasites detected were Giardia lamblia (15.0%), Entamoeba histolytica/dispar (5.4%), and Ascaris lumbricoides (5.0%). The median of age of diarrheal patients with Hymenolepis species, Schistosoma mansoni and G. lamblia was significantly lower (5 y., 10.5 y., and 18 y., respectively; p<0.001). The median age of diarrheal patients with Taenia species, S. stercoralis, and E. histolytica/dispar was significantly higher (24 y., 24 y., and 20 y., respectively; p<0.01). In conclusion, Giardia lamblia was the most prevalent intestinal parasite and the profile of intestinal parasitic infections is influenced by age.

Understanding levels of morbidity and hospitalization in Kerala, India.

PubMed Central

Dilip, T. R.

2002-01-01

The prevalence of ailments and hospitalization in Kerala was examined using data from the 52 nd National Sample Survey Data on Health Care in Kerala in 1995-6. The survey included 24401 people from 4928 households. Age and seasonality had considerable effects on the morbidity of individuals. The burden of ill health was higher in rural areas than in urban areas. People who were more likely to have a better lifestyle had a higher level of morbidity and hospitalization. Regional differences were seen, with levels of morbidity and hospitalization higher in the comparatively developed regions of Southern Kerala than in Northern Kerala. Factors like physical accessibility of health care services and capacity to seek health care services could create artificial differences in morbidity and hospitalization among different subgroups of the population in Kerala. PMID:12378294

Consumer Nutrition Environments of Hospitals: An Exploratory Analysis Using the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops, 2012

PubMed Central

Sallis, James F.; Swartz, Michael D.; Hoelscher, Deanna M.; Peskin, Melissa F.

2013-01-01

Introduction Hospitals are the primary worksite of over 5 million adults in the United States, and millions of meals are procured and consumed in this setting. Because many worksite nutrition initiatives use an ecological framework to improve the dietary habits of employees, the nutrition values of foods served in hospitals is receiving attention. Methods This study used the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops to quantitatively describe the consumer nutrition environments of 39 hospitals in Southern California. Data were collected by visiting each facility once from February 2012 through May 2012. Results On average, hospitals achieved only 29%, 33%, and less than 1% of the total possible points for their cafeteria, vending machines, and gift shops sections, respectively; overall, hospitals scored 25% of the total possible points. Large facility size and contracted food service operations were associated with some healthy practices in hospital cafeterias, but we found no association between these variables and the sectional or overall nutrition composite scores. Conclusion The average consumer nutrition environment of hospitals in this sample was minimally conducive to healthful eating. Nutrition-related interventions are warranted in hospital settings. PMID:23823699

Consumer nutrition environments of hospitals: an exploratory analysis using the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops, 2012.

PubMed

Winston, Courtney P; Sallis, James F; Swartz, Michael D; Hoelscher, Deanna M; Peskin, Melissa F

2013-07-03

Hospitals are the primary worksite of over 5 million adults in the United States, and millions of meals are procured and consumed in this setting. Because many worksite nutrition initiatives use an ecological framework to improve the dietary habits of employees, the nutrition values of foods served in hospitals is receiving attention. This study used the Hospital Nutrition Environment Scan for Cafeterias, Vending Machines, and Gift Shops to quantitatively describe the consumer nutrition environments of 39 hospitals in Southern California. Data were collected by visiting each facility once from February 2012 through May 2012. On average, hospitals achieved only 29%, 33%, and less than 1% of the total possible points for their cafeteria, vending machines, and gift shops sections, respectively; overall, hospitals scored 25% of the total possible points. Large facility size and contracted food service operations were associated with some healthy practices in hospital cafeterias, but we found no association between these variables and the sectional or overall nutrition composite scores. The average consumer nutrition environment of hospitals in this sample was minimally conducive to healthful eating. Nutrition-related interventions are warranted in hospital settings.

Prevalence of Impaired Memory in Hospitalized Adults and Associations with In-Hospital Sleep Loss

PubMed Central

Calev, Hila; Spampinato, Lisa M; Press, Valerie G; Meltzer, David O; Arora, Vineet M

2015-01-01

Background Effective inpatient teaching requires intact patient memory, but studies suggest hospitalized adults may have memory deficits. Sleep loss among inpatients could contribute to memory impairment. Objective To assess memory in older hospitalized adults, and to test the association between sleep quantity, sleep quality and memory, in order to identify a possible contributor to memory deficits in these patients. Design Prospective cohort study Setting General medicine and hematology/oncology inpatient wards Patients 59 hospitalized adults at least 50 years of age with no diagnosed sleep disorder. Measurements Immediate memory and memory after a 24-hour delay were assessed using a word recall and word recognition task from the University of Southern California Repeatable Episodic Memory Test (USC-REMT). A vignette-based memory task was piloted as an alternative test more closely resembling discharge instructions. Sleep duration and efficiency overnight in the hospital were measured using actigraphy. Results Mean immediate recall was 3.8 words out of 15 (SD=2.1). Forty-nine percent of subjects had poor memory, defined as immediate recall score of 3 or lower. Median immediate recognition was 11 words out of 15 (IQR=9, 13). Median delayed recall score was 1 word and median delayed recognition was 10 words (IQR= 8–12). In-hospital sleep duration and efficiency were not significantly associated with memory. The medical vignette score was correlated with immediate recall (r=0.49, p<0.01) Conclusions About half of inpatients studied had poor memory while in the hospital, signaling that hospitalization might not be an ideal teachable moment. In-hospital sleep was not associated with memory scores. PMID:25872763

Occurrence of antimicrobial resistant bacteria in healthy dogs and cats presented to private veterinary hospitals in southern Ontario: A preliminary study

PubMed Central

Murphy, Colleen; Reid-Smith, Richard J.; Prescott, John F.; Bonnett, Brenda N.; Poppe, Cornelis; Boerlin, Patrick; Weese, J. Scott; Janecko, Nicol; McEwen, Scott A.

2009-01-01

The prevalence and patterns of antimicrobial susceptibility of fecal Escherichia coli, Salmonella spp., extended β-lactamase producing E. coli (ESBL-E. coli), methicillin-resistant Staphylococcus aureus (MRSA), and methicillin-resistant Staphylococcus pseudintermedius (MRSP) were determined for healthy dogs (n = 188) and cats (n = 39) from veterinary hospitals in southern Ontario that had not had recent exposure to antimicrobials. The prevalence of antimicrobial resistance in E. coli was as follows: streptomycin (dogs — 17%, cats — 2%), ampicillin (dogs — 13%, cats — 4%), cephalothin (dogs — 13%, cats — < 1%), and tetracycline (dogs — 11%, cats — 2%). Eleven percent of dogs and 15% of cats had isolates that were resistant to at least 2 antimicrobials. Cephamycinase (CMY)-2 producing E. coli was cultured from 2 dogs. No Salmonella spp., ESBL-E. coli, MRSA, or MRSP isolates were recovered. The observed prevalence of resistance in commensal E. coli from this population was lower than that previously reported in companion animals, but a small percentage of dogs may be a reservoir for CMY-2 E. coli. PMID:20046603

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.

[Residential cohort study on mortality and hospitalization in Viggiano and Grumento Nova Municipalities in the framework of HIA in Val d'Agri (Basilicata Region, Southern Italy)].

PubMed

Minichilli, Fabrizio; Bianchi, Fabrizio; Ancona, Carla; Cervino, Marco; De Gennaro, Gianluigi; Mangia, Cristina; Santoro, Michele; Bustaffa, Elisa

2018-01-01

to evaluate the associations among the emissions produced by "Centro olio Val d'Agri" (COVA), with mortality and hospitalization of residents in the Viggiano and Grumento Nova Municipalities, located in Val d'Agri (Basilicata Region, Southern Italy). residential cohort study. Lagrangians dispersion models to estimate the level of exposure at the address of residence to NOX concentrations as tracers of COVA emissions. Based on the tertile of NOX distribution, individual exposure was classified and a Cox model analysis was performed (hazard ratio, HR, trend with relative 95%CI). The association among exposure to NOX and the cohort mortality/hospitalization was evaluated considering age, socioeconomic status, and distance from the high traffic density road. The cohort included 6,795 residents (73,270 person-years) in the period 2000-2014. causes of mortality and hospitalization due to cardio-respiratory diseases, recognised as associated to air pollution, with medium-short latency induction period, consistent with the period of operation at the COVA. increasing trends were observed on three exposure classes for mortality due to circulatory system diseases (HR trend: 1.19; 95%CI 1.02-1.39), stronger considering women (HR trend: 1.19; 95%CI 1.02-1.39). From hospitalizations results, an increased risk emerges for respiratory diseases (HR trend: 1.12; 95%CI 1.01-1.25) and, for women, for diseases of the circulatory system (HR trend: 1.19; 95%CI 1.03-1.38), for ischemic diseases (HR trend: 1.33; 95%CI 1.02-1.74) and respiratory diseases (HR trend: 1.22; 95%CI 1.03-1.46). the excesses of mortality and hospitalization emerged in areas most exposed to pollutants of industrial origin are relevant for preventive actions. It is recommended to define and implement a surveillance system for the entire resident population based on indicators of environmental pollution and related health outcomes on the basis of the scientific literature and the results achieved by the present study.

Grandmultiparity: outcome of delivery in a tertiary hospital in southern Nigeria.

PubMed

Abasiattai, Aniekan M; Utuk, Ntiense M; Udoma, Edem J; Umoh, Augustine V

2011-01-01

Grandmultiparity is traditionally associated with increased risk of complications during pregnancy and delivery. Reports from developed countries where obstetric facilities are excellent and the standard ofperinatal care is high indicate that currently, obstetric complications among grandmultipara are now independently associated with progressive maternal age. In Nigeria and other developing nations however, grandmultiparity still contributes a significant proportion of the obstetric population. The aim of this study is to evaluate the outcome of delivery of grandmultiparous patients at the University of Uyo Teaching Hospital. The case records of all grandmultiparous patients who delivered at the University of Uyo Teaching Hospital, Uyo over a six-year period were studied. Grandmultiparous women constituted 6.4% of the parturients who delivered in the hospital during the study period. Their ages ranged from 20-45 years with majority (71.5%) being 30-39 years. Majority (77.9%) were para 5 and 6 and 326 (80.1%) of the patients booked and received antenatal care in the hospital. Majority of the booked patients (79.8%) initiated antenatal care after 32 weeks of gestation while all the unbooked patients 68 (16.7%) and the antenatal clinic defaulters 8 (2.0%) were brought from unorthodox health facilities when they developed obstetric complications. Two hundred and forty three patients (59.7%) had spontaneous vaginal delivery, 15 (3.7%) of the patients had laparotomy for ruptured uterus and out of these ten of them (66.7%) had a subtotal abdominal hysterectomy while five (33.4%) had uterine repair and bilateral tubal ligation. The perinatal mortality rate was 128/1000 births. There were three maternal deaths, two from eclampsia while one followed postpartum haemorrhage resulting in a maternal mortality rate of 7.4/1000. The prevalence of grandmultiparity in our centre is relatively low. It is, however, associated with high perinatal and maternal morbidity and mortality

Intersection of Southern Parkway and Southern Heights, looking toward the ...

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

Intersection of Southern Parkway and Southern Heights, looking toward the Beechmont Historic District, showing changes in landscaping, northeast - Southern Heights-Beechmont District Landscapes, Louisville, Jefferson County, KY

Emergence of carbapenem-resistant Acinetobacter baumannii as the major cause of ventilator-associated pneumonia in intensive care unit patients at an infectious disease hospital in southern Vietnam

PubMed Central

Nhu, Nguyen Thi Khanh; Lan, Nguyen Phu Huong; Campbell, James I.; Parry, Christopher M.; Thompson, Corinne; Tuyen, Ha Thanh; Hoang, Nguyen Van Minh; Tam, Pham Thi Thanh; Le, Vien Minh; Nga, Tran Vu Thieu; Nhu, Tran Do Hoang; Van Minh, Pham; Nga, Nguyen Thi Thu; Thuy, Cao Thu; Dung, Le Thi; Yen, Nguyen Thi Thu; Van Hao, Nguyen; Loan, Huynh Thi; Yen, Lam Minh; Nghia, Ho Dang Trung; Hien, Tran Tinh; Thwaites, Louise; Thwaites, Guy; Chau, Nguyen Van Vinh

2014-01-01

Ventilator-associated pneumonia (VAP) is a serious healthcare-associated infection that affects up to 30 % of intubated and mechanically ventilated patients in intensive care units (ICUs) worldwide. The bacterial aetiology and corresponding antimicrobial susceptibility of VAP is highly variable, and can differ between countries, national provinces and even between different wards in the same hospital. We aimed to understand and document changes in the causative agents of VAP and their antimicrobial susceptibility profiles retrospectively over an 11 year period in a major infectious disease hospital in southern Vietnam. Our analysis outlined a significant shift from Pseudomonas aeruginosa to Acinetobacter spp. as the most prevalent bacteria isolated from quantitative tracheal aspirates in patients with VAP in this setting. Antimicrobial resistance was common across all bacterial species and we found a marked proportional annual increase in carbapenem-resistant Acinetobacter spp. over a 3 year period from 2008 (annual trend; odds ratio 1.656, P = 0.010). We further investigated the possible emergence of a carbapenem-resistant Acinetobacter baumannii clone by multiple-locus variable number tandem repeat analysis, finding a blaOXA-23-positive strain that was associated with an upsurge in the isolation of this pathogen. We additionally identified a single blaNDM-1-positive A. baumannii isolate. This work highlights the emergence of a carbapenem-resistant clone of A. baumannii and a worrying trend of antimicrobial resistance in the ICU of the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam. PMID:25038137

Hantavirus Pulmonary Syndrome , Southern Chile, 1995–2012

PubMed Central

Riquelme, Raúl; Rioseco, María Luisa; Bastidas, Lorena; Trincado, Daniela; Riquelme, Mauricio; Loyola, Hugo; Valdivieso, Francisca

2015-01-01

Hantavirus is endemic to the Region de Los Lagos in southern Chile; its incidence is 8.5 times higher in the communes of the Andean area than in the rest of the region. We analyzed the epidemiologic aspects of the 103 cases diagnosed by serology and the clinical aspects of 80 hospitalized patients during 1995–2012. Cases in this region clearly predominated during winter, whereas in the rest of the country, they occur mostly during summer. Mild, moderate, and severe disease was observed, and the case-fatality rate was 32%. Shock caused death in 75% of those cases; high respiratory frequency and elevated creatinine plasma level were independent factors associated with death. Early clinical suspicion, especially in rural areas, should prompt urgent transfer to a hospital with an intensive care unit and might help decrease the high case-fatality rate. PMID:25816116

Seroprevalence of Chikungunya in Southern Odisha

PubMed Central

Mohanty, Indrani; Dash, Muktikesh; Sahu, Susmita; Narasimham, M.V.; Panda, Pritilata; Padhi, Sanghamitra

2013-01-01

Background: The emergence of chikungunya (CHIK) infection was observed in Odisha, India in 2006. Thereafter many cases with symptoms suggestive of CHIK were reported from different districts of Southern-Odisha. This study was aimed to know the seroprevalence, clinical presentations and seasonal trends of CHIK infection in this region. Materials and Methods: This study was conducted in a tertiary hospital of this region. Serum samples received in the Department of Microbiology from various districts of Southern-Odisha from April 2011 to March 2012 were included in the study. The samples were tested for CHIK and dengue Immunoglobin M (IgM) antibodies by enzyme-linked immunosorbent assay and malaria parasite by immunochromatographic test (ICT) method. Results: Out of the 678 serum samples tested, 174 were positive for CHIK, 15 for dengue and two samples were positive for both CHIK and dengue IgM antibodies. The most affected age group was 16-45 years. Females were more affected than males. Conclusion: The seroprevalence of CHIK among the suspected cases was 25.7%. Co-infection with CHIK and dengue was found to be 1.15%. The infection had spread to new areas during this outbreak. PMID:24479040

Crisis & Commitment: 150 Years of Service by Los Angeles County Public Hospitals

PubMed Central

Cousineau, Michael R.; Tranquada, Robert E.

2007-01-01

The Los Angeles County University of Southern California Medical Center will open soon, replacing the county’s current 74-year-old facility with a modern, although smaller, facility. Los Angeles County has provided hospital care to the indigent since 1858, during which time, the operation of public hospitals has shifted from a state-mandated welfare responsibility to a preeminent part of the county’s public health mission. As this shift occurred, the financing of Los Angeles County hospitals changed from primarily county support to state and federal government sources, particularly Medicaid. The success of the new hospital will depend on whether government leaders at all levels provide the reforms needed to help the county and its partners stabilize its funding base. PMID:17329642

Prevalence of depressive symptoms and work-related risk factors among nurses in public hospitals in southern China: a cross-sectional study.

PubMed

Gong, Yanhong; Han, Tieguang; Yin, Xiaoxv; Yang, Guoan; Zhuang, Runsen; Chen, Yuqi; Lu, Zuxun

2014-11-27

Poor mental health among nurses not only hinders professional performance but also affects the quality of healthcare provided. To improve the prevention and management of depression among nurses in mainland China, we investigated the association between working conditions and depressive symptoms using a cross-sectional study with a sample of 3474 nurses with more than 1 year of work experience in public hospitals in Shenzhen in southern China. Participants completed a structured questionnaire and a validated measure of depressive symptoms. Multivariable linear mixed models were used to identify work-related risk factors for depressive symptoms scores. An estimated 38% of nurses had depressive symptoms. More than 10% of the nurses often experienced workplace violence, and 64.22% encountered it occasionally. Depressive symptoms were associated with frequent workplace violence, long working hours (more than 45 hours per week), frequent night shifts (two or more per week), and specific departments. These findings indicate that interventions to minimize workload and improve nurse-patient relationships are essential to combat depressive symptoms among nurses. Additionally, in the prevention and management of depression among nurses, we must consider inter-department differences.

[Hospital self-management policy in Chile: perceptions of decision-makers].

PubMed

Méndez, Claudio A; Miranda, Christian; Torres, M Cristina; Márquez, Myriam

2013-01-01

To learn the perceptions of decision-makers concerning the imple-men-t-ation stage of a hospital self-management policy in two highly complex hospitals in southern Chile. A descriptive, exploratory, qualitative study based on semi-structured in-depth interviews of decision-makers at the Regional Hospital of Valdivia and the Hospital San José de Osorno from August 2010 to December 2011. A convenience sample of 26 decision-makers was selected. The 26 interviews were recorded and transcribed verbatim. The information was analyzed using inductive content analysis. The interviewees consider the concept of self-management to be determined by autonomy in decision-making about resource allocation and the financing of health service delivery in the hospitals. They also stated that human resources and financing policies should be included to improve the implementation stage. They related weaknesses with the lack of organizational capabilities and managerial skills in the health teams implementing the changes. Conceptually, the hospital self-management policy is based on financial autonomy, and implementation is affected by persistent capacity gaps in policy design.

Cystic echinococcosis in Southern Israel.

PubMed

Ben-Shimol, Shalom; Sagi, Orli; Houri, Ohad; Bazarsky, Elina; Berkowitz, Anat; Bulkowstein, Shlomi; Barrett, Chiya; Greenberg, David

2016-01-01

The aim of this retrospective, population-based study was to characterize demographically and clinically cystic-echinococcosis (CE) in southern Israel, between 2005 and 2012. Newly-diagnosed (nd-CE) and past-diagnosed (pd-CE, diagnosed before the study) cases were defined. Two populations live in southern-Israel, receiving medical treatment at a single hospital: the Jewish and the Bedouin populations (resembling resource-rich and resource-poor populations, respectively). 126 CE cases were identified; 55 nd-CE and 71 pd-CE. Mean annual nd-CE incidence per 100,000 in the Bedouin and Jewish populations were 2.7 ± 1.2 and 0.4 ± 0.3, respectively (P<0.001). None of the Bedouin and 86.5% of the Jewish patients were born outside Israel. Liver and lung involvement were recorded in 85.7% and 15.1% of overall-CE, respectively. Abdominal pain, cough, fever, eosinophilia and asymptomatic disease were documented in 63.6%, 32.7%, 27.3%, 41.5% and 12.7% of nd-CE, respectively. Serology sensitivity for first test and any positive test were 67.3% and 83.3%, respectively. Computed tomography, ultrasonography and X-ray diagnosis were documented in 79.2%, 58.4% and 17.0% of overall-CE, respectively, with ultrasonography mainly used in liver-CE and X-ray in lung-CE. Treatment included surgery and albendazole in 50.0% and 55.3% of CE, respectively. We conclude that CE is endemic in southern-Israel among the Bedouin population, while disease is probably mainly imported in the Jewish population. Liver involvement and eosinophilia rates were high compared with those of other endemic regions, possibly due to differences in the timing of diagnosis. These findings may help developing treatment and prevention strategies.

The effects of for-profit multihospital system ownership on hospital financial and operating performance.

PubMed

Lynch, J R; McCue, M J

1990-11-01

The financial and operating performance of independent not-for-profit hospitals acquired by US for-profit multi-hospital systems in 10 Southern states between the years 1978 and 1982 was explored. The impact of system ownership on acquired hospitals was investigated by comparing the average financial performance of hospitals in the two years immediately prior to acquisition to the average for 1984 and 1985 and by comparing changes in the performance of acquired hospitals with changes in matched independent facilities. Findings suggest that for-profit multi-hospital systems were able to improve many of the financial and operating problems of acquired facilities. In comparison to independent not-for-profit hospitals, acquired hospitals were found to increase access to long-term debt, make improvements to plant and equipment, improve profitability, and increase efficiency to a greater extent. Prices in acquired hospitals rose more than those in independents and liquidity decreased to a greater extent.

Rural hospital information technology implementation for safety and quality improvement: lessons learned.

PubMed

Tietze, Mari F; Williams, Josie; Galimbertti, Marisa

2009-01-01

This grant involved a hospital collaborative for excellence using information technology over 3-year period. The project activities focused on the improvement of patient care safety and quality in Southern rural and small community hospitals through the use of technology and education. The technology component of the design involved the implementation of a Web-based business analytic tool that allows hospitals to view data, create reports, and analyze their safety and quality data. Through a preimplementation and postimplementation comparative design, the focus of the implementation team was twofold: to recruit participant hospitals and to implement the technology at each of the 66 hospital sites. Rural hospitals were defined as acute care hospitals located in a county with a population of less than 100 000 or a state-administered Critical Access Hospital, making the total study population target 188 hospitals. Lessons learned during the information technology implementation of these hospitals are reflective of the unique culture, financial characteristics, organizational structure, and technology architecture of rural hospitals. Specific steps such as recruitment, information technology assessment, conference calls for project planning, data file extraction and transfer, technology training, use of e-mail, use of telephones, personnel management, and engaging information technology vendors were found to vary greatly among hospitals.

Southern Pine Beetle

Treesearch

Robert C. Thatcher; Patrick J. Barry

1982-01-01

The southern pine beetle (Dendroctonus frontalis Zimmermann) is one of pine's most destructive insect enemies in the Southern United States, Mexico, and Central America. Because populations build rapidly to outbreak proportions and large numbers of trees are killed, this insect generates considerable concern among managers of southern pine forests. The beetle...

Unusual infections due to Listeria monocytogenes in the Southern California Desert.

PubMed

Cone, Lawrence A; Somero, Michael S; Qureshi, Farsana J; Kerkar, Shuba; Byrd, Richard G; Hirschberg, Joel M; Gauto, Anibal R

2008-11-01

During the past 22 years, 14 patients have been hospitalized with infection due to Listeria monocytogenes at the Eisenhower Medical Center, a regional 300-bed hospital in the desert southwest of Southern California. A large number of patients are retired, elderly, and have underlying and often systemic disease. Blood agar and routine media were inoculated with liquid from a sterile site such as blood, cerebrospinal fluid, or joint fluid and observed daily for growth. Appropriate biochemical studies were used to speciate the organism. While bacteremia and meningitis constitute 75% of infections in most studies, they made up only 36% of patients in the current study. Listeriosis occurred mostly in patients with infected aortic aneurysms and brain abscesses, and in prosthetic joint infections. While mortality is generally stated to be around 45% in patients with listeriosis, it was 35% in this study. However, there were no deaths in five patients with bacteremia or meningitis inferring that organ involvement poses a greater hazard for survival. Listeriosis usually presents as a bacteremia or meningitis due to a food-borne invasive infection. In the desert of Southern California most cases are seen in older patients with underlying disease and present with infected aortic aneurysms, prosthetic joints, and brain abscesses. They represent a greater threat to survival due to organ involvement.

The Second Lebanon War Experience at Western Galilee Hospital.

PubMed

Lino, Bartholomew; Eisenman, Arie; Schuster, Richard; Giloni, Carlos; Bharoum, Masad; Daniel, Moshe; Dallas, Cham

2016-02-01

The summer of 2006 in northern Israel served as the battleground for the second war against Hezbollah based along Israel's border with southern Lebanon. Western Galilee Hospital (WGH), which is located only 6 miles from the Lebanese border, served as a major medical center in the vicinity of the fighting. The hospital was directly impacted by Hezbollah with a Katyusha rocket, which struck the ophthalmology department on the 4th floor. WGH was able to utilize a 450-bed underground facility that maintained full hospital functionality throughout the conflict. In a major feat of rapid evacuation, the entire hospital population was relocated under the cover of darkness to these bunkers in just over 1 hour, thus emptying the building prior to the missile impact. Over half of the patients presenting during the conflict did not incur physical injury but qualified as acute stress disorder patients. The particulars of this evacuation remain unique owing to the extraordinary circumstances, but many of the principles employed in this maneuver may serve as a template for other hospitals requiring emergency evacuation. Hospital functionality drastically changed to accommodate the operational reality of war, and many of these tactics warrant closer investigation for possible implementation in other conflict zones.

Status of infection control policies and organisation in European hospitals, 2001: the ARPAC study.

PubMed

Struelens, M J; Wagner, D; Bruce, J; MacKenzie, F M; Cookson, B D; Voss, A; van den Broek, P J; Gould, I M

2006-08-01

Patient safety in hospital care depends on effective infection control (IC) programmes. The Antimicrobial Resistance Prevention and Control (ARPAC) study assessed the organisation, components and human resources of IC programmes in European hospitals. A questionnaire survey of policies and procedures implemented in 2001 for the surveillance and control of nosocomial infection and antibiotic resistance was completed by 169 acute-care hospitals from 32 European countries, categorised by five geographical regions. A formal IC programme existed in 72% of hospitals, and a multidisciplinary IC committee was operational in 90%. Trained IC nurses (ICNs) were present in 80% of hospitals (ranging from 54% in south-east and central-eastern Europe, to 100% in northern Europe), whereas 74% had one or more trained IC doctors (ICDs) (ranging from 46% in south-east Europe to 84% in western Europe). Median staffing levels were 2.33 ICNs/1,000 beds and 0.94 ICDs/1,000 beds. The intensity of IC programmes scored higher in centres from northern and western Europe than from other European regions. Written guidelines promoted hand hygiene for healthcare workers in 89% of hospitals, education in 85%, and audit in 46%. Guidelines recommended use of alcohol-based solutions (70%) and/or medicated/antiseptic soap (43%) for decontamination of non-soiled hands. Use of alcohol-based solutions varied according to region, from 41% in southern Europe to 100% in northern Europe, compared with use of medicated soap from 77% in southern Europe to 11% in northern Europe (p < 0.01). These findings showed that IC programmes in European hospitals suffer from major deficiencies in human resources and policies. Staffing levels for ICNs were below recommended standards in the majority of hospitals. Education programmes were incomplete and often not supported by audit of performance. Hand hygiene procedures were sub-standard in one-third of centres. Strengthening of IC policies in European hospitals should

30 Years of radiotherapy service in Southern Thailand: workload vs resources.

PubMed

Phungrassami, Temsak; Funsian, Amporn; Sriplung, Hutcha

2013-01-01

To study the pattern of patient load, personnel and equipment resources from 30-years experience in Southern Thailand. This retrospective study collected secondary data from the Division of Therapeutic Radiology and Oncology and the Songklanagarind Hospital Tumor Registry database, Faculty of Medicine, Prince of Songkla University, during the period of 1982-2012. The number of new patients who had radiation treatment gradually increased from 121 in 1982 to 2,178 in 2011. Shortages of all kinds of personnel were demonstrated as compared to the recommendations, especially in radiotherapy technicians. In 2011, Southern Thailand, with two radiotherapy centers, had 0.44 megavoltage radiotherapy machines (cobalt or linear accelerator) per million of population. This number is suboptimal, but could be managed cost-effectively by prolonging machine operating times during personnel shortages. This study identified a discrepancy between workload and resources in one medical school radiotherapy center in.

Phylogeography of Recently Emerged DENV-2 in Southern Viet Nam

PubMed Central

Rabaa, Maia A.; Ty Hang, Vu Thi; Wills, Bridget; Farrar, Jeremy; Simmons, Cameron P.; Holmes, Edward C.

2010-01-01

Revealing the dispersal of dengue viruses (DENV) in time and space is central to understanding their epidemiology. However, the processes that shape DENV transmission patterns at the scale of local populations are not well understood, particularly the impact of such factors as human population movement and urbanization. Herein, we investigated trends in the spatial dynamics of DENV-2 transmission in the highly endemic setting of southern Viet Nam. Through a phylogeographic analysis of 168 full-length DENV-2 genome sequences obtained from hospitalized dengue cases from 10 provinces in southern Viet Nam, we reveal substantial genetic diversity in both urban and rural areas, with multiple lineages identified in individual provinces within a single season, and indicative of frequent viral migration among communities. Focusing on the recently introduced Asian I genotype, we observed particularly high rates of viral exchange between adjacent geographic areas, and between Ho Chi Minh City, the primary urban center of this region, and populations across southern Viet Nam. Within Ho Chi Minh City, patterns of DENV movement appear consistent with a gravity model of virus dispersal, with viruses traveling across a gradient of population density. Overall, our analysis suggests that Ho Chi Minh City may act as a source population for the dispersal of DENV across southern Viet Nam, and provides further evidence that urban areas of Southeast Asia play a primary role in DENV transmission. However, these data also indicate that more rural areas are also capable of maintaining virus populations and hence fueling DENV evolution over multiple seasons. PMID:20668540

Phylogeography of recently emerged DENV-2 in southern Viet Nam.

PubMed

Rabaa, Maia A; Ty Hang, Vu Thi; Wills, Bridget; Farrar, Jeremy; Simmons, Cameron P; Holmes, Edward C

2010-07-27

Revealing the dispersal of dengue viruses (DENV) in time and space is central to understanding their epidemiology. However, the processes that shape DENV transmission patterns at the scale of local populations are not well understood, particularly the impact of such factors as human population movement and urbanization. Herein, we investigated trends in the spatial dynamics of DENV-2 transmission in the highly endemic setting of southern Viet Nam. Through a phylogeographic analysis of 168 full-length DENV-2 genome sequences obtained from hospitalized dengue cases from 10 provinces in southern Viet Nam, we reveal substantial genetic diversity in both urban and rural areas, with multiple lineages identified in individual provinces within a single season, and indicative of frequent viral migration among communities. Focusing on the recently introduced Asian I genotype, we observed particularly high rates of viral exchange between adjacent geographic areas, and between Ho Chi Minh City, the primary urban center of this region, and populations across southern Viet Nam. Within Ho Chi Minh City, patterns of DENV movement appear consistent with a gravity model of virus dispersal, with viruses traveling across a gradient of population density. Overall, our analysis suggests that Ho Chi Minh City may act as a source population for the dispersal of DENV across southern Viet Nam, and provides further evidence that urban areas of Southeast Asia play a primary role in DENV transmission. However, these data also indicate that more rural areas are also capable of maintaining virus populations and hence fueling DENV evolution over multiple seasons.

Hospital-at-home Integrated Care Program for Older Patients With Orthopedic Processes: An Efficient Alternative to Usual Hospital-Based Care.

PubMed

Closa, Conxita; Mas, Miquel À; Santaeugènia, Sebastià J; Inzitari, Marco; Ribera, Aida; Gallofré, Miquel

2017-09-01

To compare outcomes and costs for patients with orthogeriatric conditions in a home-based integrated care program versus conventional hospital-based care. Quasi-experimental longitudinal study. An acute care hospital, an intermediate care hospital, and the community of an urban area in the North of Barcelona, in Southern Europe. In a 2-year period, we recruited 367 older patients attended at an orthopedic/traumatology unit in an acute hospital for fractures and/or arthroplasty. Patients were referred to a hospital-at-home integrated care unit or to standard hospital-based postacute orthogeriatric unit, based on their social support and availability of the resource. We compared home-based care versus hospital-based care for Relative Functional Gain (gain/loss of function measured by the Barthel Index), mean direct costs, and potential savings in terms of reduction of stay in the acute care hospital. No differences were found in Relative Functional Gain, median (Q25-Q75) = 0.92 (0.64-1.09) in the home-based group versus 0.93 (0.59-1) in the hospital-based group, P =.333. Total health service direct cost [mean (standard deviation)] was significantly lower for patients receiving home-based care: €7120 (3381) versus €12,149 (6322), P < .001. Length of acute hospital stay was significantly shorter in patients discharged to home-based care [10.1 (7)] than in patients discharged to the postacute orthogeriatric hospital-based unit [15.3 (12) days, P < .001]. The hospital-at-home integrated care program was suitable for managing older patients with orthopedic conditions who have good social support for home care. It provided clinical care comparable to the hospital-based model, and it seems to enable earlier acute hospital discharge and lower direct costs. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Analysis of the Internal Bed Regulation Committees from hospitals of a Southern Brazilian city

PubMed Central

Soares, Vinícius Sabedot

2017-01-01

ABSTRACT Objective To evaluate the composition of the Internal Regulation Committees created in hospitals of a capital city. Methods A cross-sectional descriptive study assessing the structure, processes and results of each Committee. Results The main reasons for implementing the committees were legal issues and overcrowding in the emergency department. The most monitored indicators were the occupancy rate and the mean length of stay, and the most observed results were reductions in the latter. Institutional protocols were developed in 70% of cases, and the degree of support that the Internal Regulation Committee received from the hospital managers was high, despite being only average the support received from the medical teams. Promoting the efficient use of beds seemed to be the main goal. To achieve it, the Internal Regulation Committee had to control hospital capacity at levels that allowed proper and safe bed turnover for patients. The strategies for this were varied and needed to integrate administrative and care issues. Conclusion The Internal Regulation Committees were a management tool with great potential and promising results in the experiences evaluated. PMID:29091157

Hospital markup and operation outcomes in the United States.

PubMed

Gani, Faiz; Ejaz, Aslam; Makary, Martin A; Pawlik, Timothy M

2016-07-01

Although the price hospitals charge for operations has broad financial implications, hospital pricing is not subject to regulation. We sought to characterize national variation in hospital price markup for major cardiothoracic and gastrointestinal operations and to evaluate perioperative outcomes of hospitals relative to hospital price markup. All hospitals in which a patient underwent a cardiothoracic or gastrointestinal procedure were identified using the Nationwide Inpatient Sample for 2012. Markup ratios (ratio of charges to costs) for the total cost of hospitalization were compared across hospitals. Risk-adjusted morbidity, failure-to-rescue, and mortality were calculated using multivariable, hierarchical logistic regression. Among the 3,498 hospitals identified, markup ratios ranged from 0.5-12.2, with a median markup ratio of 2.8 (interquartile range 2.7-3.9). For the 888 hospitals with extreme markup (greatest markup ratio quartile: markup ratio >3.9), the median markup ratio was 4.9 (interquartile range 4.3-6.0), with 10% of these hospitals billing more than 7 times the Medicare-allowable costs (markup ratio ≥7.25). Extreme markup hospitals were more often large (46.3% vs 33.8%, P < .001), urban, nonteaching centers (57.0% vs 37.9%, P < .001), and located in the Southern (46.4% vs 32.8%, P < .001) or Western (27.8% vs 17.6%, P < .001) regions of the United States. Of the 639 investor-owned, for-profit hospitals, 401 hospitals (62.8%) had an extreme markup ratio compared with 19.3% (n = 452) and 6.8% (n = 35) of nonprofit and government hospitals, respectively. Perioperative morbidity (32.7% vs 26.4%, P < .001) was greater at extreme markup hospitals. There is wide variation in hospital markup for cardiothoracic and gastrointestinal procedures, with approximately a quarter of hospital charges being 4 times greater than the actual cost of hospitalization. Hospitals with an extreme markup had greater perioperative morbidity. Copyright © 2016

Transfusion audit of fresh-frozen plasma in southern Taiwan.

PubMed

Yeh, C-J; Wu, C-F; Hsu, W-T; Hsieh, L-L; Lin, S-F; Liu, T-C

2006-10-01

The demand for transfusions has increased rapidly in southern Taiwan. Between 1993 and 2003, requests for fresh-frozen plasma (FFP) in particular rose dramatically at Kaohsiung Medical University Hospital (KMUH). Transfusion orders were not tightly regulated, and inappropriate use of blood products was common. We carried out a prospective analysis of transfusion requests from October 2003 to January 2004 at KMUH, and then repeated the audit for another 3-month period after the clinical faculty had undergone five sessions of education on transfusion guidelines. Later, our consultant haematologist applied computerized guidelines to periodic audits. A 5.2% decrease in inappropriate FFP usage followed the educational programme and a further 30% reduction took place after the application of computerized transfusion guidelines. With the guidelines and periodic audits, FFP transfusions decreased by 74.6% and inappropriate requests from 65.2% to 30%. Hospital policy, computerized transfusion guidelines and periodic audits greatly reduced inappropriate FFP transfusions. An educational campaign had a more limited effect.

Southern Living and Southern Voices: Models of Regional Magazine Success and Failure.

ERIC Educational Resources Information Center

English, John W.

This paper examines the phenomenon of magazine success and failure as demonstrated by two regional magazines, "Southern Living" and "Southern Voices." The former, a combination of articles about food, travel, sports, and other positive aspects of southern life, was quickly accepted by its readers and advertisers and began…

Ciguatera fish poisoning. A southern California epidemic.

PubMed Central

Barton, E D; Tanner, P; Turchen, S G; Tunget, C L; Manoguerra, A; Clark, R F

1995-01-01

Ciguatera fish poisoning results from the bioconcentration of a variety of toxins produced by marine dinoflagellates. Signs and symptoms vary widely, but it usually presents as gastrointestinal and neurologic complaints beginning shortly after the ingestion of fish containing the toxins. Symptoms may persist for months and sometimes even years. Although cases have been reported throughout the United States, epidemics are most common along tropical and subtropical coasts and usually involve the ingestion of large carnivorous fish. We review the literature and report the first epidemic of 25 cases of ciguatera fish poisoning presenting to area hospitals in Southern California that were successfully tracked by the Department of Health Services and isolated to fish caught off the coast of Baja California, Mexico. Images Figure 1. PMID:7667980

Differences in prevalence of parasites in stool samples between three distinct ethnic pediatric populations in southern Israel, 2007-2011.

PubMed

Ben-Shimol, Shalom; Sagi, Orli; Greenberg, David

2014-04-01

Intestinal parasites cause significant morbidity worldwide, particularly in developing populations. At least three pediatric populations reside in southern Israel: the Bedouin population, the general Jewish population and Jewish children of Ethiopian origin. Our aim was to compare intestinal parasite prevalence between the three pediatric populations in southern Israel. This is a retrospective, laboratory, population-based surveillance. Most ova and parasite (O&P) tests in southern Israel (hospital and community obtained) are performed by the hospital parasitology laboratory. All pediatric stool O&P tests examined by the hospital laboratory between 2007 and 2011 were included. Overall, 45,978 samples were examined; 27,354, 16,969 and 1655 from Bedouin, non-Ethiopian Jewish and Ethiopian children, respectively. 16,317 parasites were identified in 12,325 (26.8%) positive samples. Total prevalences were 36%, 11% and 46% for Bedouin, non-Ethiopian Jewish and Ethiopian children, respectively. Blastocystis hominis, Giardia lamblia and Entamoeba species were the most common parasites identified, constituting ≥80% of positive samples in all groups. Hymenolepis nana was rarely identified in non-Ethiopian Jewish children (0.04% of isolates compared with 2.6% and 0.5% in Bedouin and Ethiopian children, respectively). Other helminths, excluding H. nana and Enterobius vermicularis, were identified almost exclusively in Ethiopian children ≥5years of age. In conclusion, the Bedouin and Ethiopian children were characterized by higher parasite prevalence in stool, compared with the non-Ethiopian Jewish children, probably reflecting higher intestinal parasitic disease rates. Certain helminthic infections were identified almost exclusively in the Ethiopian children. These differences may be associated with lifestyle differences between the three populations. © 2013.

Teleradiology in southern Sweden--a tool for reorganization of health care and for education.

PubMed

Pettersson, H; Holmer, N G

1998-01-01

The county organization, including health care, is reorganized in the province of Scania in southern Sweden. As part of the restructuring of health care, a program for digitalization of the departments of diagnostic imaging, as well as for teleradiology, has been set up. Standards for network, radiology information systems, and workstations have been settled, and teleradiology links both for on-call consultations and for on-line consultations day-time have been implemented, mainly running at 10 Mb/s. Further digitalization and implementation of teleradiology is planned for the nearest years. Parallel to this, a video conference system including several disciplines, hospitals and health care levels in the whole of southern Sweden has been implemented. The links are now also used for education, both in the province and internationally.

Pre-ART retention in care and prevalence of tuberculosis among HIV-infected children at a district hospital in southern Ethiopia.

PubMed

Westerlund, Emil; Jerene, Degu; Mulissa, Zewdie; Hallström, Inger; Lindtjørn, Bernt

2014-10-04

The Ethiopian epidemic is currently on the wane. However, the situation for infected children is in some ways lagging behind due to low treatment coverage and deficient prevention of mother-to-child transmission. Too few studies have examined HIV infected children presenting to care in low-income countries in general. Considering the presence of local variations in the nature of the epidemic a study in Ethiopia could be of special value for the continuing fight against HIV. The aim of this study is to describe the main characteristics of children with HIV presenting to care at a district hospital in a resource-limited area in southern Ethiopia. The aim was also to analyse factors affecting pre-ART loss to follow-up, time to ART-initiation and disease stage upon presentation. This was a prospective cohort study. The data analysed were collected in 2009 for the period January 2003 through December 2008 at Arba Minch Hospital and additional data on the ART-need in the region were obtained from official reports. The pre-ART loss to follow-up rate was 29.7%. Older children (10-14 years) presented in a later stage of their disease than younger children (76.9% vs. 45.0% in 0-4 year olds, chi-square test, χ2 = 8.8, P = 0.01). Older girls presented later than boys (100.0% vs. 57.1%, Fisher's exact test, P = 0.02). Children aged 0-4 years were more likely to be lost to follow-up (40.0 vs. 21.8%, chi-square test, χ2 = 5.4, P = 0.02) and had a longer time to initiate ART (Cox regression analysis, HR: 0.50, 95% CI: 0.25-0.97, P = 0.04, controlling for sex, place of residence, enrollment phase and WHO clinical stage upon presentation). Neither sex was overrepresented in the sample. Tuberculosis prevalence upon presentation and previous history of tubercolosis were 14.5% and 8% respectively. The loss to follow-up is alarmingly high and children present too late. Further research is needed to explore specific causes and possible solutions.

Investigation of antimicrobial use at a tertiary care hospital in Southern Punjab, Pakistan using WHO methodology.

PubMed

Atif, Muhammad; Azeem, Muhammad; Saqib, Anum; Scahill, Shane

2017-01-01

Globally, between 20 to 50% of antimicrobial consumption is inappropriate, causing significant impact on the quality of care, cost of therapy and incidence of adverse drug reactions. The purpose of this study was to investigate the prescribing patterns and utilization of antimicrobials in ten selected wards at Bahawal Victoria Hospital (BVH), Bahawalpur, Punjab, Pakistan. A descriptive cross-sectional study was designed using the World Health Organization (WHO) indicators for antimicrobial use. Standard data collection forms were used in ten wards and the Pharmacy Department at BVH. Antimicrobial utilization patterns in terms of frequency and percentage were also determined. Systematic random sampling techniques were used to collect data from 1,000 prescription records out of 21,115 prescriptions written for the six months January to June 2016. For the hospital indicators, a formulary list or essential medicines list (FL/EML) was available, but standard treatment guidelines (STGs) for infectious diseases was not. The average number of days that key antimicrobials were out of stock was 3.3 days per month. The expenditure on antimicrobials as a percentage of the total medicines costs was 12.2%. For the prescribing indicators, the percentage of hospitalizations with antimicrobial(s) prescribed was 82.3%, and the average number of antimicrobials per hospitalization was 1.4 (SD = 0.6). The average duration of antimicrobial treatment per hospitalization was 5.4 days (SD = 3.2). The average cost of antimicrobials prescribed per hospitalization was USD 5.4 (SD = 6.7). None of the patients who were prescribed antimicrobials, received AM according to the STGs (pneumonia and cesarean section cases). Among the patient-care and supplemental indicators, the average duration of hospital stay of patients who received antimicrobials was 6.4 (SD = 4.3) days. The drug sensitivity testing was almost non-existent, with only 0.24% prescription records having drug

Increasing Prevalence of Hepatitis C among Hospitalized Children Is Associated with an Increase in Substance Abuse.

PubMed

Barritt, A Sidney; Lee, Brian; Runge, Thomas; Schmidt, Monica; Jhaveri, Ravi

2018-01-01

To evaluate the impact of substance abuse on pediatric hepatitis C virus (HCV) prevalence, we examined geographic and demographic data on inpatient hospitalizations in children with HCV. We examined hospitalizations in children using the Kids' Inpatient Database, a part of the Healthcare Cost and Utilization Project. We identified cases using the International Classification of Diseases, 9th edition, codes for HCV infection during 2006, 2009, and 2012. Nonparametric tests for trend were used to calculate trend statistics. From 2006 to 2012 nationally, the number of hospitalizations of children with HCV increased 37% (2.69 to 3.69 per 10 000 admissions; P < .001). The mean age of children hospitalized was 17.6 years (95% CI, 17.4-17.8). HCV cases among those 19-20 years of age represented 68% of the total HCV diagnoses, with a 54% increase over the years sampled (P < .001 for trend). The burden of HCV in children was highest in whites, those in the lowest income quartile, and in the Northeast and Southern regions of the US (all P < .0001). The prevalence of substance use among children with HCV increased from 25% in 2006 to 41% in 2012 (P < .001). The increases of HCV in hospitalized children are largely in teenagers, highly associated with substance abuse, and concentrated in Northeast and Southern states. These results strongly suggest that public health efforts to prevent and treat HCV will also need to include adolescents. Copyright © 2017 Elsevier Inc. All rights reserved.

76 FR 35508 - Alabama Southern Railroad, L.L.C.-Temporary Trackage Rights Exemption-Norfolk Southern Railway...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-17

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [Docket No. FD 35510] Alabama Southern Railroad, L.L.C.--Temporary Trackage Rights Exemption--Norfolk Southern Railway Company Norfolk Southern... grant nonexclusive overhead temporary trackage rights to Alabama Southern Railroad, L.L.C. (ABS) over a...

Southern Pine Beetle Information System (SPBIS)

Treesearch

Valli Peacher

2011-01-01

The southern pine beetle (SPB) is the most destructive forest insect in the South. The SPB attacks all species of southern pine, but loblolly and shortleaf are most susceptible. The Southern Pine Beetle Information System (SPBIS) is the computerized database used by the national forests in the Southern Region for tracking individual southern pine beetle infestations....

Infants 1-90 days old hospitalized with human rhinovirus infection.

PubMed

Bender, Jeffrey M; Taylor, Charla S; Cumpio, Joven; Novak, Susan M; She, Rosemary C; Steinberg, Evan A; Marlowe, Elizabeth M

2014-09-01

Human rhinovirus (HRV) is a common cause of respiratory illness in children. The impact of HRV infection on 1- to 90-day-old infants is unclear. We hypothesized that HRV infection would be clinically similar to respiratory syncytial virus (RSV) infection in the hospitalized infants. We conducted a retrospective study of hospitalized infants, who were 1-90 days old, with HRV or RSV within the Southern California Kaiser Permanente network over a 1-year period (August 2010 to October 2011). We identified 245 hospitalized infants who underwent respiratory virus testing. HRV was found in 52 infants (21%) compared to 79 infants (32%) with RSV (P = 0.008). Infants with HRV infection experienced longer hospital stays compared to those with RSV (median length of stay 4 days vs. 3 days, P = 0.009) and had fewer short hospital stays ≤3 days (P = 0.029). There was a trend in infants with HRV infection to be younger (P = 0.071) and have more fevers (P = 0.052). Recent advances in diagnostics allow for identification of a broad range of viral pathogens in infants. Compared to RSV, HRV was associated with longer hospital stays. Additional studies and improved, more specific testing, methods are needed to further define the effects of HRV infection in infants 1-90 days old. © 2014 Wiley Periodicals, Inc.

Southern Pine Beetle Competitors

Treesearch

Fred M. Stephen

2011-01-01

When southern pine beetles mass attack a living pine tree, if colonization is successful the tree dies and its phloem becomes immediately available to a complex of other bark beetles and long-horned beetles, all of which, in order to reproduce, compete for the new resource. In southern pines the phloem-inhabiting guild is composed of the southern pine beetle...

[Effect of hospital policies on patient mobility: Siennese experience].

PubMed

Messina, G G; Addari, P; Macchi, C; Nante, N

2005-01-01

The Italian National Health Service (S.S.N.), adopted in 1978 (Law n 833) and based on Beveridge's model, emphasises the citizens freedom to choose and the equal opportunity in accessing health care structures. Local Health Authorities--L.H.A. (U.S.L.--Unità Sanitarie Locali) become owners of almost all the structures in their territories and directly responsible for the satisfaction of all residents health needs. The former hospitals' network, based on independent first, second and third level public hospitals, in potential competition, was dismantled. Hospitals' financing, the main economic role of the S.S.N., was based on the documented running expenses: therefore the hospital interest to attract patients diminished and expenses increased in a uncontrolled way. In 1992, the Italian Government, (re)introduced (Law n 502) the quasi-market administered competition between Italian hospitals, making the major ones independent (Aziende Ospedaliere--A.O.) from the L.H.A. Hospital income from then is based on DRGs; the L.H.A. (and hospitals) leadership is now entrusted to managers and not politicians. We describe now how these changes were experienced by our hospital (A.O. Senese), placed in Southern Tuscany, Italy. We elaborated hospitalisation data regarding residents in the province of Siena (252,000 inhabitants) and activity data regarding its main hospital (A.O. Senese, 1200 beds, 47,000 admissions/year). Using the Gandy's Nomogram, we show the variation of patients mobility from 1988 to 1999. Our survey demonstrates that the Italian hospital system answers well enough to the legislative regulations: following the Law 833/1978 our hospital diminished its ability to attract patients from other areas; at the same time migrations of hospitals patients from Siena increased. Following the Law 502/1992, the power of attraction of our hospital is increased. Nevertheless the flow of escape continued to increase. It appears that to discourage the attraction power means to

The financial impact and drivers of hospital charges in contralateral prophylactic mastectomy and reconstruction: a Nationwide Inpatient Sample hospital analysis.

