Epidemiology and trend of common cancers in Iran (2004-2008).

Science.gov (United States)

Amori, N; Aghajani, M; Asgarian, F S; Jazayeri, M

2017-09-01

Cancer is one of the most important causes of mortality worldwide. It includes approximately 13% of death cases. This study aimed to investigate the incidence trend of common cancers in Iran during 2004-2008 to improve reporting distribution the disease. This was a retrospective study. The study population was all cases of cancer diagnosed in Iran during 2004-2008. The crude incidence rate of cancers was calculated per 100 000 people by age groups and sex. Age-standardised incidence rates (ASRs) were calculated using direct standardisation and the world standard population. Data were analysed using SPSS (version 17) and Microsoft Office Excel 2007. In this study, a total of 301 055 cases of cancer were diagnosed. ASRs were 60.51 and 84.51 in women and men respectively. Most common cancers in men were skin (ASR = 18.85), stomach (15.02), bladder (ASR = 11.25), prostate (ASR = 8.93) and colorectal (ASR = 8.29). Most common cancers in women were breast (ASR = 18.24), skin (ASR = 12.01), colorectal (ASR = 7.75), stomach (ASR = 7.05) and haematocyte (ASR = 4.01). A significant increase was observed in the incidence of cancers in the country. Therefore, it is necessary to perform screening, early diagnosis and treatment in early stages of cancers. © 2016 John Wiley & Sons Ltd.

Impacto de los subsidios a la investigación en la productividad científica : Argentina 2004-2008

OpenAIRE

Vázquez, Claudia

2015-01-01

El objetivo de este trabajo consiste en evaluar el impacto de un programa de subsidios a la investigación. En particular, se evalúan las convocatorias 2004 a 2008 de los Proyectos de Investigación Científica y Tecnológica (PICT), el principal instrumento de apoyo a la investigación científica dentro de la ANPCyT de Argentina. Siguiendo a la literatura, las variables de resultado se basan en indicadores bibliométricos construidos a partir de la base de datos SCOPUS. Se encuentra que el program...

Finansowanie leczenia lekami biologicznymi chorych na reumatoidalne i młodzieńcze idiopatyczne zapalenia stawów w ramach programów zdrowotnych NFZ w latach 2004–2008

Directory of Open Access Journals (Sweden)

Andrzej Śliwczyński

2010-02-01

Full Text Available Celem pracy była ocena realizacji obowiązujących w Polscew latach 2004–2008 programów leczenia lekami biologicznymichorych na reumatoidalne i młodzieńcze idiopatyczne zapaleniastawów. Leczenie jest prowadzone przez 81 ośrodków rozmieszczonychrównomiernie w całym kraju. W tym okresie leczonołącznie 8160 chorych. W 2008 r. leczonych było 2282 chorych, costanowi około 2% wszystkich chorych na reumatoidalne zapaleniestawów; 72% z nich stanowiły kobiety, najczęściej w wieku45–55 lat. Lekiem najczęściej stosowanym był etanercept, rzadziejinfliksymab, bardzo rzadko adalimumab i rituksymab. Pieniądzeprzeznaczane przez NFZ na ten rodzaj leczenia nie sąwykorzystywane w pełni, w 2008 r. nie wykorzystano 13,5%.W podsumowaniu podkreślono, że należy zwiększyć liczbę leczonychchorych poprzez poprawienie wykorzystania przeznaczanychnakładów, a następnie ich zwiększenie.

Environmental policy memorandum of the Dutch Ministry of Defence 2004; Defensie Milieubeleidsnota 2004

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-01-01

Starting point of the title memorandum is environmental sound operational management of the Ministry of Defence. In the memorandum 26 policy targets are formulated for the period 2004-2008 in the fields of climate and energy, noise, hazardous materials, environmental care, and biological diversity and nature. One of the projects concerns the participation in a wind turbine farm in the Dutch province Drenthe. [Dutch] Uitgangspunt van de nota is een milieuverantwoorde bedrijfsvoering. Na een grondige evaluatie van de Defensie Milieubeleidsnota (DMB) 2000 zijn in de DMB 2004 zo'n 26 doelstellingen geformuleerd tot en met het jaar 2008. De belangrijkste doelstellingen liggen op het gebied van klimaat en energie, geluid, gevaarlijke stoffen, afval, milieuzorg, en biodiversiteit en natuur. Een van de opvallendste projecten uit DMB 2004 is een windturbinepark in Drenthe. Defensie gaat daarbij deelnemen aan een provinciaal project op en naast het magazijnencomplex te Coevorden. Van acht a negen te plaatsen turbines, die elk 2 MegaWatt elektriciteit gaan opwekken, zal het ministerie van Defensie er zes voor zijn rekening nemen. Dat betekent een investering van ruim 19 miljoen euro. Deze investering wordt echter binnen tien jaar geheel terugverdiend. Het turbinepark past in de doelstelling dat bij Defensie, conform het Rijksbeleid, eind 2008 zo'n 75% van het elektriciteitsverbruik duurzaam wordt opgewekt.

Stabilization of overweight prevalence and improvement of dietary habits in French children between 2004 and 2008.

Science.gov (United States)

Carriere, Caroline; Langevin, Coralie; Déti, Eduoard Kossi; Barberger-Gateau, Pascale; Maurice, Sylvie; Thibault, Hélène

2015-07-01

The objective of the present study was to describe changes in overweight and obesity prevalence and eating habits among 7.5-10.5-year-old children in Aquitaine (France) between 2004 and 2008, and to assess how the programme 'Nutrition, Prevention and Health of children and teenagers in Aquitaine' implemented in 2004 may have impacted these changes. Two cross-sectional studies were conducted in two samples of children: the 'before programme' sample during the school year 2004/2005 and the 'after programme' sample during the school year 2008/2009. Settings Data were collected on gender, age, weight, height, area of residence (rural/urban) and socio-economic status of the school (non-low socio-economic/low socio-economic). Multivariate analyses were used to assess the effect of the regional programme intervention on the evolution of overweight and obesity prevalence and eating habits independently. The 'before programme' sample included 1836 children from 163 schools during the school year 2004/2005 and the 'after programme' sample included 3483 children from 210 schools during the school year 2008/2009. After adjustment of the model for age, residential area and socio-economic status of the area of residence, the prevalence of overweight including obesity (OR = 1.05; 95% CI 0.89, 1.23, P = 0.56) and of obesity (OR = 0.99; 95% CI 0.71, 1.39, P = 0.96) was found to have stabilized and eating habits had improved: intake of light afternoon meals had increased (OR = 1.38; 95% CI 1.13, 1.69, P = 0.002) while snacking in the morning (OR = 0.50; 95 % CI 0.45, 0.57, P eating habits in order to stabilize or decrease the prevalence of overweight.

DOE Solar Energy Technologies Program: FY 2004 Annual Report

Energy Technology Data Exchange (ETDEWEB)

2005-10-01

The DOE Solar Energy Technologies Program FY 2004 Annual Report chronicles the R&D results of the U.S. Department of Energy Solar Energy Technologies Program for Fiscal Year 2004. In particular, the report describes R&D performed by the Program's national laboratories (National Renewable Energy Laboratory, Sandia National Laboratories, Oak Ridge National Laboratory, and Brookhaven National Laboratory) and university and industry partners.

Learning from research on the information behaviour of healthcare professionals: a review of the literature 2004-2008 with a focus on emotion.

Science.gov (United States)

Fourie, Ina

2009-09-01

A review, focusing on emotion, was conducted of reported studies on the information behaviour of healthcare professionals (2004-2008). Findings were intended to offer guidelines on information services and information literacy training, to note gaps in research and to raise research interest. Databases were searched for literature published from January 2004 to December 2008 and indexed on eric, Library and Information Science Abstracts, medline, PsycINFO, Social Services Abstracts, Sociological Abstracts, Health Source: Nursing/Academic Edition; Library, Information Science & Technology Abstracts; Psychology and Behavioral Sciences Collection; Social Work Abstracts; SocINDEX with Full Text; SPORTDiscus; cinhal; and the ISI Web of Knowledge databases. Key journals were manually scanned and citations followed. Literature was included if reporting on issues concerning emotion. Emotion in information behaviour in healthcare contexts is scantily addressed. This review, however, offers some insight into the difficulty in identifying and expressing information needs; sense making and the need to fill knowledge gaps; uncertainty; personality and coping skills; motivation to seeking information; emotional experiences during information seeking; self-confidence and attitude; emotional factors in the selection of information channels; and seeking information for psychological or emotional reasons. Suggestions following findings, address information literacy programs, information services and research gaps.

Trailing (L5) Neptune Trojans: 2004 KV18 and 2008 LC18

International Nuclear Information System (INIS)

Guan Pu; Zhou Liyong; Li Jian

2012-01-01

The population of Neptune Trojans is believed to be bigger than that of Jupiter Trojans and that of asteroids in the main belt, although only eight members of this distant asteroid swarm have been observed up to now. Six leading Neptune Trojans around the Lagrange point L 4 discovered earlier have been studied in detail, but two trailing ones found recently around the L 5 point, 2004 KV18 and 2008 LC18, have not yet been investigated. We report our investigations on the dynamical behaviors of these two new Neptune Trojans. Our calculations show that the asteroid 2004 KV18 is a temporary Neptune Trojan. Most probably, it was captured into the trailing Trojan cloud no earlier than 2.03 × 10 5 yr ago, and it will not maintain this position later than 1.65 × 10 5 yr in the future. Based on the statistics from our orbital simulations, we argue that this object is more like a scattered Kuiper belt object. By contrast, the orbit of 2008 LC18 is much more stable. Among the clone orbits spreading within the orbital uncertainties, a considerable portion of clones may survive on the L 5 tadpole orbits for 4 Gyr. The strong dependence of the stability on the semimajor axis and resonant angle suggests that further observations are badly required to constrain the orbit in the stable region. We also discuss the implications of the existence and dynamics of these two trailing Trojans over the history of the solar system.

Evaluating the McDonald’s business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004–2010

Science.gov (United States)

Rao, Vasudha Tirumalasetti; Mahapatra, Bidhubhusan; Juneja, Sachin; Singh, Indra R

2013-01-01

Background This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV) prevention intervention for long-distance truck drivers operating on the national highways of India. Methods The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald’s business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004–2010) and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402) and July 2009 (n = 1407). Results The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P business model for HIV prevention helped to increase program coverage and service utilization among long-distance truckers. Implementing HIV prevention programs in a highly mobile population such as truckers, in a limited number of high-impact locations, supported by branding of services, could help in saturating coverage and optimum utilization of available resources. PMID:23439724

CHARACTERIZATION OF SUICIDE IN ARMENIA, COLOMBIA, 2004 – 2008

Directory of Open Access Journals (Sweden)

Oscar Medina Pérez

2010-04-01

Full Text Available This paper describes trends in mortality from suicide and its main features in the city of Armenia, Colombia, in the period 2004-2008. The suicide figures have been provided by the National Institute of Legal Medicine and Forensic Sciences and population projections are taken from the National Bureau of Statistics (DANE. The results indicate a municipal rate of 8.2 for the five years, falling 64% higher than the rest of the country. A total of 116 suicides were reported during the study period, in the distribution by sex and age groups, the highest rates were found in men aged 70-79 years, with 31.5 cases/100.000 hab.; In female population figure corresponded to the range of 10-19 years, with a rate of 8.6. In general, rates are high compared with other  parts of Colombia. It further identifies the urgency of this public health problem locally, closely related to social factors.

Finnish Media Literacy Education Policies and Best Practices in Early Childhood Education and Care since 2004

Science.gov (United States)

Rantala, Leena

2011-01-01

The purpose of the article is to describe Finnish media literacy policies and good media education practices in early childhood education and care. This article will focus on describing two central action lines related to the Children and Media Program, initiated by the Division for Cultural Policy of the Ministry of Education and Culture in 2004.…

Ectopic pregnancy morbidity and mortality in low-income women, 2004-2008.

Science.gov (United States)

Stulberg, D B; Cain, L; Dahlquist, I H; Lauderdale, D S

2016-03-01

Does the risk of adverse outcomes at the time of ectopic pregnancy vary by race/ethnicity among women receiving Medicaid, the public health insurance program for low-income people in the USA? Among Medicaid beneficiaries with ectopic pregnancy, 11% experienced at least one complication, and women from all racial/ethnic minority groups were significantly more likely than whites to experience complications. In this population of Medicaid recipients, African American women are significantly more likely than whites to experience ectopic pregnancy, but the risk of adverse outcomes has not previously been assessed. We conducted a cross-sectional observational study of all women (n = 19 135 106) ages 15-44 enrolled in Medicaid for any amount of time during 2004-2008 who lived in one of the following 14 US states: Arizona; California; Colorado; Florida; Illinois; Indiana; Iowa; Louisiana; Massachusetts; Michigan; Minnesota; Mississippi; New York; and Texas. We analyzed Medicaid claims records for inpatient and outpatient encounters and identified ectopic pregnancies with a principal diagnosis code for ectopic pregnancy from 2004-2008. We calculated the ectopic pregnancy complication rate as the number of ectopic pregnancies with at least one complication (blood transfusion, hysterectomy, any sterilization, or length-of-stay (LOS) > 2 days) divided by the total number of ectopic pregnancies. We used Poisson regression to assess the risk of ectopic pregnancy complication by race/ethnicity. Secondary outcomes were each individual complication, and ectopic pregnancy-related death. We calculated the ectopic pregnancy mortality ratio as the number of deaths divided by live births. Ectopic pregnancy-associated complications occurred in 11% of cases. Controlling for age and state, the risk of any complication was significantly higher among women who were black (incidence risk ratio [IRR] 1.47, 95% CI 1.43-1.53, P American Indian/Alaskan Native (IRR 1.34 95% CI 1.16-1.55, P white

DOE Hydrogen Program 2004 Annual Merit Review and Peer Evaluation Report

Energy Technology Data Exchange (ETDEWEB)

2004-10-01

This document summarizes the project evaluations and comments from the DOE Hydrogen Program 2004 Annual Program Review. Hydrogen production, delivery and storage; fuel cells; technology validation; safety, codes and standards; and education R&D projects funded by DOE in FY2004 are reviewed.

Evolução das principais linhas de crédito ao exportador brasileiro entre 2004 e 2008

Directory of Open Access Journals (Sweden)

Julio Cesar de Oliveira

2010-01-01

Full Text Available Este trabalho analisa a evolução das duas principais linhas de crédito aos exportadores brasileiros no período entre 2004 e 2008. Inicialmente descrevem-se as linhas de financiamento estudadas, apresentando suas características, restrições e trâmites para obtenção. Os resultados demonstram que, nos últimos cinco anos, as duas principais linhas de crédito não acompanharam o percentual de aumento das exportações brasileiras.Abstract This work analyzes the evolution of the two main credit lines to Brazilian exporters between 2004 and 2008. Initially, it describes the credit lines that were studied, showing its features, restrictions and the necessary procedures for a trader in order to obtain it. The results show that, in the last five years, these credit lines have not accompanied the Brazilian export growth.

Perceived discrimination, psychological distress, and current smoking status: results from the Behavioral Risk Factor Surveillance System Reactions to Race module, 2004-2008.

Science.gov (United States)

Purnell, Jason Q; Peppone, Luke J; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J; Carroll, Jennifer K; Shacham, Enbal; Morrow, Gary R

2012-05-01

We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination-smoking association. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment.

Building Technologies Program Multi-Year Program Plan Research and Development 2008

Energy Technology Data Exchange (ETDEWEB)

None, None

2008-01-01

Building Technologies Program Multi-Year Program Plan 2008 for research and development, including residential and commercial integration, lighting, HVAC and water heating, envelope, windows, and analysis tools.

15 CFR 2008.16 - Security education program.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Security education program. 2008.16 Section 2008.16 Commerce and Foreign Trade Regulations Relating to Foreign Trade Agreements OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE REGULATIONS TO IMPLEMENT E.O. 12065; OFFICE OF THE UNITED STATES TRADE...

Identification of land cover changes in the coastal area of Dakshina Kannada district, South India during the year 2004–2008

Directory of Open Access Journals (Sweden)

J. Jayanth

2016-06-01

Full Text Available This study investigates land cover (LC changes in the coastal area of Dakshina Kannada district in the state of Karnataka, South India, during the years 2004–2008 as a case study. IRS P-6, Linear Imaging Self Scanning sensor (LISS-IV satellite images were used in the present work. Classification was carried out using artificial bee colony algorithm and support vector machine (SVM which gave a better result compared to other traditional classification techniques. The best overall classification accuracy for the study area was achieved with an ABC classifier with an OCA of 80.35% for 2004 year data and OCA of 80.40% for 2008 year data, whereas the OCA in SVM, for the same training set is 71.42% for 2004 data and 71.38% for 2008 data on study area 1 and the results were optimised with respect to multispectral data. In study area 2, ABC algorithm achieved an OCA of 78.17% and MLC of 62.63% which was used to check the universality of the classifier. The classification results with post-classification technique for study area 1 indicate that urbanisation in the study area has almost increased twice. During the same time there is an increase in the forest plantation, agricultural plantation and a decrease in crop land and land without scrubs, indicates rapid changes in the coastal environment.

Serial Assessment of Trauma Care Capacity in Ghana in 2004 and 2014.

Science.gov (United States)

Stewart, Barclay T; Quansah, Robert; Gyedu, Adam; Boakye, Godfred; Abantanga, Francis; Ankomah, James; Donkor, Peter; Mock, Charles

2016-02-01

Trauma care capacity assessments in developing countries have generated evidence to support advocacy, detailed baseline capabilities, and informed targeted interventions. However, serial assessments to determine the effect of capacity improvements or changes over time have rarely been performed. To compare the availability of trauma care resources in Ghana between 2004 and 2014 to assess the effects of a decade of change in the trauma care landscape and derive recommendations for improvements. Capacity assessments were performed using direct inspection and structured interviews derived from the World Health Organization's Guidelines for Essential Trauma Care. In Ghana, 10 hospitals in 2004 and 32 hospitals in 2014 were purposively sampled to represent those most likely to care for injuries. Clinical staff, administrators, logistic/procurement officers, and technicians/biomedical engineers who interacted, directly or indirectly, with trauma care resources were interviewed at each hospital. Availability of items for trauma care was rated from 0 (complete absence) to 3 (fully available). Factors contributing to deficiency in 2014 were determined for items rated lower than 3. Each item rated lower than 3 at a specific hospital was defined as a hospital-item deficiency. Scores for total number of hospital-item deficiencies were derived for each contributing factor. There were significant improvements in mean ratings for trauma care resources: district-level (smaller) hospitals had a mean rating of 0.8 for all items in 2004 vs 1.3 in 2014 (P = .002); regional (larger) hospitals had a mean rating of 1.1 in 2004 vs 1.4 in 2014 (P = .01). However, a number of critical deficiencies remain (eg, chest tubes, diagnostics, and orthopedic and neurosurgical care; mean ratings ≤ 2). Leading contributing factors were item absence (503 hospital-item deficiencies), lack of training (335 hospital-item deficiencies), and stockout of consumables (137 hospital-item deficiencies

Perceived Discrimination, Psychological Distress, and Current Smoking Status: Results From the Behavioral Risk Factor Surveillance System Reactions to Race Module, 2004–2008

Science.gov (United States)

Peppone, Luke J.; Alcaraz, Kassandra; McQueen, Amy; Guido, Joseph J.; Carroll, Jennifer K.; Shacham, Enbal; Morrow, Gary R.

2012-01-01

Objectives. We examined the association between perceived discrimination and smoking status and whether psychological distress mediated this relationship in a large, multiethnic sample. Methods. We used 2004 through 2008 data from the Behavioral Risk Factor Surveillance System Reactions to Race module to conduct multivariate logistic regression analyses and tests of mediation examining associations between perceived discrimination in health care and workplace settings, psychological distress, and current smoking status. Results. Regardless of race/ethnicity, perceived discrimination was associated with increased odds of current smoking. Psychological distress was also a significant mediator of the discrimination–smoking association. Conclusions. Our results indicate that individuals who report discriminatory treatment in multiple domains may be more likely to smoke, in part, because of the psychological distress associated with such treatment. PMID:22420821

Evaluating the McDonald's business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004-2010.

Science.gov (United States)

Rao, Vasudha Tirumalasetti; Mahapatra, Bidhubhusan; Juneja, Sachin; Singh, Indra R

2013-01-01

This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV) prevention intervention for long-distance truck drivers operating on the national highways of India. The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald's business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004-2010) and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402) and July 2009 (n = 1407). The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P < 0.001). A significant increase was also observed in the percentage of truckers who watched street plays (10% to 56%, P < 0.001), and participated in health exhibitions (6% to 35%, P < 0.001). Furthermore, an increase from round 1 to round 2 was observed in the percentage who received condoms (13% to 22%, P < 0.001), and attended one-one counseling (15% to 21%, P < 0.01). Treatment-seeking from program clinics for symptoms related to sexually transmitted infections increased six-fold during this period (16% versus 50%, P < 0.001). Adoption of a business model for HIV prevention helped to increase program coverage and service utilization among long-distance truckers. Implementing HIV prevention programs in a highly mobile population such as truckers, in a limited number of high-impact locations, supported by branding of

Waste statistics 2004

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-04-07

The 2004 reporting to the ISAG comprises 394 plants owned by 256 enterprises. In 2003, reports covered 403 plants owned by 273 enterprises. Waste generation in 2004 is compared to targets for 2008 in the government's Waste Strategy 2005-2008. The following summarises waste generation in 2004: 1) In 2004, total reported waste arisings amounted to 13,359,000 tonnes, which is 745,000 tonnes, or 6 per cent, more than in 2003. 2) If amounts of residues from coal-fired power plants are excluded from statistics, waste arisings in 2004 were 12,179,000 tonnes, which is a 9 per cent increase from 2003. 3) If amounts of residues from coal-fired power plants and waste from the building and construction sector are excluded from statistics, total waste generation in 2004 amounted to 7,684,000 tonnes, which is 328,000 tonnes, or 4 per cent, more than in 2002. In other words, there has been an increase in total waste arisings, if residues and waste from building and construction are excluded. Waste from the building and construction sector is more sensitive to economic change than most other waste. 4) The total rate of recycling was 65 per cent. The 2008 target for recycling is 65 per cent. The rate of recycling in 2003 was also 65 per cent. 5) The total amount of waste led to incineration amounted to 26 per cent, plus an additional 1 per cent left in temporary storage to be incinerated at a later time. The 2008 target for incineration is 26 per cent. These are the same percentage figures as applied to incineration and storage in 2003. 6) The total amount of waste led to landfills amounted to 8 per cent, which is one percentage point better than the overall landfill target of a maximum of 9 per cent landfilling in 2008. Also in 2003, 8 per cent of the waste was landfilled. 7) The targets for treatment of waste from individual sectors are still not being met: too little waste from households and the service sector is being recycled, and too much waste from industry is being

78 FR 7387 - Continuation of 2008 Farm Bill-Dairy Forward Pricing Program

Science.gov (United States)

2013-02-01

...] Continuation of 2008 Farm Bill--Dairy Forward Pricing Program AGENCY: Agricultural Marketing Service, USDA... the Dairy Forward Pricing Program contained in the Food, Conservation and Energy Act of 2008 (the 2008... associations of producers may enter into forward price contracts under the Dairy Forward Pricing Program...

Health risks and travel preparation among foreign visitors and expatriates during the 2008 Beijing Olympic and Paralympic Games.

Science.gov (United States)

Jentes, Emily S; Davis, Xiaohong M; Macdonald, Susan; Snyman, P Johann; Nelson, Hugh; Quarry, Doug; Lai, Irene; van Vliet, Erik W N; Balaban, Victor; Marano, Cinzia; Mues, Katherine; Kozarsky, Phyllis; Marano, Nina

2010-03-01

During the 2008 Olympic and Paralympic Games, we conducted surveillance of illnesses among travelers at six Beijing clinics. Surveys asked about demographic, pre-travel, and vaccination information, and physician-provided diagnoses. Of 807 respondents, 38% and 57% were classified as foreign visitors (FV) and expatriates, respectively. Less than one-half of FV sought pre-travel advice; sources included health-care providers and friends/family. FV vaccination rate was also low; however, most vaccines given were recommended by the Centers for Disease Control and Prevention. The most common FV diagnoses were respiratory, injury/musculoskeletal, and gastrointestinal illnesses; for expatriates, injury/musculoskeletal, respiratory, and dermatologic were the most common illnesses. Respiratory illnesses in expatriates were significantly less in 2008 than during 2004-2007 (chi(2) = 10.2; P = 0.0014), suggesting that control programs may have reduced pollutants/respiratory irritants during the 2008 Games. We found no previous studies of health outcomes among expatriates living in cities with mass travel events. These findings highlight the need to continuously disseminate information to health-care providers advising travelers.

Agrarian foreign trade of the Czech Republic in the period of 2004–2008, competitiveness of commodities

Directory of Open Access Journals (Sweden)

Jaroslava Burianová

2011-01-01

Full Text Available The paper deals with agrarian foreign trade (AFT of the Czech Republic during the period of 2004–2008. Distinct changes in the trade volume, but also changes in the net export structure were observed. The export is being assisted with a much larger trading area without customs restrictions but it is also exposed to a much tougher competition. A methodology that makes it possible to evaluate the competitiveness of individual commodities is described in the first part. A sequence of individual items from a total list of basic food goods was analyzed using chosen indicators – Balass indicator RCA (Revealed Comparative Advantage as well as the Michaely index MI that shows a specific degree of specialization for export. In the Results section, attention is firstly focused on the year 2004. The values of export and import for 24 items of basic food commodities are summarised, and the most important items in respect of the share in total export are selected. Analogical output was acquired for the year 2008. The values of RCA and MI indicators are then itemised, and a sequence is determined for the highest values for the commodities able to compete that shows the specific degree of specialization for export.

Quality of groundwater at and near an aquifer storage and recovery site, Bexar, Atascosa, and Wilson Counties, Texas, June 2004-August 2008

Science.gov (United States)

Otero, Cassi L.; Petri, Brian L.

2010-01-01

recovery wells likely indicate some degree of mixing of the two waters occurred rather than continued decay of radium-226 in the injected water. Geochemical and isotope data measured in samples collected in May 2005 from two Carrizo aquifer monitoring wells and in July 2008 from the three ASR production-only wells in the northern section of the ASR site indicate that injected Edwards aquifer water had not migrated to these five sites. Geochemical and isotope data measured in samples collected from Carrizo aquifer wells in 2004, 2005, and 2008 were graphically analyzed to determine if changes in chemistry could be detected. Major-ion, trace element, and isotope chemistry varied spatially in the samples collected from the Carrizo aquifer. With the exception of a few samples, major-ion concentrations measured in samples collected in Carrizo aquifer wells in 2004, 2005, and 2008 were similar. A slightly larger sulfate con-centration and a slightly smaller bicarbonate concentration were measured in samples collected in 2005 and 2008 from well NC1 compared to samples collected at well NC1 in 2004. Larger sodium concentrations and smaller calcium, magnesium, bicarbonate, and sulfate concentrations were measured in samples collected in 2008 from well WC1 than in samples collected at this well in 2004 and 2005. Larger calcium and magnesium concentrations and a smaller sodium concentration were measured in the samples collected in 2008 at well EC2 compared to samples collected at this well in 2004 and 2005. While in some cases the computed percent differences (compared to concentrations from June 2004) in dissolved iron and dissolved manganese concentrations in 11 wells sampled in the Carrizo aquifer in 2005 and 2008 were quite large, no trends that might have been caused by migration of injected Edwards aquifer water were observed. Because of the natural variation in geochemical data in the Carrizo aquifer and the small data set collected for this study, differences in major

ORNLs Laboratory Directed Research and Development Program FY 2008 Annual Report

Energy Technology Data Exchange (ETDEWEB)

None, None

2009-03-01

The Oak Ridge National Laboratory (ORNL) Laboratory Directed Research and Development (LDRD) Program reports its status to the U.S. Department of Energy (DOE) in March of each year. The program operates under the authority of DOE Order 413.2B, “Laboratory Directed Research and Development” (April 19, 2006), which establishes DOE’s requirements for the program while providing the Laboratory Director broad flexibility for program implementation. LDRD funds are obtained through a charge to all Laboratory programs. This report includes summaries all ORNL LDRD research activities supported during FY 2008. The associated FY 2008 ORNL LDRD Self-Assessment (ORNL/PPA-2008/2) provides financial data and an internal evaluation of the program’s management process.

Results of the 2008/2009 Knowledge and Opinions Surveys Conducted for the U.S. Department of Energy Hydrogen Program

Energy Technology Data Exchange (ETDEWEB)

Schmoyer, R. L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Truett, Tykey [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Cooper, Christy [Dept. of Energy (DOE), Washington DC (United States); Chew, Andrea [Dept. of Energy (DOE), Washington DC (United States)

2010-04-01

This report presents results of a 2008/2009 survey of hydrogen and fuel cell awareness conducted for the U.S. Department of Energy (DOE). The 2008/2009 survey follows up on a similar DOE survey conducted in 2004, measuring levels of awareness and understanding of hydrogen and fuel cell technologies in four populations: (1) the general public, (2) students, (3) personnel in state and local governments, and (4) potential end users of hydrogen and fuel cell technologies in business and industry. The 2008/2009 survey includes these four groups and adds a fifth group, safety and code officials. The same survey methods were used for both surveys; the 2008/2009 survey report includes a comparison of 2004 and 2008/2009 findings. Information from these surveys will be used to enhance hydrogen and fuel cell education strategies.

Improving immediate newborn care practices in Philippine hospitals: impact of a national quality of care initiative 2008-2015.

Science.gov (United States)

Silvestre, Maria Asuncion A; Mannava, Priya; Corsino, Marie Ann; Capili, Donna S; Calibo, Anthony P; Tan, Cynthia Fernandez; Murray, John C S; Kitong, Jacqueline; Sobel, Howard L

2018-03-31

To determine whether intrapartum and newborn care practices improved in 11 large hospitals between 2008 and 2015. Secondary data analysis of observational assessments conducted in 11 hospitals in 2008 and 2015. Eleven large government hospitals from five regions in the Philippines. One hundred and seven randomly sampled postpartum mother-baby pairs in 2008 and 106 randomly sampled postpartum mothers prior to discharge from hospitals after delivery. A national initiative to improve quality of newborn care starting in 2009 through development of a standard package of intrapartum and newborn care services, practice-based training, formation of multidisciplinary hospital working groups, and regular assessments and meetings in hospitals to identify actions to improve practices, policies and environments. Quality improvement was supported by policy development, health financing packages, health facility standards, capacity building and health communication. Sixteen intrapartum and newborn care practices. Between 2008 and 2015, initiation of drying within 5 s of birth, delayed cord clamping, dry cord care, uninterrupted skin-to-skin contact, timing and duration of the initial breastfeed, and bathing deferred until 6 h after birth all vastly improved (P<0.001). The proportion of newborns receiving hygienic cord handling and the hepatitis B birth dose decreased by 11-12%. Except for reduced induction of labor, inappropriate maternal care practices persisted. Newborn care practices have vastly improved through an approach focused on improving hospital policies, environments and health worker practices. Maternal care practices remain outdated largely due to the ineffective didactic training approaches adopted for maternal care.

75 FR 54028 - Technical Revisions To Conform With the Veterans' Mental Health Care Act of 2008 and Other Laws

Science.gov (United States)

2010-09-03

...,'' authorizing VA to exercise discretion to provide certain mental health services, counseling, and training for... Health and Medical Program of the Department of Veterans Affairs, which provides health benefits for... the Veterans' Mental Health Care Act of 2008 and Other Laws AGENCY: Department of Veterans Affairs...

Building Technologies Program Multi-Year Program Plan Technology Validation and Market Introduction 2008

Energy Technology Data Exchange (ETDEWEB)

None, None

2008-01-01

Building Technologies Program Multi-Year Program Plan 2008 for technology validation and market introduction, including ENERGY STAR, building energy codes, technology transfer application centers, commercial lighting initiative, EnergySmart Schools, EnergySmar

Medicaid and Children's Health Insurance Programs; Mental Health Parity and Addiction Equity Act of 2008; the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations, the Children's Health Insurance Program (CHIP), and Alternative Benefit Plans. Final rule.

Science.gov (United States)

2016-03-30

This final rule will address the application of certain requirements set forth in the Public Health Service Act, as amended by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, to coverage offered by Medicaid managed care organizations, Medicaid Alternative Benefit Plans, and Children’s Health Insurance Programs.

Trends in Utility Green Pricing Programs (2004)

Energy Technology Data Exchange (ETDEWEB)

Bird, L.; Brown, E.

2005-10-01

In the early 1990s, only a handful of utilities offered their customers a choice of purchasing electricity generated from renewable energy sources. Today, nearly 600 utilities in regulated electricity markets--or almost 20% of all utilities nationally--provide their customers a "green power" option. Because some utilities offer programs in conjunction with cooperative associations or other publicly owned power entities, the number of distinct programs totals about 125. Through these programs, more than 40 million customers spanning 34 states have the ability to purchase renewable energy to meet some portion or all of their electricity needs--or make contributions to support the development of renewable energy resources. Typically, customers pay a premium above standard electricity rates for this service. This report presents year-end 2004 data on utility green pricing programs, and examines trends in consumer response and program implementation over time. The data in this report, which were obtained via a questionnaire distributed to utility green pricing program managers, can be used by utilities as benchmarks by which to gauge the success of their green power programs.

2008 DOE Hydrogen Program Annual Merit Review and Peer Evaluation Report

Energy Technology Data Exchange (ETDEWEB)

none,

2008-06-13

This report summarizes comments from the Peer Review Panel at the 2008 DOE Hydrogen Program Annual Merit Review, held on June 9-13, 2008, in Arlington, Virginia. It covers the program areas of hydrogen production and delivery; hydrogen storage; fuel cells; technology validation; safety, codes, and standards; education; systems analysis; and manufacturing.

INL Advanced Radiotherapy Research Program Annual Report 2004

Energy Technology Data Exchange (ETDEWEB)

James Venhuizen

2005-06-01

This report summarizes the activities and major accomplishments for the Idaho National Laboratory Advanced Radiotherapy Research Program for calendar year 2004. Topics covered include boron analysis in biological samples, computational dosimetry and treatment planning software development, medical neutron source development and characterization, and collaborative dosimetry studies at the RA-1 facility in Buenos Aires, Argentina.

Compendium of student papers : 2008 Undergraduate Transportation Scholars Program.

Science.gov (United States)

2008-08-01

This report is a compilation of research papers written by students participating in the 2008 Undergraduate : Transportation Scholars Program. The ten-week summer program, now in its eighteenth year, provides : undergraduate students in Civil Enginee...

GAMBARAN DISTRIBUSI RABIES DI KABUPATEN SIKKA PROVINSI NUSA TENGGARA TIMUR 2004-2008

Directory of Open Access Journals (Sweden)

Fridolina Mau

2013-09-01

Full Text Available AbstractRabies has long been known as one of the major public healht problems in Sikka district, East Nusa Tenggara Province,Indonesia. Flores is an isolated preveiously rabies- free. It started with the importation of three dogs from rabies endemicSulawesi in September 1997. The rabies virus is present in the saliva of infected animals; all warm-blooded animals aresusceptible to rabies, and some may serve as natural reservoirs of the virus. Rabies is still a problem for world healthincluding Indonesia. Data of deathcase of rabies (lyssa in Indonesia register 125 cases each year. Rabies in Indonesia is aserious health problem because almost fatal after clinical symptom of the disease with death rate of 100%. Since 2004 toDecember 2009 rabies spread to 24 provinces in East Nusa Tenggara Province. Number of cases due to bite of a mad dogwas 16.000 cases. The aim of this study is to know distribution of rabies casse and the main control measures isimmunizing dogs. Tipe of this study is cross sectional. The result of this study showed the improvement in the last five years(2004 until August 2008 of the occurences of dog bite in cases and human deaths highest in 128 cases (32,48% incommunity health centers Waipare and population dog highest in Kewapante subdistrict 7213 (26,27% although thecoverage of immunization was very low that was 2523 (10,77% out of 6210 population. In average the dog bite casesoccurred in April.Key Word; Description, Distribution, Rabies

Patient evaluation of infertility management in an ISO 9001:2008-certified centre for reproductive medicine.