PubMed

Bucknor, Alexandra; Chattha, Anmol; Ultee, Klaas; Wu, Winona; Kamali, Parisa; Bletsis, Patrick; Chen, Austin; Lee, Bernard T; Cronin, Claire; Lin, Samuel J

2017-09-01

Rates of contralateral prophylactic mastectomy (CPM) have increased over the last decade; it is important for surgeons and hospital systems to understand the economic drivers of increased costs in these patients. This study aims to identify factors affecting charges in those undergoing CPM and reconstruction. Analysis of the Healthcare Cost and Utilization Project National Inpatient Sample was undertaken (2009-2012), identifying women aged ≥18 with unilateral breast cancer undergoing unilateral mastectomy with CPM and immediate breast reconstruction (IBR) (CPM group), in addition to unilateral mastectomy and IBR alone (UM group). Generalized linear modeling with gamma regression and a log-link function provided mean marginal hospital charge (MMHC) estimates associated with the presence or absence of patient, hospital and operative characteristics, postoperative complications, and length of stay (LOS). Overall, 70,695 women underwent mastectomy and reconstruction for unilateral breast cancer; 36,691 (51.9%) in the CPM group, incurring additional MMHCs of $20,775 compared to those in the UM group (p < 0.001). In the CPM group, MMHCs were reduced in those aged >60 years (p < 0.001), while African American or Hispanic origin increased MMHCs (p < 0.001). Diabetes, depression, and obesity increased MMHCs (p < 0.001). MMHCs increased with larger (p < 0.001) hospitals, Western location (p < 0.001), greater household income (p < 0.001), complications (p < 0.001), and increasing LOS (p < 0.001). MMHCs decreased in urban teaching hospitals and Midwest or Southern regions (p < 0.001). There are many patient and hospital factors affecting charges; this study provides surgeons and hospital systems with transparent, quantitative charge data in patients undergoing contralateral prophylactic mastectomy and immediate breast reconstruction.

Seasonal variation and trends in stroke hospitalizations and mortality in a South American community hospital.

PubMed

Díaz, Alejandro; Gerschcovich, Eliana Roldan; Díaz, Adriana A; Antía, Fabiana; Gonorazky, Sergio

2013-10-01

Numerous studies have reported the presence of temporal variations in biological processes. Seasonal variation (SV) in stroke has been widely studied, but little data have been published on this phenomenon in the Southern Hemisphere, and there have been no studies reported from Argentina. The goals of the present study were to describe the SV of admissions and deaths for stroke and examine trends in stroke morbidity and mortality over a 3-year period in a community hospital in Argentina. Hospital discharge reports from the electronic database of vital statistics between 1999 and 2001 were examined retrospectively. Patients who had a main discharge diagnosis of stroke (ischemic or hemorrhagic) or cerebrovascular accident (International Classification of Diseases, Ninth Revision codes 431, 432, 434, and 436) were selected. The study sample included 1382 hospitalizations by stroke (3.5% of all admissions). In-hospital mortality demonstrated a winter peak (25.5% vs 17% in summer; P = .001). The crude seasonal stroke attack rate (ischemic and hemorrhagic) was highest in winter (164 per 100,000 population; 95% CI, 159-169 per 100,000) and lowest in summer (124 per 100,000; 95% CI, 120-127 per 100,000; P = .008). Stroke admissions followed a seasonal pattern, with a winter-spring predominance (P = .008). Our data indicate a clear SV in stroke deaths and admissions in this region of Argentina. The existence of SV in stroke raises a different hypothesis about the rationale of HF admissions and provides information for the organization of care and resource allocation. Copyright © 2013 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Cancer incidence in Songkhla, southern Thailand, 1990-1994.

PubMed

Thongsuksai, P; Sriplung, H; Phungrassami, T; Prechavittayakul, P

1997-01-01

A population-based cancer registry of Songkhla was established by the Cancer Unit of Songklanagarind Hospital under the support of the IARC in 1990. The province is in the southern region of Thailand and has a population of 1.2 million. This study presents the average annual incidence rate of the provincial total and of the district level covering 1990-1994. It is aimed at providing a comprehensive picture of descriptive epidemiology of cancer in the province. Data were collected from all hospitals in the provinces. Analysis was done under the program provided by IARC. There were 3,973 invasive cancer cases in the period. The age-standardized rate for all cancers was 116.7 in males and 88.7 in females. Lung, oral cavity, liver, and esophagus were the main leading sites in males while the cervix and breast were outstanding in females. By comparison, the incidence of most cancers were lower than other registries in Thailand except for two cancer sites. The incidence of male oral cavity and esophagus cancers in males (ASR 10.7 and 8.5 respectively) were considerably higher. Na Mom, Hat Yai, Sadao and Muang were districts having a high incidence of cancer.

Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance

PubMed Central

Huang, Qiu Sue; Turner, Nikki; Baker, Michael G; Williamson, Deborah A; Wong, Conroy; Webby, Richard; Widdowson, Marc-Alain

2015-01-01

The 2009 influenza A(H1N1)pdm09 pandemic highlighted the need for improved scientific knowledge to support better pandemic preparedness and seasonal influenza control. The Southern Hemisphere Influenza and Vaccine Effectiveness Research and Surveillance (SHIVERS) project, a 5-year (2012–2016) multiagency and multidisciplinary collaboration, aimed to measure disease burden, epidemiology, aetiology, risk factors, immunology, effectiveness of vaccination and other prevention strategies for influenza and other respiratory infectious diseases of public health importance. Two active, prospective, population-based surveillance systems were established for monitoring influenza and other respiratory pathogens among those hospitalized patients with acute respiratory illness and those enrolled patients seeking consultations at sentinel general practices. In 2015, a sero-epidemiological study will use a sample of patients from the same practices. These data will provide a full picture of the disease burden and risk factors from asymptomatic infections to severe hospitalized disease and deaths and related economic burden. The results during the first 2 years (2012–2013) provided scientific evidence to (a) support a change to NZ's vaccination policy for young children due to high influenza hospitalizations in these children; (b) contribute to the revision of the World Health Organization's case definition for severe acute respiratory illness for global influenza surveillance; and (c) contribute in part to vaccine strain selection using vaccine effectiveness assessment in the prevention of influenza-related consultations and hospitalizations. In summary, SHIVERS provides valuable international platforms for supporting seasonal influenza control and pandemic preparedness, and responding to other emerging/endemic respiratory-related infections. PMID:25912617

Social Networking Family of Caregivers during Hospitalization of Children.

PubMed

Menezes, Marina; Moré, Carmen Leontina Ojeda Ocampo; Barros, Luísa

2016-06-01

To identify and analyze the significant networks of family, social and hospital support described by the family caregivers of hospitalized children 5-12 years during the hospital stay. Descriptive study, exploratory and qualitative study conducted with 20 caregivers of children hospitalized in a hospital in a city in southern Brazil, through semi-structured interviews and significant social networks maps, tailored to the hospital setting. Data analysis showed that the most active social network was comprised of families through emotional support, material aid and services. Relations with hospital health care team and the hospital context were cited as providing support to the caregivers of the hospitalized child. The identification of social networks in the child's hospitalization course enables equip professionals working in the institution aiming at better targeting of actions and care for the family and hospitalized children. Identificar e analisar as redes significativas de suporte familiar, social e hospitalar descritas pelos familiares acompanhantes de crianças hospitalizadas de 5 a 12 anos, durante o período de internação. Estudo descritivo, exploratório e de cunho qualitativo realizado com 20 acompanhantes de crianças hospitalizadas em uma unidade hospitalar em uma cidade do Sul do Brasil, por meio de entrevistas semiestruturadas e dos Mapas de Redes sociais significativas, adaptado para o contexto hospitalar. A análise dos dados demonstrou que a rede social mais atuante foi composta por familiares, através de apoio emocional, ajuda material e de serviços. As relações com a equipe de saúde do hospital e com o contexto hospitalar foram citadas como capazes de fornecer apoio ao acompanhante da criança internada. a identificação das redes sociais no curso da hospitalização da criança possibilita instrumentalizar os profissionais que atuam na instituição objetivando um melhor direcionamento de ações e cuidados destinados à família e a

[Occupational and environmental cancer in southern Sardinia: a survey on ten years of hospitalizations].

PubMed

Argiolas, F; Marras, V; Porcu, S; Senis, G; Saderi, L; Spada, L; Santus, S; Coppola, R C; Cocco, P; Campagna, M; Steri, G

2012-01-01

Based on hospital discharges in 1001-2010, we calculated risk of tumours with an elevated occupational and environmental etiological fraction by health district of residence within the Local Health Unit (LHU) N. 8 of Sardinia. With reference to the age and gender-specific hospitalization rates of the whole LHU, residents in the urban Cagliari health district showed an excess risk of haemolymphopoietic cancer (RR = 1.07; 95% CI 1.03-1.12) and bladder cancer (RR = 1.10; 95% CI 1.05-1.16); in both instances, risks were higher among female residents. The highest excess risk for lung cancer was observed among residents in the Quartu-Parteolla health district (RR = 1.13; 95% CI 1.05-1.21), and it was slightly higher among male residents. The results appear to confirm the role of urban factors in increasing cancer risk.

Factors affecting the labor efficiency of hospital-based blood bank laboratories.

PubMed

Lam, H C; Kominski, G F; Petz, L D; Sofaer, S

1994-09-01

A variety of financing mechanisms and managerial innovations have been developed in the past decade to control hospital costs. Some evidence suggests that those changes have not produced substantial improvements in labor efficiency among employees in the hospital's technical level, such as in the blood bank laboratories. This study measured labor efficiency in 40 hospital-based blood bank laboratories in Southern California during the year from July 1989 to June 1990 and explored the impact of financial, managerial, and operational factors on labor efficiency. With standardized output measures used in all blood bank laboratories, a wide variation of labor efficiency was found. Multivariate analyses indicate that the labor efficiency of blood bank employees was not influenced by organizational financial incentives, but was affected by the managerial styles of blood bank managers. Interpretation of the findings suggests that labor efficiency is affected by operational designs intended to improve responses to variable workloads and reduce slack time.

Adapting and Implementing a Community Program to Improve Retention in Care among Patients with HIV in Southern Haiti: "Group of 6".

PubMed

Naslund, John A; Dionne-Odom, Jodie; Junior Destiné, Cléonas; Jogerst, Kristen M; Renold Sénécharles, Redouin; Jean Louis, Michelande; Desir, Jasmin; Néptune Ledan, Yvette; Beauséjour, Jude Ronald; Charles, Roland; Werbel, Alice; Talbot, Elizabeth A; Joseph, Patrice; Pape, Jean William; Wright, Peter F

2014-01-01

Objective. In Mozambique, a patient-led Community ART Group model developed by Médecins Sans Frontières improved retention in care and adherence to antiretroviral therapy (ART) among persons with HIV. We describe the adaptation and implementation of this model within the HIV clinic located in the largest public hospital in Haiti's Southern Department. Methods. Our adapted model was named Group of 6. Hospital staff enabled stable patients with HIV receiving ART to form community groups with 4-6 members to facilitate monthly ART distribution, track progress and adherence, and provide support. Implementation outcomes included recruitment success, participant retention, group completion of monthly monitoring forms, and satisfaction surveys. Results. Over one year, 80 patients from nine communities enrolled into 15 groups. Six participants left to receive HIV care elsewhere, two moved away, and one died of a non-HIV condition. Group members successfully completed monthly ART distribution and returned 85.6% of the monthly monitoring forms. Members reported that Group of 6 made their HIV management easier and hospital staff reported that it reduced their workload. Conclusions. We report successful adaptation and implementation of a validated community HIV-care model in Southern Haiti. Group of 6 can reduce barriers to ART adherence, and will be integrated as a routine care option.

Hypodermoclysis therapy. In a chronic care hospital setting.

PubMed

Worobec, G; Brown, M K

1997-06-01

Occasionally, elderly patients experience acute, episodic incidents of illness that result in dehydration or a high potential for dehydration (e.g., flu, diarrhea). At times, patients may be unable, or refuse, to take fluids orally. Enteral routes via a nasogastric tube or enteral stomach tube may also not be available. In the past, these patients often had to be transferred from home or long-term care facilities to an acute care hospital for intravenous therapy. A transfer of the acutely ill elderly patient to an acute care hospital is often very stressful to the patient and his/her family and is costly to the health care delivery system. Hypodermoclysis, the process of rehydrating a patient by providing isotonic fluids into the subcutaneous tissues over a short time period, provides an alternative method to deal with acute, short-term fluid deficit problems in the elderly. Hypodermoclysis therapy can be administered in a chronic care setting thus potentially decreasing the need to transfer the elderly client to an acute care hospital. The purpose of this study was to investigate the use of hypodermoclysis therapy in solving acute, or potentially acute fluid deficit problems, that were anticipated to be both reversible and short term in nature. This was carried out in an elderly population that resided in a 284-bed chronic care hospital in southern Ontario.

[The family in the Pediatric Unit: living with rules and hospital routines].

PubMed

Xavier, Daiani Modernel; Gomes, Giovana Calcagno; Santos, Silvana Sidney Costa; Lunardi, Valéria Lerch; Pintanel, Aline Campelo; Erdmann, Alacoque Lorenzini

2014-01-01

The study aimed to know, in Foucault's view, how the family caregiver of the child deals with the rules and routines in the hospital. Descriptive qualitative study, conducted in the second half of 2011. It had the Grounded Theory as methodological framework. It was developed in the pediatric unit of a university hospital in southern Brazil, with eighteen family caregivers. The data collection was performed by semi-structured interviews and the analysis through open, axial and selective coding. It was noticed that the family tends to conform to such rules and routines in the hospital, but recognizes the importance of its flexibility, exercising endurance, as dialoguing, or as trespassing such rules and routines, in search of autonomy, when they realize that these do not address their needs. It is important to use rules and routines to enable the family practices and spaces of freedom, autonomy and resistance.

77 FR 17122 - Indiana Southern Railroad, LLC-Temporary Trackage Rights Exemption-Norfolk Southern Railway Company

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-23

... Railroad, LLC--Temporary Trackage Rights Exemption--Norfolk Southern Railway Company Norfolk Southern Railway Company (NSR), pursuant to a written trackage rights agreement (Agreement), has agreed to grant overhead temporary trackage rights to Indiana Southern Railroad, LLC (ISRR) over NSR's line of railroad...

Fertilizing Southern Hardwoods

Treesearch

W. M. Broadfoot; A. F. Ike

1967-01-01

If present trends continue, fertilizing may soon be economically feasible in southern hardwood stands. Demands for the wood are rising, and the acreage alloted for growing it is steadily shrinking. To supply anticipated requests for information, the U. S. Forest Service has established tree nutrition studies at the Southern Hardwoods Laboratory in Stoneville,...

Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland

PubMed Central

Kołpa, Małgorzata; Wałaszek, Marta; Gniadek, Agnieszka; Wolak, Zdzisław; Dobroś, Wiesław

2018-01-01

Healthcare-associated infections (HAIs) occurring in patients treated in an intensive care unit (ICU) are serious complications in the treatment process. Aetiological factors of these infections can have an impact on treatment effects, treatment duration and mortality. The aim of the study was to determine the prevalence and microbiological profile of HAIs in patients hospitalized in an ICU over a span of 10 years. The active surveillance method was used to detect HAIs in adult patients who spent over 48 h in a general ICU ward located in southern Poland between 2007 and 2016. The study was conducted in compliance with the methodology recommended by the Healthcare-associated Infections Surveillance Network (HAI-Net) of the European Centre for Disease Prevention and Control (ECDC). During the 10 years of the study, 1849 patients hospitalized in an ICU for a total of 17,599 days acquired 510 with overall HAIs rates of 27.6% and 29.0% infections per 1000 ICU days. Intubation-associated pneumonia (IAP) posed the greatest risk (15.2 per 1000 ventilator days), followed by CLA-BSI (8.0 per 1000 catheter days) and CA-UTI (3.0 per 1000 catheter days). The most common isolated microorganism was Acinetobacter baumannii (25%) followed by Coagulaase-negativ staphylococci (15%), Escherichia coli (9%), Pseudomonas aeruginosa (8%), Klebsiella pneumoniae (7%), Candida albicans (6%). Acinetobacter baumannii in 87% and were classified as extensive-drug resistant (XDR). In summary, in ICU patients pneumonia and bloodstream infections were the most frequently found. Acinetobacter baumannii strains were most often isolated from clinical materials taken from HAI patients and showed resistance to many groups of antibiotics. A trend of increasing resistance of Acinetobacter baumannii to carbapenems was observed. PMID:29324651

Service quality assessment of a referral hospital in southern Iran with SERVQUAL technique: patients' perspective.

PubMed

Aghamolaei, Teamur; Eftekhaari, Tasnim Eghbal; Rafati, Shideh; Kahnouji, Kobra; Ahangari, Shamsieh; Shahrzad, Mohammad Esmaeil; Kahnouji, Ataollah; Hoseini, Seyedeh Hamideh

2014-07-27

Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. According to the results, this hospital was not able to meet patients' expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients.

Hospitalization due to drug use did not change after a decade of the Psychiatric Reform

PubMed Central

Balbinot, Alexandre Dido; Horta, Rogério Lessa; da Costa, Juvenal Soares Dias; Araújo, Renata Brasil; Poletto, Simone; Teixeira, Marina Bressaneli

2016-01-01

ABSTRACT OBJECTIVE To investigate whether the psychiatric hospitalization rates due to use of psychoactive substances and average time of hospitalization suffered any changes after the first decade of effective implementation of the psychiatric reform in Brazil. METHODS This article examines the evolution of hospitalizations due to disorders arising from the use of alcohol or other substances in the state of Santa Catarina, Southern Brazil, from 2000 to 2012. This is an ecological, time-series study, which uses data from admissions obtained by the Informatics Service of the Brazilian Unified Health System. Hospitalization rates by 100,000 inhabitants and average time of occupancy of beds were estimated. Coefficients of variation of these rates were estimated by Poisson Regression. RESULTS The total and male hospitalization rates did not vary (p = 0.056 and p = 0.244, respectively). We observed an increase of 3.0% for the female sex (p = 0.049). We did not observe any significant variation for occupancy time of beds. CONCLUSIONS The deployment of services triggered by the Brazilian psychiatric reform was not accompanied by a reduction of hospitalization rates or mean occupancy time of hospitalized patients during this first decade of implementation of the reform. PMID:27253902

Southern Pine Bark Beetle Guild

Treesearch

T. Evan Nebeker

2011-01-01

Dendroctonus frontalis (southern pine beetle), D. terebrans (black turpentine beetle), Ips avulsus (small southern pine engraver or four-spined engraver), I. grandicollis (five-spined engraver), and I. calligraphus (six-spined engraver) comprise the southern pine bark beetle guild. Often they are found sharing the same hosts in the Southeastern United States. They...

Southern cascades bioregion

Treesearch

Carl N. Skinner; Alan H. Taylor

2006-01-01

The Cascade Range extends from British Columbia, Canada, south to northern California where it meets the Sierra Nevada. The Southern Cascades bioregion in California is bounded on the west by the Sacramento Valley and the Klamath Mountains, and on the east by the Modoc Plateau and Great Basin. The bioregion encompasses the Southern Cascades section of Miles and Goudey...

Impact of seasonality and annual immunization of elderly people upon influenza-related hospitalization rates.

PubMed

Cruzeta, Alana Patrício Stols; Schneider, Ione Jayce Ceola; Traebert, Jefferson

2013-12-01

The objective of this study was to estimate the impact of seasonality and immunization on hospitalization rates of elderly people in a southern Brazilian state. An epidemiological study of ecological design, combining time-series in the period 1995-2009, was carried out. The medical records of individuals residing in Santa Catarina aged≥60 years were obtained from the Hospital Information System of the Brazilian National Health System. Multiple linear regression analysis was used to calculate the impact exerted by seasonality and by influenza immunization coverage on hospitalization rates. A decrease of 5.73% in the rate of hospitalization was observed in the first quarters of the years, and an increase of 8.75% in the third quarters of the years, showing the impact of seasonality. The results also showed that as the vaccination coverage rate increased 1%, a decrease of 0.1% was observed in the hospitalization rate. Seasonality and immunization had an impact on the hospitalization rates of individuals aged≥60 years in the state of Santa Catarina during the period studied. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Occurrence of hypothermia in a prehospital setting, southern Sweden.

PubMed

Kornfält, Jonas; Johansson, Anders

2010-04-01

Severe accidental hypothermia mainly affects victims of outdoor accidents. However, hypothermia can also occur in non-traumatized indoor patients. The aim of this study was to examine the occurrence of hypothermia obtained at the scene of the rescue in patients classified as priority 1 cases during two three-month periods in southern Sweden. This prospective, clinical cohort study was performed in a prehospital setting, southern Sweden. Ninety-four patients were included during two three-month periods. According to where the patients were found they were split into two groups, outdoor or indoor and then separated into three categories; general medicine-, trauma- and intoxicated patients. The environment temperature was measured on arrival according to the location where the rescue occurred and core temperatures (tympanic membrane) of patients were measured in connection with the monitoring in the ambulance before departure and at the time of arrival to the emergency room at the hospital. This study demonstrated that the only group that shows body core temperature below 36 degrees C, was the outdoor intoxication-group during the winter-period (35.7+/-1.3 degrees C). We conclude that intoxicated patients are at higher risk for hypothermia than minor trauma patients. Copyright 2009 Elsevier Ltd. All rights reserved.

Southern rim of Pacific Ocean basin: southern Andes to southern Alps

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

Dalziel, I.W.D.; Garrett, S.W.; Grunow, A.M.

1986-07-01

Between the southern Andes of Tierra del Fuego and the southern Alps of New Zealand lies the least accessible and geologically least explored part of the Pacific Ocean basin. A joint United Kingdom-United States project was initiated in 1983 to elucidate the geologic history and structure of the Pacific margin of Antarctica from the Antarctic Peninsula to Pine Island Bay at approximately lone. 105/sup 0/W. The first season (1983-1984) of this West Antarctic Tectonics Project was spent in the Ellsworth-Whitmore crustal block, and the second (1984-1985) in the Thurston Island crustal block. The project involves structural and general field geology,more » petrology, geochemistry, paleomagnetism, and airborne geophysics (magnetics and radar ice echo sounding). A final geologic season will be spent in the Pensacola Mountains of the Transantarctic Range in 1987-1988.« less

Relationship between occurrence of surgical complications and hospital finances.

PubMed

Eappen, Sunil; Lane, Bennett H; Rosenberg, Barry; Lipsitz, Stuart A; Sadoff, David; Matheson, Dave; Berry, William R; Lester, Mark; Gawande, Atul A

2013-04-17

The effect of surgical complications on hospital finances is unclear. To determine the relationship between major surgical complications and per-encounter hospital costs and revenues by payer type. Retrospective analysis of administrative data for all inpatient surgical discharges during 2010 from a nonprofit 12-hospital system in the southern United States. Discharges were categorized by principal procedure and occurrence of 1 or more postsurgical complications, using International Classification of Diseases, Ninth Revision, diagnosis and procedure codes. Nine common surgical procedures and 10 major complications across 4 payer types were analyzed. Hospital costs and revenue at discharge were obtained from hospital accounting systems and classified by payer type. Hospital costs, revenues, and contribution margin (defined as revenue minus variable expenses) were compared for patients with and without surgical complications according to payer type. Of 34,256 surgical discharges, 1820 patients (5.3%; 95% CI, 4.4%-6.4%) experienced 1 or more postsurgical complications. Compared with absence of complications, complications were associated with a $39,017 (95% CI, $20,069-$50,394; P < .001) higher contribution margin per patient with private insurance ($55,953 vs $16,936) and a $1749 (95% CI, $976-$3287; P < .001) higher contribution margin per patient with Medicare ($3629 vs $1880). For this hospital system in which private insurers covered 40% of patients (13,544), Medicare covered 45% (15,406), Medicaid covered 4% (1336), and self-payment covered 6% (2202), occurrence of complications was associated with an $8084 (95% CI, $4903-$9740; P < .001) higher contribution margin per patient ($15,726 vs $7642) and with a $7435 lower per-patient total margin (95% CI, $5103-$10,507; P < .001) ($1013 vs -$6422). In this hospital system, the occurrence of postsurgical complications was associated with a higher per-encounter hospital contribution margin for patients covered by

Appropriateness of antibiotic prescription for targeted therapy of infections caused by multidrug-resistant bacteria: assessment of the most common improper uses in a tertiary hospital in southern Italy.

PubMed

Viceconte, Giulio; Maraolo, Alberto Enrico; Iula, Vita Dora; Catania, Maria Rosaria; Tosone, Grazia; Orlando, Raffaele

2017-09-01

A huge proportion of antibiotic therapies for infections caused by multidrug-resistant bacteria (MDR) are inappropriate. In this study, we described the most common causes of inappropriateness of definitive antibiotic regimes in a large university hospital in southern Italy and we evaluated the impact on microbial eradication, length of stay, 30-day readmission and mortality. We retrospectively assessed 45 patients who received a definitive antibiotic therapy after isolation of multidrug-resistant Staphylococcus aureus, Enterococcus spp., Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp. strains between 2014 and 2015. From the literature, we set a series of criteria to retrospectively determine the appropriateness of the therapy. In all, 61% of the prescribed antibiotic regimes were found to be inappropriate, especially due to incorrect drug dosage. It emerged that meropenem was the antibiotic most frequently inappropriately used. In 46% of infections caused by MDR but not extended-spectrum β-lactamase-producing Enterobacteriaceae, carbapenems were inappropriately administered. Microbial eradication was achieved in 87% of the appropriate therapy group compared to 31% of the inappropriate therapy group (chi-square=6.750, p<0.027). No statistically significant association was found between inappropriate therapy and the length of stay (chi-square=3.084, p=0.101) and 30-day readmission (p=0.103). Definitive antibiotic therapy in infections caused by multidrug-resistant bacteria in a large university hospital is often inappropriate, especially due to the drug dosing regimen, particularly in the case of meropenem and colistin. This inappropriateness has a significant impact on post-treatment microbial eradication in specimens collected after antibiotic therapy.

Short-term effects of particulate matter constituents on daily hospitalizations and mortality in five South-European cities: results from the MED-PARTICLES project.

PubMed

Basagaña, Xavier; Jacquemin, Bénédicte; Karanasiou, Angeliki; Ostro, Bart; Querol, Xavier; Agis, David; Alessandrini, Ester; Alguacil, Juan; Artiñano, Begoña; Catrambone, Maria; de la Rosa, Jesús D; Díaz, Julio; Faustini, Annunziata; Ferrari, Silvia; Forastiere, Francesco; Katsouyanni, Klea; Linares, Cristina; Perrino, Cinzia; Ranzi, Andrea; Ricciardelli, Isabella; Samoli, Evangelia; Zauli-Sajani, Stefano; Sunyer, Jordi; Stafoggia, Massimo

2015-02-01

Few recent studies examined acute effects on health of individual chemical species in the particulate matter (PM) mixture, and most of them have been conducted in North America. Studies in Southern Europe are scarce. The aim of this study is to examine the relationship between particulate matter constituents and daily hospital admissions and mortality in five cities in Southern Europe. The study included five cities in Southern Europe, three cities in Spain: Barcelona (2003-2010), Madrid (2007-2008) and Huelva (2003-2010); and two cities in Italy: Rome (2005-2007) and Bologna (2011-2013). A case-crossover design was used to link cardiovascular and respiratory hospital admissions and total, cardiovascular and respiratory mortality with a pre-defined list of 16 PM10 and PM2.5 constituents. Lags 0 to 2 were examined. City-specific results were combined by random-effects meta-analysis. Most of the elements studied, namely EC, SO4(2-), SiO2, Ca, Fe, Zn, Cu, Ti, Mn, V and Ni, showed increased percent changes in cardiovascular and/or respiratory hospitalizations, mainly at lags 0 and 1. The percent increase by one interquartile range (IQR) change ranged from 0.69% to 3.29%. After adjustment for total PM levels, only associations for Mn, Zn and Ni remained significant. For mortality, although positive associations were identified (Fe and Ti for total mortality; EC and Mg for cardiovascular mortality; and NO3(-) for respiratory mortality) the patterns were less clear. The associations found in this study reflect that several PM constituents, originating from different sources, may drive previously reported results between PM and hospital admissions in the Mediterranean area. Copyright © 2014 Elsevier Ltd. All rights reserved.

Real-World Effectiveness of Pentavalent Rotavirus Vaccine Among Bedouin and Jewish Children in Southern Israel.

PubMed

Leshem, Eyal; Givon-Lavi, Noga; Tate, Jacqueline E; Greenberg, David; Parashar, Umesh D; Dagan, Ron

2016-05-01

Pentavalent rotavirus vaccine (RV5) was introduced into the Israeli National Immunization Program in January 2011. We determined RV5 vaccine effectiveness (VE) in southern Israel, a region characterized by 2 distinct populations: Bedouins living in a low- to middle-income, semirural setting, and Jews living in a high-income, urban setting. We enrolled vaccine-eligible children who visited the emergency department (ED) or were hospitalized due to acute gastroenteritis (AGE) during the first 3 rotavirus seasons after RV5 vaccine introduction (2011-2013). Fecal specimens were tested for rotavirus by enzyme immunoassay and genotyped. Vaccination among laboratory-confirmed rotavirus cases was compared with rotavirus-negative AGE controls. Regression models were used to calculate VE estimates by age, clinical setting, and ethnicity. Of 515 enrolled patients, 359 (70%) were Bedouin. Overall, 185 (36%) patients were rotavirus positive; 79 of 119 (66%) were G1P[8] genotype. The adjusted VE for a full 3-dose course of RV5 against ED visit or hospitalization was 63% (95% confidence interval [CI], 38%-78%). RV5 provided G1P[8] genotype-specific effectiveness of 78% (95% CI, 58%-88%). By age, RV5 VE was 64% (95% CI, 21%-84%) and 71% (95% CI, 39%-86%) among children aged 6-11 months and 12-23 months, respectively. By clinical setting, RV5 VE was 59% (95% CI, 23%-78%) against hospitalization, and 67% (95% CI, 11%-88%) against ED visit. The adjusted VE of a full RV5 course among Bedouin children was 62% (95% CI, 29%-79%). RV5 significantly protected against rotavirus-associated ED visits and hospitalizations in a diverse population of vaccine-eligible children living in southern Israel. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Factors Associated with Hospital Length of Stay among Cancer Patients with Febrile Neutropenia

PubMed Central

Rosa, Regis G.; Goldani, Luciano Z.

2014-01-01

Purpose This study sought to evaluate factors associated with hospital length of stay in cancer patients with febrile neutropenia. Methods A prospective cohort study was performed at a single tertiary referral hospital in southern Brazil from October 2009 to August 2011. All adult cancer patients with febrile neutropenia admitted to the hematology ward were evaluated. Stepwise random-effects negative binomial regression was performed to identify risk factors for prolonged length of hospital stay. Results In total, 307 cases of febrile neutropenia were evaluated. The overall median length of hospital stay was 16 days (interquartile range 18 days). According to multiple negative binomial regression analysis, hematologic neoplasms (P = 0.003), high-dose chemotherapy regimens (P<0.001), duration of neutropenia (P<0.001), and bloodstream infection involving Gram-negative multi-drug-resistant bacteria (P = 0.003) were positively associated with prolonged hospital length of stay in patients with febrile neutropenia. The condition index showed no evidence of multi-collinearity effect among the independent variables. Conclusions Hematologic neoplasms, high-dose chemotherapy regimens, prolonged periods of neutropenia, and bloodstream infection with Gram-negative multi-drug-resistant bacteria are predictors of prolonged length hospital of stay among adult cancer patients with febrile neutropenia. PMID:25285790

Service quality assessment of a referral hospital in Southern Iran with SERVQUAL technique: patients’ perspective

PubMed Central

2014-01-01

Background Providing services to patients according to their expectations and needs is necessary for the success of an organization in order to remain in the competitive market. Recognizing these needs and expectations is an important step in offering high quality services. This study was designed to determine the service quality gap of the main hospital of Hormozgan province. Methods This cross sectional study was conducted in 2013 in Bandar Abbas ShahidMohammadi Hospital in the south of Iran. All 96 participants of this study were provided by SERVQUAL questionnaire. Data was analyzed by Wilcoxon and Kruskal-Wallis tests. Results Service quality gaps were seen in all five service quality dimensions and the overall quality of service. The mean of quality perception score and quality expectation score was 3.44 ± 0.693 and 4.736 ± 0.34, respectively. The highest perception was in assurance dimension and the highest expectation was in Responsiveness and assurance dimensions. Also, the lowest perception was in responsiveness dimension and the lowest expectation was about empathy. In this study, 56.1% of participants defined the quality of services as average. Conclusion According to the results, this hospital was not able to meet patients’ expectations completely. Therefore, action must be taken to decrease the gap between the perception and expectation of the patients. PMID:25064475

Escherichia coli and selected veterinary and zoonotic pathogens isolated from environmental sites in companion animal veterinary hospitals in southern Ontario.

PubMed

Murphy, Colleen P; Reid-Smith, Richard J; Boerlin, Patrick; Weese, J Scott; Prescott, John F; Janecko, Nicol; Hassard, Lori; McEwen, Scott A

2010-09-01

Hospital-based infection control in veterinary medicine is emerging and the role of the environment in hospital-acquired infections (HAI) in veterinary hospitals is largely unknown. This study was initiated to determine the recovery of Escherichia coli and selected veterinary and zoonotic pathogens from the environments of 101 community veterinary hospitals. The proportion of hospitals with positive environmental swabs were: E. coli--92%, Clostridium difficile--58%, methicillin-resistant Staphylococcus aureus (MRSA)--9%, CMY-2 producing E. coli--9%, methicillin-resistant Staphylococcus pseudintermedius--7%, and Salmonella--2%. Vancomycin-resistant Enterococcus spp., canine parvovirus, and feline calicivirus were not isolated. Prevalence of antimicrobial resistance in E. coli isolates was low. Important potential veterinary and human pathogens were recovered including Canadian epidemic strains MRSA-2 and MRSA-5, and C. difficile ribotype 027. There is an environmental reservoir of pathogens in veterinary hospitals; therefore, additional studies are required to characterize risk factors associated with HAI in companion animals, including the role of the environment.

Viral etiology of aseptic meningitis among children in southern Iran.

PubMed

Hosseininasab, Ali; Alborzi, Abdolvahab; Ziyaeyan, Mazyar; Jamalidoust, Marzieh; Moeini, Mahsa; Pouladfar, Gholamreza; Abbasian, Amin; Kadivar, Mohamad Rahim

2011-05-01

Aseptic meningitis refers to a clinical syndrome of meningeal inflammation in which bacteria cannot be identified in the cerebrospinal fluid (CSF). The viral etiology and the epidemiological, clinical, and laboratory characteristics of aseptic meningitis among children aged 2 months to 15 years in Shiraz, southern Iran were determined. From May 2007 to April 2008, 65 patients were admitted to the hospital with aseptic meningitis. Seven viruses, non-polio human enteroviruses, mumps virus, herpes simplex virus (HSV), varicella-zoster virus (VZV), human cytomegalovirus (HCMV), human herpes virus type 6 (HHV-6), and Epstein-Barr virus (EBV) were investigated by polymerase chain reaction (PCR) method. Viruses were detected in 30 (46.2%) patients in whom non-polio human enterovirus and mumps virus were detected in 13 (43.3%) and 11 (36.7%), respectively. The remaining 6 (20%) of the cases were caused by HSV, VZV, HCMV, and HHV-6. Haemophilus influenzae and non-polio human enterovirus were detected in one patient simultaneously. Viral meningitis was found to be more frequent during spring and summer. The majority (66.6%) of the patients were treated in the hospital for 10 days and had received antibiotics in the case of bacterial meningitis. Rapid diagnosis of viral meningitis using PCR testing of CSF can help shorten hospitalization, and avoid the unnecessary use of antibiotics. Copyright © 2011 Wiley-Liss, Inc.

Hospitalizations for Cardiovascular Disease in African Americans and Whites with HIV/AIDS

PubMed Central

Oramasionwu, Christine U.; Morse, Gene D.; Lawson, Kenneth A.; Brown, Carolyn M.; Koeller, Jim M.

2013-01-01

Abstract Therapeutic advances have resulted in an epidemiological shift in the predominant causes of hospitalization for patients with HIV/AIDS. An emerging cause for hospitalization in this patient population is cardiovascular disease (CVD); however, data are limited regarding how this shift affects different racial groups. The objective of this observational, retrospective study was to evaluate the association between race and hospitalization for CVD in African Americans and whites with HIV/AIDS and to compare the types of CVD-related hospitalizations between African Americans and whites with HIV/AIDS. Approximately 1.5 million hospital discharges from the US National Hospital Discharge Surveys for the years of 1996 to 2008 were identified. After controlling for potential confounders, the odds of CVD-related hospitalization in patients with HIV/AIDS were 45% higher for African Americans than whites (odds ratio [OR]=1.45, 95% CI, 1.39–1.51). Other covariates that were associated with increased odds of hospitalization for CVD included chronic kidney disease (OR=1.43, 95% CI, 1.36–1.51), age≥50 years (OR=3.22, 95% CI, 2.94–3.54), region in the Southern United States (OR=1.17, 95% CI, 1.11–1.23), and Medicare insurance coverage (OR=1.71, 95% CI, 1.60–1.83). Male sex was not significantly associated with the study outcome (OR=0.99, 95% CI, 0.96–1.02). Compared to whites with HIV/AIDS, African Americans with HIV/AIDS had more hospitalizations for heart failure and hypertension, but fewer hospitalizations for stroke and coronary heart disease. In conclusion, African Americans with HIV/AIDS have increased odds of CVD-related hospitalization as compared to whites with HIV/AIDS. Furthermore, the most common types of CVD-related hospitalizations differ significantly in African Americans and whites. (Population Health Management 2012;16:201–207) PMID:23194035

Hospitalizations for cardiovascular disease in African Americans and whites with HIV/AIDS.

PubMed

Oramasionwu, Christine U; Morse, Gene D; Lawson, Kenneth A; Brown, Carolyn M; Koeller, Jim M; Frei, Christopher R

2013-06-01

Therapeutic advances have resulted in an epidemiological shift in the predominant causes of hospitalization for patients with HIV/AIDS. An emerging cause for hospitalization in this patient population is cardiovascular disease (CVD); however, data are limited regarding how this shift affects different racial groups. The objective of this observational, retrospective study was to evaluate the association between race and hospitalization for CVD in African Americans and whites with HIV/AIDS and to compare the types of CVD-related hospitalizations between African Americans and whites with HIV/AIDS. Approximately 1.5 million hospital discharges from the US National Hospital Discharge Surveys for the years of 1996 to 2008 were identified. After controlling for potential confounders, the odds of CVD-related hospitalization in patients with HIV/AIDS were 45% higher for African Americans than whites (odds ratio [OR]=1.45, 95% CI, 1.39-1.51). Other covariates that were associated with increased odds of hospitalization for CVD included chronic kidney disease (OR=1.43, 95% CI, 1.36-1.51), age≥50 years (OR=3.22, 95% CI, 2.94-3.54), region in the Southern United States (OR=1.17, 95% CI, 1.11-1.23), and Medicare insurance coverage (OR=1.71, 95% CI, 1.60-1.83). Male sex was not significantly associated with the study outcome (OR=0.99, 95% CI, 0.96-1.02). Compared to whites with HIV/AIDS, African Americans with HIV/AIDS had more hospitalizations for heart failure and hypertension, but fewer hospitalizations for stroke and coronary heart disease. In conclusion, African Americans with HIV/AIDS have increased odds of CVD-related hospitalization as compared to whites with HIV/AIDS. Furthermore, the most common types of CVD-related hospitalizations differ significantly in African Americans and whites.

Influenza epidemiology and influenza vaccine effectiveness during the 2014-2015 season: annual report from the Global Influenza Hospital Surveillance Network.

PubMed

Puig-Barberà, Joan; Burtseva, Elena; Yu, Hongjie; Cowling, Benjamin J; Badur, Selim; Kyncl, Jan; Sominina, Anna

2016-08-22

The Global Influenza Hospital Surveillance Network (GIHSN) has established a prospective, active surveillance, hospital-based epidemiological study to collect epidemiological and virological data for the Northern and Southern Hemispheres over several consecutive seasons. It focuses exclusively on severe cases of influenza requiring hospitalization. A standard protocol is shared between sites allowing comparison and pooling of results. During the 2014-2015 influenza season, the GIHSN included seven coordinating sites from six countries (St. Petersburg and Moscow, Russian Federation; Prague, Czech Republic; Istanbul, Turkey; Beijing, China; Valencia, Spain; and Rio de Janeiro, Brazil). Here, we present the detailed epidemiological and influenza vaccine effectiveness findings for the Northern Hemisphere 2014-2015 influenza season.

A Large-Scale Community-Based Outbreak of Paratyphoid Fever Caused by Hospital-Derived Transmission in Southern China.

PubMed

Yan, Meiying; Yang, Bo; Wang, Zhigang; Wang, Shukun; Zhang, Xiaohe; Zhou, Yanhua; Pang, Bo; Diao, Baowei; Yang, Rusong; Wu, Shuyu; Klena, John D; Kan, Biao

2015-01-01

Since the 1990s, paratyphoid fever caused by Salmonella Paratyphi A has emerged in Southeast Asia and China. In 2010, a large-scale outbreak involving 601 cases of paratyphoid fever occurred in the whole of Yuanjiang county in China. Epidemiological and laboratory investigations were conducted to determine the etiology, source and transmission factors of the outbreak. A case-control study was performed to identify the risk factors for this paratyphoid outbreak. Cases were identified as patients with blood culture-confirmed S. Paratyphi A infection. Controls were healthy persons without fever within the past month and matched to cases by age, gender and geography. Pulsed-field gel electrophoresis and whole-genome sequencing of the S. Paratyphi A strains isolated from patients and environmental sources were performed to facilitate transmission analysis and source tracking. We found that farmers and young adults were the populations mainly affected in this outbreak, and the consumption of raw vegetables was the main risk factor associated with paratyphoid fever. Molecular subtyping and genome sequencing of S. Paratyphi A isolates recovered from improperly disinfected hospital wastewater showed indistinguishable patterns matching most of the isolates from the cases. An investigation showed that hospital wastewater mixed with surface water was used for crop irrigation, promoting a cycle of contamination. After prohibition of the planting of vegetables in contaminated fields and the thorough disinfection of hospital wastewater, the outbreak subsided. Further analysis of the isolates indicated that the origin of the outbreak was most likely from patients outside Yuanjiang county. This outbreak is an example of the combined effect of social behaviors, prevailing ecological conditions and improper disinfection of hospital wastewater on facilitating a sustained epidemic of paratyphoid fever. This study underscores the critical need for strict treatment measures of hospital

Escherichia coli and selected veterinary and zoonotic pathogens isolated from environmental sites in companion animal veterinary hospitals in southern Ontario

PubMed Central

Murphy, Colleen P.; Reid-Smith, Richard J.; Boerlin, Patrick; Weese, J. Scott; Prescott, John F.; Janecko, Nicol; Hassard, Lori; McEwen, Scott A.

2010-01-01

Hospital-based infection control in veterinary medicine is emerging and the role of the environment in hospital-acquired infections (HAI) in veterinary hospitals is largely unknown. This study was initiated to determine the recovery of Escherichia coli and selected veterinary and zoonotic pathogens from the environments of 101 community veterinary hospitals. The proportion of hospitals with positive environmental swabs were: E. coli — 92%, Clostridium difficile — 58%, methicillin-resistant Staphylococcus aureus (MRSA) — 9%, CMY-2 producing E. coli — 9%, methicillin-resistant Staphylococcus pseudintermedius — 7%, and Salmonella — 2%. Vancomycin-resistant Enterococcus spp., canine parvovirus, and feline calicivirus were not isolated. Prevalence of antimicrobial resistance in E. coli isolates was low. Important potential veterinary and human pathogens were recovered including Canadian epidemic strains MRSA-2 and MRSA-5, and C. difficile ribotype 027. There is an environmental reservoir of pathogens in veterinary hospitals; therefore, additional studies are required to characterize risk factors associated with HAI in companion animals, including the role of the environment. PMID:21119862

HLA molecules and nasal carriage of Staphylococcus aureus isolated from dialysis and kidney transplant patients at a hospital in Southern Brazil

PubMed Central

2012-01-01

Background Healthy individuals can host Staphylococcus aureus in the nasopharynx, body surface and vagina. Most invasive infections by this bacterium are endogenous, caused by strains spread from the nasopharynx of carriers. S. aureus is a pathogen involved in the etiology of hospital- and community-acquired infections. Transplant and dialysis patients are at risk of colonization or infection by multi-resistant S. aureus. Infection is directly linked to individual immunity, and the major histocompatibility complex (MHC) plays a crucial role in determining susceptibility to diseases. Different MHC specificities have been shown to be more frequent in individuals suffering from certain diseases. This study aimed to investigate the association between HLA class I (HLA-A and -B) and class II (HLA-DRB1) molecules and nasal carriage of S. aureus in dialysis and kidney transplant patients at a hospital in Southern Brazil. Results The sample consisted of 70 dialysis and 46 kidney transplant patients, totaling 116 patients. All subjects were typed for HLA molecules using LABType® SSO (One Lambda). Nasal swab samples of S. aureus were isolated from the nasal cavity (both nostrils) of patients undergoing dialysis or kidney transplantation. In renal dialysis patients, HLA-A*02 was the most frequent allele in both carriers (25.5%) and non-carriers (21.2%) of S. aureus. Allele A*68 was not observed in the carrier group, but the allele was observed six times in the non-carrier group (p = 0.0097). Regarding HLA-B and HLA-DRB1, no allele was shown to be involved in protection against or susceptibility to carriage of S. aureus. In kidney transplant patients, allele A*03 was more frequent in the non-carrier (20.83%) than in the carrier (5.88%) group (p = 0.0486). HLA-B*15 was present in carriers (5.88%) and non-carriers (25%) (p = 0.0179). Regarding class II alleles, DRB1*03 appeared to be related to susceptibility to carriage of S. aureus (p = 0.0319). Conclusions Our findings

Southern pulpwood production, 1982

Treesearch

James F. Rosson

1982-01-01

The annual report of southern pulpwood production is based on a canvass of all pulpmills that fall within the 12 states of the Southern and Southeastern Forest Experiment Station regions. Neighboring experiment stations exchange information on mills located beyond the region but utilizing wood from the region.

Evaluation of a streptococcal pharyngitis score in southern Taiwan.

PubMed

Shih, Ching-Tang; Lin, Ching-Chiang; Lu, Chung-Ching

2012-02-01

Group A streptococcus (GAS) pharyngitis can cause serious complications such as rheumatic heart disease. The McIsaac sore throat score is a clinical prediction score used to improve the detection rate of GAS pharyngitis. We evaluated the validity of the McIsaac sore throat score in Southern Taiwan and compared our findings to those of other studies. We retrospectively analyzed chart records from children aged 3 to 15 years old who complained of fever and sore throat. They had throat cultures collected at the outpatient pediatric clinic of Fooyin University Hospital, located in Pingtung County, Taiwan during the period between January 2007 and January 2010. Clinical characteristics were reviewed, and sore throat score was analyzed. A total of 342 throat cultures met the inclusion criteria of sore throat and fever. The positive rate of GAS was 4.1%. Culture-positive cases were associated with higher odds for a skin rash [adjusted odds ratio (AOR): 14.66, 95% confidence interval (CI): 4.63-46.40, p < 0.001), lower odds for cough (AOR: 0.19, 95% CI: 0.04-0.85, p = 0.030) and having a runny nose (AOR: 0.22, 95% CI: 0.05-0.99, p = 0.048). The most common physical sign was scarlet fever rash (AOR: 57.35, 95% CI: 15.45-212.98, p < 0.001). A McIsaac score of 5 had a sensitivity of 71%, specificity of 70%, and a positive predictive value of only 9.3%. Pediatric streptococcal pharyngitis in Southern Taiwan is uncommon. Diagnosis of GAS pharyngitis based on the McIsaac sore throat score is unreliable among pediatric patients with febrile pharyngitis in Southern Taiwan. Copyright © 2012. Published by Elsevier B.V.

The Recent Rise of Southern Magazines.

ERIC Educational Resources Information Center

Hynds, Ernest C.

During the past decade states in the southern United States have produced an increasing percentage of the nation's "city" magazines. Three magazines illustrate what the southern metropolitan magazines are doing to serve their readers and their communities. "Southern Living" provides information about its readers' interests as…

Southern pulpwood production, 1993

Treesearch

Michael Howell; Andrew J. Hartsell

1993-01-01

In 1993, Southern pulpwood production declined 2 percent to 66.3 million cords. Roundwood production decreased 2 percent to 46.3 million cords, and wood residue production fell 4 percent to 19.9 million cords. Pulping capacity of the 102 Southern pulpmills was 132,327 tons per day.

High prevalence of Behçet's disease in southern Italy.

PubMed

Olivieri, Ignazio; Leccese, Pietro; Padula, Angela; Nigro, Angelo; Palazzi, Carlo; Gilio, Michele; D'Angelo, Salvatore

2013-01-01

This paper aims to estimate the prevalence of Behçet's disease (BD) in the city of Potenza, the regional capital of Basilicata (or Lucania) Region, in southern Italy. Patients with BD living in Potenza for at least 12 months prior to diagnosis were identified through the following sources: general practitioners, community-based specialists, San Carlo Hospital specialists, the Basilicata centralised index and the Basilicata database for rare diseases. All identified patients were contacted by phone and were recalled to our outpatient clinic for re-evaluation. Patients were classified as having complete BD if they met the International Study Group (ISG) criteria for BD. By surveying a population of 69.060 subjects, 13 patients with a diagnosis of BD were identified. All were white and Italian by descendent. Eleven out of these satisfied the ISG criteria and allowed us to obtain a prevalence rate of 15.9 per 100.000 (95%CI 8.9-28.5), which is the highest ever found value in Europe. This cross-sectional population-based study suggests that BD is more frequent in the southern part than in the northern part of Italy and confirms that the prevalence of the disease increases in a north-to-south manner within the European continent.

Southern pulpwood production, 1990

Treesearch

John S. Vissage; Patrick E. Miller

1992-01-01

In 1990, Southern pulpwood production exceeded 65 million cords, roundwood production increased 9 percent to 45.6 million cords, and wood residue production increased 2 percent to 19.4 million cords. The pulping capacity of the 103 Southern pulpmills was 129,290 tons per day. One pulpmill was under construction.

Differences in Readiness between Rural Hospitals and Primary Care Providers for Telemedicine Adoption and Implementation: Findings from a Statewide Telemedicine Survey

ERIC Educational Resources Information Center

Martin, Amy Brock; Probst, Janice C.; Shah, Kyle; Chen, Zhimin; Garr, David

2012-01-01

Purpose: Published advantages of and challenges with telemedicine led us to examine the scope of telemedicine adoption, implementation readiness, and barriers in a southern state where adoption has been historically low. We hypothesized that rural hospitals and primary care providers (RPCPs) differ on adoption, readiness, and implementation…

Human coronavirus and severe acute respiratory infection in Southern Brazil.

PubMed

Trombetta, Hygor; Faggion, Heloisa Z; Leotte, Jaqueline; Nogueira, Meri B; Vidal, Luine R R; Raboni, Sonia M

2016-05-01

Human coronaviruses (HCoVs) are an important cause of respiratory tract infection and are responsible for causing the common cold in the general population. Thus, adequate surveillance of HCoV is essential. This study aimed to analyze the impact of HCoV infections and their relation to severe acute respiratory infection (SARI) in a hospitalized population in Southern Brazil. A cross-sectional study was conducted at a tertiary care hospital, and assessed inpatients under investigation for SARI by the hospital epidemiology department, and all patients who had nasopharyngeal aspirates collected from January 2012 to December 2013 to detect respiratory viruses (RVs). Viral infection was detected by multiplex reverse transcriptase polymerase chain reaction (RT-PCR), with primers specific to the subtypes HCoV-229E/NL63 and OC43/HKU1. The overall positivity rate was 58.8% (444/755), and HCoVs were detected in 7.6% (n = 34) of positive samples. Children below two years of age were most frequently affected (62%). Comorbidities were more likely to be associated with HCoVs than with other RVs. Immunosuppression was an independent risk factor for HCoV infection (OR = 3.5, 95% CI 1.6-7.6). Dyspnea was less frequently associated with HCoV infection (p < 0.001), and HCoV accounted for 6% of the SARI cases. Three patients infected with HCoV (9%) died from respiratory infection. HCoVs are important respiratory pathogens, especially in hospitalized children under 2 years of age and in immunosuppressed patients. They may account for a small proportion of SARI diagnoses, increased need for mechanical ventilation, intensive care unit admission, and death.

Syphilis and psychiatry at the Mysore Government Mental Hospital (NIMHANS) in the early 20th century

PubMed Central

Ghani, Sarah; Murthy, Pratima; Jain, Sanjeev; Sarin, Alok

2018-01-01

Prior to the advent of the Wasserman Test as a diagnostic tool for Syphilis, the identification rate for Syphilis at the Mysore Government Mental Hospital in Southern India was 1%. With the introduction of the test, there was a dramatic increase in the diagnosis of Syphilis, with 17% of the patients testing positive. This paper throws light on the early notions of Syphilis and GPI, societal responses to the disease, early misdiagnosis, the advent of the Wasserman test and treatment management as reflected in the records of the early 20th century at the Mysore Government Mental Hospital (currently known as NIMHANS). PMID:29527060

Southern Pine Beetle II

Treesearch

R. N. Coulson; Kier Klepzig

2011-01-01

The knowledge base for the southern pine beetle, Dendroctonus frontalis Zimmermann (Coleoptera: Curculionidae) has increased dramatically since the last comprehensive and interpretative summary (Thatcher and others 1980). This insect continues to be a significant pest affecting the forest environment of the Southern US and adjoining states and it is also the subject of...

Southern pulpwood production, 1974

Treesearch

Daniel F. Bertelson

1975-01-01

Southern pulpwood production in 1974 reached a record high of 49,102,144 cords, a 4-percent increase over the previous year. Daily pulping capacity at the 114 southern pulpmills rose 3 per- cent to 94,982 tons; the increase resulted from expansion of existing facilities and the opening of three new mills.

The Southern Annual Forest Inventory System

Treesearch

Gregory A. Reams; Paul C. van Deusen

1999-01-01

The Southern Annual Forest Inventory System (SAFIS) is in various stages of implementation in 7 of the 13 southern states serviced by the Southern Research Station. The SAFIS design is an interpenetrating design where the n units (1/6 acre plots) are divided into k = 5 panels, each panel containing m = n...

Southern pulpwood production, 1989

Treesearch

Cecil C. Hutchins

1991-01-01

This annual publication issued in alternate years by the Southeastern and Southern Forest Experiment stations, is based on 100-percent canvass of all pulpmills in the 12 Southern States from Virginia to Texas. The movement of raw material between regions is obtained by exchanging information with other regional Experiment Stations. Roundwood volumes are recorded in...

Meteor showers of the southern hemisphere

NASA Astrophysics Data System (ADS)

Molau, Sirko; Kerr, Steve

2014-04-01

We present the results of an exhaustive meteor shower search in the southern hemisphere. The underlying data set is a subset of the IMO Video Meteor Database comprising 50,000 single station meteors obtained by three Australian cameras between 2001 and 2012. The detection technique was similar to previous single station analysis. In the data set we find 4 major and 6 minor northern hemisphere meteor showers, and 12 segments of the Antihelion source (including the Northern and Southern Taurids and six streams from the MDC working list). We present details for 14 southern hemisphere showers plus the Centaurid and Puppid-Velid complex, with the η Aquariids and the Southern δ Aquariids being the strongest southern showers. Two of the showers (θ^2 Sagittariids and τ Cetids) were previously unknown and have received preliminary designations by the MDC. Overall we find that the fraction of southern meteor showers south of -30deg declination (roughly 25%) is clearly smaller than the fraction of northern meteor showers north of +30deg declination (more than 50%) obtained in our previous analysis.

Southern Ocean carbon-wind stress feedback

NASA Astrophysics Data System (ADS)

Bronselaer, Ben; Zanna, Laure; Munday, David R.; Lowe, Jason

2018-02-01

The Southern Ocean is the largest sink of anthropogenic carbon in the present-day climate. Here, Southern Ocean pCO2 and its dependence on wind forcing are investigated using an equilibrium mixed layer carbon budget. This budget is used to derive an expression for Southern Ocean pCO2 sensitivity to wind stress. Southern Ocean pCO2 is found to vary as the square root of area-mean wind stress, arising from the dominance of vertical mixing over other processes such as lateral Ekman transport. The expression for pCO2 is validated using idealised coarse-resolution ocean numerical experiments. Additionally, we show that increased (decreased) stratification through surface warming reduces (increases) the sensitivity of the Southern Ocean pCO2 to wind stress. The scaling is then used to estimate the wind-stress induced changes of atmospheric pCO_2 in CMIP5 models using only a handful of parameters. The scaling is further used to model the anthropogenic carbon sink, showing a long-term reversal of the Southern Ocean sink for large wind stress strength.

Patient Safety Climate: A Study of Southern California Healthcare Organizations.

PubMed

Avramchuk, Andre S; McGuire, Stephen J J

2018-01-01

Human error remains the most important factor in unnecessary deaths and suffering in U.S. hospitals. Human error results from healthcare providers' attitudes and behaviors toward patients in different settings. Therefore, taking periodic snapshots of the attitudes and behaviors prevalent in an organization and manifested in its patient safety climate (PSC) is essential.We developed and tested a short survey instrument intended as an organization-level measure of PSC with good psychometric properties that can be used in hospitals, clinics, or other healthcare provider settings. Analysis of data from 61 Southern California healthcare organizations resulted in a PSC model with four distinct, reliable factors: (1) Assistance From Others and the Organization, (2) Leadership Messages of Support in Policy and Behavior, (3) Resources and Work Environment, and (4) Error Reporting Behavior. A PSC score, ranging from 0 to 100, was generated for each organization.For a subsample of hospitals in our study, preliminary results indicate a predictive quality of the model. The higher the PSC score, the lower the number of violations detected by the Centers for Medicare & Medicaid Services in complaint inspections, and the fewer the safety problems reported by The Leapfrog Group.Given the association between PSC and health outcomes, we urge healthcare leaders to use various means, such as our survey, to monitor the degree to which their organizations maintain a climate that fosters patient safety and use such data to pinpoint areas for improvement.

Southern pulpwood production, 1991

Treesearch

Michael Howell

1993-01-01

In 1991, Southern pulpwood production climbed 1 percent, to 65.08 million cords. Roundwood production increased 2 percent to 46.6 million cords, and wood residue production fell 5 percent to 18.4 million cords. One new pulpmill began operating in the region. Pulping capacity of the 104 southern pulpmill was 133.331 tons per day.

Southern pulpwood production, 1984

Treesearch

Dennis M. May

1986-01-01

This publication presents the findings of 100-percent canvass of all wood-using pulpmills drawing roundwood or wood residues from the 12 southern states (fig. 1). Canvass data are compiled annually and analyzed on an alternating basis by personnel of the Forest Inventory and Analysis Units of the Southern and southeastern Forest Experiment Stations. All production...

Violence in the nursing workplace - a descriptive correlational study in a public hospital.

PubMed

Chen, Kang-Pan; Ku, Yan-Chiou; Yang, Hsiu-Fan

2013-03-01

To explore the prevalence, types and sources of violence in the nursing workplace and to assess the factors related to violence. Workplace violence in nursing is not a new phenomenon; in recent years, much more attention has been paid to the issue in Taiwan. Few studies, however, have investigated the overall distribution of violence and the reasons for not reporting these incidents in nursing workplaces. This descriptive, correlational study used structured questionnaires to collecting information about workplace violence experienced by nurses over the last year. Nurses (n = 880) working in a public hospital in southern Taiwan were invited to complete the questionnaires, with a response rate of 89·9%. Nurses working in outpatient units and emergency rooms experienced more frequent violence than those on surgical wards and intensive care units. These findings provide evidence of workplace violence in hospitals and may aid hospital and nursing administration to reduce and control violence. RELEVANCE TO NURSING PRACTICE: These results provide evidence in relation to the importance of effective communication training to nurses and will assist hospital administrations in establishing higher-quality, healthy workplace environments. © 2012 Blackwell Publishing Ltd.

Southern Annular Mode drives multicentury wildfire activity in southern South America.

PubMed

Holz, Andrés; Paritsis, Juan; Mundo, Ignacio A; Veblen, Thomas T; Kitzberger, Thomas; Williamson, Grant J; Aráoz, Ezequiel; Bustos-Schindler, Carlos; González, Mauro E; Grau, H Ricardo; Quezada, Juan M

2017-09-05

The Southern Annular Mode (SAM) is the main driver of climate variability at mid to high latitudes in the Southern Hemisphere, affecting wildfire activity, which in turn pollutes the air and contributes to human health problems and mortality, and potentially provides strong feedback to the climate system through emissions and land cover changes. Here we report the largest Southern Hemisphere network of annually resolved tree ring fire histories, consisting of 1,767 fire-scarred trees from 97 sites (from 22 °S to 54 °S) in southern South America (SAS), to quantify the coupling of SAM and regional wildfire variability using recently created multicentury proxy indices of SAM for the years 1531-2010 AD. We show that at interannual time scales, as well as at multidecadal time scales across 37-54 °S, latitudinal gradient elevated wildfire activity is synchronous with positive phases of the SAM over the years 1665-1995. Positive phases of the SAM are associated primarily with warm conditions in these biomass-rich forests, in which widespread fire activity depends on fuel desiccation. Climate modeling studies indicate that greenhouse gases will force SAM into its positive phase even if stratospheric ozone returns to normal levels, so that climate conditions conducive to widespread fire activity in SAS will continue throughout the 21st century.

Southern Annular Mode drives multicentury wildfire activity in southern South America

PubMed Central

Paritsis, Juan; Mundo, Ignacio A.; Veblen, Thomas T.; Kitzberger, Thomas; Williamson, Grant J.; Aráoz, Ezequiel; Bustos-Schindler, Carlos; González, Mauro E.; Grau, H. Ricardo; Quezada, Juan M.

2017-01-01

The Southern Annular Mode (SAM) is the main driver of climate variability at mid to high latitudes in the Southern Hemisphere, affecting wildfire activity, which in turn pollutes the air and contributes to human health problems and mortality, and potentially provides strong feedback to the climate system through emissions and land cover changes. Here we report the largest Southern Hemisphere network of annually resolved tree ring fire histories, consisting of 1,767 fire-scarred trees from 97 sites (from 22 °S to 54 °S) in southern South America (SAS), to quantify the coupling of SAM and regional wildfire variability using recently created multicentury proxy indices of SAM for the years 1531–2010 AD. We show that at interannual time scales, as well as at multidecadal time scales across 37–54 °S, latitudinal gradient elevated wildfire activity is synchronous with positive phases of the SAM over the years 1665–1995. Positive phases of the SAM are associated primarily with warm conditions in these biomass-rich forests, in which widespread fire activity depends on fuel desiccation. Climate modeling studies indicate that greenhouse gases will force SAM into its positive phase even if stratospheric ozone returns to normal levels, so that climate conditions conducive to widespread fire activity in SAS will continue throughout the 21st century. PMID:28827329

Hospital administrative characteristics and volunteer resource management practices.

PubMed

Intindola, Melissa; Rogers, Sean; Flinchbaugh, Carol; Della Pietra, Doug

2016-05-16

Purpose - The purpose of this paper is to explore the links between various characteristics of hospital administration and the utilization of classes of volunteer resource management (VRM) practices. Design/methodology/approach - This paper uses original data collected via surveys of volunteer directors in 122 hospitals in five Northeastern and Southern US states. Findings - Structural equation modeling results suggest that number of paid volunteer management staff, scope of responsibility of the primary volunteer administrator, and hospital size are positively associated with increased usage of certain VRM practices. Research limitations/implications - First, the authors begin the exploration of VRM antecedents, and encourage others to continue this line of inquiry; and second, the authors assess dimensionality of practices, allowing future researchers to consider whether specific dimensions have a differential impact on key individual and organizational outcomes. Practical implications - Based on the findings of a relationship between administrative characteristics and the on-the-ground execution of VRM practice, a baseline audit comparing current practices to those VRM practices presented here might be useful in determining what next steps may be taken to focus investments in VRM that can ultimately drive practice utilization. Originality/value - The exploration of the dimensionality of volunteer management adds a novel perspective to both the academic study, and practice, of volunteer management. To the authors' knowledge, this is the first empirical categorization of VRM practices.

Southern Identity in "Southern Living" Magazine

ERIC Educational Resources Information Center

Lauder, Tracy

2012-01-01

A fantasy-theme analysis of the editors' letters in "Southern Living" magazine shows an editorial vision of valuing the past and showcasing unique regional qualities. In addition, a content analysis of the visual representation of race in the magazine's formative years and recent past validates that inhabitants of the region were portrayed…

Knowledge and power necessary to reconstruct nursing after management changes at a teaching hospital.

PubMed

Bernardino, Elizabeth; Felli, Vanda Elisa Andres

2008-01-01

This study was carried out at a teaching hospital in Southern Brazil, which adopted a management model that provoked the dismantling of the nursing service and the disbandment of nursing professionals. Its general goal was to promote changes that would be implemented in the re-organization of nursing work. It is a case study with a historical-dialectic approach, whose data were collected in March and April 2005 through the focal group technique. The study subjects were eight nurses, two technicians and two nursing auxiliaries. Data were analyzed through thematic content analysis. Results evidenced that the greatest challenges nursing faced at this hospital were: to construct a new identity, carry out teamwork while maintaining its professional identity, acquire visibility in the institution, change care and expand management.

Impact of pulsed xenon ultraviolet light on hospital-acquired infection rates in a community hospital.

PubMed

Vianna, Pedro G; Dale, Charles R; Simmons, Sarah; Stibich, Mark; Licitra, Carmelo M

2016-03-01

The role of contaminated environments in the spread of hospital-associated infections has been well documented. This study reports the impact of a pulsed xenon ultraviolet no-touch disinfection system on infection rates in a community care facility. This study was conducted in a community hospital in Southern Florida. Beginning November 2012, a pulsed xenon ultraviolet disinfection system was implemented as an adjunct to traditional cleaning methods on discharge of select rooms. The technology uses a xenon flashlamp to generate germicidal light that damages the DNA of organisms in the hospital environment. The device was implemented in the intensive care unit (ICU), with a goal of using the pulsed xenon ultraviolet system for disinfecting all discharges and transfers after standard cleaning and prior to occupation of the room by the next patient. For all non-ICU discharges and transfers, the pulsed xenon ultraviolet system was only used for Clostridium difficile rooms. Infection data were collected for methicillin-resistant Staphylococcus aureus, C difficile, and vancomycin-resistant Enterococci (VRE). The intervention period was compared with baseline using a 2-sample Wilcoxon rank-sum test. In non-ICU areas, a significant reduction was found for C difficile. There was a nonsignificant decrease in VRE and a significant increase in methicillin-resistant S aureus. In the ICU, all infections were reduced, but only VRE was significant. This may be because of the increased role that environment plays in the transmission of this pathogen. Overall, there were 36 fewer infections in the whole facility and 16 fewer infections in the ICU during the intervention period than would have been expected based on baseline data. Implementation of pulsed xenon ultraviolet disinfection is associated with significant decreases in facility-wide and ICU infection rates. These outcomes suggest that enhanced environmental disinfection plays a role in the risk mitigation of hospital

Southern pulpwood production, 1973

Treesearch

Thomas R. Bellamy

1973-01-01

Southern pulpwood production in 1973 increased 6 percent to over 47.1 million cords--over 66 percent of the Nation's total. Plant byproducts used for pulping made the largest volume gain in history and now account for 27 percent of the total pulpwood production Southern pulpwood was processed at 126 mills, of which 111 are in the South. Pulping capacity in the 12...

Southern pulpwood production, 1992

Treesearch

Patrick E. Miller

1994-01-01

In 1992, southern pulpwood production increased 4 percent to 67.9 million cords. Roundwood production increased 1 percent to 47.3 million cords, and wood residue production increased 12 percent to 20.7 million cords. One pulpmill changed processes, reducing the number to 103. The pulping capacity of the 103 southern pulpmills was 133,400 tons per day. No new...

Southern pulpwood production, 1970

Treesearch

Roy C. Beltz

1971-01-01

Southern pulpwood production climbed to 42,152,410 cords in 1970, exceeding last year’s record by 3 percent. This increase is smaller than those of recent years. Pulping capacity also rose 3 percent to 83,316 tons per day, and four mills are currently under construction. Of the 119 mills processing southern pulpwood, 107 were located within the region.

Willingness of nurses to report medication administration errors in southern Taiwan: a cross-sectional survey.

PubMed

Lin, Yu-Hua; Ma, Su-mei

2009-01-01

Underreporting of medication administering errors (MAEs) is a threat to the quality of nursing care. The reasons for MAEs are complex and vary by health professional and institution. The purpose of this study was to explore the prevalence of MAEs and the willingness of nurses to report them. A cross-sectional study was conducted involving a survey of 14 medical surgical hospitals in southern Taiwan. Nurses voluntarily participated in this study. A structured questionnaire was completed by 605 participants. Data were collected from February 1, 2005 to March 15, 2005 using the following instruments: MAEs Unwillingness to Report Scale, Medication Errors Etiology Questionnaire, and Personal Features Questionnaire. One additional question was used to identify the willingness of nurses to report medication errors: "When medication errors occur, should they be reported to the department?" This question helped to identify the willingness or lack thereof, to report incident errors. The results indicated that 66.9% of the nurses reported experiencing MAEs and 87.7% of the nurses had a willingness to report the MAEs if there were no consequences for reporting. The nurses' willingness to report MAEs differed by job position, nursing grade, type of hospital, and hospital funding. The final logistic regression model demonstrated hospital funding to be the only statistically significant factor. The odds of a willingness to report MAEs increased 2.66-fold in private hospitals (p = 0.032, CI = 1.09 to 6.49), and 3.28 in nonprofit hospitals (p = 0.00, CI = 1.73 to 6.21) when compared to public hospitals. This study demonstrates that reporting of MAEs should be anonymous and without negative consequences in order to monitor and guide improvements in hospital medication systems.

[Nursing beliefs and actions in exercising patient advocacy in a hospital context].

PubMed

Barlem, Jamila Geri Tomaschewski; Lunardi, Valéria Lerch; Barlem, Edison Luiz Devos; Ramos, Aline Marcelino; Figueira, Aline Belletti; Fornari, Nerizane Cerutti

2015-10-01

Analyzing beliefs and actions of nurses in exercising patient advocacy in a hospital context. A quantitative cross-sectional exploratory and descriptive study, conducted with 153 nurses from two hospitals in southern Brazil, one public and one philanthropic, by applying Protective Nursing Advocacy Scale - Brazilian version. Data were analyzed using descriptive statistics and analysis of variance. Nurses believe they are advocating for patients in their workplaces, and agree that they should advocate, especially when vulnerable patients need their protection. Personal values and professional skills have been identified as major sources of support for the practice of advocacy. Nurses do not disagree nor agree that advocating for patients in their working environments can bring them negative consequences. It is necessary to recognize how the characteristics of public and private institutions have helped or not helped in exercising patient advocacy by nurses.

JOB SATISFACTION AND PSYCHOLOGICAL HEALTH OF MEDICAL DOCTORS IN CALABAR, SOUTHERN NIGERIA.

PubMed

Bello, S; Asuzu, M C; Ofili, A N

2013-06-01

Employees should be happy at their work, considering the amount of time they devote to it throughout their working life. There is paucity of data on the job satisfaction and psychological health of medical doctors in Nigeria. To assess the level of job satisfaction and its relationship to psychological health among medical doctors in a southern city of Nigeria. A cross-sectional descriptive survey. Three major public hospitals in Calabar, Nigeria. Medical doctors who had worked for at least six months in the hospitals. Response rate was 73.0%. More than half (56.7%) of the respondents expressed overall satisfaction with their job. Inadequate pay and work overload were the most commonly mentioned reasons for job dissatisfaction. About a fifth of the respondents were at increased likelihood of psychological disorder. There was a statistically significant negative correlation between job satisfaction scores and GHQ scores. Satisfied respondents were least likely to have psychological disorder. Causes of job dissatisfaction among medical doctors should be addressed to improve their psychological health.

Advance care planning and end-of-life care in a network of rural Western Australian hospitals.

PubMed

Auret, Kirsten; Sinclair, Craig; Averill, Barbara; Evans, Sharon

2015-08-01

To provide a current perspective on end-of-life (EOL) care in regional Western Australia, with a particular focus on the final admission prior to death and the presence of documented advance care planning (ACP). Retrospective medical notes audit. One regional hospital (including colocated hospice) and four small rural hospitals in the Great Southern region of Western Australia. Ninety recently deceased patients, who died in hospitals in the region. Fifty consecutive patients from the regional hospital and 10 consecutive patients from each of the four rural hospitals were included in the audit. A retrospective medical notes audit was undertaken. A 94-item audit tool assessed patient demographics, primary diagnosis, family support, status on admission and presence of documented ACP. Detailed items described the clinical care delivered during the final admission, including communication with family, referral to palliative care, transfers, medical investigations, medical treatments and use of EOL care pathways. Fifty-two per cent were women; median age was 82 years old. Forty per cent died of malignancy. Median length of stay was 7 days. Thirty-nine per cent had formal or informal ACP documented. Rural hospitals performed comparably with the regional hospital on all measures. This study provides benchmarking information that can assist other rural hospitals and suggests ongoing work on optimal methods of measuring quality in EOL care. © 2015 National Rural Health Alliance Inc.

The Southern Nevada Agency Partnership Science and Research Synthesis: Science to support land management in Southern Nevada

Treesearch

Jeanne C. Chambers; Matthew L. Brooks; Burton K. Pendleton; Carol B. Raish

2013-01-01

This synthesis provides information related to the Southern Nevada Agency Partnership (SNAP) Science and Research Strategy Goal 1 - to restore, sustain and enhance southern Nevada’s ecosystems - and Goal 2 - to provide for responsible use of southern Nevada’s lands in a manner that preserves heritage resources and promotes an understanding of human interaction with the...

Active surveillance for acute flaccid paralysis in poliomyelitis high-risk areas in southern China.

PubMed Central

Chiba, Y.; Hikita, K.; Matuba, T.; Chosa, T.; Kyogoku, S.; Yu, J.; Wang, Z.

2001-01-01

OBJECTIVE: On 29 October 2000 poliomyelitis was officially declared to have been eradicated from the Western Pacific Region. This article describes the results of surveillance for cases of acute flaccid paralysis (AFP) in China during the final phase of the eradication effort. METHODS: We conducted hospital-based active surveillance in high-risk areas for poliomyelitis in 5 provinces of southern-China (Sichuan, Yunnan, Guizhou, Guangxi and Jiangxi) between 1995 and 1997 to determine the adequacy of reporting and laboratory diagnosis of cases of AFP. FINDINGS: A total of 1069 AFP cases occurring since 1993 were identified in 311 hospital visits. Less than 50% of AFP cases occurring in 1993 and 1994 had been reported by AFP surveillance, and laboratory diagnosis had been carried out on only a small proportion of these. However, improved cooperation between hospital sectors increased the rate of case reporting and laboratory diagnosis to 85% and 78%, respectively, in 1997. Despite this overall improvement, these two indicators were approximately 10-20% lower in Yunnan Province. Epidemiological analysis revealed that cases of clinical poliomyelitis accounted for as much as one-third of all AFP in 1993 and that some of these cases were clustered. Clusters were rarely observed after 1994. Active surveillance in the China-Myanmar border areas of Yunnan over 1995-96 detected 9 cross-border cases of clinical poliomyelitis, including 2 of wild poliomyelitis. Import of poliomyelitis was thus considered to have occurred frequently until 1996 in this border area of Yunnan. These data were important for the outbreak response immunization carried out in 1996 in the border prefectures of Yunnan. CONCLUSION: Our investigation confirmed a high level of AFP surveillance in poliomyelitis high-risk areas of the five provinces and provided valuable information on the interruption of wild poliovirus circulation in southern China that will be of use to countries in other regions that have

A Molecular Epidemiology Survey of Respiratory Adenoviruses Circulating in Children Residing in Southern Palestine

PubMed Central

Qurei, Lina; Seto, Donald; Salah, Zaidoun; Azzeh, Maysa

2012-01-01

A molecular epidemiology survey was performed in order to establish and document the respiratory adenovirus pathogen profiles among children in Southern Palestine. Three hundred and thirty-eight hospitalized pediatric cases with adenovirus-associated respiratory tract infections were analyzed. Forty four cases out of the 338 were evaluated in more detail for the adenoviruses types present. All of the children resided in Southern Palestine, that is, in city, village and refugee camp environments within the districts of Hebron and Bethlehem. Human adenoviruses circulated throughout 2005–2010, with major outbreaks occurring in the spring months. A larger percent of the children diagnosed with adenoviral infections were male infants. DNA sequence analysis of the hexon genes from 44 samples revealed that several distinct adenovirus types circulated in the region; these were HAdV-C1, HAdV-C2, HAdV-B3 and HAdV-C5. However, not all of these types were detected within each year. This is the first study ever conducted in Palestine of the genetic epidemiology of respiratory adenovirus infections. PMID:22880092

Do spirituality and faith make a difference? Report from the Southern European Psycho-Oncology Study Group.

PubMed

Travado, Luzia; Grassi, Luigi; Gil, Francisco; Martins, Cristina; Ventura, Cidália; Bairradas, Joana

2010-12-01

In the last decade, some attention has been given to spirituality and faith and their role in cancer patients' coping. Few data are available about spirituality among cancer patients in Southern European countries, which have a big tradition of spirituality, namely, the Catholic religion. As part of a more general investigation (Southern European Psycho-Oncology Study--SEPOS), the aim of this study was to examine the effect of spirituality in molding psychosocial implications in Southern European cancer patients. A convenience sample of 323 outpatients with a diagnosis of cancer between 6 to 18 months, a good performance status (Karnofsky Performance Status > 80), and no cognitive deficits or central nervous system (CNS) involvement by disease were approached in university and affiliated cancer centers in Italy, Spain, Portugal, and Switzerland (Italian speaking area). Each patient was evaluated for spirituality (Visual Analog Scale 0-10), psychological morbidity (Hospital Anxiety and Depression Scale--HADS), coping strategies (Mini-Mental Adjustment to Cancer--Mini-MAC) and concerns about illness (Cancer Worries Inventory--CWI). RESULTS. The majority of patients (79.3%) referred to being supported by their spirituality/faith throughout their illness. Significant differences were found between the spirituality and non-spirituality groups (p ≤ 0.01) in terms of education, coping styles, and psychological morbidity. Spirituality was significantly correlated with fighting spirit (r = -0.27), fatalism (r = 0.50), and avoidance (r = 0.23) coping styles and negatively correlated with education (r = -0.25), depression (r = -0.22) and HAD total (r = -0.17). Spirituality is frequent among Southern European cancer patients with lower education and seems to play some protective role towards psychological morbidity, specifically depression. Further studies should examine this trend in Southern European cancer patients.

El Niño–Southern Oscillation diversity and Southern Africa teleconnections during Austral Summer

USGS Publications Warehouse

Hoell, Andrew; Funk, Christopher C.; Magadzire, Tamuka; Zinke, Jens; Husak, Gregory J.

2014-01-01

A wide range of sea surface temperature (SST) expressions have been observed during the El Niño–Southern Oscillation events of 1950–2010, which have occurred simultaneously with different global atmospheric circulations. This study examines the atmospheric circulation and precipitation during December–March 1950–2010 over the African Continent south of 15∘S, a region hereafter known as Southern Africa, associated with eight tropical Pacific SST expressions characteristic of El Niño and La Niña events. The self-organizing map method along with a statistical distinguishability test was used to isolate the SST expressions of El Niño and La Niña. The seasonal precipitation forcing over Southern Africa associated with the eight SST expressions was investigated in terms of the horizontal winds, moisture budget and vertical motion. El Niño events, with warm SST across the east and central Pacific Ocean and warmer than average SST over the Indian Ocean, are associated with precipitation reductions over Southern Africa. The regional precipitation reductions are forced primarily by large-scale mid-tropospheric subsidence associated with anticyclonic circulation in the upper troposphere. El Niño events with cooler than average SST over the Indian Ocean are associated with precipitation increases over Southern Africa associated with lower tropospheric cyclonic circulation and mid-tropospheric ascent. La Niña events, with cool SST anomalies over the central Pacific and warm SST over the west Pacific and Indian Ocean, are associated with precipitation increases over Southern Africa. The regional precipitation increases are forced primarily by lower tropospheric cyclonic circulation, resulting in mid-tropospheric ascent and an increased flux of moisture into the region.

"If I only touch her cloak": the Sisters of Charity of St. Joseph in New Orleans hospital, 1834-1860.

PubMed

Kong, Hyejung Grace; Kim, Ock-Joo

2015-04-01

This study is about the Sisters of Charity of St. Joseph in New Orleans' Charity Hospital during the years between 1834 and 1860. The Sisters of Charity of St. Joseph was founded in 1809 by Saint Elizabeth Ann Bailey Seton (first native-born North American canonized in 1975) in Emmitsburg, Maryland. Seton's Sisters of Charity was the first community for religious women to be established in the United States and was later incorporated with the French Daughters of Charity of St. Vincent de Paul in 1850. A call to work in New Orleans' Charity Hospital in the 1830s meant a significant achievement for the Sisters of Charity, since it was the second oldest continuously operating public hospitals in the United States until 2005, bearing the same name over the decades. In 1834, Sister Regina Smith and other sisters were officially called to Charity Hospital, in order to supersede the existing "nurses, attendants, and servants," and take a complete charge of the internal management of Charity Hospital. The existing scholarship on the history of hospitals and Catholic nursing has not integrated the concrete stories of the Sisters of Charity into the broader histories of institutionalized medicine, gender, and religion. Along with a variety of primary sources, this study primarily relies on the Charity Hospital History Folder stored at the Daughters of Charity West Center Province Archives. Located in the "Queen city of the South," Charity Hospital was the center of the southern medical profession and the world's fair of people and diseases. Charity Hospital provided the sisters with a unique situation that religion and medicine became intertwined. The Sisters, as nurses, constructed a new atmosphere of caring for patients and even their families inside and outside the hospital, and built their own separate space within the hospital walls. As hospital managers, the Sisters of Charity were put in complete charge of the hospital, which was never seen in other hospitals. By

Seasonal variation and trend of chicken pox in the southern region of Saudi Arabia (2007-2012).

PubMed

Saleh, Noha; Al Moghazy, Bassem

2014-12-01

Chicken pox is a contagious disease caused by varicella zoster virus. Children are most susceptible to infection. In 1998, the WHO recommended that routine childhood varicella vaccination be considered in countries where the disease is a relatively important public health concern. There are few data on the trends of chicken pox. We aimed to evaluate the trend of chicken pox in Saudi Arabia (KSA) during the period 2007-2012. Data were collected by retrospective review of the existing anonymous surveillance records and book registries of chicken pox cases at the preventive medicine department of Armed Forces Hospital of the Southern Region of Saudi Arabia from 2007 to 2012. The collected data included the number, age, and sex of registered cases. A seasonal pattern was clearly demonstrated, with peak in March and April. There was also a decreasing trend from 2007 to 2012. Most cases occurred in the age group 4-15 years. The number of infected male patients was a little higher compared with female patients. These results indicate success in controlling the disease in the southern region of Saudi Arabia, which may be attributed to the implementation of public health interventions targeted at reducing infectious diseases (such as the introduction of varicella zoster vaccine in 2008). We recommend that a future study be conducted on the severity of chicken pox infection in adults (hospitalization, complications, and death) and a national survey among adults for the seroprevalence of markers of infection with varicella zoster.

The Southern Hemisphere VLBI experiment

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

Preston, R.A.; Meier, D.L.; Louie, A.P.

1989-07-01

Six radio telescopes were operated as the first Southern Hemisphere VLBI array in April and May 1982. Observations were made at 2.3 and 8.4 GHz. This array provided VLBI modeling and hybrid imaging of celestial radio sources in the Southern Hemisphere, high-accuracy VLBI geodesy between Southern Hemisphere sites, and subarcsecond radio astrometry of celestial sources south of declination -45 deg. The goals and implementation of the array are discussed, the methods of modeling and hybrid image production are explained, and the VLBI structure of the sources that were observed is summarized. 36 refs.

Creation of inpatient capacity during a major hospital relocation: lessons for disaster planning.

PubMed

Jen, Howard C; Shew, Stephen B; Atkinson, James B; Rosenthal, J Thomas; Hiatt, Jonathan R

2009-09-01

To identify tools to aid the creation of disaster surge capacity using a model of planned inpatient census reduction prior to relocation of a university hospital. Prospective analysis of hospital operations for 1-week periods beginning 2 weeks (baseline) and 1 week (transition) prior to move day; analysis of regional hospital and emergency department capacity. Large metropolitan university teaching hospital. Hospital census figures and patient outcomes. Census was reduced by 36% from 537 at baseline to 345 on move day, a rate of 18 patients/d (P < .005). Census reduction was greater for surgical services than nonsurgical services (46% vs 30%; P = .02). Daily volume of elective operations also decreased significantly, while the number of emergency operations was unchanged. Hospital admissions were decreased by 42%, and the adjusted discharges per occupied bed were increased by 8% (both P < .05). Inpatient mortality was not affected. Regional capacity to absorb new patients was limited. During a period in which southern California population grew by 8.5%, acute care beds fell by 3.3%, while Los Angeles County emergency departments experienced a 13% diversion rate due to overcrowding. Local or regional disasters of any size can overwhelm the system's ability to respond. Our strategy produced a surge capacity of 36% without interruption of emergency department and trauma services but required 3 to 4 days for implementation, making it applicable to disasters and mass casualty events with longer lead times. These principles may aid in disaster preparedness and planning.

Patient experiences of transitioning from hospital to home: an ethnographic quality improvement project.

PubMed

Cain, Carol H; Neuwirth, Estee; Bellows, Jim; Zuber, Christi; Green, Jennifer

2012-01-01

Little is known about patient perspectives of the transition from hospital to home. To develop a richly detailed, patient-centered view of patient and caregiver needs in the hospital-to-home transition. An ethnographic approach including participant observation and in-depth, semi-structured video recorded interviews. Kaiser Permanente's Southern California, Colorado, and Hawaii regions. Twenty-four adult inpatients hospitalized for a range of acute and chronic conditions and characterized by variety in diagnoses, illness severity, planned or unplanned hospitalization, age, and ability to self manage. During the hospital-to-home transition, patients and caregivers expressed or demonstrated experiences in 6 domains: 1) translating knowledge into safe, health-promoting actions at home; 2) inclusion of caregivers at every step of the transition process; 3) having readily available problem-solving resources; 4) feeling connected to and trusting providers; 5) transitioning from illness-defined experience to "normal" life; and 6) anticipating needs after discharge and making arrangements to meet them. The work of transitioning occurs for patients and caregivers in the hours and days after they return home and is fraught with challenges. Reducing readmissions will remain challenging without a broadened understanding of the types of support and coaching patients need after discharge. We are piloting strategies such as risk stratification and tailoring of care, a specialized phone number for recently discharged patients, standardized same-day discharge summaries to primary care providers, medication reconciliation, follow-up phone calls, and scheduling appointments before discharge. Copyright © 2012 Society of Hospital Medicine.

Identifying the Infection Control Areas Requiring Modifications in Thoracic Surgery Units: Results of a Two-Year Surveillance of Surgical Site Infections in Hospitals in Southern Poland.

PubMed

Dubiel, Grzegorz; Rogoziński, Paweł; Żaloudik, Elżbieta; Bruliński, Krzysztof; Różańska, Anna; Wójkowska-Mach, Jadwiga

2017-10-01

Surgical site infection (SSI) is considered to be a priority in infection control. The objective of this study is the analysis of results of active targeted surveillance conducted over a two-year period in the Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra, in southern Poland. The retrospective analysis was carried out on the basis of results of active monitoring of SSI in the 45-bed Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra between April 1, 2014 and April 30, 2016. Surgical site infections were identified based on the definitions of the European Centre for Disease Prevention and Control (ECDC) taking into account the time of symptom onset, specifically, whether the symptoms occurred within 30 d after the surgical procedure. Detection of SSI relied on daily inspection of incisions by a trained nurse, analysis of medical and nursing entries in the computer system, and analysis of all results of microbiologic tests taken in the unit and in the operating room. In the study period, data were collected regarding 1,387 treatment procedures meeting the registration criteria. Forty cases of SSI were detected yielding an incidence rate of 3%. Most cases (55%) were found in the course of hospitalization and 45% were detected after the patient's discharge. The SSIs were classified as follows: superficial, 37.5%; deep infections, 7.5%; and organ/space infection, 55%. Among patients who were diagnosed with SSI, most were male (77.5%). For patients with an American Society of Anesthesiologists (ASA) score I-II the incidence rate was 2%; ASA score III or more, 3.7%. The incidence rate varied from 0.3% in clean surgical site to 6.5% in clean-contaminated site. The study validated the usefulness of targeted surveillance in monitoring SSIs in patients hospitalized in thoracic surgery departments. Surgical site infection surveillance identified areas of care requiring modifications, namely

Reliability of the hospital nutrition environment scan for cafeterias, vending machines, and gift shops.

PubMed

Winston, Courtney P; Sallis, James F; Swartz, Michael D; Hoelscher, Deanna M; Peskin, Melissa F

2013-08-01

According to ecological models, the physical environment plays a major role in determining individual health behaviors. As such, researchers have started targeting the consumer nutrition environment of large-scale foodservice operations when implementing obesity-prevention programs. In 2010, the American Hospital Association released a call-to-action encouraging health care facilities to join in this movement and improve their facilities' consumer nutrition environments. The Hospital Nutrition Environment Scan (HNES) for Cafeterias, Vending Machines, and Gift Shops was developed in 2011, and the present study evaluated the inter-rater reliability of this instrument. Two trained raters visited 39 hospitals in southern California and completed the HNES. Percent agreement, kappa statistics, and intraclass correlation coefficients were calculated. Percent agreement between raters ranged from 74.4% to 100% and kappa statistics ranged from 0.458 to 1.0. The intraclass correlation coefficient for the overall nutrition composite scores was 0.961. Given these results, the HNES demonstrated acceptable reliability metrics and can now be disseminated to assess the current state of hospital consumer nutrition environments. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Hospital activity and hospital profits.

PubMed

Hegji, Charles E

2007-01-01

The paper uses data from a cross section of southeastern hospitals to examine which activities are profitable for hospitals. The analysis suggests that hospitals may operate at less than profit-maximizing levels of output. In addition, contrary to popular belief emergency rooms are shown to be profit generating centers for hospitals.

Silvicultural Considerations in Managing Southern Pine Stands in the Context of Southern Pine Beetle

Treesearch

James M. Guldin

2011-01-01

Roughly 30 percent of the 200 million acres of forest land in the South supports stands dominated by southern pines. These are among the most productive forests in the nation. Adapted to disturbance, southern pines are relatively easy to manage with even-aged methods such as clearcutting and planting, or the seed tree and shelterwood methods with natural regeneration....

Triton Southern Hemisphere

NASA Image and Video Library

1998-06-08

This polar projection from NASA Voyager 2 of Triton southern hemisphere provides a view of the southern polar cap and bright equatorial fringe. The margin of the cap is scalloped and ranges in latitude from +10 degrees to -30 degrees. The bright fringe is closely associated with the cap's margin; from it, diffuse bright rays extend north-northeast for hundreds of kilometers. The bright fringe probably consists of very fresh nitrogen frost or snow, and the rays consist of bright-fringe materials that were redistributed by north-moving Coriolis-deflected winds. http://photojournal.jpl.nasa.gov/catalog/PIA00423

Southern Ocean Iron Experiment (SOFex)

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

Coale, Kenneth H.

The Southern Ocean Iron Experiment (SOFeX) was an experiment decades in the planning. It's implementation was among the most complex ship operations that SIO has been involved in. The SOFeX field expedition was successful in creating and tracking two experimentally enriched areas of the Southern Ocean, one characterized by low silicic acid, one characterized by high silicic acid. Both experimental sites were replete with abundant nitrate. About 100 scientists were involved overall. The major findings of this study were significant in several ways: (1) The productivity of the southern ocean is limited by iron availability. (2) Carbon uptake and fluxmore » is therefore controlled by iron availability (3) In spite of low silicic acid, iron promotes non-silicious phytoplankton growth and the uptake of carbon dioxide. (4) The transport of fixed carbon from the surface layers proceeds with a C:N ratio that would indicate differential remineralization of nitrogen at shallow depths. (5) These finding have major implications for modeling of carbon export based on nitrate utilization. (6) The general results of the experiment indicate that, beyond other southern ocean enrichment experiments, iron inputs have a much wider impact of productivity and carbon cycling than previously demonstrated. Scientific presentations: Coale, K., Johnson, K, Buesseler, K., 2002. The SOFeX Group. Eos. Trans. AGU 83(47) OS11A-0199. Coale, K., Johnson, K. Buesseler, K., 2002. SOFeX: Southern Ocean Iron Experiments. Overview and Experimental Design. Eos. Trans. AGU 83 (47) OS22D-01. Buesseler, K.,et al. 2002. Does Iron Fertilization Enhance Carbon Sequestration? Particle flux results from the Southern Ocean Iron Experiment. Eos. Trans. AGU 83 (47), OS22D-09. Johnson, K. et al. 2002. Open Ocean Iron Fertilization Experiments From IronEx-I through SOFeX: What We Know and What We Still Need to Understand. Eos. Trans. AGU 83 (47), OS22D-12. Coale, K. H., 2003. Carbon and Nutrient Cycling During the

A critical ethnography of doctor-patient interaction in southern Iran.

PubMed

Sadati, Ahmad Kalateh; Iman, Mohammad Taghi; Lankarani, Kamran Bagheri; Derakhshan, Soghra

2016-01-01

Doctor-patient interaction is a subject with ethical ramifications, besides being an important issue in medical sociology. The main goal of this critical study is to explore the interactional experience of hospital admitted patients. For this reason, the study, carried out in an educational hospital in southern Iran, entailed 156 recorded clinical consultations, 920 hours of participant observation, and six focus groups consisting of patients and their families. The research method used is Critical Ethnography, which was introduced by PF Carspecken. The results showed that negative interactional experience was common among the participants. Six related themes were: doctors' inattentiveness; weak interaction; violation of patients' privacy; unjustified pain; long waiting period and ambiguity; and faceless physicians. According to the participants' observations, poor interaction with doctors has led to these negative experiences. The findings showed that doctors were inconsiderate about patients' concerns and due to this, patients were dissatisfied. Theoretically, this form of fragmented collaboration has deep roots in the framework of modern medicine, but in the context of this study, the intensity of the fragmentation between doctors and patients was observed to be intolerable. To solve this problem, models of patient-centredness and narrative medicine are recommended. In addition, the health system should monitor and evaluate the observance of ethics by physicians.

Guidelines for regenerating southern pine beetle spots

Treesearch

J.C.G. Goelz; B.L. Strom; J.P. Barnett; M.A. Sword Sayer

2012-01-01

Southern pine forests are of exceptional commercial and ecological importance to the United States, and the southern pine beetle is their most serious insect pest. The southern pine beetle generally kills overstory pines, causing spots of tree mortality that are unpredictable in time and space and frequently disruptive to management activities and goals. The canopy...

Southern Coal Corporation Clean Water Settlement

EPA Pesticide Factsheets

Southern Coal Corporation is a coal mining and processing company headquartered in Roanoke, VA. Southern Coal Corporation and the following 26 affiliated entities are located in Alabama, Kentucky, Tennessee, Virginia and West Virginia

Viral Etiology of Encephalitis in Children in Southern Vietnam: Results of a One-Year Prospective Descriptive Study

PubMed Central

Tan, Le Van; Qui, Phan Tu; Ha, Do Quang; Hue, Nguyen Bach; Bao, Lam Quoi; Cam, Bach Van; Khanh, Truong Huu; Hien, Tran Tinh; Vinh Chau, Nguyen Van; Tram, Tran Tan; Hien, Vo Minh; Nga, Tran Vu Thieu; Schultsz, Constance; Farrar, Jeremy; van Doorn, H. Rogier; de Jong, Menno D.

2010-01-01

Background Acute encephalitis is an important and severe disease in children in Vietnam. However, little is known about the etiology while such knowledge is essential for optimal prevention and treatment. To identify viral causes of encephalitis, in 2004 we conducted a one-year descriptive study at Children's Hospital Number One, a referral hospital for children in southern Vietnam including Ho Chi Minh City. Methodology/Principal Findings Children less than 16 years of age presenting with acute encephalitis of presumed viral etiology were enrolled. Diagnostic efforts included viral culture, serology and real time (RT)-PCRs. A confirmed or probable viral causative agent was established in 41% of 194 enrolled patients. The most commonly diagnosed causative agent was Japanese encephalitis virus (n = 50, 26%), followed by enteroviruses (n = 18, 9.3%), dengue virus (n = 9, 4.6%), herpes simplex virus (n = 1), cytomegalovirus (n = 1) and influenza A virus (n = 1). Fifty-seven (29%) children died acutely. Fatal outcome was independently associated with patient age and Glasgow Coma Scale (GCS) on admission. Conclusions/Significance Acute encephalitis in children in southern Vietnam is associated with high mortality. Although the etiology remains unknown in a majority of the patients, the result from the present study may be useful for future design of treatment and prevention strategies of the disease. The recognition of GCS and age as predictive factors may be helpful for clinicians in managing the patient. PMID:21049060

Studies in Site Evaluation for Southern Hardwoods

Treesearch

Thomas C. Nelson; William R. Beaufait

1956-01-01

SOUTHERN HARDWOODS, which supply more than half of the nation's hardwood lumber, are a complex and varied mixture of nearly 40 commercial species. On a good share of the 112 million acres of southern hardwood types the hardwoods are mixed with or have replaced southern pines. Faced with this profusion of species, the silviculturist's first problem is to know...

Situation analysis for cervical cancer diagnosis and treatment in east, central and southern African countries.

PubMed Central

Chirenje, Z. M.; Rusakaniko, S.; Kirumbi, L.; Ngwalle, E. W.; Makuta-Tlebere, P.; Kaggwa, S.; Mpanju-Shumbusho, W.; Makoae, L.

2001-01-01

OBJECTIVE: To determine the factors influencing cervical cancer diagnosis and treatment in countries of East, Central and Southern Africa (ECSA). METHODS: Data were collected from randomly selected primary health care centres, district and provincial hospitals, and tertiary hospitals in each participating country. Health care workers were interviewed, using a questionnaire; the facilities for screening, diagnosing, and treating cervical cancer in each institution were recorded, using a previously designed checklist. FINDINGS: Although 95% of institutions at all health care levels in ECSA countries had the basic infrastructure to carry out cervical cytology screening, only a small percentage of women were actually screened. Lack of policy guidelines, infrequent supply of basic materials, and a lack of suitable qualified staff were the most common reasons reported. CONCLUSIONS: This study demonstrates that there is an urgent need for more investment in the diagnosis and treatment of cervical cancer in ECSA countries. In these, and other countries with low resources, suitable screening programmes should be established. PMID:11242819

Dimensional stabilization of southern pines

Treesearch

E.T. Choong; H.M. Barnes

1969-01-01

The effectiveness of five dimensional stabilizing agents and three impregnation methods on southern pine was determined. Four southern pine species were studies in order to determine the effect of wood factors. The best dimensional stability was obtained when the wood was preswollen and the chemical was impregnated by a diffusion process. In general, polyethylene...

Southern Pinwheel

NASA Image and Video Library

2010-06-28

This image from NASA Wide-field Infrared Survey Explorer shows the nearby galaxy M83. This is a spiral galaxy approximately 15 million light-years away in the constellation Hydra, sometimes referred to as the southern Pinwheel galaxy.

Prevention of meticillin-resistant Staphylococcus aureus bloodstream infections in European hospitals: moving beyond policies.

PubMed

Borg, M A; Hulscher, M; Scicluna, E A; Richards, J; Azanowsky, J-M; Xuereb, D; Huis, A; Moro, M L; Maltezou, H C; Frank, U

2014-08-01

There is evidence that meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia can be reduced with improved infection control and antibiotic stewardship. To survey infection control and antibiotic stewardship practices within European hospitals and to identify initiatives that correlate with reduced MRSA prevalence. Online questionnaires were sent to European hospitals about their surveillance, hand hygiene, intravenous device management, admission screening, isolation, antibiotic prescribing, hospital demographics and MRSA blood culture isolates during 2010. In all, 269 replies were received from hospitals in 29 European countries. Lower MRSA prevalence showed significant association with presence of incidence surveillance, performance of root cause analysis, mandatory training requirements for hand hygiene, accountability measures for persistent non-compliance, and multi-stakeholder teamwork in antibiotic prescribing. Presence of policies on intravenous catheter insertion and management showed no variation between different MRSA prevalence groups. However, low-prevalence hospitals reported more competency assessment programmes in insertion and maintenance of peripheral and central venous catheters. Hospitals from the UK and Ireland reported the highest uptake of infection control and antibiotic stewardship practices that were significantly associated with low MRSA prevalence, whereas Southern European hospitals exhibited the lowest. In multiple regression analysis, isolation of high-risk patients, performance of root cause analysis, obligatory training for nurses in hand hygiene, and undertaking joint ward rounds including microbiologists and infectious disease physicians remained significantly associated with lower MRSA prevalence. Proactive infection control and antibiotic stewardship initiatives that instilled accountability, ownership, teamwork, and validated competence among healthcare workers were associated with improved MRSA outcomes. Copyright �

Southern Pine Beetle Field Survey

Treesearch

Saul D. Petty

2011-01-01

Southern pine beetle (SPB) is one of the most formidable insect pests impacting southern forests. Federal, State, and private forest managers have always dealt with this pest in some capacity. One of the primary requirements for controlling SPB is locating infestations on the ground. Once the infestation has been located, data is collected and used in management...