Science.gov (United States)

Van den Broeck, Uschi; Spiessens, Carl; Dancet, Eline; Bakelants, Els; Vrancken, Annelies; Demyttenaere, Koen; Enzlin, Paul; D'Hooghe, Thomas

2012-03-01

Quality management according to ISO 9001:2008 guidelines includes infertility care quality assessment and improvement. This study aimed to describe the development process of a questionnaire for infertility management. A literature review, qualitative interviews with experts and patients resulted in a content-valid and face-valid questionnaire. Three cross-sectional surveys were performed in 2004, 2007 and 2008 in a tertiary university infertility centre. First (2004), the questionnaire – measuring eight a-priori dimensions of infertility management – was tested. Second (2007), improvement projects for infertility management were evaluated. Third (2008), factor analysis was performed and internal consistency was documented. The developed patient questionnaire to evaluate infertility management and pre-set desired levels of agreement served to set targets for and assess quality improvement projects. The final patient questionnaire to evaluate infertility management within an ISO framework was valid and reliable and contained 14 items covering four dimensions of infertility management: Telephone Access, Reception, Information and Patient-centeredness. ISO 9001:2008-certified infertility centres can evaluate infertility management with this 14-item questionnaire. This top-down approach to evaluate the patients’ perspective on quality aspects selected by health professionals can be complementary to the bottom-up approach evaluating the patients’ complete experiences of quality of care.

2008 Federal Energy Management Program (FEMP) Market Report

Energy Technology Data Exchange (ETDEWEB)

Tremper, C.

2009-07-01

This report assesses the market for Federal Energy Management Program (FEMP) services as it existed in FY 2008. It discusses Federal energy management goal progress in FY 2008, and examines the environment in which agencies implemented energy management projects over the last three years. The report also discusses some recent events that will increase the market for FEMP services, and outlines FEMP's major strategies to address these changes in FY 2009 and beyond.

Ecological Monitoring and Compliance Program Fiscal/Calendar Year 2004 Report

Energy Technology Data Exchange (ETDEWEB)

Bechtel Nevada

2005-03-01

The Ecological Monitoring and Compliance program, funded through the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, monitors the ecosystem of the Nevada Test Site and ensures compliance with laws and regulations pertaining to Nevada Test Site biota. This report summarizes the program's activities conducted by Bechtel Nevada during the Fiscal Year 2004 and the additional months of October, November, and December 2004, reflecting a change in the monitoring period to a calendar year rather than a fiscal year as reported in the past. This change in the monitoring period was made to better accommodate information required for the Nevada Test Site Environmental Report, which reports on a calendar year rather than a fiscal year. Program activities included: (1) biological surveys at proposed construction sites, (2) desert tortoise compliance, (3) ecosystem mapping and data management, (4) sensitive species and unique habitat monitoring, (5) habitat restoration monitoring, and (6) biological monitoring at the Hazardous Materials Spill Center.

The 2004–2008 dome-building eruption at Mount St. Helens, Washington: Epilogue

Science.gov (United States)

Dzurisin, Daniel; Moran, Seth C.; Lisowski, Michael; Schilling, Steve P.; Anderson, Kyle R.; Werner, Cynthia A.

2015-01-01

The 2004–2008 dome-building eruption at Mount St. Helens ended during winter 2007–2008 at a time when field observations were hampered by persistent bad weather. As a result, recognizing the end of the eruption was challenging—but important for scientists trying to understand how and why long-lived eruptions end and for public officials and land managers responsible for hazards mitigation and access restrictions. In hindsight, the end of the eruption was presaged by a slight increase in seismicity in December 2007 that culminated on January 12–13, 2008, with a burst of more than 500 events, most of which occurred in association with several tremor-like signals and a spasmodic burst of long-period earthquakes. At about the same time, a series of regular, localized, small-amplitude tilt events—thousands of which had been recorded during earlier phases of the eruption—came to an end. Thereafter, seismicity declined to 10–20 events per day until January 27–28, when a spasmodic burst of about 50 volcano-tectonic earthquakes occurred over a span of 3 h. This was followed by a brief return of repetitive “drumbeat” earthquakes that characterized much of the eruption. By January 31, however, seismicity had declined to 1–2 earthquakes per day, a rate similar to pre-eruption levels. We attribute the tilt and seismic observations to convulsive stagnation of a semisolid magma plug in the upper part of the conduit. The upward movement of the plug ceased when the excess driving pressure, which had gradually decreased throughout the eruption as a result of reservoir deflation and increasing overburden from the growing dome, was overcome by increasing friction as a result of cooling and crystallization of the plug.

Tuberculosis pediátrica en un hospital de referencia durante el período 2004-2008 Pediatric tuberculosis at a reference hospital during the 2004-2008 period

Directory of Open Access Journals (Sweden)

Mónica G. Rodríguez

2011-03-01

and cared for at Hospital Piñero during the 2004-2008 period were analyzed according to epidemiological and clinical criteria. The bacteriological contribution was evaluated to confirm the disease diagnosis. A descriptive retrospective analysis of the cases was done. A total of 8409 samples were received for mycobacterial culture: 1542 (18% of which were pediatric and distributed as follows: 1407 (91%, pulmonary and 135 (9%, extra-pulmonary. The sample examination included staining for acid-fast bacilli, culture, identification and drug susceptibility testing. The following are the results of analized demographic variables: Nationality: 1218 Argentinean (79%, 247 foreigners (16% and 77, not disclosed (5%; Gender: 787 female (51% and 755 male (49%. Patients were grouped according to age into: Group A, 0 to 4 years 674 (45%; Group B, 5-9 years 354 (24% and Group C, 10-15 years 464 (31%. Morbidity causes associated with the disease were mainly malnutrition and infection by Human Immunodeficiency Virus. Staining for acid-fast bacilli was positive in 41 samples (2.6% and 84 cultures resulted positive (5.4%, 78 (93% of which were pulmonary and 6 (7% extra-pulmonary samples. All the strains were identified as Mycobacterium tuberculosis. Isolates were susceptible to streptomycin, isoniazid, rifampicin, and ethambutol, except for one strain that was resistant both to ethambutol and streptomycin, and another one which was resistant to isoniazid. Bacteriological confirmation of pediatric tuberculosisis is rarely achieved due to the predominantly paucibacillary nature of the disease in children (5% in our study, but plays a fundamental role in diagnosis accuracy, allowing the identification and susceptibility testing of the strain.

NNSA Nonproliferation Graduate Fellowship Program Annual Report June 2008 - May 2009

Energy Technology Data Exchange (ETDEWEB)

Berkman, Clarissa O.; Fankhauser, Jana G.

2010-03-01

In 2009, the Nonproliferation Graduate Fellowship Program (NGFP) completed its 16th successful year in support of the NNSA’s mission by developing future leaders in nonproliferation and promoting awareness of career opportunities. We provide this annual report to review program activities from June 2008 through May 2009 - the fellowship term for the Class of 2008. Contents include: Welcome Letter Introduction The NGFP Team Program Management Highlights Class of 2008 Incoming Fellows Orientation Travel Career Development Management of the Fellows Performance Highlights Closing Ceremony Encore Performance Where They Are Now Alumnus Career Highlights: Christine Buzzard Class of 2009 Applicant Database Upgrades Fall Recruitment Activities Interviews Hiring and Clearances Introducing the Class of 2009 Class of 2010 Recruitment Strategy On the Horizon Appendix A: Class of 2009 Fellows

Evaluating the McDonald's business model for HIV prevention among truckers to improve program coverage and service utilization in India, 2004–2010

Directory of Open Access Journals (Sweden)

Tirumalasetti Rao V

2013-02-01

Full Text Available Vasudha Tirumalasetti Rao,1 Bidhubhusan Mahapatra,2 Sachin Juneja,1 Indra R Singh11Transport Corporation of India Foundation, Gurgaon, Haryana, India 2Population Council, New Delhi, IndiaBackground: This study describes the experiences and results of a large-scale human immunodeficiency virus (HIV prevention intervention for long-distance truck drivers operating on the national highways of India.Methods: The intervention for long-distance truckers started in 2004 across 34 trans-shipment locations. However, due to poor coverage and utilization of services by truckers in the initial 18-month period, the intervention was redesigned to focus on only 17 trans-shipment locations. The redesigned intervention model was based on the McDonald's business franchise model where the focus is on optimal placement of services, supported with branding and standardization of services offered, and a surround sound communication approach. Program output indicators were assessed using program monitoring data over 7 years (2004–2010 and two rounds of cross-sectional behavioral surveys conducted in January 2008 (n = 1402 and July 2009 (n = 1407.Results: The number of truckers contacted per month per site increased from 374 in 2004 to 4327 in 2010. Analysis of survey data showed a seven-fold increase in clinic visits in the past 12 months from 2008 to 2009 (21% versus 63%, P < 0.001. A significant increase was also observed in the percentage of truckers who watched street plays (10% to 56%, P < 0.001, and participated in health exhibitions (6% to 35%, P < 0.001. Furthermore, an increase from round 1 to round 2 was observed in the percentage who received condoms (13% to 22%, P < 0.001, and attended one-one counseling (15% to 21%, P < 0.01. Treatment-seeking from program clinics for symptoms related to sexually transmitted infections increased six-fold during this period (16% versus 50%, P < 0.001.Conclusion: Adoption of a business model for HIV prevention helped to

Snake River Sockeye Salmon Captive Broodstock Program; Hatchery Element, 2004 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

Baker, Dan J.; Heindel, Jeff A.; Redding, Jeremy (Idaho Department of Fish and Game, Boise, ID)

2006-05-01

On November 20, 1991, the National Marine Fisheries Service listed Snake River sockeye salmon Oncorhynchus nerka as endangered under the Endangered Species Act of 1973. In 1991, the Idaho Department of Fish and Game, the Shoshone-Bannock Tribes, and the National Marine Fisheries Service initiated efforts to conserve and rebuild populations in Idaho. Initial steps to recover sockeye salmon included the establishment of a captive broodstock program at the Idaho Department of Fish and Game Eagle Fish Hatchery. Sockeye salmon broodstock and culture responsibilities are shared with the National Oceanic and Atmospheric Administration at two locations adjacent to Puget Sound in Washington State. Activities conducted by the Shoshone-Bannock Tribes and the National Oceanic and Atmospheric Administration are reported under separate cover. Idaho Department of Fish and Game monitoring and evaluation activities of captive broodstock program fish releases (annual report to the Bonneville Power Administration for the research element of the program) are also reported separately. Captive broodstock program activities conducted between January 1, 2004 and December 31, 2004 for the hatchery element of the program are presented in this report. In 2004, twenty-seven anadromous sockeye salmon returned to the Sawtooth Valley. Traps on Redfish Lake Creek and the upper Salmon River at the Sawtooth Fish Hatchery intercepted one and four adults, respectively. Additionally, one adult sockeye salmon was collected at the East Fork Salmon River weir, 18 were seined from below the Sawtooth Fish Hatchery weir, one adult sockeye salmon was observed below the Sawtooth Fish Hatchery weir but not captured, and two adult sockeye salmon were observed in Little Redfish Lake but not captured. Fish were captured/collected between July 24 and September 14, 2004. The captured/collected adult sockeye salmon (12 females and 12 males) originated from a variety of release strategies and were transferred to

O desafio da convivência: assessoria de diversidade e apoio aos cotistas (2004-2008 El desafío de la convivencia: asesoría de diversidad y apoyo a los cotizantes (2004-2008 The challenge of conviviality: advisory For diversity and support to quota holders (2004-2008

Directory of Open Access Journals (Sweden)

Jaqueline Gomes de Jesus

2013-01-01

Full Text Available Em 2003, a Universidade de Brasília adotou uma política de ações afirmativas para pessoas negras, o Sistema de Cotas para Negros. Em 2004, foi criada a Assessoria de Diversidade e Apoio aos Cotistas - ADAC. Ante à demanda do movimento social por uma sala de apoio aos estudantes, desenvolveu-se o Centro de Convivência Negra - CCN, espaço aberto a toda a comunidade acadêmica. O presente artigo apresenta a experiência da ADAC até 2008 e analisa os desafios da convivência entre estudantes cotistas e o espaço acadêmico a partir de pesquisa qualitativa sobre percepções, sentimentos e expectativas acerca do CCN, na forma de questionários com uma pergunta de evocação ao CCN, aplicados a 35 estudantes universitários oriundos do Sistema de Cotas para Negros frequentadores do CCN. Os dados de evocação foram analisados utilizando-se o software Evoc. Os resultados indicam que o CCN, no período analisado, era reconhecido por seus usuários como um espaço de acolhimento ante a uma organização acadêmica heterogênea, marcada por preconceitos. São discutidas as limitações e as possibilidades de intervenção a partir do uso do CCN, e uma agenda propositiva para a ADAC, com foco na gestão da diversidade.En 2003, la Universidad de Brasilia adoptó una política de acciones afirmativas para personas negras, el Sistema de Cotas para Negros. En 2004, fue creada la Asesoría de Diversidad y Apoyo a los Cotizantes - ADAC. Ante la demanda del movimiento social por una sala de apoyo a los estudiantes, se desarrolló el Centro de Convivencia Negra - CCN, espacio abierto a toda la comunidad académica. El presente artículo presenta la experiencia de la ADAC hasta 2008 y analiza los desafíos de la convivencia entre estudiantes cotizantes y el espacio académico a partir de una investigación cualitativa sobre percepciones, sentimientos y expectativas acerca del CCN, en la forma de cuestionarios con una pregunta de evocación al CCN, aplicados

Umatilla River Subbasin Fish Habitat Improvement Program, 2004-2005 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

St. Hilaire, Danny R. (Oregon Department of Fish and Wildlife, Pendleton, OR)

2006-02-01

This annual report is in fulfillment of contractual obligations with Bonneville Power Administration (BPA), which is the funding source for the Oregon Department of Fish and Wildlife's (ODFW), Umatilla River Subbasin Fish Habitat Improvement Program (Program). The Program works cooperatively with private landowners to develop long-term restoration, under which, passive and active Habitat Improvement Projects are conducted. Historically, projects have included livestock exclusion fencing (passive restoration) to protect riparian habitats, along with the installation of instream structures (active restoration) to address erosion and improve fish habitat. In recent years, the focus of active restoration has shifted to bioengineering treatments and, more recently, to channel re-design and reconstruction aimed at improving fish habitat, by restoring stable channel function. This report provides a summary of Program activities for the 2004 calendar year (January 1 through December 31, 2004), within each of the four main project phases, including: (1) Implementation--Pre-Work, (2) Implementation--On Site Development, (3) Operation and Maintenance, and (4) Monitoring and Evaluation. This report also summarizes Program Administrative, Interagency Coordination, and Public Education activities.

SKB's program for societal research 2004-2011. An evaluation; SKB:s program foer samhaellsforskning 2004-2011. En utvaerdering

Energy Technology Data Exchange (ETDEWEB)

Soederberg, Olof [Energi- och miljoestrategi O. Soederberg, Solna (Sweden)

2012-04-15

This evaluation of the program of societal research that SKB conducted the years 2004-2011 has been performed on behalf of Swedish Nuclear Fuel and Waste Management Company (SKB). The review has focused on answers to a series of questions as follows: General questions - Why was a program started? - What was SKB's purpose with the program? - Does the result mean that the objective has been achieved? - Has the program had effects (positive or negative) that were not anticipated when the purpose was formulated? - Strengths and weaknesses of the program? Questions about the implementation - How did announcement and selection procedures work? - Which forms were used for reporting results from the research projects? Questions about the continued investment in societal research - Are there such needs? - In that case, is it in SKB's interest to contribute financially to such research? - What forms might be appropriate if SKB sees interest to contribute financially to such research?.

Site environmental report for 2008 Sandia National Laboratories, California.

Energy Technology Data Exchange (ETDEWEB)

Larsen, Barbara L.

2009-04-01

Sandia National Laboratories, California (SNL/CA) is a government-owned/contractor operated laboratory. Sandia Corporation, a Lockheed Martin Company, operates the laboratory for the Department of Energy's National Nuclear Security Administration (NNSA). The NNSA Sandia Site Office oversees operations at the site, using Sandia Corporation as a management and operating contractor. This Site Environmental Report for 2008 was prepared in accordance with DOE Order 231.1A (DOE 2004a). The report provides a summary of environmental monitoring information and compliance activities that occurred at SNL/CA during calendar year 2008. General site and environmental program information is also included.

Atmospheric 3H impact assessment (2004-2008) around Narora Atomic Power Station

International Nuclear Information System (INIS)

Kumar, A.; Gautam, Y.P.; Sharma, A.K.; Sharma, S.; Rao, K.S.; Kumar, J.; Kumar, V.; Singh, B.; Hedge, A.G.

2010-01-01

Atmospheric tritium activity is measured regularly around Narora Atomic Power Station (NAPS) since gaseous waste, which contains tritium, is being released through a 145 m high stack at NAPS site. Atmospheric data collected during 2004-2008 shows a large variation of 3 H concentration in air, fluctuating in the range of ≤0.2-91.6 Bq.m -3 . Significantly, higher tritium levels were measured in samples near the site boundary (1.6 km) of NAPS compared to off-site locations. The atmospheric dilution factor was found to be in the range of 1.1x10 -7 -7.3x10 -7 s.m -3 . The scavenging of NAPS site was found to be varying from 0.2x10 4 to 14.1x10 4 (Bq.m -3 rain water per Bqm -3 air). The inhalation dose to a member of general public at different distances (1.6-30 km) from NAPS site was found to be in the range of 0.21 μSv.y -1 . (author)

The dynamics of health care opinion, 2008-2010: partisanship, self-interest, and racial resentment.

Science.gov (United States)

Henderson, Michael; Hillygus, D Sunshine

2011-12-01

Recent debate over the Patient Protection and Affordable Care Act highlights the extent of party polarization in Washington. While the partisan divide on this issue is stark among political elites, it is less clear how the mass electorate has responded to this divisive conflict. In this article we examine individual-level dynamics in health care attitudes between 2008 and 2010. We find partisan attachments and self-interests strongly predict change in health care attitudes, with Republicans growing more opposed to universal health insurance between 2008 and 2010, and those personally worried about medical expenses less likely to abandon support. We find, however, that the effect of partisanship is moderated by self-interest, with strong Republicans significantly less likely to switch to opposition if they were personally worried about medical expenses. Finally, we find that health care policy preferences, already tinged with racial attitudes in 2008, became increasingly so by 2010.

Calendar Year 2008 Program Benefits for ENERGY STAR Labeled Products

Energy Technology Data Exchange (ETDEWEB)

Homan, GregoryK; Sanchez, Marla; Brown, RichardE; Lai, Judy

2010-08-24

This paper presents current and projected savings for ENERGY STAR labeled products, and details the status of the model as implemented in the September 2009 spreadsheets. ENERGY STAR is a voluntary energy efficiency labeling program operated jointly by the Environmental Protection Agency (US EPA) and the U.S. Department of Energy (US DOE), designed to identify and promote energy-efficient products, buildings and practices. Since the program inception in 1992, ENERGY STAR has become a leading international brand for energy efficient products, and currently labels more than thirty products, spanning office equipment, heating, cooling and ventilation equipment, commercial and residential lighting, home electronics, and major appliances. ENERGY STAR's central role in the development of regional, national and international energy programs necessitates an open process whereby its program achievements to date as well as projected future savings are shared with stakeholders. This report presents savings estimates for ENERGY STAR labeled products. We present estimates of energy, dollar, and carbon savings achieved by the program in the year 2008, annual forecasts for 2009 and 2010, and cumulative savings estimates for the period 1993 through 2008 and cumulative forecasts for the period 2009 through 2015. Through 2008 the program saved 8.8 Quads of primary energy and avoided the equivalent of 158 metric tones carbon (MtC). The forecast for the period 2009-2015 is 18.1 Quads or primary energy saved and 316 MtC emissions avoided. The sensitivity analysis bounds the best estimate of carbon avoided between 104 MtC and 213 MtC (1993 to 2008) and between 206 MtC and 444 MtC (2009 to 2015). In this report we address the following questions for ENERGY STAR labeled products: (1) How are ENERGY STAR impacts quantified; (2) What are the ENERGY STAR achievements; and (3) What are the limitations to our method?

32 CFR 2004.20 - National Industrial Security Program Operating Manual (NISPOM) [201(a)].

Science.gov (United States)

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false National Industrial Security Program Operating... Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL ARCHIVES AND RECORDS ADMINISTRATION NATIONAL INDUSTRIAL SECURITY PROGRAM DIRECTIVE NO. 1 Operations § 2004.20 National Industrial Security Program...

The 2004 NASA Faculty Fellowship Program Research Reports

Science.gov (United States)

Pruitt, J. R.; Karr, G.; Freeman, L. M.; Hassan, R.; Day, J. B. (Compiler)

2005-01-01

This is the administrative report for the 2004 NASA Faculty Fellowship Program (NFFP) held at the George C. Marshall Space Flight Center (MSFC) for the 40th consecutive year. The NFFP offers science and engineering faculty at U.S. colleges and universities hands-on exposure to NASA s research challenges through summer research residencies and extended research opportunities at participating NASA research Centers. During this program, fellows work closely with NASA colleagues on research challenges important to NASA's strategic enterprises that are of mutual interest to the fellow and the Center. The nominal starting and .nishing dates for the 10-week program were June 1 through August 6, 2004. The program was sponsored by NASA Headquarters, Washington, DC, and operated under contract by The University of Alabama, The University of Alabama in Huntsville, and Alabama A&M University. In addition, promotion and applications are managed by the American Society for Engineering Education (ASEE) and assessment is completed by Universities Space Research Association (USRA). The primary objectives of the NFFP are to: Increase the quality and quantity of research collaborations between NASA and the academic community that contribute to the Agency s space aeronautics and space science mission. Engage faculty from colleges, universities, and community colleges in current NASA research and development. Foster a greater public awareness of NASA science and technology, and therefore facilitate academic and workforce literacy in these areas. Strengthen faculty capabilities to enhance the STEM workforce, advance competition, and infuse mission-related research and technology content into classroom teaching. Increase participation of underrepresented and underserved faculty and institutions in NASA science and technology.

Appendix C: Biomass Program inputs for FY 2008 benefits estimates

Energy Technology Data Exchange (ETDEWEB)

None, None

2009-01-18

Document summarizes the results of the benefits analysis of EERE’s programs, as described in the FY 2008 Budget Request. EERE estimates benefits for its overall portfolio and nine Research, Development, Demonstration, and Deployment (RD3) programs.

National Nuclear Security Administration Nonproliferation Graduate Fellowship Program Annual Report in Brief: October 2007 - May 2008

Energy Technology Data Exchange (ETDEWEB)

Berkman, Clarissa O.; Fankhauser, Jana G.; Sandusky, Jessica A.

2009-05-01

This abbreviated Annual Report covers program activities of the National Nuclear Security Administration (NNSA) Nonproliferation Graduate Fellowship Program (NGFP) from October 2007 through May 2008--the timeframe between the last Annual Report (which covered activities through September 2007) and the next report (which will begin with June 2008 activities). In that timeframe, the NGFP continued building a solid foundation as the program began reaping the benefits of recently implemented changes. This report is organized by Fellowship class and the pertinent program activities for each, including: October 2007 Recruiting events and final applications (Class of 2008) Winter 2007 Selection and hiring (Class of 2008) Spring 2008 Career development roundtables (Class of 2007) Orientation planning (Class of 2008) Recruitment planning and university outreach (Class of 2009) May 2008 Closing ceremony (Class of 2007)

Reduction of social inequalities in utilization of dental care in Brazil from 1998 to 2008.

Science.gov (United States)

Peres, Karen Glazer; Peres, Marco Aurélio; Boing, Antonio Fernando; Bertoldi, Andréa Dâmaso; Bastos, João Luiz; Barros, Aluisio J D

2012-04-01

To analyze access to and utilization of dental care services in Brazil. We used data from the 2003 and 2008 Brazilian National Household Surveys, which we compared to data from the 1998 survey. We investigated access and utilization variables at ages three, six, nine, 12, 15, and 19 years in the first (Q1) and fifth (Q5) quintiles of per capita family income. All analyses took into account the complex sampling strategy. The proportion of subjects that had never seen a dentist decreased during the period (18.7% in 1998, 15.9% in 2003 and 11.7% in 2008). There was an important reduction in the absolute difference in failure to use dental care services after age nine years between Q1 and Q5 from 1998 to 2008, which decreased to about half its value at 15 (30.3 percentage points - pp to 16.1 pp) and 19 years (20.4 pp to 9.9 pp). Q5/Q1 ratios for recent dental appointments fell across all age groups, especially between zero and six years (Q5/Q1 from 3.2 to 2.6); utilization of the National Health Care System for dental care increased in Q1 and Q5, with a reduction in the Q1/Q5 ratio of approximately 20%. Use of the National Health Care System for dental care increased by approximately 8% in Q1 and 35% in Q5 between 2003 and 2008. There have been considerable advances in terms of reducing inequalities in access to, and increasing the utilization of, dental care services in Brazil between 1998 and 2008. However, inequality between social groups remains substantial.

[Scientific articles in the Icelandic Medical Journal 2004-2008: an overview].

Science.gov (United States)

Gudbjartsson, Tómas; Sigurdsson, Engilbert

2009-10-01

In the past 5 years the Icelandic Medical Journal has undergone many changes during a period of flourishing research in Iceland. The process of reviewing and editing scientific articles has been revised since the Journal joined the Medline database in 2005 and the proportion of rejected articles has risen. New columns have been launched covering medical history, professionalism, ethics and hobbies of the medical profession. We categorized all scientific articles from the period 2004-2008, that is research articles, review articles, case reports and clinical guidelines, according to types of articles and to which medical speciality or subspeciality the publication should belong. The number of scientific articles rose during the period but the number of research articles remained around 20 most years during the period. The relative proportion of research articles therefore fell whereas the number and proportion of review articles and case reports increased. Clinical guidelines ceased to appear in the Journal. The contribution of individual specialities to the Journal varied widely. Researchers amongst doctors and related professions need be encouraged to submit scientific articles to the Journal. The publication of scientific articles in English in the web-based form of the Journal may prove to be stimulating in this regard for Icelandic doctors abroad as well as for some researchers in Iceland.

2004 status report: Savings estimates for the Energy Star(R)voluntarylabeling program

Energy Technology Data Exchange (ETDEWEB)

Webber, Carrie A.; Brown, Richard E.; McWhinney, Marla

2004-03-09

ENERGY STAR(R) is a voluntary labeling program designed toidentify and promote energy-efficient products, buildings and practices.Operated jointly by the Environmental Protection Agency (EPA) and theU.S. Department of Energy (DOE), ENERGY STAR labels exist for more thanthirty products, spanning office equipment, residential heating andcooling equipment, commercial and residential lighting, home electronics,and major appliances. This report presents savings estimates for a subsetof ENERGY STAR labeled products. We present estimates of the energy,dollar and carbon savings achieved by the program in the year 2003, whatwe expect in 2004, and provide savings forecasts for two marketpenetration scenarios for the periods 2004 to 2010 and 2004 to 2020. Thetarget market penetration forecast represents our best estimate of futureENERGY STAR savings. It is based on realistic market penetration goalsfor each of the products. We also provide a forecast under the assumptionof 100 percent market penetration; that is, we assume that all purchasersbuy ENERGY STAR-compliant products instead of standard efficiencyproducts throughout the analysis period.

PROGRAM OF PALLIATIVE CANCER CARE – OUR EXPERIENCE

Directory of Open Access Journals (Sweden)

Iva Slánská

2013-01-01

Full Text Available Introduction: Annually more than 27,000 persons die of cancer in the Czech Republic and the overall incidence of malignancies is still increasing. These data shows the need for affordable and good follow-up care especially for patients without any cancer treatment due to irreversible progression of tumor. Currently the outpatient palliative cancer care gets more into the forefront. Prerequisite for a well working outpatient palliative care is cooperation with general practitioners and home health care agencies. The purpose of the so called program of palliative cancer care is to guide a patient in palliative cancer care and to improve the cooperation among health care providers. Methods: During the period from January 2008 to October 2010 we evaluated in patient without any oncology treatment due to irreversible progression of tumor. Results: In palliative outpatient clinic we treated 446 patients, 119 of them received home care services with average length of 27.8 days. 77 patients died at home, 51 in health facilities and 41 in inpatient hospice care. Conclusion: We present pilot study focusing on outpatient palliative cancer care which shows the real benefit from early indication of palliative cancer care. This type of care allows patients to stay as long as possible at home among their close relatives.

Focus and coverage of Bolsa Família Program in the Pelotas 2004 birth cohort.

Science.gov (United States)

Schmidt, Kelen H; Labrecque, Jeremy; Santos, Iná S; Matijasevich, Alicia; Barros, Fernando C; Barros, Aluisio J D

2017-03-30

To describe the focalization and coverage of Bolsa Família Program among the families of children who are part of the 2004 Pelotas birth cohort (2004 cohort). The data used derives from the integration of information from the 2004 cohort and the Cadastro Único para Programas Sociais do Governo Federal (CadÚnico - Register for Social Programs of the Federal Government), in the 2004-2010 period. We estimated the program coverage (percentage of eligible people who receive the benefit) and its focus (proportion of eligible people among the beneficiaries). We used two criteria to define eligibility: the per capita household income reported in the cohort follow-ups and belonging to the 20% poorest families according to the National Economic Indicator (IEN), an asset index. Between 2004 and 2010, the proportion of families in the cohort that received the benefit increased from 11% to 34%. We observed an increase in all wealth quintiles. In 2010, by income and wealth quintiles (IEN), 62%-72% of the families were beneficiaries among the 20% poorest people, 2%-5% among the 20% richest people, and about 30% of families of the intermediate quintile. According to household income (minus the benefit) 29% of families were eligible in 2004 and 16% in 2010. By the same criteria, the coverage of the program increased from 43% in 2004 to 71% in 2010. In the same period, by the wealth criterion (IEN), coverage increased from 29% to 63%. The focalization of the program decreased from 78% in 2004 to 32% in 2010 according to income, and remained constant (37%) according to the IEN. Among the families of the 2004 cohort, there was a significant increase in the program coverage, from its inception until 2010, when it was near 70%. The focus of the program was below 40% in 2010, indicating that more than half of the beneficiaries did not belong to the target population. Descrever a focalização e a cobertura do Programa Bolsa Família nas famílias de crianças que fazem parte da coorte

Projected Benefits of Federal Energy Efficiency and Renewable Energy Programs - FY 2008 Budget Request

Energy Technology Data Exchange (ETDEWEB)

2007-03-01

This document summarizes the results of the benefits analysis of EERE's programs, as described in the FY 2008 Budget Request. EERE estimates benefits for its overall portfolio and for each of its nine Research, Development, Demonstration, and Deployment (RD3) programs. Benefits for the FY 2008 budget request are estimated for the midterm (2008-2030) and long term (2030-2050).

Concentrations and loads of nutrients in the tributaries of the Lake Okeechobee watershed, south-central Florida, water years 2004-2008

Science.gov (United States)

Byrne, Michael J.; Wood, Molly S.

2011-01-01

Lake Okeechobee in south-central Florida is the second largest freshwater lake in the contiguous United States. Excessive phosphorus loading, harmful high and low water levels, and rapid expansion of non-native vegetation have threatened the health of the lake in recent decades. A study was conducted to monitor discharge and nutrient concentrations from selected tributaries into Lake Okeechobee and to evaluate nutrient loads. The data analysis was performed at 16 monitoring stations from December 2003 to September 2008. Annual and seasonal discharge measured at monitoring stations is affected by rainfall. Hurricanes affected three wet years (2004, 2005, and the latter part of 2008) and resulted in substantially greater discharge than the drought years of 2006, 2007, and the early part of 2008. Rainfall supplies about 50 percent of the water to Lake Okeechobee, discharge from the Kissimmee River supplies about 25 percent, and discharge from tributaries and groundwater seepage along the lake perimeter collectively provide the remaining 25 percent. Annually, tributary discharge from basins located on the west side of the Kissimmee River is about 5 to 6 times greater than that from basins located on the east side. For the purposes of this study, the basins on the east side of the Kissimmee River are called "priority basins" because of elevated phosphorus concentrations, while those on the west side are called "nonpriority" basins. Total annual discharge in the non-priority basins ranged from 245,000 acre-feet (acre-ft) in 2007 to 1,322,000 acre-ft in 2005, while annual discharge from the priority basins ranged from 41,000 acre-ft in 2007 to 219,000 acre-ft in 2005. Mean total phosphorus concentrations ranged from 0.10 to 0.54 milligrams per liter (mg/L) at the 16 tributaries during 2004–2008. Mean concentrations were significantly higher at priority basin sites than at non-priority basin sites, particularly at Arbuckle Creek and C 41A Canal. Concentrations of organic

Exposição ocupacional por material biológico no Hospital Santa Casa de Pelotas - 2004 a 2008 La exposición ocupacional a material biológico en el Hospital Santa Casa de Pelotas - 2004 a 2008 Occupational exposure to biological material at the Hospital Santa Casa de Pelotas - 2004 to 2008

Directory of Open Access Journals (Sweden)

Lílian Moura de Lima

2011-03-01

Full Text Available A pesquisa trata de exposições ocupacionais por material biológico a que foram submetidos os profissionais de saúde, no Hospital Santa Casa de Misericórdia de Pelotas, no período de janeiro de 2004 a junho de 2008. Trata-se de um estudo transversal, descritivo, com abordagem quantitativa. Utilizou-se como instrumento de pesquisa um questionário elaborado com base na ficha de notificação de acidente de trabalho da referida instituição. Os dados foram digitados e analisados no programa Epi-info 6.04. Como principal resultado encontrou-se a maior ocorrência de acidentes de trabalho com material biológico entre os profissionais técnicos em enfermagem do sexo feminino (38,6%, com idade de 21 a 30 anos (53,9%. A maioria dos acidentes aconteceu através de lesões com perfurocortantes (82,2%, sendo 24,1% no Centro Cirúrgico e 84,5% envolvendo sangue. Conclui-se que o estudo é de extrema relevância, pois, com base no reconhecimento do tipo de acidentes mais frequentes, pode-se conhecer os riscos existentes e intervir na sua redução, por meio de ações preventivas que beneficiem o trabalhador e a instituição.El estudio aborda la exposición ocupacional a material biológico a que fueron sometidos los profesionales de salud en el Hospital Santa Casa de Misericordia de Pelotas, de enero de 2004 a junio de 2008. Este es un corte transversal, descriptivo y cuantitativo. Se utiliza como herramienta de investigación un cuestionario basado en el formulario de informe de accidente de trabajo de esa institución. Los datos fueron introducidos y analizados con Epi-Info 6.04. Como principal resultado se encontró una mayor incidencia de accidentes con material biológico entre los profesionales técnicos de enfermería del sexo femenino (38,6%, de 21 años a 30 años (53,9%. La mayoría de los accidentes ocurrió a través de lesiones con objetos punzantes (82,2%, siendo que 24,1% ocurrió en el Centro Quirúrgico, y 84,5% con sangre. Se

Evaluation of the 2014 Best Undergraduate Accounting Programs as Compared to the 2004 Top Undergraduate Accounting Programs

Science.gov (United States)

Moore, Paula Hearn; Griffin, Richard B.

2017-01-01

This paper describes and compares the profiles of the top accounting programs in the United States as identified by "U.S. News and World Report" in 2004 with the profiles of the top accounting programs in the United States as identified by the "Accounting Degree Review" in 2014. The "Accounting Degree Review"'s list…

NYPA/TH!NK Clean Commute Program Report – Inception Through May 2004

Energy Technology Data Exchange (ETDEWEB)

Don Karner; James Francfort; Randall Solomon

2004-11-01

The Clean Commute Program uses TH!NK city electric vehicles from Ford Motor Company’s electric vehicle group, TH!NK Mobility, to demonstrate the feasibility of using electric vehicles for transportation in urban applications. Suburban New York City railroad commuters use the TH!NK city vehicles to commute from their private residences to railroad stations, where they catch commuter trains into New York City. Electric vehicle charging infrastructure for the TH!NK city vehicles is located at the commuters’ private residences as well as seven train stations. Ford leased 97 TH!NK city electric vehicles to commuters from Westchester, Putnam, Rockland, Queens, Nassau, and Suffolk counties for $199 per month per vehicle. The first Clean Commute Program vehicle deliveries occurred late in 2001, with data collection commencing in February 2002. Through May 2004, 24 of the lessees have returned their vehicles to Ford and no longer participate in the Clean Commute Program. Reasons given for returning the vehicles include relocation out of the Program area, change in employment status, change in commuting status, and, in a few cases, dissatisfaction with the vehicle. Additionally, 13 vehicles have been returned to Ford as their leases have completed. In August 2002, Ford announced that it was ceasing production of the TH!NK city and would not extend any TH!NK city leases. Through May 2004, participants in the Clean Commute Program have driven their vehicles over 370,000 miles, avoiding the use of over 17,000 gallons of gasoline. The TH!NK city vehicles are driven an average of between 180 and 230 miles per month, and over 95% of all trips taken with the TH!NK city vehicles replace trips previously taken in gasoline vehicles. This report covers the period from Program inception through May 2004.

Trouble Sleeping Associated With Lower Work Performance and Greater Health Care Costs: Longitudinal Data From Kansas State Employee Wellness Program.

Science.gov (United States)

Hui, Siu-kuen Azor; Grandner, Michael A

2015-10-01

To examine the relationships between employees' trouble sleeping and absenteeism, work performance, and health care expenditures over a 2-year period. Utilizing the Kansas State employee wellness program (EWP) data set from 2008 to 2009, multinomial logistic regression analyses were conducted with trouble sleeping as the predictor and absenteeism, work performance, and health care costs as the outcomes. EWP participants (N = 11,698 in 2008; 5636 followed up in 2009) who had higher levels of sleep disturbance were more likely to be absent from work (all P work performance ratings (all P health care costs (P work attendance, work performance, and health care costs.

Appendix E: Wind Technologies Program inputs for FY 2008 benefits estimates

Energy Technology Data Exchange (ETDEWEB)

None, None

2009-01-18

Document summarizes the results of the benefits analysis of EERE’s programs, as described in the FY 2008 Budget Request. EERE estimates benefits for its overall portfolio and nine Research, Development, Demonstration, and Deployment (RD3) programs.

Appendix G: Building Technologies Program inputs for FY 2008 benefits estimates

Energy Technology Data Exchange (ETDEWEB)

None, None

2009-01-18

Document summarizes the results of the benefits analysis of EERE’s programs, as described in the FY 2008 Budget Request. EERE estimates benefits for its overall portfolio and nine Research, Development, Demonstration, and Deployment (RD3) programs.

SKB's program for societal research 2004-2011. An evaluation

International Nuclear Information System (INIS)

Soederberg, Olof

2012-04-01

This evaluation of the program of societal research that SKB conducted the years 2004-2011 has been performed on behalf of Swedish Nuclear Fuel and Waste Management Company (SKB). The review has focused on answers to a series of questions as follows: General questions - Why was a program started? - What was SKB's purpose with the program? - Does the result mean that the objective has been achieved? - Has the program had effects (positive or negative) that were not anticipated when the purpose was formulated? - Strengths and weaknesses of the program? Questions about the implementation - How did announcement and selection procedures work? - Which forms were used for reporting results from the research projects? Questions about the continued investment in societal research - Are there such needs? - In that case, is it in SKB's interest to contribute financially to such research? - What forms might be appropriate if SKB sees interest to contribute financially to such research?

Ecological Monitoring and Compliance Program 2008 Report

Energy Technology Data Exchange (ETDEWEB)

Hansen, Dennis J.; Anderson, David C.; Hall, Derek B.; Greger, Paul D.; Ostler, W. Kent

2009-04-30

The Ecological Monitoring and Compliance Program, funded through the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO), monitors the ecosystem of the Nevada Test Site (NTS) and ensures compliance with laws and regulations pertaining to NTS biota. This report summarizes the program’s activities conducted by National Security Technologies, LLC (NSTec), during calendar year 2008. Program activities included (a) biological surveys at proposed construction sites, (b) desert tortoise compliance, (c) ecosystem mapping and data management, (d) sensitive plant species monitoring, (e) sensitive and protected/regulated animal monitoring, (f) habitat monitoring, (g) habitat restoration monitoring, and (h) monitoring of the Nonproliferation Test and Evaluation Complex (NPTEC).

DOE Hydropower Program Annual Report for FY 2004

Energy Technology Data Exchange (ETDEWEB)

Sommers, Garold L. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hunt, Richard T. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Cada, Glenn F. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Sale, Michael J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Dauble, Dennis D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Carlson, Thomas [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Ahlgrimm, James [U.S. Dept. of Energy, Washington, D.C. (United States); Acker, Tomas L. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2005-02-01

This report describes the progress of the R&D conducted in FY 2004 the under four program areas at the time: (1) Advanced Hydropower Technology (Large Turbine Field Testing, Water Use Optimization, and Improved Mitigation Practices); (2) Supporting Research and Testing (Environmental Performance Testing Methods, Computational and Physical Modeling, Instrumentation and Controls, and Environmental Analysis); (3) Systems Integration and Technology Acceptance (Hydro/Wind Integration, National Hydropower Collaborative, and Integration and Communications); and (4) Supporting Engineering and Analysis (Valuation Methods and Assessments and Characterization of Innovative Technology).

Krsko Nuclear Power Plant's Environmental Management System in Compliance with ISO 14001:2004

International Nuclear Information System (INIS)

Kusar, A.; Kavsek, D.

2010-01-01

Krsko Nuclear Power Plant (NPP) pays special attention to environmental protection and practices environmental safety in all plant processes and management. In 2008, Krsko NPP introduced the Environmental Management System in compliance with ISO 14001:2004 standard. The plant management announced the Environmental policy which is a part of the business strategy of Krsko NPP which is an eco-friendly company. The Policy is a commitment of the plant management and all staff to act in compliance with requirements of ISO 14001:2004. The standard served as a basis for developing some new documentation such as Environmental Management System Quality Manual, Environmental planning procedures identifying legal and other requirements, Register of environmental aspects, Register of legal and other requirements etc. When establishing the Register of environmental aspects, all possible environmental impacts of the plant were carefully reviewed and estimated. Following the introduction and certification audit in October and December 2008 of Bureau Veritas Certification, Krsko NPP was awarded certificate ISO 14001:2004 attesting conformity of its Environmental Management System with this standard. The Environmental Certificate means that Krsko NPP will promote a positive environmental culture and maintain a safe, healthy and environmentally-sound workplace for all its employees, contractors and visitors.(author).

Compendium of Data for the Hanford Site (Fiscal Years 2004 to 2008) Applicable to Estimation of Recharge Rates

Energy Technology Data Exchange (ETDEWEB)

Nichols, William E.; Rockhold, Mark L.; Downs, Janelle L.

2008-09-24

This report is a compendium of recharge data collected in Fiscal Years 2004 through 2008 at various soil and surface covers found and planned in the 200 West and 200 East Areas of the U.S. Department of Energy’s Hanford Site in southeast Washington State. The addition of these new data to previously published recharge data will support improved estimates of recharge with respect to location and soil cover helpful to evaluations and risk assessments of radioactive and chemical wastes at this site. Also presented are evaluations of the associated uncertainties, limitations, and data gaps in the existing knowledge base for recharge at the Hanford Site.

Hospitalizations for varicella in children and adolescents in a referral hospital in Hong Kong, 2004 to 2008: A time series study

Directory of Open Access Journals (Sweden)

Chan WM

2011-05-01

Full Text Available Abstract Background Varicella accounts for significant morbidities and remains a public health issue worldwide. Climatic factors have been shown to associate with the incidence and transmission of various infectious diseases. We describe the epidemiology of varicella in paediatric patients hospitalized at a tertiary referral hospital in Hong Kong from 2004 to 2008, and to explore the possible association between the occurrence of varicella infection and various climatic factors. Methods The hospital discharge database of Princess Margaret Hospital was retrospectively analyzed for admissions associated with varicella from 2004 to 2008. Meteorological data were obtained from the monthly meteorological reports from the Hong Kong Observatory website. Time series analysis was performed with Poisson regression using a Generalized Estimating Equation (GEE approach. Results During the study period, 598 children were hospitalized for varicella. The mean age on admission was 57.6 months, and the mean duration of hospitalization was 3.7 days. The overall complication rate was 47%. The mean monthly relative humidity, especially in cool seasons, was inversely correlated with the monthly varicella cases of the same month. Conclusions Varicella can lead to serious complications and prolonged hospitalization, even in previously healthy children. Lower relative humidity in cool seasons is associated with higher number of paediatric varicella hospital admissions. These findings are useful for a better understanding of the pattern of paediatric varicella hospitalization in Hong Kong.

INEEL Cultural Resource Management Program Annual Report - 2004

International Nuclear Information System (INIS)

Clayton F. Marler

2005-01-01

As a federal agency, the U.S. Department of Energy has been directed by Congress, the U.S. president, and the American public to provide leadership in the preservation of prehistoric, historic, and other cultural resources on the lands it administers. This mandate to preserve cultural resources in a spirit of stewardship for the future is outlined in various federal preservation laws, regulations, and guidelines such as the National Historic Preservation Act, the Archaeological Resources Protection Act, and the National Environmental Policy Act. The Idaho National Engineering and Environmental Laboratory Site is located in southeastern Idaho, and is home to vast numbers and a wide variety of important cultural resources representing at least 13,000-year span of human occupation in the region. These resources are nonrenewable, bear valuable physical and intangible legacies, and yield important information about the past, present, and perhaps the future. There are special challenges associated with balancing the preservation of these resources with the management and ongoing operation of an active scientific laboratory, while also cleaning up the waste left by past programs and processes. The Department of Energy Idaho Operations Office has administrative responsibility for most of the Site, excluding lands and resources managed by the Naval Reactors Facility and (in 2004) Argonne National Laboratory-West. The Department of Energy is committed to a cultural resource program that accepts these challenges in a manner reflecting both the spirit and intent of the legislative requirements. This annual report is an overview of Cultural Resource Management Program activities conducted during Fiscal Year 2004 and is intended to be both informative to external stakeholders and to serve as a planning tool for future cultural resource management work to be conducted on the Site

INEEL Cultural Resource Management Program Annual Report - 2004

Energy Technology Data Exchange (ETDEWEB)

Clayton F. Marler

2005-01-01

As a federal agency, the U.S. Department of Energy has been directed by Congress, the U.S. president, and the American public to provide leadership in the preservation of prehistoric, historic, and other cultural resources on the lands it administers. This mandate to preserve cultural resources in a spirit of stewardship for the future is outlined in various federal preservation laws, regulations, and guidelines such as the National Historic Preservation Act, the Archaeological Resources Protection Act, and the National Environmental Policy Act. The Idaho National Engineering and Environmental Laboratory Site is located in southeastern Idaho, and is home to vast numbers and a wide variety of important cultural resources representing at least 13,000-year span of human occupation in the region. These resources are nonrenewable, bear valuable physical and intangible legacies, and yield important information about the past, present, and perhaps the future. There are special challenges associated with balancing the preservation of these resources with the management and ongoing operation of an active scientific laboratory, while also cleaning up the waste left by past programs and processes. The Department of Energy Idaho Operations Office has administrative responsibility for most of the Site, excluding lands and resources managed by the Naval Reactors Facility and (in 2004) Argonne National Laboratory-West. The Department of Energy is committed to a cultural resource program that accepts these challenges in a manner reflecting both the spirit and intent of the legislative requirements. This annual report is an overview of Cultural Resource Management Program activities conducted during Fiscal Year 2004 and is intended to be both informative to external stakeholders and to serve as a planning tool for future cultural resource management work to be conducted on the Site.

Pandemic Influenza Preparedness Among Child Care Center Directors in 2008 and 2016.

Science.gov (United States)

Shope, Timothy R; Walker, Benjamin H; Aird, Laura D; Southward, Linda; McCown, John S; Martin, Judith M

2017-06-01

Children in child care centers represent an important population to consider in attempts to mitigate the spread of an influenza pandemic. This national survey, conducted in 2008 and 2016, assessed directors' reports of their child care centers' pandemic influenza preparation before and after the 2009 H1N1 novel influenza pandemic. This was a telephone-based survey of child care center directors randomly selected from a national database of licensed US child care centers who were queried about their preparedness for pandemic influenza. We grouped conceptually related items in 6 domains into indexes: general infection control, communication, seasonal influenza control, use of health consultants, quality of child care, and perceived barriers. These indexes, along with other center and director characteristics, were used to predict pandemic influenza preparedness. Among 1500 and 518 child care center directors surveyed in 2008 and 2016, respectively, preparation for pandemic influenza was low and did not improve. Only 7% of directors had taken concrete actions to prepare their centers. Having served as a center director during the 2009 influenza pandemic did not influence preparedness. After adjusting for covariates, child care health consultation and years of director's experience were positively associated with pandemic influenza preparation, whereas experiencing perceived barriers such as lack of knowing what to do in the event of pandemic influenza, was negatively associated with pandemic influenza preparedness. Pandemic influenza preparedness of child care center's directors needs to improve. Child care health consultants are likely to be important collaborators in addressing this problem. Copyright © 2017 by the American Academy of Pediatrics.

Annual Report of the Integrated Status and Effectiveness Monitoring Program: Fiscal Year 2008

Energy Technology Data Exchange (ETDEWEB)

Terraqua, Inc. (Wauconda, WA)

2009-07-20

This document was created as an annual report detailing the accomplishments of the Integrated Status and Effectiveness Monitoring Program (ISEMP) in the Upper Columbia Basin in fiscal year 2008. The report consists of sub-chapters that reflect the various components of the program. Chapter 1 presents a report on programmatic coordination and accomplishments, and Chapters 2 through 4 provide a review of how ISEMP has progressed during the 2008 fiscal year in each of the pilot project subbasins: the John Day (Chapter 2), Wenatchee/Entiat (Chapter 3) and Salmon River (Chapter 4). Chapter 5 presents a report on the data management accomplishments in 2008.

Laboratory Directed Research and Development Program FY 2004 Annual Report

Energy Technology Data Exchange (ETDEWEB)

Sjoreen, Terrence P [ORNL

2005-04-01

The Oak Ridge National Laboratory (ORNL) Laboratory Directed Research and Development (LDRD) Program reports its status to the U.S. Department of Energy (DOE) in March of each year. The program operates under the authority of DOE Order 413.2A, 'Laboratory Directed Research and Development' (January 8, 2001), which establishes DOE's requirements for the program while providing the Laboratory Director broad flexibility for program implementation. LDRD funds are obtained through a charge to all Laboratory programs. This report describes all ORNL LDRD research activities supported during FY 2004 and includes final reports for completed projects and shorter progress reports for projects that were active, but not completed, during this period. The FY 2004 ORNL LDRD Self-Assessment (ORNL/PPA-2005/2) provides financial data about the FY 2004 projects and an internal evaluation of the program's management process. ORNL is a DOE multiprogram science, technology, and energy laboratory with distinctive capabilities in materials science and engineering, neutron science and technology, energy production and end-use technologies, biological and environmental science, and scientific computing. With these capabilities ORNL conducts basic and applied research and development (R&D) to support DOE's overarching national security mission, which encompasses science, energy resources, environmental quality, and national nuclear security. As a national resource, the Laboratory also applies its capabilities and skills to the specific needs of other federal agencies and customers through the DOE Work For Others (WFO) program. Information about the Laboratory and its programs is available on the Internet at . LDRD is a relatively small but vital DOE program that allows ORNL, as well as other multiprogram DOE laboratories, to select a limited number of R&D projects for the purpose of: (1) maintaining the scientific and technical vitality of the

Cardiovascular services and human resources in Puerto Rico - 2008.

Science.gov (United States)

García-Palmieri, Mario R

2009-01-01

Available information (2004-2008) concerning population statistics, the occurrence of cardiovascular disease, cardiovascular services and human resources in Puerto Rico is presented. Relevant information concerning life expectancy at birth, death by specific causes in a recent four years period, the commonest causes of death, and the related cardiovascular risk factors prevalence data available is included. The surgical and medical interventional services rendered to cardiovascular patients in different institutions and their locations in Puerto Rico in the year 2008 is presented. Some remarks concerning the productivity of physicians by our Schools of Medicine is included. Information about ACGME accredited postgraduate cardiovascular training programs conducted in Puerto Rico is presented. Data concerning the prevalence of hypertension, diabetes mellitus, overweight and obesity obtained by BRFSS in presented.

Socioeconomic inequalities in dental health services in Sao Paulo, Brazil, 2003-2008.

Science.gov (United States)

Monteiro, Camila Nascimento; Beenackers, Mariëlle A; Goldbaum, Moisés; de Azevedo Barros, Marilisa Berti; Gianini, Reinaldo José; Cesar, Chester Luiz Galvão; Mackenbach, Johan P

2016-12-07

Access to, and use of, dental health services in Brazil have improved since 2003. The increase of private health care plans and the implementation of the "Smiling Brazil" Program, the largest public oral health care program in the world, could have influenced this increase in access. However, we do not yet know if inequalities in the use of dental health services persist after the improvement in access. The aims of this study are to analyze socioeconomic differences for dental health service use between 2003 and 2008 in São Paulo and to examine changes in these associations since the implementation of the Smiling Brazil program in 2003. Data was obtained via two household health surveys (ISA-Capital 2003 and ISA-Capital 2008) which investigated living conditions, lifestyle, health status and use of health care services. Logistic regression was used to analyze associations between socioeconomic factors and dental services use. Additionally, trends from 2003 to 2008 regarding socioeconomic characteristics and dental health service use were explored. Overall, dental health service use increased between 2003 and 2008 and was at both time points more common among those who had higher income, better education, better housing conditions, private health care plans and were Caucasian. Inequalities in use of dental health care did not decrease over time. Among the reasons for not seeking dental care, not having teeth and financial difficulty were more common in lower socioeconomic groups, while thinking it was unnecessary was more common in higher socioeconomic groups. The Brazilian oral health policy is still in a period of expansion and seems to have contributed slightly to increased dental health service use, but has not influenced socioeconomic inequalities in the use of these services. Acquiring deeper knowledge about inequalities in dental health service use will contribute to better understanding of potential barriers to reducing them.

Wind energy research program 2008 - 2011; Energieforschungsprogramm Windenergie fuer die Jahre 2008-2011

Energy Technology Data Exchange (ETDEWEB)

Horbaty, R.

2008-07-01

This report published by the Swiss Federal Office of Energy (SFOE) discusses the Swiss research program on wind energy for the years 2008 to 2011. The Swiss government's energy research programs are defined every four years in co-operation with the Swiss Federal Energy Research Commission. This paper takes a look at the present situation in Switzerland and discusses current developments. Key figures are quoted. National work on basic and production-oriented research is discussed. The various actors and their co-ordination are discussed. National and international networking between research and practice is commented on. Technical and commercial goals are looked at, as are the possibilities for funding the work. Finally, four areas of emphasis for research are noted.

Operation databook of the fuel treatment system of the Static Experiment Critical Facility (STACY) and the Transient Experiment Critical Facility (TRACY). JFY 2004 to JFY 2008

International Nuclear Information System (INIS)

Kokusen, Junya; Sumiya, Masato; Seki, Masakazu; Kobayashi, Fuyumi; Ishii, Junichi; Umeda, Miki

2013-02-01

Uranyl nitrate solution fuel used in the Static Experiment Critical Facility (STACY) and the Transient Experiment Critical Facility (TRACY) is adjusted in the Fuel Treatment System, in which such parameters are varied as concentration of uranium, free nitric acid, soluble neutron poison, and so on. Operations for concentration and denitration of the solution fuel were carried out with an evaporator from JFY 2004 to JFY 2008 in order to adjust the fuel to the experimental condition of the STACY and the TRACY. In parallel, the solution fuel in which some kinds of soluble neutron poison were doped was also adjusted in JFY 2005 and JFY 2006 for the purpose of the STACY experiments to determine neutron absorption effects brought by fission products, etc. After these experiments in the STACY, a part of the solution fuel including the soluble neutron poison was purified by the solvent extraction method with mixer-settlers in JFY 2006 and JFY 2007. This report summarizes operation data of the Fuel Treatment System from JFY 2004 to JFY 2008. (author)

Special Milk Program

Science.gov (United States)

US Department of Agriculture, 2009

2009-01-01

The Special Milk Program provides milk to children in schools, child care institutions and eligible camps that do not participate in other Federal child nutrition meal service programs. The program reimburses schools and institutions for the milk they serve. In 2008, 4,676 schools and residential child care institutions participated, along with…

Racial and Ethnic Variations in Preventive Dental Care Utilization among Middle-aged and Older Americans, 1999-2008

Directory of Open Access Journals (Sweden)

Bei eWu

2013-12-01

Full Text Available Objective: This study examined recent trends of preventive dental care utilization among Americans aged 50 and above, focusing on variations across racial and ethnic groups including Whites, Blacks, Hispanics, American Indians/Alaska Natives, and Asians. Methods: Self-reported information on oral health behaviors was collected from 644,635 participants in the Behavioral Risk Factor Surveillance System (BRFSS between 1999 and 2008.Results: Despite a significant upward trend of frequency of dental cleaning from 1999 to 2008 (OR=1.02, in 2008 still only 56 to 77% of any ethnic or racial group reported having had a dental cleaning in the previous 12 months. Relative to Whites, Blacks (OR=.64 were less likely to have a dental cleaning in the previous 12 months. These variations persisted even when SES, health conditions, health behaviors, and number of permanent teeth were controlled. In contrast, Hispanics, Asians, and American Indians/Alaskan Natives did not differ from Whites in dental cleanings. Discussion: This is the first study to provide national estimates of the frequency of dental cleaning and associated trends over time for five major ethnic groups aged 50 and above in the U.S. simultaneously. Our findings suggest that public health programs with an emphasis on educating middle-aged and older minority populations on the benefits of oral health could have a large impact, as there is much room for improvement. Given the importance of oral health and a population that is rapidly becoming older and more diverse, the need for improved dental care utilization is significant.

Advantages and pitfalls of the Swedish National Program for Suicide Prevention 2008

Directory of Open Access Journals (Sweden)

Anna Baran

2015-12-01

Full Text Available Introduction: The World Health Organization report (2014 recommends the introduction of national programs for suicide prevention. However, the research on their effectiveness is scarce. As a result, policy makers do not have sufficient data for their decisions on the appropriate level of investment in suicide prevention. It is of great importance to know whether the introduction of a national prevention program results in a reduction in suicide rates, and if so, in what age groups and over what period of time after the announcement of the program. Sweden introduced the first suicide prevention program in 1995. It was then modified in 2008, and most recently in 2015. Objectives: The aim of this study was to answer the question about the impact of the suicide prevention program in Sweden (2008 on the total suicide rate as well as the age- and gender-specific suicide rates in the subsequent years. Material and methods: The study provides the overview of the suicide prevention program and suicide rates in Sweden in males and females, in the age groups 0–24, 25–44, 45–64 and over 65, 1, 3 and 6 years before and after the introduction of the national program for suicide prevention. The study presents the statistical analysis of changes in average suicide rates following the announcement of the Swedish National Program for Suicide Prevention 2008 with reference to chosen periods. Conclusions: The Swedish National Program for Suicide Prevention did not result in the reduction of suicide rates in the year after its introduction, whereas suicide rates decreased in all groups, except for the youth (under 24 years old, in 2009–2011 and 2009–2014.

Biomass energy research program 2008 - 2011; Energieforschungsprogramm Biomasse fuer die Jahre 2008-2011

Energy Technology Data Exchange (ETDEWEB)

Hermle, S.; Binggeli, D.; Guggisberg, B.

2008-07-01

This report published by the Swiss Federal Office of Energy (SFOE) discusses the Swiss research program on energy from biomass for the years 2008 to 2011. The Swiss government's energy research programs are defined every four years in co-operation with the Swiss Federal Energy Research Commission. This paper describes the concept for the biomass area. Research into modern technological concepts and ways of transforming biomass into energy are discussed and main areas of research to be addressed are discussed. Three main technological areas are defined: combustion, gasification and anaerobic fermentation. Important themes to be examined include system optimisation and integration, quality assurance and the promotion of new technologies. National and international networking between research and practice is commented on, as are the possibilities for the funding of the work.

2008 AESON JOURNAL

African Journals Online (AJOL)

OLUWOLE AKINNAGBE

However, research reports and official documents show that poor people in. Nigeria tend to be concentrated in communities that lack the benefits of modern development. Rural areas and urban fringes have a slightly higher concentration of poor people (Ayanwale and Alimi 2004). Generally, available estimates (CIA 2008, ...

Meteorological factors and pollen season dynamics of selected herbaceous plants in Szczecin, 2004-2008

Directory of Open Access Journals (Sweden)

Małgorzata Puc

2012-12-01

Full Text Available The pollen of mugwort, plantain, sorrel, nettle and pigweed is an important airborne allergen source worldwide. The occurrence of pollen grains in the air is a seasonal phenomenon and estimation of seasonal variability in the pollen count permits evaluation of the threat posed by allergens over a given area. The aim of the study was to analyse the dynamics of Artemisia, Plantago, Rumex, Urticaceae and Chenopodiaceae pollen season in Szczecin (western Poland in 2004-2008 and to establish a relationship between the meteorological parameters versus the pollen count of the taxa studied. Measurements were performed by the Hirst volumetric trap (model Lanzoni VPPS 2000. Consecutive phases during the pollen season were defined for each taxon (1, 5, 25, 50, 75, 95, 99% of annual total and duration of the season was determined using the 98% method. On the basis of this analysis, temporary differences in the dynamics of the seasons were most evident for Artemisia. Correlation analysis with weather parameters demonstrated that the maximum wind speed, mean and maximum air temperature, relative humidity and dew point are the main factors influencing the average daily pollen concentrations in the atmosphere.

Years of life lost because of premature death due to intentional and unintentional accidents in Ghazvin province from 2004 till 2008

Directory of Open Access Journals (Sweden)

Nahid Jafari

2015-01-01

Full Text Available Background: Accidents are the second cause of death in Iran and one of the significant challenges in public health. They can affect people in all ages. In this study, we try to calculate years of life lost due to intentional and unintentional injuries, which is considered as one of the main indicators for prioritizing public health problems.  Methods: This study is a practical cross sectional survey research HSR (health system research that uses secondary analysis on the death data of Ghazvin province. The calculations also take into account the WHO standards in age group, sex and years of life lost (YLL due to death.  Results: This study showed that the unintentional accidents were the leading cause of death based on YLL from 2004 until 2008 in Ghazvin province. The number of deaths due to intentional and unintentional accidents was 3796 deaths as of which 2954 (77.8% was male and 842 (22.2% female. In general three quarter of the YLL due to early death relates to accidents for males and less than a quarter relates to accidents for females. Between 2004 until 2008, the maximum number of years of life lost (YLL in both sexes is for the age group of 15 to 49.  Conclusion: Considering the high level of years of life lost (YLL due to accident in this province, especially in men, more appropriate interventions for the more risk prone age groups and male in general need to be taken into account.

Wait watchers: the application of a waiting list active management program in ambulatory care.

Science.gov (United States)

de Belvis, Antonio Giulio; Marino, Marta; Avolio, Maria; Pelone, Ferruccio; Basso, Danila; Dei Tos, Gian Antonio; Cinquetti, Sandro; Ricciardi, Walter

2013-04-01

This study describes and evaluates the application of a waiting list management program in ambulatory care. Waiting list active management survey (telephone call and further contact); before and after controlled trial. Local Health Trust in Veneto Region (North-East of Italy) in 2008-09. Five hundred and one people on a 554 waiting list for C Class ambulatory care diagnostic and/or clinical investigations (electrocardiography plus cardiology ambulatory consultation, eye ambulatory consultation, carotid vessels Eco-color-Doppler, legs Eco-color-Doppler or colonoscopy, respectively). Active list management program consisting of a telephonic interview on 21 items to evaluate socioeconomic features, self-perceived health status, social support, referral physician, accessibility and patients' satisfaction. A controlled before-and-after study was performed to evaluate anonymously the overall impact on patients' self-perceived quality of care. The rate of patients with deteriorating healthcare conditions; rate of dropout; interviewed degree of satisfaction about the initiative; overall impact on citizens' perceived quality of care. 95.4% patients evaluated the initiative as useful. After the intervention, patients more likely to have been targeted with the program showed a statistically significant increase in self-reported quality of care. Positive impact of the program on some dimensions of ambulatory care quality (health status, satisfaction, willingness to remain in the queue), thus confirming the outstanding value of 'not to leave people alone' and 'not to leave them feeling themselves alone' in healthcare delivery.

Appendix J: Weatherization and Intergovernmental Program (WIP) inputs for FY 2008 benefits estimates

Energy Technology Data Exchange (ETDEWEB)

None, None

2009-01-18

Document summarizes the results of the benefits analysis of EERE’s programs, as described in the FY 2008 Budget Request. EERE estimates benefits for its overall portfolio and nine Research, Development, Demonstration, and Deployment (RD3) programs.

Gestión y financiamiento de las investigaciones por el Instituto Nacional de Salud, Perú 2004-2008 Management and funding of the research by the peruvian National Institute of Health, 2004-2008

Directory of Open Access Journals (Sweden)

Gladys Garro

2010-09-01

Full Text Available Se analizó los resultados de los proyectos de investigación que han sido aprobados y financiados por el Instituto Nacional de Salud durante el periodo 2004-2008. De 182 investigaciones aprobadas y presupuestadas, se ejecutaron 150 (82%; 86% (129/150 culminaron en informe final y solo 14% (18/129 se publicaron en revistas indizadas, el promedio de tiempo de publicación de un artículo fue de 2,7 años. De las investigaciones presentadas, 68 (45%, fueron a través del fondo concursable, 60 (40% institucionales, 14 (9% de direcciones regionales de salud y 8 (5% colaborativas. El presupuesto ejecutado fue de $5 032 906,62. En promedio, se asignó a cada investigación $ 33 552,71 y el costo por cada publicación fue de $ 279 605,92; la distribución del presupuesto según objeto o tema de estudio fue 61% para enfermedades transmisibles, 12% para no transmisibles y 27% para desarrollo tecnológico. La promoción, desarrollo y financiamiento de la investigación en el Instituto Nacional de Salud durante este periodo, ha tenido una tendencia descendente, influenciada por la política institucional. Para revertir esta situación no solo a nivel institucional sino nacional, es necesario que el Estado defina su política nacional de investigación, respetando las prioridades nacionales y regionales de investigación en salud.The results of the research projects that have been approved and funded by the Instituto Nacional de Salud (Peru during the period 2004-2008 were analyzed. Out of 182 approved and funded research projects, 150 (82% were actually performed, 86% (129/150 ended in the final report and only 14% (18/129 were published in indexed journals, the mean time for publication of an article was of 2,7 years. Out of the presented research projects, 68 (45% were through a competitive fund, 60 (40% were institutional, 14 (9% coming from regional (provincial health directions and 8 (5% collaborative. The executed budget was of $ 5’032,906.62. The

NYPA/TH!NK Clean Commute Program Final Report - Inception through December 2004

Energy Technology Data Exchange (ETDEWEB)

James Francfort; Don Karner

2005-11-01

The Clean Commute Program uses TH!NK city electric vehicles from Ford Motor Company’s electric vehicle group, TH!NK Mobility, to demonstrate the feasibility of using electric transportation in urban applications. Suburban New York City railroad commuters use the TH!NK city vehicles to commute from their private residences to railroad stations, where they catch commuter trains into New York City. Electric vehicle charging infrastructure for the TH!NK city vehicles is located at the commuters’ private residences as well as seven train stations. Ford leased at total of 97 TH!NK city electric vehicles to commuters from Westchester, Putnam, Rockland, Queens, Nassau, and Suffolk counties for $199 per month. First Clean Commute Program vehicle deliveries occurred late in 2001, with data collection commencing in February 2002. Through May, 2004, 24 of the lessees have returned their vehicles to Ford and no longer participate in the Clean Commute Program. Reasons given for leaving the Program include relocation out of the Program area, change in employment status, change in commuting status, and, in a few cases, dissatisfaction with the vehicle. Additionally, 13 vehicles were returned to Ford when the lease was completed. In August 2002, Ford announced that it was ceasing production of the TH!NK city and would not extend any TH!NK city leases. Mileage accumulation dropped in the last quarter of the program as vehicle leases were returned to Ford. The impact of the program overall was significant as participants in the Clean Commute Program drove their vehicles over 406,074 miles, avoiding the use of over 18,887 gallons of gasoline. During the active portion of the program, the TH!NK city vehicles were driven an average of between 180 and 230 miles per month. Over 95% of all trips taken with the TH!NK city vehicles replaced trips previously taken in gasoline vehicles. This report covers the period from Program inception through December 2004.

Results of monitoring at Olkiluoto in 2008. Foreign Materials

International Nuclear Information System (INIS)

Juhola, P.

2009-08-01

This report focuses on foreign materials introduced to ONKALO. These foreign materials are not part of the multi-barrier system or the natural environment. All the allowed materials introduced to ONKALO are included in the material handbook. All materials used in ONKALO 2008 are listed in this report. During 2008 the ONKALO access tunnel was excavated from chainage 2581 to chainage 3307 and the total excavated volume in 2008 was 38812 m 3 . During 2004 to 2008 the total excavated volume was 161060 m 3 . This report also summaries the total amount of foreign materials used in ONKALO since 2004. All waters used during the excavation of ONKALO are pumped up to the surface into a sedimentation pool. In 2008 water samples were taken from sedimentation pool and from the outlet ditch. The chemistry of these waters can predict us how the use of foreign materials has affected to the baseline groundwater chemistry. (orig.)

Diseño e implantación de un sistema integrado de calidad y medio ambiente (ISO 9001: 2008 e ISO14001:2004) en una empresa de obra civil

OpenAIRE

Campano Calleja, Juan Manuel

2012-01-01

El Proyecto Fin de Carrera tiene como objetivos el diseño, desarrollo e implantación de un Sistema de Gestión Integrado de Calidad y de Medio Ambiente según las normas ISO 9001:2008 e ISO 14001:2004 para una empresa ficticia llamada MID EXCAVACIONES S.L.

Neighborhood disparities in prevalence of childhood obesity among low-income children before and after implementation of New York City child care regulations.

Science.gov (United States)

Sekhobo, Jackson P; Edmunds, Lynn S; Dalenius, Karen; Jernigan, Jan; Davis, Christopher F; Giddings, Mark; Lesesne, Catherine; Kettel Khan, Laura

2014-10-16

New York City Article 47 regulations, implemented in 2007, require licensed child care centers to improve the nutrition, physical activity, and television-viewing behaviors of enrolled children. To supplement an evaluation of the Article 47 regulations, we conducted an exploratory ecologic study to examine changes in childhood obesity prevalence among low-income preschool children enrolled in the Nutrition Program for Women, Infants, and Children (WIC) in New York City neighborhoods with or without a district public health office. We conducted the study 3 years before (from 2004 through 2006) and after (from 2008 through 2010) the implementation of the regulations in 2007. We used an ecologic, time-trend analysis to compare 3-year cumulative obesity prevalence among WIC-enrolled preschool children during 2004 to 2006 and 2008 to 2010. Outcome data were obtained from the New York State component of the Centers for Disease Control and Prevention's Pediatric Nutrition Surveillance System. Early childhood obesity prevalence declined in all study neighborhoods from 2004-2006 to 2008-2010. The greatest decline occurred in Manhattan high-risk neighborhoods where obesity prevalence decreased from 18.6% in 2004-2006 to 15.3% in 2008-2010. The results showed a narrowing of the gap in obesity prevalence between high-risk and low-risk neighborhoods in Manhattan and the Bronx, but not in Brooklyn. The reductions in early childhood obesity prevalence in some high-risk and low-risk neighborhoods in New York City suggest that progress was made in reducing health disparities during the years just before and after implementation of the 2007 regulations. Future research should consider the built environment and markers of differential exposure to known interventions and policies related to childhood obesity prevention.

Michigan's fee-for-value physician incentive program reduces spending and improves quality in primary care.

Science.gov (United States)

Lemak, Christy Harris; Nahra, Tammie A; Cohen, Genna R; Erb, Natalie D; Paustian, Michael L; Share, David; Hirth, Richard A

2015-04-01

As policy makers and others seek to reduce health care cost growth while improving health care quality, one approach gaining momentum is fee-for-value reimbursement. This payment strategy maintains the traditional fee-for-service arrangement but includes quality and spending incentives. We examined Blue Cross Blue Shield of Michigan's Physician Group Incentive Program, which uses a fee-for-value approach focused on primary care physicians. We analyzed the program's impact on quality and spending from 2008 to 2011 for over three million beneficiaries in over 11,000 physician practices. Participation in the incentive program was associated with approximately 1.1 percent lower total spending for adults (5.1 percent lower for children) and the same or improved performance on eleven of fourteen quality measures over time. Our findings contribute to the growing body of evidence about the potential effectiveness of models that align payment with cost and quality performance, and they demonstrate that it is possible to transform reimbursement within a fee-for-service framework to encourage and incentivize physicians to provide high-quality care, while also reducing costs. Project HOPE—The People-to-People Health Foundation, Inc.

Effect of improved access to antiretroviral therapy on clinical characteristics of patients enrolled in the HIV care and treatment clinic, at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania.

Science.gov (United States)

Mugusi, Sabina F; Mwita, Julius C; Francis, Joel M; Aboud, Said; Bakari, Muhammad; Aris, Eric A; Swai, Andrew B; Mugusi, Ferdinand M; Pallangyo, Kisali; Sandstrom, Eric

2010-05-28

Sub-Saharan Africa has been severely affected by the HIV and AIDS pandemic. Global efforts at improving care and treatment has included scaling up use of antiretroviral therapy (ART). In Tanzania, HIV care and treatment program, including the provision of free ART started in 2004 with a pilot program at Muhimbili National Hospital in Dar es Salaam. This study describes the socio-demographic and clinical features of patients enrolled at the care and treatment clinic at MNH, Dar es Salaam, Tanzania. A cross-sectional study looking at baseline characteristics of patients enrolled at the HIV clinic at MNH between June 2004-Dec 2005 compared to those enrolled between 2006 and September 2008. Of all enrolled patients, 2408 (58.5%) were used for analysis. More females than males were attending the clinic. Their baseline median CD4 cell count was low (136 cells/microl) with 65.7% having below 200 cells/microl. Females had higher CD4 cell counts (150 cells/microl) than males (109 cells/microl) p MNH HIV clinic were predominantly females, and presented with advanced immune-deficiency. Improved access to HIV care and treatment services seems to be associated with patients' early presentation to the clinics in the course of HIV disease.