Fusiform Rust of Southern Pines

Treesearch

W. R. Phelps; F. L. Czabator

1978-01-01

Fusiform rust, caused by the fungus Cronartium fusiforme Hedg. & Hunt ex Cumm., is distributed in the Southern United States from Maryland to Florida and west to Texas and southern Arkansas. Infections by the fungus, which develops at or near the point of infection, result in tapered, spindle-shaped swells, called galls, on branches and stems of pines. (see photo...

Influence of southern spiritual beliefs on perceptions of mental illness.

PubMed

Morrison, E F; Thornton, K A

1999-01-01

Cultural religious beliefs influence perceptions of mental illness, and any clinician interested in treating mentally ill people and their families must consider these beliefs so that he or she can develop culturally specific interventions. This article reports on the results of interviews with African American experts, mentally ill persons, and nurses caring for the mentally ill. A case study is used to illustrate the influence of southern religious beliefs on perceptions of mental illness and the behaviors of people who are mentally ill. Although many issues are considered in this analysis (i.e., ethnicity, geographic location, and religion), it is the influence of three religious traditions in the South--voodoo, slave religion, and evangelical Protestantism--that takes precedence in the analysis. Mental health professionals, especially psychiatric nurses, will find this information helpful when assisting hospitalized patients.

Increasing access to legal termination of pregnancy and postabortion contraception at the University Teaching Hospital, Lusaka, Zambia.

PubMed

Macha, Swebby; Muyuni, Mutinta; Nkonde, Scholastica; Faúndes, Anibal

2014-07-01

The Zambian Association of Gynecology and Obstetrics is one of the International Federation of Gynecology and Obstetrics (FIGO) member societies participating in the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences from the East, Central, and Southern Africa region. The activities included in this country's plan of action were to provide access to safe abortion within the full extent of the law to women receiving care at the University Teaching Hospital in Lusaka, and to increase the proportion of women leaving the hospital with a contraceptive method. Zambian law regarding abortion is liberal, but in general it was not applied until very recently. The proportion of legal terminations of pregnancy among patients receiving abortion care at the hospital increased from 3.2% in 2009 to 7.7% in 2011, while the percentage of women leaving the hospital with a contraceptive method increased from 25.3% to 69.4% over the same period. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Maribor General Hospital from its foundation until World War II.

PubMed

Pivec, Gregor

2006-01-01

The author describes the history of Maribor General Hospital from its foundation in 1799 until the beginning of World War II. In 1799 the magistrate of the town of Maribor issued a memorandum regarding the establishment of a town hospital in the renovated building of the town hospice, providing space for 24 patients. The work of the hospital was carried out in the former hospice building until 1855. In the period between its establishment and eventual relocation 26 beds were added. The last two decades of the hospital's operation at the original location were marked by the assiduous work of the town's physicist, Dr. Anton Kuker. In the first half of the 19th century, the population of Maribor grew rapidly as a consequence of the construction of the Southern Railway. The town authorities therefore purchased the Prosenjak family villa in the Magdalena suburbs and relocated the hospital to it in 1855, providing 28 rooms for 110 patients. For a whole century, the care of patients was taken over by the Daughters of Charity of Saint Vincent de Paul. The hospital was soon admitting over 1000 patients a year, the most common complaints being pulmonary catarrh, gastritis and fever. In 1872, when the Master of Surgery Feliks Ferk joined the hospital, the internal "medical" and the "external" surgical departments were formed. Although medical studies were not easily accessible, there were a number of Slovene physicians working in the hospital and the town in that period. In the last decades of the 19th century, the hospital was often renovated and enlarged. The infrastructure (telephone, water supply system, heating, lighting) had also been modernized before World War I. In 1914, the first X-ray apparatus was purchased. Between the wars, the hospital's development was boosted by recruitment of the Slovene physicians Ivan Matko, Mirko Cernic, Janko Dernovsek and Hugon Robic. The initial external and medical departments split into several departments: internal medicine, surgery

The Southern Nevada Agency Partnership Science and Research Synthesis: Science to support land management in Southern Nevada - Executive Summary

Treesearch

Jeanne C. Chambers; Matthew L. Brooks; Burton K. Pendleton; Carol B. Raish

2013-01-01

This synthesis provides information related to the Southern Nevada Agency Partnership (SNAP) Science and Research Strategy Goal 1 - to restore, sustain and enhance southern Nevada’s ecosystems - and Goal 2 - to provide for responsible use of southern Nevada’s lands in a manner that preserves heritage resources and promotes an understanding of human interaction with the...

Southern Ocean warming due to human influence

NASA Astrophysics Data System (ADS)

Fyfe, John C.

2006-10-01

I show that the latest series of climate models reproduce the observed mid-depth Southern Ocean warming since the 1950s if they include time-varying changes in anthropogenic greenhouse gases, sulphate aerosols and volcanic aerosols in the Earth's atmosphere. The remarkable agreement between observations and state-of-the art climate models suggests significant human influence on Southern Ocean temperatures. I also show that climate models that do not include volcanic aerosols produce mid-depth Southern Ocean warming that is nearly double that produced by climate models that do include volcanic aerosols. This implies that the full effect of human-induced warming of the Southern Ocean may yet to be realized.

Dysmenorrhoea and self-care behaviours among hospital nurses: a questionnaire survey.

PubMed

Chiu, Min-Hui; Wang, Hsiu-Hung; Hsu, Su-Chen; Liu, I-Ping

2013-11-01

To investigate self-care behaviours and its predictors for dysmenorrhoea among hospital nurses. Dysmenorrhoea is an important issue in hospital nurses for its influence on job performance and quality of patient care. Given the difficulties in reorganising work schedule for taking menstrual leave in Taiwan, it is necessary to improve the comfort level of nurses during menstruation. A cross-sectional correlation study using a structured questionnaire. A convenience sampling method was used to select two hospitals in Southern Taiwan, and participants were recruited by random sampling method. Questionnaire used in the study contained personal information, Dysmenorrheic Knowledge Scale, Menstrual Attitude Scale and Dysmenorrheic Self-Care Behavior Scale (DSCBS). Two hundred and ninety-seven participants had experienced dysmenorrhoea in the last six months, with the prevalence rate of 70·7%. Results showed the average age of the participants was 30·3 years, and 252 participants (82·4%) self-perceived they were bothered by dysmenorrhoea. The score of DSCBS was 29·9 (±5·3). The results of stepwise multiple regression analysis revealed the predictors of DSCBS included whether the participants (1) were married, (2) had irregular menstruation, (3) had received health education on dysmenorrhoea, (4) visited doctor for dysmenorrhoea, (5) knew they may take menstrual leave and (6) were identified with menstruation as a natural event. The r(2) was 18·4%. Hospital nurses' self-care behaviour for dysmenorrhoea is suggested to be improved through enhanced peer support and caring. The prevalence rate of dysmenorrhoea among hospital nurses is high. Most of them take analgesics to reduce pain to return to work. We recommend hospitals to provide women-friendly workplace and empowerment activities to improve the self-care ability and comfort level of nurses during menstruation. © 2013 John Wiley & Sons Ltd.

Southern California Daily Energy Report

EIA Publications

2016-01-01

EIA has updated its Southern California Daily Energy Report to provide additional information on key energy market indicators for the winter season. The dashboard includes information that EIA regularly compiles about energy operations and the management of natural gas and electricity systems in Southern California in the aftermath of a leak at the Aliso Canyon natural gas storage facility outside of Los Angeles

Molecular Identification and Epidemiological Features of Human Adenoviruses Associated with Acute Respiratory Infections in Hospitalized Children in Southern China, 2012-2013.

PubMed

Chen, Yi; Liu, Fanghua; Wang, Changbing; Zhao, Mingqi; Deng, Li; Zhong, Jiayu; Zhang, Yingying; Ye, Jun; Jing, Shuping; Cheng, Zetao; Guan, Yongxin; Ma, Yi; Sun, Yuanyuan; Zhu, Bing; Zhang, Qiwei

2016-01-01

Acute respiratory infections (ARI) are the major worldwide health problem associated with high morbidity and mortality rates. Human adenovirus (HAdV) is one of the most common pathogens associated with viral ARI, and thus calls for specific diagnosis and better understanding of the epidemiology and clinical characteristics. Total 4,130 children with ARI requiring hospitalization from 2012 to 2013 were retrospectively studied. Throat swab specimens were collected from each patient. Fluorescence Quantitative PCR was performed to detect adenovirus as well as other common ARI-related pathogens. The seven HAdV hypervariable regions (HVRs) of the hexon gene from fifty-seven HAdVs-positive samples collected in the seasonal peaks were sequenced. Phylogenetic analysis of HVRs was also conducted to confirm the molecular types and genetic variation. In addition, epidemiological features and co-infection with other human respiratory pathogens were investigated and analyzed. Of 4,130 hospitalized pediatric patients tested, the positive rates of respiratory syncytial virus (RSV), Mycoplasma pneumoniae (MP), and HAdV were 13.7%, 13.2%, and 12.0%, respectively. The HAdV positive patients accounted for 7.9%, 17.2%, 17.5% and 10.7% in age groups <1, 1-3, 3-6 and 6-14 years, respectively. Eighty-four HAdV positive children were co-infected with other respiratory pathogens (84/495, 17.0%). The most common co-infection pathogens with HAdV were MP (57.1%) and Human Bocavirus (HBoV) (16.7%). The majority of HAdV infected patients were totally recovered (96.9%, 480/495); However, four (0.8%) patients, who were previously healthy and at the age of 2 years or younger died of pneumonia. Seasonal peaks of HAdV infection occurred in the summer season of 2012 and 2013; the predominant HAdV type was HAdV-3 (70%), followed by HAdV-7 (28%). These epidemiological features were different from those in Northern China. The HAdV-55 was identified and reported for the first time in Guangzhou

Establishing strategic alliance among hospitals through SAIS: a case study in Taiwan.

PubMed

Hung, Won-Fu; Hwang, Hsin-Ginn; Liao, Chechen

2005-01-01

Due to a reformed healthcare insurance system and a gradually decreasing public affairs' budget by the government year by year, Central Taiwan Office (CTO), the Department of Health (DOH) in Taiwan, initiated a strategic alliance project of the hospitals subordinated to the DOH in November, 2001. This project was a five-year plan with an attempt to expand and develop three more strategic alliances covering the northern, southern and eastern regions of Taiwan respectively. Through a cooperative system, such an alliance allows the following: resource sharing, technique collaboration, marketing affiliations and so on. In order to decrease operation management costs and improve the quality of service at hospitals, the strategic alliance practice is supported by IS. We call this alignment the IS-enabled strategic alliance. All the IS-enabled functions are supported by the Strategic Alliance Information System (SAIS). In this article, the SAIS developed by the CTO of the DOH is introduced.

Smoke from Fires in Southern Mexico

NASA Image and Video Library

2002-05-08

On May 2, 2002, numerous fires in southern Mexico sent smoke drifting northward over the Gulf of Mexico. These views from NASA Terra satellite illustrate the smoke extent over parts of the Gulf and the southern Mexican states of Tabasco, Campeche and Ch

The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the Southern (Asir) province, Saudi Arabia.

PubMed

Al-Zahrani, Ibrahim A; Alsiri, Bander A

2018-01-01

To identify the prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) and the most common types of cabapenemases among CRKP in the Southern (Asir) province hospitals, Saudi Arabia. Methods: The cross-sectional study was conducted between late April and September in 2015. A total of 54 Klebsiella pneumoniae (K. pneumoniae) isolates with reduced sensitivity to carbapenems were obtained from various clinical specimens of the 2 largest hospitals in the Southern province. Minimum inhibitory concentrations (MICs) of carbapenems were confirmed using E-test. Molecular detection of the most common carbapenemase genes (blaIMP, bla-carbapenem-hydrolyzing oxacillinase [OXA-48], blaVIM, bla-New Delhi metallo-ß-lactamas [NDM], and blaKPC) was performed using multiplex-polymerase chain reaction. Results: The current study found that increasing age and intensive care unit admission were associated with CRKP isolation. The major type of carbapenemases was OXA-48 with 81.5% (n=44) and it seems to reach an endemic level. New Delhi metallo-ß-lactamas (NDM) was the second most frequent carbapenemase by 7.4% (n=4) of isolates while Verona integron-encoded metallo-ß-lactamase (VIM) was reported only in one isolate. Conclusion: Saudi Arabia receives large numbers of visitors and migrant workers from OXA-48 and NDM endemic countries such as Turkey, India, and Pakistan every year.

Hospital admissions of adults with community-acquired pneumonia in Portugal between 2000 and 2009.

PubMed

Froes, Filipe; Diniz, António; Mesquita, Margarida; Serrado, Margarida; Nunes, Baltazar

2013-05-01

Recent studies in the USA and northern Europe have shown an increase in community-acquired pneumonia (CAP). In southern Europe, this increase has not yet been documented. We carried out a retrospective analysis from encoded information from the Portuguese database for hospital admissions that included all individuals aged ≥18 years, with a primary diagnosis of pneumonia, who were discharged between 2000 and 2009. We excluded patients infected with HIV, individuals immunocompromised as a result of anti-cancer or immunosuppressive treatment, and transplant recipients. Of the 294 027 admissions for CAP, 56% were male. The mean age was 73.1 years and the median age 77 years. Between 2000 and 2009, there was a 5% increase in the average age of patients admitted with CAP. Admissions for CAP represented 3.7% of total admissions of adult patients. The average annual rate of hospital admissions for adults with CAP was 3.61 per 1000 total population, rising to 13.4 for those aged ≥65 years. Between 2000-2004 and 2005-2009 the average annual rate of hospital admission for CAP per 1000 population increased by 28.2%. Hospital admissions for CAP in Portugal increased between 2000 and 2009. It has grown consistently over time, varying according to age with males over-represented.

Tenacious Southern Progressives: Confounding Mencken's Myth of Mediocrity.

ERIC Educational Resources Information Center

Allen, Louise; Reynolds, Katherine

After H.L. Mencken in a 1920 essay labeled the American South "the Sahara of the Bozart," the journalist Gerald Johnson debated with him the merits of southern intellectual life primarily as indicated in southern literature. There were noteworthy southern artists, journalists, social anthropologists, and educators, ranging from the…

The First Evidence of Lyme Neuroborreliosis in Southern Bosnia and Herzegovina

PubMed Central

Skocibusic, Sinisa; Nikolic, Jadranka

2014-01-01

Lyme borreliosis (LB) is caused by the spirochete Borrelia burgdorferi, which is transmitted to humans by ticks of the Ixodes ricinus complex. It is manifested by a variety of clinical symptoms and affects skin, joints, heart, and nervous system. Neurological manifestations are predictable and usually include meningoencephalitis, facial palsy, or radiculopathy. Recently, a dramatic rise in the number of diagnosed cases of LB has been observed on the global level. Here we show the first case of Lyme neuroborreliosis in southern Bosnia and Herzegovina, which was first presented by erythema chronicum migrans. Unfortunately, it was not recognized or well treated at the primary care medicine. After eight weeks, the patient experienced headache, right facial palsy, and lumbar radiculopathy. After the clinical examination, the neurologist suspected meningoencephalitis and the patient was directed to the Clinic for Infectious Disease of the University Hospital Mostar, where he was admitted. The successful antimicrobial treatment with the 21-day course of ceftriaxone was followed by normalization of neurological status, and then he was discharged from the hospital. This case report represents an alert to all physicians to be aware that LB is present in all parts of Bosnia and Herzegovina, as well as in the neighboring regions. PMID:25580319

Radiography on wheels arrives to nursing homes - an economic assessment of a new health care technology in southern Sweden.

PubMed

Dozet, Alexander; Ivarsson, Bodil; Eklund, Karin; Klefsgård, Rosemarie; Geijer, Mats

2016-12-01

The process of transferring older, vulnerable adults from an elder care facility to the hospital for medical care can be an emotionally and physically stressful experience. The recent development of modern mobile radiography may help to ease this anxiety by allowing for evaluation in the nursing home itself. Up until this point, no health economic evaluation of the technology has been attempted in a Swedish setting. The objective of this study was to determine whether examinations of patients in elder care facilities with mobile radiography were cost-effective from a societal perspective compared with hospital-based radiological examinations. This prospective study included two groups of nursing home residents in two different areas in southern Sweden. All residents in the nursing homes were targeted for the study. Seventy-one patients were examined with hospital-based radiography at two hospitals, and 312 patients were examined using mobile radiography in nursing homes. Given that the diagnostic effects are regarded as equivalent, a cost minimization method was applied. Direct costs were estimated using prices from the county council, Region Skåne, Sweden. From a societal perspective, mobile radiography was shown to have significantly lower costs per examination compared with hospital-based radiography. The difference in health care-related costs was also significant in favour of mobile radiography. Mobile radiography can be used to examine patients in nursing homes at a lower cost than hospital-based radiography. Patients benefit from not having to transfer to a hospital for radiography, resulting in reduced anxiety for patients. © 2016 John Wiley & Sons, Ltd.

Detection of Clostridium difficile infection clusters, using the temporal scan statistic, in a community hospital in southern Ontario, Canada, 2006-2011.

PubMed

Faires, Meredith C; Pearl, David L; Ciccotelli, William A; Berke, Olaf; Reid-Smith, Richard J; Weese, J Scott

2014-05-12

In hospitals, Clostridium difficile infection (CDI) surveillance relies on unvalidated guidelines or threshold criteria to identify outbreaks. This can result in false-positive and -negative cluster alarms. The application of statistical methods to identify and understand CDI clusters may be a useful alternative or complement to standard surveillance techniques. The objectives of this study were to investigate the utility of the temporal scan statistic for detecting CDI clusters and determine if there are significant differences in the rate of CDI cases by month, season, and year in a community hospital. Bacteriology reports of patients identified with a CDI from August 2006 to February 2011 were collected. For patients detected with CDI from March 2010 to February 2011, stool specimens were obtained. Clostridium difficile isolates were characterized by ribotyping and investigated for the presence of toxin genes by PCR. CDI clusters were investigated using a retrospective temporal scan test statistic. Statistically significant clusters were compared to known CDI outbreaks within the hospital. A negative binomial regression model was used to identify associations between year, season, month and the rate of CDI cases. Overall, 86 CDI cases were identified. Eighteen specimens were analyzed and nine ribotypes were classified with ribotype 027 (n = 6) the most prevalent. The temporal scan statistic identified significant CDI clusters at the hospital (n = 5), service (n = 6), and ward (n = 4) levels (P ≤ 0.05). Three clusters were concordant with the one C. difficile outbreak identified by hospital personnel. Two clusters were identified as potential outbreaks. The negative binomial model indicated years 2007-2010 (P ≤ 0.05) had decreased CDI rates compared to 2006 and spring had an increased CDI rate compared to the fall (P = 0.023). Application of the temporal scan statistic identified several clusters, including potential outbreaks not detected by hospital

The internal migration between public and faith-based health providers: a cross-sectional, retrospective and multicentre study from southern Tanzania.

PubMed

Tabatabai, Patrik; Prytherch, Helen; Baumgarten, Inge; Kisanga, Oberlin M E; Schmidt-Ehry, Bergis; Marx, Michael

2013-07-01

To assess the magnitude, direction and underlying dynamics of internal health worker migration between public and faith-based health providers from a hospital perspective. Two complementary tools were implemented in 10 public and six faith-based hospitals in southern Tanzania. A hospital questionnaire assessed magnitude and direction of staff migration between January 2006 and June 2009. Interviews with 42 public and 20 faith-based maternity nurses evaluated differences in staff perspectives and motives for the observed migration patterns. The predominant direction of staff movement was from the faith-based to the public sector: 69.1% (n = 105/152) of hospital staff exits and 60.6% (n = 60/99) of hospital staff gains. Nurses were the largest group among the migrating health workforce. Faith-based hospitals lost 59.3% (n = 86/145) of nurses and 90.6% (n = 77/85) of registered nurses to the public sector, whereby public hospitals reported 13.5% (n = 59/436) of nurses and 24.4% (n = 41/168) of registered nurses being former faith-based employees. Interviews revealed significantly inferior staff perspectives among faith-based respondents than their public colleagues. Main differences were identified regarding career development and training, management support, employee engagement and workload. This study revealed considerable internal health worker migration from the faith-based to the public sector. Staff retention and motivation within faith-based hospitals are not restricted to financial considerations, and salary gaps can no longer uniquely explain this movement pattern. The consequences for the catchment area of faith-based hospitals are potentially severe and erode cooperation potential between the public and private health sector.

Surgical informed consent in obstetric and gynecologic surgeries: experience from a comprehensive teaching hospital in Southern Ethiopia.

PubMed

Teshome, Million; Wolde, Zenebe; Gedefaw, Abel; Tariku, Mequanent; Asefa, Anteneh

2018-05-24

Surgical Informed Consent (SIC) has long been recognized as an important component of modern medicine. The ultimate goals of SIC are to improve clients' understanding of the intended procedure, increase client satisfaction, maintain trust between clients and health providers, and ultimately minimize litigation issues related to surgical procedures. The purpose of the current study is to assess the comprehensiveness of the SIC process for women undergoing obstetric and gynecologic surgeries. A hospital-based cross-sectional study was undertaken at Hawassa University Comprehensive Specialized Hospital (HUCSH) in November and December, 2016. A total of 230 women who underwent obstetric and/or gynecologic surgeries were interviewed immediately after their hospital discharge to assess their experience of the SIC process. Thirteen components of SIC were used based on international recommendations, including the Royal College of Surgeon's standards of informed consent practices for surgical procedures. Descriptive summaries are presented in tables and figures. Forty percent of respondents were aged between 25 and 29 years. Nearly a quarter (22.6%) had no formal education. More than half (54.3%) of respondents had undergone an emergency surgical procedure. Only 18.4% of respondents reported that the surgeon performing the operation had offered SIC, while 36.6% of respondents could not recall who had offered SIC. All except one respondent provided written consent to undergo a surgical procedure. However, 8.3% of respondents received SIC service while already on the operation table for their procedure. Only 73.9% of respondents were informed about the availability (or lack thereof) of alternative treatment options. Additionally, a majority of respondents were not informed about the type of anesthesia to be used (88.3%) and related complications (87.4%). Only 54.2% of respondents reported that they had been offered at least six of the 13 SIC components used by the

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization.

PubMed

Barreto, Maynara Fernanda Carvalho; Dellaroza, Mara Solange Gomes; Kerbauy, Gilselena; Grion, Cintia Magalhães Carvalho

2016-04-01

To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients. Estimar o custo da internação de pacientes com sepse grave ou choque séptico admitidos ou diagnosticados no setor de Urgências e Emergências de um hospital universitário e seguidos até o desfecho clínico. Estudo epidemiológico, prospectivo e observacional, realizado em um hospital público do sul do Brasil, no período de 1 ano (agosto de 2013 a agosto de 2014). A coleta dos dados clínico-epidemiológicos utilizou fichas de notificação de sepse, prontuários e dados do setor de custos. Foi realizada análise de tendência central, dispersão e quartis dos custos das internações. Amostra composta por 95 pacientes que totalizaram elevado custo da internação (R$ 3.692.421,00), com média de R$ 38.867,60 por paciente. Mais da metade do valor total do tratamento da sepse (R$ 2.215.773,50) destinou-se a pacientes que evoluíram a

2001-2002 Southern California Regional Travel Survey | Transportation

Science.gov Websites

Secure Data Center | NREL 01-2002 Southern California Regional Travel Survey 2001-2002 Southern California Regional Travel Survey The 2001-2002 Southern California Regional Travel Survey collected data on conduct the survey following the 2000 decennial census. Methodology Survey data collection occurred in

Southern deepwater swamps

Treesearch

William H. Conner

1998-01-01

The authors define, classify, and analyze the economic significance of southern deepwater swamps. They discuss the physical environment, vegetational communities, animal communities, management issues, and research needs for this complex resource.

Effort-reward imbalance and quality of life of healthcare workers in military hospitals: a cross-sectional study.

PubMed

Tzeng, Dong-Sheng; Chung, Wei-Ching; Lin, Chi-Hung; Yang, Chun-Yuh

2012-09-08

Taiwan's National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals. We posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the Effort-Reward Imbalance (ERI) Questionnaire. High effort-reward (ER) ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution. The survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males. There was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress.

Straight studs are produced from southern pine cordwood

Treesearch

Peter Koch

1967-01-01

A Process for converting southern pine veneer cores into 8-foot 2 by 4's of SPIB Stud grade and better has been developed at the Alexandria, Louisiana, Utilization Laboratory of the Southern Forest Experiment Station. The research leading to this development suggests that a similiar process would be practical for converting 8-foot southern pine cordwood into studs...

Southern Forest Resource Assessment - Technical Report

Treesearch

David N. Wear; John G. Greis

2002-01-01

The southern forest resource assessment provides a comprehensive analysis of the history, status, and likely future of forests in the Southern United States. Twenty-three chapters address questions regarding social/economic systems, terrestrial ecosystems, water and aquatic ecosystems, forest health, and timber management; 2 additional chapters provide a background on...

The Distribution of Southern Black Population.

ERIC Educational Resources Information Center

Tucker, Jack; Lee, Everett S.

Between 1960 and 1970, the black population of the southern United States increased only four percent by comparison with a national increase in black population of twenty percent. Considering the many factors involved in population redistribution, this report compares southern and overall national trends in black population and analyzes the…

DIET OF THE SOUTHERN TOAD FROM THE SOUTHERN EVERGLADES

EPA Science Inventory

We examined the diet of a February-May sample of the southern toad (Bufo Terrestris) from the Everglades National Park. Above the familial level, 13 taxa were consumed, but ants (Hymenoptera) and beetles (Coleoptera) were consumed most by, and in the greatest number of s...

Glutaraldehyde degradation in hospital wastewater by photoozonation.

PubMed

Kist, Lourdes Teresinha; Rosa, Ellen Caroline; Machado, Enio Leandro; Camargo, Maria Emilia; Moro, Celso Camilo

2013-01-01

In this paper, we assessed aqueous solutions of glutaraldehyde (GA), a chemical used for the disinfection of hospital materials, using advanced oxidative processes, O3, and UV, and the combination of the latter two. Assays with different ozone concentrations at distinct pH levels were conducted to determine the best treatment process. GA concentrations before and after each treatment were measured by spectrophotometry. The best treatment was that which combined O3 and UV, yielding a degradation of 72.0-75.0% in relation to the initial concentration with pH between 4 and 9. Kinetics demonstrated that GA degradation is not dependent on pH, as there was a first-order reaction with a rate constant of k = 0.0180 min(-1) for initial pH 9 and of k = 0.0179 min(-1) for initial pH 7, that is, the values are virtually the same. Secondary wastewater samples were also analysed using the septic tank/filter system of a regional hospital in Vale do Rio Pardo, state of Rio Grande do Sul, southern Brazil. In this case, the characteristics of the wastewater were described and, after treatment, a GA degradation rate of 23.3% was noted, with reductions of 75% for chemical oxygen demand, 81% for biochemical oxygen demand, 68% for turbidity, 70% for surfactants and total disinfection in terms of thermotolerant coliforms.

Unintentional ingestion of Cordyceps fungus-infected cicada nymphs causing ibotenic acid poisoning in Southern Vietnam.

PubMed

Doan, Uyen Vy; Mendez Rojas, Bomar; Kirby, Ralph

2017-09-01

Cordyceps fungus found in infected cicada nymphs ("cicada flowers") is utilized in traditional Chinese medicine. Cordyceps fungus toxicity in humans has not been previously reported. We report 60 cases of apparent Cordyceps poisoning in Southern Vietnam. We retrospectively collected demographic and clinical data from the medical records (21 cases) and by telephone interview (39 cases) of patients admitted to seven hospitals in Southern Vietnam following ingestion of cicada flowers between 2008 and 2015. We also determined the species of Cordyceps present in the cicada flowers and performed a partial chemical analysis of the fungus. Sixty cases of toxic effects following ingestion of cicada flowers were documented. Symptom onset occurred within 60 minutes following ingestion. Symptoms included dizziness, vomiting, salivation, mydriasis, jaw stiffness, urinary retention, seizures, agitated delirium, hallucinations, somnolence and coma. None of the patients suffered liver or kidney injury. There was one fatality. The Cordyceps fungus involved in these poisoning was identified as Ophiocordyceps heteropoda. The presence of ibotenic acid was confirmed, but musimol and muscarine were absent. Cicada infected with Ophiocordyceps heteropoda in Vietnam contain ibotenic acid and are associated with a clinical syndrome consistent with its effects.

Forest resources of southern New England

Treesearch

Robert T. Brooks; David B. Kittredge; Carol L. Alerich; Carol L. Alerich

1993-01-01

An analytical report of the third forest inventory of the three southern New England states of Connecticut, Massachusetts, and Rhode Island. Included is a discussion of forest area, number of trees, timber volume, tree biomass, timber value, forest wildlife habitat, ownership, management opportunities, and the future of forest resources in southern New England.

Magnet hospital recognition in hospital systems over time.

PubMed

Lasater, Karen B; Richards, Michael R; Dandapani, Nikila B; Burns, Lawton R; McHugh, Matthew D

2017-06-13

Magnet hospitals are recognized for nursing excellence and high-value patient outcomes, yet little is known about which and when hospitals pursue Magnet recognition. Concurrently, hospital systems are becoming a more prominent feature of the U.S. health care landscape. The aim of the study was to examine Magnet adoption among hospital systems over time. Using American Hospital Association surveys (1998-2012), we characterized the proportion of Magnet hospitals belonging to systems. We used hospital level fixed-effects regressions to capture changes in a given system hospital's Magnet status over time in relation to a variety of conditions, including prior Magnet adoption by system affiliates and nonaffiliates in local and geographically distant markets and whether these relationships varied by degree of system centralization. The proportion of Magnet hospitals belonging to a system is increasing. Prior Magnet adoption by a hospital within the local market was associated with an increased likelihood of a given system hospital becoming Magnet, but the effect was larger if there was prior adoption by affiliates (7.4% higher likelihood) versus nonaffiliates (2.7% higher likelihood). Prior adoption by affiliates and nonaffiliates in geographically distant markets had a lesser effect. Hospitals belonging to centralized systems were more reactive to Magnet adoption of nonaffiliate hospitals as compared with those in decentralized systems. Hospital systems take an organizational perspective toward Magnet adoption, whereby more system affiliates achieve Magnet recognition over time. The findings are relevant to health care and nursing administrators and policymakers interested in the diffusion of an empirically supported organizational innovation associated with quality outcomes, particularly in a time of increasing hospital consolidation and system expansion. We identify factors associated with Magnet adoption across system hospitals and demonstrate the importance of

Mold contamination in a controlled hospital environment: a 3-year surveillance in southern Italy.

PubMed

Caggiano, Giuseppina; Napoli, Christian; Coretti, Caterina; Lovero, Grazia; Scarafile, Giancarlo; De Giglio, Osvalda; Montagna, Maria Teresa

2014-11-15

Environmental monitoring of airborne filamentous fungi is necessary to reduce fungal concentrations in operating theaters and in controlled environments, and to prevent infections. The present study reports results of a surveillance of filamentous fungi carried out on samples from air and surfaces in operating theaters and controlled environments in an Italian university hospital. Sampling was performed between January 2010 and December 2012 in 32 operating theaters and five departments with high-risk patients. Indoor air specimens were sampled using a microbiological air sampler; Rodac contact plates were used for surface sampling. Fungal isolates were identified at the level of genera and species. Sixty-one samples (61/465; 13.1%) were positive for molds, with 18 from controlled environments (18/81; 22.2%) and 43 (43/384; 11.2%) from operating theaters. The highest air fungal load (AFL, colony-forming units per cubic meter [CFU/m(3)]) was recorded in the ophthalmology operating theater, while the pediatric onco-hematology ward had the highest AFL among the wards (47 CFU/m(3)). The most common fungi identified from culture of air specimens were Aspergillus spp. (91.8%), Penicillium spp., (6%) and Paecilomyces spp. (1.5%). During the study period, a statistically significant increase in CFU over time was recorded in air-controlled environments (p = 0.043), while the increase in AFL in operating theaters was not statistically significant (p = 0.145). Molds were found in 29.1% of samples obtained from surfaces. Aspergillus fumigatus was the most commonly isolated (68.5%). Our findings will form the basis for action aimed at improving the air and surface quality of these special wards. The lack of any genetic analysis prevented any correlation of fungal environmental contamination with onset of fungal infection, an analysis that will be undertaken in a prospective study in patients admitted to the same hospital.

Zonally asymmetric response of the Southern Ocean mixed-layer depth to the Southern Annular Mode

NASA Astrophysics Data System (ADS)

Sallée, J. B.; Speer, K. G.; Rintoul, S. R.

2010-04-01

Interactions between the atmosphere and ocean are mediated by the mixed layer at the ocean surface. The depth of this layer is determined by wind forcing and heating from the atmosphere. Variations in mixed-layer depth affect the rate of exchange between the atmosphere and deeper ocean, the capacity of the ocean to store heat and carbon and the availability of light and nutrients to support the growth of phytoplankton. However, the response of the Southern Ocean mixed layer to changes in the atmosphere is not well known. Here we analyse temperature and salinity data from Argo profiling floats to show that the Southern Annular Mode (SAM), the dominant mode of atmospheric variability in the Southern Hemisphere, leads to large-scale anomalies in mixed-layer depth that are zonally asymmetric. From a simple heat budget of the mixed layer we conclude that meridional winds associated with departures of the SAM from zonal symmetry cause anomalies in heat flux that can, in turn, explain the observed changes of mixed-layer depth and sea surface temperature. Our results suggest that changes in the SAM, including recent and projected trends attributed to human activity, drive variations in Southern Ocean mixed-layer depth, with consequences for air-sea exchange, ocean sequestration of heat and carbon, and biological productivity.

Maternity hospital practices and breast feeding self-efficacy in Finnish primiparous and multiparous women during the immediate postpartum period.

PubMed

Koskinen, Katja S; Aho, Anna L; Hannula, Leena; Kaunonen, Marja

2014-04-01

to explore the relationship between maternity hospital practices and breast feeding self-efficacy. the data were collected using a cross-sectional survey. The study is a part of a larger longitudinal research and development project called 'Urban parenthood'. three urban maternity hospitals in Southern Finland. altogether 1400 questionnaires were given out and 573 primiparous and multiparous women completed the questionnaire within a week after childbirth. The response rate was 41%. early and successful initiation of breast feeding, rooming-in and exclusive breast feeding during the hospital stay were associated with higher maternal breast feeding self-efficacy in both primiparous and multiparous women. The reason (medical or non-medical), frequency or method (bottle or cup) for supplementation was not associated with breast feeding self-efficacy. breast feeding experiences during the immediate postpartum period have an association with breast feeding self-efficacy. Mothers who are not able to initiate breast feeding within an hour after birth or whose infants are supplemented during the hospital stay may benefit from additional support and breast feeding counselling. Copyright © 2013 Elsevier Ltd. All rights reserved.

Can hospitals compete on quality? Hospital competition.

PubMed

Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

2015-09-01

In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples.

Predators of the Southern Pine Beetle

Treesearch

John D. Reeve

2011-01-01

This chapter of the Southern Pine Beetle II reviews the overall influence of predators on southern pine beetle (SPB) population dynamics, as well as recent research on specific predators such as the clerid beetle Thanasimus dubius. Several lines of evidence suggest that predators and other natural enemies generate significant SPB mortality that contributes to outbreak...

Motorcycle-related hospitalization of adolescents in a Level I trauma center in southern Taiwan: a cross-sectional study.

PubMed

Liang, Chi-Cheng; Liu, Hang-Tsung; Rau, Cheng-Shyuan; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

2015-08-28

The aim of this study was to investigate and compare the injury pattern, mechanisms, severity, and mortality of adolescents and adults hospitalized for treatment of trauma following motorcycle accidents in a Level I trauma center. Detailed data regarding patients aged 13-19 years (adolescents) and aged 30-50 years (adults) who had sustained trauma due to a motorcycle accident were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2012. The Pearson's chi-squared test, Fisher's exact test, or the independent Student's t-test were performed to compare the adolescent and adult motorcyclists and to compare the motorcycle drivers and motorcycle pillion. Analysis of Abbreviated Injury Scale (AIS) scores revealed that the adolescent patients had sustained higher rates of facial, abdominal, and hepatic injury and of cranial, mandibular, and femoral fracture but lower rates of thorax and extremity injury; hemothorax; and rib, scapular, clavicle, and humeral fracture compared to the adults. No significant differences were found between the adolescents and adults regarding Injury Severity Score (ISS), New Injury Severity Score (NISS), Trauma-Injury Severity Score (TRISS), mortality, length of hospital stay, or intensive care unit (ICU) admission rate. A significantly greater percentage of adolescents compared to adults were found not to have worn a helmet. Motorcycle riders who had not worn a helmet were found to have a significantly lower first Glasgow Coma Scale (GCS) score, and a significantly higher percentage was found to present with unconscious status, head and neck injury, and cranial fracture compared to those who had worn a helmet. Adolescent motorcycle riders comprise a major population of patients hospitalized for treatment of trauma. This population tends to present with a higher injury severity compared to other hospitalized trauma patients and a bodily injury pattern differing from that of adult motorcycle riders, indicating the

Southern Sand Dunes

NASA Image and Video Library

2003-01-15

At first glance, this NASA Mars Odyssey image showing impact craters and linear ridges and troughs is typical of the southern highlands. However, upon closer examination migrating sand dunes are observed within the troughs.

Rurality and birth outcomes: findings from southern appalachia and the potential role of pregnancy smoking.

PubMed

Bailey, Beth A; Cole, Laura K Jones

2009-01-01

Rates of preterm birth (PTB) and low birth weight (LBW) vary by region, with disparities particularly evident in the Appalachian region of the South. Community conditions related to rurality likely contribute to adverse birth outcomes in this region. This study examined associations between rurality and related community conditions, and newborn outcomes in southern Appalachia, and explored whether pregnancy smoking explained such associations. Data for all births in a southern Appalachian county over a 2-year period were extracted from hospital records. Data were available for 4,144 births, with 45 different counties of residence. Babies born to women from completely rural counties, on average, weighed 700 g less, were 1.5 inches shorter, and were born over 3 weeks earlier than less rural infants. In addition, these babies were 4.5 times more likely to be LBW, 4 times more likely to be PTB, and 5 times more likely to be admitted to the neonatal intensive care unit (NICU). Effects were also found for per capita income, poverty rate, and unemployment rate, all of which were associated with rurality. Some, but not all of the association was explained by elevated rates of pregnancy smoking. Babies born to women residing in rural and economically depressed counties in southern Appalachia are at substantially increased risk for poor birth outcomes. Improving these outcomes in the rural South will likely require addressing access to health services and information, health care provider retention, transportation services, employment opportunities, and availability of public health services including smoking cessation assistance.

The Perceptions and Expectations Toward the Social Responsibility of Hospitals and Organizational Commitment of Nursing Staff.

PubMed

Hsieh, Sheng-Che; Chiu, Herng-Chia; Hsieh, Ya-Hui; Ho, Pei-Shen; Chen, Li-Chin; Chang, Wei-Chou

2016-09-01

The labor rights of medical workers in hospitals in Taiwan have been a key issue of discussion and controversy in recent years. Generally, poor work conditions and manpower shortages in hospitals have resulted in a vicious circle of severely overworked medical and healthcare staff and chronically low staffing and retention rates. This study employed corporate social responsibility as the conceptual framework of the social responsibility of hospitals to examine the perceptions and expectations of nurses toward the social responsibility practices of the hospital where they serve and to explore the relationship between these perceptions and organizational commitment (OC). The participants were all nurses who were employed by one medical group in southern Taiwan. Two hundred forty anonymous questionnaires, which included scales that were designed to measure the social responsibility of hospitals and OC, were distributed. Two hundred twenty-seven valid questionnaires were returned. Exploratory factor analysis was used to validate the dimension of the social responsibility of hospitals, and hierarchical multiregression analyses were used to verify the relationship between the perceptions of nurses with regard to the social responsibility practices of the hospital where nurses serve and OC. There were considerable differences between participants' perceptions and expectations toward the social responsibility of hospitals. The nurses with high perceptions toward the social responsibility practices of the hospital where they serve tended to have relatively high OC. Senior nurses who had high perceptions of the legal and rational, ethical, and economic dimensions of the social responsibility practices of the hospital where they serve exhibited relatively strong affective commitment. Nurses in junior positions who had high perceptions of the practices of ethical responsibilities exhibited relatively strong continuance commitment. Senior nurses who had high perceptions of the

Cost of hospitalization for childbirth in India: how equitable it is in the post-NRHM era?

PubMed

Tripathy, Jaya Prasad; Shewade, Hemant D; Mishra, Sanskruti; Kumar, A M V; Harries, A D

2017-08-15

Information on out-of-pocket (OOP) expenditure during childbirth in public and private health facilities in India is needed to make rational decisions for improving affordability to maternal care services. We undertook this study to evaluate the OOP expenditure due to hospitalization from childbirth and its impact on households. This is a secondary data analysis of a nationwide household survey by the National Sample Survey Organization in 2014. The survey reported health service utilization and health care related expenditure by income quintiles and type of health facility. The recall period for hospitalization expenditure was 365 days. OOP expenditure amounting to more than 10% of annual consumption expenditure was termed as catastrophic. Median expenditure per episode of hospitalisation due to childbirth was US$54. The expenditure incurred was about six times higher among the richest quintile compared to the poorest quintile. Median private sector OOP hospitalization expenditure was nearly nine times higher than in the public sector. Hospitalization in a private sector facility leads to a significantly higher prevalence of catastrophic expenditure than hospitalization in a public sector (60% vs. 7%). Indirect cost (43%) constituted the largest share in the total expenditure in public sector hospitalizations. Urban residence, poor wealth quintile, residing in eastern and southern regions of India and delivery in private hospital were significantly associated with catastrophic expenditure. We strongly recommend cash transfer schemes with effective pro-poor targeting to reduce the impact of catastrophic expenditure. Strengthening of public health facilities is required along with private sector regulation.

Unprecedented Fires in Southern Africa

NASA Technical Reports Server (NTRS)

2002-01-01

The fires that raged across southern Africa this August and September produced a thick 'river of smoke' over the region. NASA-supported studies currently underway on the event will contribute to improved air pollution policies in the region and a better understanding of its impact on climate change. This year the southern African fire season peaked in early September. The region is subject to some of the highest levels of biomass burning in the world. The heaviest burning was in western Zambia, southern Angola, northern Namibia, and northern Botswana. Some of the blazes had fire fronts 20 miles long that lasted for days. In this animation, multiple fires are burning across the southern part of the African continent in September 2000. The fires, indicated in red, were observed by the Advanced Very High Resolution Radiometer (AVHRR) instrument on board the NOAA-14 satellite. The fires generated large amounts of heat-absorbing aerosols (the dark haze), which were observed with the Earth Probe Total Ozone Mapping Spectrometer (TOMS) instrument. These observations were collected as part of a NASA-supported field campaign called SAFARI 2000 (Southern African Regional Science Initiative). The recent six-week 'dry-season' portion of this experiment was planned to coincide with the annual fires. SAFARI 2000 planners tracked the changing location of fires with daily satellite maps provided by researchers at NASA's Goddard Space Flight Center. 'Every year African biomass burning greatly exceeds the scale of the fires seen this year in the western United States,' says Robert Swap of the University of Virginia, one of the campaign organizers. 'But the southern African fire season we just observed may turn out to be an extreme one even by African standards. It was amazing how quickly this region went up in flames.' The thick haze layer from these fires was heavier than campaign participants had seen in previous field studies in the Amazon Basin and during the Kuwati oil fires

[Decrease in hospitalizations due to polyvalent medical day hospital].

PubMed

Escobar, M A; García-Egido, A A; Carmona, R; Lucas, A; Márquez, C; Gómez, F

2012-02-01

The day hospital is an alternative to hospitalization. This alternative improves accessibility and comfort of the patients, and avoids hospitalizations. Nevertheless, the efficacy of the polyvalent medical day hospital in avoiding hospitalizations has not been evaluated. To analyze hospital stays avoided by the polyvalent medical day hospital of a university hospital of the Andalusian Health Service. An observational prospective study of the patients studied and/or treated in the polyvalent medical day hospital of the Hospital Universitario Puerto Real over a one year period. A total of 9640 patients were attended to, with 1413 procedures and 4921 i.v. treatments. There were 3182 visits to the priority consultation of the polyvalent medical day hospital. The most frequent consultation complaints were constitutional symptoms (15.9%) and anemia (14.5%). After the first visit, 21.5% of the patients were discharged and fewer than 3% were hospitalized. Hospitalization was avoided in 16.8% of the patients, there being a 6.0% decrease in the need for hospital beds (5.0% reduction in the internal medicine unit). Inadequate hospitalizations and 30-day readmissions decreased 93.3% and 4.2%, respectively. The most frequent diagnosis was neoplasm (26.0%), and most of the beds freed up were generated by patients diagnosed of neoplasm (26.7%). With this type of polyvalent medical day hospital, we have observed improved efficiency of health care, freeing up hospital beds by reducing hospitalizations, inadequate hospitalizations and re-admissions in the medical units involved. Copyright © 2011 Elsevier España, S.L. All rights reserved.

The Southern Ocean biogeochemical divide.

PubMed

Marinov, I; Gnanadesikan, A; Toggweiler, J R; Sarmiento, J L

2006-06-22

Modelling studies have demonstrated that the nutrient and carbon cycles in the Southern Ocean play a central role in setting the air-sea balance of CO(2) and global biological production. Box model studies first pointed out that an increase in nutrient utilization in the high latitudes results in a strong decrease in the atmospheric carbon dioxide partial pressure (pCO2). This early research led to two important ideas: high latitude regions are more important in determining atmospheric pCO2 than low latitudes, despite their much smaller area, and nutrient utilization and atmospheric pCO2 are tightly linked. Subsequent general circulation model simulations show that the Southern Ocean is the most important high latitude region in controlling pre-industrial atmospheric CO(2) because it serves as a lid to a larger volume of the deep ocean. Other studies point out the crucial role of the Southern Ocean in the uptake and storage of anthropogenic carbon dioxide and in controlling global biological production. Here we probe the system to determine whether certain regions of the Southern Ocean are more critical than others for air-sea CO(2) balance and the biological export production, by increasing surface nutrient drawdown in an ocean general circulation model. We demonstrate that atmospheric CO(2) and global biological export production are controlled by different regions of the Southern Ocean. The air-sea balance of carbon dioxide is controlled mainly by the biological pump and circulation in the Antarctic deep-water formation region, whereas global export production is controlled mainly by the biological pump and circulation in the Subantarctic intermediate and mode water formation region. The existence of this biogeochemical divide separating the Antarctic from the Subantarctic suggests that it may be possible for climate change or human intervention to modify one of these without greatly altering the other.

Southern Pine Beetle Behavior and Semiochemistry

Treesearch

Brian T. Sullivan

2011-01-01

The southern pine beetle (SPB) feeds both as adults and larvae within the inner bark of pine trees, which invariably die as a result of colonization. Populations of the SPB erupt periodically and produce catastrophic losses of pines, while at other times the beetles persist almost undetectably in the environment. The southern pine beetle has evolved behaviors that...

Ecological Impacts of Southern Pine Beetle

Treesearch

Maria D. Tchakerian; Robert N. Coulson

2011-01-01

The southern pine beetle (SPB) is the most important biotic disturbance in southern pine forests and causes extensive changes to the forest environment. In this chapter we provide an overview of the ecological impacts of the SPB on forest conditions (the state of the forest) and on forest resources (uses and values associated with the forest). We define ecological...

Birth weight following pregnancy during the 2003 Southern California wildfires.

PubMed

Holstius, David M; Reid, Colleen E; Jesdale, Bill M; Morello-Frosch, Rachel

2012-09-01

In late October 2003, a series of wildfires exposed urban populations in Southern California to elevated levels of air pollution over several weeks. Previous research suggests that short-term hospital admissions for respiratory outcomes increased specifically as a result of these fires. We assessed the impact of a wildfire event during pregnancy on birth weight among term infants. Using records for singleton term births delivered to mothers residing in California's South Coast Air Basin (SoCAB) during 2001-2005 (n = 886,034), we compared birth weights from pregnancies that took place entirely before or after the wildfire event (n = 747,590) with those where wildfires occurred during the first (n = 60,270), second (n = 39,435), or third (n = 38,739) trimester. The trimester-specific effects of wildfire exposure were estimated using a fixed-effects regression model with several maternal characteristics included as covariates. Compared with pregnancies before and after the wildfires, mean birth weight was estimated to be 7.0 g lower [95% confidence interval (CI): -11.8, -2.2] when the wildfire occurred during the third trimester, 9.7 g lower when it occurred during the second trimester (95% CI: -14.5, -4.8), and 3.3 g lower when it occurred during the first trimester (95% CI: -7.2, 0.6). Pregnancy during the 2003 Southern California wildfires was associated with slightly reduced average birth weight among infants exposed in utero. The extent and increasing frequency of wildfire events may have implications for infant health and development.

The Southern California Twin Register at the University of Southern California: III

PubMed Central

Baker, Laura A.; Tuvblad, Catherine; Wang, Pan; Gomez, Karina; Bezdjian, Serena; Niv, Sharon; Raine, Adrian

2013-01-01

The Southern California Twin Register at the University of Southern California (USC) was initiated in 1984 and continues to provide an important resource for studies investigating genetic and environmental influences on human behavior. This article provides an update on the current register and its potential for future twin studies using recruitment through school district databases and voter records. An overview is also provided for an ongoing longitudinal twin study investigating the development of externalizing psychopathology from childhood to young adulthood, the USC Study of Risk Factors for Antisocial Behavior. Characteristics of the twins and their families are presented, including recruitment and participation rates, as well as attrition analyses and a summary of key findings to date. PMID:23394193

Smoke in Southern Africa

NASA Technical Reports Server (NTRS)

2002-01-01

This SeaWiFS true-color image acquired over Southern Africa on Sept. 4, 2000, shows a thick shroud of smoke and haze blanketing much of the southern half of the continent. The smoke in this scene is being generated by a tremendous number of fires burning over a large area across the countries of Angola, Zambia, Mozambique, Zimbabwe, Botswana, and the Northern Province of South Africa. In this image, the smoke (grey pixels) is easily distinguished from clouds (bright white pixels). Refer to the Images and Data section for a larger scale view of the fires in Southern Africa. Data from both the SeaWiFS and Terra satellites are being used by an international team of scientists participating in the SAFARI field experiment. The objective of SAFARI is to measure the effects of windblown smoke and dust on air quality and the Earth's radiant energy budget. This image was produced using SeaWiFS channels 6, 5, and 1 (centered at 670 nm, 555 nm , and 412 nm, respectively). The data were acquired and provided by the Satellite Applications Center in Pretoria, South Africa. Image courtesy Gene Feldman, SeaWiFS Project and Orbital Sciences

Northerners versus southerners: Italian anthropology and psychology faced with the "southern question".