Development and evaluation of a self care program on breastfeeding in Japan: A quasi-experimental study

Directory of Open Access Journals (Sweden)

Awano Masayo

2010-08-01

Full Text Available Abstract Background Although the importance of breastfeeding is well known in Japan, in recent years less than 50% of mothers were fully breastfeeding at one month after birth. The purpose of this study was to develop a self-care program for breastfeeding aimed at increasing mothers' breastfeeding confidence and to evaluate its effectiveness. Methods A quasi-experimental pretest-posttest design was conducted in Japan. The intervention, a breastfeeding self-care program, was created to improve mothers' self-efficacy for breastfeeding. This Breastfeeding Self-Care Program included: information on the advantages and basics of breastfeeding, a breastfeeding checklist to evaluate breastfeeding by mothers and midwives, and a pamphlet and audiovisual materials on breastfeeding. Mothers received this program during their postpartum hospital stay. A convenience sample of 117 primiparous women was recruited at two clinical sites from October 2007 to March 2008. The intervention group (n = 55, who gave birth in three odd-numbered months, received standard care and the Breastfeeding Self-Care Program while the control group (n = 62 gave birth in three even numbered months and received standard breastfeeding care. To evaluate the effectiveness of the Breastfeeding Self-Care Program, breastfeeding self-efficacy and breastfeeding rate were measured early postpartum, before the intervention, and after the intervention at one month postpartum. The study used the Japanese version of The Breastfeeding Self-Efficacy Scale Short Form (BSES-SF to measure self-efficacy. Results The BSES-SF score of the intervention group rose significantly from 34.8 at early postpartum to 49.9 at one month after birth (p Conclusion Results indicate that the Breastfeeding Self-Care Program increased mothers' self-efficacy for breastfeeding and had a positive effect on the continuation of breastfeeding. Trial Registration Number UMIN000003517

The Prenatal Care at School Program

Science.gov (United States)

Griswold, Carol H.; Nasso, Jacqueline T.; Swider, Susan; Ellison, Brenda R.; Griswold, Daniel L.; Brooks, Marilyn

2013-01-01

School absenteeism and poor compliance with prenatal appointments are concerns for pregnant teens. The Prenatal Care at School (PAS) program is a new model of prenatal care involving local health care providers and school personnel to reduce the need for students to leave school for prenatal care. The program combines prenatal care and education…

Hood River and Pelton Ladder Evaluation Studies, 2008 Annual Report : October 2007 - September 2008.

Energy Technology Data Exchange (ETDEWEB)

Reagan, Robert E.; Olsen, Erik A. [Oregon Department of Fish and Wildlife

2009-09-28

This report summarizes the life history and production data collected in the Hood River subbasin during FY 2008. Included is a summary of jack and adult life history data collected at the Powerdale Dam trap on seventeen complete run years of winter steelhead, spring and fall chinook salmon, and coho salmon, and on fifteen complete run years of summer steelhead. Also included are summaries of (1) the hatchery winter steelhead broodstock collection program; (2) hatchery production releases in the Hood River subbasin; (3) subbasin wild summer and winter steelhead smolt production, (4) numbers of hatchery summer and winter steelhead smolts leaving the subbasin; (5) smolt migration timing past Bonneville Dam, (6) wild and hatchery steelhead smolt-to-adult survival rates; (7) wild summer and winter steelhead egg to smolt survival rates; and (8) streamflow at selected locations in the Hood River subbasin. Data will be used in part to (1) evaluate the HRPP relative to its impact on indigenous populations of resident and anadromous salmonids (see Ardren Draft), (2) evaluate the HRPP's progress towards achieving the biological fish objectives defined in the Hood River Subbasin Plan (Coccoli 2004) and the Revised Master Plan for the Hood River Production Program (HDR|FishPro, ODFW, and CTWSRO 2008), (3) refine spawner escapement objectives to more accurately reflect subbasin carrying capacity, and (4) refine estimates of subbasin smolt production capacity to more accurately reflect current and potential subbasin carrying capacity.

Acute myocardial infarction mortality in Cuba, 1999-2008.

Science.gov (United States)

Armas, Nurys B; Ortega, Yanela Y; de la Noval, Reinaldo; Suárez, Ramón; Llerena, Lorenzo; Dueñas, Alfredo F

2012-10-01

Acute myocardial infarction is one of the leading causes of death in the world. This is also true in Cuba, where no national-level epidemiologic studies of related mortality have been published in recent years. Describe acute myocardial infarction mortality in Cuba from 1999 through 2008. A descriptive study was conducted of persons aged ≥25 years with a diagnosis of acute myocardial infarction from 1999 through 2008. Data were obtained from the Ministry of Public Health's National Statistics Division database for variables: age; sex; site (out of hospital, in hospital or in hospital emergency room) and location (jurisdiction) of death. Proportions, age- and sex-specific rates and age-standardized overall rates per 100,000 population were calculated and compared over time, using the two five-year time frames within the study period. A total of 145,808 persons who had suffered acute myocardial infarction were recorded, 75,512 of whom died, for a case-fatality rate of 51.8% (55.1% in 1999-2003 and 49.7% in 2004-2008). In the first five-year period, mortality was 98.9 per 100,000 population, falling to 81.8 per 100,000 in the second; most affected were people aged ≥75 years and men. Of Cuba's 14 provinces and special municipality, Havana, Havana City and Camagüey provinces, and the Isle of Youth Special Municipality showed the highest mortality; Holguín, Ciego de Ávila and Granma provinces the lowest. Out-of-hospital deaths accounted for the greatest proportion of deaths in both five-year periods (54.8% and 59.2% in 1999-2003 and 2004-2008, respectively). Although risk of death from acute myocardial infarction decreased through the study period, it remains a major health problem in Cuba. A national acute myocardial infarction case registry is needed. Also required is further research to help elucidate possible causes of Cuba's high acute myocardial infarction mortality: cardiovascular risk studies, studies of out-of-hospital mortality and quality of care

Not all are lost: interrupted laboratory monitoring, early death, and loss to follow-up (LTFU in a large South African treatment program.

Directory of Open Access Journals (Sweden)

Aima A Ahonkhai

Full Text Available Many HIV treatment programs in resource-limited settings are plagued by high rates of loss to follow-up (LTFU. Most studies have not distinguished between those who briefly interrupt, but return to care, and those more chronically lost to follow-up.We conducted a retrospective cohort study of 11,397 adults initiating antiretroviral therapy (ART in 71 Southern African Catholic Bishops Conference/Catholic Relief Services HIV treatment clinics between January 2004 and December 2008. We distinguished among patients with early death, within the first 7 months on ART; patients with interruptions in laboratory monitoring (ILM, defined as missing visits in the first 7 months on ART, but returning to care by 12 months; and those LTFU, defined as missing all follow-up visits in the first 12 months on ART. We used multilevel logistic regression models to determine patient and clinic-level characteristics associated with these outcomes.In the first year on ART, 60% of patients remained in care, 30% missed laboratory visits, and 10% suffered early death. Of the 3,194 patients who missed laboratory visits, 40% had ILM, resuming care by 12 months. After 12 months on ART, patients with ILM had a 30% increase in detectable viremia compared to those who remained in care. Risk of LTFU decreased with increasing enrollment year, and was lowest for patients who enrolled in 2008 compared to 2004 [OR 0.49, 95%CI 0.39-0.62].In a large community-based cohort in South Africa, nearly 30% of patients miss follow-up visits for CD4 monitoring in the first year after starting ART. Of those, 40% have ILM but return to clinic with worse virologic outcomes than those who remain in care. The risk of chronic LTFU decreased with enrollment year. As ART availability increases, interruptions in care may become more common, and should be accounted for in addressing program LTFU.

Appendix F: FreedomCAR and Vehicle Technologies Program inputs for FY 2008 benefits estimates

Energy Technology Data Exchange (ETDEWEB)

None, None

2009-01-18

Document summarizes the results of the benefits analysis of EERE’s programs, as described in the FY 2008 Budget Request. EERE estimates benefits for its overall portfolio and nine Research, Development, Demonstration, and Deployment (RD3) programs.

[Analysis of the results of the SEIMC External Quality Control Program. Year 2008].

Science.gov (United States)

Serrano, María del Remedio Guna; Mira, Nieves Orta; de Gopegui, Enrique Ruiz; Ovies, María Rosario; Cardona, Concepción Gimeno; Pérez, José L

2010-01-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria and virology. This article present the most relevant conclusions and lessons from the 2008 controls. As a whole, the results obtained in 2008 confirm the excellent skill and good technical standards of the microbiology laboratories in Spain found in previous editions. However, a few deviations can be obtained in any laboratory, even in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal an external controls in order to assure the maximal quality of the microbiological tests. 2010 Elsevier España S.L. All rights reserved.

Spent fuel sabotage aerosol ratio program : FY 2004 test and data summary.

Energy Technology Data Exchange (ETDEWEB)

Brucher, Wenzel (Gesellschaft fur Anlagen- und Reaktorsicherheit, Germany); Koch, Wolfgang (Fraunhofer Institut fur Toxikologie und Experimentelle Medizin, Germany); Pretzsch, Gunter Guido (Gesellschaft fur Anlagen- und Reaktorsicherheit, Germany); Loiseau, Olivier (Institut de Radioprotection et de Surete Nucleaire, France); Mo, Tin (U.S. Nuclear Regulatory Commission, Washington, DC); Billone, Michael C. (Argonne National Laboratory, Argonne, IL); Autrusson, Bruno A. (Institut de Radioprotection et de Surete Nucleaire, France); Young, F. I. (U.S. Nuclear Regulatory Commission, Washington, DC); Coats, Richard Lee; Burtseva, Tatiana (Argonne National Laboratory, Argonne, IL); Luna, Robert Earl; Dickey, Roy R.; Sorenson, Ken Bryce; Nolte, Oliver (Fraunhofer Institut fur Toxikologie und Experimentelle Medizin, Germany); Thompson, Nancy Slater (U.S. Department of Energy, Washington, DC); Hibbs, Russell S. (U.S. Department of Energy, Washington, DC); Gregson, Michael Warren; Lange, Florentin (Gesellschaft fur Anlagen- und Reaktorsicherheit, Germany); Molecke, Martin Alan; Tsai, Han-Chung (Argonne National Laboratory, Argonne, IL)

2005-07-01

This multinational, multi-phase spent fuel sabotage test program is quantifying the aerosol particles produced when the products of a high energy density device (HEDD) interact with and explosively particulate test rodlets that contain pellets of either surrogate materials or actual spent fuel. This program has been underway for several years. This program provides data that are relevant to some sabotage scenarios in relation to spent fuel transport and storage casks, and associated risk assessments. The program also provides significant technical and political benefits in international cooperation. We are quantifying the Spent Fuel Ratio (SFR), the ratio of the aerosol particles released from HEDD-impacted actual spent fuel to the aerosol particles produced from surrogate materials, measured under closely matched test conditions, in a contained test chamber. In addition, we are measuring the amounts, nuclide content, size distribution of the released aerosol materials, and enhanced sorption of volatile fission product nuclides onto specific aerosol particle size fractions. These data are the input for follow-on modeling studies to quantify respirable hazards, associated radiological risk assessments, vulnerability assessments, and potential cask physical protection design modifications. This document includes an updated description of the test program and test components for all work and plans made, or revised, during FY 2004. It also serves as a program status report as of the end of FY 2004. All available test results, observations, and aerosol analyses plus interpretations--primarily for surrogate material Phase 2 tests, series 2/5A through 2/9B, using cerium oxide sintered ceramic pellets are included. Advanced plans and progress are described for upcoming tests with unirradiated, depleted uranium oxide and actual spent fuel test rodlets. This spent fuel sabotage--aerosol test program is coordinated with the international Working Group for Sabotage Concerns of

Spent fuel sabotage aerosol ratio program : FY 2004 test and data summary

International Nuclear Information System (INIS)

Brucher, Wenzel; Koch, Wolfgang; Pretzsch, Gunter Guido; Loiseau, Olivier; Mo, Tin; Billone, Michael C.; Autrusson, Bruno A.; Young, F. I.; Coats, Richard Lee; Burtseva, Tatiana; Luna, Robert Earl; Dickey, Roy R.; Sorenson, Ken Bryce; Nolte, Oliver; Thompson, Nancy Slater; Hibbs, Russell S.; Gregson, Michael Warren; Lange, Florentin; Molecke, Martin Alan; Tsai, Han-Chung

2005-01-01

This multinational, multi-phase spent fuel sabotage test program is quantifying the aerosol particles produced when the products of a high energy density device (HEDD) interact with and explosively particulate test rodlets that contain pellets of either surrogate materials or actual spent fuel. This program has been underway for several years. This program provides data that are relevant to some sabotage scenarios in relation to spent fuel transport and storage casks, and associated risk assessments. The program also provides significant technical and political benefits in international cooperation. We are quantifying the Spent Fuel Ratio (SFR), the ratio of the aerosol particles released from HEDD-impacted actual spent fuel to the aerosol particles produced from surrogate materials, measured under closely matched test conditions, in a contained test chamber. In addition, we are measuring the amounts, nuclide content, size distribution of the released aerosol materials, and enhanced sorption of volatile fission product nuclides onto specific aerosol particle size fractions. These data are the input for follow-on modeling studies to quantify respirable hazards, associated radiological risk assessments, vulnerability assessments, and potential cask physical protection design modifications. This document includes an updated description of the test program and test components for all work and plans made, or revised, during FY 2004. It also serves as a program status report as of the end of FY 2004. All available test results, observations, and aerosol analyses plus interpretations--primarily for surrogate material Phase 2 tests, series 2/5A through 2/9B, using cerium oxide sintered ceramic pellets are included. Advanced plans and progress are described for upcoming tests with unirradiated, depleted uranium oxide and actual spent fuel test rodlets. This spent fuel sabotage--aerosol test program is coordinated with the international Working Group for Sabotage Concerns of

75 FR 67751 - Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting

Science.gov (United States)

2010-11-03

...] Medicare Program: Community-Based Care Transitions Program (CCTP) Meeting AGENCY: Centers for Medicare... guidance and ask questions about the upcoming Community-based Care Transitions Program. The meeting is open... conference will also provide an overview of the Community-based Care Transitions Program (CCTP) and provide...

Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008.

Science.gov (United States)

Shah, Ira; Lala, Mamatha; Damania, Kaizad

2017-01-01

Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother-to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Prevalence of HIV in pregnant women in Mumbai is decreasing.

Iowa's Forests 2008

Science.gov (United States)

Mark D. Nelson; Matt Brewer; Christopher W. Woodall; Charles H. Perry; Grant M. Domke; Ronald J. Piva; Cassandra M. Kurtz; W. Keith Moser; Tonya W. Lister; Brett J. Butler; Dacia M. Meneguzzo; Patrick D. Miles; Charles J. Barnett; Dale Gormanson

2011-01-01

The second full annual inventory of Iowa's forests (2004-2008) reports more than 3 million acres of forest land, almost all of which is timberland (98 percent), with an average volume of more than 1,000 cubic feet of growing stock per acre. American elm and eastern hophornbeam are the most numerous tree species, but silver maple and bur oak predominate in terms of...

Changes in Morbidity and Abortion Care in Ethiopia After Legal Reform: National Results from 2008 and 2014

Science.gov (United States)

Gebrehiwot, Yirgu; Fetters, Tamara; Gebreselassie, Hailemichael; Moore, Ann; Hailemariam, Mengistu; Dibaba, Yohannes; Bankole, Akinrinola; Getachew, Yonas

2017-01-01

CONTEXT In Ethiopia, liberalization of the abortion law in 2005 led to changes in abortion services. It is important to examine how levels and types of abortion care—i.e., legal abortion and treatment of abortion complications—changed over time. METHODS Between December 2013 and May 2014, data were collected on symptoms, procedures and treatment from 5,604 women who sought abortion care at a sample of 439 public and private health facilities; the sample did not include lower-level private facilities—some of which provide abortion care—to maintain comparability with the sample from a 2008 study. These data were combined with monitoring data from 105,806 women treated in 74 nongovernmental organization facilities in 2013. Descriptive analyses were conducted and annual estimates were calculated to compare the numbers and types of abortion care services provided in 2008 and 2014. RESULTS The estimated annual number of women seeking a legal abortion in the types of facilities sampled increased from 158,000 in 2008 to 220,000 in 2014, and the estimated number presenting for postabortion care increased from 58,000 to 125,000. The proportion of abortion care provided in the public sector increased from 36% to 56% nationally. The proportion of women presenting for postabortion care who had severe complications rose from 7% to 11%, the share of all abortion procedures accounted for by medical abortion increased from 0% to 36%, and the proportion of abortion care provided by midlevel health workers increased from 48% to 83%. Most women received postabortion contraception. CONCLUSIONS Ethiopia has made substantial progress in expanding comprehensive abortion care; however, eradication of morbidity from unsafe abortion has not yet been achieved. PMID:28825903

Utilization of Hospital Emergency Departments for non-traumatic dental care in New Hampshire, 2001-2008.

Science.gov (United States)

Anderson, Ludmila; Cherala, Sai; Traore, Elizabeth; Martin, Nancy R

2011-08-01

Hospital Emergency Departments (ED) provide a variety of medical care, some of which is for non-urgent, chronic conditions. We describe the statewide use of hospital ED for selected non-traumatic dental conditions that occurred during 2001-2008 in New Hampshire. Using the administrative hospital discharge dataset for 2001-2007, and provisional 2008 data, we identified all visits for selected dental conditions and calculated age-adjusted rates per 10,000 New Hampshire residents by several socio-demographic characteristics. The Spearman correlation coefficient was used to assess the statistical significance for trend over time. Emergency department visits for non-traumatic dental conditions increased significantly from 11,067 in 2001 to 16,238 visits in 2007 (P dental care users. The most frequent dental complains (46%) were diseases of the teeth and supporting structures, diagnostic code ICD-9-CM-525. Dental care associated ED visits have increased in New Hampshire. Individuals seeking dental treatment in ED are not receiving definitive treatment, and they misuse limited resources. Future studies need to determine the specific barriers to timely and effective dental care in dental offices. Ongoing consistent monitoring of ED use for non-traumatic dental conditions is essential.

Annual Site Environmental Report, 2004

Energy Technology Data Exchange (ETDEWEB)

Nuckolls, H.; /SLAC

2006-04-19

This report provides information about environmental programs during 2004 at the Stanford Linear Accelerator Center (SLAC). Seasonal activities that span calendar years are also included. Production of an annual site environmental report (ASER) is a requirement established by the United States Department of Energy (DOE) for all management and operating (M&O) contractors throughout the DOE complex. SLAC is a federally-funded, research and development center with Stanford University as the M&O contractor. The most noteworthy information in this report is summarized in this section. This summary demonstrates the effective application of SLAC environmental management in meeting the site's integrated safety management system (ISMS) goals. For normal daily activities, all SLAC managers and supervisors are responsible for ensuring that proper procedures are followed so that worker safety and health are protected; the environment is protected; and compliance is ensured. Throughout 2004, SLAC focused on these activities through the SLAC management systems (described in Chapter 3). These systems were also the way SLAC approached implementing ''greening of the government'' initiatives such as Executive Order 13148. The management systems at SLAC are effective, supporting compliance with all relevant statutory and regulatory requirements. There were no reportable releases to the environment from SLAC operations during 2004. In addition, many improvements were continued during 2004, in waste minimization, recycling, decreasing air emission rates, stormwater drain system, groundwater restoration, and planning for a chemical management system to manage chemical use better. Program-specific details discussed are: (1) Air Quality--SLAC operates its air quality management program in compliance with its established permit conditions: 2004 was the seventh consecutive year the air quality management program operated without receiving any notices of violation

Center to Advance Palliative Care palliative care clinical care and customer satisfaction metrics consensus recommendations.

Science.gov (United States)

Weissman, David E; Morrison, R Sean; Meier, Diane E

2010-02-01

Data collection and analysis are vital for strategic planning, quality improvement, and demonstration of palliative care program impact to hospital administrators, private funders and policymakers. Since 2000, the Center to Advance Palliative Care (CAPC) has provided technical assistance to hospitals, health systems and hospices working to start, sustain, and grow nonhospice palliative care programs. CAPC convened a consensus panel in 2008 to develop recommendations for specific clinical and customer metrics that programs should track. The panel agreed on four key domains of clinical metrics and two domains of customer metrics. Clinical metrics include: daily assessment of physical/psychological/spiritual symptoms by a symptom assessment tool; establishment of patient-centered goals of care; support to patient/family caregivers; and management of transitions across care sites. For customer metrics, consensus was reached on two domains that should be tracked to assess satisfaction: patient/family satisfaction, and referring clinician satisfaction. In an effort to ensure access to reliably high-quality palliative care data throughout the nation, hospital palliative care programs are encouraged to collect and report outcomes for each of the metric domains described here.

2004 Annual Scientific Conference. Program and Abstracts

International Nuclear Information System (INIS)

Barborica, Andrei; Bulinski, Mircea; Stefan, Sabina

2005-01-01

As consequence of a long experience in educational as well as research field the Physics Department of the Bucharest University is offering high-standard undergraduate and graduate programs of higher education in physical sciences. The long-term strategy adopted by the faculty was focused on developing scientific research in modern topics of theoretical, experimental and applied physics as well as in inter-disciplinary fields as biophysics, medical physics, physics and protection of environment, physics-computer science. Following this strategy the Faculty of Physics has diversified the research activity, developing new research laboratories and encouraging the academic community to approach modern and competitive research projects. Every year the Physics Department of the University of Bucharest organizes the 'Annual Scientific Conference' to present the most interesting scientific results, obtained within the department. This 2004 scientific session is opened also to the interested physics researchers from other institutes and universities in the country. This scientific event represents a recognition and a continuation of the prestigious tradition of physics research performed within University. The scientific research in the Physics Department is performed in groups and research centers, the terminal year undergraduate students and graduate students being involved in a high extent in the research works. There are 5 research centers with the status of Center of excellence in research. The long-term strategy adopted by the faculty was focused on developing the scientific research in modern topics of theoretical, experimental and applied physics, as well as in inter-disciplinary fields as biophysics, medical physics, physics and protection of the environment, physics - computer science. Following this strategy, the Faculty of Physics has diversified the research activity, developing new research laboratories and encouraging the academic community to perform modern

Explaining variations in state foster care maintenance rates and the implications for implementing new evidence-based programs

Science.gov (United States)

Goldhaber-Fiebert, Jeremy D.; Babiarz, Kimberly S.; Garfield, Rachel L.; Wulczyn, Fred; Landsverk, John; Horwitz, Sarah M.

2013-01-01

Background U.S. Child Welfare systems are involved in the lives of millions of children, and total spending exceeds $26 billion annually. Out-of-home foster care is a critical and expensive Child Welfare service, a major component of which is the maintenance rate paid to support housing and caring for a foster child. Maintenance rates vary widely across states and over time, but reasons for this variation are not well understood. As evidence-based programs are disseminated to state Child Welfare systems, it is important to understand what may be the important drivers in the uptake of these practices including state spending on core system areas. Data and methods We assembled a unique, longitudinal, state-level panel dataset (1990–2008) for all 50 states with annual data on foster care maintenance rates and measures of child population in need, poverty, employment, urbanicity, proportion minority, political party control of the state legislature and governorship, federal funding, and lawsuits involving state foster care systems. All monetary values were expressed in per-capita terms and inflation adjusted to 2008 dollars. We used longitudinal panel regressions with robust standard errors and state and year fixed effects to estimate the relationship between state foster care maintenance rates and the other factors in our dataset, lagging all factors by one year to mitigate the possibility that maintenance rates influenced their predictors. Exploratory analyses related maintenance rates to Child Welfare outcomes. Findings State foster care maintenance rates have increased in nominal terms, but in many states, have not kept pace with inflation, leading to lower real rates in 2008 compared to those in 1991 for 54% of states for 2 year-olds, 58% for 9 year-olds, and 65% for 16 year-olds. In multivariate analyses including socioeconomic, demographic, and political factors, monthly foster care maintenance rates declined $15 for each 1% increase in state unemployment and

Three years of HIV/AIDS care and treatment services in Tanzania ...

African Journals Online (AJOL)

The Tanzania HIV Care and Treatment Plan was launched in October 2004 aiming at providing 440,000 AIDS patients with antiretroviral drugs (ARVs) and track disease progression in 1.2 million HIV+ persons by the end of the 2008. This paper is intended to provide information to stake holders of the achievements and ...

Appendix B: Hydrogen, Fuel Cells, and Infrastructure Technologies Program inputs for FY 2008 benefits estimates

Energy Technology Data Exchange (ETDEWEB)

None, None

2009-01-18

Document summarizes the results of the benefits analysis of EERE’s programs, as described in the FY 2008 Budget Request. EERE estimates benefits for its overall portfolio and nine Research, Development, Demonstration, and Deployment (RD3) programs.

Child Care Program Office

Science.gov (United States)

Information Medicaid Public Health Centers Temporary "Cash" Assistance Senior Benefits Program the proposed regulation changes, including the potential costs to private persons of complying with Heating Assistance Medicaid Senior Benefits Temporary Assistance Get Help Food Health Care Cash Child Care

Laboratory Directed Research and Development Program FY2004

Energy Technology Data Exchange (ETDEWEB)

Hansen, Todd C.

2005-03-22

The Ernest Orlando Lawrence Berkeley National Laboratory (Berkeley Lab or LBNL) is a multi-program national research facility operated by the University of California for the Department of Energy (DOE). As an integral element of DOE's National Laboratory System, Berkeley Lab supports DOE's missions in fundamental science, energy resources, and environmental quality. Berkeley Lab programs advance four distinct goals for DOE and the nation: (1) To perform leading multidisciplinary research in the computing sciences, physical sciences, energy sciences, biosciences, and general sciences in a manner that ensures employee and public safety and protection of the environment. (2) To develop and operate unique national experimental facilities for qualified investigators. (3) To educate and train future generations of scientists and engineers to promote national science and education goals. (4) To transfer knowledge and technological innovations and to foster productive relationships among Berkeley Lab's research programs, universities, and industry in order to promote national economic competitiveness. Berkeley Lab's research and the Laboratory Directed Research and Development (LDRD) program support DOE's Strategic Goals that are codified in DOE's September 2003 Strategic Plan, with a primary focus on Advancing Scientific Understanding. For that goal, the Fiscal Year (FY) 2004 LDRD projects support every one of the eight strategies described in the plan. In addition, LDRD efforts support the goals of Investing in America's Energy Future (six of the fourteen strategies), Resolving the Environmental Legacy (four of the eight strategies), and Meeting National Security Challenges (unclassified fundamental research that supports stockpile safety and nonproliferation programs). The LDRD supports Office of Science strategic plans, including the 20 year Scientific Facilities Plan and the draft Office of Science Strategic Plan. The research also

Effect of Improved access to Antiretroviral Therapy on clinical characteristics of patients enrolled in the HIV care and treatment clinic, at Muhimbili National Hospital (MNH, Dar es Salaam, Tanzania

Directory of Open Access Journals (Sweden)

Swai Andrew B

2010-05-01

Full Text Available Abstract Background Sub-Saharan Africa has been severely affected by the HIV and AIDS pandemic. Global efforts at improving care and treatment has included scaling up use of antiretroviral therapy (ART. In Tanzania, HIV care and treatment program, including the provision of free ART started in 2004 with a pilot program at Muhimbili National Hospital in Dar es Salaam. This study describes the socio-demographic and clinical features of patients enrolled at the care and treatment clinic at MNH, Dar es Salaam, Tanzania. Methods A cross-sectional study looking at baseline characteristics of patients enrolled at the HIV clinic at MNH between June 2004 - Dec 2005 compared to those enrolled between 2006 and September 2008. Results Of all enrolled patients, 2408 (58.5% were used for analysis. More females than males were attending the clinic. Their baseline median CD4 cell count was low (136 cells/μl with 65.7% having below 200 cells/μl. Females had higher CD4 cell counts (150 cells/μl than males (109 cells/μl p Conclusion Patients enrolled to the MNH HIV clinic were predominantly females, and presented with advanced immune-deficiency. Improved access to HIV care and treatment services seems to be associated with patients' early presentation to the clinics in the course of HIV disease.

Research program on nuclear technology and nuclear safety - Synthesis report 2008

International Nuclear Information System (INIS)

Dreier, J.

2009-06-01

This report for the Swiss Federal Office of Energy (SFOE) summarises the program's main points of interest, work done in the year 2008 and the results obtained. Four main projects at the Paul Scherrer Institute's Laboratory for Reactor Physics and System Behaviour LRS are noted, and work done at the Laboratories for Thermohydraulics LTH, Nuclear Materials LNM, Final Depository Safety LES and Energy System Analyses LEA are discussed. The results obtained in thirteen areas of research in 2008 are discussed in some detail. Finally, national and international co-operation is briefly looked at and work to be done in 2009 is reviewed. The report is completed with a list of the PSI research and development projects referred to

Results of the 2008/2009 Knowledge and Opinions Surveys Conducted for the U.S. Department of Energy Hydrogen Program

Energy Technology Data Exchange (ETDEWEB)

Schmoyer, Richard L [ORNL; Truett, Lorena Faith [ORNL; Cooper, Christy [U.S. Department of Energy; Chew, Andrea [U.S. Department of Energy

2010-04-01

The U.S. Department of Energy (DOE) Fuel Cell Technologies Program (FCT) conducts comprehensive efforts to enable the widespread commercialization of fuel cells in diverse sectors of the economy - with emphasis on applications that will most effectively strengthen our nation's energy security and improve our stewardship of the environment. Expanding the use of fuel cells requires a sustained education effort to lay the foundation for future commercial market introduction. The FCT education subprogram seeks to facilitate fuel cell demonstrations and support future commercialization by providing technically accurate and objective information to key target audiences both directly and indirectly involved in the use of fuel cells today. These key target audiences include a public that is familiar and comfortable with using a new fuel, state and local government officials who understand the near-term realities and long-term potential of the technology, an educated business and industry component, and trained safety and codes officials. With this in mind, the DOE FCT program established an education key activity to address the training and informational needs of target audiences that have a role in the near-term transition and the long-term development of a hydrogen economy. Whether or not changes can be attributed to the program, designing and maintaining an effective education program entails measuring baseline awareness and periodically measuring what has been learned. The purpose of this report is to document the data and results of statistical surveys undertaken in 2008 and 2009 to measure and establish changes in understanding and awareness about hydrogen and fuel cell technologies since a baseline survey was conducted in 2004. This report is essentially a data book, a digest of the survey data and an exposition of changes in knowledge of and opinions about hydrogen and fuel cell technology since 2004. Many conclusions can be made from the survey data. However

Primary medical care in Irish prisons

OpenAIRE

ALLWRIGHT, SHANE PATRICIA ANN; DARKER, CATHERINE; BARRY, JOSEPH; O'DOWD, THOMAS

2010-01-01

PUBLISHED Background: An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review. Methods: This study utilised a mixed methods approach. An independent expert medical evaluator (one of ...

Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

Science.gov (United States)

Shah, Ira; Lala, Mamatha; Damania, Kaizad

2017-01-01

Aim: Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother–to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. Materials and Methods: All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. Results: A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Conclusion: Prevalence of HIV in pregnant women in Mumbai is decreasing. PMID:29302524

Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

Directory of Open Access Journals (Sweden)

Ira Shah

2017-01-01

Full Text Available Aim: Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother–to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. Materials and Methods: All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. Results: A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Conclusion: Prevalence of HIV in pregnant women in Mumbai is decreasing.

Research program on regulatory safety research - Synthesis report 2008

International Nuclear Information System (INIS)

Mailaender, R

2009-06-01

This report for the Swiss Federal Office of Energy (SFOE) summarises the program's main points of interest, work done in the year 2008 and the results obtained. The main points of the research program, which is co-ordinated by the Swiss Federal Nuclear Safety Inspectorate ENSI, are discussed. Topics covered concern reactor safety as well as human, organisational and safety aspects. Work done in several areas concerning reactor safety and materials as well as interactions in severe accidents in light-water reactors is described. Radiation protection, the transport and disposal of radioactive wastes and safety culture are also looked at. Finally, national and international co-operation is briefly looked at and work to be done in 2009 is reviewed. The report is completed with a list of research and development projects co-ordinated by ENSI

Profile of children placed in residential psychiatric program: Association with delinquency, involuntary mental health commitment, and reentry into care.

Science.gov (United States)

Yampolskaya, Svetlana; Mowery, Debra; Dollard, Norín

2014-05-01

This study examined characteristics and profiles of youth receiving services in 1 of Florida's Medicaid-funded residential mental health treatment programs--State Inpatient Psychiatric Program (SIPP)--between July 1, 2004, and June 30, 2008 (N=1,432). Latent class analysis (LCA) was used to classify youth, and 3 classes were identified: Children With Multiple Needs, Children With No Caregivers, and Abused Children With Substantial Maltreatment History. The results of LCA showed that Children With Multiple Needs experienced the greatest risk for adverse outcomes. Compared with youth in the other 2 classes, these children were more likely to get readmitted to SIPP, more likely to become involved with the juvenile justice system, and more likely to experience involuntary mental health assessments. Implications of the findings are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved

Primary care in a post-communist country 10 years later: comparison of service profiles of Lithuanian primary care physicians in 1994 and GPs in 2004.

NARCIS (Netherlands)

Liseckiene, I.; Boerma, W.G.W.; Milasauskiene, Z.; Valius, L.; Miseviciene, I.; Groenewegen, P.P.

2007-01-01

OBJECTIVES: The study aimed, firstly, to assess changes in the service profile of primary care physicians between 1994, when features of the Soviet health system prevailed, and 2004, when retraining of GPs was completed. Secondly, to compare service profiles among current GPs, taking into account

Dietary Changes over 25 Years in Tianjin Residents: Findings from the 1986–1988, 2000–2004, and 2008–2011 Nutrition Surveys

Directory of Open Access Journals (Sweden)

Xuan Wang

2016-01-01

Full Text Available In China, the rates of chronic diseases characteristic of countries in nutritional transition have been increasing. However, few studies have examined diet changes in recent decades. We analyzed dietary changes in Tianjin, China. The data in this descriptive, population-based study in ≥18-year-old adults were collected from three surveys from 1986 to 2011. Food consumption and nutrient intake were compared among the three surveys separately for urban and rural areas. Differences in food consumption between urban and rural areas in different periods were also shown. The consumption of cereals, vegetables, and oils decreased, and that of fruits and beans increased in both urban and rural areas. Moreover, the total consumption of animal foods, especially milk, increased (0.01% in 1986–1988; 1.72% in 2008–2011 in rural areas. Although milk consumption also increased in urban areas, consumption of other animal foods decreased (19.33% in 1986–1988; 13.74% in 2008–2011. Meanwhile, cereals consumption rebounded from 22.63% in 2000–2004 to 29.75% in 2008–2011. Moreover, the lack of dairy products and some nutrients, e.g., retinol, calcium, and dietary fiber (<80% of recommended nutrient intake, in the diet persisted in both urban and rural areas. In conclusion, differences in diet between urban and rural areas decreased over time.

Status of whitebarkpine in the Greater Yellowstone Ecosystem: A step-trend analysis comparing 2004-2007 to 2008-2011

Science.gov (United States)

Shanahan, Erin; Irvine, Kathryn M.; Roberts, Dave; Litt, Andrea R.; Legg, Kristin; Daley, Rob; Chambers, Nina

2014-01-01

Whitebark pine (Pinus albicaulis) is a foundation and keystone species in upper subalpine environments of the northern Rocky Mountains that strongly influences the biodiversity and productivity of high-elevation ecosystems (Tomback et al. 2001, Ellison et al. 2005). Throughout its historic range, whitebark pine has decreased significantly as a major component of high-elevation forests. As a result, it is critical to understand the challenges to whitebark pine—not only at the tree and stand level, but also as these factors influence the distribution of whitebark pine across the Greater Yellowstone Ecosystem (GYE). In 2003, the National Park Service (NPS) Greater Yellowstone Inventory & Monitoring Network identified whitebark pine as one of twelve significant natural resource indicators or vital signs to monitor (Jean et al. 2005, Fancy et al. 2009) and initiated a long-term, collaborative monitoring program. Partners in this effort include the U.S. Geological Survey, U.S. Forest Service, and Montana State University with representatives from each comprising the Greater Yellowstone Whitebark Pine Monitoring Working Group. The objectives of the monitoring program are to assess trends in (1) the proportion of live, whitebark pine trees (>1.4-m tall) infected with white pine blister rust (blister rust); (2) to document blister rust infection severity by the occurrence and location of persisting and new infections; (3) to determine mortality of whitebark pine trees and describe potential factors contributing to the death of trees; and (4) to assess the multiple components of the recruitment of understory whitebark pine into the reproductive population. In this report we summarize the past eight years (2004-2011) of whitebark pine status and trend monitoring in the GYE. Our study area encompasses six national forests (NF), two national parks (NP), as well as state and private lands in portions of Wyoming, Montana, and Idaho; this area is collectively described as the

Residential aged care in Auckland, New Zealand 1988-2008: do real trends over time match predictions?

Science.gov (United States)

Broad, Joanna B; Boyd, Michal; Kerse, Ngaire; Whitehead, Noeline; Chelimo, Carol; Lay-Yee, Roy; von Randow, Martin; Foster, Susan; Connolly, Martin J

2011-07-01

in Auckland, New Zealand in 1988, 7.7% of those aged over 65 years lived in licenced residential aged care. Age-specific rates approximately doubled for each 5-year age group after the age of 65 years. Even with changes in policies and market forces since 1988, population increases are forecast to drive large growth in demand. This study shows previously unrecognised 20-year trends in rates of care in a geographically defined population. four cross-sectional surveys of all facilities (rest homes and hospitals) licenced for long-term care of older people were conducted in Auckland, New Zealand in 1988, 1993, 1998 and 2008. Facility staff completed survey forms for each resident. Numbers of licenced and occupied beds and trends in age-specific and age-standardised rates in residential aged care are reported. over the 20-year period, Auckland's population aged over 65 years increased by 43% (from 91,000 to 130,000) but actual numbers in care reduced slightly. Among those aged over 65 years, the proportion living in care facilities reduced from 1 in 13 to 1 in 18. Age-standardised rates in rest-home level care reduced from 65 to 33 per thousand, and in hospital level care, from 29 to 23 per thousand. Had rates remained stable, over 13,200 people, 74% more than observed, would have been in care in 2008. growth predicted in the residential aged care sector is not yet evident. The introduction of standardised needs assessments before entry, increased availability of home-based services, and growth in retirement villages may have led to reduced utilisation.

Monitoring lava-dome growth during the 2004-2008 Mount St. Helens, Washington, eruption using oblique terrestrial photography

Science.gov (United States)

Major, J.J.; Dzurisin, D.; Schilling, S.P.; Poland, Michael P.

2009-01-01

We present an analysis of lava dome growth during the 2004–2008 eruption of Mount St. Helens using oblique terrestrial images from a network of remotely placed cameras. This underutilized monitoring tool augmented more traditional monitoring techniques, and was used to provide a robust assessment of the nature, pace, and state of the eruption and to quantify the kinematics of dome growth. Eruption monitoring using terrestrial photography began with a single camera deployed at the mouth of the volcano's crater during the first year of activity. Analysis of those images indicates that the average lineal extrusion rate decayed approximately logarithmically from about 8 m/d to about 2 m/d (± 2 m/d) from November 2004 through December 2005, and suggests that the extrusion rate fluctuated on time scales of days to weeks. From May 2006 through September 2007, imagery from multiple cameras deployed around the volcano allowed determination of 3-dimensional motion across the dome complex. Analysis of the multi-camera imagery shows spatially differential, but remarkably steady to gradually slowing, motion, from about 1–2 m/d from May through October 2006, to about 0.2–1.0 m/d from May through September 2007. In contrast to the fluctuations in lineal extrusion rate documented during the first year of eruption, dome motion from May 2006 through September 2007 was monotonic (± 0.10 m/d) to gradually slowing on time scales of weeks to months. The ability to measure spatial and temporal rates of motion of the effusing lava dome from oblique terrestrial photographs provided a significant, and sometimes the sole, means of identifying and quantifying dome growth during the eruption, and it demonstrates the utility of using frequent, long-term terrestrial photography to monitor and study volcanic eruptions.

Putting out the welcome mat-targeting outreach efforts under the Affordable Care Act: Evidence from the Minnesota Community Application Agent Program.

Science.gov (United States)

Dybdal, Kristin; Blewett, Lynn A; Pintor, Jessie Kemmick; Johnson, Kelli

2015-01-01

An evaluation of the Minnesota Community Application Agent (MNCAA) Program was conducted for the MN Minnesota Department of Human Services and funded by the Health Resources and Services Administration's State Health Access Program grant. The MNCAA evaluation assessed effectiveness in reaching disparate populations, explored overall program value, and sought lessons applicable to the Navigator programs required under the Affordable Care Act. Mixed-methods approach using quantitative analysis of tracking and payment data and interviews with key informants to elicit "lessons learned" about the MNCAA program. The MNCAA program offers incentive payments and technical assistance to community partner organizations that assist individuals in applying for public health care coverage. A total of 140 unique community organizations participated in the MNCAA program in 2008 to 2012. Outreach staff and directors from participating MNCAAs and state/local government officials were interviewed. The article highlights a strategy for targeting outreach to individuals eligible for Medicaid coverage or subsidies under the Affordable Care Act by presenting evaluation findings from a unique outreach program to increase access to care for vulnerable populations in Minnesota. Almost two-thirds of applicants were successfully enrolled but lengthy waiting periods persisted. Seventy percent of applications came from health care organizations. Only 13% of applicants assisted by MNCAAs were new to public health care programs. Most MNCAAs believed that the incentive payment-$25 per successful enrollee-was insufficient. Significant expertise in enrolling individuals in public health care programs exists within a core group of community organizations. Incentives to leverage the capacity of community organizations must be accompanied by recruiting and training. Outreach providers and navigators also need timely access to client information. More investment in financial incentives will be required.

The US Air Force suicide prevention program: implications for public health policy.

Science.gov (United States)

Knox, Kerry L; Pflanz, Steven; Talcott, Gerald W; Campise, Rick L; Lavigne, Jill E; Bajorska, Alina; Tu, Xin; Caine, Eric D

2010-12-01

We evaluated the effectiveness of the US Air Force Suicide Prevention Program (AFSPP) in reducing suicide, and we measured the extent to which air force installations implemented the program. We determined the AFSPP's impact on suicide rates in the air force by applying an intervention regression model to data from 1981 through 2008, providing 16 years of data before the program's 1997 launch and 11 years of data after launch. Also, we measured implementation of program components at 2 points in time: during a 2004 increase in suicide rates, and 2 years afterward. Suicide rates in the air force were significantly lower after the AFSPP was launched than before, except during 2004. We also determined that the program was being implemented less rigorously in 2004. The AFSPP effectively prevented suicides in the US Air Force. The long-term effectiveness of this program depends upon extensive implementation and effective monitoring of implementation. Suicides can be reduced through a multilayered, overlapping approach that encompasses key prevention domains and tracks implementation of program activities.

Measuring change in health care equity using small-area administrative data - evidence from the English NHS 2001-2008.

Science.gov (United States)

Cookson, Richard; Laudicella, Mauro; Donni, Paolo Li

2012-10-01

This study developed a method for measuring change in socio-economic equity in health care utilisation using small-area level administrative data. Our method provides more detailed information on utilisation than survey data but only examines socio-economic differences between neighbourhoods rather than individuals. The context was the English NHS from 2001 to 2008, a period of accelerated expenditure growth and pro-competition reform. Hospital records for all adults receiving non-emergency hospital care in the English NHS from 2001 to 2008 were aggregated to 32,482 English small areas with mean population about 1500 and combined with other small-area administrative data. Regression models of utilisation were used to examine year-on-year change in the small-area association between deprivation and utilisation, allowing for population size, age-sex composition and disease prevalence including (from 2003 to 2008) cancer, chronic kidney disease, coronary heart disease, diabetes, epilepsy, hypertension, hypothyroidism, stroke, transient ischaemic attack and (from 2006 to 2008) atrial fibrillation, chronic obstructive pulmonary disease, obesity and heart failure. There was no substantial change in small-area associations between deprivation and utilisation for outpatient visits, hip replacement, senile cataract, gastroscopy or coronary revascularisation, though overall non-emergency inpatient admissions rose slightly faster in more deprived areas than elsewhere. Associations between deprivation and disease prevalence changed little during the period, indicating that observed need did not grow faster in more deprived areas than elsewhere. We conclude that there was no substantial deterioration in socio-economic equity in health care utilisation in the English NHS from 2001 to 2008, and if anything, there may have been a slight improvement. Copyright © 2012 Elsevier Ltd. All rights reserved.

Status and progress of the RERTR program in the year 2004

International Nuclear Information System (INIS)

Travelli, A.

2005-01-01

The overall status of the RERTR program at the time of the last RERTR meeting is reviewed and the progress achieved since that meeting is described. In the fuel area, unexpected failures of LEU U-Mo dispersion plates and tubes under irradiation testing have prompted a revision of the plans to qualify these fuels. While potential solutions to the difficulties with U-Mo dispersion fuels are being explored in collaboration with our international partners, greater emphasis has been placed on accelerating development of monolithic LEU U-Mo fuel. The feasibility of converting several Russian-designed research reactors to LEU fuels has been addressed, and progress has been made in the development of LEU based 99 Mo production processes. The Russian RERTR program has made significant advances. A very important event of 2004 was the US DOE establishment of the Global Threat Reduction Initiative (GTRI). This new program accelerates and combines under the same US DOE management several programs, including RERTR, which aim to secure, remove, or dispose of, nuclear and other radioactive materials throughout the world that are vulnerable to theft by terrorists. (author)

Home-based intermediate care program vs hospitalization

Science.gov (United States)

Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

2008-01-01

OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

Primary medical care in Irish prisons

OpenAIRE

Barry, Joe M; Darker, Catherine D; Thomas, David E; Allwright, Shane PA; O'Dowd, Tom

2010-01-01

Abstract Background An industrial dispute between prison doctors and the Irish Prison Service (IPS) took place in 2004. Part of the resolution of that dispute was that an independent review of prison medical and support services be carried out by a University Department of Primary Care. The review took place in 2008 and we report here on the principal findings of that review. Methods This study utilised a mixed methods approach. An independent expert medical evaluator (one of the authors, DT)...

JUST Vol. 28 No. 2 Aug 2008

African Journals Online (AJOL)

ben

2008-08-02

Aug 2, 2008 ... operating in fading environments (Hueda and Rod- rigruez, 2004), and ... networks supporting mobile computing (Lee et al.,. 1999). ... The transition diagram of the system analyzed in this report is given in Fig. 1, having N+1 ...

Grande Ronde Basin Spring Chinook Salmon Captive Broodstock Program, 2008 Annual Report.

Energy Technology Data Exchange (ETDEWEB)

Hoffnagle, Timothy L.; Hair, Donald; Gee, Sally

2009-03-31

The Grande Ronde Basin Spring Chinook Salmon Captive Broodstock Program is designed to rapidly increase numbers of Chinook salmon in stocks that are in imminent danger of extirpation in Catherine Creek (CC), Lostine River (LR) and upper Grande Ronde River (GR). Natural parr are captured and reared to adulthood in captivity, spawned (within stocks) and their progeny reared to smoltification before being released into the natal stream of their parents. This program is co-managed by ODFW, National Marine Fisheries Service, Nez Perce Tribe and Confederated Tribes of the Umatilla Indian Reservation. Presmolt rearing was initially conducted at Lookingglass Fish Hatchery (LFH) but parr collected in 2003 and later were reared at Wallowa Fish Hatchery (WFH). Post-smolt rearing is conducted at Bonneville Fish Hatchery (BOH - freshwater) and at Manchester Research Station (MRS - saltwater). The CC and LR programs are being terminated, as these populations have achieved the goal of a consistent return of 150 naturally spawning adults, so the 2005 brood year was the last brood year collected for theses populations. The Grande Ronde River program continued with 300 fish collected each year. Currently, we are attempting to collect 150 natural parr and incorporate 150 parr collected as eggs from females with low ELISA levels from the upper Grande Ronde River Conventional Hatchery Program. This is part of a comparison of two methods of obtaining fish for a captive broodstock program: natural fish vs. those spawned in captivity. In August 2007, we collected 152 parr (BY 2006) from the upper Grande Ronde River and also have 155 Grande Ronde River parr (BY 2006) that were hatched from eyed eggs at LFH. During 2008, we were unable to collect natural parr from the upper Grande Ronde River. Therefore, we obtained 300 fish from low ELISA females from the upper Grande Ronde River Conventional Program. In October 2008 we obtained 170 eyed eggs from the upper Grande Ronde river Conventional

The Affordable Care Act, Insurance Coverage, and Health Care Utilization of Previously Incarcerated Young Men: 2008-2015.

Science.gov (United States)

Winkelman, Tyler N A; Choi, HwaJung; Davis, Matthew M

2017-05-01

To estimate health insurance and health care utilization patterns among previously incarcerated men following implementation of the Affordable Care Act's (ACA's) Medicaid expansion and Marketplace plans in 2014. We performed serial cross-sectional analyses using data from the National Survey of Family Growth between 2008 and 2015. Our sample included men aged 18 to 44 years with (n = 3476) and without (n = 8702) a history of incarceration. Uninsurance declined significantly among previously incarcerated men after ACA implementation (-5.9 percentage points; 95% confidence interval [CI] = -11.5, -0.4), primarily because of an increase in private insurance (6.8 percentage points; 95% CI = 0.1, 13.3). Previously incarcerated men accounted for a large proportion of the remaining uninsured (38.6%) in 2014 to 2015. Following ACA implementation, previously incarcerated men continued to be significantly less likely to report a regular source of primary care and more likely to report emergency department use than were never-incarcerated peers. Health insurance coverage improved among previously incarcerated men following ACA implementation. However, these men account for a substantial proportion of the remaining uninsured. Previously incarcerated men continue to lack primary care and frequently utilize acute care services.

Infection Control Link Nurse Program: An interdisciplinary approach n targeting health care-acquired infection

Science.gov (United States)

Sopirala, Madhuri M.; Yahle-Dunbar, Lisa; Smyer, Justin; Wellington, Linda; Dickman, Jeanne; Zikri, Nancy; Martin, Jennifer; Kulich, Pat; Taylor, David; Mekhjian, Hagop; Nash, Mary; Mansfield, Jerry; Pancholi, Preeti; Howard, Mary; Chase, Linda; Brown, Susan; Kipp, Kristopher; Lefeld, Kristen; Myers, Amber; Pan, Xueliang; Mangino, Julie E.

2014-01-01

Background We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting. Methods Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per 1,000 patient-days (PD) was compared between baseline and intervention period along with total and non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage. Hand hygiene compliance was assessed. Results A reduction in MRSA rates was as follows in intervention period compared with baseline: HCA-MRSA decreased by 28% from 0.92 to 0.67 cases per 1,000 PD (incidence rate ratio, 0.72; 95% confidence interval: 0.62–0.83, P Hand soap/sanitizer usage and compliance with hand hygiene also increased significantly during IP. Conclusion Link nurse program effectively reduced HCA-MRSA. Goal-defined metrics with ongoing reeducation for the nurses by IP personnel helped drive these results. PMID:24548456

Testing EGM2008 on Leveling Data from Scandinavia, Adjacent Baltic Areas, and Greenland

DEFF Research Database (Denmark)

Strykowski, Gabriel; Forsberg, René

2010-01-01

We tested EGM2008 on GPS/leveling data from Scandinavia and adjacent areas. EGM2008 performs at the same level as the best regional geoid model, NKG2004. However, the direct evaluation of EGM2008 is difficult in Greenland because no leveling data are available. Nevertheless, we show on 78 GPS-MSS...

76 FR 34541 - Child and Adult Care Food Program Improving Management and Program Integrity

Science.gov (United States)

2011-06-13

... 7 CFR Parts 210, 215, 220 et al. Child and Adult Care Food Program Improving Management and Program..., 220, 225, and 226 RIN 0584-AC24 Child and Adult Care Food Program Improving Management and Program... management and integrity in the Child and Adult Care Food Program (CACFP), at 67 FR 43447 (June 27, 2002) and...

Impacto de las certificaciones ISO 9001 y BASC en los despachos de exportación definitiva de las agencias de aduanas peruanas: 2004-2008

OpenAIRE

Osorio Asencio, Estrella

2010-01-01

Objetivo: Realización del análisis del impacto de las certificaciones ISO 9001 y BASC en las agencias de aduanas peruanas, durante el periodo 2004 al 2008. Método: Se analizó la evolución del valor FOB de exportación y se determinó el factor que influye en la decisión para la obtención de la certificación ISO 9001 y BASC. La investigación tuvo un diseño descriptivo correlacional. La población fue de 252 agencias de aduanas, de las cuales se tomó una muestra por estratos con selección intencio...

Rurality and nursing home quality: evidence from the 2004 National Nursing Home Survey.

Science.gov (United States)

Kang, Yu; Meng, Hongdao; Miller, Nancy A

2011-12-01

To evaluate the impact of rural geographic location on nursing home quality of care in the United States. The study used cross-sectional observational design. We obtained resident- and facility-level data from 12,507 residents in 1,174 nursing homes from the 2004 National Nursing Home Survey. We used multilevel regression models to predict risk-adjusted rates of hospitalization, influenza and pneumococcal vaccination, and moderate to severe pain while controlling for resident and facility characteristics. Adjusting for covariates, residents in rural facilities were more likely to experience hospitalization (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.16-1.94) and moderate to severe pain (OR = 1.68, 95% CI = 1.35-2.09). Significant facility-level predictors of higher quality included higher percentage of Medicaid beneficiaries, accreditation status, and special care programs. Medicare payment findings were mixed. Significant resident-level predictors included dementia diagnosis and being a "long-stay" resident. Rural residents were more likely to reside in facilities without accreditations or special care programs, factors that increased their odds of receiving poorer quality of care. Policy efforts to enhance Medicare payment approaches as well as increase rural facilities' accreditation status and provision of special care programs will likely reduce quality of care disparities in facilities.

Dynamics and Determinants of Supplemental Nutrition Assistance Program Participation from 2008 to 2012

OpenAIRE

James Mabli; Thomas Godfrey; Nancy Wemmerus; Joshua Leftin; Stephen Tordella

2014-01-01

Mathematica nutrition experts recently conducted research on the dynamics and determinants of Supplemental Nutrition Assistance Program (SNAP) participation. A study examines SNAP participation dynamics between October 2008 and December 2012. In particular, it describes patterns of SNAP entry, length of time on the program, and re-entry for policy-relevant subgroups, and discusses how these patterns have changed over time. This work was conducted in conjunction with an analysis presented on t...

Pharmacist's Role in Diabetes Care

Centers for Disease Control (CDC) Podcasts

2008-05-19

This podcast is for a professional audience and discusses the role pharmacists can play on the diabetes care team, through collaborative practice agreements and medication therapy management.  Created: 5/19/2008 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT), National Diabetes Education Program (NDEP).   Date Released: 6/4/2008.

[Bibliometric map of research done in primary care in Spain during the period 2008-2012].

Science.gov (United States)

López-Torres Hidalgo, Jesús; Basora Gallisà, Josep; Orozco Beltrán, Domingo; Bellón Saameño, Juan Ángel

2014-12-01

To describe the Spanish scientific production of primary care during 2008-2012. Observational study bibliometric. Spanish scientific production in primary care. The study focused on publications indexed in Medline. In each record was obtained journal, year of publication, first/last author, workplace and autonomous community. Later, articles were classified according to their content or areas of research. The impact factor was obtained from the basis of bibliometric analysis Journal Citation Reports. Using search criteria, were selected 1,048 documents. The transiency rate was 62.6%. Production increased from 170 papers in 2008 to 291 in 2012. Most (65.7%) came from health centers, but we observed a significant increase (P=.01) of the articles from units or research institutes (5.9% in 2008, 12.0% in 2012). Of the total, 61.6% were classified as «clinical aspects», 22.5% were published in the journal Atención Primaria, 80.5% in journals with impact factor and 33.49% in foreign journals, being higher this proportion (P<.001) in units or research institutes (70.5% vs. 29.8%). In relation to population (articles/100.000 inhab.), the most productive communities were Cataluña (4.1), Castilla-La Mancha (3.6), Aragón (3.4) and Navarra (3.4). In primary care publications there is great diversity in both research areas such as in journals where published. Most are from health centers, treat clinical aspects and published in Spanish journals. Differences in the volume of scientific production between regions are observed. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

Laboratory Directed Research and Development Program FY 2008 Annual Report

Energy Technology Data Exchange (ETDEWEB)

editor, Todd C Hansen

2009-02-23

The Ernest Orlando Lawrence Berkeley National Laboratory (Berkeley Lab or LBNL) is a multi-program national research facility operated by the University of California for the Department of Energy (DOE). As an integral element of DOE's National Laboratory System, Berkeley Lab supports DOE's missions in fundamental science, energy resources, and environmental quality. Berkeley Lab programs advance four distinct goals for DOE and the nation: (1) To perform leading multidisciplinary research in the computing sciences, physical sciences, energy sciences, biosciences, and general sciences in a manner that ensures employee and public safety and protection of the environment. (2) To develop and operate unique national experimental facilities for qualified investigators. (3) To educate and train future generations of scientists and engineers to promote national science and education goals. (4) To transfer knowledge and technological innovations and to foster productive relationships among Berkeley Lab's research programs, universities, and industry in order to promote national economic competitiveness. Berkeley Lab's research and the Laboratory Directed Research and Development (LDRD) program support DOE's Strategic Themes that are codified in DOE's 2006 Strategic Plan (DOE/CF-0010), with a primary focus on Scientific Discovery and Innovation. For that strategic theme, the Fiscal Year (FY) 2008 LDRD projects support each one of the three goals through multiple strategies described in the plan. In addition, LDRD efforts support the four goals of Energy Security, the two goals of Environmental Responsibility, and Nuclear Security (unclassified fundamental research that supports stockpile safety and nonproliferation programs). The LDRD program supports Office of Science strategic plans, including the 20-year Scientific Facilities Plan and the Office of Science Strategic Plan. The research also supports the strategic directions periodically under

Laboratory Directed Research and Development Program FY 2008 Annual Report

International Nuclear Information System (INIS)

Hansen, Todd C.

2009-01-01

The Ernest Orlando Lawrence Berkeley National Laboratory (Berkeley Lab or LBNL) is a multi-program national research facility operated by the University of California for the Department of Energy (DOE). As an integral element of DOE's National Laboratory System, Berkeley Lab supports DOE's missions in fundamental science, energy resources, and environmental quality. Berkeley Lab programs advance four distinct goals for DOE and the nation: (1) To perform leading multidisciplinary research in the computing sciences, physical sciences, energy sciences, biosciences, and general sciences in a manner that ensures employee and public safety and protection of the environment. (2) To develop and operate unique national experimental facilities for qualified investigators. (3) To educate and train future generations of scientists and engineers to promote national science and education goals. (4) To transfer knowledge and technological innovations and to foster productive relationships among Berkeley Lab's research programs, universities, and industry in order to promote national economic competitiveness. Berkeley Lab's research and the Laboratory Directed Research and Development (LDRD) program support DOE's Strategic Themes that are codified in DOE's 2006 Strategic Plan (DOE/CF-0010), with a primary focus on Scientific Discovery and Innovation. For that strategic theme, the Fiscal Year (FY) 2008 LDRD projects support each one of the three goals through multiple strategies described in the plan. In addition, LDRD efforts support the four goals of Energy Security, the two goals of Environmental Responsibility, and Nuclear Security (unclassified fundamental research that supports stockpile safety and nonproliferation programs). The LDRD program supports Office of Science strategic plans, including the 20-year Scientific Facilities Plan and the Office of Science Strategic Plan. The research also supports the strategic directions periodically under consideration and review by the

[Treatment of eating disorders during hospitalization: presentation of a hospital intensive care program in pediatric age].

Science.gov (United States)

D'Argenio, L; Zaccagnino, M; Donati, C; Perini, A; Fazzi, E

2013-04-01

The aim of this study was to present a hospital intensive care program for patients affected by a severe eating disorders, with a significant loss of weight (BMI110 bpm or inability to sustain core body temperature), abnormal laboratory data, especially electrolyte imbalance and refusal to take food and fluids. In our study we reported 2 year follow-up of 16 patients treated with the hospital intensive care program between 2007 and 2008 in our department. The proposed program was proved an efficient method in a critical phase of the alimentary behavior disorders. It was possible for all the patients to avoid alternative feeding techniques (enteral or parenteral) and to obtain a correct alimentation with a satisfactory improvement of clinical conditions. Eight patients (50%) fully recovered. 5 patients (31.25%) had a significant improvement reaching a BMI>18.5 and one of them had a regular menstrual cycle, too. However in this group of patients a strict modality to alimentation and concern about weight and physical appearance remain. In 3 patients (18.5%) the BMI is still low and amenorrhea persists. The hospital intensive care program, inspired by the cognitive-behavioral model, through a food rehabilitation and a psychotherapeutic and psychoeducational help, lets the patients and their family understand and modify the dysfunctional patterns, experimenting a right modality to approach alimentation, with a satisfactory improvement in clinical conditions.

Evaluating the Effectiveness of the 2003-2004 NASA SCIence Files(trademark) Program

Science.gov (United States)

Caton, Randall H.; Ricles, Shannon S.; Pinelli, Thomas E.; Legg, Amy C.; Lambert, Matthew A.

2005-01-01

The NASA SCI Files is an Emmy award-winning series of instructional programs for grades 3-5. Produced by the NASA Center for Distance Learning, programs in the series are research-, inquiry-, standards-, teacher- and technology-based. Each NASA SCI Files program (1) integrates mathematics, science, and technology; (2) uses Problem-Based Learning (PBL) to enhance and enrich the teaching and learning of science; (3) emphasizes science as inquiry and the scientific method; (4) motivates students to become critical thinkers and active problem solvers; and (5) uses NASA research, facilities, and personnel to raise student awareness of careers and to exhibit the "real-world" application of mathematics, science, and technology. In April 2004, 1,500 randomly selected registered users of the NASA SCI Files were invited to complete a survey containing a series of questions. A total of 263 surveys were received. This report contains the quantitative and qualitative results of that survey.

Awareness of the Food and Drug Administration's Bad Ad Program and Education Regarding Pharmaceutical Advertising: A National Survey of Prescribers in Ambulatory Care Settings.

Science.gov (United States)

O'Donoghue, Amie C; Boudewyns, Vanessa; Aikin, Kathryn J; Geisen, Emily; Betts, Kevin R; Southwell, Brian G

2015-01-01

The U.S. Food and Drug Administration's Bad Ad program educates health care professionals about false or misleading advertising and marketing and provides a pathway to report suspect materials. To assess familiarity with this program and the extent of training about pharmaceutical marketing, a sample of 2,008 health care professionals, weighted to be nationally representative, responded to an online survey. Approximately equal numbers of primary care physicians, specialists, physician assistants, and nurse practitioners answered questions concerning Bad Ad program awareness and its usefulness, as well as their likelihood of reporting false or misleading advertising, confidence in identifying such advertising, and training about pharmaceutical marketing. Results showed that fewer than a quarter reported any awareness of the Bad Ad program. Nonetheless, a substantial percentage (43%) thought it seemed useful and 50% reported being at least somewhat likely to report false or misleading advertising in the future. Nurse practitioners and physician assistants expressed more openness to the program and reported receiving more training about pharmaceutical marketing. Bad Ad program awareness is low, but opportunity exists to solicit assistance from health care professionals and to help health care professionals recognize false and misleading advertising. Nurse practitioners and physician assistants are perhaps the most likely contributors to the program.

Footing the bill: the introduction of Medicare Benefits Schedule rebates for podiatry services in Australia

Directory of Open Access Journals (Sweden)

Short Anthony J

2009-12-01

Full Text Available Abstract The introduction of Medicare Benefits Schedule items for allied health professionals in 2004 was a pivotal event in the public funding of non-medical primary care services. This commentary seeks to provide supplementary discussion of the article by Menz (Utilisation of podiatry services in Australia under the Medicare Enhanced Primary Care program, 2004-2008 Journal of Foot and Ankle Research 2009, 2:30, by placing these findings within the context of the podiatry profession, clinical decision making and the broader health workforce and government policy.

Nuclear Engineering Enrollments and Degrees Survey, 2008 Data

International Nuclear Information System (INIS)

2009-01-01

The survey includes degrees granted between September 1, 2007, and August 31, 2008, and fall 2008 enrollments. Thirty-one academic programs reported having nuclear engineering programs during 2008, and data was provided by all thirty-one programs

PEMETAAN KARYA TULIS ILMIAH LPNK: STUDI KASUS LIPI DAN BPPT (2004-2008

Directory of Open Access Journals (Sweden)

Yupi Royani

2013-06-01

Full Text Available This research aims to determine: the rank of authors of LIPI and BPPT whose articles are mostly cited by other authors, the type of publications, the level of collaboration, the productivity level of authors, the coverage areas, and the topics contained in the scientific work through the subject analysis. The data were obtained from Google Scholar from 2004 to 2008. The collected data were then analyzed by using ‘co-word’ analysis. The ‘co-word’ structure was known after the mapping using bibliometric method. A total of 593 analyzed scientific papers consist of 472 from LIPI and 121 from BPPT. The results show that the highest citation number (100 citations comes from LIPI scientific papers, while BPPT scientific papers are 36 citations. Most types of publication produced by LIPI and BPPT are from journal articles and papers, each of 235 documents (49.79% and 101 documents (21.40% by LIPI and 71 documents (58.68% and 42 documents (34.71% by BPPT. LIPI researcher collaboration level was 0.82 and BPPT was 0.89. The most productive LIPI researcher in writing paper is Danny Hilman Natawidjaya (Geotechnology Research Center with 31 scientific papers, while BPPT is Yusuf Surachman Djajadihardja with 34 scientific papers. The most dominant topic written by LIPI researcher is basic science or pure science i.e. 63.56%, with details: biology 131 documents (27.75% followed by geology 121 documents (25.64%, chemistry 47 documents (9.96% and mathematics 1 document (0.21%. The topic most widely written by BPPT researchers is the field of applied research i.e. 56.19% with the details: environment 33 (27.27%, engineering 27 (22.31%, biotechnology 5 (4.13%, food technology 2 (1.65% and fisheries 1 document (0.83%. The relationship among the topics is shown in the line among the descriptors on each field. More relation lines among descriptors, the closer the relationships among documents.

Care and outcomes of Asian-American acute myocardial infarction patients: findings from the American Heart Association Get With The Guidelines-Coronary Artery Disease program.

Science.gov (United States)

Qian, Feng; Ling, Frederick S; Deedwania, Prakash; Hernandez, Adrian F; Fonarow, Gregg C; Cannon, Christopher P; Peterson, Eric D; Peacock, W Frank; Kaltenbach, Lisa A; Laskey, Warren K; Schwamm, Lee H; Bhatt, Deepak L

2012-01-01

Asian-Americans represent an important United States minority population, yet there are limited data regarding the clinical care and outcomes of Asian-Americans following acute myocardial infarction (AMI). Using data from the American Heart Association Get With The Guidelines-Coronary Artery Disease (GWTG-CAD) program, we compared use of and trends in evidence-based care AMI processes and outcome in Asian-American versus white patients. We analyzed 107,403 AMI patients (4412 Asian-Americans, 4.1%) from 382 United States centers participating in the Get With The Guidelines-Coronary Artery Disease program between 2003 and 2008. Use of 6 AMI performance measures, composite "defect-free" care (proportion receiving all eligible performance measures), door-to-balloon time, and in-hospital mortality were examined. Trends in care over this time period were explored. Compared with whites, Asian-American AMI patients were significantly older, more likely to be covered by Medicaid and recruited in the west region, and had a higher prevalence of diabetes, hypertension, heart failure, and smoking. In-hospital unadjusted mortality was higher among Asian-American patients. Overall, Asian-Americans were comparable with whites regarding the baseline quality of care, except that Asian-Americans were less likely to get smoking cessation counseling (65.6% versus 81.5%). Asian-American AMI patients experienced improvement in the 6 individual measures (P≤0.048), defect-free care (PAsian-Americans and whites. Compared with whites, the adjusted in-hospital mortality rate was higher for Asian-Americans (adjusted relative risk: 1.16; 95% confidence interval: 1.00-1.35; P=0.04). Evidence-based care for AMI processes improved significantly over the period of 2003 to 2008 for Asian-American and white patients in the Get With The Guidelines-Coronary Artery Disease program. Differences in care between Asian-Americans and whites, when present, were reduced over time.

Trends in the Mental Health Act Review Tribunals: a Welsh experience 2004-2008.

Science.gov (United States)

Aziz, V M

2009-10-01

This study aims at identifying any local trend in the appeal process and to determine if we are complying with the MHA 1983 and the Code of Practice by reviewing all the appeals to Mental Health Review Tribunals in a psychiatric hospital in South Wales for the period from 2004 to 2008. The total numbers of sections and appeals remain steady over the years. Men are slightly more detained than women mainly under Sections 2 and 3 of the MH Act 1983. The main diagnoses for detention were: bipolar affective disorder, schizophrenia and psychosis. 95% of cases had appeals and 5% referrals. A hearing was held in 52% of cases (n=60), the RMO discharged 38% of patients and the patient withdrew appeal in 10% of cases. 95% of cases were British White ethnicity. Single men tended to appeal more than women 68% vs. 32%. There was no observed trend in the result of the appeals and the proportions of appeal discharged by the hearing remained unchanged. The results of the appeals were not associated with gender, ethnicity, marital status, age or the type of section involved. The patients who were previously detained tend to appeal more, i.e. the more number of detentions, the more number of appeals. In only 12% of cases who had the hearings, the appeal was successful and the patients were discharged from their sections. The study shows steady volume of sections and appeals and the appeals are no more likely to result in discharge. The amendments of the Act 2007 also attract an increase in the appeal process especially in relation to the Community Treatment Orders and the Deprivation of Liberty. The use of both the Act and the Mental Capacity Act 2005 will increase workload for all involved practitioners. 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine.

Disease Management, Case Management, Care Management, and Care Coordination: A Framework and a Brief Manual for Care Programs and Staff.

Science.gov (United States)

Ahmed, Osman I

2016-01-01

With the changing landscape of health care delivery in the United States since the passage of the Patient Protection and Affordable Care Act in 2010, health care organizations have struggled to keep pace with the evolving paradigm, particularly as it pertains to population health management. New nomenclature emerged to describe components of the new environment, and familiar words were put to use in an entirely different context. This article proposes a working framework for activities performed in case management, disease management, care management, and care coordination. The author offers standard working definitions for some of the most frequently used words in the health care industry with the goal of increasing consistency for their use, especially in the backdrop of the Centers for Medicaid & Medicare Services offering a "chronic case management fee" to primary care providers for managing the sickest, high-cost Medicare patients. Health care organizations performing case management, care management, disease management, and care coordination. Road map for consistency among users, in reporting, comparison, and for success of care management/coordination programs. This article offers a working framework for disease managers, case and care managers, and care coordinators. It suggests standard definitions to use for disease management, case management, care management, and care coordination. Moreover, the use of clear terminology will facilitate comparing, contrasting, and evaluating all care programs and increase consistency. The article can improve understanding of care program components and success factors, estimate program value and effectiveness, heighten awareness of consumer engagement tools, recognize current state and challenges for care programs, understand the role of health information technology solutions in care programs, and use information and knowledge gained to assess and improve care programs to design the "next generation" of programs.

ACE Inhibitor and ARB utilization and expenditures in the Medicaid fee-for-service program from 1991 to 2008.