PubMed

Cimino, Guido; Foschi, Renato

2014-11-01

Following the Unification of Italy (1861), when confronted with the underdevelopment problems of the south that had given rise to the so-called "southern question," some Italian anthropologists and psychologists began to study the populations of the south from the psycho-anthropological point of view. These scientists, at times subject to preconceived ideas toward the southerners, conveyed observations and descriptions of the southern character traits that, in general, were considered different, in a negative sense, with respect to those of the northern peoples. To explain such diversity in the "psychological" characteristics between the north and south of the country (presumed cause also of the south's backwardness), various hypotheses were advanced related to the kind of heredity theory adopted, which could be of, more or less, an "innatist" or "transformist" or "environmentalist" kind. The distinction proposed in this article between at least 2 different "hereditarian" theories formulated by the Italian scientists, and the confrontation of these theories with the hypotheses expressed by the "southernist" sociologists, contrary to the idea of "racial varieties" present in the Italian population, allows one to understand in what way and in what sense, at the threshold of the 20th century, there arose the ideology of "Nordicism" and the roots of racism were planted.

Geomorphical and Geochronological Constrains of the Last Glacial Period in Southern Patagonia, Southern South America

NASA Astrophysics Data System (ADS)

García, J.; Hall, B. L.; Kaplan, M. R.; Vega, R. M.; Binnie, S. A.; Hein, A.; Gómez, G. N.; Ferrada, J. J.

2013-12-01

Despite the outer limits of the former Patagonian ice sheet (PIS, ~38-55S) having been extensively mapped, it remains unknown if the Patagonian glaciers fluctuated synchronously or asynchronously during the last glacial period. Previous work has revealed asynchronous spatiotemporal ice dynamics along the eastern and western ice-margins at the end of the last glaciation but it is not well understood if the northern and southern parts of the PIS reached concurrent maximum glaciation during the last glacial cycle. The Patagonian Andes is the only landmass involving the southern westerly wind belt latitudinal range, which is thought to have played a key role in past glacial and climate changes. Therefore, reconstructing southern Andes glacier history constitutes a key element for understanding the cause of glaciations in Patagonia and the role of the westerlies in climate change. Here, we discuss paleoglaciological and paleoclimatological implications of new 10Be and 14C data obtained from moraines and strategically selected mires in two contiguous glacially molded basins of south Patagonia (48-55S): Torres del Paine (51S) and Última Esperanza (52S). In this region, we focused our 10Be cosmogenic-dating efforts in the previously undated outer moraines deposited (supposedly) during the last glacial cycle. In order to crosscheck cosmogenic data we collected boulders embedded in moraines and cobbles from the main glaciofluvial plains grading from the outermost moraines. Geomorphic and cosmogenic dating affords evidence for glacial maximum conditions occurring between 40-50 ka (ka = thousand of years before present) in southern Patagonia, which is different from other chronologies within southern South America. We obtained 14C basal ages from sites located within moraine depressions and on former paleolake shorelines and thus these may provide key data on deglaciation and debated regional paleolake history.

Eddies in the Southern Ocean

NASA Image and Video Library

2015-04-08

The cloud cover over the Southern Ocean occasionally parts as it did on January 1, 2015 just west of the Drake Passage where the VIIRS instrument on the Suomi NPP satellite glimpsed the above collection of ocean-color delineated eddies which have diameters ranging from a couple of kilometers to a couple of hundred kilometers. Recent studies indicate that eddy activity has been increasing in the Southern Ocean with possible implications for climate change. Credit: NASA's OceanColor/Suomi NPP/VIIRS

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

A methodology for assessing annual risk of southern pine beetle outbreaks across the southern region using pheromone traps

Treesearch

Ronald F Billings; William W. Upton

2010-01-01

An operational system to forecast infestation trends (increasing, static, declining) and relative population levels (high, moderate, low) of the southern pine beetle (SPB), Dendroctonus frontalis, has been implemented in the Southern and Eastern United States. Numbers of dispersing SPB and those of a major predator (the clerid beetle, ...

Major burden of severe anemia from non-falciparum malaria species in Southern Papua: a hospital-based surveillance study.

PubMed

Douglas, Nicholas M; Lampah, Daniel A; Kenangalem, Enny; Simpson, Julie A; Poespoprodjo, Jeanne R; Sugiarto, Paulus; Anstey, Nicholas M; Price, Ric N

2013-12-01

The burden of anemia attributable to non-falciparum malarias in regions with Plasmodium co-endemicity is poorly documented. We compared the hematological profile of patients with and without malaria in southern Papua, Indonesia. Clinical and laboratory data were linked for all patients presenting to a referral hospital between April 2004 and December 2012. Data were available on patient demographics, malaria diagnosis, hemoglobin concentration, and clinical outcome, but other potential causes of anemia could not be identified reliably. Of 922,120 patient episodes (837,989 as outpatients and 84,131 as inpatients), a total of 219,845 (23.8%) were associated with a hemoglobin measurement, of whom 67,696 (30.8%) had malaria. Patients with P. malariae infection had the lowest hemoglobin concentration (n = 1,608, mean = 8.93 [95% CI 8.81-9.06]), followed by those with mixed species infections (n = 8,645, mean = 9.22 [95% CI 9.16-9.28]), P. falciparum (n = 37,554, mean = 9.47 [95% CI 9.44-9.50]), and P. vivax (n = 19,858, mean = 9.53 [95% CI 9.49-9.57]); p-value for all comparisons <0.001. Severe anemia (hemoglobin <5 g/dl) was present in 8,151 (3.7%) patients. Compared to patients without malaria, those with mixed Plasmodium infection were at greatest risk of severe anemia (adjusted odds ratio [AOR] 3.25 [95% CI 2.99-3.54]); AORs for severe anaemia associated with P. falciparum, P. vivax, and P. malariae were 2.11 (95% CI 2.00-2.23), 1.87 (95% CI 1.74-2.01), and 2.18 (95% CI 1.76-2.67), respectively, p<0.001. Overall, 12.2% (95% CI 11.2%-13.3%) of severe anemia was attributable to non-falciparum infections compared with 15.1% (95% CI 13.9%-16.3%) for P. falciparum monoinfections. Patients with severe anemia had an increased risk of death (AOR = 5.80 [95% CI 5.17-6.50]; p<0.001). Not all patients had a hemoglobin measurement, thus limitations of the study include the potential for selection bias, and possible residual confounding in

The Southern Forest Futures Project: technical report

Treesearch

David N. Wear; John G. Greis

2013-01-01

Please visit the Southern Forest Futures Project website for more information.The Southern Forest Futures Project provides a science-based “futuring” analysis of the forests of the 13 States of the Southeastern United States. With findings...

Steam-bending properties of southern pine

Treesearch

Truett J. Lemoine; Peter Koch

1971-01-01

Southern pine wood can be successfully steam-bent if the bending jig incorporates a flexible metal bending strap together with a mechanism to apply a uniform end compression load during the bending operation. With clear, 1/2- and 1-inch-thick southern pine at 17-percent moisture content, highest bending rating where obtained with fast-grown, vertical-grain, low-density...

Pteropods in Southern Ocean ecosystems

NASA Astrophysics Data System (ADS)

Hunt, B. P. V.; Pakhomov, E. A.; Hosie, G. W.; Siegel, V.; Ward, P.; Bernard, K.

2008-09-01

To date, little research has been carried out on pelagic gastropod molluscs (pteropods) in Southern Ocean ecosystems. However, recent predictions are that, due to acidification resulting from a business as usual approach to CO 2 emissions (IS92a), Southern Ocean surface waters may begin to become uninhabitable for aragonite shelled thecosome pteropods by 2050. To gain insight into the potential impact that this would have on Southern Ocean ecosystems, we have here synthesized available data on pteropod distributions and densities, assessed current knowledge of pteropod ecology, and highlighted knowledge gaps and directions for future research on this zooplankton group. Six species of pteropod are typical of the Southern Ocean south of the Sub-Tropical Convergence, including the four Thecosomes Limacina helicina antarctica, Limacina retroversa australis, Clio pyramidata, and Clio piatkowskii, and two Gymnosomes Clione limacina antarctica and Spongiobranchaea australis. Limacina retroversa australis dominated pteropod densities north of the Polar Front (PF), averaging 60 ind m -3 (max = 800 ind m -3) and 11% of total zooplankton at the Prince Edward Islands. South of the PF L. helicina antarctica predominated, averaging 165 ind m -3 (max = 2681 ind m -3) and up to >35% of total zooplankton at South Georgia, and up to 1397 ind m -3 and 63% of total zooplankton in the Ross Sea. Combined pteropods contributed <5% to total zooplankton in the Lazarev Sea, but 15% (max = 93%) to macrozooplankton in the East Antarctic. In addition to regional density distributions we have synthesized data on vertical distributions, seasonal cycles, and inter-annual density variation. Trophically, gymnosome are specialist predators on thecosomes, while thecosomes are considered predominantly herbivorous, capturing food with a mucous web. The ingestion rates of L. retroversa australis are in the upper range for sub-Antarctic mesozooplankton (31.2-4196.9 ng pig ind -1 d -1), while those of L

[The 10-year stroke risk in hypertensive outpatients combined with diabetes in cardiovascular clinics of 36 tertiary hospitals in China].

PubMed

Bao, Bingnan; Zhou, Yingsheng; Liu, Jun; Huo, Yong

2014-12-01

To assess the estimated 10-year risk of stroke among hypertensive outpatients known with diabetes from cardiovascular clinics of 36 tertiary hospitals in China and to analyze the characteristics of the risk factors and the 10-year risk of stroke between the southern and the northern patients. A multi-center prevalence survey was conducted from October 2011 to June 2012. Hypertensive outpatients known with diabetes were enrolled from cardiovascular clinics of 36 tertiary hospitals in China. A total of 15 914 outpatients were included in the final analysis. The 10-year probability of stroke was evaluated by the Framingham stroke risk profile. According to the 10-year probability of stroke, patients were divided into low risk ( ≤ 5%), medium risk (6%∼9%) and high risk ( ≥ 10%). (1) Of all the hypertensive outpatients known with diabetes, the mean age was (64.6 ± 10.1) years and the mean systolic pressure was (138.7 ± 19.3) mmHg (1 mmHg = 0.133 kPa). Among them, 7.4% with atrial fibrillation, 11.2% with left ventricular hypertrophy, 57.2% with cardiovascular diseases, 17.1% smokers and 37.0% using mono-hypoglycemic agent. The southern patients who were older with more smokers had higher proportions of men and left ventricular hypertrophy, lower levels of systolic blood pressure, and lower proportions of other cardiovascular diseases than those of the northern patients ( all P < 0.05). (2) The mean 10-year probability of stroke was (20.9 ± 16.2) %. The southern patients had a higher mean 10-year probability of stroke than that of the northern patients [(22.4 ± 17.1) % vs (19.7 ± 15.2) %] (P < 0.01) . After adjusted by age and sex, the southern patients still had a higher mean 10-year probability of stroke (P < 0.05) . (3) All the patients had 7.7% with low risk, 17.4% with medium risk, and 74.9% with high risk. The southern patients had lower proportions of low and medium risk than those of the northern patients (6.7% vs 8.4%, 15.5% vs 18.9%), but had a

Hospital Readmission Risk: Isolating Hospital from Patient Effects

PubMed Central

Krumholz, Harlan M.; Wang, Kun; Lin, Zhenqiu; Dharmarajan, Kumar; Horwitz, Leora I.; Ross, Joseph S.; Drye, Elizabeth E.; Bernheim, Susannah M.; Normand, Sharon-Lise T.

2017-01-01

Background To isolate hospital effects on hospitals’ risk-standardized readmission rates, we examined readmission outcomes among patients with multiple admissions for a similar diagnosis at >1 hospital within a given year. Methods We divided the Centers for Medicare & Medicaid Services hospital-wide readmission measure cohort from July 2014–June 2015 into 2 random samples. We used the first sample to calculate each hospital’s risk-standardized readmission rate and classified hospitals into performance quartiles. In the second sample, we identified patients with 2 admissions for similar diagnoses at different hospitals that occurred more than a month and less than a year apart, and compared observed readmission rates for those admitted to hospitals in different performance quartiles. Results In the sample used to characterize hospital performance, the median risk-standardized readmission rate was 15.5% (IQR 15.3%–15.8%). The other sample included 37,508 patients with 2 admissions for similar diagnoses at 4,272 different hospitals. The observed readmission rate was consistently higher when patients were admitted to hospitals in the worse performing quartile, but the only statistically significant difference was observed when the same patients were admitted to hospitals in the best and worst performing quartiles, in which the absolute readmission rate difference was 1.95 percentage points (95% CI, 0.39%–3.50%). Conclusions When the same patients were admitted with similar diagnoses to hospitals in the best performing quartile compared with the worst performing quartile for hospital readmission performance, there is a significant difference in rates of readmission within 30 days. The findings suggest that hospital quality contributes in part to readmission rates independent of patient factors. PMID:28902587

Ethics Instruction in Community College Leadership Programs: Southern Perspectives

ERIC Educational Resources Information Center

Ware, Nikisha Green

2011-01-01

The purpose of this study was to discover which southern universities have graduate preparatory programs in community college leadership and how, if at all, ethics is addressed in their curricula and in instruction. Surveys were mailed to 38 southern universities located in the Southern Regional Education Board member states. Of the 21 responses…

Sexty Southerners: Sexting Content and Behaviors among Selected Southern Undergraduates

ERIC Educational Resources Information Center

Hudson, Heather K.; Marshall, S. Alexandra

2016-01-01

Sexting is defined as sending/posting/sharing sexually explicit messages or nude/semi-nude images via electronic communication. Purpose: The purpose of this study was to assess and determine relationships of sexting behavioral intentions, sexting behaviors, and sexting content among selected Southern undergraduate students. Methods: Survey…

Multinomial Logistic Regression Predicted Probability Map To Visualize The Influence Of Socio-Economic Factors On Breast Cancer Occurrence in Southern Karnataka

NASA Astrophysics Data System (ADS)

Madhu, B.; Ashok, N. C.; Balasubramanian, S.

2014-11-01

Multinomial logistic regression analysis was used to develop statistical model that can predict the probability of breast cancer in Southern Karnataka using the breast cancer occurrence data during 2007-2011. Independent socio-economic variables describing the breast cancer occurrence like age, education, occupation, parity, type of family, health insurance coverage, residential locality and socioeconomic status of each case was obtained. The models were developed as follows: i) Spatial visualization of the Urban- rural distribution of breast cancer cases that were obtained from the Bharat Hospital and Institute of Oncology. ii) Socio-economic risk factors describing the breast cancer occurrences were complied for each case. These data were then analysed using multinomial logistic regression analysis in a SPSS statistical software and relations between the occurrence of breast cancer across the socio-economic status and the influence of other socio-economic variables were evaluated and multinomial logistic regression models were constructed. iii) the model that best predicted the occurrence of breast cancer were identified. This multivariate logistic regression model has been entered into a geographic information system and maps showing the predicted probability of breast cancer occurrence in Southern Karnataka was created. This study demonstrates that Multinomial logistic regression is a valuable tool for developing models that predict the probability of breast cancer Occurrence in Southern Karnataka.

Effort-reward imbalance and quality of life of healthcare workers in military hospitals: a cross-sectional study

PubMed Central

2012-01-01

Background Taiwan’s National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals. Methods We posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ), the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the Effort-Reward Imbalance (ERI) Questionnaire. High effort-reward (ER) ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution. Results The survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males. Conclusions There was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress. PMID:22958365

Stem Profile for Southern Equations for Southern Tree Species

Treesearch

Alexander Clark; Ray A. Souter; Bryce E. Schlaegel

1991-01-01

Form-class segmented-profile equations for 58 southern tree species and species groups are presented.The profile equations are based on taper data for 13,469 trees sampled in natural stands in many locations across the South.The profile equations predict diameter at any given height, height to give diameter, and volume between two heights.Equation coefficients for use...

Stand density management of southern bottomland hardwoods

Treesearch

J.C.G. Goelz; J.S. Meadows

1997-01-01

We present tools to guide stand density management of southern bottomiand hardwoods and we provide guidance in their implementation. We present stocking guides for southern bottomland hardwoods and variants for associated forest types, water tupelo (Nyssa aquarica L.) and sweetgum (Liquidumbar styraciflua L.). The A-line...

50 CFR 223.211 - Southern DPS of spotted seal.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 9 2011-10-01 2011-10-01 false Southern DPS of spotted seal. 223.211... Applicable to Threatened Marine and Anadromous Species § 223.211 Southern DPS of spotted seal. The... species shall apply to the Southern Distinct Population Segment of the spotted seal listed in § 223.102(a...

Silviculture and management strategies applicable to southern upland hardwoods

Treesearch

Ray R. Hicks; Deborah K. Kennard; H. Michael Rauscher; Daniel L. Schmoldt; Patricia A. Flebbe

2001-01-01

The southern upland hardwoods include extensive areas in the southern Appalachians, Cumberland Plateau and Ozark/Ouachita regions. The majority of commercial hardwoods in the south occur in the region often referred to as the "Southern Appalachian Region". For purposes of this discussion, this region includes the hilly or mountainous area west and north of...

Simulating the impacts of southern pine beetle and fire on the dynamics of xerophytic pine landscapes in the southern Appalachians

Treesearch

J.D. Waldron; C.W. Lafon; R.N. Coulson; D.M. Cairns; M.D. Tchakerian; A. Birt; K.D. Klepzig

2007-01-01

Question: Can fire be used to maintain Yellow pine (Pinus subgenus Diploxylon) stands disturbed by periodic outbreaks of southern pine beetle?Location: Southern Appalachian Mountains, USA.Methods: We used LANDIS to model vegetation disturbance and succession...

Southern pine beetle infestations in relation to forest stand conditions, previous thinning, and prescribed burning: evaluation of the Southern Pine Beetle Prevention Program

Treesearch

John T. Nowak; James R. Meeker; David R. Coyle; Chris A. Steiner; Cavell Brownie

2015-01-01

Since 2003, the Southern Pine Beetle Prevention Program (SPBPP) (a joint effort of the USDA Forest Service and Southern Group of State Foresters) has encouraged and provided cost-share assistance for silvicultural treatments to reduce stand/forest susceptibility to the southern pine beetle (SPB)(Dendroctonus frontalis Zimmermann) in the southeastern United States....

The application of hospitality elements in hospitals.

PubMed

Wu, Ziqi; Robson, Stephani; Hollis, Brooke

2013-01-01

In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

Blue-stain Fungi Associated with Roots of Southern Pine Trees Attacked by the Southern Pine Beetle, Dendroctonus frontalis

Treesearch

William J. Otrosina; Nolan J. Hess; Stanley J. Zarnoch; Thelma J. Perry; John P. Jones

1997-01-01

Forty paired plots were established from eastern Texas to Alabama to study root-infecting, blue-stain fungi in southern pine stands undergoing southern pine beetle (SPB) attack. Woody roots were sampled in plots undergoing recent or current attack by the SPB. Comparisons were made between occurrence of Lcptogrqhiumspp. and related fungi and data on various...

2014 Southern Nevada Household Travel Survey | Transportation Secure Data

Science.gov Websites

Center | NREL 14 Southern Nevada Household Travel Survey 2014 Southern Nevada Household Travel Survey The 2014 Southern Nevada Household Travel Survey collected information from residents in the Las conduct the survey. Methodology The survey was conducted in two phases-from March to May 2014 and from

The effect of exchange rates on southern pine exports

Treesearch

H.W. Wisdom; James E. Granskog

2003-01-01

Changes in exchange rates affect southern pine exports by changing the cost of southern wood in foreign markets. A strong dollar discourages exports; a weak dollar encourages exports. A simple economic export market model is developed to determine whether changes in the exchange rates in foreign markets of southern pine products have, in fact, let to significant...

Southern hardwood forestry group going strong after 50 years

Treesearch

Brian Roy Lockhart; Steve Meadows; Jeff Portwood

2005-01-01

On November 15,200 1, the Southern Hardwood Forestry Group (referred to as the Group) met at the U.S. Forest Service Southern Research Station's Southern Hardwoods Laboratory in Stoneville, hlississippi to celebrate the Group's 50th anniversary. About 130 members and guests attended to celebrate the 50th anniversary of the Group and to honor its charter...

Southern Appalachian Man and the Biosphere - SAMAB.ORG

Science.gov Websites

Southern Appalachian Man and the Biosphere Home Who We Are SAMAB Initiatives Archives Welcome to SAMAB This slideshow requires JavaScript. The Southern Appalachian Man and the Biosphere (SAMAB

A nurse-led model at public academic hospitals maintains high adherence to colorectal cancer surveillance guidelines.

PubMed

Symonds, Erin L; Simpson, Kalindra; Coats, Michelle; Chaplin, Angela; Saxty, Karen; Sandford, Jayne; Young Am, Graeme P; Cock, Charles; Fraser, Robert; Bampton, Peter A

2018-06-18

To examine the compliance of colorectal cancer surveillance decisions for individuals at greater risk with current evidence-based guidelines and to determine whether compliance differs between surveillance models. Prospective auditing of compliance of surveillance decisions with evidence-based guidelines (NHMRC) in two decision-making models: nurse coordinator-led decision making in public academic hospitals and physician-led decision making in private non-academic hospitals. Selected South Australian hospitals participating in the Southern Co-operative Program for the Prevention of Colorectal Cancer (SCOOP). Proportions of recall recommendations that matched NHMRC guideline recommendations (March-May 2015); numbers of surveillance colonoscopies undertaken more than 6 months ahead of schedule (January-December 2015); proportions of significant neoplasia findings during the 15 years of SCOOP operation (2000-2015). For the nurse-led/public academic hospital model, the recall interval recommendation following 398 of 410 colonoscopies (97%) with findings covered by NHMRC guidelines corresponded to the guideline recommendations; for the physician-led/private non-academic hospital model, this applied to 257 of 310 colonoscopies (83%) (P < 0.001). During 2015, 27% of colonoscopies in public academic hospitals (mean, 27 months; SD, 13 months) and 20% of those in private non-academic hospitals (mean, 23 months; SD, 12 months) were performed more than 6 months earlier than scheduled, in most cases because of patient-related factors (symptoms, faecal occult blood test results). The ratio of the numbers of high risk adenomas to cancers increased from 6.6:1 during 2001-2005 to 16:1 during 2011-2015. The nurse-led/public academic hospital model for decisions about colorectal cancer surveillance intervals achieves a high degree of compliance with guideline recommendations, which should relieve burdening of colonoscopy resources.

Pattern of congenital heart disease in Southern Yemeni children referred for echocardiography.

PubMed

Saleh, Hussein K

2009-06-01

To study the distribution of age, gender, and the relative frequency of congenital heart defects at the time of the diagnosis in Southern Yemeni children. This retrospective study focused on echocardiographic findings of 393 symptomatic children affected by congenital heart disease. It was conducted in the Echocardiography Department of a referral hospital for Aden city and surrounding governorates, Yemen, from January 2001 to December 2005. Out of 987 referred children, congenital heart defects were detected in 393 (39.8%); mean age was 3.45+/-4 years; of them, 48% males and 52% females. They were 85% non-cyanotic and 15% cyanotic. Patients comprised neonates, 5 (1.3%); infants under one year, 156 (39.7%), and children more than one year, 232 (59%). Most cyanotic patients (66%) presented during their first year of life, but only 8.5% were neonates. Most non-cyanotic (64%) presented after their first year mean age 3.9 years, none of them were neonates. The most frequent defects were: ventricular septal defect (26.5%), pulmonary stenosis (17.6%), patent ductus arteriosus (17.3%), and atrial septal defect (15.8%). Tetralogy of Fallot (8.9%) and transposition of great vessels (3.1%) were the most frequent cyanotic defects. The pattern of congenital heart diseases in Southern Yemen, is characterized by simple, potentially correctable heart defects, under-representation of cyanotic, and absence of critical defects that provokes high mortality during infancy.

The Impact of Hospital Size on CMS Hospital Profiling.

PubMed

Sosunov, Eugene A; Egorova, Natalia N; Lin, Hung-Mo; McCardle, Ken; Sharma, Vansh; Gelijns, Annetine C; Moskowitz, Alan J

2016-04-01

The Centers for Medicare & Medicaid Services (CMS) profile hospitals using a set of 30-day risk-standardized mortality and readmission rates as a basis for public reporting. These measures are affected by hospital patient volume, raising concerns about uniformity of standards applied to providers with different volumes. To quantitatively determine whether CMS uniformly profile hospitals that have equal performance levels but different volumes. Retrospective analysis of patient-level and hospital-level data using hierarchical logistic regression models with hospital random effects. Simulation of samples including a subset of hospitals with different volumes but equal poor performance (hospital effects=+3 SD in random-effect logistic model). A total of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 heart failure admissions in 4930 hospitals between July 1, 2005 and June 30, 2008. CMS methodology was used to determine the rank and proportion (by volume) of hospitals reported to perform "Worse than US National Rate." Percent of hospitals performing "Worse than US National Rate" was ∼40 times higher in the largest (fifth quintile by volume) compared with the smallest hospitals (first quintile). A similar gradient was seen in a cohort of 100 hospitals with simulated equal poor performance (0%, 0%, 5%, 20%, and 85% in quintiles 1 to 5) effectively leaving 78% of poor performers undetected. Our results illustrate the disparity of impact that the current CMS method of hospital profiling has on hospitals with higher volumes, translating into lower thresholds for detection and reporting of poor performance.

Channeled Southern Highlands

NASA Image and Video Library

2018-04-30

This enhanced color image from NASA's Mars Reconnaissance Orbiter (MRO) shows the heavily channeled and ancient southern highlands of Mars. The elongated and jagged features are windblown dunes, perhaps hardened and eroded. For more information see https://photojournal.jpl.nasa.gov/catalog/PIA22436

'I was told not to do it but…': Infant feeding practices amongst HIV-positive women in southern Thailand.

PubMed

Suwankhong, Dusanee; Liamputtong, Pranee

2017-05-01

mothers living with HIV are encouraged not to breastfeed as it can transmit HIV to their infants. However, there is little known about how Thai women with HIV perceive and experience their infant feeding practices. This paper explores the breastfeeding experiences among Thai women living with HIV in southern Thailand. semi-structured interviews and drawing methods were used with 30 HIV-positive women in rural communities of southern Thailand. Thematic analysis was used for data analysis. HIV-positive mothers had ambivalent feelings about not being able to breastfeed their infants. They perceived themselves as a 'contaminated mother'. Healthcare centres and hospitals supply free infant formula for HIV-positive mothers up to one and a half years. Despite this, many mothers had to deal with some difficulties. Some infants developed an allergy to the infant formula. The free infant formula was not sufficient for some infants and the mothers had to find alternative means for the well-being of their infants: many mothers relied on condensed milk whereas some fed mashed banana. The women made every effort to fulfill their ideology of being a good and responsible mother. this paper contributes a conceptual understanding about the lived experiences of breastfeeding among women living with HIV in southern Thailand. The findings have implications for midwifery care and health policy. The provision of different options of feeding should be made available to infants along with accessible resources and professional support and guidance. Copyright © 2017 Elsevier Ltd. All rights reserved.

1991 Southern California origin-destination survey : summary findings

DOT National Transportation Integrated Search

1993-02-01

This report presents the findings from the 1991 Southern California Origin-Destination Survey. The survey was coordinated and managed by the Southern California Association of Governments (SCAG) for the following five agencies representing their resp...

Work accidents and self-esteem of nursing professional in hospital settings.

PubMed

Santos, Sérgio Valverde Marques Dos; Macedo, Flávia Ribeiro Martins; Silva, Luiz Almeida da; Resck, Zelia Marilda Rodrigues; Nogueira, Denismar Alves; Terra, Fábio de Souza

2017-04-20

to analyze the occurrence of work accidents and the self-esteem of nurses in hospitals of a municipality of Minas Gerais. descriptive-analytical and cross-sectional study developed with 393 nursing professionals from three hospitals of a municipality in southern Minas Gerais. The Rosenberg Self-Esteem Scale and a questionnaire to characterize the population and work accidents were used for data collection. Data analysis was performed using Person's chi-squared test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. of the professionals studied, 15% had suffered an accident at work and 70.2% presented high self-esteem. Through the analysis, it was observed that smoking, religious belief and an outstanding event in the career were significantly associated with work accidents. In relation to self-esteem, family income, length of time working in the profession and an outstanding event in the career presented significant associations. factors such as smoking, religious belief, family income, length of time working in the profession and an outstanding event in the career can cause professionals to have accidents and/or cause changes in self-esteem, which can compromise their physical and mental health and their quality of life and work.

Taking the (southern) waters: science, slavery, and nationalism at the Virginia springs.

PubMed

LaFauci, Lauren E

2011-04-01

'Taking the (southern) waters' argues that, in the pre-Civil War period, the space of Virginia's mineral water resorts and the philosophy of southern hydropathic medicine enabled--indeed, fostered--white southerners' constructions of a 'nationalist,' pro-slavery ideology. In the first half of the paper, the author explains how white southern health-seekers came to view the springs region as a medicinal resource peculiarly designed for the healing of southern diseases and for the restoration of white southern constitutions; in the second half, she shows how physical and social aspects of the resorts, such as architectural choices and political events, supported and encouraged pro-slavery ideologies. Taken together, these medical-social analyses reveal how elite white southerners in the antebellum period came to associate the health of their peculiarly 'southern' bodies with the future health of an independent southern nation, one that elided black bodily presence at the same time that its social structures and scientific apparatuses relied upon enslaved black labor.

Insect and Disease Pests of Southern Hardwoods

Treesearch

L. P. Abrahamson; F. I. McCracken

1971-01-01

Insects and diseases seldom kill southern hardwood trees in managed stands, but they cause major economic losses by lowering wood quality and reducing tree growth. In discussing the most important insects and diseases of southern hardwoods, let us consider first those that attack natural hardwood stands and then those associated with plantation culture.

Southern Forest Resource Assessment - Summary of Findings

Treesearch

David N. Wear; John G. Greis

2002-01-01

The Southern Forest Resource Assessment (SFRA) was initiated in spring 1999 to address broad questions concerning the status, trends, and likely future of southern forests. A descriptive assessment such as SFRA can be used to highlight the major dynamics and uncertainties at play within a region's forested ecosystems, thereby focusing public discourse. Because...

Proceedings of the 2001 Southern Mensurationists' Conference

Treesearch

Paul F. Doruska; Don C. Bragg

2000-01-01

The 2001 Southern Mensurationists' Conference was held in scenic Chattanooga, Tennessee at the historical Chattanooga Choo Choo Holiday Inn. This conference was the latest in the series of annual gatherings of southern biometricians, and attracted speakers and participants from Texas to Virginia. A variety of papers were presented and the quaint atmosphere, as...

Birth Weight following Pregnancy during the 2003 Southern California Wildfires

PubMed Central

Holstius, David M.; Reid, Colleen E.; Jesdale, Bill M.

2012-01-01

Background: In late October 2003, a series of wildfires exposed urban populations in Southern California to elevated levels of air pollution over several weeks. Previous research suggests that short-term hospital admissions for respiratory outcomes increased specifically as a result of these fires. Objective: We assessed the impact of a wildfire event during pregnancy on birth weight among term infants. Methods: Using records for singleton term births delivered to mothers residing in California’s South Coast Air Basin (SoCAB) during 2001–2005 (n = 886,034), we compared birth weights from pregnancies that took place entirely before or after the wildfire event (n = 747,590) with those where wildfires occurred during the first (n = 60,270), second (n = 39,435), or third (n = 38,739) trimester. The trimester-specific effects of wildfire exposure were estimated using a fixed-effects regression model with several maternal characteristics included as covariates. Results: Compared with pregnancies before and after the wildfires, mean birth weight was estimated to be 7.0 g lower [95% confidence interval (CI): –11.8, –2.2] when the wildfire occurred during the third trimester, 9.7 g lower when it occurred during the second trimester (95% CI: –14.5, –4.8), and 3.3 g lower when it occurred during the first trimester (95% CI: –7.2, 0.6). Conclusions: Pregnancy during the 2003 Southern California wildfires was associated with slightly reduced average birth weight among infants exposed in utero. The extent and increasing frequency of wildfire events may have implications for infant health and development. PMID:22645279

Distribution and phenology of ixodid ticks in southern Zambia.

PubMed

Speybroeck, N; Madder, M; Van Den Bossche, P; Mtambo, J; Berkvens, N; Chaka, G; Mulumba, M; Brandt, J; Tirry, L; Berkvens, D

2002-12-01

Distribution data for epidemiologically important ticks (Acari: Ixodidae) in the Southern Province of Zambia, one of the main cattle areas of the country, are presented. Boophilus microplus (Canestrini) was not recorded in southern Zambia, whereas Boophilus decoloratus (Koch) is present throughout the area. New distribution patterns for less economically important ixodid ticks are also discussed. Southern Zambia is a transition zone because it is the most northern area in Africa where mixed Rhipicephalus appendiculatus Neumann and Rhipicephalus zambeziensis Walker, Norval & Corwin populations were reported. Although a second generation of adult R. appendiculatus/R. zamnbeziensis was encountered, simulations indicated that this phenomenon is very rare in southern Zambia, mainly because of the colder temperatures during the early dry season and lower rainfall. These simulations were supported by a development trial under experimental conditions. Tick body size measurements showed that southern Zambian ticks are larger than eastern Zambian R. appendiculatus. It is hypothesized that body size is related to diapausing intensity in this species. The epidemiological consequences are that a different approach to control Theileria parva (Theiler) (Piroplasmida: Theileriidae) and other tick-borne diseases is needed in southern Zambia, compared to the one adopted in eastern Zambia.

A numerical investigation of the Southern Gyre using ROMS

NASA Astrophysics Data System (ADS)

Gamoyo, Majambo; Reason, Chris J. C.; Collins, Charine

2017-05-01

A numerical model (The Regional Ocean Modelling System-ROMS), configured over the western Indian Ocean and driven by monthly climatology winds and heat fluxes, is applied to examine the Southern Gyre in the Somali Current system during the Southwest Monsoon. Despite the Southern Gyre playing a role in transporting water masses and other properties northwards across the equator, it has not been much studied. The model results indicate that the Southern Gyre appears in early June in the upper ocean as a result of instability in the northward flowing Somali Current. The arrival of downwelling Rossby wave energy at the East African coast intensifies the recirculation of the Southern Gyre and causes its northward movement. The Southern Gyre is characterized as a shallow feature which deepens from 100 m in June to 300 m in July-August. The average spatial scale of the gyre is about 400 km with subsequent development of positive vorticity bursts which are identified as potential contributors to the decay of the Southern Gyre. Cool and fresh waters observed in the gyre resulted from advection via the South Equatorial Current and then through the Somali Current (SC).

Physical oceanography and tracer chemistry of the southern ocean

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

Not Available

This report considers technical and scientific developments and research questions in studies of the Southern Ocean since its predecessor, /open quotes/Southern Ocean Dynamics--A Strategy for Scientific Exploration 1973-1983/close quotes/ was published. The summary lists key research questions in Southern Ocean oceanography. Chapter 1 describes how Southern Ocean research has evolved to provide the basis for timely research toward more directed objectives. Chapter 2 recommends four research programs, encompassing many of the specific recommendations that follow. Appendix A provides the scientific background and Reference/Bibliography list for this report for: on air-sea-ice interaction; the Antarctic Circumpolar Current; water mass conversion; chemical tracermore » oceanography; and numerical modeling of the Southern Ocean. Appendix B describes the satellite-based observation systems expected to be active during the next decade. Appendix C is a list of relevant reports published during 1981-1987. 146 refs.« less

Role of the Hospital Library Within the Hospital System *†

PubMed Central

Lorenzi, Nancy M.

1969-01-01

The results of a survey of hospital administrators, attending staff and house staff physicians, librarians, library committee chairmen, and nursing staff in five Northeastern Ohio hospitals concerning the status of the hospital library within the total hospital system are related. Results indicate that hospital libraries operate in the “fringe” area of the hospital system. A concentric-circle figure indicates the present position of the majority of hospital libraries surveyed. The future relationship of the library within the hospital system has also been represented by a concentric-circle figure. PMID:5778727

Interannual variability of the frontal activity in the Southern Hemisphere: relationship with atmospheric circulation and precipitation over southern South America

NASA Astrophysics Data System (ADS)

Blázquez, Josefina; Solman, Silvina A.

2017-04-01

The interannual variability of the frontal activity over the western Southern Hemisphere and its linkage with the variability of the atmospheric circulation and precipitation over southern South America is studied. The analysis is focused on the austral winter and spring seasons. The frontal activity is represented by an index defined as the product between the horizontal gradient of temperature and the relative vorticity at 850 hPa (FI) and is computed from the ERA Interim and NCEP2 reanalysis. For the two seasons the main mode of variability of FI, as depicted by the first Empirical Orthogonal Function, presents centres of action located in the southern part of the western Southern Hemisphere. This pattern is present in the two reanalysis datasets. The correlation coefficients between the principal component of the leading mode of FI and the two main modes of the 500 hPa geopotential height indicate that both the ENSO-mode and the SAM modulate the leading pattern of FI in winter while during the spring season the ENSO-mode controls the FI variability. The variability of the FI has a robust influence on the interannual variability of precipitation over southern South America and adjacent oceans. Over the continent, it was found that the pattern of precipitation anomalies associated with the variability of the FI depicts significant signals over southeastern South America (SESA), centre and south of Chile for winter and over SESA and southeastern Brazil for spring and agrees with the pattern of the leading mode of precipitation variability over southern South America.

Cone Analysis of Southern Pines - A Guidebook

Treesearch

D.L. Bramlett; E.W. Belcher; G.L. DeBarr; G.D. Hertel; Robert P. Karrfalt; C.W. Lantz; T. Miller; K.D. Ware; H.O. Yates

1977-01-01

Southern pine tree improvement programs require an ample supply of improved seeds, but productron from southern pine seed orchards has often been disappointing. If high productron is to be malntained yields must be monitored and causes of seed losses must be identified. Techniques for determining seed efficiency were first used for red pine, Pinus resinosa...

Southern Women's Literature: A Process of Discovery.

ERIC Educational Resources Information Center

Meese, Elizabeth A.

Teachers and students worked together at the University of Alabama to evolve a literature course that dealt with the Southern regional character and culture as manifested in the writings of women. The course began with an orientation to the region, with emphasis on the images and stereotypes of Southern women. Literary material included in the…

Southern California Edison PDF

EPA Pesticide Factsheets

This Southern California Edison report describes an evaluation of SCE’s Retail Appliance Recycling Program (Retail ARP) trial that was initiated in late October 2010 and completed in September of 2011.

The reinvigoration of the Southern Ocean carbon sink.

PubMed

Landschützer, Peter; Gruber, Nicolas; Haumann, F Alexander; Rödenbeck, Christian; Bakker, Dorothee C E; van Heuven, Steven; Hoppema, Mario; Metzl, Nicolas; Sweeney, Colm; Takahashi, Taro; Tilbrook, Bronte; Wanninkhof, Rik

2015-09-11

Several studies have suggested that the carbon sink in the Southern Ocean-the ocean's strongest region for the uptake of anthropogenic CO2 -has weakened in recent decades. We demonstrated, on the basis of multidecadal analyses of surface ocean CO2 observations, that this weakening trend stopped around 2002, and by 2012, the Southern Ocean had regained its expected strength based on the growth of atmospheric CO2. All three Southern Ocean sectors have contributed to this reinvigoration of the carbon sink, yet differences in the processes between sectors exist, related to a tendency toward a zonally more asymmetric atmospheric circulation. The large decadal variations in the Southern Ocean carbon sink suggest a rather dynamic ocean carbon cycle that varies more in time than previously recognized. Copyright © 2015, American Association for the Advancement of Science.

Emerging zoonoses in the southern United States: toxocariasis, bovine tuberculosis and southern tick-associated rash illness.

PubMed

Clinton, Rachel M; Carabin, Hélène; Little, Susan E

2010-09-01

The majority of emerging diseases in humans have been linked to zoonotic pathogens originating in domestic animals or wildlife. This is a public health concern because zoonotic infections affect several aspects of the society. The complex interactions among pathogen, host and environment also pose challenges in estimating the true burden of those infections. However, the recent development of new molecular diagnostic tools has allowed for better diagnosis of zoonotic infections. This review focuses on 3 emerging zoonoses, namely toxocariasis, bovine tuberculosis and southern tick-associated rash illness, and demonstrates that these infections may be more prevalent in the southern United States than previously recognized. This review places special emphasis on the recent epidemiologic trends, intra/interspecies transmission and clinical features of each of these zoonoses. In addition, treatment and prevention for each zoonotic pathogen are discussed. Clinicians working in the southern United States should be aware of the presence of those zoonotic infections.

An overview of the Southern Nevada Agency Partnership science and research synthesis: Chapter 1 in The Southern Nevada Agency Partnership science and research synthesis: science to support land management in southern Nevada

USGS Publications Warehouse

Chambers, Jeanne C.; Brooks, Matthew L.; Turner, Kent; Raish, Carol B.; Ostoja, Steven M.

2013-01-01

Maintaining and restoring the diverse ecosystems and resources that occur in southern Nevada in the face of rapid socio-economic and ecological change presents numerous challenged to Federal land managers. Rapid population growth since the 1980s, the land uses associated with that growth, and the interactions of those uses with the generally dry and highly variable climate result in numerous stresses to ecosystems, species, and cultural resource. In addition, climate models predict that the rate of temperature increase and, thus, changes in ecological processes, will be highest for ecosystems like the Mojave Desert. The Southern Nevada Agency Partnership (SNAP; http:www.SNAP.gov) was established in 1999 to address common issues pertaining to public lands in southern Nevada. Partners include the Bureau of Land Management, National Park Service, U.S. Fish and Wildlife Service, and USDA Forest Service and they work with each other, the local community, and other partners. SNAP agencies manage more than seven million acres of public lands in southern Nevada (95% of the land area). Federal land includes two national recreation areas, two national conservation area, four national wildlife refuges, 18 congressionally designated wilderness areas, five wilderness study areas, and 22 areas of critical environmental concern. The partnership's activities are mainly centered in Southern Nevada's Clark County (fig. 1.1), but lands managed by SNAP partner agencies also include portions of Lake Mead National Recreation Area in Mohave County, Arizona, U.S. Fish and Wildlife Service, and USDA Forest Service-managed lands in Lincoln and Nye Counties, Nevada, and all lands and activities managed by the Southern Nevada District Office of the Bureau of Land Management. These lands encompass nine distinct ecosystem types (fig. 1.2), support multiple species of management concern an 17 listed species, and are rich in cultural and historic resource. This introductory executive summary

Impact of a transition-of-care pharmacist during hospital discharge.

PubMed

Balling, Lauren; Erstad, Brian L; Weibel, Kurt

2015-01-01

To assess the impact of a transition-of-care pharmacist during hospital discharge. An academic medical center in southern Arizona. One pharmacist coordinated patient discharges in two inpatient units from August 2012 through July 2013. The pharmacist attended interdisciplinary discharge coordination meetings, ensured appropriate discharge orders, facilitated the filling of medications, and educated patients on discharge medications. The implementation of a transition-of-care pharmacist to provide discharge medication reconciliation and education. Readmission rates and medication interventions made by the pharmacist at discharge. The pharmacist was involved in the education of 1,011 patients and performed 452 interventions. There were more readmissions per month in the control year versus the year of pharmacist involvement (median 27.5 vs. 25, P = 0.0369). Interventions made by the pharmacist to improve discharge management included starting an omitted medication (23.5%), preventing multiple discharge problems (16.4%), avoiding duplication of therapy (15.7%), correcting insurance issues related to medication coverage (12.2%), changing an improper medication dose or quantity (11.3%), changing an inappropriate prescription for a medication (5.1%), preventing a drug interaction (3.3%), and resolving other problems (12.6%). The most common medication classes involved were antimicrobial agents (9.1%), anticoagulants (8%), antihyperglycemic agents (3.8%), other drug classes (24%), and multiple drug classes (35%). A transition-of-care pharmacist is in a unique position to educate patients on hospital discharge, to intercept a substantial number of medication errors, and to resolve insurance issues that may lead to adherence problems. These improvements in care may result in reduced hospital readmission rates.

Alluvial Scrub Vegetation in Coastal Southern California

Treesearch

Ted L. Hanes; Richard D. Friesen; Kathy Keane

1989-01-01

Certain floodplain systems in southern California sustain a unique scrub vegetation rather than riparian woodlands due to a lack of perennial water. Alluvial scrub occurs on outwash fans and riverine deposits along the coastal side of major mountains of southern California. This vegetation type is adapted to severe floods and erosion, nutrient-poor substrates, and the...

Mechanical Control of Southern Pine Beetle Infestations

Treesearch

Ronald F. Billings

2011-01-01

Periodic outbreaks of the southern pine beetle (SPB) may affect thousands of acres of commercial pine forests in the Southeastern United States, Mexico, and Central America. Accordingly, this species is the target of more aggressive and effective suppression programs than any other bark beetle pest in the world. The strategy for controlling the southern pine beetle...

Syntectonic remagnetization in the southern Methow block: Resolving large displacements in the southern Canadian Cordillera

USGS Publications Warehouse

Enkin, R.J.; Mahoney, J.B.; Baker, J.; Kiessling, M.; Haugerud, R.A.

2002-01-01

The Upper Cretaceous Ventura Member of the Goat Wall unit in the southern Methow block of southern British Columbia and northern Washington State holds a syntectonic magnetization. Eight new sites from Manning Park in British Columbia give a mean direction of D = 27.5??, I = 60.1??, k = 304.7, ??95 = 3.2?? after optimal partial tilt correction. Of five groups of bedded sites from farther south in the basin reported by Bazard et al. [1990], four have a syntectonic remanence with a direction similar to what we observe. The exception is one group which has optimal concentration of remanence directions on >100% untilting and an abherent direction which must be rejected. Combining the accepted sites, the optimal differential syntilting direction is D = 11.8??, I = 61.5??, k = 39.3, ??95 = 3.4?? (N = 47), giving a mean pole of 79.8??N, 359.2??E, K = 19.5, and A95 = 4.8??. The age of the remagnetization is constrained to be between 88 and 80 Ma. Compared to cratonic North America, this result indicates that the southern Methow block was displaced from the south by 1800 ?? 500 km, meaning it lay south of the Sierra Nevada subduction zone but well north of other paleomagnetically constrained Cretaceous rock units from the Insular superterrane, including correlative strata of the Mount Tatlow area in the northern Methow block. Among several possibilities to reconcile this discrepancy, the most plausible has the whole Methow block translated coherently but with the southern Methow block strata remagnetized during transit.

Steering Patients to Safer Hospitals? The Effect of a Tiered Hospital Network on Hospital Admissions

PubMed Central

Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B

2008-01-01

Objective To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. Data Sources/Study Setting A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety “leaps.” The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Study Design Changes in hospital admissions’ patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Principal Findings Patients affiliated with the engineers’ union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists’ union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Conclusions Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear. PMID:18761676

75 FR 52715 - Southern Arizona Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-27

... DEPARTMENT OF AGRICULTURE Forest Service Southern Arizona Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Southern Arizona Resource Advisory... held at the National Advanced Fire and Resource Institute (NAFRI) at 3265 E. Universal Way, Tucson...

75 FR 60066 - Southern Arizona Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-29

... DEPARTMENT OF AGRICULTURE Forest Service Southern Arizona Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Southern Arizona Resource Advisory... at the Tucson Interagency Fire Center, 2646 E. Commerce Center Place, Tucson, AZ 85706. Send written...

DIET OF THE SOUTHERN TOAD (BUFO TERRESTRIS) FROM THE SOUTHERN EVERGLADES

EPA Science Inventory

We examined the diet of a February-May sample of the southern toad (Bufo terrestris) from the Everglades National Park. Above the familial level, 13 taxa were consumed, but ants (Hymenoptera) and beetles (Coleoptera) were consumed most by, and in the greatest number of sto...

Incidence of Rheumatoid Arthritis in the Southern part of Denmark from 1995 to 2001

PubMed Central

Pedersen, Jens K; Svendsen, Anders J; Hørslev-Petersen, Kim

2007-01-01

We estimated the incidence of rheumatoid arthritis in the southern part of Denmark from 1995 to 2001. At a rheumatology hospital serving a population of about 200 000 people over the age of 15, medical records were scrutinized. As case definition we used the tree and list format of 1987 American College of Rheumatology criteria for rheumatoid arthritis. The mean annual incidence rate per 100 000 person years was 40 in females, 21 in males, and 31 in females and males combined. The incidence of rheumatoid arthritis in Denmark is in accordance with recent studies from North America, the UK, and Northern European countries. The aetiology of rheumatoid arthritis is unknown but this study indicates that in these populations the exposure to non-genetic host and environmental aetiological factors is similar. PMID:19088896

Southern Ocean Deep-Convection as a Driver of Centennial-to-Millennial-Scale Climate Variability at Southern High Latitudes

NASA Astrophysics Data System (ADS)

Pedro, J. B.; Martin, T.; Steig, E. J.; Jochum, M.; Park, W.; Rasmussen, S.

2015-12-01

Antarctic Isotope Maxima (AIM) are centennial-to-millennial scale warming events observed in Antarctic ice core records from the last glacial period and deglaciation. Mounting evidence links AIM events to parallel variations in atmospheric CO2, Southern Ocean (SO) sea surface temperatures and Antarctic Bottom Water production. According to the prevailing view, AIM events are forced from the North Atlantic by melt-water discharge from ice sheets suppressing the production of North Atlantic Deep Water and associated northward heat transport in the Atlantic. However observations and model studies increasingly suggest that melt-water fluxes have the wrong timing to be invoked as such a trigger. Here, drawing on results form the Kiel Climate Model, we present an alternative hypothesis in which AIM events are forced via internal oscillations in SO deep-convection. The quasi-periodic timescale of deep-convection events is set by heat (buoyancy) accumulation at SO intermediate depths and stochastic variability in sea ice conditions and freshening at the surface. Massive heat release from the SO convective zone drives Antarctic and large-scale southern hemisphere warming via a two-stage process involving changes in the location of Southern Ocean fronts, in the strength and intensity of the Westerlies and in meridional ocean and atmospheric heat flux anomalies. The potential for AIM events to be driven by internal Southern Ocean processes and the identification of time-lags internal to the southern high latitudes challenges conventional views on the North Atlantic as the pacemaker of millennial-scale climate variability.

The genetic prehistory of southern Africa.

PubMed

Pickrell, Joseph K; Patterson, Nick; Barbieri, Chiara; Berthold, Falko; Gerlach, Linda; Güldemann, Tom; Kure, Blesswell; Mpoloka, Sununguko Wata; Nakagawa, Hirosi; Naumann, Christfried; Lipson, Mark; Loh, Po-Ru; Lachance, Joseph; Mountain, Joanna; Bustamante, Carlos D; Berger, Bonnie; Tishkoff, Sarah A; Henn, Brenna M; Stoneking, Mark; Reich, David; Pakendorf, Brigitte

2012-01-01

Southern and eastern African populations that speak non-Bantu languages with click consonants are known to harbour some of the most ancient genetic lineages in humans, but their relationships are poorly understood. Here, we report data from 23 populations analysed at over half a million single-nucleotide polymorphisms, using a genome-wide array designed for studying human history. The southern African Khoisan fall into two genetic groups, loosely corresponding to the northwestern and southeastern Kalahari, which we show separated within the last 30,000 years. We find that all individuals derive at least a few percent of their genomes from admixture with non-Khoisan populations that began ∼1,200 years ago. In addition, the East African Hadza and Sandawe derive a fraction of their ancestry from admixture with a population related to the Khoisan, supporting the hypothesis of an ancient link between southern and eastern Africa.

Major Burden of Severe Anemia from Non-Falciparum Malaria Species in Southern Papua: A Hospital-Based Surveillance Study

PubMed Central

Douglas, Nicholas M.; Lampah, Daniel A.; Kenangalem, Enny; Simpson, Julie A.; Poespoprodjo, Jeanne R.; Sugiarto, Paulus; Anstey, Nicholas M.; Price, Ric N.

2013-01-01

Background The burden of anemia attributable to non-falciparum malarias in regions with Plasmodium co-endemicity is poorly documented. We compared the hematological profile of patients with and without malaria in southern Papua, Indonesia. Methods and Findings Clinical and laboratory data were linked for all patients presenting to a referral hospital between April 2004 and December 2012. Data were available on patient demographics, malaria diagnosis, hemoglobin concentration, and clinical outcome, but other potential causes of anemia could not be identified reliably. Of 922,120 patient episodes (837,989 as outpatients and 84,131 as inpatients), a total of 219,845 (23.8%) were associated with a hemoglobin measurement, of whom 67,696 (30.8%) had malaria. Patients with P. malariae infection had the lowest hemoglobin concentration (n = 1,608, mean = 8.93 [95% CI 8.81–9.06]), followed by those with mixed species infections (n = 8,645, mean = 9.22 [95% CI 9.16–9.28]), P. falciparum (n = 37,554, mean = 9.47 [95% CI 9.44–9.50]), and P. vivax (n = 19,858, mean = 9.53 [95% CI 9.49–9.57]); p-value for all comparisons <0.001. Severe anemia (hemoglobin <5 g/dl) was present in 8,151 (3.7%) patients. Compared to patients without malaria, those with mixed Plasmodium infection were at greatest risk of severe anemia (adjusted odds ratio [AOR] 3.25 [95% CI 2.99–3.54]); AORs for severe anaemia associated with P. falciparum, P. vivax, and P. malariae were 2.11 (95% CI 2.00–2.23), 1.87 (95% CI 1.74–2.01), and 2.18 (95% CI 1.76–2.67), respectively, p<0.001. Overall, 12.2% (95% CI 11.2%–13.3%) of severe anemia was attributable to non-falciparum infections compared with 15.1% (95% CI 13.9%–16.3%) for P. falciparum monoinfections. Patients with severe anemia had an increased risk of death (AOR = 5.80 [95% CI 5.17–6.50]; p<0.001). Not all patients had a hemoglobin measurement, thus limitations of the study include the potential for

Remote biomonitoring of temperatures in mothers and newborns: design, development and testing of a wearable sensor device in a tertiary-care hospital in southern India.

PubMed

Mony, Prem K; Thankachan, Prashanth; Bhat, Swarnarekha; Rao, Suman; Washington, Maryann; Antony, Sumi; Thomas, Annamma; Nagarajarao, Sheela C; Rao, Hiteshwar; Amrutur, Bharadwaj

2018-04-01

Newer technologies such as wearables, sensors, mobile telephony and computing offer opportunities to monitor vital physiological parameters and tackle healthcare problems, thereby improving access and quality of care. We describe the design, development and testing of a wearable sensor device for remote biomonitoring of body temperatures in mothers and newborns in southern India. Based on client needs and technological requirements, a wearable sensor device was designed and developed using principles of 'social innovation' design. The device underwent multiple iterations in product design and engineering based on user feedback, and then following preclinical testing, a techno-feasibility study and clinical trial were undertaken in a tertiary-care teaching hospital in Bangalore, India. Clinical trial phases I and IIa for evaluation of safety and efficacy were undertaken in the following sequence: 7 healthy adult volunteers; 18 healthy mothers; 3 healthy babies; 10 stable babies in the neonatal care intensive unit and 1 baby with morbidities. Time-stamped skin temperature readings obtained at 5 min intervals over a 1-hour period from the device secured on upper arms of mothers and abdomen of neonates were compared against readings from thermometers used routinely in clinical practice. Devices were comfortably secured on to adults and neonates, and data were efficiently transmitted via the gateway device for secure storage and retrieval for analysis. The mean skin temperatures in mothers were lower than the axillary temperatures by 2°C; and in newborns, there was a precision of -0.5°C relative to axillary measurements. While occasional minimal adverse events were noted in healthy volunteers, no adverse events were noted in mothers or neonates. This proof-of-concept study shows that this device is promising in terms of feasibility, safety and accuracy (with appropriate calibration) with potential for further refinements in device accuracy and pursuit of further

Southern Pine Beetle Handbook: Southern Pine Beetles Can Kill Your Ornamental Pine

Treesearch

Robert C. Thatcher; Jack E. Coster; Thomas L. Payne

1974-01-01

Southern pine beetles are compulsive eaters. Each year in the South from Texas to Virginia the voracious insects conduct a movable feast across thousands of acres of pine forests. Most trees die soon after the beetles sink their teeth into them.

Hospital variation in survival trends for in-hospital cardiac arrest.

PubMed

Girotra, Saket; Cram, Peter; Spertus, John A; Nallamothu, Brahmajee K; Li, Yan; Jones, Philip G; Chan, Paul S

2014-06-10

During the past decade, survival after in-hospital cardiac arrest has improved markedly. It remains unknown whether the improvement in survival has occurred uniformly at all hospitals or was driven by large improvements at only a few hospitals. We identified 93 342 adults with an in-hospital cardiac arrest at 231 hospitals in the Get With The Guidelines(®)-Resuscitation registry during 2000-2010. Using hierarchical regression models, we evaluated hospital-level trends in survival to discharge. Mean age was 66 years, 59% were men, and 21% were black. Between 2000 and 2010, there was a significant decrease in age, prevalence of heart failure and myocardial infarction, and cardiac arrests due to shockable rhythms (P<0.001 for all) and an increase in prevalence of sepsis, respiratory insufficiency, renal insufficiency, intensive care unit location, and mechanical ventilation before arrest (P<0.001 for all). After adjustment for temporal trends in baseline characteristics, hospital rates of in-hospital cardiac arrest survival improved by 7% per year (odds ratio [OR] 1.07, 95% CI 1.06 to 1.08, P<0.001). Improvement in survival varied markedly and ranged from 3% in the bottom hospital quartile to 11% in the top hospital quartile. Compared with minor teaching hospitals (OR 1.04, 95% CI 1.02 to 1.06), hospital rate of survival improvement was greater at major teaching (OR 1.08, 95% CI 1.06 to 1.10) and nonteaching hospitals (OR 1.07, 95% CI 1.05 to 1.09, P value for interaction=0.03). Although in-hospital cardiac arrest survival has improved during the past decade, the magnitude of improvement varied across hospitals. Future studies are needed to identify hospital processes that have led to the largest improvement in survival. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Microbial contamination of water intended for milk container washing in smallholder dairy farming and milk retailing houses in southern Ethiopia.

PubMed

Amenu, Kebede; Shitu, Desalew; Abera, Mesele

2016-01-01

The water used during handling and processing of milk products can be potential sources of microbial contamination with possible negative consequences on food safety. Especially, the water used in keeping the hygiene of milking and milk storage utensils is crucial to keep the quality and safety of the products. Therefore, the current study was designed to assess the bacteriological quality of water used for cleaning milking and milk storage equipment in smallholder dairy production in Hawassa and its surroundings. A total of 79 water samples were collected: 26 from milk collecting houses in Hawassa and 53 from selected smallholder dairy farms (Hawassa = 14, Arsi Negele = 29 and Yirgalem = 10). Out of the total samples, 18 samples were collected directly from pipe and 61 from storage containers (46 from narrow opening and 15 from wide opening containers). The overall prevalence of E. coli exceeding zero CFU/ml was 39.2 %. From analyzed samples, high prevalence of positive samples for E. coli was found in water samples taken from wide opening containers (66.7 %). A number of bacteria were isolated and presumptively identified which include Bacillus sp. 6.3 % (n = 5), Citrobacter sp. 1.3 %(n = 1), E. coli 39.2 % (n = 31), Enterobacter sp. 2.5 % (n = 2), Klebisella sp. 7.6 % (n = 6), Micrococcus sp. 6.3 % (n = 5), Pseudomonas sp. 6.3 % (n = 5), Staphylococcus aureus 6.3 % (n = 5), Staphylococcus epidermidis 13.9 % (n = 11) and Streptococcus sp. 1.3 % (n = 1). The bacteriological quality of water especially, water stored in household storage containers in present study area was found to be contaminated with different bacteria indicating potential food safety problem and health risk to the society. In this respect, people handling water should be educated on its proper handling and the risk of contamination during storage. To minimize contamination, materials with narrow mouth and lid should be used. Further study is recommended on

Holocene Geologic Slip Rate for the Banning Strand of the Southern San Andreas Fault near San Gorgonio Pass, Southern California

NASA Astrophysics Data System (ADS)

Gold, P. O.; Behr, W. M.; Rood, D. H.; Kendrick, K. J.; Rockwell, T. K.; Sharp, W. D.

2014-12-01

We present the first Holocene geologic slip rate for the Banning strand of the southern San Andreas Fault in southern California. The southern San Andreas Fault splays into the sub-parallel Banning and Mission Creek strands in the northwestern Coachella Valley, and although it has long been surmised that the Banning strand eventually accommodates the majority of displacement and transfers it into San Gorgonio Pass, until now it has been uncertain how slip is actually partitioned between these two fault strands. Our new slip rate measurement, critically located at the northwestern end of the Banning strand, overlaps within errors with the published rate for the southern San Andreas Fault measured at Biskra Palms Oasis. This indicates that the majority of southern San Andreas Fault displacement transfers from the southeastern Mission Creek strand northwest to the Banning strand and into San Gorgonio Pass. Our result corroborates the UCERF3 hazard model, and is consistent with most previous interpretations of how slip is partitioned between the Banning and Mission Creek fault strands. To measure this slip rate, we used B4 airborne LiDAR to identify the apex of an alluvial fan offset laterally 30 ± 5 m from its source. We calculated the depositional age of the fan using 10Be in-situ cosmogenic exposure dating of 5 cobbles and a depth profile. We calculated a most probable fan age of 4.0 +2.0/-1.6 ka (1σ) by combining the inheritance-corrected cobble ages assuming Gaussian uncertainty. However, the probability density function yielded a multi-peaked distribution, which we attribute to variable 10Be inheritance in the cobbles, so we favor the depth profile age of 2.2-3.6 ka. Combined, these measurements yield a late Holocene slip rate for the Banning strand of the southern San Andreas Fault of 11.1 +3.1/-3.3 mm/yr. This slip rate does not preclude possibility that some slip transfers north along the Mission Creek strand and the Garnet Hill fault, but it does confirm

Southern Forest Resource Assessment and Linkages to the National RPA

Treesearch

Fredrick Cubbage; Jacek Siry; Steverson Moffat; David N. Wear; Robert Abt

1998-01-01

We developed a Southern Forest Resource Assessment Consortium (SOFAC) in 1994, which is designed to enhance our capabilities to analyze and model the southern forest and timber resources. Southern growth and yield analyses prepared for the RPA via SOFAC indicate that substantial increases in timber productivity can occur given current technology. A survey about NIPF...

The relationship of hospital ownership and service composition to hospital charges

PubMed Central

Eskoz, Robin; Peddecord, K. Michael

1985-01-01

The relationship of hospital ownership and service composition to hospital charges was examined for 456 general acute hospitals in California. Ancillary services had higher profit margins, both gross and net profits, than daily hospital services. Ancillary services accounted for 55.3 percent of total patient revenue. Charges per day were 23 percent higher for ancillary services than for daily hospital services. Net profits for daily and ancillary services were lowest at county hospitals. Proprietary hospitals had the highest net profits for total ancillary services and the highest mean charges. Not-for-profit hospitals had the highest profit margins for daily hospital services. Neither direct nor total costs for ancillary services were significantly different among ownership groups, although direct costs for daily hospital services were significantly higher at proprietary hospitals. PMID:10311161

The beginnings of the Southern Child/Pediatric Neurology Society.

PubMed

Dyken, Paul Richard; Bodensteiner, John B

2015-04-01

The founding and early development of the Southern Pediatric Neurology Society was in many ways parallel to that of the Child Neurology Society. The organization started out as the Southern Child Neurology Society but the name was changed at the time of incorporation so as to avoid confusion of identity and purpose with the larger Child Neurology Society. Although there are archives of early days and the later development of the Southern Pediatric Neurology Society, the details have never been set down in a narrative explaining the events that led to the development of the organization. In this paper, we try to produce a written record of the history of the founding and early development of the Southern Pediatric Neurology Society. © The Author(s) 2014.

Southern Ocean Climate and Sea Ice Anomalies Associated with the Southern Oscillation.

NASA Astrophysics Data System (ADS)

Kwok, R.; Comiso, J. C.

2002-03-01

The anomalies in the climate and sea ice cover of the Southern Ocean and their relationships with the Southern Oscillation (SO) are investigated using a 17-yr dataset from 1982 to 1998. The polar climate anomalies are correlated with the Southern Oscillation index (SOI) and the composites of these anomalies are examined under the positive (SOI > 0), neutral (0 > SOI > 1), and negative (SOI < 1) phases of SOI. The climate dataset consists of sea level pressure, wind, surface air temperature, and sea surface temperature fields, while the sea ice dataset describes its extent, concentration, motion, and surface temperature. The analysis depicts, for the first time, the spatial variability in the relationship of the above variables with the SOI. The strongest correlation between the SOI and the polar climate anomalies are found in the Bellingshausen, Amundsen, and Ross Seas. The composite fields reveal anomalies that are organized in distinct large-scale spatial patterns with opposing polarities at the two extremes of SOI, and suggest oscillations that are closely linked to the SO. Within these sectors, positive (negative) phases of the SOI are generally associated with lower (higher) sea level pressure, cooler (warmer) surface air temperature, and cooler (warmer) sea surface temperature in these sectors. Associations between these climate anomalies and the behavior of the Antarctic sea ice cover are evident. Recent anomalies in the sea ice cover that are clearly associated with the SOI include the following: the record decrease in the sea ice extent in the Bellingshausen Sea from mid-1988 to early 1991; the relationship between Ross Sea SST and the ENSO signal, and reduced sea ice concentration in the Ross Sea; and the shortening of the ice season in the eastern Ross Sea, Amundsen Sea, far western Weddell Sea and lengthening of the ice season in the western Ross Sea, Bellinghausen Sea, and central Weddell Sea gyre during the period 1988-94. Four ENSO episodes over the

The Moving Edge: Perspectives on the Southern Wildland-Urban Interface

Treesearch

Martha C. Monroe; Alison W. Bowers; L. Annie Hermansen

2003-01-01

To better understand the wildland-urban interface across the 13 Southern States and to identify issues to be covered in the USDA Forest Service report, "Human Influences on Forest Ecosystems: The Southern Wildland-Urban Interface Assessment," 12 focus groups were conducted in 6 of the Southern States in May and June 2000. The groups were guided through a...

Hospital output forecasts and the cost of empty hospital beds.

PubMed Central

Pauly, M V; Wilson, P

1986-01-01

This article investigates the cost incurred when hospitals have different levels of beds to treat a given number of patients. The cost of hospital care is affected by both the forecasted level of admissions and the actual number of admissions. When the relationship between forecasted and actual admissions is held constant, it is found that an empty hospital bed at a typical hospital in Michigan has a relatively low cost, about 13 percent or less of the cost of an occupied bed. However, empty beds in large hospitals do add significantly to cost. If hospital beds are closed, whether by closing beds at hospitals which remain in business or by closing entire hospitals, cost savings are estimated to be small. PMID:3759473

Hospital Variation in Survival Trends for In‐hospital Cardiac Arrest

PubMed Central

Girotra, Saket; Cram, Peter; Spertus, John A.; Nallamothu, Brahmajee K.; Li, Yan; Jones, Philip G.; Chan, Paul S.

2014-01-01

Background During the past decade, survival after in‐hospital cardiac arrest has improved markedly. It remains unknown whether the improvement in survival has occurred uniformly at all hospitals or was driven by large improvements at only a few hospitals. Methods and Results We identified 93 342 adults with an in‐hospital cardiac arrest at 231 hospitals in the Get With The Guidelines®‐Resuscitation registry during 2000–2010. Using hierarchical regression models, we evaluated hospital‐level trends in survival to discharge. Mean age was 66 years, 59% were men, and 21% were black. Between 2000 and 2010, there was a significant decrease in age, prevalence of heart failure and myocardial infarction, and cardiac arrests due to shockable rhythms (P<0.001 for all) and an increase in prevalence of sepsis, respiratory insufficiency, renal insufficiency, intensive care unit location, and mechanical ventilation before arrest (P<0.001 for all). After adjustment for temporal trends in baseline characteristics, hospital rates of in‐hospital cardiac arrest survival improved by 7% per year (odds ratio [OR] 1.07, 95% CI 1.06 to 1.08, P<0.001). Improvement in survival varied markedly and ranged from 3% in the bottom hospital quartile to 11% in the top hospital quartile. Compared with minor teaching hospitals (OR 1.04, 95% CI 1.02 to 1.06), hospital rate of survival improvement was greater at major teaching (OR 1.08, 95% CI 1.06 to 1.10) and nonteaching hospitals (OR 1.07, 95% CI 1.05 to 1.09, P value for interaction=0.03). Conclusion Although in‐hospital cardiac arrest survival has improved during the past decade, the magnitude of improvement varied across hospitals. Future studies are needed to identify hospital processes that have led to the largest improvement in survival. PMID:24922627

Resource-Sharing and Self-Reliance in Southern Africa.

ERIC Educational Resources Information Center

Lungu, Charles B. M.

1987-01-01

Discusses the need for a regional information network in southern Africa to provide policy makers with access to needed information and reduce dependence on foreign advisers. The progress of the Southern Africa Documentation and Information System is described, and future trends and possible difficulties are identified. (CLB)

Southern pulpwood production, 1981

Treesearch

Cecil C. Hutchins

1982-01-01

Southern pulpwood production has remained almost constant for the past 3 years. In 1981, production totaled 54.3 million cords with softwood roundwood accounting for about 50 percent, hardwood roundwood 18 percent, and mill byproducts 32 percent.

New Zealand Southern Alps

NASA Image and Video Library

2001-06-20

This anaglyph from the MISR instrument aboard NASA Terra spacecraft shows the rugged Southern Alps extending some 650 kilometers along the western side of New Zealand South Island. 3D glasses are necessary to view this image.

A spatial analysis of heat stress related emergency room visits in rural Southern Ontario during heat waves.

PubMed

Bishop-Williams, Katherine E; Berke, Olaf; Pearl, David L; Kelton, David F

2015-08-06

In Southern Ontario, climate change may have given rise to an increasing occurrence of heat waves since the year 2000, which can cause heat stress to the general public, and potentially have detrimental health consequences. Heat waves are defined as three consecutive days with temperatures of 32 °C and above. Heat stress is the level of discomfort. A variety of heat stress indices have been proposed to measure heat stress (e.g., the heat stress index (HSI)), and has been shown to predict increases in morbidity and/or mortality rates in humans and other species. Maps visualizing the distribution of heat stress can provide information about related health risks and insight for control strategies. Information to inform heat wave preparedness models in Ontario was previously only available for major metropolitan areas. Hospitals in communities of fewer than 100,000 individuals were recruited for a pilot study by telephone. The number of people visiting the emergency room or 24-hour urgent care service was collected for a total of 27 days, covering three heat waves and six 3-day control periods from 2010-2012. The heat stress index was spatially predicted using data from 37 weather stations across Southern Ontario by geostatistical kriging. Poisson regression modeling was applied to determine the rate of increased number of emergency room visits in rural hospitals with respect to the HSI. During a heat wave, the average rate of emergency room visits was 1.11 times higher than during a control period (IRR = 1.11, CI95% (IRR) = (1.07,1.15), p ≤ 0.001). In a univariable model, HSI was not a significant predictor of emergency room visits, but when accounting for the confounding effect of a spatial trend polynomial in the hospital location coordinates, a one unit increase in HSI predicted an increase in daily emergency rooms visits by 0.4% (IRR = 1.004, CI95%(IRR) = (1.0005,1.007), p = 0.024) across the region. One high-risk cluster and no low risk

Transport of Biomass Burning Emissions from Southern Africa

NASA Technical Reports Server (NTRS)

Sinha, Parikhit; Jaegle,Lyatt; Hobbs, Peter V.; Liang, Qing

2004-01-01

The transport of biomass burning emissions from southern Africa to the neighboring Atlantic and Indian Oceans during the dry season (May-October) of 2000 is characterized using ground, ozonesonde, and aircraft measurements of carbon monoxide (CO) and ozone (O3) in and around southern Africa, together with the GEOS-CHEM global model of tropospheric chemistry. The model shows a positive bias of approximately 20% for CO and a negative bias of approximately 10-25% for O3 at oceanic sites downwind of fire emissions. Near areas of active fire emissions the model shows a negative bias of approximately 60% and approximately 30% for CO and O3, respectively, likely due to the coarse spatial (2 deg. x 2.5 deg.) and temporal (monthly) resolution of the model compared to that of active fires. On average, from 1994 to 2000, approximately 60 Tg of carbon monoxide (CO) from biomass burning in southern Africa was transported eastward to the Indian Ocean across the latitude band 0 deg. -60 S during the 6 months of the dry season. Over the same time period, approximately 40 Tg of CO from southern African biomass burning was transported westward to the Atlantic Ocean over the latitudes 0 deg. -20 S during the 6-month dry season, but most of that amount was transported back eastward over higher latitudes to the south (21 deg. -60 S). Eastward transport of biomass burning emissions from southern Africa enhances CO concentrations by approximately 4- 13 ppbv per month over the southern subtropical Indian Ocean during the dry season, with peak enhancements in September. Carbon monoxide from southern African and South American biomass burning is seen in the model simulations as far away as Australia, contributing approximately 8 ppbv and approximately 12-15 ppbv CO, respectively, and thus explaining the approximately 20- 25 ppbv observed enhancement of CO over Melbourne in mid-September 2000.

The Southern Forest Futures Project: summary report

Treesearch

David N. Wear; John G. Greis

2012-01-01

The Southern Forest Futures Project provides a science-based “futuring” analysis of the forests of the 13 States of the Southeastern United States. With findings organized in a set of scenarios and using a combination of computer models and science synthesis, the authors of the Southern Forest Futures Project examine a variety of possible futures that could shape...

A descriptive epidemiological study on the patterns of occupational injuries in a coastal area and a mountain area in Southern China

PubMed Central

Li, Liping; Liu, Xiaojian; Lu, Yaogui; Yu, Min

2012-01-01

Objectives This study compared patterns of occupational injuries in two different areas, coastal (industrial) and mountain (agricultural), in Southern China to provide information for development of occupational injury prevention measures in China. Design Descriptive epidemiological study. Setting Data were obtained from the Hospital Injury Surveillance System based on hospital data collected from 1 April 2006 to 31 March 2008. Participants Cases of occupational injury, defined as injury that occurred when the activity indicated was work. Outcome measures Distribution and differences of patterns of occupational injuries between the two areas. Results Men were more likely than women to experience occupational injuries, and there was no difference in the two areas (p=0.112). In the coastal area, occupational injury occurred more in the 21–30-year age group, but in the mountain area, it was the 41–50-year age group (p<0.001). Occupational injuries in the two areas differed by location of hometown, education and occupation (all p<0.001). Occupational injuries peaked differently in the month of the year in the two areas (p<0.001). Industrial and construction areas were the most frequent locations where occupational injuries occurred (p<0.001). Most occupational injuries were unintentional and not serious, and patients could go home after treatment. The two areas also differed in external causes and consequences of occupational injuries. Conclusions The differing patterns of occupational injuries in the coastal and mountain areas in Southern China suggest that different preventive measures should be developed. Results are relevant to other developing countries that have industrial and agricultural areas. PMID:22710129

Southern Hemisphere rainfall variability over the past 200 years

NASA Astrophysics Data System (ADS)

Gergis, Joëlle; Henley, Benjamin J.

2017-04-01

This study presents an analysis of three palaeoclimate rainfall reconstructions from the Southern Hemisphere regions of south-eastern Australia (SEA), southern South Africa (SAF) and southern South America (SSA). We provide a first comparison of rainfall variations in these three regions over the past two centuries, with a focus on identifying synchronous wet and dry periods. Despite the uncertainties associated with the spatial and temporal limitations of the rainfall reconstructions, we find evidence of dynamically-forced climate influences. An investigation of the twentieth century relationship between regional rainfall and the large-scale climate circulation features of the Pacific, Indian and Southern Ocean regions revealed that Indo-Pacific variations of the El Niño-Southern Oscillation (ENSO) and the Indian Ocean dipole dominate rainfall variability in SEA and SAF, while the higher latitude Southern Annular Mode (SAM) exerts a greater influence in SSA. An assessment of the stability of the regional rainfall-climate circulation modes over the past two centuries revealed a number of non-stationarities, the most notable of which occurs during the early nineteenth century around 1820. This corresponds to a time when the influence of ENSO on SEA, SAF and SSA rainfall weakens and there is a strengthening of the influence of SAM. We conclude by advocating the use of long-term palaeoclimate data to estimate decadal rainfall variability for future water resource management.

Cognitive plasticity as a moderator of functional dependency in elderly patients hospitalized for bone fractures.

PubMed

Calero-García, M J; Calero, M D; Navarro, E; Ortega, A R

2015-01-01

Bone fractures in older adults involve hospitalization and surgical intervention, aspects that have been related to loss of autonomy and independence. Several variables have been studied as moderators of how these patients recover. However, the implications of cognitive plasticity for functional recovery have not been studied to date. The present study analyzes the relationship between cognitive plasticity--defined as the capacity for learning or improved performance under conditions of training or performance optimization--and functional recovery in older adults hospitalized following a bone fracture. The study comprised 165 older adults who underwent surgery for bone fractures at a hospital in southern Spain. Participants were evaluated at different time points thereafter, with instruments that measure activities of daily life (ADL), namely the Barthel Index (BI) and the Lawton Index, as well as with a learning potential (cognitive plasticity) assessment test (Auditory Verbal Learning Test of Learning Potential, AVLT-LP). Results show that most of the participants have improved their level of independence 3 months after the intervention. However, some patients continue to have medium to high levels of dependency and this dependency is related to cognitive plasticity. The results of this study reveal the importance of the cognitive plasticity variable for evaluating older adults hospitalized for a fracture. They indicate a possible benefit to be obtained by implementing programs that reduce the degree of long-term dependency or decrease the likelihood of it arising.

75 FR 77677 - Southern Nuclear Operating Company, Inc.

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-13

... NUCLEAR REGULATORY COMMISSION [Docket No. 50-366; NRC-2010-0345] Southern Nuclear Operating Company, Inc. Edwin I Hatch Nuclear Plant, Unit No. 2; Exemption 1.0 Background The Southern Nuclear...-5 which authorizes operation of the Edwin I. Hatch Nuclear Plant, Unit No. 2 (HNP-2). The license...

Southern pulpwood production, 1961

Treesearch

Vernon L. Robinson; Agnes C. Nichols

1962-01-01

Southern pulpwood production reached 24,230,728 cords in 1961--60 percent of the Nations total. Significant increases were noted in the consumption of hardwood and residues. But pine roundwood remained virtually unchanged for the third consecutive year.

Optimal Level of Expenditure to Control the Southern Pine Beetle

Treesearch

Joseph E. de Steiguer; Roy L. Hedden; John M. Pye

1987-01-01

Optimal level of expenditure to control damage to commercial timber stands by the southern pine beetle was determined by models that simulated and analyzed beetle attacks during a typical season for 11 Southern States. At a real discount rate of 4 percent, maximized net benefits for the Southern region are estimated at about $50 million; at 10 percent, more than $30...

Paleolakes in the Gobi region of southern Mongolia

NASA Astrophysics Data System (ADS)

Lehmkuhl, Frank; Grunert, Jörg; Hülle, Daniela; Batkhishig, Ochirbat; Stauch, Georg

2018-01-01

Numerous lakes and remnants of paleolakes exist in western and southern Mongolia. For six basins in the area, detailed geomorphological maps were compiled, based on extensive field studies and remote sensing datasets. Several phases of high and low lake levels were reconstructed and dated by radiocarbon and optically stimulated luminescence. During the marine isotope stage (MIS) 6 lakes in southern and western Mongolia mostly disappeared. In contrast, large paleolakes existed during the last interglacial (MIS 5e) and lasted probably until the beginning of the last glacial. These huge lakes were caused by a strong East Asian summer monsoon, which reached southern and even western Mongolia. During the MIS 3 the monsoon was considerably weaker and most of the lakes were relatively small or even disappeared. Higher lake levels of this period were only recorded at the Orog Nuur. However, at this time the lake was fed by glacial melt water from the Khangai Mountains. The MIS 2 was again a very dry period. The previously supposed phase of synchronous high lake levels and glaciations in southern and western Mongolia is not supported by the data presented here. During the Holocene, lakes in the western and southern part of the study area evolved differently. Early Holocene high lake levels were reconstructed for the western lakes, while most of the southern lakes had highest lake levels in the mid-Holocene. These differences can be attributed to different moisture bearing atmospheric systems. In the late Holocene lake levels were generally low and in the last 50 years most lakes completely disappeared due to a strong human usage of the water resources.

Accretion of southern Alaska

USGS Publications Warehouse

Hillhouse, J.W.

1987-01-01

Paleomagnetic data from southern Alaska indicate that the Wrangellia and Peninsular terranes collided with central Alaska probably by 65 Ma ago and certainly no later than 55 Ma ago. The accretion of these terranes to the mainland was followed by the arrival of the Ghost Rocks volcanic assemblage at the southern margin of Kodiak Island. Poleward movement of these terranes can be explained by rapid motion of the Kula oceanic plate, mainly from 85 to 43 Ma ago, according to recent reconstructions derived from the hot-spot reference frame. After accretion, much of southwestern Alaska underwent a counterclockwise rotation of about 50 ?? as indicated by paleomagnetic poles from volcanic rocks of Late Cretaceous and Early Tertiary age. Compression between North America and Asia during opening of the North Atlantic (68-44 Ma ago) may account for the rotation. ?? 1987.

Japanese hospitals--culture and competition: a study of ten hospitals.

PubMed

Anbäcken, O

1994-01-01

Japanese health care is characterized by a pluralistic system with a high degree of private producers. Central government regulates the prices and the financing system. All citizens are covered by a mandatory employment-based health insurance operating on a non-profit basis. The consumer has a free choice of physician and hospital. A comparison between Japan, Sweden and some other countries shows significant dissimilarities in the length of stay, number of treatments per hospital bed and year and the staffing of hospitals. About 80 per cent of the hospitals and 94 per cent of the clinics are privately owned. The typical private hospital owned by a physician has less than 100 beds. In this paper, data collected (1992/93) in an empirical study of Japanese hospitals and their leadership is presented. Also discussed are the hospitals' style of management, tools and strategies for competition and competences--personal and formal skills required of the leadership in the hospital. There follows a study of ten hospitals, among which hospital directors and chief physicians were interviewed. Interviews are also made with key persons in the Ministry of Health and Welfare and other organizations in the health care field. The result is also analysed from a cultural perspective--'what kind of impact does the Japanese culture have on the health care organization?' and/or 'what kind of sub-culture is developed in the Japanese hospitals'. Some comparisons are made with Sweden, USA, Canada and Germany. The different roles of the professions in the hospital are included in the study as well as the incentives for different kinds of strategies--specialization, growing in size, investments in new equipment, different kind of ownership and hospitals. Another issue discussed is the attempt to uncover whether there is an implicit distribution of specialties--silent agreements between hospitals, etc.

40 CFR 81.158 - Southern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Southern Wisconsin Intrastate Air... Air Quality Control Regions § 81.158 Southern Wisconsin Intrastate Air Quality Control Region. The Southern Wisconsin Intrastate Air Quality Control Region consists of the territorial area encompassed by...

40 CFR 81.158 - Southern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 17 2011-07-01 2011-07-01 false Southern Wisconsin Intrastate Air... Air Quality Control Regions § 81.158 Southern Wisconsin Intrastate Air Quality Control Region. The Southern Wisconsin Intrastate Air Quality Control Region consists of the territorial area encompassed by...

40 CFR 81.158 - Southern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 18 2013-07-01 2013-07-01 false Southern Wisconsin Intrastate Air... Air Quality Control Regions § 81.158 Southern Wisconsin Intrastate Air Quality Control Region. The Southern Wisconsin Intrastate Air Quality Control Region consists of the territorial area encompassed by...

40 CFR 81.158 - Southern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 18 2014-07-01 2014-07-01 false Southern Wisconsin Intrastate Air... Air Quality Control Regions § 81.158 Southern Wisconsin Intrastate Air Quality Control Region. The Southern Wisconsin Intrastate Air Quality Control Region consists of the territorial area encompassed by...

40 CFR 81.158 - Southern Wisconsin Intrastate Air Quality Control Region.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 18 2012-07-01 2012-07-01 false Southern Wisconsin Intrastate Air... Air Quality Control Regions § 81.158 Southern Wisconsin Intrastate Air Quality Control Region. The Southern Wisconsin Intrastate Air Quality Control Region consists of the territorial area encompassed by...

The Southern Cone: A critical element in North American geology

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

Dalziel, I.W.D.

1993-02-01

The Pacific and Atlantic-Gulf of Mexico continental margins converge towards southern Mexico, delimiting the Southern Cone of North American. The margins are controlled by late Precambrian to early Paleozoic rift systems. The Neoproterozoic rifts along the Pacific margin truncate the 1.3--1.0 Ga Grenville-Llano front and still older structural boundaries within the craton, such as the Snowbird line. The Atlantic margin originated by separation from another continent within the Grenville orogen near the time of the Precambrian-Cambrian boundary. The Gulf of Mexico margin was initiated with rifting at that time, but appears to truncate the Ordovician Taconian orogen in Georgia. Themore » continental margins of the Southern Cone may prove critical in understanding the origin of North America as a discrete continent. A possible continuation of the Grenville-Llano front has now been identified along the Pacific margin of the East Antarctic craton; the opposite side of the Grenville orogen may be present in South America and East Antarctic; a southern continuation of the Taconic Appalachians may have been identified in southern South American and Antarctica (L. Dalla Salda et al., Geology, 1992 a;b: I. Dalziel, Geology, 1991, and GSA Today, 1992; P. Hoffman, Science, 1991; E. Moores, Geology, 1991). Thus the geology of the Southern Cone of North America provides opportunities for critical testing of these globally important hypotheses, notably through geochronometry, isotope geochemistry, stratigraphy, and paleobiogeography. Conversely, East Antarctica, southern Africa, and the proto-Andean margin of South America may offer exciting opportunities to further understanding of pre-Pangea geology across southern North America.« less

The Southern Manifesto as Education Policy in Mississippi

ERIC Educational Resources Information Center

Luckett, Robert, Jr.

2016-01-01

In 1956, southern Congressmen signed the Southern Manifesto, rejecting the Supreme Court's "Brown v. Board of Education" ruling. This moment, in the general American consciousness, marked the rise of White massive resistance to Black advancement, a racist foray doomed to be swept aside by civil rights forces and a determined federal…

Hospital Characteristics Associated With Postdischarge Hospital Readmission, Observation, and Emergency Department Utilization.

PubMed

Horwitz, Leora I; Wang, Yongfei; Altaf, Faseeha K; Wang, Changqin; Lin, Zhenqiu; Liu, Shuling; Grady, Jacqueline; Bernheim, Susannah M; Desai, Nihar R; Venkatesh, Arjun K; Herrin, Jeph

2018-04-01

Whether types of hospitals with high readmission rates also have high overall postdischarge acute care utilization (including emergency department and observation care) is unknown. Cross-sectional analysis. Nonfederal United States acute care hospitals. Using methodology established by the Centers for Medicare & Medicaid Services, we calculated each hospital's "excess days in acute care" for fee-for-service (FFS) Medicare beneficiaries aged over 65 years discharged after hospitalization for acute myocardial infarction, heart failure (HF), or pneumonia, representing the mean difference between predicted and expected total days of acute care utilization in the 30 days following hospital discharge, per 100 discharges. We assessed the multivariable association of 8 hospital characteristics with excess days in acute care and the proportion of hospitals with each characteristic that were statistical outliers (95% credible interval estimate does not include 0). We included 2184 hospitals for acute myocardial infarction [228 (10.4%) better than expected, 549 (25.1%) worse than expected], 3720 hospitals for HF [484 (13.0%) better and 840 (22.6%) worse], and 4195 hospitals for pneumonia [673 (16.0%) better, 1005 (24.0%) worse]. Results for all conditions were similar. Worse than expected outliers for pneumonia included: 18.8% of safety net hospitals versus 26.1% of nonsafety net hospitals; 16.7% of public hospitals versus 33.1% of for-profit hospitals; 19.5% of nonteaching hospitals versus 52.2% of major teaching hospitals; 7.9% of rural hospitals versus 42.1% of large urban hospitals; 5.9% of hospitals with 24-<50 beds versus 58% of hospitals with >500 beds; and 29.0% of hospitals with nurse-to-bed ratios >1.0-1.5 versus 21.7% of hospitals with ratios >2.0. Including emergency department and observation stays in measures of postdischarge utilization produces similar results as measuring only readmissions in that major teaching, urban and for-profit hospitals still perform

The single-hospital county: is its hospital at risk?

PubMed Central

Chang, C F; Tuckman, H P

1991-01-01

This article focuses on a hospital group that has not received adequate attention in the literature: the sole provider of short-term, acute hospital care located in a county. In Tennessee, SPHs (single provider hospitals) are fewer in number but are present in more counties than multiprovider hospitals (MPHs). They are smaller in size, less labor and capital intensive, more likely to be a government hospital, and more likely to be in a rural area with low income and limited health care resources. SPHs operate with lower costs, charge patients less, and have lower revenue write-offs than MPHs. As a result, their cash flow is sufficient to fund their depreciation and they consistently earn modest returns. Between 1982 and 1988, a total of 16 hospitals failed in Tennessee but only 3 were SPHs. While SPHs have not been profitable enough to make them ideal candidates for takeover by major hospital systems, they are not a population that is unduly at risk. PMID:1905685

Hospital autonomy: the experience of Kenyatta National Hospital.

PubMed

Collins, D; Njeru, G; Meme, J; Newbrander, W

1999-01-01

An increasing number of countries are exploring the introduction or expansion of autonomous hospitals as one of the numerous health reforms they are introducing to their health system. Hospital autonomy is one of the forms of decentralization that is focused on a specific institution rather than on a political unit. It has gained much interest because it is an attempt to amalgamate the best elements of the public and private sectors in how a hospital is governed, managed and financed. This paper reviews the key elements of the concept of hospital autonomy, the reasons for its expanded use in many countries and a specific example of making a major teaching hospital autonomous in Kenya. A review of the successful experience of Kenyatta National Hospital and its process of introducing autonomy, with regard to governance, operations and management, and finances, lead to several conclusions on replicability. The legal framework is a critical element for successfully structuring the autonomous hospital. Additionally, success is highly dependent on the extent to which there is adequate funding during the process of attaining autonomy due to the length of the transition period needed. Autonomy must be granted within the context of the national health system and national health objectives and be consistent with those aims and their underlying societal values. Finally, as with decentralization, success is dependent upon the preparation done with the systems and management necessary for the proper governance and operation of autonomous hospitals.

Southern regional report

Treesearch

Bryce J Stokes

1997-01-01

It appears as if many in wood procurement, forest management, operations, manufacturing, and sales in the Southern U.S. are simultaneously biting the bullet and showing signs of guarded optimism for the future. On the one hand, during last year, purchasing costs were high, selling prices were low, quotas ruled, and machine purchases sagged. However, there is continued...

Sociocultural and linguistic boundaries influencing intercultural communication between nurses and Moroccan patients in southern Spain: a focused ethnography.

PubMed

Plaza Del Pino, Fernando J; Soriano, Encarnación; Higginbottom, Gina Ma

2013-01-01

During the last 25 years, cultural diversity has increased substantially with global migration. In more recent years this has become highly evident in the south of Spain with its steadily increasing Moroccan population. The accompanying differences in ethnocultural values and traditions between the host and newcomer populations may greatly impact healthcare interactions and thus also effective provision of care. This landscape provides for excellent exploration of intercultural communication in healthcare settings and elucidation of possible ways to overcome existing barriers to provision of culturally competent care by nurses. This study aimed to ascertain how nurses perceive their intercultural communication with Moroccan patients and what barriers are evident which may be preventing effective communication and care. A focused ethnography was conducted with semi-structured interviews of 32 nurses in three public hospitals in southern Spain. Interviews were audio-recorded and transcribed verbatim before undergoing translation and back-translation between Spanish and English. Data was managed, classified and ordered with the aid of AQUAD.6 (Günter L. Huber, Tübingen, Germany) qualitative data analysis software. As an important dimension of cultural competence, findings from the interviews with nurses in this study were interpreted within the framework of intercultural communication. Various barriers, for which we have termed "boundaries", seem to exist preventing effective communication between nurses and their patients. The substantial language barrier seems to negatively affect communication. Relations between the nurses and their Moroccan patients are also marked by prejudices and social stereotypes which likely compromise the provision of culturally appropriate care. The language barrier may compromise nursing care delivery and could be readily overcome by implementation of professional interpretation within the hospital settings. Moreover, it is essential

Sociocultural and linguistic boundaries influencing intercultural communication between nurses and Moroccan patients in southern Spain: a focused ethnography

PubMed Central

2013-01-01

Background During the last 25 years, cultural diversity has increased substantially with global migration. In more recent years this has become highly evident in the south of Spain with its steadily increasing Moroccan population. The accompanying differences in ethnocultural values and traditions between the host and newcomer populations may greatly impact healthcare interactions and thus also effective provision of care. This landscape provides for excellent exploration of intercultural communication in healthcare settings and elucidation of possible ways to overcome existing barriers to provision of culturally competent care by nurses. This study aimed to ascertain how nurses perceive their intercultural communication with Moroccan patients and what barriers are evident which may be preventing effective communication and care. Methods A focused ethnography was conducted with semi-structured interviews of 32 nurses in three public hospitals in southern Spain. Interviews were audio-recorded and transcribed verbatim before undergoing translation and back-translation between Spanish and English. Data was managed, classified and ordered with the aid of AQUAD.6 (Günter L. Huber, Tübingen, Germany) qualitative data analysis software. Results As an important dimension of cultural competence, findings from the interviews with nurses in this study were interpreted within the framework of intercultural communication. Various barriers, for which we have termed “boundaries”, seem to exist preventing effective communication between nurses and their patients. The substantial language barrier seems to negatively affect communication. Relations between the nurses and their Moroccan patients are also marked by prejudices and social stereotypes which likely compromise the provision of culturally appropriate care. Conclusions The language barrier may compromise nursing care delivery and could be readily overcome by implementation of professional interpretation within the

Geographical evaluation of Neuroparacoccidioidomycosis and Paracoccidioidomycosis in Southern Brazil.

PubMed

de Almeida, Sergio Monteiro; Salvador, Gabriel L O; Roza, Thiago Henrique; Izycki, Luís Felipe; Dos Santos, Isaias; Aragão, Afonso; Kulik, Amanda; Muro, Marisol; Torres, Luis Fernando Bleggi; de Noronha, Lucia Helena

2018-04-17

Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis among immunocompetent patients in Latin America. This study aimed to describe the expansion over time and the geographical distribution of confirmed Neuroparacoccidioidomycosis (NPCM) and PCM cases, and relate it to environmental characteristics such as climate, soil types, and coffee crops. This was a retrospective study of autopsy and biopsy reports between 1951 and 2014 from the Medical Pathology Section of the Hospital de Clinicas, UFPR, Curitiba, Southern Brazil. PCM was predominant in male agricultural workers. PCM cases predominated in areas with subtropical climate with hot summers in North West Parana state. NPCM cases were distributed statewide more frequent in rural than metropolitan area. There was no association with climate, soil type, or coffee crop culture. Most of the PCM cases were in the metropolitan area of the capital, chiefly due to migration fluxes. Even though the history is predominantly agricultural activities. PCM cases were distributed mainly in the metropolitan area of the state capital, there was no association with climate and soil. NPCM cases were numerically more frequent in rural than metropolitan area. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Research priorities for nursing and midwifery in Southern Ireland.

PubMed

McCarthy, G; Savage, E; Lehane, E

2006-06-01

To identify research priorities for nursing and midwifery in the Southern Health Board area in Ireland for the immediate and long term. Ten focus groups were conducted over a 2-month period with 70 nurses and midwives working in clinical, managerial and educational roles participating. Based on focus group findings and a literature review a multi-item Likert type questionnaire was constructed and administered to 520 nurses and midwives (response rate 95%n=494). Research priorities were identified as: (1) impact of staff shortages on retention of RNs/RM's (80%); (2) quality of life of chronically ill patients (76%); (3) stress and bullying in the workplace (76%); (4) assessment and management of pain (75%); (5) skill mix and staff burnout (73%); (6) cardio-pulmonary resuscitation decision making (72%); (7) coordination of care between hospital and primary care settings (69%); (8) medication errors (67%); and (9) promoting healthy lifestyles (64%). Respondents also indicated that these priorities warranted immediate attention. Implications for practice include the need for: (1) emphasis on quality pain control; (2) recognition and exploration of the ethical issues relating to resuscitation; and (3) management of the context within which clinical care is given.

Patients' perceptions of interactions with hospital staff are associated with hospital readmissions: a national survey of 4535 hospitals.

PubMed

Yang, Lianping; Liu, Chaojie; Huang, Cunrui; Mukamel, Dana B

2018-01-29

Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest. We selected six different clinical conditions for analyses, including acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), heart failure, hip/knee surgery, pneumonia, and stroke. Data included all acute care hospitals reporting in Hospital Compare in 2014. The number of hospitals with reported readmissions ranged from 2234 hospitals for AMI to 3758 hospitals for pneumonia. The average 30-day readmission rates ranged from 5.19% for knee/hip surgery to 22.7% for COPD. Patient experience of hospital-staff responsiveness as "top-box" ranged from 64% to 67% across the six clinical conditions, communication with nurses ranged from 77% to 79% and communication with doctors ranged from 80% to 81% (higher numbers are better). Our finding suggests that hospitals with better staff responsiveness were significantly more likely to have lower 30-day readmissions for all conditions. The effect size depended on the baseline readmission rates, with the largest effect on hospitals in the upper 75th quartile. A ten-percentage-point increase in staff responsiveness led to a 0.03-0.18 percentage point decrease in readmission rates. We found that neither communication with physicians nor communication with nurses was significantly associated with hospital readmissions. Our findings

Hospital successes and failures indicate change in hospital marketing.

PubMed

Krampf, R F; Miller, D W

1993-01-01

Marketing has become an essential management function for hospitals during the past decade. A number of changes have occurred in hospital marketing as they have progressed through the marketing adoption process. A survey of Hospital CEOs reporting hospital successes and failures in the area of marketing have recently placed emphasis on sales and advertising based upon marketing research programs thus indicating entrance into the "Integrated Tactical Marketing" phase. This study also indicates that a few hospitals have entered the "Strategic Marketing Orientation" phase while future plans reported by the CEOs provide evidence that this trend is likely to continue.

The Angola Low: relationship with southern African rainfall and ENSO

NASA Astrophysics Data System (ADS)

Crétat, Julien; Pohl, Benjamin; Dieppois, Bastien; Berthou, Ségolène; Pergaud, Julien

2018-05-01

The main states of the Angola Low (AL) are identified using clustering analysis applied to daily anomalous patterns of 700-hPa wind vorticity over Angola and adjacent countries from November to March for the 1980/81-2014/15 period. At the daily timescale, we examine the extent to which the main states of the AL modulate daily rainfall over southern Africa. At the interannual timescale, we assess both the relationship between the occurrence of these AL states and El Niño southern oscillation (ENSO) and the role of the AL in explaining ENSO's failure in driving southern African rainfall at times. Three reanalyses are considered to account for uncertainties induced by the scarcity of data available for assimilation over southern Africa. Three preferential states of the Angola Low are identified: AL state close to its seasonal climatology with slight zonal displacements, anomalously weak AL state and anomalously strong AL state with meridional displacements. These different states all significantly modulate daily southern African rainfall. Near-climatological AL state promotes wet rainfall anomalies over eastern subtropical southern Africa and dry rainfall anomalies over its western part. A slight westward shift in the near-climatological position of the AL leads to reversed zonal gradient in rainfall. The remaining regimes significantly modulate the meridional gradient in southern African rainfall. Anomalously weak and anomalously northward AL states promote wet rainfall anomalies over tropical southern Africa and dry rainfall anomalies over subtropical southern Africa. The reverse prevails for anomalously southward AL. At the interannual timescale, ENSO significantly modulates the seasonal occurrence of most AL states in the three reanalyses. Anomalously weak and southward AL states are more strongly correlated with regional rainfall than ENSO in all reanalyses, suggesting that accounting for AL variability may improve seasonal forecasts. Case study analysis of the

Book review: Southern Forested Wetlands: Ecology and Management

Treesearch

Carl C. Trettin

2000-01-01

The southern region has the largest proportion of wetlands in the conterminous US. The majority of that wetland resource is forested by diverse vegetation communities reflecting differences in soil, hydrology, geomorphology, climatic conditions and past management. Wetland resources in the southern US are very important to the economy providing both commodity and non-...

Managing hospitals in turbulent times: do organizational changes improve hospital survival?

PubMed Central

Lee, S Y; Alexander, J A

1999-01-01

OBJECTIVE: To examine (1) the degree to which organizational changes affected hospital survival; (2) whether core and peripheral organizational changes affected hospital survival differently; and (3) how simultaneous organizational changes affected hospital survival. DATA SOURCES: AHA Hospital Surveys, the Area Resource File, and the AHA Hospital Guides, Part B: Multihospital Systems. STUDY DESIGN: The study employed a longitudinal panel design. We followed changes in all community hospitals in the continental United States from 1981 through 1994. The dependent variable, hospital closure, was examined as a function of multiple changes in a hospital's core and peripheral structures as well as the hospital's organizational and environmental characteristics. Cox regression models were used to test the expectations that core changes increased closure risk while peripheral changes decreased such risk, and that simultaneous core and peripheral changes would lead to higher risk of closure. PRINCIPAL FINDINGS: Results indicated more peripheral than core changes in community hospitals. Overall, findings contradicted our expectations. Change in specialty, a core change, was beneficial for hospitals, because it reduced closure risk. The two most frequent peripheral changes, downsizing and leadership change, were positively associated with closure. Simultaneous organizational changes displayed a similar pattern: multiple core changes reduced closure risk, while multiple peripheral changes increased the risk. These patterns held regardless of the level of uncertainty in hospital environments. CONCLUSIONS: Organizational changes are not all beneficial for hospitals, suggesting that hospital leaders should be both cautious and selective in their efforts to turn their hospitals around. PMID:10536977

Developing IT Infrastructure for Rural Hospitals: A Case Study of Benefits and Challenges of Hospital-to-Hospital Partnerships.