Science.gov (United States)

Bian, Boyang; Kelton, Christina M L; Guo, Jeff J; Wigle, Patricia R

2010-01-01

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are widely prescribed for the treatment of hypertension and heart failure, as well as for kidney disease prevention in patients with diabetes mellitus and the management of patients after myocardial infarction. To (a) describe ACE inhibitor and ARB utilization and spending in the Medicaid fee-for-service program from 1991 through 2008, and (b) estimate the potential cost savings for the collective Medicaid programs from a higher ratio of generic ACE inhibitor utilization. A retrospective, descriptive analysis was performed using the National Summary Files from the Medicaid State Drug Utilization Data, which are composed of pharmacy claims that are subject to federally mandated rebates from pharmaceutical manufacturers. For the years 1991-2008, quarterly claim counts and expenditures were calculated by summing data for individual ACE inhibitors and ARBs. Quarterly per-claim expenditure as a proxy for drug price was computed for all brand and generic drugs. Market shares were calculated based on the number of pharmacy claims and Medicaid expenditures. In the Medicaid fee-for-service program, ACE inhibitors accounted for 100% of the claims in the combined market for ACE inhibitors and ARBs in 1991, 80.6% in 2000, and 64.7% in 2008. The Medicaid expenditure per ACE inhibitor claim dropped from $37.24 in 1991 to $24.03 in 2008 when generics accounted for 92.5% of ACE inhibitor claims; after adjusting for inflation for the period from 1991 to 2008, the real price drop was 59.2%. Brand ACE inhibitors accounted for only 7.5% of the claims in 2008 for all ACE inhibitors but 32.1% of spending; excluding the effects of manufacturer rebates, Medicaid spending would have been reduced by $28.7 million (9%) in 2008 if all ACE inhibitor claims were generic. The average price per ACE inhibitor claim in 2008 was $24.03 ($17.64 per generic claim vs. $103.45 per brand claim) versus $81.98 per ARB

Health Physics Enrollments and Degrees Survey, 2004 Data

International Nuclear Information System (INIS)

Oak Ridge Institute for Science and Education

2005-01-01

This annual report details the number of health physics bachelor's, master's, and doctoral degrees awarded at a sampling of academic programs from 1998-2004. It also looks at health physics degrees by curriculum and the number of students enrolled in health physics degree programs at 28 U.S. universities in 2004

Annual Statistical Supplement, 2004

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2004 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Web GIS in practice: an interactive geographical interface to English Primary Care Trust performance ratings for 2003 and 2004

Directory of Open Access Journals (Sweden)

Kamel Boulos Maged N

2004-07-01

Full Text Available Abstract Background On 21 July 2004, the Healthcare Commission http://www.healthcarecommission.org.uk/ released its annual star ratings of the performance of NHS Primary Care Trusts (PCTs in England for the year ending March 2004. The Healthcare Commission started work on 1 April 2004, taking over all the functions of the former Commission for Health Improvement http://www.chi.nhs.uk/, which had released the corresponding PCT ratings for 2002/2003 in July 2003. Results We produced two Web-based interactive maps of PCT star ratings, one for 2003 and the other for 2004 http://healthcybermap.org/PCT/ratings/, with handy functions like map search (by PCT name or part of it. The maps feature a colour-blind friendly quadri-colour scheme to represent PCT star ratings. Clicking a PCT on any of the maps will display the detailed performance report of that PCT for the corresponding year. Conclusion Using our Web-based interactive maps, users can visually appreciate at a glance the distribution of PCT performance across England. They can visually compare the performance of different PCTs in the same year and also between 2003 and 2004 (by switching between the synchronised 'PCT Ratings 2003' and 'PCT Ratings 2004' themes. The performance of many PCTs has improved in 2004, whereas some PCTs achieved lower ratings in 2004 compared to 2003. Web-based interactive geographical interfaces offer an intuitive way of indexing, accessing, mining, and understanding large healthcare information sets describing geographically differentiated phenomena. By acting as an enhanced alternative or supplement to purely textual online interfaces, interactive Web maps can further empower organisations and decision makers.

2008 report on the Monitoring of good practices programs and independence for electricity and natural gas system operators

International Nuclear Information System (INIS)

2009-01-01

Electricity and natural gas transmission system operators (TSO) and distribution system operators (DSO) are regulated operators that provide public service functions for the benefit of the network users and the consumers they serve. Accordingly, European and French law requires that they be under independent and nondiscriminatory obligations. In particular, they must develop a good practices program which includes a range of measures to prevent the risk of discriminatory practices in network access. Pursuant to Article L.134-15 of the Energy Code, the Energy Regulatory Commission (CRE) is publishing this year its 4. annual report on the monitoring of good practices programs and independence for electricity and natural gas system operators for the year 2008. This report is based on analysis of the 'reports on the implementation of good practices programs' submitted to the CRE by the operators in late 2008 and audits carried out by the CRE services in these companies in 2008

2004 Molecular Basis of Microbial One-Carbon Metabolism Gordon Conference - August 1-6, 2004

Energy Technology Data Exchange (ETDEWEB)

Joseph A. Krzycki

2005-09-15

The Gordon Research Conference (GRC) on 2004 Molecular Basis of Microbial One-Carbon Metabolism Gordon Conference - August 1-6, 2004 was held at Mount Holyoke College, South Hadley, MA from August 1-6, 2004. The Conference was well-attended with 117 participants (attendees list attached). The attendees represented the spectrum of endeavor in this field coming from academia, industry, and government laboratories, both U.S. and foreign scientists, senior researchers, young investigators, and students. In designing the formal speakers program, emphasis was placed on current unpublished research and discussion of the future target areas in this field. There was a conscious effort to stimulate lively discussion about the key issues in the field today. Time for formal presentations was limited in the interest of group discussions. In order that more scientists could communicate their most recent results, poster presentation time was scheduled. Attached is a copy of the formal schedule and speaker program and the poster program. In addition to these formal interactions, 'free time' was scheduled to allow informal discussions. Such discussions are fostering new collaborations and joint efforts in the field.

Environmental and radiological remediation under Canada's global partnership program 2004-11 - 59185

International Nuclear Information System (INIS)

Washer, Michael J.

2012-01-01

Following the '911' attack on the USA in 2001 the international community under Canada's G8 leadership established a $20 billion Global Partnership initiative in 2002 to collaboratively address threats to global security posed by the proliferation and potential terrorist use of Weapons and Materials of Mass Destruction (WMMD) and related materials and knowledge. This major international initiative addressed four priority areas: (1) Chemical Weapon Destruction (2) Nuclear powered submarine eliminations (3) Nuclear and radiological security; and (4) Employment for former weapon scientists. Additionally the initiative has addressed Biological Non- Proliferation. Canada's execution of all these program areas has resulted in substantial environmental benefits aside from the eradication and securing of WMMD. This paper reviews the environmental and radiological remediation achievements of the four primary Global Partnership program areas addressed under Canadian funding 2004 through 2011. (author)

Job mobility among parents of children with chronic health conditions: Early effects of the 2010 Affordable Care Act.

Science.gov (United States)

Chatterji, Pinka; Brandon, Peter; Markowitz, Sara

2016-07-01

We examine the effects of the 2010 Patient Protection and Affordable Care Act's (ACA) prohibition of preexisting conditions exclusions for children on job mobility among parents. We use a difference-in-difference approach, comparing pre-post policy changes in job mobility among privately-insured parents of children with chronic health conditions vs. privately-insured parents of healthy children. Data come from the 2004 and 2008 Survey of Income and Program Participation (SIPP). Among married fathers, the policy change is associated with about a 0.7 percentage point, or 35 percent increase, in the likelihood of leaving an employer voluntarily. We find no evidence that the policy change affected job mobility among married and unmarried mothers. Copyright © 2016 Elsevier B.V. All rights reserved.

Caracterização de genótipos de rotavírus em creches: era pré- e pós-vacinação contra o rotavírus Characterization of rotavirus strains from day care centers: pre- and post-rotavirus vaccine era

Directory of Open Access Journals (Sweden)

Simone G. Morillo

2010-04-01

Full Text Available OBJETIVOS: Em 2006, a vacina contra rotavírus foi incluída no Programa Nacional de Imunização. Este estudo teve como objetivo analisar os resultados da vigilância de genótipos de rotavírus em crianças OBJECTIVES: In 2006 the rotavirus vaccine was included in the Brazilian Immunization Program. The aim of this study was to report the results of a 5-year surveillance study of rotavirus strains in children < 5 years with acute gastroenteritis from day care centers in the state of São Paulo, Brazil. METHODS: This retrospective study was conducted with 30 day care centers from 2004 to 2008 with convenient surveillance fecal specimens, investigated by ELISA, SDS-PAGE, RT-PCR and gene sequencing to genotype characterization. RESULTS: Rotavirus infection was detected in 28.3% of samples (38/134. The most frequent genotypes detected were G9P[8] and G1P[8] in 2004; G1P[8] in 2005; GNTP[NT] in 2006; G2P[4] in 2007; and there were no cases in 2008. Mixed infections were not observed. Detection rate declined from 65.7% (23/35 in 2004 to 50% (9/18 in 2007. CONCLUSIONS: Genotype distribution varied according to collection year, accompanied by a reduction in detection rate. Use of rotavirus vaccine requires implementation of post-marketing surveillance to monitor rotavirus strain diversity and its efficacy against possible new emerging genotypes.

Impact of a diabetic foot care education program on lower limb amputation rate

Directory of Open Access Journals (Sweden)

Abdullah M Al-Wahbi

2010-10-01

Full Text Available Abdullah M Al-WahbiDepartment of Surgery, King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, Riyahd, Kingdom of Saudi ArabiaBackground: Diabetic foot complications are a leading cause of lower extremity amputation. With the increasing incidence of diabetes mellitus in the Arab world, specifically in the Kingdom of Saudi Arabia, the rate of amputation will rise significantly. A diabetic foot care program was implemented at King Abdulaziz Medical City in Riyadh, Saudi Arabia, in 2002. The program was directed at health care staff and patients to increase their awareness about diabetic foot care and prevention of complications. The purpose of this study was to perform a primary evaluation of the program’s impact on the rate of lower extremity amputation due to diabetic foot complications.Method: This pilot study was the first analysis of the diabetic foot care program and examined two groups of participants for comparison, ie, a “before” group having had diabetic foot ulcers managed between 1983, when the hospital was first established, and 2002 when the program began and an “after group” having had foot ulcers managed between 2002 and 2004, in the program’s initial phase. A total of 41 charts were randomly chosen retrospectively. A data sheet containing age, gender, medical data, and the presentation, management, and outcome of diabetic foot cases was used for the analysis.Results: The before group contained 20 patients (17 males and the after group contained 21 patients (16 males. There was no difference between the two groups with regard to age and comorbidities. The rate of amputation was 70% in the before group and 61.9% in the after group. There was a decrease in the percentage of toe amputation in the after group and an increase in the percentage of below-knee amputation in the before group. However, these changes were not significant.Conclusion: The program, although evaluated at an early

What influences success in family medicine maternity care education programs?

Science.gov (United States)

Biringer, Anne; Forte, Milena; Tobin, Anastasia; Shaw, Elizabeth; Tannenbaum, David

2018-01-01

Abstract Objective To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs. Design Qualitative research using semistructured telephone interviews. Setting Purposive sample of 6 family medicine programs from 5 Canadian provinces. Participants Eighteen departmental leaders and program directors. METHODS Semistructured telephone interviews were conducted with program leaders in family medicine maternity care. Departmental leaders identified maternity care programs deemed to be “successful.” Interviews were audiorecorded and transcribed verbatim. Team members conducted thematic analysis. Main findings Participants considered their education programs to be successful in family medicine maternity care if residents achieved competency in intrapartum care, if graduates planned to include intrapartum care in their practices, and if their education programs were able to recruit and retain family medicine maternity care faculty. Five key factors were deemed to be critical to a program’s success in family medicine maternity care: adequate clinical exposure, the presence of strong family medicine role models, a family medicine–friendly hospital environment, support for the education program from multiple sources, and a dedicated and supportive community of family medicine maternity care providers. Conclusion Training programs wishing to achieve greater success in family medicine maternity care education should employ a multifaceted strategy that considers all 5 of the interdependent factors uncovered in our research. By paying particular attention to the informal processes that connect these factors, program leaders can preserve the possibility that family medicine residents will graduate with the competence and confidence to practise full-scope maternity care. PMID:29760273

The E-rate Program and Libraries and Library Consortia, 2000-2004: Trends and Issues

Directory of Open Access Journals (Sweden)

Paul T. Jaeger

2005-06-01

Full Text Available The E-rate program has provided tremendous benefits to libraries, allowing many libraries and library systems to acquire technological equipment and services that would otherwise be too expensive, increasing the availability of public Internet access through libraries. This article analyzes the data related to the E-rate program and the discounts that it has provided to libraries and library systems between 2000 and 2004. By examining the E-rate data in a longitudinal manner, this article explores the trends in the application for and the provision of E-rate discounts to libraries and library consortia at national and state levels. The data suggest that, despite a number of controversies over the years, the program has provided a significant level of support for libraries and library consortia.

75 FR 13123 - Energy Conservation Program for Consumer Products: Representative Average Unit Costs of Energy

Science.gov (United States)

2010-03-18

... that of heating oil, based on the 2004-2008 averages for these two fuels. The source for these price... DEPARTMENT OF ENERGY Office of Energy Efficiency and Renewable Energy Energy Conservation Program... and Renewable Energy, Department of Energy. ACTION: Notice. SUMMARY: In this notice, the U.S...

Retention among North American HIV-infected persons in clinical care, 2000-2008.

Science.gov (United States)

Rebeiro, Peter; Althoff, Keri N; Buchacz, Kate; Gill, John; Horberg, Michael; Krentz, Hartmut; Moore, Richard; Sterling, Timothy R; Brooks, John T; Gebo, Kelly A; Hogg, Robert; Klein, Marina; Martin, Jeffrey; Mugavero, Michael; Rourke, Sean; Silverberg, Michael J; Thorne, Jennifer; Gange, Stephen J

2013-03-01

Retention in care is key to improving HIV outcomes. The goal of this study was to describe 'churn' in patterns of entry, exit, and retention in HIV care in the United States and Canada. Adults contributing ≥1 CD4 count or HIV-1 RNA (HIV-lab) from 2000 to 2008 in North American AIDS Cohort Collaboration on Research and Design clinical cohorts were included. Incomplete retention was defined as lack of 2 HIV-laboratories (≥90 days apart) within 12 months, summarized by calendar year. Beta-binomial regression models were used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) of factors associated with incomplete retention. Among 61,438 participants, 15,360 (25%) with incomplete retention significantly differed in univariate analyses (P churn. In addition to the programmatic and policy implications, the findings of this study identify patient groups who may benefit from focused retention efforts.

The socioeconomic impacts of the 2004-2008 drought in the Ebro river basin (Spain): A comprehensive and critical assessment

Science.gov (United States)

Hernández-Mora, N.; Garrido, A.; Gil, M.

2012-04-01

Water scarcity and drought are particularly relevant phenomena in Spain, a country with a Mediterranean climate and intense pressure on existing water resources. Spain's drought management policies have evolved significantly over time, and today Spain is at the forefront of drought management and mitigation planning in Europe. However, drought management policies are not informed by comprehensive or accurate estimations of the socioeconomic impacts of drought, nor by the efficiency or efficacy of drought management and mitigation measures. Previous studies attempting to estimate on the impacts of drought are based on direct economic users of water, primarily irrigated agriculture and hydropower. Existing analyses do not take into consideration the impacts on other economic sectors, such as recreational uses, which have a growing importance from a socioeconomic perspective. Additionally, the intangible or non-market impacts (on social welfare and wellbeing and on the environment) are not considered or measured, although they can be significant. This paper presents the mid-point results of the PREEMPT project (Policy relevant assessment of the socioeconomic effects of droughts and floods, ECHO - grant agreement # 070401/2010/579119/SUB/C4), an effort to provide a comprehensive assessment of the socioeconomic impacts of the 2004-2008 drought in the Ebro river basin. The study gathers existing information on direct and indirect economic impacts of drought on different sectors, completing existing gaps and comparing the results of studies that use different methodologies. It also estimates the welfare losses resulting from domestic water use restrictions and environmental degradation as a result of the drought using a value transfer approach from results derived from value choice experiments developed for other Spanish and international river basins. Results indicate that there is a clear need to improve our knowledge of the direct and indirect impacts of drought and to

Laboratory Directed Research and Development Program Activities for FY 2008.

Energy Technology Data Exchange (ETDEWEB)

Looney,J.P.; Fox, K.

2009-04-01

Brookhaven National Laboratory (BNL) is a multidisciplinary laboratory that maintains a primary mission focus the physical sciences, energy sciences, and life sciences, with additional expertise in environmental sciences, energy technologies, and national security. It is managed by Brookhaven Science Associates, LLC, (BSA) under contract with the U. S. Department of Energy (DOE). BNL's Fiscal year 2008 budget was $531.6 million. There are about 2,800 employees, and another 4,300 guest scientists and students who come each year to use the Laboratory's facilities and work with the staff. The BNL Laboratory Directed Research and Development (LDRD) Program reports its status to the U.S. Department of Energy (DOE) annually in March, as required by DOE Order 413.2B, 'Laboratory Directed Research and Development,' April 19, 2006, and the Roles, Responsibilities, and Guidelines for Laboratory Directed Research and Developlnent at the Department of Energy/National Nuclear Security Administration Laboratories dated June 13, 2006. Accordingly, this is our Annual Report in which we describe the Purpose, Approach, Technical Progress and Results, and Specific Accomplishments of all LDRD projects that received funding during Fiscal Year 2008. BNL expended $12 million during Fiscal Year 2008 in support of 69 projects. The program has two categories, the annual Open Call LDRDs and Strategic LDRDs, which combine to meet the overall objectives of the LDRD Program. Proposals are solicited annually for review and approval concurrent with the next fiscal year, October 1. For the open call for proposals, an LDRD Selection Committee, comprised of the Associate Laboratory Directors (ALDs) for the Scientific Directorates, an equal number of scientists recommended by the Brookhaven Council, plus the Assistant Laboratory Director for Policy and Strategic Planning, review the proposals submitted in response to the solicitation. The Open Can LDRD category emphasizes innovative research concepts

Consumption of psychoactive substances among 535 women entering a Lyon prison (France) between June 2004 and December 2008.

Science.gov (United States)

Sahajian, F; Lamothe, P; Fabry, J; Vanhems, P

2012-10-01

In France, recent data on the consumption of psychoactive substances (PASs) among women entering prison are virtually nonexistent. The objective of this study was to describe the characteristics of female entrants at Montluc prison in Lyon (France) and to estimate their PAS consumption. Between June 1, 2004 and December 31, 2008, of 841 women entering the Lyon correctional facility, 535 had an entrance interview, conducted by a nurse, during which a questionnaire was systematically proposed; 306 detainees did not have this interview and could not be included in the study because of an immediate transfer to another prison or emergency hospitalization. Socioeconomic and incarceration characteristics, PAS consumption, as well as consumption level (occasional, regular, abusive or dependence) and psychological distress of the 535 interviewed detainees were systematically noted. This psychological distress was defined by the presence in the entrant talks or behavior suggesting clinical symptoms such as anxiety, depression, delusion, delirium, and mood or behavior disorders. Descriptive analysis was undertaken with the Chi(2) test and Fisher's exact test for differences between the proportions observed. The average age of the 534 responding detainees was 31.5 years; 59.2% had had no ongoing professional activity in the 12 months prior to incarceration, and 21.6% had already been imprisoned before; 37.5% of the entrants reported dependence on tobacco and 13.7% on alcohol; 6.6% reported regular, abusive use or dependence on cannabis, 20.4% on psychotropic medications, and 7.7% on other drugs (heroin, cocaine, synthetic drugs) in the 6 months preceding their incarceration; 39.2% of the consumers at risk reported using at least two substances; 7.1% of detainees were on opioid substitution treatment. A multiple correspondence factor analysis was used to note specific characteristics of three groups of PAS consumers. More frequent among young women detainees, overall PAS

2008 annual merit review

Energy Technology Data Exchange (ETDEWEB)

None, None

2009-01-18

The 2008 DOE Vehicle Technologies Program Annual Merit Review was held February 25-28, 2008 in Bethesda, Maryland. The review encompassed all of the work done by the Vehicle Technologies Program: a total of 280 individual activities were reviewed, by a total of just over 100 reviewers. A total of 1,908 individual review responses were received for the technical reviews, and an additional 29 individual review responses were received for the plenary session review.

National School Lunch Program

Science.gov (United States)

US Department of Agriculture, 2009

2009-01-01

The National School Lunch Program is a federally assisted meal program operating in over 101,000 public and non-profit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or free lunches to more than 30.5 million children each school day in 2008. In 1998, Congress expanded the National School Lunch…

Využití vyšší nadmořské výšky v OH cyklu 2004-2008 (na příkladu veslování)

OpenAIRE

Knapková, Miroslava

2010-01-01

Title: The use of altitude training in Olympic cycle 2004-2008 (in the example of rowing) Aim: The operational objective of this work is to provide a summary of selected published information on the issue of altitude training, and its use in rowing. The main aim of this work will be the practical verification of the theory of recovery training at higher altitude, focusing on the example of rowing through the evaluation of biochemical analysis. Another aim will be to determine whether training...

Impact of Implementation of Direct Cash Transfer Program 2008/2009 on Household Consumption in Central Java Province

Science.gov (United States)

Subanti, S.; Hakim, A. R.; Hakim, I. M.

2017-04-01

This study aims to see the impact of direct cash transfer program for 2008/2009 on household consumption of food, nonfood, education, and health in Central Java Province. The study is expected to provide important findings for the improvement of a similar program in the future. This study findings that (1) the increasing in food and non-food consumption for direct cash transfer recipients than non direct cash transfer recipients; (2) the impact of households expenditure on education for direct cash transfer recipients is higher than non direct cash transfer recipients; (3) the impact of households expenditure on health for direct cash transfer recipients is lower than non direct cash transfer recipients. This study recommended that (1) implementation of direct cash transfer program 2008/2009 must be managed to be better because this program can defend household welfare. It shows from several indicators of well-being such as consumption spending, education, and health; (2) data targets for poor households (very poor, poor, nearly poor) must be updated.

Participation of ARN (Autoridad Regulatoria Nuclear) Argentina in the quality assessment program, EML-USDOE since 2002-2004

International Nuclear Information System (INIS)

Equillor, Hugo E.; Serdeiro, Nelida H.; Fernandez, Jorge A.; Gavini, Ricardo M.; Grinman, Ana. D. R.; Lewis, Esther C.; Palacios, Miguel A.

2004-01-01

In this report, the results corresponding to five consecutive exercises (period 2002-2004) obtained by the Autoridad Regulatoria Nuclear (ARN) in alpha, beta and gamma measurements, on four different matrixes, within the framework of Environmental Measurements Laboratory (EML) Quality Assessment Program (QAP) of the United States, are presented. (author)

Participation in preventive care programs: individual determinants, social interactions and program design.

OpenAIRE

Bouckaert, Nicolas

2014-01-01

This doctoral research focuses on existing medical preventive care programs. Because of externalities (e.g. in the prevention of communicable diseases) or the program cost-benefit ratio, preventive care programs require high participation rates. In the United States, the Centers for Disease Control and Prevention have set clear participation objectives – next to quality targets – which are measured and evaluated over time (National Center for Health Statistics, 2012). For example, the 2010 pa...

Coronary Heart Disease Mortality in Czech Men, 1980-2004

Czech Academy of Sciences Publication Activity Database

Reissigová, Jindra; Tomečková, Marie

2008-01-01

Roč. 4, č. 1 (2008), s. 12-16 ISSN 1801-5603 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : coronary heart disease * cardiovascular * mortality * 1980-2004 Subject RIV: IN - Informatics, Computer Science http://www.ejbi.org/articles/200812/33/1.html

Report: FISMA - Fiscal Year 2004 Status of EPA’s Computer Security Program

Science.gov (United States)

Report #2004-S-00007, September 30, 2004. This report synopsizes the results of information technology security work the U.S. Environmental Protection Agency’s Office of Inspector General (OIG) performed during Fiscal Year (FY) 2004.

Attracting Future Radiation Oncologists: An Analysis of the National Resident Matching Program Data Trends From 2004 to 2015.

Science.gov (United States)

Ahmed, Awad A; Holliday, Emma B; Deville, Curtiland; Jagsi, Reshma; Haffty, Bruce G; Wilson, Lynn D

2015-12-01

A significant physician shortage has been projected to occur by 2025, and demand for oncologists is expected to outpace supply to an even greater degree. In response to this, many have called to increase the number of radiation oncology residency positions. The purpose of this study is to evaluate National Resident Matching Program (NRMP) data for the number of residency positions between 2004 and 2015 as well as the number and caliber of applicants for those positions and to compare radiation oncology to all residency specialties. NRMP data for all specialties participating in the match, including radiation oncology, were assessed over time examining the number of programs participating in the match, the number of positions offered, and the ratio of applicants to positions in the match from 2004 to 2015. From 2004 to 2015, the number of total programs participating in the match has increased by 26.7%, compared to the increase of 28.6% in the number of radiation oncology programs from during the same time period. The total number of positions offered in the match increased by 53.4%, whereas radiation oncology positions increased by 56.3%, during the same time period. The ratio of applicants (defined as those selecting a specialty as their first or only choice) to positions for all specialties has fluctuated over this time period and has gone from 1.21 to 1.15, whereas radiation oncology experienced a decrease from 1.45 to 1.14. NRMP data suggest that senior medical student applications to radiation oncology are decreasing compared to those of other specialties. If we hope to continue to attract the best and brightest to enter our field, we must continue to support early exposure to radiation oncology, positive educational experiences, and dedicated mentorship to interested medical students. Copyright © 2015 Elsevier Inc. All rights reserved.

Attracting Future Radiation Oncologists: An Analysis of the National Resident Matching Program Data Trends From 2004 to 2015

Energy Technology Data Exchange (ETDEWEB)

Ahmed, Awad A., E-mail: Awad.ahmed@jhsmiami.org [Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida (United States); Holliday, Emma B. [Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Deville, Curtiland [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Jagsi, Reshma [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Haffty, Bruce G. [Department of Radiation Oncology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey (United States); Wilson, Lynn D. [Department of Therapeutic Radiology, Yale School of Medicine and Yale Cancer Center, New Haven, Connecticut (United States)

2015-12-01

Purpose: A significant physician shortage has been projected to occur by 2025, and demand for oncologists is expected to outpace supply to an even greater degree. In response to this, many have called to increase the number of radiation oncology residency positions. The purpose of this study is to evaluate National Resident Matching Program (NRMP) data for the number of residency positions between 2004 and 2015 as well as the number and caliber of applicants for those positions and to compare radiation oncology to all residency specialties. Methods: NRMP data for all specialties participating in the match, including radiation oncology, were assessed over time examining the number of programs participating in the match, the number of positions offered, and the ratio of applicants to positions in the match from 2004 to 2015. Results: From 2004 to 2015, the number of total programs participating in the match has increased by 26.7%, compared to the increase of 28.6% in the number of radiation oncology programs from during the same time period. The total number of positions offered in the match increased by 53.4%, whereas radiation oncology positions increased by 56.3%, during the same time period. The ratio of applicants (defined as those selecting a specialty as their first or only choice) to positions for all specialties has fluctuated over this time period and has gone from 1.21 to 1.15, whereas radiation oncology experienced a decrease from 1.45 to 1.14. Conclusions: NRMP data suggest that senior medical student applications to radiation oncology are decreasing compared to those of other specialties. If we hope to continue to attract the best and brightest to enter our field, we must continue to support early exposure to radiation oncology, positive educational experiences, and dedicated mentorship to interested medical students.

The status of diabetes control in Malaysia: results of DiabCare 2008.

Science.gov (United States)

Mafauzy, M; Hussein, Z; Chan, S P

2011-08-01

DiabCare Malaysia 2008 evaluated the current status of diabetes care in Malaysia as a continuation of similar cross-sectional studies conducted previously in 1997, 1998, 2001 and 2003. The current study recruited 1670 patients from general hospitals, diabetes clinics and referral clinics to study current scenario of diabetes management. We report the results of type 2 diabetic population who constituted 92.8% (n = 1549). Results showed deteriorating glycaemic control with mean HbA1c of 8.66 +/- 2.09% with only 22% of the patients achieving ADA target of 2.6 mmol/L; 19.8% had triglycerides > 2.2 mmol/L; 27.4% had HDL exercise and self testing of blood glucose. In conclusion, majority of the patients were still not satisfactorily controlled. There is an urgent need for effective remedial measures to increase adherence to practice guidelines and to educate both patients and healthcare personnel on importance of achieving clinical targets for metabolic control.

Competition and rural primary care programs.

Science.gov (United States)

Ricketts, T C

1990-04-01

Rural primary care programs were established in areas where there was thought to be no competition for patients. However, evidence from site visits and surveys of a national sample of subsidized programs revealed a pattern of competitive responses by the clinics. In this study of 193 rural primary care programs, mail and telephone surveys produced uniform data on the organization, operation, finances, and utilization of a representative sample of clinics. The programs were found to compete in terms of: (1) price, (2) service mix, (3) staff availability, (4) structural accessibility, (5) outreach, and (6) targeting a segment of the market. The competitive strategies employed by the clinics had consequences that affected their productivity and financial stability. The strategies were related to the perceived missions of the programs, and depended heavily upon the degree of isolation of the program and the targeting of the services. The competitive strategy chosen by a particular program could not be predicted based on service area population and apparent competitors in the service area. The goals and objectives of the programs had more to do with their competitive responses than with market characteristics. Moreover, the chosen strategies may not meet the demands of those markets.

Overview of the 2006-2008 JOGMEC/NRCan/Aurora Mallik Gas Hydrate Production Test Program

Science.gov (United States)

Yamamoto, K.; Dallimore, S. R.

2008-12-01

During the winters of 2007 and 2008 the Japan Oil, Gas and Metals National Corporation (JOGMEC) and Natural Resources Canada (NRCan), with Aurora Research Institute as the operator, carried out an on-shore gas hydrate production test program at the Mallik site, Mackenzie Delta, Northwest Territories, Canada. The prime objective of the program was to verify the feasibility of depressurization technique by drawing down the formation pressure across a 12m perforated gas hydrate bearing section. This project was the second full scale production test at this site following the 2002 Japex/JNOC/GSC et al Mallik research program in which seven participants organizatinos from five countries undertook a thermal test using hot water circulation Field work in 2007 was devoted to establishing a production test well, installing monitoring devices outside of casing, conducting base line geophysical studies and undertaking a short test to gain practical experience prior to longer term testing planned for 2008 . Hydrate-dissociated gas was produced to surface by depressurization achieved by lowering the fluid level with a dowhole pump. However, the operation was terminated 60 hours after the start of the pumping mainly due to sand production problems. In spite of the short period (12.5 hours of ellapsed pumping time), at least 830m3 of the gas was produced and accumulated in the borehole. Sand screens were installed across the perforated interval at the bottom hole for the 2008 program to overcome operational problems encountered in 2007 and achieve sustainable gas production. Stable bottom hole flowing pressures were successfully achieved during a 6 day test with continuous pump operation. Sustained gas production was achieved with rates between 2000- 4000m3/day and cummulative gas volume in the surface of approximately 13,000m3. Temperature and pressure data measured at the bottom hole and gas and water production rates gave positive evidence for the high efficiency of gas

Trends in Alcohol Consumption among Undergraduate Students at a Northeastern Public University, 2002-2008

Science.gov (United States)

Bulmer, Sandra Minor; Irfan, Syed; Mugno, Raymond; Barton, Barbara; Ackerman, Louise

2010-01-01

Objective: This study examined alcohol consumption patterns and trends at a public university in the Northeast from 2002 to 2008. Participants: Stratified random sampling was used to select undergraduate students enrolled in courses during spring semesters in 2002, 2004, 2006, and 2008. Methods: Data were collected during regularly scheduled…

Research program of the Neutrino Research Group. Year 2004

International Nuclear Information System (INIS)

2004-01-01

For the last two decades, neutrino physics has been producing major discoveries including neutrino oscillations. These results gave clear confirmation that active neutrinos oscillate and therefore have mass with three different mass states. This is a very important result showing that the Minimal Standard Model is incomplete and requires an extension which is not yet known. The neutrino research field is very broad and active, at the frontier of today's particle physics. The creation of a Neutrino Research Group (GDR) was proposed in 2004 with the aim of gathering CEA and CNRS research teams working on Neutrino Physics on experimental or theoretical level. This document presents the Research program of the Neutrino Research Group which is divided into 5 working groups with the following activities: 1 - Determination of neutrino parameters; 2 - Physics beyond the standard model; 3 - Neutrinos in the universe; 4 - Accelerators, detection means, R and D and valorisation; 5 - Common tools to all working groups. The research group participating laboratories and teams are listed at the end of the document

Global review of health care surveys using lot quality assurance sampling (LQAS), 1984-2004.

Science.gov (United States)

Robertson, Susan E; Valadez, Joseph J

2006-09-01

We conducted a global review on the use of lot quality assurance sampling (LQAS) to assess health care services, health behaviors, and disease burden. Publications and reports on LQAS surveys were sought from Medline and five other electronic databases; the World Health Organization; the World Bank; governments, nongovernmental organizations, and individual scientists. We identified a total of 805 LQAS surveys conducted by different management groups during January 1984 through December 2004. There was a striking increase in the annual number of LQAS surveys conducted in 2000-2004 (128/year) compared with 1984-1999 (10/year). Surveys were conducted in 55 countries, and in 12 of these countries there were 10 or more LQAS surveys. Geographically, 317 surveys (39.4%) were conducted in Africa, 197 (28.5%) in the Americas, 115 (14.3%) in the Eastern Mediterranean, 114 (14.2%) in South-East Asia, 48 (6.0%) in Europe, and 14 (1.8%) in the Western Pacific. Health care parameters varied, and some surveys assessed more than one parameter. There were 320 surveys about risk factors for HIV/AIDS/sexually transmitted infections; 266 surveys on immunization coverage, 240 surveys post-disasters, 224 surveys on women's health, 142 surveys on growth and nutrition, 136 surveys on diarrheal disease control, and 88 surveys on quality management. LQAS surveys to assess disease burden included 23 neonatal tetanus mortality surveys and 12 surveys on other diseases. LQAS is a practical field method which increasingly is being applied in assessment of preventive and curative health services, and may offer new research opportunities to social scientists. When LQAS data are collected recurrently at multiple time points, they can be used to measure the spatial variation in behavior change. Such data provide insight into understanding relationships between various investments in social, human, and physical capital, and into the effectiveness of different public health strategies in achieving

Annual Site Environmental Report for Calendar Year 2004

International Nuclear Information System (INIS)

Finley, M.

2009-01-01

This report provides the U.S. Department of Energy (DOE) and the public with information on the level of radioactive and non-radioactive pollutants (if any) that are added to the environment as a result of Princeton Plasma Physics Laboratory's (PPPL) operations. The results of the 2004 environmental surveillance and monitoring program for PPPL's are presented and discussed. The report also summarizes environmental initiatives, assessments, and programs that were undertaken in 2004

Varicella-related Primary Health-care Visits, Hospitalizations and Mortality in Norway, 2008-2014.

Science.gov (United States)

Mirinaviciute, Grazina; Kristensen, Erle; Nakstad, Britt; Flem, Elmira

2017-11-01

Norway does not currently implement universal varicella vaccination in childhood. We aimed to characterize health care burden of varicella in Norway in the prevaccine era. We linked individual patient data from different national registries to examine varicella vaccinations and varicella-coded primary care consultations, hospitalizations, outpatient hospital visits, deaths and viral infections of central nervous system in the whole population of Norway during 2008-2014. We estimated health care contact rates and described the epidemiology of medically attended varicella infection. Each year approximately 14,600 varicella-related contacts occurred within primary health care and hospital sector in Norway. The annual contact rate was 221 cases per 100,000 population in primary health care and 7.3 cases per 100,000 in hospital care. Both in primary and hospital care, the highest incidences were observed among children 1 year of age: 2,654 and 78.1 cases per 100,000, respectively. The annual varicella mortality was estimated at 0.06 deaths per 100,000 and in-hospital case-fatality rate at 0.3%. Very few (0.2-0.5%) patients were vaccinated against varicella. Among hospitalized varicella patients, 22% had predisposing conditions, 9% had severe-to-very severe comorbidities and 5.5% were immunocompromised. Varicella-related complications were reported in 29.3% of hospitalized patients. Varicella zoster virus was the third most frequent virus found among 16% of patients with confirmed viral infections of central nervous system. Varicella causes a considerable health care burden in Norway, especially among children. To inform the policy decision on the use of varicella vaccination, a health economic assessment of vaccination and mathematical modeling of vaccination impact are needed.

Births: final data for 2004.

Science.gov (United States)

Martin, Joyce A; Hamilton, Brady E; Sutton, Paul D; Ventura, Stephanie J; Menacker, Fay; Kirmeyer, Sharon

2006-09-29

This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2004 are presented. Denominators for population-based rates are post-censal estimates derived from the U.S. 2000 census. In 2004, 4,112,052 births were registered in the United States, less than 1 percent more than the number in 2003. The crude birth rate declined slightly; the general fertility rate increased by less than 1 percent. Childbearing among teenagers and women aged 20-24 years declined to record lows. Rates for women aged 25-34 and 45-49 years were unchanged, whereas rates for women aged 35-44 years increased. All measures of unmarried childbearing rose in 2004. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate jumped 6 percent to another all-time high, whereas the rate of vaginal birth after previous cesarean fell by 13 percent. Preterm and low birthweight rates continued their steady rise

Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program.