PubMed

Reddy, Madhu C; Purao, Sandeep; Kelly, Mary

2008-01-01

This article presents a study identifying benefits and challenges of a novel hospital-to-hospital information technology (IT) outsourcing partnership (HHP). The partnership is an innovative response to the problem that many smaller, rural hospitals face: to modernize their IT infrastructure in spite of a severe shortage of resources. The investigators studied three rural hospitals that outsourced their IT infrastructure, through an HHP, to a larger, more technologically advanced hospital in the region. The study design was based on purposive sampling and interviews of senior managers from the four hospitals. The results highlight the HHP's benefits and challenges from both the rural hospitals' and vendor hospital's perspectives. The HHP was considered a success: a key outcome was that it has improved the rural hospitals' IT infrastructure at an affordable cost. The investigators discuss key elements for creating a successful HHP and offer preliminary answers to the question of what it takes for an HHP to be successful.

Developing IT Infrastructure for Rural Hospitals: A Case Study of Benefits and Challenges of Hospital-to-Hospital Partnerships

PubMed Central

Reddy, Madhu C.; Purao, Sandeep; Kelly, Mary

2008-01-01

This article presents a study identifying benefits and challenges of a novel hospital-to-hospital information technology (IT) outsourcing partnership (HHP). The partnership is an innovative response to the problem that many smaller, rural hospitals face: to modernize their IT infrastructure in spite of a severe shortage of resources. The investigators studied three rural hospitals that outsourced their IT infrastructure, through an HHP, to a larger, more technologically advanced hospital in the region. The study design was based on purposive sampling and interviews of senior managers from the four hospitals. The results highlight the HHP's benefits and challenges from both the rural hospitals' and vendor hospital's perspectives. The HHP was considered a success: a key outcome was that it has improved the rural hospitals' IT infrastructure at an affordable cost. The investigators discuss key elements for creating a successful HHP and offer preliminary answers to the question of what it takes for an HHP to be successful. PMID:18436901

Industrial Physics---Southern California Style

NASA Astrophysics Data System (ADS)

Leslie, Stuart

2013-03-01

Only in Southern California did space-age style really come into its own as a unique expression of Cold War scientific culture. The corporate campuses of General Atomic in San Diego and North American Aviation in Los Angeles perfectly expressed the exhilarating spirit of Southern California's aerospace era, scaling up the residential version of California modernism to industrial proportion. Architects William Pereira and A.C. Martin Jr., in collaboration with their scientific counterparts, fashioned military-industrial `dream factories' for industrial physics that embodied the secret side of the space-age zeitgeist, one the public could only glimpse of in photographs, advertisements, and carefully staged open houses. These laboratories served up archetypes of the California dream for a select audience of scientists, engineers, and military officers, live-action commercials for a lifestyle intended to lure the best and brightest to Southern California. Paradoxically, they hid in plain sight, in the midst of aerospace suburbs, an open secret, at once visible and opaque, the public face of an otherwise invisible empire. Now, at the end of the aerospace era, these places have become an endangered species, difficult to repurpose, on valuable if sometimes highly polluted land. Yet they offer an important reminder of a more confident time when many physicists set their sights on the stars.

Measuring hospital input price increases: The rebased hospital market basket

PubMed Central

Freeland, Mark S.; Chulis, George S.; Brown, Aaron P.; Skellan, David; Maple, Brenda T.; Singer, Naphtale; Lemieux, Jeffrey; Arnett, Ross H.

1991-01-01

The input prices indexes used in part to set payment rates for Medicare inpatient hospital services in both prospective payment system (PPS) and PPS-excluded hospitals were rebased from 1982 to 1987 beginning with payments for fiscal year 1991. In this article, the issues and evidence used to determine the composition of the revised hospital input price indexes are discussed. One issue is the need for a separate market basket for PPS-excluded hospitals. Also, the payment implications of using hospital-industry versus economywide measures of wage rates as price proxies for the growth in hospital wage rates are addressed. PMID:10113610

Southern blotting.

PubMed

Brown, T

2001-05-01

Southern blotting is the transfer of DNA fragments from an electrophoresis gel to a membrane support, resulting in immobilization of the DNA fragments, so the membrane carries a semipermanent reproduction of the banding pattern of the gel. After immobilization, the DNA can be subjected to hybridization analysis, enabling bands with sequence similarity to a labeled probe to be identified. This unit describes Southern blotting via upward capillary transfer of DNA from an agarose gel onto a nylon or nitrocellulose membrane, and subsequent immobilization by UV irradiation (for nylon) or baking (for nitrocellulose). A Support Protocol describes how to calibrate a UV transilluminator for optimal UV irradiation of a nylon membrane. An alternate protocol details transfer using nylon membranes and an alkaline buffer, and is primarily used with positively charged nylon membranes. A second alternate protocol describes a transfer method based on a different transfer-stack setup. The traditional method of upward capillary transfer of DNA from gel to membrane has certain disadvantages, notably the fact that the gel can become crushed by the weighted filter papers and paper towels that are laid on top of it. This slows down the blotting process and may reduce the amount of DNA that can be transferred. The downward capillary method described in the second alternate protocol is therefore more rapid and can result in more complete transfer.

Severe malnutrition among children under the age of 5 years admitted to a rural district hospital in southern Mozambique.

PubMed

Nhampossa, Tacilta; Sigaúque, Betuel; Machevo, Sónia; Macete, Eusebio; Alonso, Pedro; Bassat, Quique; Menéndez, Clara; Fumadó, Victoria

2013-09-01

To describe the burden, clinical characteristics and prognostic factors of severe malnutrition in children under the age of 5 years. Retrospective study of hospital-based data systematically collected from January 2001 to December 2010. Rural Mozambican district hospital. All children aged <5 years admitted with severe malnutrition. During the 10-year long study surveillance, 274 813 children belonging to Manhiça’s Demographic Surveillance System were seen at out-patient clinics, almost half of whom (47 %) presented with some indication of malnutrition and 6% (17 188/274 813) with severe malnutrition. Of these, only 15% (2522/17 188) were eventually admitted. Case fatality rate of severe malnutrition was 7% (162/2274). Bacteraemia, hypoglycaemia, oral candidiasis, prostration, oedema, pallor and acute diarrhoea were independently associated with an increased risk of in-hospital mortality, while malaria parasitaemia and breast-feeding were independently associated with a lower risk of a poor outcome. Overall minimum communitybased incidence rate was 15 cases per 1000 child-years at risk and children aged 12–23 months had the highest incidence. Severe malnutrition among admitted children in this Mozambican setting was common but frequently went undetected, despite being associated with a high risk of death. Measures to improve its recognition by clinicians responsible for the first evaluation of patients at the out-patient level are urgently needed so as to improve their likelihood of survival. Together with this, the rapid management of complications such as hypoglycaemia and concomitant co-infections such as bacteraemia, acute diarrhoea, oral candidiasis and HIV/AIDS may contribute to reverse the intolerable toll that malnutrition poses in the health of children in rural African settings.

Work accidents and self-esteem of nursing professional in hospital settings

PubMed Central

dos Santos, Sérgio Valverde Marques; Macedo, Flávia Ribeiro Martins; da Silva, Luiz Almeida; Resck, Zelia Marilda Rodrigues; Nogueira, Denismar Alves; Terra, Fábio de Souza

2017-01-01

Abstract Objective: to analyze the occurrence of work accidents and the self-esteem of nurses in hospitals of a municipality of Minas Gerais. Method: descriptive-analytical and cross-sectional study developed with 393 nursing professionals from three hospitals of a municipality in southern Minas Gerais. The Rosenberg Self-Esteem Scale and a questionnaire to characterize the population and work accidents were used for data collection. Data analysis was performed using Person's chi-squared test, Fisher's exact test, Cronbach's alpha, odds ratio and logistic regression. Results: of the professionals studied, 15% had suffered an accident at work and 70.2% presented high self-esteem. Through the analysis, it was observed that smoking, religious belief and an outstanding event in the career were significantly associated with work accidents. In relation to self-esteem, family income, length of time working in the profession and an outstanding event in the career presented significant associations. Conclusion: factors such as smoking, religious belief, family income, length of time working in the profession and an outstanding event in the career can cause professionals to have accidents and/or cause changes in self-esteem, which can compromise their physical and mental health and their quality of life and work. PMID:28443993

Epidemiology of Rheumatoid Arthritis in Southern Albania.

PubMed

Koko, Vjollca; Ndrepepa, Ana; Skenderaj, Skender

2015-06-01

The aim of this study was to assess the prevalence, incidence and the burden of rheumatoid arthritis (RA) in the Southern Albania. This is an epidemiologic observational study with cross-sectional analyses of all patients with RA who lived in Southern Albania during the 1995-2011 years. The RA prevalence, incidence and disability-adjusted life years (DALY) were assessed. During the 1995-2011 years, 194 patients (154 females and 40 males) with RA living in Southern Albania were identified. The prevalence of RA in 2011 was 0.25% in general population and 0.34% in adult (>14 years) population. The incidence of RA in 2011 was 0.012% (12 new cases per 100000 inhabitants) and 0.016% (16 new cases per 100000 adults). The prevalence increased (from 0.036% in 1996 to 0.25% in 2011) and the incidence did not change over the study period. The mortality was 3.2% (n=7 deaths). The DALY due to RA was 823 years per 100000 inhabitants during 1995-2011 years. RA in Southern Albania has a prevalence of 0.25 % and an annual incidence of 0.012% in the general population in 2011. RA was responsible for a considerable burden on the health of population during the 1995-2011 years.

Genetic diversity of Plasmodium vivax clinical isolates from southern Pakistan using pvcsp and pvmsp1 genetic markers

PubMed Central

2013-01-01

Background Plasmodium vivax is the prevalent malarial species accounting for 70% of malaria burden in Pakistan; however, there is no baseline data on the circulating genotypes. Studies have shown that polymorphic loci of gene encoding antigens pvcsp and pvmsp1 can be used reliably for conducting molecular epidemiological studies. Therefore, this study aimed to bridge the existing knowledge gap on population structure on P. vivax from Pakistan using these two polymorphic genes. Methods During the period January 2008 to May 2009, a total of 250 blood samples were collected from patients tested slide positive for P. vivax, at the Aga Khan University Hospital, Karachi, or its collection units located in Baluchistan and Sindh Province. Nested PCR/RFLP was performed, using pvcsp and pvmsp1 markers to detect the extent of genetic diversity in clinical isolates of P. vivax from southern Pakistan. Results A total of 227/250 (91%) isolates were included in the analysis while the remainder were excluded due to negative PCR outcome for P.vivax. Pvcsp analysis showed that both VK 210 (85.5%, 194/227) and VK 247 type (14.5%, 33/227) were found to be circulating in P. vivax isolates from southern Pakistan. A total of sixteen and eighty-seven genotypes of pvcsp and pvmsp-1 were detected respectively. Conclusion This is the first report from southern Pakistan on characterization of P. vivax isolates confirming that extensively diverse pvcsp and pvmsp1 variants are present within this region. Results from this study provide valuable data on genetic diversity of P. vivax that will be helpful for further epidemiological studies. PMID:23311628

Trends in Southern Ocean Eddy Kinetic Energy

NASA Astrophysics Data System (ADS)

Chambers, Don

2016-04-01

A recent study by Hogg et al. (JGR, 2015) has demonstrated a 20-year trend in eddy kinetic energy (EKE) computed from satellite altimetry data. However, this estimate is based on an averaging over large spatial areas. In this study, we use the same methods to examine regional EKE trends throughout the Southern Ocean, from 1993-2015. We do find significant positive trends in several areas of the Southern Ocean, mainly in regions with high mean EKE associated with interactions between jets and bathymetry. At the same time, however, there are also regions with significant negative trends. Overall, EKE in the majority of the Southern Ocean has not changed. These results suggest that the estimates of Hogg et al. may have been biased by these regional extremes, and that more work is needed to quantify climatic changes in EKE.

Trends in Southern Ocean Eddy Kinetic Energy

NASA Astrophysics Data System (ADS)

Chambers, D. P.

2016-02-01

A recent study by Hogg et al. (JGR, 2015) has demonstrated a 20-year trend in eddy kinetic energy (EKE) computed from satellite altimetry data. However, this estimate is based on an averaging over large spatial areas. In this study, we use the same methods to examine regional EKE trends throughout the Southern Ocean, from 1993-2015. We do find significant positive trends in several areas of the Southern Ocean, mainly in regions with high mean EKE associated with interactions between jets and bathymetry. At the same time, however, there are also regions with significant negative trends. Overall, EKE in the majority of the Southern Ocean has not changed. These results suggest that the estimates of Hogg et al. may have been biased by these regional extremes, and that more work is needed to quantify climatic changes in EKE.

Atmospheric Chemistry Over Southern Africa

NASA Technical Reports Server (NTRS)

Gatebe, Charles K.; Levy, Robert C.; Thompson, Anne M.

2011-01-01

During the southern African dry season, regional haze from mixed industrial pollution, biomass burning aerosol and gases from domestic and grassland fires, and biogenic sources from plants and soils is worsened by a semi-permanent atmosphere gyre over the subcontinent. These factors were a driver of several major international field campaigns in the 1990s and early 2000s, and attracted many scientists to the region. Some researchers were interested in understanding fundamental processes governing chemistry of the atmosphere and interaction with climate change. Others found favorable conditions for evaluating satellite-derived measurements of atmospheric properties and a changing land surface. With that background in mind a workshop on atmospheric chemistry was held in South Africa. Sponsored by the International Commission for Atmospheric Chemistry and Global Pollution (ICACGP; http://www.icacgp.org/), the workshop received generous support from the South African power utility, Eskom, and the Climatology Research Group of the University of the Witwatersrand, Johannesburg, South Africa. The purpose of the workshop was to review some earlier findings as well as more recent findings on southern African climate vulnerability, chemical changes due to urbanization, land-use modification, and how these factors interact. Originally proposed by John Burrows, president of ICACGP, the workshop was the first ICACGP regional workshop to study the interaction of air pollution with global chemical and climate change. Organized locally by the University of the Witwatersrand, the workshop attracted more than 60 delegates from South Africa, Mozambique, Botswana, Zimbabwe, France, Germany, Canada, and the United States. More than 30 presentations were given, exploring both retrospective and prospective aspects of the science. In several talks, attention was focused on southern African chemistry, atmospheric pollution monitoring, and climate processes as they were studied in the field

Sleep duration, daytime napping, markers of obstructive sleep apnea and stroke in a population of southern China

PubMed Central

Wen, Ye; Pi, Fu-Hua; Guo, Pi; Dong, Wen-Ya; Xie, Yu-Qing; Wang, Xiang-Yu; Xia, Fang-Fang; Pang, Shao-Jie; Wu, Yan-Chun; Wang, Yuan-Yuan; Zhang, Qing-Ying

2016-01-01

Sleep habits are associated with stroke in western populations, but this relation has been rarely investigated in China. Moreover, the differences among stroke subtypes remain unclear. This study aimed to explore the associations of total stroke, including ischemic and hemorrhagic type, with sleep habits of a population in southern China. We performed a case-control study in patients admitted to the hospital with first stroke and community control subjects. A total of 333 patients (n = 223, 67.0%, with ischemic stroke; n = 110, 23.0%, with hemorrhagic stroke) and 547 controls were enrolled in the study. Participants completed a structured questionnaire to identify sleep habits and other stroke risk factors. Least absolute shrinkage and selection operator (Lasso) and multiple logistic regression were performed to identify risk factors of disease. Incidence of stroke, and its subtypes, was significantly associated with snorting/gasping, snoring, sleep duration, and daytime napping. Snorting/gasping was identified as an important risk factor in the Lasso logistic regression model (Lasso’ β = 0.84), and the result was proven to be robust. This study showed the association between stroke and sleep habits in the southern Chinese population and might help in better detecting important sleep-related factors for stroke risk. PMID:27698374

The earliest unequivocally modern humans in southern China.

PubMed

Liu, Wu; Martinón-Torres, María; Cai, Yan-jun; Xing, Song; Tong, Hao-wen; Pei, Shu-wen; Sier, Mark Jan; Wu, Xiao-hong; Edwards, R Lawrence; Cheng, Hai; Li, Yi-yuan; Yang, Xiong-xin; de Castro, José María Bermúdez; Wu, Xiu-jie

2015-10-29

The hominin record from southern Asia for the early Late Pleistocene epoch is scarce. Well-dated and well-preserved fossils older than ∼45,000 years that can be unequivocally attributed to Homo sapiens are lacking. Here we present evidence from the newly excavated Fuyan Cave in Daoxian (southern China). This site has provided 47 human teeth dated to more than 80,000 years old, and with an inferred maximum age of 120,000 years. The morphological and metric assessment of this sample supports its unequivocal assignment to H. sapiens. The Daoxian sample is more derived than any other anatomically modern humans, resembling middle-to-late Late Pleistocene specimens and even contemporary humans. Our study shows that fully modern morphologies were present in southern China 30,000-70,000 years earlier than in the Levant and Europe. Our data fill a chronological and geographical gap that is relevant for understanding when H. sapiens first appeared in southern Asia. The Daoxian teeth also support the hypothesis that during the same period, southern China was inhabited by more derived populations than central and northern China. This evidence is important for the study of dispersal routes of modern humans. Finally, our results are relevant to exploring the reasons for the relatively late entry of H. sapiens into Europe. Some studies have investigated how the competition with H. sapiens may have caused Neanderthals' extinction (see ref. 8 and references therein). Notably, although fully modern humans were already present in southern China at least as early as ∼80,000 years ago, there is no evidence that they entered Europe before ∼45,000 years ago. This could indicate that H. neanderthalensis was indeed an additional ecological barrier for modern humans, who could only enter Europe when the demise of Neanderthals had already started.

North-Seeking Magnetotactic Gammaproteobacteria in the Southern Hemisphere

PubMed Central

Leão, Pedro; Teixeira, Lia C. R. S.; Cypriano, Jefferson; Farina, Marcos; Abreu, Fernanda; Bazylinski, Dennis A.

2016-01-01

ABSTRACT Magnetotactic bacteria (MTB) comprise a phylogenetically diverse group of prokaryotes capable of orienting and navigating along magnetic field lines. Under oxic conditions, MTB in natural environments in the Northern Hemisphere generally display north-seeking (NS) polarity, swimming parallel to the Earth's magnetic field lines, while those in the Southern Hemisphere generally swim antiparallel to magnetic field lines (south-seeking [SS] polarity). Here, we report a population of an uncultured, monotrichously flagellated, and vibrioid MTB collected from a brackish lagoon in Brazil in the Southern Hemisphere that consistently exhibits NS polarity. Cells of this organism were mainly located below the oxic-anoxic interface (OAI), suggesting it is capable of some type of anaerobic metabolism. Magnetosome crystalline habit and composition were consistent with elongated prismatic magnetite (Fe3O4) particles. Phylogenetic analysis based on 16S rRNA gene sequencing indicated that this organism belongs to a distinct clade of the Gammaproteobacteria class. The presence of NS MTB in the Southern Hemisphere and the previously reported finding of SS MTB in the Northern Hemisphere reinforce the idea that magnetotaxis is more complex than we currently understand and may be modulated by factors other than O2 concentration and redox gradients in sediments and water columns. IMPORTANCE Magnetotaxis is a navigational mechanism used by magnetotactic bacteria to move along geomagnetic field lines and find an optimal position in chemically stratified sediments. For that, magnetotactic bacteria swim parallel to the geomagnetic field lines under oxic conditions in the Northern Hemisphere, whereas those in the Southern Hemisphere swim antiparallel to magnetic field lines. A population of uncultured vibrioid magnetotactic bacteria was discovered in a brackish lagoon in the Southern Hemisphere that consistently swim northward, i.e., the opposite of the overwhelming majority of other

Large-Scale Weather Disturbances in Mars’ Southern Extratropics

NASA Astrophysics Data System (ADS)

Hollingsworth, Jeffery L.; Kahre, Melinda A.

2015-11-01

Between late autumn and early spring, Mars’ middle and high latitudes within its atmosphere support strong mean thermal gradients between the tropics and poles. Observations from both the Mars Global Surveyor (MGS) and Mars Reconnaissance Orbiter (MRO) indicate that this strong baroclinicity supports intense, large-scale eastward traveling weather systems (i.e., transient synoptic-period waves). These extratropical weather disturbances are key components of the global circulation. Such wave-like disturbances act as agents in the transport of heat and momentum, and generalized scalar/tracer quantities (e.g., atmospheric dust, water-vapor and ice clouds). The character of large-scale, traveling extratropical synoptic-period disturbances in Mars' southern hemisphere during late winter through early spring is investigated using a moderately high-resolution Mars global climate model (Mars GCM). This Mars GCM imposes interactively lifted and radiatively active dust based on a threshold value of the surface stress. The model exhibits a reasonable "dust cycle" (i.e., globally averaged, a dustier atmosphere during southern spring and summer occurs). Compared to their northern-hemisphere counterparts, southern synoptic-period weather disturbances and accompanying frontal waves have smaller meridional and zonal scales, and are far less intense. Influences of the zonally asymmetric (i.e., east-west varying) topography on southern large-scale weather are examined. Simulations that adapt Mars’ full topography compared to simulations that utilize synthetic topographies emulating key large-scale features of the southern middle latitudes indicate that Mars’ transient barotropic/baroclinic eddies are highly influenced by the great impact basins of this hemisphere (e.g., Argyre and Hellas). The occurrence of a southern storm zone in late winter and early spring appears to be anchored to the western hemisphere via orographic influences from the Tharsis highlands, and the Argyre

Southern Pine Seed Sources

Treesearch

Ronald C. Schmidtling

2001-01-01

The selection of an appropriate seed source is critical for successful southern pine plantations. Guidelines for selection of seed sources are presented for loblolly (Pinus taeda L.), slash (P. elliottii Engelm.), longleaf (P. palustris Mill.), Virginia (P. virginiana Mill.), shortleaf (P. echinata...

Silviculture and management strategies applicable to southern hardwoods

Treesearch

Ray R. Hicks; William H. Conner; Robert C. Kellison; David Van Lear

2004-01-01

Southern hardwood forests stretch from the Virginias to Florida and from the mid-Atlantic to Missouri. They can generally be grouped into upland forests and bottomland forests. The upland hardwood forests of the southern region are usually associated with the mountainous topography of the Appalachians and Ozarks. Bottomland hardwoods are found along the floodplains of...

A new tree classification system for southern hardwoods

Treesearch

James S. Meadows; Daniel A. Jr. Skojac

2008-01-01

A new tree classification system for southern hardwoods is described. The new system is based on the Putnam tree classification system, originally developed by Putnam et al., 1960, Management ond inventory of southern hardwoods, Agriculture Handbook 181, US For. Sew., Washington, DC, which consists of four tree classes: (1) preferred growing stock, (2) reserve growing...

Southern California Earthquake Center Geologic Vertical Motion Database

NASA Astrophysics Data System (ADS)

Niemi, Nathan A.; Oskin, Michael; Rockwell, Thomas K.

2008-07-01

The Southern California Earthquake Center Geologic Vertical Motion Database (VMDB) integrates disparate sources of geologic uplift and subsidence data at 104- to 106-year time scales into a single resource for investigations of crustal deformation in southern California. Over 1800 vertical deformation rate data points in southern California and northern Baja California populate the database. Four mature data sets are now represented: marine terraces, incised river terraces, thermochronologic ages, and stratigraphic surfaces. An innovative architecture and interface of the VMDB exposes distinct data sets and reference frames, permitting user exploration of this complex data set and allowing user control over the assumptions applied to convert geologic and geochronologic information into absolute uplift rates. Online exploration and download tools are available through all common web browsers, allowing the distribution of vertical motion results as HTML tables, tab-delimited GIS-compatible text files, or via a map interface through the Google Maps™ web service. The VMDB represents a mature product for research of fault activity and elastic deformation of southern California.

Climate and southern Africa's water-energy-food nexus

NASA Astrophysics Data System (ADS)

Conway, Declan; van Garderen, Emma Archer; Deryng, Delphine; Dorling, Steve; Krueger, Tobias; Landman, Willem; Lankford, Bruce; Lebek, Karen; Osborn, Tim; Ringler, Claudia; Thurlow, James; Zhu, Tingju; Dalin, Carole

2015-09-01

In southern Africa, the connections between climate and the water-energy-food nexus are strong. Physical and socioeconomic exposure to climate is high in many areas and in crucial economic sectors. Spatial interdependence is also high, driven, for example, by the regional extent of many climate anomalies and river basins and aquifers that span national boundaries. There is now strong evidence of the effects of individual climate anomalies, but associations between national rainfall and gross domestic product and crop production remain relatively weak. The majority of climate models project decreases in annual precipitation for southern Africa, typically by as much as 20% by the 2080s. Impact models suggest these changes would propagate into reduced water availability and crop yields. Recognition of spatial and sectoral interdependencies should inform policies, institutions and investments for enhancing water, energy and food security. Three key political and economic instruments could be strengthened for this purpose: the Southern African Development Community, the Southern African Power Pool and trade of agricultural products amounting to significant transfers of embedded water.

Natural History of the Southern Pine Beetle

Treesearch

Fred P. Hain; Adrian J. Duehl; Micah J. Gardner; Thomas L. Payne

2011-01-01

The southern pine beetle (SPB) is a tree killer of southern yellow pines. All life stages—eggs, larvae, pupae, and adults—infest the inner bark or phloem tissue of the host tree. Adult beetles overcome the tree’s defenses through a mass-attack phenomenon. They are attracted to the tree by a pheromone system consisting of volatiles produced by the beetles and the host....

Hospital at home versus in-patient hospital care.

PubMed

Shepperd, S; Iliffe, S

2005-07-20

Hospital at home is defined as a service that provides active treatment by health care professionals, in the patient's home, of a condition that otherwise would require acute hospital in-patient care, always for a limited period. To assess the effects of hospital at home compared with in-patient hospital care. We searched the Cochrane Effective Practice and Organisation of Care Group (EPOC) specialised register (November 2004), MEDLINE (1966 to 1996), EMBASE (1980 to 1995), Social Science Citation Index (1992 to 1995), Cinahl (1982 to 1996), EconLit (1969 to 1996), PsycLit (1987 to 1996), Sigle (1980 to 1995) and the Medical Care supplement on economic literature (1970 to 1990). Randomised trials of hospital at home care compared with acute hospital in-patient care. The participants were patients aged 18 years and over. Two reviewers independently extracted data and assessed study quality. Twenty two trials are included in this update of the review. Among trials evaluating early discharge hospital at home schemes we found an odds ratio (OR) for mortality of 1.79 95% CI 0.85 to 3.76 for elderly medical patients (age 65 years and over) (n = 3 trials); OR 0.58; 95% CI 0.29 to 1.17 for patients with chronic obstructive pulmonary disease (COPD) (n = 5 trials); and OR 0.78; 95%CI 0.52 to 1.19 for patients recovering from a stroke (n = 4 trials). Two trials evaluating the early discharge of patients recovering from surgery reported an OR 0.43 (95% CI 0.02 to 10.89) for patients recovering from a hip replacement and an OR 1.01 (95% CI 0.37 to 2.81) for patients with a mix of conditions at three months follow-up. For readmission to hospital we found an OR 1.76; 95% CI 0.78 to 3.99 at 3 months follow-up for elderly medical patients (n = 2 trials); OR 0.81; 95% CI 0.55 to 1.19 for patients with COPD (n = 5 trials); and OR 0.96; 95% CI 0.63 to 1.45 for patients recovering from a stroke (n = 3 trials). No significant heterogeneity was observed. One trial recruiting patients

The choice of alternatives to acute hospitalization: a descriptive study from Hallingdal, Norway

PubMed Central

2013-01-01

Background Hallingdal is a rural region in southern Norway. General practitioners (GPs) refer acutely somatically ill patients to any of three levels of care: municipal nursing homes, the regional community hospital or the local general hospital. The objective of this paper is to describe the patterns of referrals to the three different somatic emergency service levels in Hallingdal and to elucidate possible explanations for the differences in referrals. Methods Quantitative methods were used to analyse local patient statistics and qualitative methods including focus group interviews were used to explore differences in referral rates between GPs. The acute somatic admissions from the six municipalities of Hallingdal were analysed for the two-year period 2010–11 (n = 1777). A focus group interview was held with the chief municipal medical officers of the six municipalities. The main outcome measure was the numbers of admissions to the three different levels of acute care in 2010–11. Reflections of the focus group members about the differences in admission patterns were also analysed. Results Acute admissions at a level lower than the local general hospital ranged from 9% to 29% between the municipalities. Foremost among the local factors affecting the individual doctor’s admission practice were the geographical distance to the different places of care and the GP’s working experience in the local community. Conclusion The experience from Hallingdal demonstrates that GPs use available alternatives to hospitalization but to varying degrees. This can be explained by socio-demographic factors and factors related to the medical reasons for admission. However, there are also important local factors related to the individual GP and the structural preparedness for alternatives in the community. PMID:23800090

Anxiety symptoms in crack cocaine and inhalant users admitted to a psychiatric hospital in southern Brazil.

PubMed

Zubaran, Carlos; Foresti, Katia; Thorell, Mariana Rossi; Franceschini, Paulo Roberto

2013-01-01

The occurrence of psychiatric comorbidity among individuals with crack or inhalant dependence is frequently observed. The objective of this study was to investigate anxiety symptoms among crack cocaine and inhalant users in southern Brazil. The study investigated two groups of volunteers of equal size (n=50): one group consisted of crack cocaine users, and the other group consisted of inhalant users. Research volunteers completed the Portuguese versions of the State-Trait Anxiety Inventory (STAI), Hamilton Anxiety Rating Scale (HAM-A), and Self-Report Questionnaire (SRQ). Both crack and inhalant users experience significant symptoms of anxiety. Inhalant users presented significantly more anxiety symptoms than crack users according to the HAM-A questionnaire only. In contrast to the results of the HAM-A, the STAI failed to demonstrate a significant difference between the two groups of substance users. SRQ scores revealed that crack and inhalants users had significant degrees of morbidity. A significant difference regarding anxiety symptomatology, especially state anxiety, was observed among inhalant and crack users. Anxiety and overall mental psychopathology were significantly correlated in this sample. The results indicate that screening initiatives to detect anxiety and additional psychiatric comorbidities among crack and inhalant users are feasible and relevant. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

The forest-land owners of southern New England

Treesearch

Neal P. Kingsley

1976-01-01

A statistical-analytical report of a mail canvass of the owners of privately owned commercial forest land in the three Southern New England States-Connecticut, Massachusetts, and Rhode Island. The study was conducted in conjunction with the second forest survey of Southern New England by the USDA Forest Service. Trends in forest-land ownership and the attitudes and...

New cooperative seismograph networks established in southern California

USGS Publications Warehouse

Hill, D.P.

1974-01-01

Southern California has more active faults located close to large, urban population centers than any other region in the United States. Reduction of risk to life and property posed by potential earthquakes along these active faults is a primary motivation for a cooperative earthquake research program between the U.S Geological Survey and major universities in Southern California. 

Hospitals look to hospitality service firms to meet TQM goals.

PubMed

Hard, R

1992-05-20

Hospitals that hire contract service firms to manage one or all aspects of their hospitality service departments increasingly expect those firms to help meet total quality management goals as well as offer the more traditional cost reduction, quality improvement and specialized expertise, finds the 1992 Hospital Contract Services Survey conducted by Hospitals.

Influencing factors of dysmenorrhoea among hospital nurses: a questionnaire survey in Taiwan

PubMed Central

Chiu, Min-Hui; Hsieh, Hsiu-Fen; Yang, Yi-Hsin; Chen, Huei-Mein; Hsu, Su-Chen

2017-01-01

Objectives Nurses are at high risk of dysmenorrhoea while working with patients. The study objectives were to: (1) describe the demographic and menstruation characteristics of dysmenorrhoea, knowledge about dysmenorrhoea and menstrual attitudes towards menstruation among dysmenorrhoeal and non-dysmenorrhoeal hospital nurses; (2) identify significant differences between the groups; and (3) examine factors influencing dysmenorrhoea. Methods This cross-sectional survey used a structured questionnaire, administered at two hospitals in southern Taiwan. Participants included hospital nurses at least 18 years of age who agreed to participate. All participants were recruited through random sampling. The questionnaire included demographic data, the Dysmenorrhoea Knowledge Scale and Menstrual Attitude Scale (MAS). Results A total of 420 nurses completed the questionnaire. Among them, 297 (70.7%) had experienced dysmenorrhoea in the past 6 months and 123 (29.3%) had not. Significant differences in age (P<0.001), marital status (P<0.001), childbearing status (P<0.001), age at menarche (P<0.05) and rotating three shift ratio (P<0.05) were identified between the dysmenorrhoea and non-dysmenorrhoea groups. Analysis of the MAS results revealed significant differences between the groups regarding consideration of menstruation as a debilitating (P<0.001) or bothersome event (P<0.05), anticipation and prediction of menstruation onset (P<0.01) and denial of any effects from menstruation (P<0.001). Results of the multiple logistic regression showed that predictive factors included age <40 years (4.46 vs 1.00), working three shift rotations (2.07 vs 1.00), marital status (2.59 vs 1.00), acknowledging menstruation as a debilitating event (2.72 vs 1.00) and denial of effects from menstruation (2.59 vs 1.00). Conclusions These findings could help nursing managers to create a caring and friendly work environment for hospital nurses at risk of dysmenorrhoea. PMID:29259057

Southern Hemisphere Neutron Map

NASA Image and Video Library

2002-03-01

NASA Mars Odyssey spacecraft produced this high-energy neutron detector map of neutrons in Mars southern hemisphere. The blue region around the south pole indicates a high content of hydrogen in the upper 2 to 3 meters 7 to 10 feet of the surface.

Hospitals Known for Nursing Excellence Associated with Better Hospital Experience for Patients.

PubMed

Stimpfel, Amy Witkoski; Sloane, Douglas M; McHugh, Matthew D; Aiken, Linda H

2016-06-01

To examine the relationship between Magnet recognition, an indicator of nursing excellence, and patients' experience with their hospitalization reported in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This secondary analysis includes cross-sectional data from the 2010 HCAHPS survey, the American Hospital Association, and the American Nurses Credentialing Center. We conducted a retrospective observational study. Using common hospital identifiers, we created a matched set of 212 Magnet hospitals and 212 non-Magnet hospitals. Patients in Magnet hospitals gave their hospitals higher overall ratings, were more likely to recommend their hospital, and reported more positive care experiences with nurse communication. Magnet recognition is associated with better patient care experiences, which may positively enhance reimbursement for hospitals. © Health Research and Educational Trust.

Do HMO penetration and hospital competition impact quality of hospital care?

PubMed

Rivers, P A; Fottler, M D

2004-11-01

This study examines the impact of HMO penetration and competition on hospital markets. A modified structure-conduct-performance paradigm was applied to the health care industry in order to investigate the impact of HMO penetration and competition on risk-adjusted hospital mortality rates (i.e. quality of hospital care). Secondary data for 1957 acute care hospitals in the USA from the 1991 American Hospital Association's Annual Survey of Hospitals were used. The outcome variables were risk-adjusted mortality rates in 1991. Predictor variables were market characteristics (i.e. managed care penetration and hospital competition). Control variables were environmental, patient, and institutional characteristics. Associations between predictor and outcome variables were investigated using statistical regression techniques. Hospital competition had a negative relationship with risk-adjusted mortality rates (a negative indicator of quality of care). HMO penetration, hospital competition, and an interaction effect of HMO penetration and competition were not found to have significant effects on risk-adjusted mortality rates. These findings suggest that when faced with intense competition, hospitals may respond in ways associated with reducing their mortality rates.

[Vaccines: producers in countries of the Southern hemisphere].

PubMed

Bertrand, J J

2007-08-01

Vaccine producers in southern hemisphere countries now contribute significantly to global output. In 2006 southern hemisphere countries accounted for more than 10% of the total worldwide production with a progression approximately 70% greater than all producers combined in the two-year period between 2004 and 2006. Though difficult to measure, production in volume is higher due to lower prices practiced in most of these countries. For many years before the 1980s, production was scattered among numerous limited-scale companies. Most were founded at the initiative of governments striving to cover the needs of the population for essential vaccines. A number of institutions and private structures such as Institut Pasteur Production, Connaught Laboratories, and Institut Merieux have also set up production facilities. Today's producers can be divided into two categories, i.e., local producers that produce mainly monovalent vaccines and worldwide producers with strong R&D investment programs. Local producers are located mainly in large southern hemisphere countries such as China, India, Brazil, and Indonesia as well as in eastern countries. For the most dynamic companies, international development is focused on southern hemisphere countries excluding North America and Europe. With the support international organization such as WHO, UNICEF and GAVI, alliances are now being formed and networks are being organized in an effort to ensure reliable supplies of high quality vaccines at affordable prices in developing countries. The contribution of these producers will increase for the greater benefit of the people living in the southern hemisphere.

77 FR 49776 - Southern New Mexico Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-17

... DEPARTMENT OF AGRICULTURE Forest Service Southern New Mexico Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Southern New Mexico Resource Advisory Committee will meet in Socorro, New Mexico. The purpose of the committee is to improve collaborative...

76 FR 46722 - Southern New Mexico Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

... DEPARTMENT OF AGRICULTURE Forest Service Southern New Mexico Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Southern New Mexico Resource Advisory Committee will meet in Socorro, New Mexico. The committee is authorized under the Secure Rural Schools and...

76 FR 16603 - Southern New Mexico Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-24

... DEPARTMENT OF AGRICULTURE Forest Service Southern New Mexico Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Southern New Mexico Resource Advisory Committee (RAC) will meet in Socorro, New Mexico. The committee is meeting as authorized under the Secure...

75 FR 69916 - Southern New Mexico Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-16

... DEPARTMENT OF AGRICULTURE Forest Service Southern New Mexico Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Southern New Mexico Resource Advisory Committee (RAC) will meet in Socorro, New Mexico. The committee is meeting as authorized under the Secure...

75 FR 39655 - Southern New Mexico Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-12

... DEPARTMENT OF AGRICULTURE Forest Service Southern New Mexico Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Southern New Mexico Resource Advisory Committee (RAC) will meet in Socorro, New Mexico. The committee is meeting as authorized under the Secure...

75 FR 30772 - Southern New Mexico Resource Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-02

... DEPARTMENT OF AGRICULTURE Forest Service Southern New Mexico Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Southern New Mexico Resource Advisory Committee will meet in Socorro, New Mexico. The committee is meeting as authorized under the Secure Rural...

Aggregation behavior of the southern chinch bug (Hemiptera: Blissidae)

USDA-ARS?s Scientific Manuscript database

The southern chinch bug, Blissus insularis Barber, forms dense, multigenerational aggregations in St. Augustinegrass lawns leading to grass death from sap feeding. We conducted several bioassays to better understand the signals responsible for the formation and maintenance of southern chinch bug ag...

The Spatial Concentration of Southern Whites and Argument-Based Lethal Violence

ERIC Educational Resources Information Center

Lee, Matthew R.; Shihadeh, Edward S.

2009-01-01

This analysis examines how the spatial concentration of Southern whites is associated with white argument-based lethal violence. Using a well-known measure of spatial segregation (V, the adjusted P* index) among Southern-born whites in U.S. counties in 2000, the results reveal that the spatial concentration of Southern-born whites is only…

Hospital and Community Characteristics Associated With Pediatric Direct Admission to Hospital.

PubMed

Leyenaar, JoAnna K; Shieh, Meng-Shiou; Lagu, Tara; Pekow, Penelope S; Lindenauer, Peter K

2017-10-27

One quarter of pediatric hospitalizations begin as direct admissions, defined as hospitalization without receiving care in the hospital's emergency department (ED). Direct admission rates are highly variable across hospitals, yet previous studies have not examined reasons for this variation. We aimed to determine the relationships between hospital and community factors and pediatric direct admission rates, and to evaluate the degree to which these characteristics explain variation in risk-adjusted direct admission rates. We conducted a cross-sectional study of the Healthcare Cost and Utilization Project's Kids Inpatient Database, American Hospital Association Database, and Area Health Resource File, including children <18 years of age who were admitted for a medical hospitalization in states contributing data to all data sets. Using hierarchical generalized linear modeling, we generated risk-adjusted direct admission rates and used generalized linear models to assess the association of hospital and community characteristics with these risk-adjusted rates. We included 211,458 children discharged from 933 hospitals and 26 states; 20.2% were admitted directly. One-fifth of the variance in risk-adjusted direct admission rates was attributed to observed hospital and community factors. The greatest proportion of this explained variance was related to ED volume (37%), volume of pediatric hospitalizations (27%), and size of the pediatrician workforce (12%). Direct admission rates were associated with several hospital and community characteristics, but the majority of variation in hospitals' direct admission rates was not explained by these factors. These findings suggest opportunities for diverse hospital types to develop the infrastructure and communication systems necessary to support pediatric direct admissions. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2014-08-01

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

Public-Private Partnership in Health Care: A Comparative Cross-sectional Study of Perceived Quality of Care Among Parents of Children Admitted in Two Government District-hospitals, Southern India.

PubMed

Baliga, B Shantaram; Ravikiran, S R; Rao, Suchetha S; Coutinho, Anitha; Jain, Animesh

2016-02-01

Perceived better quality of care draws lower socio-economic classes of Indians to more expensive private setups, leading to poverty illness poverty cycle. Urgent measures need to be taken to improve perceived quality of public hospitals. The present study compares the difference in perceived quality of care among parents of children admitted at two government district hospitals. A cross-sectional, comparative, questionnaire based study was conducted between February 2011 and February 2012 at Government medical college hospitals of two district headquarters in South-India: one with private-public-partnership (PPP-model); another directly operated by government - Public Hospital-model (PH-model). A total of 461 inpatients from the PH model hospital and 580 from the PPP model hospital were eligible. Patients who left against advice (LAMA) (n=44 in PH and 19 in PPP) and expired (n=25 in PH and 59 in PPP) were excluded. Fourteen incomplete forms from PH and 10 from PPP model hospital were also excluded. Responders rated perception on a 1-5 scale in each domain: accessibility of health-facility, time spent waiting, manner and quality of physician, manner and quality of nurse, manner and quality of supporting staff, perception of equipment, explanation of treatment details and general comfort. The responders also rated overall satisfaction on a 1-10 scale. In the 1-5 scale, rating≥4 in each domain was considered good. Rating≥8 in 1-10 scale was considered satisfaction. Responders from PPP-model hospital were significantly more satisfied than those from PH-model {n=529 (91.2%) vs. n=148 (32.1%) p<0.001}. This was true even when controlled for age-group, sex, maternal education, family-type, days of hospital-stay and socioeconomic class {O.R.(CI) =23.58 (16.13-34.48); p<0.001} by binary logistic regression model. In the PPP-model hospital the time spent waiting for treatment {4.28(2.07-8.82), p<.001} and manner of support staff {3.64(1.02-12.99), p=0.04} significantly

Archean sedimentation and tectonics in southern Africa

NASA Technical Reports Server (NTRS)

Kidd, W. S. F.

1984-01-01

Sequences in the Barberton Mountain Land greenstone belt (southern Africa) were examined to determine the nature of the sedimentary rocks, their tectonic implications, and their bearing on the present large-scale structural condition of the belt. Also assessed was whether there was evidence for a significant component of shallow-water-deposited sedimentary rocks in the parent materials of the Limpopo belt. The nature of a largehigh strain zone on the southern margin of the central Limpopo belt was examined.

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

PubMed

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

2010-10-01

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

Early German Plans for a Southern Observatory

NASA Astrophysics Data System (ADS)

Wolfschmidt, Gudrun

As early as the 18th and 19th centuries, French and English observers were active in South Africa. Around the beginning of the 20th century the Heidelberg astronomer Max Wolf (1863-1932) proposed a southern observatory. In 1907 Hermann Carl Vogel (1841-1907), director of the Astrophysical Observatory Potsdam, suggested a southern station in Spain. His ideas for building an observatory in Windhuk for photographing the sky and measuring the solar constant were taken over by the Göttingen astronomers. In 1910 Karl Schwarzschild (1873-1916), after having visited the observatories in America, pointed out the usefulness of an observatory in South West Africa, where it would have better weather than in Germany and also give access to the southern sky. Seeing tests were begun in 1910 by Potsdam astronomers, but WW I stopped the plans. In 1928 Erwin Finlay-Freundlich (1885-1964), inspired by the Hamburg astronomer Walter Baade (1893-1960), worked out a detailed plan for a southern observatory with a reflecting telescope, spectrographs and an astrograph with an objective prism. Paul Guthnick (1879-1947), director of the Berlin observatory, in cooperation with APO Potsdam and Hamburg, made a site survey to Africa in 1929 and found the conditions in Windhuk to be ideal. Observations were started in the 1930s by Berlin and Breslau astronomers, but were stopped by WW II. In the 1950s, astronomers from Hamburg and The Netherlands renewed the discussion in the framework of European cooperation, and this led to the founding of ESO in 1963, as is well described by Blaauw (1991). Blaauw, Adriaan: ESO's Early History. The European Southern Observatory from Concept to Reality. Garching bei München: ESO 1991.

The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients' views.

PubMed

Barke, Antonia; Nyarko, Seth; Klecha, Dorothee

2011-11-01

Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves. A convenience sample of 403 participants (210 men, mean age 32.4±12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9±11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale. High levels of stigma prevailed in the population as shown by high proportions of assent to items expressing authoritarian and socially restrictive views, coexisting with agreement with more benevolent attitudes. A higher level of education was associated with more positive attitudes on all subscales (Authoritarianism, Social Restrictiveness, Benevolence and Acceptance of Community Based Mental Health Services). The patients reported a high degree of experienced stigma with secrecy concerning the illness as a widespread coping strategy. Perceived stigma was not associated with sex or age. The extent of stigmatising attitudes within the urban population of Southern Ghana is in line with the scant research in other countries in sub-Saharan Africa and mirrored by the experienced stigma reported by the patients. These results have to be seen in the context of the extreme scarcity of resources within the Ghanaian psychiatric system. Anti-stigma efforts should include interventions for mentally ill persons themselves and not exclusively focus on public attitudes.

3. Oil House, Southern Pacific Railroad Carlin, northeast elevation, view ...

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

3. Oil House, Southern Pacific Railroad Carlin, northeast elevation, view to southwest (135mm lens). - Southern Pacific Railroad, Carlin Shops, Oil House, Foot of Sixth Street, Carlin, Elko County, NV

78 FR 14400 - Southern USA Resources, Inc., Order of Suspension of Trading

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-05

... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] Southern USA Resources, Inc., Order of... lack of current and accurate information concerning the securities of Southern USA Resources, Inc. (``Southern USA'') because of questions regarding the accuracy of publicly-disseminated information concerning...

Multilingualism in Southern Africa.

ERIC Educational Resources Information Center

Peirce, Bonny Norton; Ridge, Stanley G. M.

1997-01-01

Reviews recent research in multilingualism in Southern Africa, focusing on the role of languages in education, sociolinguistics, and language policy. Much of the research is on South Africa. Topics discussed include language of instruction in schools, teacher education, higher education, adult literacy, language contact, gender and linguistic…

[Hospitalization period and nutritional status in hospitalized patients].

PubMed

Merhi, V A Leandro; de Oliveira, Ma R Marques; Caran, A L; Tristão, T Menuzzo Graupner; Ambo, R Miante; Tanner, M A; Vergna, C Marton

2007-01-01

With the objective of studying the nutritional status and its relationship with hospitalization period, a cross-sectional study was done with patients from a private hospital representing a population with a better socioeconomic condition. The anthropometric data of 267 patients, 46% males and 54% females ranging from 20 to 80 years of age, were assessed on the second day of hospitalization. Hospitalization period associated with nutritional status. The data were analyzed by the software Excel and Sigma Stat, using Fisher's exact test and the chi-square test. The studied population presented a body mass index of 25.9 +/- 5.3 and most patients lost weight during hospitalization. The longest hospitalization periods were found among patients with lung diseases (13 days), some being pre-obese (40%) with a small prevalence of undernutrition (4%). The percentage distribution of nutritional status among the groups according to diagnosis was different (P < 0.01) when assessed by the Fisher's exact test and the percentage distribution in weight variation between men and women was different (P < 0.02) when assessed by the chi-square test. When the population was segmented according to age, the percentage distribution of the nutritional status between > 60 and < or = 60 did not present a difference when assessed by the chi-square test. The results of this study show that the nutritional status in some diseases deserves special attention given the greater risk found in these situations, contributing to a longer hospitalization period.

Informal optics education and outreach programs in Southern California

NASA Astrophysics Data System (ADS)

Silberman, Donn M.; Cartland, Robert; Monacelli, Brian; Whitmore, Desire

2010-08-01

Over the past decade, Southern California has seen informal optics education and outreach programs grow substantially, mainly due to efforts from members of the Optical Society of Southern California (OSSC) and more recently the Optical Society of America, UC Irvine, Student Chapter. Also, the Optics Institute of Southern California (OISC) has served as a focal point for many of these programs, as an independent organization working closely with society members and other partners. This paper provides an update of these programs, including a new OSSC website that provides a new platform for significantly expanding the member participation efforts.

The southern forest resource assessment: What we learned

Treesearch

David N. Wear; John G. Greis

2004-01-01

The Southern Forest Resource Assessment was initiated in the spring of 1999 to address broad questions concerning the status, trends, and possible future of southern forests. The overall objective of the assessment was to develop a thorough and objective description of forest conditions and trends in the South, and to present it in a way that would help the public...

Economic Burden of Hepatitis C Virus Infection in Different Stages of Disease: A Report From Southern Iran.

PubMed

Zare, Fatemeh; Fattahi, Mohammad Reza; Sepehrimanesh, Masood; Safarpour, Ali Reza

2016-04-01

Hepatitis C virus (HCV) infection is a major blood-borne infection which imposes high economic cost on the patients. The current study aimed to evaluate the total annual cost due to chronic HCV related diseases imposed on each patient and their family in Southern Iran. Economic burden of chronic hepatitis C-related liver diseases (chronic hepatitis C, cirrhosis and hepatocellular carcinoma) were examined. The current retrospective study evaluated 200 Iranian patients for their socioeconomic status, utilization (direct and indirect costs) and treatment costs and work days lost due to illness by a structured questionnaire in 2015. Costs of hospital admissions were extracted from databases of Nemazee hospital, Shiraz, Iran. The outpatient expenditure per patient was measured through the rate of outpatient visits and average cost per visit reported by the patients; while the inpatient costs were calculated through annual rate of hospital admissions and average expenditure. Self-medication and direct non-medical costs were also reported. The human capital approach was used to measure the work loss cost. The total annual cost per patient for chronic hepatitis C, cirrhosis and hepatocellular carcinoma (HCC) based on purchasing power parity (PPP) were USD 1625.50, USD 6117.2, and USD 11047.2 in 2015, respectively. Chronic hepatitis C-related liver diseases impose a substantial economic burden on patients, families and the society. The current study provides useful information on cost of treatment and work loss for different disease states, which can be further used in cost-effectiveness evaluations.

HIV/AIDS in the Southern USA: a disproportionate epidemic.