Science.gov (United States)

Verweij, Lisanne Marlieke; Wehrens, Rik; Oldenhof, Lieke; Bal, Roland; Francke, Anneke L

2018-05-02

The perspectives of nursing professionals might differ from those of older adults when it comes to care for older people. This cross-sectional study compares the views of older adults with the views of nursing professionals on the quality of care after a nationwide improvement program for care for older people was implemented (2008-2016) in the Netherlands. Questionnaire data were used from 385 nursing professionals (response rate 51%) that were part of the Nursing Staff Panel, a nationwide representative group of nursing staff, and working in home care, hospitals or general practices. Additionally, questionnaire data were used from 73 older adults (response rate 81%) who were involved in regional networks to discuss project proposals and to represent the voice of older adults in the nationwide improvement program. Participants were asked to evaluate care for older people with regard to collaboration between healthcare organizations and with regard to the tailored service, accessibility, and quality of care within their organizations and in the region in which they lived. A majority of older adults (54%) and nursing professionals (61%) felt that collaboration with others had improved over the last few years. Approximately one third of the older adults stated that care for older people was tailored to fit individual needs and was accessible most of the time or always, as opposed to approximately two thirds of the professionals. Moreover, 17% older adults thought that the quality of care was good, compared with 54% of the nursing professionals. 77% of the nursing professionals and 94% of the older adults thought that improvements were still needed in care for older people, for example better integration of the different aspects of care and a more patient-centered approach. Older adults who were involved in networks of the improvement program generally gave a less positive evaluation of aspects of care for older people and its development than nursing professionals

Development of a hospital-based care coordination program for children with special health care needs.

Science.gov (United States)

Petitgout, Janine M; Pelzer, Daniel E; McConkey, Stacy A; Hanrahan, Kirsten

2013-01-01

A hospital-based Continuity of Care program for children with special health care needs is described. A family-centered team approach provides care coordination and a medical home. The program has grown during the past 10 years to include inpatients and outpatients from multiple services and outreach clinics. Improved outcomes, including decreased length of stay, decreased cost, and high family satisfaction, are demonstrated by participants in the program. Pediatric nurse practitioners play an important role in the medical home, collaborating with primary care providers, hospital-based specialists, community services, and social workers to provide services to children with special health care needs. Copyright © 2013 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.

Semiannual Report to Congress, No. 49. April 1, 2004-September 30, 2004

Science.gov (United States)

US Department of Education, 2004

2004-01-01

This report highlights significant work of the U.S. Department of Education's Office of Inspector General for the 6-month period ending September 30, 2004. Sections include: Activities and Accomplishments; Elimination of Fraud and Error in Student Aid Programs; Budget and Performance Integration; Financial Management; Expanded Electronic…

Retention Among North American HIV–infected Persons in Clinical Care, 2000–2008

Science.gov (United States)

Rebeiro, Peter; Althoff, Keri N.; Buchacz, Kate; Gill, M. John; Horberg, Michael; Krentz, Hartmut; Moore, Richard; Sterling, Timothy R.; Brooks, John T.; Gebo, Kelly A.; Hogg, Robert; Klein, Marina; Martin, Jeffrey; Mugavero, Michael; Rourke, Sean; Silverberg, Michael J.; Thorne, Jennifer; Gange, Stephen J.

2013-01-01

Background Retention in care is key to improving HIV outcomes. Our goal was to describe “churn” in patterns of entry, exit, and retention in HIV care in the US and Canada. Methods Adults contributing ≥1 CD4 count or HIV-1 RNA (HIV-lab) from 2000–2008 in North American Cohort Collaboration on Research and Design (NA-ACCORD) clinical cohorts were included. Incomplete retention was defined as lack of 2 HIV-labs (≥90 days apart) within 12 months, summarized by calendar year. We used beta-binomial regression models to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) of factors associated with incomplete retention. Results Among 61,438 participants, 15,360 (25%) with incomplete retention significantly differed in univariate analyses (pchurn. In addition to the programmatic and policy implications, our findings identify patient groups who may benefit from focused retention efforts. PMID:23242158

Socioeconomic differences in self-rated oral health and dental care utilisation after the dental care reform in 2008 in Sweden

OpenAIRE

Molarius, Anu; Engström, Sevek; Flink, Håkan; Simonsson, Bo; Tegelberg, Åke

2014-01-01

BACKGROUND: The aims of this study were to determine self-rated oral health and dental attendance habits among Swedish adults, with special reference to the role of social inequalities, after the Swedish dental care reform in 2008. METHODS: The study is based on a survey questionnaire, sent to 12,235 residents of a Swedish county, in 2012. The age group was 16-84 years: 5,999 (49%) responded. Using chi-square statistics, differences in prevalence of self-rated oral health and regular dental a...

Annual Report 2008

International Nuclear Information System (INIS)

2009-01-01

The year 2008 marked a milestone year in the history of the Philippine Nuclear Research Institute (PNRI) as it celebrated its 50th Founding Anniversary. For five decades, the PNRI, formerly the Philippine Atomic Energy Commission (PAEC), had made noteworthy contributions in agriculture, health care, industry, energy and care of the environment and had offered quality research and development activities, services and ensured nuclear safety through nuclear regulations

Annual Site Environmental Report for Calendar Year 2004

Energy Technology Data Exchange (ETDEWEB)

V. Finley

2009-03-26

This report provides the U.S. Department of Energy (DOE) and the public with information on the level of radioactive and non-radioactive pollutants (if any) that are added to the environment as a result of Princeton Plasma Physics Laboratory's (PPPL) operations. The results of the 2004 environmental surveillance and monitoring program for PPPL's are presented and discussed. The report also summarizes environmental initiatives, assessments, and programs that were undertaken in 2004.

Evaluation of a Research Mentorship Program in Community Care

Science.gov (United States)

Ploeg, Jenny; de Witt, Lorna; Hutchison, Brian; Hayward, Lynda; Grayson, Kim

2008-01-01

This article describes the results of a qualitative case study evaluating a research mentorship program in community care settings in Ontario, Canada. The purpose of the program was to build evaluation and research capacity among staff of community care agencies through a mentorship program. Data were collected through in-depth, semi-structured…

[Epidemiological analysis of viral hepatitis A in China, 2004-2015].

Science.gov (United States)

Sun, X J; Wang, F Z; Zheng, H; Miao, N; Yuan, Q L; Wang, H Q; Yin, Z D; Zhang, G M

2017-12-06

Objective: To analyze the epidemiological characteristics of hepatitis A cases in China from 2004 to 2015. Methods: Data of hepatitis A were reported through national notifiable disease information reporting system, which covered the 31 provinces (Hong Kong, Macau and Taiwan excluded). The inclusion criteria was: date of illness onset was between January 1(st) 2004 and December 31(st) 2015, the status of reported card was confirmed, the case was classified as laboratory confirmed or clinical diagnosed, the disease was Hepatitis A. The information such as sex, date of birth, date of illness onset, place of residence was collected. The data was divided into three phases, 2004-2007, 2008-2011, 2012-2015, which represented the phase before expanded program on immunization (EPI), first 4 years after EPI, second 4 years after EPI. Results: From 2004 to 2015, there were totally 574 697 hepatitis A cases in China, the mean annual incidence was 3.62/100 000. The risk ratio of hepatitis A in 2015 was 0.23 when compared with 2004. Sichuan, Xinjiang and Yunnan contributed to 27.27% of the total cases in China. In 2012-2015, the incidence of western (3.46/100 000) region was significantly higher than that in central (1.21/100 000) and eastern (1.08/100 000) regions. From 2004-2015, number of cases in each age group declined greatly, with number of cases declining from 43 711 to 5 938 in the age group of 5-9 years, from 29 722 to 3 438 in 10-14, from 23 212 to 3 646 in 15-19. The number of cases declined from 24 079 to 10 304 in the age group of 0-4 (declined by 57.21%), but in 2012-2015, the incidence of 0-4 age group was still the highest, with 77.72% cases in Xinjiang and Sichuan. Famers, students and scattered children accounted for 69.95% of total cases, with student cases declined from 24.08% (2004-2007) to 8.67% (2012-2015). Conclusion: The incidence of hepatitis A in China is decreasing year by year, the risk has been decreasing to a relatively low level. However, in

The NITRD Program: FY2004 Interagency Coordination Report

Data.gov (United States)

Networking and Information Technology Research and Development, Executive Office of the President — This Interagency Coordination Report ICR provides a comprehensive description of the FY 2004 activities of the multi-agency $2 billion Federal Networking and...

What influences success in family medicine maternity care education programs? Qualitative exploration.

Science.gov (United States)

Biringer, Anne; Forte, Milena; Tobin, Anastasia; Shaw, Elizabeth; Tannenbaum, David

2018-05-01

To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs. Qualitative research using semistructured telephone interviews. Purposive sample of 6 family medicine programs from 5 Canadian provinces. Eighteen departmental leaders and program directors. Semistructured telephone interviews were conducted with program leaders in family medicine maternity care. Departmental leaders identified maternity care programs deemed to be "successful." Interviews were audiorecorded and transcribed verbatim. Team members conducted thematic analysis. Participants considered their education programs to be successful in family medicine maternity care if residents achieved competency in intrapartum care, if graduates planned to include intrapartum care in their practices, and if their education programs were able to recruit and retain family medicine maternity care faculty. Five key factors were deemed to be critical to a program's success in family medicine maternity care: adequate clinical exposure, the presence of strong family medicine role models, a family medicine-friendly hospital environment, support for the education program from multiple sources, and a dedicated and supportive community of family medicine maternity care providers. Training programs wishing to achieve greater success in family medicine maternity care education should employ a multifaceted strategy that considers all 5 of the interdependent factors uncovered in our research. By paying particular attention to the informal processes that connect these factors, program leaders can preserve the possibility that family medicine residents will graduate with the competence and confidence to practise full-scope maternity care. Copyright© the College of Family Physicians of Canada.

EVALUASI PROGRAM WAJIB BELAJAR PENDIDIKAN DASAR DI DKI JAKARTA PADA PERIODE 2008-2011

Directory of Open Access Journals (Sweden)

HENRY ERYANTO

2014-03-01

Full Text Available This study aimed to evaluate the Compulsory Basic Education Programm period 2008-2011 in Jakarta and knew the extent of the success of the program, and formulate policy recommendations to improve this activity in the future . This study uses the CIPP evaluation process to assess whether the program is appropriate to proceed or not. From the research, it is seen that in the context of the stage success indicators compulsory education program, it can be concluded that the implementation of the law that underlies the program has not done well. Referring to the input stage of program success indicators compulsory education, it can be concluded that the population of school age enrolled in school at that level has been well absorbed. Referring to the indicators of the success of the process stages of compulsory education program, it can be concluded that the stage of the process is quite successful. As well as referring to the indicators of the success of the product phase of compulsory education program, it can be concluded that the stage of successful products, because its value at a high level of completeness that range from 94% -103 %.

Emergence Corporate Financial Distressin Emerging Market: Empirical Evidence from Indonesia Stock Exchange(IDX 2004-2008

Directory of Open Access Journals (Sweden)

Koes Pranowo

2011-11-01

Full Text Available Normal 0 false false false MicrosoftInternetExplorer4 st1\\:*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} Financial recovery is the most difficult in financial management. Therefore, this is important to study how a company in financially-distress can survive to rise up to a healthy financial condition (emergence financial distress. The research consists of 200 non financial companies which are listed on Indonesia Stock Exchange (IDX for the period of 2004-2008. This study focuses on management of working capital. How a company fulfill its current liabilities, and its sources in current assets which shall be cashed at the short term period. By using Multinomial logit, we analyzed the probability a financially-distress company rise up to emergence financial distress or stay of the status of financial distress and what are financial indicators affect to a company in the status of Non Financial Distress tend to Financial Distress. Thus, the important thing is to determine financial ratios which can be an indicator to determine of emergence financial distress. We find a positive relationship between Profit, efficiency and emergence financial distress and a negative relationship between leverage and emergence financial distress.   Keywords: Emergence Financial Distress, Indonesia Stock Exchange (IDX, Multinomial Logit JEL Classification Codes: G 3

Implementing Internet-Based Self-Care Programs in Primary Care: Qualitative Analysis of Determinants of Practice for Patients and Providers.

Science.gov (United States)

Hermes, Eric; Burrone, Laura; Perez, Elliottnell; Martino, Steve; Rowe, Michael

2018-05-18

Access to evidence-based interventions for common mental health conditions is limited due to geographic distance, scheduling, stigma, and provider availability. Internet-based self-care programs may mitigate these barriers. However, little is known about internet-based self-care program implementation in US health care systems. The objective of this study was to identify determinants of practice for internet-based self-care program use in primary care by eliciting provider and administrator perspectives on internet-based self-care program implementation. The objective was explored through qualitative analysis of semistructured interviews with primary care providers and administrators from the Veterans Health Administration. Participants were identified using a reputation-based snowball design. Interviews focused on identifying determinants of practice for the use of internet-based self-care programs at the point of care in Veterans Health Administration primary care. Qualitative analysis of transcripts was performed using thematic coding. A total of 20 physicians, psychologists, social workers, and nurses participated in interviews. Among this group, internet-based self-care program use was relatively low, but support for the platform was assessed as relatively high. Themes were organized into determinants active at patient and provider levels. Perceived patient-level determinants included literacy, age, internet access, patient expectations, internet-based self-care program fit with patient experiences, interest and motivation, and face-to-face human contact. Perceived provider-level determinants included familiarity with internet-based self-care programs, changes to traditional care delivery, face-to-face human contact, competing demands, and age. This exploration of perspectives on internet-based self-care program implementation among Veterans Health Administration providers and administrators revealed key determinants of practice, which can be used to develop

Naval Law Review, Volume 56, 2008

Science.gov (United States)

2008-01-01

the plastic bag for fingerprints and recovered more from inside the van.20 On March 13, 2004, the SNP submitted digital photographs of the latent21...original images were of low resolution, the FBI requested that SNP send higher resolution digital photographs of the latent prints.27 These were...by the Supreme Court in Medellin v. Texas, 128 S.Ct. 1346, 1368 (2008) (“Justice Jackson’s familiar tripartite scheme provides the accepted

Evaluation of a program to improve diabetes care through intensified care management activities and diabetes medication copayment reduction.

Science.gov (United States)

Kogut, Stephen J; Johnson, Scott; Higgins, Tara; Quilliam, Brian

2012-05-01

Medication copayment reduction can be integrated with disease management programs to incentivize patient engagement in chronic care management. While disease management programs in diabetes have been evaluated across a range of settings and designs, less is known regarding the effectiveness of copayment reduction as a component of disease management. To evaluate the short-term results of a diabetes-focused disease management program that included copayment reduction, care coordination, and patient goal setting, focusing on rates of evidence-based care processes and all-cause pharmacy and health care costs. Blue Cross Blue Shield of Rhode Island offered large employer groups the opportunity to participate in a diabetes disease management initiative that featured reduced copayments (from $7/$25/$40 for generic, tier 2, and tier 3 drugs, respectively, to $0 for generic and $0-$2 for brand drugs) for diabetes-related medications. In return for the copayment reduction, participants agreed to the following: (a) participate in care coordination with a case manager, (b) have an annual physical examination, (c) have a hemoglobin A1c blood test at least twice annually, and (d) have a low-density lipoprotein cholesterol (LDL-C) test at least once annually. Patients received personalized support provided by a registered nurse and dietician, disease-related education provided by nurses, and intensified case management services, including working with a health coach to establish healthy behavioral change goals. All study subjects were aged 18 years or older and had at least 1 ICD-9-CM code for diabetes and at least 1 claim for an antidiabetic drug during a 12-month measurement period, which was each subject's most recent 12-month period of continuous enrollment from January 1, 2008, through May 31, 2010. Administrative claims data were used to determine the percentage of intervention (participating) and nonintervention (nonparticipating) subjects from among all of the plan

Nesting Activity of Loggerhead Turtles (Caretta caretta at Göksu Delta, Turkey during 2004 and 2008 nesting seasons

Directory of Open Access Journals (Sweden)

Salih H. Durmus

2011-07-01

Full Text Available Göksu Delta is one of the most important nesting beaches in Turkey for the endangered loggerhead turtle (Caretta caretta. This paper provides information on the nesting activities of loggerhead turtles, the spatial and temporal distribution of nesting, nesting success, nesting density, hatching success, incubation duration and clutch size over two nesting seasons. A total of 902 emergences occurred over two seasons, of which 239 (26.5% nests were deposited (137 nests in 2004 and 102 nests in 2008 and the overall mean nesting density was 3.4 nests/km. The peak of nesting emergences takes place mainly in June. Of the overall nests, 226 (94.6% were excavated and 16044 eggs were counted. Of these eggs, 3680 (22.9% hatchlings emerged and 2695 (73.2% of hatchlings of them were able to reach the sea. The mean number of eggs per clutch was 71 (range: 15 – 143. The shortest and longest incubation duration in these 2 seasons ranged from 46 to 62 days with a mean of 53 days. The main problems are negatively affecting loggerhead turtle population at Göksu Delta are dense jackal predation both adult and eggs and inundation in nests. The average nesting effort here (mean: 119.5 nests/season confirms that Göksu Delta is one of the most important nesting sites for loggerhead turtles in Turkey.

Horonobe Underground Research Laboratory project. Investigation program for the 2008 fiscal year

International Nuclear Information System (INIS)

Nakayama, Masashi; Sanada, Hiroyuki; Yamaguchi, Takehiro; Sugita, Yutaka

2008-09-01

As part of the research and development program on geological disposal of high-level radioactive waste (HLW), the Horonobe Underground Research Center, a division of the Japan Atomic Energy Agency (JAEA), is implementing the Horonobe Underground Research Laboratory Project (Horonobe URL Project) with the aim at investigating sedimentary rock formations. According to the research plan described in the Midterm Plan of JAEA, geological investigations are to be carried out during the drilling of a shaft down to intermediate depth, while research and development in the areas of engineering technology and safety assessment are to be promoted by collaboration with other research organizations. The results of the R and D activities will be systematized as a 'knowledge base' that supports a wide range of arguments related to the safety of geological disposal. The Horonobe URL Project is planned to extend over a period of 20 years. The investigations will be conducted in three phases, namely 'Phase 1: Surface-based investigations', 'Phase 2: Construction phase' (investigations during construction of the underground facilities) and 'Phase 3: Operation phase' (research in the underground facilities). This report summarizes the investigation program for the 2008 fiscal year (2008/2009), the 4th year of the Phase 2 investigations. In the 2008 fiscal year, investigations in geoscientific research', including 'development of techniques for investigating the geological environment', 'development of techniques for long-term monitoring of the geological environment', 'development of engineering techniques for use in the deep underground environment' and studies on the long-term stability of the geological environment', are continuously carried out. Investigations in 'research and development on geological disposal technology', including 'improving the reliability of disposal technologies' and 'enhancement of safety assessment methodologies', are also continuously carried out

Health Physics Enrollments and Degrees Survey, 2008 Data

International Nuclear Information System (INIS)

2009-01-01

The survey includes degrees granted between September 1, 2007 and August 31, 2008. Enrollment information refers to the fall term 2008. Twenty-six academic programs were included in the survey universe, and all 26 programs provided data

QUALITY OF PERINATAL CARE IN SLOVENIA 2003–2008

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Tanja Premru-Sršen

2018-02-01

Full Text Available Background: The purpose of this analysis was to find whether the quality indicators of perinatal care in Slovenia change. Methods: We used the same quality indicators which are used in the European project Europeristat1 to compare the quality of perinatal care among the countries of the European Union. We used two 5-year periods, from 1998 to 2002 (reference period and from 2003 to 2008 (observed period. Data for perinatal quality were collected from the National Perinatal Information System of the Republic of Slovenia.2 Statistical significance was tested using the Pearson’s chi-square test. Results: Between 1998 and 2002, there were 87.679 labours ending in the delivery of 88.678 new- borns, and between 2003 and 2008, there were 90.662 labours ending in the delivery of 91.736 babies. In the observed period (2003 do 2008 mothers had statistically significantly higher educational level, a higher percentage came to their first pregnancy examination before the 12th week of gestation (84.0 % vs. 75.3 %, a higher percentage conceived after assisted reproductive techniques (2.0 % vs. 1.7 %, and the incidence of multiple pregnancies was higher (1.7 % vs. 1.6 %. Significantly lower were the percentages of labours without medical interventions (34.7 % vs. 41.9 % and of spontaneous onset of labour (74.0 % vs. 92.6 %. The percentages of induced labours and of elective cesarean sections increased dramatically (20.1 % vs. 6.6 % and 6.0 % vs. 0.9 %. The increase in the overall percentage of cesarean sections (14.8 % vs. 11.0 % is mainly due to increased incidence of elective cesarean sections, but the percentage of operative termination of vaginal labour increased as well (3.1 % vs. 2.6 %. The incidence of episiotomies was lower (48.7 % vs. 51.0 % and so was the incidence of 2nd degree perineal lacerations (4.5 % vs. 5.4 %, while the incidence of 3rd–4th degree lacerations was higher (0.3 % vs. 0.2 %. Transfusion was required in a lower percentage (0

Barriers to adequate prenatal care utilization in American Samoa

Science.gov (United States)

Hawley, Nicola L; Brown, Carolyn; Nu’usolia, Ofeira; Ah-Ching, John; Muasau-Howard, Bethel; McGarvey, Stephen T

2013-01-01

Objective To describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Methods Using data from prenatal clinic records, women (n=692) were categorized according to the Adequacy of Prenatal Care Utilization Index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way Analysis of Variance (ANOVA) and independent samples t-tests. Results Between 2001 and 2008 85.4% of women received inadequate prenatal care. Parity (P=0.02), maternal unemployment (P=0.03), and both parents being unemployed (P=0.03) were negatively associated with the timing of prenatal care initation. Giving birth in 2007–2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 versus 25.12 weeks; Pprenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007–2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population. PMID:24045912

Review of Trace-Element Field-Blank Data Collected for the California Groundwater Ambient Monitoring and Assessment (GAMA) Program, May 2004-January 2008

Science.gov (United States)

Olsen, Lisa D.; Fram, Miranda S.; Belitz, Kenneth

2010-01-01

Trace-element quality-control samples (for example, source-solution blanks, field blanks, and field replicates) were collected as part of a statewide investigation of groundwater quality in California, known as the Priority Basins Project of the Groundwater Ambient Monitoring and Assessment (GAMA) Program. The GAMA Priority Basins Project is being conducted by the U.S. Geological Survey (USGS) in cooperation with the California State Water Resources Control Board (SWRCB) to assess and monitor the quality of groundwater resources used for drinking-water supply and to improve public knowledge of groundwater quality in California. Trace-element field blanks were collected to evaluate potential bias in the corresponding environmental data. Bias in the environmental data could result from contamination in the field during sample collection, from the groundwater coming into contact with contaminants on equipment surfaces or from other sources, or from processing, shipping, or analyzing the samples. Bias affects the interpretation of environmental data, particularly if any constituents are present solely as a result of extrinsic contamination that would have otherwise been absent from the groundwater that was sampled. Field blanks were collected, analyzed, and reviewed to identify and quantify extrinsic contamination bias. Data derived from source-solution blanks and laboratory quality-control samples also were considered in evaluating potential contamination bias. Eighty-six field-blank samples collected from May 2004 to January 2008 were analyzed for the concentrations of 25 trace elements. Results from these field blanks were used to interpret the data for the 816 samples of untreated groundwater collected over the same period. Constituents analyzed were aluminum (Al), antimony (Sb), arsenic (As), barium (Ba), beryllium (Be), boron (B), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), iron (Fe), lead (Pb), lithium (Li), manganese (Mn), mercury (Hg), molybdenum

Medication safety programs in primary care: a scoping review.

Science.gov (United States)

Khalil, Hanan; Shahid, Monica; Roughead, Libby

2017-10-01

Medication safety plays an essential role in all healthcare organizations; improving this area is paramount to quality and safety of any wider healthcare program. While several medication safety programs in the hospital setting have been described and the associated impact on patient safety evaluated, no systematic reviews have described the impact of medication safety programs in the primary care setting. A preliminary search of the literature demonstrated that no systematic reviews, meta-analysis or scoping reviews have reported on medication safety programs in primary care; instead they have focused on specific interventions such as medication reconciliation or computerized physician order entry. This scoping review sought to map the current medication safety programs used in primary care. The current scoping review sought to examine the characteristics of medication safety programs in the primary care setting and to map evidence on the outcome measures used to assess the effectiveness of medication safety programs in improving patient safety. The current review considered participants of any age and any condition using care obtained from any primary care services. We considered studies that focussed on the characteristics of medication safety programs and the outcome measures used to measure the effectiveness of these programs on patient safety in the primary care setting. The context of this review was primary care settings, primary healthcare organizations, general practitioner clinics, outpatient clinics and any other clinics that do not classify patients as inpatients. We considered all quantitative studied published in English. A three-step search strategy was utilized in this review. Data were extracted from the included studies to address the review question. The data extracted included type of medication safety program, author, country of origin, aims and purpose of the study, study population, method, comparator, context, main findings and outcome

La gestión de los espacios y recursos costeros en España: Política e instituciones de una legislatura (2004-2008

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Barragán Muñoz, Juan Manuel

2010-07-01

Full Text Available This article studies the government of Spain’s coastal management during one legislature (2004-2008 as an analysis of a specific public policy; it assesses progress in the management model through ten key issues related to the Ministry of the Environment’s Directorate General of Coasts. The results allow us to offer several affirmations: firstly, a notable lack of integration in Spain’s coastal management still remains; secondly, interesting initiatives for changing the traditional coastal management model have arisen; thirdly, these initiatives have had very little impact on management for a number of different reasons (the absence of a policy based on a broad perspective, very slow-paced application, impediments in the relationship between the government system and the scope of management and lastly, the management model will need to overcome serious stumbling blocks as long as progress is not achieved in several of the key issues studied (policy, coordination, institutions, strategy, administrators and participation, etc..

El artículo estudia la gestión costera del gobierno de España a lo largo de una legislatura (2004-2008. Este ejercicio se interpreta como análisis de una política pública específica. Los avances constatados en el modelo de gestión se evalúan a través de diez temas clave relacionados con la Dirección General de Costas del Ministerio de Medio Ambiente. Los resultados permiten varias afirmaciones: 1 La situación de la gestión costera en España todavía dista mucho de ser integrada. 2 Surgen interesantes iniciativas de cambio en el modelo tradicional de gestión costera. 3 Estas iniciativas han tenido bajo impacto en la gestión real por diferentes causas (ausencia de política de amplia perspectiva, aplicación muy lenta, dificultades de relación entre el sistema de gobierno y el ámbito de gestión. 4 El modelo de gestión tendrá grandes obstáculos para mejorar mientras no se progrese en varios

Wellness Programs: Preventive Medicine to Reduce Health Care Costs.

Science.gov (United States)

Martini, Gilbert R., Jr.

1991-01-01

A wellness program is a formalized approach to preventive health care that can positively affect employee lifestyle and reduce future health-care costs. Describes programs for health education, smoking cessation, early detection, employee assistance, and fitness, citing industry success figures. (eight references) (MLF)

Caring for the new uninsured: Hospital charity care for older people without coverage.

Science.gov (United States)

DeLia, Derek

2006-12-01

Despite near-universal coverage through Medicare, a number of elderly residents in the United States do not have health insurance coverage. To the author's knowledge, this study is the first to document trends in the use of hospital charity care by uninsured older people. Data from the New Jersey Charity Care Program, which subsidizes hospitals for services provided to low-income uninsured people, were used to analyze trends in charity care utilization by older people from 1999 to 2004. Charity care charges are standardized to uniform Medicaid reimbursement rates and inflation adjusted using the Medical Care Consumer Price Index. From 1999 to 2004, use of charity care by older people grew much faster than it did for younger patients. As a result, older people now account for a greater share of hospital charity care in New Jersey than children. Elderly users of charity care generated higher costs per patient than their younger counterparts. Cost differences were especially salient at the upper end of the distribution, where high-cost elderly patients used significantly more resources than high-cost patients in other age groups. These results highlight an emerging source of strain on the healthcare safety net and point to a growing population of uninsured residents who have costly and complex medical needs. Similar experiences are likely to be found in other states, especially those that have growing populations of elderly immigrants who are likely to lack health insurance.

Integrated Pest Management: A Curriculum for Early Care and Education Programs

Science.gov (United States)

California Childcare Health Program, 2011

2011-01-01

This "Integrated Pest Management Toolkit for Early Care and Education Programs" presents practical information about using integrated pest management (IPM) to prevent and manage pest problems in early care and education programs. This curriculum will help people in early care and education programs learn how to keep pests out of early…

Receipt of preventive oral health care by U.S. children: a population-based study of the 2005-2008 medical expenditure panel surveys.

Science.gov (United States)

Huebner, Colleen E; Bell, Janice F; Reed, Sarah C

2013-11-01

This study provides estimates of the annual use of preventive oral health care by U.S. children ages 6 months-17 years. We estimated the annual use of preventive oral health care with data from the Medical Expenditure Panel Survey for the years 2005 through 2008 (n = 18,218). Additionally, we tested associations between use of preventive oral health care and predisposing factors, enabling factors and health need within three age groups: young children, school-age children and youth. Overall, 21 % of the sample was reported to have received preventive oral health care in the prior year. More school-age children received preventive care than did young children or youth regardless of gender, race/ethnicity, health status, residence, or family size. Among the youngest children, low parental education and lack of health insurance were associated with lower odds of receiving preventive care. School-age children of racial and ethnic minority groups had a higher odds of receiving preventive care than did non-Hispanic Whites. Youth with special health care needs were less likely to receive care than their peers. Within each age group, use of preventive care increased significantly from 2005 to 2008. In the U.S. there has been an increase in use of pediatric preventive dental care. Continued effort is needed to achieve primary prevention. Outreach and education should include all parents and especially parents with low levels of education, parents of children with special health care needs and those without health insurance.

A comparative study of pregnancy complications and outcomes for the years 1999 and 2004 at a rural hospital in South Africa: Implications for antenatal care

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Monjurul Hoque

2010-10-01

Objectives: This study reviewed the demographic variables, pregnancy and obstetric complications and perinatal outcomes for the years 1999 and 2004 in a rural hospital in KwaZulu-Natal Province, South Africa, with the aim of evaluating trends and gaps that may enhance appropriate strategies for improvement of antenatal care. Method: A retrospective comparative study, with representative samples of pregnant women, were randomly selected for the respective years 1999 and 2004. Descriptive statistics were calculated depending on measurement scale. A Z-test was carried out to assess the significant difference (p < 0.05 in proportions between pregnancy complications and outcomes of the groups. Multivariate logistic regression analysis was undertaken to determine the significant predictors for outcome variables. Results: The numbers of pregnancies among young women (< 25 years increased significantly by 8% (p < 0.05 in the year 2004. Compared with 1999, the reduction in the numbers of pregnancies (1% among higher parity (parity 5 or more women in 2004 was remarkable. There were significant reductions of eclampsia, anaemia and post partum haemorrhage. Women with breech presentation were 3.75 times more likely to deliver preterm, and 5.45 times more likely to deliver low birth-weight babies. Similarly, women with pregnancy-induced hypertension were more likely to have preterm (OR = 3.50, 95% CI 2.83; 4.35 and low birth-weight babies (OR = 2.09, 95% CI 1.62; 2.71. Eclampsia was also a risk factor associated with preterm deliveries (OR = 6.14, 95% CI 3.74; 10.09 and low birth-weight babies (OR = 3.40, 95% CI 1.83; 6.28. Conclusion: This study suggests that further research is needed to find the causes of higher rate of teenage pregnancies and an increase in quality of antenatal care is more important in improving maternal and perinatal health. Training of staff to standard protocol and guidelines on antenatal care and care during delivery, and adherence to it, should be

The critical care air transport program.

Science.gov (United States)

Beninati, William; Meyer, Michael T; Carter, Todd E

2008-07-01

The critical care air transport team program is a component of the U.S. Air Force Aeromedical Evacuation system. A critical care air transport team consists of a critical care physician, critical care nurse, and respiratory therapist along with the supplies and equipment to operate a portable intensive care unit within a cargo aircraft. This capability was developed to support rapidly mobile surgical teams with high capability for damage control resuscitation and limited capacity for postresuscitation care. The critical care air transport team permits rapid evacuation of stabilizing casualties to a higher level of care. The aeromedical environment presents important challenges for the delivery of critical care. All equipment must be tested for safety and effectiveness in this environment before use in flight. The team members must integrate the current standards of care with the limitation imposed by stresses of flight on their patient. The critical care air transport team capability has been used successfully in a range of settings from transport within the United States, to disaster response, to support of casualties in combat.

Hong Kong's domestic health spending--financial years 1989/90 through 2004/05.

Science.gov (United States)

Leung, G M; Tin, K Y K; Yeung, G M K; Leung, E S K; Tsui, E L H; Lam, D W S; Tsang, C S H; Fung, A Y K; Lo, S V

2008-04-01

This report presents the latest estimates of Hong Kong's domestic health spending between fiscal years 1989/90 and 2004/05, cross-stratified and categorised by financing source, provider and function on an annual basis. Total expenditure on health was HK$67,807 million in fiscal year 2004/05. In real terms, total expenditure on health showed positive growth averaging 7% per annum throughout the period covered in this report while gross domestic product grew at 4% per annum on average, indicating a growing percentage of health spending relative to gross domestic product, from 3.5% in 1989/90 to 5.2% in 2004/05. This increase was largely driven by the rise in public spending, which rose 9% per annum on average in real terms over the period, compared with 5% for private spending. This represents a growing share of public spending from 40% to 55% of total expenditure on health during the period. While public spending was the dominant source of health financing in 2004/05, private household out-of-pocket expenditure accounted for the second largest share of total health spending (32%). The remaining sources of health finance were employer-provided group medical benefits (8%), privately purchased insurance (5%), and other private sources (1%). Of the $67,807 million total health expenditure in 2004/05, current expenditure comprised $65,429 million (96%) while $2378 million (4%) were capital expenses (ie investment in medical facilities). Services of curative care accounted for the largest share of total health spending (67%) which were made up of ambulatory services (35%), in-patient curative care (28%), day patient hospital services (3%), and home care (1%). The next largest share of total health expenditure was spent on medical goods outside the patient care setting (10%). Analysed by health care provider, hospitals accounted for the largest share (46%) and providers of ambulatory health care the second largest share (30%) of total health spending in 2004/05. We

[Emergency care of vertigo patients: suggestions for efficient management].

Science.gov (United States)

Kogashiwa, Yasunao; Takei, Yasuhiko; Matsuda, Takeaki; Karaho, Takehiro; Morita, Masahiro; Kohno, Naoyuki

2009-10-01

Some diseases in which persons show vertigo or dizziness may be life-threatening, regardless of symptom severity, and require careful attention. These include diseases of the inner ear, central nervous system, and cardiovascular manifestation. In May 2006, a group in charge of primary emergency consultation began work enabling physicians to treat vertigo patients more efficiently and safely, as detailed in this report. Of the 173 persons with vertigo hospitalized from January 2004 to March 2008, six had cerebrovascular manifestations clarified only after hospitalization, underscoring the importance of careful examination, especially of those 75 years of age older, having continuous headache, having severe trunk ataxia despite apparently mild eye nystagmus, or reporting a history of high blood pressure, diabetes mellitus, hyperlipidemia, or ischemic heart disease.

Development of a chronic care ostomy self-management program.

Science.gov (United States)

Grant, Marcia; McCorkle, Ruth; Hornbrook, Mark C; Wendel, Christopher S; Krouse, Robert

2013-03-01

Each year a percentage of the 1.2 million men and women in the United States with a new diagnosis of colorectal cancer join the 700,000 people who have an ostomy. Education targeting the long-term, chronic care of this population is lacking. This report describes the development of a Chronic Care Ostomy Self-Management Program, which was informed by (1) evidence on published quality-of-life changes for cancer patients with ostomies, (2) educational suggestions from patients with ostomies, and (3) examination of the usual care of new ostomates to illustrate areas for continued educational emphases and areas for needed education and support. Using these materials, the Chronic Care Ostomy Self-Management Program was developed by a team of multi-disciplinary researchers accompanied by experienced ostomy nurses. Testing of the program is in process. Pilot study participants reported high satisfaction with the program syllabus, ostomy nurse leaders, and ostomate peer buddies.