PubMed

Reif, Susan S; Whetten, Kathryn; Wilson, Elena R; McAllaster, Carolyn; Pence, Brian W; Legrand, Sara; Gong, Wenfeng

2014-01-01

This research synthesis examined HIV/AIDS surveillance and health care financing data and reviewed relevant research literature to describe HIV epidemiology, outcomes, funding, and contributing factors to the HIV epidemic in the Southern USA with particular focus on a group of Southern states with similar demographic and disease characteristics and comparable HIV epidemics (Alabama, Georgia, Florida, Los Angeles, Mississippi, North Carolina, South Carolina, Tennessee, and Texas). These states are hereafter referred to as "targeted Southern states." Eight of the 10 states with the highest HIV diagnosis rates in 2011 were in the Southern USA; six were targeted states. Forty-nine percent of HIV diagnoses were in the South in 2011, which contains only 37% of the US population. The targeted states region had the highest HIV diagnosis rate than any other US region in 2011. The South was also found to have the highest HIV-related mortality and morbidity rates in the USA. The high levels of poverty, HIV-related stigma, and STDs found in the South, particularly in the targeted Southern states, likely contribute to greater HIV incidence and mortality. The disproportionate impact of HIV in the South, particularly among targeted states, demonstrates a critical need to improve HIV prevention and care and address factors that contribute to HIV disease in this region.

Hospital variation in time to defibrillation after in-hospital cardiac arrest.

PubMed

Chan, Paul S; Nichol, Graham; Krumholz, Harlan M; Spertus, John A; Nallamothu, Brahmajee K

2009-07-27

Delays to defibrillation are associated with worse survival after in-hospital cardiac arrest, but the degree to which hospitals vary in defibrillation response times and hospital predictors of delays remain unknown. Using hierarchical models, we evaluated hospital variation in rates of delayed defibrillation (>2 minutes) and its impact on survival among 7479 adult inpatients with cardiac arrests at 200 hospitals within the National Registry of Cardiopulmonary Resuscitation. Adjusted rates of delayed defibrillation varied substantially among hospitals (range, 2.4%-50.9%), with hospital-level effects accounting for a significant amount of the total variation in defibrillation delays after adjusting for patient factors. We found a 46% greater odds of patients with identical covariates getting delayed defibrillation at one randomly selected hospital compared with another. Among traditional hospital factors evaluated, however, only bed volume (reference category: <200 beds; 200-499 beds: odds ratio [OR], 0.62 [95% confidence interval {CI}, 0.48-0.80]; >or=500 beds: OR, 0.74 [95% CI, 0.53-1.04]) and arrest location (reference category: intensive care unit; telemetry unit: OR, 1.92 [95% CI, 1.65-2.22]; nonmonitored unit: OR, 1.90 [95% CI, 1.61-2.24]) were associated with differences in rates of delayed defibrillation. Wide variation also existed in adjusted hospital rates of survival to discharge (range, 5.3%-49.6%), with higher survival among hospitals in the top-performing quartile for defibrillation time (compared with the bottom quartile: OR for top quartile, 1.41 [95% CI, 1.11-1.77]). Rates of delayed defibrillation vary widely among hospitals but are largely unexplained by traditional hospital factors. Given its association with improved survival, future research is needed to better understand best practices in the delivery of defibrillation at top-performing hospitals.

Performance evaluation of nonhomogeneous hospitals: the case of Hong Kong hospitals.

PubMed

Li, Yongjun; Lei, Xiyang; Morton, Alec

2018-02-14

Throughout the world, hospitals are under increasing pressure to become more efficient. Efficiency analysis tools can play a role in giving policymakers insight into which units are less efficient and why. Many researchers have studied efficiencies of hospitals using data envelopment analysis (DEA) as an efficiency analysis tool. However, in the existing literature on DEA-based performance evaluation, a standard assumption of the constant returns to scale (CRS) or the variable returns to scale (VRS) DEA models is that decision-making units (DMUs) use a similar mix of inputs to produce a similar set of outputs. In fact, hospitals with different primary goals supply different services and provide different outputs. That is, hospitals are nonhomogeneous and the standard assumption of the DEA model is not applicable to the performance evaluation of nonhomogeneous hospitals. This paper considers the nonhomogeneity among hospitals in the performance evaluation and takes hospitals in Hong Kong as a case study. An extension of Cook et al. (2013) [1] based on the VRS assumption is developed to evaluated nonhomogeneous hospitals' efficiencies since inputs of hospitals vary greatly. Following the philosophy of Cook et al. (2013) [1], hospitals are divided into homogeneous groups and the product process of each hospital is divided into subunits. The performance of hospitals is measured on the basis of subunits. The proposed approach can be applied to measure the performance of other nonhomogeneous entities that exhibit variable return to scale.

The Impact of Hospital Pay-for-Performance on Hospital and Medicare Costs

PubMed Central

Kruse, Gregory B; Polsky, Daniel; Stuart, Elizabeth A; Werner, Rachel M

2012-01-01

Objective To evaluate the effects of Medicare's hospital pay-for-performance demonstration project on hospital revenues, costs, and margins and on Medicare costs. Data Sources/Study Setting All health care utilization for Medicare beneficiaries hospitalized for acute myocardial infarction (AMI; ICD-9-CM code 410.x1) in fiscal years 2002–2005 from Medicare claims, containing 420,211 admissions with AMI. Study Design We test for changes in hospital costs and revenues and Medicare payments among 260 hospitals participating in the Medicare hospital pay-for-performance demonstration project and a group of 780 propensity-score-matched comparison hospitals. Effects were estimated using a difference-in-difference model with hospital fixed effects, testing for changes in costs among pay-for-performance hospitals above and beyond changes in comparison hospitals. Principal Findings We found no significant effect of pay-for-performance on hospital financials (revenues, costs, and margins) or Medicare payments (index hospitalization and 1 year after admission) for AMI patients. Conclusions Pay-for-performance in the CMS hospital demonstration project had minimal impact on hospital financials and Medicare payments to providers. As P4P extends to all hospitals under the Affordable Care Act, these results provide some estimates of the impact of P4P and emphasize our need for a better understanding of the financial implications of P4P on providers and payers if we want to create sustainable and effective programs to improve health care value. PMID:23088391

The impact of hospital pay-for-performance on hospital and Medicare costs.

PubMed

Kruse, Gregory B; Polsky, Daniel; Stuart, Elizabeth A; Werner, Rachel M

2012-12-01

To evaluate the effects of Medicare's hospital pay-for-performance demonstration project on hospital revenues, costs, and margins and on Medicare costs. All health care utilization for Medicare beneficiaries hospitalized for acute myocardial infarction (AMI; ICD-9-CM code 410.x1) in fiscal years 2002-2005 from Medicare claims, containing 420,211 admissions with AMI. We test for changes in hospital costs and revenues and Medicare payments among 260 hospitals participating in the Medicare hospital pay-for-performance demonstration project and a group of 780 propensity-score-matched comparison hospitals. Effects were estimated using a difference-in-difference model with hospital fixed effects, testing for changes in costs among pay-for-performance hospitals above and beyond changes in comparison hospitals. We found no significant effect of pay-for-performance on hospital financials (revenues, costs, and margins) or Medicare payments (index hospitalization and 1 year after admission) for AMI patients. Pay-for-performance in the CMS hospital demonstration project had minimal impact on hospital financials and Medicare payments to providers. As P4P extends to all hospitals under the Affordable Care Act, these results provide some estimates of the impact of P4P and emphasize our need for a better understanding of the financial implications of P4P on providers and payers if we want to create sustainable and effective programs to improve health care value. © Health Research and Educational Trust.

Astrophysics in Southern Africa

NASA Astrophysics Data System (ADS)

Whitelock, Patricia

2008-03-01

The government of South Africa has identified astronomy as a field in which their country has a strategic advantage and is consequently investing very significantly in astronomical infrastructure. South Africa now operates a 10-m class optical telescope, the Southern African Large Telescope (SALT), and is one of two countries short listed to host the Square Kilometre Array (SKA), an ambitious international project to construct a radio telescope with a sensitivity one hundred times that of any existing telescope. The challenge now is to produce an indigenous community of users for these facilities, particularly from among the black population which was severely disadvantaged under the apartheid regime. In this paper I briefly describe the observing facilities in Southern Africa before going on to discuss the various collaborations that are allowing us to use astronomy as a tool for development, and at the same time to train a new generation of astronomers who will be well grounded in the science and linked to their colleagues internationally.

Epidemiology of Rheumatoid Arthritis in Southern Albania

PubMed Central

Koko, Vjollca; Ndrepepa, Ana; Skenderaj, Skender

2015-01-01

Objectives: The aim of this study was to assess the prevalence, incidence and the burden of rheumatoid arthritis (RA) in the Southern Albania. Material and Methods: This is an epidemiologic observational study with cross-sectional analyses of all patients with RA who lived in Southern Albania during the 1995-2011 years. The RA prevalence, incidence and disability-adjusted life years (DALY) were assessed. Results: During the 1995-2011 years, 194 patients (154 females and 40 males) with RA living in Southern Albania were identified. The prevalence of RA in 2011 was 0.25% in general population and 0.34% in adult (>14 years) population. The incidence of RA in 2011 was 0.012% (12 new cases per 100000 inhabitants) and 0.016% (16 new cases per 100000 adults). The prevalence increased (from 0.036% in 1996 to 0.25% in 2011) and the incidence did not change over the study period. The mortality was 3.2% (n=7 deaths). The DALY due to RA was 823 years per 100000 inhabitants during 1995-2011 years. Conclusion: RA in Southern Albania has a prevalence of 0.25 % and an annual incidence of 0.012% in the general population in 2011. RA was responsible for a considerable burden on the health of population during the 1995-2011 years. PMID:26236163

1. Oil House, Southern Pacific Railroad Carlin Shops, southwest facade, ...

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

1. Oil House, Southern Pacific Railroad Carlin Shops, southwest facade, view to northeast (135mm lens). - Southern Pacific Railroad, Carlin Shops, Oil House, Foot of Sixth Street, Carlin, Elko County, NV

4. Oil House, Southern Pacific Railroad Carlin Shops, southeast elevation, ...

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

4. Oil House, Southern Pacific Railroad Carlin Shops, southeast elevation, view to northwest (90mm lens). - Southern Pacific Railroad, Carlin Shops, Oil House, Foot of Sixth Street, Carlin, Elko County, NV

2. Oil House, Southern Pacific Railroad Carlin Shops, northwest elevation, ...

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

2. Oil House, Southern Pacific Railroad Carlin Shops, northwest elevation, view to southeast (135mm lens). - Southern Pacific Railroad, Carlin Shops, Oil House, Foot of Sixth Street, Carlin, Elko County, NV

OVERALL VIEW OF SOUTHERN DUCTILE'S PATTERN REPAIR SHOP, SHOWING A ...

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

OVERALL VIEW OF SOUTHERN DUCTILE'S PATTERN REPAIR SHOP, SHOWING A SPANISH-MADE FORADIA BORING MACHINE IN THE FOREGROUND. - Southern Ductile Casting Company, Mold Making, 2217 Carolina Avenue, Bessemer, Jefferson County, AL

Hospital diversification strategy.

PubMed

Eastaugh, Steven R

2014-01-01

To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger.

Competitive success of southern populations of Betula pendula and Sorbus aucuparia under simulated southern climate experiment in the subarctic.

PubMed

Taulavuori, Kari; Taulavuori, Erja; Saravesi, Karita; Jylänki, Tanja; Kainulainen, Aila; Pajala, Jonna; Markkola, Annamari; Suominen, Otso; Saikkonen, Kari

2017-06-01

Global warming has been commonly accepted to facilitate species' range shifts across latitudes. Cross-latitudinal transplantations support this; many tree species can well adapt to new geographical areas. However, these studies fail to capture species' adaptations to new light environment because the experiments were not designed to explicitly separate species' responses to light and temperature. Here we tested reaction norms of tree seedlings in reciprocal transplantations 1,000 km apart from each other at two latitudes (60°N and 69°N). In contrast to past studies, we exposed our experimental plants to same temperature in both sites (temperature of 60°N growing site is recorded to adjust temperature of 69°N site in real time via Internet connection) while light environment (photoperiod, light quality) remained ambient. Shoot elongation and autumn coloration were studied in seedlings of two deciduous trees ( Betula pendula and Sorbus aucuparia ), which were expected to respond differently to day length. Sorbus as a member of Rosaceae family was assumed to be indifferent to photoperiod, while Betula responds strongly to day length. We hypothesized that (1) southern and northern populations of both species perform differently; (2) southern populations perform better in both sites; (3) autumn phenology of southern populations may delay in the northern site; (4) and Sorbus aucuparia is less dependent on light environment. According to the hypotheses, shoot elongation of northern population was inherently low in both species. An evolutionary consequence of this may be a competitive success of southern populations under warming climate. Southern population of B. pendula was delayed in autumn coloration, but not in growth cessation. Sorbus aucuparia was less responsive to light environment. The results suggest that light provides selection pressure in range shifts, but the response is species dependent.

Fruit and vegetable consumption associated with reduced risk of epithelial ovarian cancer in southern Chinese women.

PubMed

Tang, Li; Lee, Andy H; Su, Dada; Binns, Colin W

2014-01-01

To investigate the association between fruit and vegetable consumption and the risk of epithelial ovarian cancer in southern Chinese women. A case-control study was undertaken in Guangzhou, Guangdong Province, between 2006 and 2008. Participants were 500 incident ovarian cancer patients and 500 hospital-based controls. Information on habitual fruit and vegetable consumption was obtained by face-to-face interview using a validated and reliable food frequency questionnaire. Unconditional logistic regression analyses were performed to assess the association between fruit and vegetable intakes and the ovarian cancer risk. The mean fruit and vegetable daily intakes of ovarian cancer patients (324.2g (SD 161.9) and 582.7 g (SD 250.2)) were significantly lower (p<0.001) than those of controls (477.3g (SD 362.1) and 983.3g (SD 739.9)). The adjusted odds ratios were 0.30 (95% confidence interval (CI) 0.21 to 0.44) and 0.07 (95% CI 0.04 to 0.12) for more than 490 g of fruits and 970 g of vegetables per day, relative to at most 320 g and 690 g per day, respectively. With the exception of lycopene, substantial risk reductions were evident for a variety of nutrients derived from fruits and vegetables. Consumption of fruits and vegetables was inversely associated with the incidence of epithelial ovarian cancer in southern Chinese women. © 2013.

Southern blotting.

PubMed

Brown, T

2001-05-01

Southern blotting is the transfer of DNA fragments from an electrophoresis gel to a membrane support (the properties and advantages of the different types of membrane, transfer buffer, and transfer method are discussed in detail), resulting in immobilization of the DNA fragments, so the membrane carries a semipermanent reproduction of the banding pattern of the gel. After immobilization, the DNA can be subjected to hybridization analysis, enabling bands with sequence similarity to a labeled probe to be identified. This appendix describes Southern blotting via upward capillary transfer of DNA from an agarose gel onto a nylon or nitrocellulose membrane, using a high-salt transfer buffer to promote binding of DNA to the membrane. With the high-salt buffer, the DNA becomes bound to the membrane during transfer but not permanently immobilized. Immobilization is achieved by UV irradiation (for nylon) or baking (for nitrocellulose). A Support Protocol describes how to calibrate a UV transilluminator for optimal UV irradiation of a nylon membrane. An alternate protocol details transfer using nylon membranes and an alkaline buffer, and is primarily used with positively charged nylon membranes. The advantage of this combination is that no post-transfer immobilization step is required, as the positively charged membrane binds DNA irreversibly under alkaline transfer conditions. The method can also be used with neutral nylon membranes but less DNA will be retained. A second alternate protocol describes a transfer method based on a different transfer-stack setup. The traditional method of upward capillary transfer of DNA from gel to membrane described in the first basic and alternate protocols has certain disadvantages, notably the fact that the gel can become crushed by the weighted filter papers and paper towels that are laid on top of it. This slows down the blotting process and may reduce the amount of DNA that can be transferred. The downward capillary method described in

Ecological importance of the Southern Boundary of the Antarctic Circumpolar Current

NASA Astrophysics Data System (ADS)

Tynan, Cynthia T.

1998-04-01

The Southern Ocean surrounds the Antarctic continent and supports one of the most productive marine ecosystems. Migratory and endemic species of whales, seals and birds benefit from the high biomass of their principal prey, krill (Euphausia superba) and cephalopods, in this area. Most species of baleen whales and male sperm whales in the Southern Hemisphere migrate between low-latitude breeding grounds in winter and highly productive Antarctic feeding grounds in summer. Here I show the importance of the southernmost reaches of the strongest ocean current, the Antarctic Circumpolar Current (ACC), to a complex and predictable food web of the Southern Ocean. The circumpolar distributions of blue, fin and humpback whales from spring to midsummer trace the non-uniform high-latitude penetration of shoaled, nutrient-rich Upper Circumpolar Deep Water, which is carried eastward by the ACC. The poleward extent of this water mass delineates the Southern Boundary of the ACC and corresponds not only to the circumpolar distributions of baleen whales, but also to distributions of krill and to regions of high, seasonally averaged, phytoplankton biomass. Sperm whales, which feed on cephalopods, also congregate in highest densities near the Southern Boundary. The association of primary production, Krill, and whales with the Southern Boundary, suggests that it provides predictably productive foraging for many species, and is of critical importance to the function of the Southern Ocean ecosystem.

Hospital Web site 'tops' in Louisiana. Hospital PR, marketing group cites East Jefferson General Hospital.

PubMed

Rees, Tom

2002-01-01

East Jefferson General Hospital in Metairie, La., launched a new Web site in October 2001. Its user-friendly home page offers links to hospital services, medical staff, and employer information. Its jobline is a powerful tool for recruitment. The site was awarded the 2002 Pelican Award for Best Consumer Web site by the Louisiana Society for Hospital Public Relations & Marketing.

Hospital fundamentals.

PubMed

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

2014-07-01

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

Dancing Southern Lights of Saturn

NASA Image and Video Library

2010-09-23

This frame from a movie, made from data obtained by NASA Cassini spacecraft, shows Saturn southern aurora shimmering over approximately 20 hours as the planet rotates. The video is available at the Photojournal.

Some upper cretaceous ammonites from southern Nigeria

NASA Astrophysics Data System (ADS)

Zaborski, P. M. P.

Ammonites of Cenomanian, Turonian, Coniacian and Maastrichtian age are described from the Calabar, Lokpanta, Nkalagu and Lokpauku regions of southern Nigeria. Two species are new Forbesiceras varicostatum sp. nov. from the Loweer Cenomanian and Romaniceras (Yubariceras) evolutum sp. nov. from the Upper Turonian. The stratigraphical significance of the described faunas is discussed. There are striking similarities between the Lower Turonian assemblages of parts of southern Nigeria and South America, particularly Venezuela, which contain common species of Mammites, Fagesia, Vascoceras, Paramammites and Neoptychites.

Spectroscopical Study of Faint Southern Cepheids with Southern African Large Telescope (salt). First Results.

NASA Astrophysics Data System (ADS)

Usenko, I. A.; Kniazev, A. Yu.; Kovtyukh, V. V.; Belik, S. I.; Berdnikov, L. N.

First Cepheids observations using echelle-spectrograph HRS fed by Southern African Large Telescope (SALT) were realized during 2016. All spectra have been obtained in the medium resoltion mode (R≍ 31000-41000) wth high S/N ratio near 50-220. All data were processed using package developed by authors based on the standard system of astronomical data reduction MIDAS. Using new echelle data we found the atmosphere parameters and chemical composition for 30 faint Cepheids of southern hemisphere, where for the most of theses stars these results we obtained for the first time. 28 stars are Cepheids after the first-dredge up stage, while ASAS 075842-25336.1 and ASAS 1131714-6605.0 having remarkable Li I 6707.8 Å absorption line and anomalous CNO and Na content could be consider as first crossing of the Cepheids instability strip.

Thirty-day readmission rates following hospitalization for pediatric sickle cell crisis at freestanding children's hospitals: risk factors and hospital variation.

PubMed

Sobota, Amy; Graham, Dionne A; Neufeld, Ellis J; Heeney, Matthew M

2012-01-01

Readmission within 30 days after hospitalization for sickle cell crisis was developed by The National Association of Children's Hospitals (NACHRI) to improve hospital quality, however, there have been few studies validating this. We performed a retrospective examination of 12,104 hospitalizations for sickle crisis from July 1, 2006 and December 31, 2008 at 33 freestanding children's hospitals in the Pediatric Health Information System (PHIS) database. Hospitalizations met NACHRI criteria; inpatient admission, APR DRG code 662, age < 18, discharge home, and length of stay within 2 SD of the mean. We describe 30-day readmission rates, identify factors associated with readmission accounting for patient-level clustering and compare unadjusted versus adjusted variation in readmission rates. We identified 4,762 patients with 12,104 qualifying hospitalizations (1-30 per patient). Two thousand seventy-four (17%) hospitalizations resulted in a readmission within 30 days. Significant factors associated with readmission were age (OR 1.06/year, P < 0.0001), inpatient use of steroids (OR 1.48, P = 0.01) admission for pain without other sickle complications (OR 1.52, P < 0.0001) and simple transfusion (OR 0.58, P = 0.0002). There was significant variation in readmission rates between hospitals, even after accounting for clustering by patient and hospital case mix. In a sample of free-standing children's hospitals, 17% of hospitalizations for sickle cell crisis result in readmission within 30 days. Older patients, those treated with steroids and those admitted for pain are more likely to be readmitted; simple transfusion is protective. Even after adjusting for case mix substantial hospital variation remains, but specific hospital to hospital comparisons differ depending on the exact methods used. Copyright © 2011 Wiley Periodicals, Inc.

NREL + Southern California Gas

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

Berdahl, Sonja E

2017-10-09

NREL and Southern California Gas Company are evaluating a new 'power-to-gas' approach - one that produces methane through a biological pathway and uses the expansive natural gas infrastructure to store it. This approach has the potential to change how the power industry approaches renewable generation and energy storage.

Skillful seasonal predictions of winter precipitation over southern China

NASA Astrophysics Data System (ADS)

Lu, Bo; Scaife, Adam A.; Dunstone, Nick; Smith, Doug; Ren, Hong-Li; Liu, Ying; Eade, Rosie

2017-07-01

Southern China experiences large year-to-year variability in the amount of winter precipitation, which can result in severe social and economic impacts. In this study, we demonstrate prediction skill of southern China winter precipitation by three operational seasonal prediction models: the operational Global seasonal forecasting system version 5 (GloSea5), the NCEP Climate Forecast System (CFSv2) and the Beijing Climate Center Climate System Model (BCC-CSM1.1m). The correlation scores reach 0.76 and 0.67 in GloSea5 and CFSv2, respectively; and the amplitude of the ensemble mean forecast signal is comparable to the observed variations. The skilful predictions in GloSea5 and CFSv2 mainly benefit from the successful representation of the observed ENSO teleconnection. El Niño weakens the Walker circulation and leads to the strengthening of the subtropical high over the northwestern Pacific. The anti-cyclone then induces anomalous northward flow over the South China Sea and brings water vapor to southern China, resulting in more precipitation. This teleconnection pattern is too weak in BCC-CSM1.1m, which explains its low skill (0.13). Whereas the most skilful forecast system is also able to simulate the influence of the Indian Ocean on southern China precipitation via changes in southwesterly winds over the Bay of Bengal. Finally, we examine the real-time forecast for 2015/16 winter when a strong El Niño event led to the highest rainfall over southern China in recent decades. We find that the GloSea5 system gave good advice as it produced the third wettest southern China in the hindcast, but underestimated the observed amplitude. This is likely due to the underestimation of the Siberian High strength in 2015/2016 winter, which has driven strong convergence over southern China. We conclude that some current seasonal forecast systems can give useful warning of impending extremes. However, there is still need for further model improvement to fully represent the complex

Hospital turnaround strategies.

PubMed

Langabeer, James

2008-01-01

Despite reports of higher profitability in recent years, hospitals are failing at a faster rate than ever before. Although many hospitals leave decisions regarding revenues and costs to chief financial officers and their staff, this is a recipe for disaster. From research conducted over the last 4 years on hospital bankruptcies and turnarounds, the author found that a common series of actions will help organizations evade collapse. The author explored these turnaround strategies through research and analysis of a variety of hospitals and health systems that had a high probability of immediate financial crisis or collapse. His continued observation and analysis of these hospitals in subsequent years showed that most hospitals never emerge from their bleak financial conditions. However, a few hospital administrations have successfully turned around their organizations.

INTERIOR OFFICES AT THE SOUTHERN END OF THE BUILDING, LOOKING ...

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

INTERIOR OFFICES AT THE SOUTHERN END OF THE BUILDING, LOOKING SOUTH - Eglin Air Force Base, Storehouse & Company Administration, Southeast of Flager Road, Nassau Lane, & southern edge of Weekly Bayou, Valparaiso, Okaloosa County, FL

76 FR 31599 - Southern Star Central Gas Pipeline, Inc.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-481-000] Southern Star Central Gas Pipeline, Inc.; Notice of Application On May 13, 2011, Southern Star Central Gas Pipeline, Inc. (Southern Star) filed with the Federal Energy Regulatory Commission (Commission) an application under...

76 FR 67160 - Southern Star Central Gas Pipeline, Inc.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP11-481-001] Southern Star Central Gas Pipeline, Inc.; Notice of Application On October 19, 2011, Southern Star Central Gas Pipeline, Inc. (Southern Star) filed with the Federal Energy Regulatory Commission (Commission) an amendment to...

Emergence of extended-spectrum β-lactamase producing Enterobacter spp. in patients with bacteremia in a tertiary hospital in southern Brazil.

PubMed

Nogueira, Keite da Silva; Paganini, Maria Cristina; Conte, Andréia; Cogo, Laura Lúcia; Taborda de Messias Reason, Iara; da Silva, Márcio José; Dalla-Costa, Libera Maria

2014-02-01

Extended-spectrum β-lactamases (ESBLs) are increasingly prevalent in Enterobacter spp., posing a challenge to the treatment of infections caused by this microorganism. The purpose of this retrospective study was to evaluate the prevalence, risk factors, and clinical outcomes of inpatients with bacteremia caused by ESBL and non ESBL-producing Enterobacter spp. in a tertiary hospital over the period 2004-2008. The presence of blaCTX-M, blaTEM, blaSHV, and blaPER genes was detected by polymerase chain reaction (PCR) and nucleotide sequence analysis. Genetic similarity between strains was defined by pulsed-field gel electrophoresis (PFGE). Enterobacter spp. was identified in 205 of 4907 of the patients who had positive blood cultures during hospitalization. Of those cases, 41 (20%) were ESBL-producing Enterobacter spp. Nosocomial pneumonia was the main source of bacteremia caused by ESBL-producing Enterobacter spp. The presence of this microorganism was associated with longer hospital stays. The ESBL genes detected were: CTX-M-2 (23), CTX-M-59 (10), CTX-M-15 (1), SHV-12 (5), and PER-2 (2). While Enterobacter aerogenes strains showed mainly a clonal profile, Enterobacter cloacae strains were polyclonal. Although no difference in clinical outcomes was observed between patients with infections by ESBL-producing and non-ESBL-producing strains, the detection of ESBL in Enterobacter spp. resulted in the change of antimicrobials in 75% of cases, having important implications in the decision-making regarding adequate antimicrobial therapy. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Hospital Report Cards for Hospital-Acquired Pressure Ulcers: How good are the grades?

PubMed Central

Meddings, Jennifer A.; Reichert, Heidi; Hofer, Tim; McMahon, Laurence F.

2013-01-01

BACKGROUND Value-based purchasing programs will use administrative data to compare hospitals by rates of hospital-acquired pressure ulcers (HAPUs) for public reporting and financial penalties. Validation of administrative data for these purposes, however, is lacking. OBJECTIVE To assess the validity of the administrative data used to generate HAPU rates to compare hospitals for public reporting and financial penalty, by comparing hospital performance as assessed by HAPU rates generated from administrative and surveillance data. DESIGN Retrospective analysis of 2 million all-payer administrative records for 448 California hospitals and quarterly hospital-wide surveillance data for 213 hospitals from the California Nursing Outcomes and Prevalence Study (as publicly reported on CalHospitalCompare). SETTING 196 acute-care hospitals with >=6 months of available administrative and surveillance data PATIENTS Non-obstetric adults discharged in 2009. MEASUREMENTS Hospital-specific HAPU rates were computed as the percentage of discharged adults (from administrative data) or examined adults (from surveillance data) with >=1 HAPU stage II and above (HAPU2+). Categorization of hospital performance using administrative data was compared to the grade assigned using the surveillance data. RESULTS By administrative data, the mean (CI) hospital-specific HAPU2+ rate was 0.15% (0.13, 0.17); by surveillance data, the mean (CI) hospital-specific HAPU2+ rate was 2.0% (1.8, 2.2). Of the 49 hospitals with HAPU2+ rates from administrative data in the highest (worst) quartile, the surveillance dataset assigned these hospitals performance grades of “Superior” for 3 hospitals, “Above Average” for 14 hospitals, “Average” for 15 hospitals, and “Below Average” for 17 hospitals. LIMITATIONS Data are from 1 state, 1 year. CONCLUSIONS Hospital performance scores generated from HAPU2+ rates varied considerably from administrative data and surveillance data, suggesting administrative

Medicare's Hospital Readmissions Reduction Program in Surgery May Disproportionately Affect Minority-serving Hospitals.

PubMed

Shih, Terry; Ryan, Andrew M; Gonzalez, Andrew A; Dimick, Justin B

2015-06-01

To project readmission penalties for hospitals performing cardiac surgery and examine how these penalties will affect minority-serving hospitals. The Hospital Readmissions Reduction Program will potentially expand penalties for higher-than-predicted readmission rates to cardiac procedures in the near future. The impact of these penalties on minority-serving hospitals is unknown. We examined national Medicare beneficiaries undergoing coronary artery bypass grafting in 2008 to 2010 (N = 255,250 patients, 1186 hospitals). Using hierarchical logistic regression, we calculated hospital observed-to-expected readmission ratios. Hospital penalties were projected according to the Hospital Readmissions Reduction Program formula using only coronary artery bypass grafting readmissions with a 3% maximum penalty of total Medicare revenue. Hospitals were classified into quintiles according to proportion of black patients treated. Minority-serving hospitals were defined as hospitals in the top quintile whereas non-minority-serving hospitals were those in the bottom quintile. Projected readmission penalties were compared across quintiles. Forty-seven percent of hospitals (559 of 1186) were projected to be assessed a penalty. Twenty-eight percent of hospitals (330 of 1186) would be penalized less than 1% of total Medicare revenue whereas 5% of hospitals (55 of 1186) would receive the maximum 3% penalty. Minority-serving hospitals were almost twice as likely to be penalized than non-minority-serving hospitals (61% vs 32%) and were projected almost triple the reductions in reimbursement ($112 million vs $41 million). Minority-serving hospitals would disproportionately bear the burden of readmission penalties if expanded to include cardiac surgery. Given these hospitals' narrow profit margins, readmission penalties may have a profound impact on these hospitals' ability to care for disadvantaged patients.

Hospital economics of primary total knee arthroplasty at a teaching hospital.

PubMed

Healy, William L; Rana, Adam J; Iorio, Richard

2011-01-01

The hospital cost of total knee arthroplasty (TKA) in the United States is a major growing expense for the Centers for Medicare & Medicaid Services (CMS). Many hospitals are unable to deliver TKA with profitable or breakeven economics under the current Diagnosis-Related Group (DRG) hospital reimbursement system. The purposes of the current study were to (1) determine revenue, expenses, and profitability (loss) for TKA for all patients and for different payors; (2) define changes in utilization and unit costs associated with this operation; and (3) describe TKA cost control strategies to provide insight for hospitals to improve their economic results for TKA. From 1991 to 2009, Lahey Clinic converted a $2172 loss per case on primary TKA in 1991 to a $2986 profit per case in 2008. The improved economics was associated with decreasing revenue in inflation-adjusted dollars and implementation of hospital cost control programs that reduced hospital expenses for TKA. Reduction of hospital length of stay and reduction of knee implant costs were the major drivers of hospital expense reduction. During the last 25 years, our economic experience with TKA is concerning. Hospital revenues have lagged behind inflation, hospital expenses have been reduced, and our institution is earning a profit. However, the margin for TKA is decreasing and Managed Medicare patients do not generate a profit. The erosion of hospital revenue for TKA will become a critical issue if it leads to economic losses for hospitals or reduced access to TKA. Level III, Economic and Decision Analyses. See Guidelines for Authors for a complete description of levels of evidence.

Southern Nevada air quality study

DOT National Transportation Integrated Search

2007-01-01

The Southern Nevada Air Quality Study (SNAQS) created cross-plume and in-plume measurement systems to quantify emissions distributions and source profiles from transportation emissions, specifically gasoline and diesel powered vehicles. The cross-plu...

Climate change and wildfire around southern Africa

NASA Astrophysics Data System (ADS)

Kimura, K.

2013-12-01

When the climate change in southern Africa is analyzed, the effects of rainfall by Inter Tropical Convergence Zone(ITCZ) and cyclone are important. In this study, the rainfall patterns are analyzed with synoptic analysis. The southern limit of ITCZ is around the arid zone around Namibia, Botswana, Zimbabwe and Mozambique. This zone has some effects of both ITCZ and extratropical cyclones by season. As well as this, the eastern part of this area has heavy rainfall by the cyclone from the Indian Ocean once in several years. In the other hand, a lot of wildfire occurs in this area. The main cause of the wildfire is anthropogenic misbehavior of the fire by the slash-and-burn agriculture. Recently we can find the wildfire detected with the satellite imagery like Terra/Aqua MODIS. We can compare the weather environment and the wildfire occurrence with Geographical Information System. We have tried making the fire weather index suitable for the southern African semi-arid area.

Ecology and control of an introduced population of Southern Watersnakes (Nerodia fasciata) in southern California

USGS Publications Warehouse

Reed, Robert; Todd, Brian D; Miano, Oliver J.; Canfield, Mark; Fisher, Robert N.; McMartin, Louanne

2016-01-01

Native to the southeastern United States, Southern Watersnakes (Nerodia fasciata) are known from two sites in California, but their ecological impacts are poorly understood. We investigated the ecology of Southern Watersnakes in Machado Lake, Harbor City, Los Angeles County, California, including an assessment of control opportunities. We captured 306 watersnakes as a result of aquatic trapping and hand captures. We captured snakes of all sizes (162–1063 mm snout–vent length [SVL], 3.5–873.3 g), demonstrating the existence of a well-established population. The smallest reproductive female was 490 mm SVL and females contained 12–46 postovulatory embryos (mean  =  21). Small watersnakes largely consumed introduced Western Mosquitofish (Gambusia affinis), while larger snakes specialized on larval and metamorph American Bullfrogs (Lithobates catesbeianus) and Green Sunfish (Lepomis cyanellus). Overall capture per unit effort (CPUE) in traps declined with time during an intensive 76-d trapping bout, but CPUE trends varied considerably among traplines and it is unlikely that the overall decline in CPUE represented a major decrease in the snake population size. Although we found no direct evidence that Southern Watersnakes are affecting native species in Machado Lake, this population may serve as a source for intentional or unintentional transportation of watersnakes to bodies of water containing imperiled native prey species or potential competitors.

7. Interior oblique view toward doorway, Oil House, Southern Pacific ...

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

7. Interior oblique view toward doorway, Oil House, Southern Pacific Railroad Carlin Shops, view to south (90mm lens). - Southern Pacific Railroad, Carlin Shops, Oil House, Foot of Sixth Street, Carlin, Elko County, NV

6. Interior oblique view from doorway, Oil House, Southern Pacific ...

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

6. Interior oblique view from doorway, Oil House, Southern Pacific Railroad Carlin Shops, view to north (90mm lens). - Southern Pacific Railroad, Carlin Shops, Oil House, Foot of Sixth Street, Carlin, Elko County, NV

Hospital Variation in Time to Epinephrine for Nonshockable In-Hospital Cardiac Arrest.

PubMed

Khera, Rohan; Chan, Paul S; Donnino, Michael; Girotra, Saket

2016-12-20

For patients with in-hospital cardiac arrests attributable to nonshockable rhythms, delays in epinephrine administration beyond 5 minutes is associated with worse survival. However, the extent of hospital variation in delayed epinephrine administration and its effect on hospital-level outcomes is unknown. Within Get With The Guidelines-Resuscitation, we identified 103 932 adult patients (≥18 years) at 548 hospitals with an in-hospital cardiac arrest attributable to a nonshockable rhythm who received at least 1 dose of epinephrine between 2000 and 2014. We constructed 2-level hierarchical regression models to quantify hospital variation in rates of delayed epinephrine administration (>5 minutes) and its association with hospital rates of survival to discharge and survival with functional recovery. Overall, 13 213 (12.7%) patients had delays to epinephrine, and this rate varied markedly across hospitals (range, 0%-53.8%). The odds of delay in epinephrine administration were 58% higher at 1 randomly selected hospital in comparison with a similar patient at another randomly selected hospital (median odds ratio, 1.58; 95% confidence interval, 1.51-1.64). The median risk-standardized survival rate was 12.0% (range, 5.4%-31.9%), and the risk-standardized survival with functional recovery was 7.4% (range, 0.9%-30.8%). There was an inverse correlation between a hospital's rate of delayed epinephrine administration and its risk-standardized rate of survival to discharge (ρ=-0.22, P<0.0001) and survival with functional recovery (ρ=-0.14, P=0.001). In comparison with a median survival rate of 12.9% (interquartile range, 11.1%-15.4%) at hospitals in the lowest quartile of epinephrine delay, risk-standardized survival was 16% lower at hospitals in the quartile with the highest rate of epinephrine delays (10.8%; interquartile range, 9.7%-12.7%). Delays in epinephrine administration following in-hospital cardiac arrest are common and variy across hospitals. Hospitals with

75 FR 40802 - Southern Star Central Gas Pipeline, Inc.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-14

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP10-2-001] Southern Star... Star Central Gas Pipeline, Inc. (Southern Star), 4700 Highway 56, Owensboro, Kentucky 42301, filed in... CP10-2-000. Specifically, Southern Star proposes to increase the working gas capacity and amend the...

77 FR 41975 - Southern Star Central Gas Pipeline, Inc.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-17

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP12-479-000] Southern Star Central Gas Pipeline, Inc.; Notice of Application Take notice that on June 27, 2012, Southern Star Central Gas Pipeline, Inc. (Southern Star), 4700 Highway 56, Owensboro, Kentucky 42301, filed an application...

77 FR 28867 - Southern Star Central Gas Pipeline, Inc.; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-16

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. CP12-285-000] Southern Star Central Gas Pipeline, Inc.; Notice of Application Take notice that on April 27, 2012, Southern Star Central Gas Pipeline, Inc. (Southern Star), 4700 Highway 56, Owensboro, Kentucky 42304, filed in Docket No...

The Hospitalized Child.

ERIC Educational Resources Information Center

Marchionne, Anne T.

Ways hospitals can promote the psychological and social well being of young patients are explored in this paper. First, the importance of familiarizing the child with the hospital is emphasized. Second, emotions hospitalized children may feel and the possible causes of those emotions are listed. Third, methods hospital personnel can use to help…

5. Northwest elevation, Roundhouse Machine Shop Extension, Southern Pacific Railroad ...

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

5. Northwest elevation, Roundhouse Machine Shop Extension, Southern Pacific Railroad Carlin Shops, view to southeast (90mm lens). - Southern Pacific Railroad, Carlin Shops, Roundhouse Machine Shop Extension, Foot of Sixth Street, Carlin, Elko County, NV

4. Southwest end, Roundhouse Machine Shop Extension, Southern Pacific Railroad ...

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

4. Southwest end, Roundhouse Machine Shop Extension, Southern Pacific Railroad Carlin Shops, view to northeast (135mm lens). - Southern Pacific Railroad, Carlin Shops, Roundhouse Machine Shop Extension, Foot of Sixth Street, Carlin, Elko County, NV

Home - Southern IPM Center

Science.gov Websites

National Institute of Food and Agriculture Invests in Research on the Implications of Gene Editing Profiles PMSPs IPM Elements Crop Timelines United States Department of Agriculture - National Institute of Food and Agriculture Website managed by the Southern IPM Center. 1730 Varsity Drive, STE 110, NCSU

Home - Southern IPM Center

Science.gov Websites

of Food and Agriculture Invests in Research on the Implications of Gene Editing Technologies USDA IPM Elements Crop Timelines United States Department of Agriculture - National Institute of Food and Agriculture Website managed by the Southern IPM Center. 1730 Varsity Drive, STE 110, NCSU Centennial Campus

Southern pulpwood production, 1977

Treesearch

Thomas R. Bellamy

1978-01-01

Southern pulpwood production increased 3 percent in 1977 to 48.9 million cords. Roundwood production increased slightly while use of plant byproducts rose 9 percent. The use of plant byproducts continues to increase and now contributes 34 percent of the total. Pulping capacity increased to 100,894 tons per day.

The evolution of pine plantation silviculture in the Southern United States

Treesearch

Thomas R. Fox; Eric J. Jokela; H. Lee Allen

2004-01-01

In the 1950s, vast acreages of cutover forest land and degraded agricultural land existed in the South. Less than 2 million acres of southern pine plantations existed at that time. By the end of the 20th century, there were 32 million acres of southern pine plantations in the Southern United States, and this region is now the woodbasket of the world. The success story...

Effects of extreme temperatures on cardiovascular emergency hospitalizations in a Mediterranean region: a self-controlled case series study.

PubMed

Ponjoan, Anna; Blanch, Jordi; Alves-Cabratosa, Lia; Martí-Lluch, Ruth; Comas-Cufí, Marc; Parramon, Dídac; Del Mar Garcia-Gil, María; Ramos, Rafel; Petersen, Irene

2017-04-04

Cold spells and heatwaves increase mortality. However little is known about the effect of heatwaves or cold spells on cardiovascular morbidity. This study aims to assess the effect of cold spells and heatwaves on cardiovascular diseases in a Mediterranean region (Catalonia, Southern Europe). We conducted a population-based retrospective study. Data were obtained from the System for the Development of Research in Primary Care and from the Catalan Meteorological Service. The outcome was first emergency hospitalizations due to coronary heart disease, stroke, or heart failure. Exposures were: cold spells; cold spells and 3 or 7 subsequent days; and heatwaves. Incidence rate ratios (IRR) and 95% confidence intervals were calculated using the self-controlled case series method. We accounted for age, time trends, and air pollutants; results were shown by age groups, gender or cardiovascular event type. There were 22,611 cardiovascular hospitalizations in winter and 17,017 in summer between 2006 and 2013. The overall incidence of cardiovascular hospitalizations significantly increased during cold spells (IRR = 1.120; CI 95%: 1.10-1.30) and the effect was even stronger in the 7 days subsequent to the cold spell (IRR = 1.29; CI 95%: 1.22-1.36). Conversely, cardiovascular hospitalizations did not increase during heatwaves, neither in the overall nor in the stratified analysis. Cold spells but not heatwaves, increased the incidence of emergency cardiovascular hospitalizations in Catalonia. The effect of cold spells was greater when including the 7 subsequent days. Such knowledge might be useful to develop strategies to reduce the impact of extreme temperature episodes on human health.

Apolipoprotein C3 (-455T>C) polymorphism confers susceptibility to nonalcoholic fatty liver disease in the Southern Han Chinese population

PubMed Central

Li, Min-Rui; Zhang, Sheng-Hong; Chao, Kang; Liao, Xian-Hua; Yao, Jia-Yan; Chen, Min-Hu; Zhong, Bi-Hui

2014-01-01

AIM: To investigate the relationship between Apolipoprotein C3 (APOC3) (-455T>C) polymorphism and nonalcoholic fatty liver disease (NAFLD) in the Southern Chinese Han population. METHODS: In this prospective case-control study, we recruited 300 NAFLD patients and 300 healthy controls to a cohort representing Southern Chinese Han population at The First Affiliated Hospital, Sun Yat-sen University, from January to December 2012. Polymerase chain reaction-restriction fragment length polymorphism and DNA sequencing were used to genotype the APOC3 (-455T>C) variants. RESULTS: After adjusting for age, gender, and body-mass index, TC and CC genotypes were found to increase the susceptibility to NAFLD compared to the TT genotype, with adjusted odds ratios (ORs) of 1.77 (95%CI: 1.16-2.72) and 2.80 (95%CI: 1.64-4.79), respectively. Further stratification analysis indicated that carriers of the CC genotype was more susceptible to insulin resistance (IR) than those of the TT genotype, with an OR of 3.24 (95%CI: 1.52-6.92). The CC genotype also was associated with a significantly higher risk of hypertension, hypertriglyceridemia, and low levels of high-density lipoprotein cholesterol (HDL) (P < 0.05). No association was found between the APOC3 (-455T>C) polymorphism and obesity, impaired glucose tolerance, hyperuricemia, hypercholesterolemia, or high levels of low-density lipoprotein cholesterol (LDL) (P > 0.05). CONCLUSION: APOC3 (-455T>C) genetic variation is involved in the susceptibility to developing NAFLD, IR, hypertension, hypertriglyceridemia, and low HDL in the Southern Chinese Han population. PMID:25320541

Southern Rural Development Center Annual Progress Report, FY 1981.

ERIC Educational Resources Information Center

Southern Rural Development Center, Mississippi State, MS.

Since 1974 the Southern Rural Development Center (SRDC) has provided support staff for capacity building and innovative programming for the experiment stations and extension services of 28 land-grant universities in 13 southern states and Puerto Rico. The Center exists to provide the best possible information and assistance to extension and…

Interest group opinions about fuel reduction in southern Appalachia

Treesearch

Carin E. Vadala; Robert D. Bixler; Thomas A. Waldrop

2013-01-01

Opinions of interested publics and interest groups (n = 640) about fuel reduction (FR) in the Southern Appalachian Mountains were investigated through social survey using both pictorial and written questions. The study identified three discrete groups based on knowledge of forest history in the Southern Appalachian Mountains, attitudes toward social and ecological...

The Culture of Southern Black Women: Approaches and Materials.

ERIC Educational Resources Information Center

Conklin, Nancy Faires; And Others

Designed for teachers and curriculum developers in postsecondary education, this curriculum focuses on traditional modes of creative expression of Southern black women as they relate to broader social and historical phenomena. The first of six sections provides an introduction to the curriculum for teachers. Section 2 examines the Southern black…

Factors Associated With the Likelihood of Hospitalization Following Emergency Department Visits for Behavioral Health Conditions.

PubMed

Hamilton, Jane E; Desai, Pratikkumar V; Hoot, Nathan R; Gearing, Robin E; Jeong, Shin; Meyer, Thomas D; Soares, Jair C; Begley, Charles E

2016-11-01

Behavioral health-related emergency department (ED) visits have been linked with ED overcrowding, an increased demand on limited resources, and a longer length of stay (LOS) due in part to patients being admitted to the hospital but waiting for an inpatient bed. This study examines factors associated with the likelihood of hospital admission for ED patients with behavioral health conditions at 16 hospital-based EDs in a large urban area in the southern United States. Using Andersen's Behavioral Model of Health Service Use for guidance, the study examined the relationship between predisposing (characteristics of the individual, i.e., age, sex, race/ethnicity), enabling (system or structural factors affecting healthcare access), and need (clinical) factors and the likelihood of hospitalization following ED visits for behavioral health conditions (n = 28,716 ED visits). In the adjusted analysis, a logistic fixed-effects model with blockwise entry was used to estimate the relative importance of predisposing, enabling, and need variables added separately as blocks while controlling for variation in unobserved hospital-specific practices across hospitals and time in years. Significant predisposing factors associated with an increased likelihood of hospitalization following an ED visit included increasing age, while African American race was associated with a lower likelihood of hospitalization. Among enabling factors, arrival by emergency transport and a longer ED LOS were associated with a greater likelihood of hospitalization while being uninsured and the availability of community-based behavioral health services within 5 miles of the ED were associated with lower odds. Among need factors, having a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, dementia, or an impulse control disorder as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization

14. Interior, Machine Shop, Roundhouse Machine Shop Extension, Southern Pacific ...

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

14. Interior, Machine Shop, Roundhouse Machine Shop Extension, Southern Pacific Railroad Carlin Shops, view to north (90mm lens). - Southern Pacific Railroad, Carlin Shops, Roundhouse Machine Shop Extension, Foot of Sixth Street, Carlin, Elko County, NV

12. Interior, Blacksmith Shop, Roundhouse Machine Shop Extension, Southern Pacific ...

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

12. Interior, Blacksmith Shop, Roundhouse Machine Shop Extension, Southern Pacific Railroad Carlin Shops, view to northwest (90mm lens). - Southern Pacific Railroad, Carlin Shops, Roundhouse Machine Shop Extension, Foot of Sixth Street, Carlin, Elko County, NV

DETAILS, ENTRY AND ROOF VENT, SOUTHERN SECTION OF THE WEST ...

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

DETAILS, ENTRY AND ROOF VENT, SOUTHERN SECTION OF THE WEST (FRONT) FACADE, LOOKING NORTHEAST - Eglin Air Force Base, Storehouse & Company Administration, Southeast of Flager Road, Nassau Lane, & southern edge of Weekly Bayou, Valparaiso, Okaloosa County, FL

Pediatric tinea faciei in southern Spain: a 30-year survey.

PubMed

del Boz, Javier; Crespo, Vicente; de Troya, Magdalena

2012-01-01

Tinea faciei (TF) is a common clinical form of tinea in children that is frequently misdiagnosed and treated with corticosteroids. No large case series of TF focusing on children have been published. The aim of this study was to analyze the main epidemiologic, clinical, and microbiologic features of TF in children over a period of 30 years and compare these features with those of other tineas. We undertook a retrospective study of 818 cases of tinea in children at a referral hospital in southern Spain, diagnosed between 1977 and 2006, concentrating for this study on TF. Of the 73 cases of TF diagnosed, 50.7% were in girls. Most children (46.6%) were 4 to 9 years old. At the time of diagnosis, 29.2% of the cases had been treated with topical steroids. The most frequently isolated dermatophyte was Trichophyton mentagrophytes, which was isolated significantly more frequently in TF than in the other tineas. Cases of TF in children were not extremely unusual, emphasizing that TF must be considered in children with inflammatory facial eruptions. This consideration and the more-frequent use of mycologic tests can help achieve the correct diagnosis, when present. © 2011 Wiley Periodicals, Inc.

Hospital library foreign language labs: the experiences of two hospital libraries.

PubMed

Whelan, Julia S; Schneider, Elizabeth; Woodworth, Karl; Markwell, Linda Garr

2006-01-01

Increasingly, hospital-based physicians, residents, and medical students are welcoming into their care foreign-born patients, who do not speak English. Most hospitals today have an Interpretive Services Department, but many of the physicians, residents, and medical students want to become more proficient in the most frequently spoken foreign languages in their respective locales. To help recruit and retain a diverse workforce, some hospitals sponsor English programs for staff. The Treadwell Library at Massachusetts General Hospital in Boston, Massachusetts, and the Grady Branch Library at Grady Memorial Hospital in Atlanta, Georgia, have developed a special collection and hospital library-based language laboratories in order to meet this need.

Physician-Owned Surgical Hospitals Outperform Other Hospitals in Medicare Value-Based Purchasing Program.