Development of a Chronic Care Ostomy Self Management Program

Science.gov (United States)

Grant, Marcia; McCorkle, Ruth; Hornbrook, Mark C.; Wendel, Christopher S.; Krouse, Robert

2012-01-01

Each year a percentage of the 1.2 million men and women in the United States with a new diagnosis of colorectal cancer join the 700,000 people who have an ostomy. Education targeting the long term, chronic care of this population is lacking. This report describes the development of a Chronic Care Ostomy Self Management Program, which was informed by (1) evidence on published quality of life changes for cancer patients with ostomies, (2) educational suggestions from patients with ostomies, and (3) examination of the usual care of new ostomates to illustrate areas for continued educational emphases and areas for needed education and support. Using these materials, the Chronic Care Ostomy Self Management Program was developed by a team of multi-disciplinary researchers accompanied by experienced ostomy nurses. Testing of the program is in process. Pilot study participants reported high satisfaction with the program syllabus, ostomy nurse leaders, and ostomate peer buddies. PMID:23104143

50 Years of Integer Programming 1958-2008 From the Early Years to the State-of-the-Art

CERN Document Server

Jünger, Michael; Naddef, Denis

2010-01-01

In 1958, Ralph E. Gomory transformed the field of integer programming when he published a paper that described a cutting-plane algorithm for pure integer programs and announced that the method could be refined to give a finite algorithm for integer programming. In 2008, to commemorate the anniversary of this seminal paper, a special workshop celebrating fifty years of integer programming was held in Aussois, France, as part of the 12th Combinatorial Optimization Workshop. It contains reprints of key historical articles and written versions of survey lectures on six of the hottest topics in the

ESTADO DEL ARTE SOBRE LOS TRABAJOS PRÁCTICOS EN LA ENSEÑANZA DE LA BIOLOGÍA ABORDADOS EN PUBLICACIONES (2004-2008: RESULTADOS RELACIONADOS CON LAS FINALIDADES

Directory of Open Access Journals (Sweden)

Mónica Alexandra Correa

2014-05-01

Full Text Available Presentamos la investigación ESTADO DEL ARTE SOBRE LOS TRABAJOS PRÁCTICOS EN LA ENSEÑANZA DE LA BIOLOGÍA (2004-2008: UN APORTE A LA FORMACIÓN DOCENTE, cuyo objetivo se centró en caracterizar los Trabajos Prácticos en la Enseñanza de la Biología a partir de 216 publicaciones de 16 revistas especializadas realizadas durante  el periodo (2004-2008 y realizar un análisis de los aportes a la formación docente derivados de esto. La metodología que orientó la caracterización corresponde a un enfoque cualitativo interpretativo-hermenéutico, la investigación documental, y la  modalidad de estado del arte. Para la sistematización de la información se empleó como instrumento el RAE, cuyo diseño se basó en los criterios que se han acogido para la caracterización de la Didáctica de las Ciencias como campo de conocimiento y los de un sistema de categorías para el análisis de Trabajos Prácticos en la enseñanza de la Biología: Problema, Composición de equipo de trabajo, Sección de la revista, Autores, Temáticas Biológicas, Tipo de trabajo, Población objeto de estudio, Metodología, Naturaleza del TP (Tipo de TP, imagen de Práctica, relación T-P, clase de TP, Finalidades, Metodología del TP, Evaluación, Relación con aspectos epistemológicos y Aspectos relacionados con la formación docente. Para efectos de esta ponencia mostramos exclusivamente los resultados relacionados con  las finalidades de los trabajos prácticos, quienes mayoritariamente propenden por finalidades que abarcan simultáneamente aspectos tanto Conceptuales y Procedimentales y aquellas que abordan exclusivamente elementos Conceptuales

Identifying potentially cost effective chronic care programs for people with COPD

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L M G Steuten

2008-12-01

Full Text Available L M G Steuten1, K M M Lemmens2, A P Nieboer2, H JM Vrijhoef31Maastricht University Medical Centre, School for Care and Public Health Research, Department of Health, Organisation, Policy and Economics, Maastricht, The Netherlands; 2Erasmus University Medical Centre, Institute of Health Policy and Management, Rotterdam, The Netherlands; 3Maastricht University Medical Centre, School for Care and Public Health Research, Department of Integrated Care, Maastricht, The NetherlandsObjective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identified.Methods: Systematic search of Medline and Cochrane databases for evaluations of multi-component disease management or chronic care programs for adults with COPD, describing process, intermediate, and end results of care. Data were independently extracted by two reviewers and descriptively summarized.Results: Twenty articles describing 17 unique COPD programs were included. There is little evidence for significant improvements in process and intermediate outcomes, except for increased provision of patient self-management education and improved disease-specific knowledge. Overall, the COPD programs generate end results equivalent to usual care, but programs containing ≥3 components show lower relative risks for hospitalization. There is limited scope for programs to break-even or save money.Conclusion: Identifying cost effective multi-component COPD programs remains a challenge due to scarce methodologically sound studies that demonstrate significant improvements on process, intermediate and end results of care. Estimations of potential cost effectiveness of specific programs illustrated in this paper can, in the absence of ‘perfect data’, support timely decision-making regarding these programs. Nevertheless, well-designed health economic studies are needed to decrease the current decision

Income inequality and foregone medical care in Europe during The Great Recession: multilevel analyses of EU-SILC surveys 2008-2013.

Science.gov (United States)

Elstad, Jon Ivar

2016-07-07

The association between income inequality and societal performance has been intensely debated in recent decades. This paper reports how unmet need for medical care has changed in Europe during The Great Recession, and investigates whether countries with smaller income differences have been more successful than inegalitarian countries in protecting access to medical care during an economic crisis. Six waves of EU-SILC surveys (2008-2013) from 30 European countries were analyzed. Foregone medical care, defined as self-reported unmet need for medical care due to costs, waiting lists, or travel difficulties, was examined among respondents aged 30-59 years (N = 1.24 million). Countries' macro-economic situation was measured by Real Gross Domestic Product (GDP) per capita. The S80/S20 ratio indicated the country's level of income inequality. Equity issues were highlighted by separate analyses of disadvantaged respondents with limited economic resources and relatively poor health. Cross-tabulations and multilevel linear probability regression models were utilized. Foregone medical care increased 2008-2013 in the majority of the 30 countries, especially among the disadvantaged parts of the population. For the disadvantaged, unmet need for medical care tended to be higher in countries with larger income inequalities, regardless of the average economic standard in terms of GDP per capita. Both for disadvantaged and for other parts of the samples, a decline in GDP had more severe effects on access in inegalitarian countries than in countries with less income inequality. During The Great Recession, unmet need for medical care increased in Europe, and social inequalities in foregone medical care widened. Overall, countries with a more egalitarian income distribution have been more able to protect their populations, and especially disadvantaged groups, against deteriorated access to medical care when the country is confronted with an economic crisis.

Rethinking collegiality: restratification in English general medical practice 2004-2008.

Science.gov (United States)

McDonald, Ruth; Checkland, Kath; Harrison, Stephen; Coleman, Anna

2009-04-01

For Freidson [(1985). The reorganisation of the medical profession. Medical Care Review, 42(1), 11-35], collegiality, or ostensible equal status amongst members of the medical profession, serves a dual purpose. It socialises members into an attitude of loyalty to colleagues and presents an image to those outside the profession that all its members are competent and trustworthy. However, Freidson saw the use of formal standards developed by one (knowledge) elite within medicine and enforced by another (administrative) elite as threatening collegiality and professional unity. Drawing on two studies in English primary medical care this paper reports the emergence of new strata or elites, with groups of doctors involved in surveillance of others and action to improve compliance in deficient individuals and organizations. Early indications are that these developments have not led to the consequences which Freidson predicted. The increasing acceptance of the legitimacy of professional scrutiny and accountability that we identify suggests that new norms are emerging in English primary medical care, the possibility of which Freidson's analysis fails to take account.

The HITRAN 2008 molecular spectroscopic database

International Nuclear Information System (INIS)

Rothman, L.S.; Gordon, I.E.; Barbe, A.; Benner, D.Chris; Bernath, P.F.; Birk, M.; Boudon, V.; Brown, L.R.; Campargue, A.; Champion, J.-P.; Chance, K.; Coudert, L.H.; Dana, V.; Devi, V.M.; Fally, S.; Flaud, J.-M.

2009-01-01

This paper describes the status of the 2008 edition of the HITRAN molecular spectroscopic database. The new edition is the first official public release since the 2004 edition, although a number of crucial updates had been made available online since 2004. The HITRAN compilation consists of several components that serve as input for radiative-transfer calculation codes: individual line parameters for the microwave through visible spectra of molecules in the gas phase; absorption cross-sections for molecules having dense spectral features, i.e. spectra in which the individual lines are not resolved; individual line parameters and absorption cross-sections for bands in the ultraviolet; refractive indices of aerosols, tables and files of general properties associated with the database; and database management software. The line-by-line portion of the database contains spectroscopic parameters for 42 molecules including many of their isotopologues.

Income dynamics and the Affordable Care Act.

Science.gov (United States)

Shore-Sheppard, Lara D

2014-12-01

To examine the sources of family income dynamics leading to movement into and out of Medicaid expansion and subsidy eligibility under the Affordable Care Act. Survey of Income and Program Participation (SIPP): 1996, 2001, 2004, 2008 panels. Considering four broad subsidy eligibility categories for monthly Modified Adjusted Gross Income (MAGI) (400 percent FPL), I use duration analysis to examine determinants of movements between categories over the course of a year. Using detailed monthly data, I determine the members of tax-filing units and calculate an approximation of MAGI at the monthly level. The analysis sample is adults ages 22-64 years. Incomes are highly variable within a year, particularly at the lower end of the income distribution. Employment transitions, including transitions not involving a period of nonemployment, and family structure changes strongly predict sufficient income volatility to trigger a change in subsidy category. Income volatility arising from employment and family structure changes is likely to trigger changes in subsidy eligibility within the year, but the sources and effects of the volatility differ substantially depending on the individual's position in the income distribution. © Health Research and Educational Trust.

Participarea femeilor din parlamentul României la procesul decizional (2004-2008 și impactul discursului lor asupra deciziei politice (The Participation of Women from the Romanian Parliament to the Decision Making Process (2004-2008 and the Impact of Their Discourse On the Political Decision

Directory of Open Access Journals (Sweden)

Monica PAVEL

2015-09-01

Full Text Available Women’s participation in political decision-making process was the main goal of any demand concerning female suffrage (to vote and to be elected. But what means political decision-making process? There are many theories which explain this concept: from the Game Theory to the Decision Theory and various types of Computational Agent Based Modeling. After a review of these theories, more interesting will be to follow the way of a legislative project to an adopted law in the Romanian Parliament, the way from theory to practice, the real manifestation of the concept of political decision-making. Our research is focused on women’s position in political decision-making in Romania along the 2004-2008 legislature. We opted for this legislature due to its importance derived from the necessity of adopting the EU accession legislation until 2007. This new legislation contained many provisions concerning the status of Romanian women. Our analysis starts by asking the following questions: Are the women in the Romanian Parliament involved in the political decision-making process? Can they influence the destiny of a law? In order to clarify those queries we analyze (quantitatively and qualitatively the paper registrations, but also the video records of any legislative debate which took place in the mentioned legislatures.

Adverse events reported to the Food and Drug Administration from 2004 to 2016 for cosmetics and personal care products marketed to newborns and infants.

Science.gov (United States)

Cornell, Erika; Kwa, Michael; Paller, Amy S; Xu, Shuai

2018-03-01

Despite their ubiquitous use and several recent health controversies involving cosmetics and personal care products for children, the Food and Drug Administration has little oversight of these products and relies on consumer-submitted adverse event reports. We assessed the recently released Center for Food Safety and Applied Nutrition's Adverse Event Reporting System database for adverse event reports submitted to the Food and Drug Administration for baby personal care products and to determine whether useful insights can be derived. We extracted the Center for Food Safety and Applied Nutrition's Adverse Event Reporting System data file from 2004 to 2016 and examined the subset classified according to the Food and Drug Administration-designated product class as a baby product. Events were manually categorized into product type and symptom type to assess for trends. Only 166 total adverse events were reported to the Food and Drug Administration for baby products from 2004 to 2016. The majority of reports indicated rash or other skin reaction; 46% of reported events led to a health care visit. Pediatric dermatologists should consider submitting cosmetics and personal care product adverse event reports and encouraging consumers to do so likewise in situations in which a product adversely affects a child's health. © 2018 Wiley Periodicals, Inc.

Factores asociados al no control de la presión arterial en pacientes inscritos al programa de hipertensión de una Entidad Promotora de Salud en Cali-Colombia, 2004 Factors associated with lack of blood pressure control in patients enrolled in a hypertension control program of a private primary Health Care Organization in Cali, Colombia, in 2004

Directory of Open Access Journals (Sweden)

Rodolfo Herrera

2009-08-01

factors associated to the lack of control of arterial blood pressure in patients enrolled in a hypertension control program of a private primary health care organization in Cali, Colombia in 2004. Methods: descriptive cross-sectional study. 356 patients >18 years were randomly chosen from the hypertension control program. Those patients with systolic blood pressure >139 mm Hg or diastolic blood pressure >89 mm Hg were classified as patients with lack of blood pressure control. Risk factors that could not be modified, behavioral, biological and administrative factors, were considered independent variables. Through a bivariate and multivariate analysis, factors associated to lack of blood pressure control were identified. Results: the prevalence of lack of blood pressure control in this health care organization was 30,1% (95% CI, 25,3-34,8, being higher in males (c2= 9,368; p=0,002. Adherence to pharmacological treatment was 56,2% (95% CI: 51,0% - 61,3%. Odds ratio (OR for lack of blood pressure control adjusted by gender and according to hypolipemic drugs combination was 1,71 (95% CI: 1,0-2,94; OR according to the contracted health care organization in comparison with the institutional health care was 2.13 (95% CI: 1.3 - 3.5. Conclusions: the prevalence of lack of blood pressure control in a hypertension control program of a private health care organization was 30,1%. Associated factors were: type of health care organization, male gender, use of inhibitors on angiotensing-converting enzyme and drug interaction with concomitant use of hypolipemis.

Manitoba 2004 oil activity review

International Nuclear Information System (INIS)

Fox, J.N.

2005-01-01

This paper presented data on oil and gas activities in Manitoba during 2004, the busiest year in Manitoba's oil patch since the mid 1980s. Increases in the leasing of Crown and freehold acreage were also noted, with accompanying increases in drilling activity for the latter part of 2004. Details of Crown land sales were presented, with a total of 43,725 hectares of crown oil and gas rights under lease. During 2004, over 15,000 hectares of Crown oil and gas leases were sold, the highest figures since 1997. More wells were licensed and drilled in 2004 than in any year since 1986. Overall drilling success rate was 96.7 per cent. Details of top drillers in Manitoba were presented, with drilling activity focused in Waskada and Daly fields and the Sinclair area. Oil production increased by 0.7 per cent, with 1474 wells in production. Daily oil production statistics were presented, with the total value of Manitoba's oil production being $196 million. Details of the top 5 producers were provided, in addition to details of horizontal well production. Recent developments in Sinclair Field, Pierson L. Amaranth MC 3b A Pool, Waskada L. Amaranth I Pool and Virden Lodgepole D Pool were reviewed. The Manitoba Drilling Incentive Program was discussed with reference to the following enhancements: new well incentives, horizontal well incentives; holiday oil volume accounts; and marginal well major workover programs. Various Oil and Gas Act amendments were reviewed. In addition, the Williston Basin Architecture and Hydrocarbon Potential Project was discussed. 3 figs

Global results of the participation of ARN Argentina in the quality assessment program, EML-DOE since 1995-2004

International Nuclear Information System (INIS)

Equillor, Hugo E.; Serdeiro, Nelida H.; Fernandez, Jorge A.; Gavini, Ricardo M.; Grinman, Ana. D. R.; Lewis, Esther C.; Palacios, Miguel A.; Bonino, Nestor O.; Diodati, Jorge M.; Medici, Marcela A.

2006-01-01

In this report, the results obtained by the laboratories of the Nuclear Regulatory Authority in measurements of alpha, beta and gamma emitters in four types of matrix are presented, in the frame of the Quality Assessment Program organized for the Environmental Measurements Laboratory of the United States of America corresponding to 19 exercises of the period 1995-2004. (author) [es

Critical Care Nurses' Reasons for Poor Attendance at a Continuous Professional Development Program.

Science.gov (United States)

Viljoen, Myra; Coetzee, Isabel; Heyns, Tanya

2016-12-01

Society demands competent and safe health care, which obligates professionals to deliver quality patient care using current knowledge and skills. Participation in continuous professional development programs is a way to ensure quality nursing care. Despite the importance of continuous professional development, however, critical care nurse practitioners' attendance rates at these programs is low. To explore critical care nurses' reasons for their unsatisfactory attendance at a continuous professional development program. A nominal group technique was used as a consensus method to involve the critical care nurses and provide them the opportunity to reflect on their experiences and challenges related to the current continuous professional development program for the critical care units. Participants were 14 critical care nurses from 3 critical care units in 1 private hospital. The consensus was that the central theme relating to the unsatisfactory attendance at the continuous professional development program was attitude. In order of importance, the 4 contributing priorities influencing attitude were communication, continuous professional development, time constraints, and financial implications. Attitude relating to attending a continuous professional development program can be changed if critical care nurses are aware of the program's importance and are involved in the planning and implementation of a program that focuses on the nurses' individual learning needs. ©2016 American Association of Critical-Care Nurses.

Employer Child Care Resources: A Guide to Developing Effective Child Care Programs and Policies.

Science.gov (United States)

Women's Bureau (DOL), Washington, DC.

Increasing numbers of employers are responding to employee child care needs by revising their benefit packages, work schedules, and recruitment plans to include child care options. This guide details ways to develop effective child care programs and policies. Section 1 of the guide describes employees' growing child care needs and employers'…

Trends in reported sun bed use, sunburn, and sun care knowledge and attitudes in a U.K. region: results of a survey of the Northern Ireland population.

Science.gov (United States)

Boyle, R; O'Hagan, A H; Donnelly, D; Donnelly, C; Gordon, S; McElwee, G; Gavin, A

2010-12-01

Sunburn and sun bed use increase risk of malignant melanoma, the incidence of which continues to rise. To document trends in reported sun bed use, sunburn, and sun care knowledge and attitudes in a U.K. region where there have been 20 years of sun-related health promotion campaigns. In 2000, 2004 and 2008, a 'care in the sun' module was included in the Northern Ireland (NI) Omnibus survey. Each year 2200 subjects aged 16 years and over were randomly selected and invited to complete a sun-related questionnaire. Proportions of respondents were analysed by demographic and socioeconomic factors, with differences tested using z-tests and the χ(2) -squared test. In total, 3623 persons responded (response rate 50-59%). Skin cancer knowledge in 2008 was high at 97%. Skin type reporting was inaccurate and since 2000 has become weighted towards the darker Fitzpatrick skin types IV and V (χ(2) = 21·5, P = 0·006). Reported sunburn rose over the 8-year period to 60% in 2008, with 39% of those aged 16-24 years reporting sunburn at least once in the previous year. Twenty per cent reported sun bed use in 2008, a fall from 28% in 2004 (P = 0·01), with greater reported use among those aged 16-24 years (24%) and among women (31% vs. 9% men, P sunburn pose risks for further rises in skin cancer. Barriers for future sun care campaigns to address include poorer sun care knowledge among men, poor skin type awareness, and women's attitudes regarding the health and attractiveness of tanning. Sun bed use, although high, has fallen, possibly in response to recent campaigns. © 2010 The Authors. BJD © 2010 British Association of Dermatologists.

Development of a Proactive Care Program (U-CARE) to Preserve Physical Functioning of Frail Older People in Primary Care

NARCIS (Netherlands)

Bleijenberg, N.; Ten Dam, V.H.; Drubbel, I.; Numans, M.E.; De Wit, N.J.; Schuurmans, M.J.

2013-01-01

Purpose: Care for older patients in primary care is currently reactive, fragmented, and time consuming. An innovative structured and proactive primary care program (U-CARE) has been developed to preserve physical functioning and enhance quality of life of frail older people. This study describes in

Medical Care Provided Under California's Workers' Compensation Program: Effects of the Reforms and Additional Opportunities to Improve the Quality and Efficiency of Care.

Science.gov (United States)

Wynn, Barbara O; Timbie, Justin W; Sorbero, Melony E

2011-01-01

Since 2004, significant changes have been made to the California workers' compensation (WC) system. The Commission on Health and Safety and Workers' Compensation (CHSWC) asked the RAND Corporation to examine the impact that these changes have on the medical care provided to injured workers. This study synthesizes findings from interviews and available information regarding the implementation of the changes affecting WC medical care and identifies areas in which additional changes might increase the quality and efficiency of care delivered under the WC system. To improve incentives for efficiently providing medically appropriate care, California should revise its fee schedule allowances for services provided by hospitals to inpatients, freestanding ambulatory surgery centers, and physicians, create nonmonetary incentives for providing medically appropriate care in the medical provider network (MPN) context through more-selective contracting with providers and reducing medical review requirements for high-performing physicians; reduce incentives for inappropriate prescribing practices by curtailing in-office physician dispensing; and implement pharmacy benefit network regulations. To increase accountability for performance, California should revise the MPN certification process to place accountability for meeting MPN standards on the entity contracting with the physician network; strengthen Division of Workers' Compensation (DWC) authorities to provide intermediate sanctions for failure to comply with MPN requirements; and modify the Labor Code to remove payers and MPNs from the definition of individually identifiable data so that performance on key measures can be publicly available. To facilitate monitoring and oversight, California should provide DWC with more flexibility to add needed data elements to medical data reporting and provide penalties for a claim administrator failing to comply with the data-reporting requirements; require that medical cost

What part of the total care consumed by type 2 diabetes patients is directly related to diabetes? Implications for disease management programs

Directory of Open Access Journals (Sweden)

Christel van Dijk

2011-12-01

Full Text Available Background: Disease management programs (DMP aim at improving coordination and quality of care and reducing healthcare costs for specific chronic diseases. This paper investigates to what extent total healthcare utilization of type 2 diabetes patients is actually related to diabetes and its implications for diabetes management programs.Research design and methods: Healthcare utilization for diabetes patients was analyzed using 2008 self-reported data (N=316 and data from electronic medical records (EMR (N=9023, and divided whether or not care was described in the Dutch type 2 diabetes multidisciplinary healthcare standard.Results: On average 4.3 different disciplines of healthcare providers were involved in the care for diabetes patients. 96% contacted a GP-practice and 63% an ophthalmologist, 24% an internist, 32% a physiotherapist and 23% a dietician. Diabetes patients had on average 9.3 contacts with GP-practice of which 53% were included in the healthcare standard. Only a limited part of total healthcare utilization of diabetes patients was included in the healthcare standard and therefore theoretically included in DMPs.Conclusion: Organizing the care for diabetics in a DMP might harm the coordination and quality of all healthcare for diabetics. DMPs should be integrated in the overall organization of care.

Prevalence of Neisseria gonorrhoeae infections among men and women entering the National Job Training Program--United States, 2004-2009.

Science.gov (United States)

Bradley, Heather; Satterwhite, Catherine Lindsey

2012-01-01

National notifiable disease data indicate that there were 99 cases of gonorrhea for every 100,000 persons in the United States in 2009, the lowest recorded gonorrhea rate in US history. However, the extent to which declining case reports signify a reduction in prevalence is unknown. Gonorrhea prevalence was estimated among 16- to 24-year-old men and women entering the National Job Training Program (NJTP) between 2004 and 2009. Multivariate logistic regression was used to assess the probability of testing positive for gonorrhea over time. A total of 95,184 men and 91,697 women were screened for gonorrhea upon entry to the NJTP between 2004 and 2009. For women, gonorrhea prevalence increased from 2004 (2.6%) to 2006 (2.9%), then decreased steadily through 2009 (1.8%). For men, prevalence increased from 2004 (1.3%) to 2005 (1.6%), then decreased through 2009 (0.9%). Gonorrhea prevalence among black women decreased from 3.6% in 2004 to 2.5% in 2009 and was 2 to 4 times higher than prevalence among white women. Likewise, prevalence among black men decreased from 2.0% to 1.5% and was 8 to 22 times higher than prevalence among white men. After adjusting for gonorrhea risk factors, the odds of women and men testing positive for gonorrhea decreased by 50% and 40%, respectively, from 2004 to 2009. Declining trends in gonorrhea infection among NJTP entrants are similar to those observed in gonorrhea case report data, suggesting that the decrease in case reports is due to a decrease in prevalence. However, targeted interventions are needed to reduce gonorrhea infections in populations with disproportionate risk.

Computer Programming Languages for Health Care

Science.gov (United States)

O'Neill, Joseph T.

1979-01-01

This paper advocates the use of standard high level programming languages for medical computing. It recommends that U.S. Government agencies having health care missions implement coordinated policies that encourage the use of existing standard languages and the development of new ones, thereby enabling them and the medical computing community at large to share state-of-the-art application programs. Examples are based on a model that characterizes language and language translator influence upon the specification, development, test, evaluation, and transfer of application programs.

Changing epidemiology of methicillin-resistant Staphylococcus aureus in Iceland from 2000 to 2008: a challenge to current guidelines

DEFF Research Database (Denmark)

Holzknecht, B.J.; Hardardottir, H.; Haraldsson, Gustav Helgi

2010-01-01

, and screening for the Panton-Valentine leukocidin (PVL) gene. Two hundred twenty-six infected (60%) or colonized (40%) individuals were detected (annual incidence 2.5 to 16/100,000). From 2000 to 2003, two health care-associated outbreaks dominated (spa types t037 and t2802), which were successfully controlled...... with extensive infection control measures. After 2004, an increasing number of community-associated (CA) cases without relation to the health care system occurred. A great variety of clones (40 PFGE types and 49 spa types) were found, reflecting an influx of MRSA from abroad. The USA300 and Southwest Pacific...... and microbiological data of all MRSA patients from the years 2000 to 2008 were collected prospectively. Isolates were characterized by pulsed-field gel electrophoresis (PFGE), sequencing of the repeat region of the Staphylococcus protein A gene (spa typing), staphylococcal cassette chromosome mec (SCCmec) typing...

West Valley Demonstration Project Annual Site Environmental Report Calendar Year 2004

Energy Technology Data Exchange (ETDEWEB)

West Valley Nuclear Services Company (WVNSCO) and URS Group, Inc.

2005-09-30

Annual Site Environmental Report for the West Valley Demonstration Project (WVDP) for Calendar Year 2004. The report summarizes the environmental protection program at the West Valley Demonstration Project for CY 2004.

West Valley Demonstration Project Annual Site Environmental Report Calendar Year 2004

International Nuclear Information System (INIS)

2005-01-01

Annual Site Environmental Report for the West Valley Demonstration Project (WVDP) for Calendar Year 2004. The report summarizes the environmental protection program at the West Valley Demonstration Project for CY 2004

Time providing care outside visits in a home-based primary care program.

Science.gov (United States)

Pedowitz, Elizabeth J; Ornstein, Katherine A; Farber, Jeffrey; DeCherrie, Linda V

2014-06-01

To assess how much time physicians in a large home-based primary care (HBPC) program spend providing care outside of home visits. Unreimbursed time and patient and provider-related factors that may contribute to that time were considered. Mount Sinai Visiting Doctors (MSVD) providers filled out research forms for every interaction involving care provision outside of home visits. Data collected included length of interaction, mode, nature, and with whom the interaction was for 3 weeks. MSVD, an academic home-visit program in Manhattan, New York. All primary care physicians (PCPs) in MSVD (n = 14) agreed to participate. Time data were analyzed using a comprehensive estimate and conservative estimates to quantify unbillable time. Data on 1,151 interactions for 537 patients were collected. An average 8.2 h/wk was spent providing nonhome visit care for a full-time provider. Using the most conservative estimates, 3.6 h/wk was estimated to be unreimbursed per full-time provider. No significant differences in interaction times were found between patients with and without dementia, new and established patients, and primary-panel and covered patients. Home-based primary care providers spend substantial time providing care outside home visits, much of which goes unrecognized in the current reimbursement system. These findings may help guide practice development and creation of new payment systems for HBPC and similar models of care. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

I-NERI 2004 Annual Report

Energy Technology Data Exchange (ETDEWEB)

None

2004-01-01

The International Nuclear Energy Research Initiative (I-NERI) supports the National Energy Policy by conducting research to advance the state of nuclear science and technology in the United States (U.S.). I-NERI sponsors innovative scientific and engineering research and development (R&D) in cooperation with participating countries. The R&D research performed under the I-NERI umbrella addresses the key issues affecting the future of nuclear energy and its global deployment. I-NERI research is directed towards improving cost performance, increasing proliferation resistance, enhancing safety, and improving the waste management of future nuclear energy systems. This I-NERI 2004 Annual Report serves to inform interested parties on the program's organization, progress of the collaborative research projects, and future planning for the program. The report covers the four years of I-NERI activity since the program's inception in fiscal year (FY) 2001. The motivation and series of events that led to the creation of the I-NERI program are discussed in Section 2. The participating countries in current I-NERI collaborative agreements are also presented. Section 3 presents an overview of the I-NERI goals and objectives, a work scope summary for the collaborative projects, and a summary of research project awards through the end of FY 2004. It also includes FY 2005 accomplishments and planned FY 2005 activities. A summary of programmatic accomplishments is presented in Section 4. Also included is a summary of new and existing projects, an overview of the I-NERI program funding, and the new collaborations anticipated in FY 2005. The R&D work scope for current I-NERI collaborative projects with Canada, France, Japan, the Organization for Economic Cooperation and Development/Nuclear Energy Agency (OECD/NEA), and the Republic of Korea are presented in Sections 5 through 9, respectively. For each participating country, an index of projects and a summary of FY 2004

Integrated Status and Effectiveness Monitoring Program - Entiat River Rotary Screw Traps,Snorkel Surveys, and Steelhead Redd Surveys, 2008.

Energy Technology Data Exchange (ETDEWEB)

Nelle, R.D.; Desgroseiller, Tom; Cotter, Michael (U.S. Fish and Wildlife Service)

2009-02-17

The USFWS Mid-Columbia River Fishery Resource Office (MCRFRO) operated two rotary screw traps on the Entiat River as part of the Integrated Status and Effectiveness Monitoring Program from March through November of 2008. Along with the smolt traps, juvenile emigrants were also captured at remote locations throughout the Entiat watershed and its major tributary, the Mad River. A total of 16,782 wild salmonids were PIT tagged during the study period. Of this, 3,961(23.6%) were wild Oncorhynchus mykiss, 6,987 (41.6%) were wild spring run O. tshawytscha, and 5,591 (33.3%) were identified as wild O. tshawytscha of unknown run. Rotary screw trap efficiencies averaged 40.3% at the upper (Rkm 11.0) trap and 7.8% for the lower (Rkm 2.0) trap. These efficiencies were pooled for emigrant O. tshawytscha and O. mykiss. The MCRFRO conducted effectiveness monitoring snorkel surveys at 24 sites during the winter period and 30 sites during the summer and fall periods of 2008 as part of the Integrated Status and Effectiveness Monitoring Program in the Entiat River. The 2008 steelhead spawning grounds surveys were conducted weekly in the main Entiat River from rkm 1.1 to 44.2. A total of 222 steelhead redds were identified over the period from February 28 to June 16 2008 with April being the peak spawning month. Approximately 80% of the steelhead redds were located downstream of the rkm 26.

Health care of youth aging out of foster care.

Science.gov (United States)

2012-12-01

Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.

32 CFR 199.16 - Supplemental Health Care Program for active duty members.

Science.gov (United States)

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Supplemental Health Care Program for active duty... (CHAMPUS) § 199.16 Supplemental Health Care Program for active duty members. (a) Purpose and applicability... the supplemental health care program for active duty members of the uniformed services, the provision...

[Nutritional care in the cardiac rehabilitation program].

Science.gov (United States)

da Vico, Letizia; Biffi, Barbara; Masini, Maria Luisa; Fattirolli, Francesco

2007-06-01

There is some evidence of the efficacy of nutritional care in modifying eating habits and behavior in patients undergoing cardiac rehabilitation: nutritional care has a relevant role in the secondary prevention of cardiovascular disease. The dietitian is the qualified sanitary professional for nutritional care. The aim of this study was to define the role of dietitians within a health care team in programs of cardiac rehabilitation. In this setting, nutritional care starts with a dietary assessment, which includes a measurement of the anthropometric parameters, and a survey of the patient knowledge and eating habits. If there is no need for change in the patient lifestyle, the patient is addressed to the normal cardiac rehabilitation program with no further nutritional intervention except one session of counseling. When lifestyle changes are needed, the dietitian defines, together with the patient, therapeutic aims and expected results. The following phase is represented by group session with patients and their relatives during which nutritional topics are discussed and nutritional education is provided Afterwards, self-monitoring sheets of eating habits are individually discussed in one visit; a last individual visit is used for a final assessment of nutritional knowledge, dietary habits, and anthropometric parameters. In case of unsatisfactory results, patients are invited to participate to three group session to be held biweekly, during which they interact with the dietitian and take part to exercises and group discussions. When the established targets are reached, the nutritional program includes individual follow up visits at six and twelve months for further assessment of medium term results.

Annual Statistical Supplement, 2008

Data.gov (United States)

Social Security Administration — The Annual Statistical Supplement, 2008 includes the most comprehensive data available on the Social Security and Supplemental Security Income programs. More than...

Day Care: A Program in Search of a Policy.

Science.gov (United States)

Bikales, Gerda

This report examines current issues relating to day care and challenges many of the policy assumptions that underlie a major public program of subsidized day care for children. A historical perspective of day care is presented and various types of day care are described. The costs and benefits of day care are examined and the relation of day care…

Mammography activity in Norway 1983 to 2008

DEFF Research Database (Denmark)

Lynge, Elsebeth; Braaten, Tonje; Njor, Sisse H

2011-01-01

In Norway, an organized screening mammography program, the Norwegian Breast Cancer Screening Program (NBCSP) started in four counties in 1996 and became nationwide in 2004. We collected data on pre-program screening activity, and in view of this activity we evaluated the potential impact...... of the program on breast cancer mortality in Norway....

76 FR 61103 - Medicare Program; Comprehensive Primary Care Initiative

Science.gov (United States)

2011-10-03

...] Medicare Program; Comprehensive Primary Care Initiative AGENCY: Centers for Medicare & Medicaid Services... organizations to participate in the Comprehensive Primary Care initiative (CPC), a multipayer model designed to... the Comprehensive Primary Care initiative or the application process. SUPPLEMENTARY INFORMATION: I...

Selecting, adapting, and sustaining programs in health care systems

Directory of Open Access Journals (Sweden)

Zullig LL

2015-04-01

Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies 

Physical rehabilitation following polytrauma. The Canadian Forces Physical Rehabilitation Program 2008-2011.

Science.gov (United States)

Besemann, Markus

2011-12-01

As a consequence of Canada's involvement in the war in Afghanistan, many members of the Canadian Forces have experienced debilitating injuries. Despite the Canadian Forces Health Services (CFHS) having outstanding relationships with many civilian care providers for the rehabilitation of injured soldiers, it became apparent early on that the high-level goals and aspirations of these returning soldiers were sometimes beyond the capability of these centres to facilitate. From this reality grew the need to develop a Physical Rehabilitation Program within the CFHS. This article describes the lessons learned since the creation of the program and outlines the future vision in terms of unique challenges and opportunities. The primary purpose of this article is to describe a hybrid model of civilian-military rehabilitation for injured soldiers and discuss the benefits and challenges of such a model of care.

Public dental health care program for persons with disability

DEFF Research Database (Denmark)

Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik

2005-01-01

The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means......) payment of service, (4) providers of oral health care, (5) special training of staff, 6) dental services delivered, (7) ethical issues, and (8) patient rights. Less than one-third of persons estimated by the health authorities were enrolled in the program. On average, 0.4% of the municipal population...... of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large...

U.S. Department of Energy Illness, and Injury Surveillance Program, Worker Health At A Glance, 1995-2004

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-01

The Department of Energy’s (DOE) Illness and Injury Surveillance Program (IISP) has monitored the health of contractor workers at selected DOE sites since 1990. For the first time, the IISP has sufficient data to describe, in a collective manner, the health trends occurring among workers at a number of DOE sites during a 10-year period. This brief report and the more detailed Worker Health Summary assess illness and injury trends of DOE workers according to gender, age, occupational group, and program office over the 10-year period, 1995 through 2004. During this time, over 137,000 individual contractor workers were employed at the 15 DOE sites participating in the IISP.

Behavior of Tuberculosis in the municipality of Jatibonico in the period 2004-2008.

Directory of Open Access Journals (Sweden)

Yailín Palmero Dones

2010-09-01

Full Text Available The tuberculosis is the more frequent cause of disease attributable to an infectious agent in the world, it is a sanitary problem of a great magnitude, related to some risk factors aggravating the human being situation. A descriptive and retrospective investigation was made in the period between December 1 st and 31 st 2008 in Jatibonico municipality with the objective of determining the behaviour of the tuberculosis. The sample was conformed by 11 cases that keep inclusion criteria. Some variable were used: incidence, age, sex, clinic forms, popular advices, and risk factors. It was observed that the highest rates concerning 100 000 inhabitants were found: year 2008 (12,5, masculine sex (51,3 with age between 15-24 years (61,1, the popular advice Majá (146,4 prevailing pulmonary tuberculosis with positive baciloscopy (100% and as risk a factor the alcoholism (54,5%. The disease had an ascending behavior, where prevailed the clinic form with positive baciloscopy, the alcoholism influence in the morbility of the disease as a risk factor.

Mississippi 2004 Lidar Coverage, USACE National Coastal Mapping Program

Data.gov (United States)

Army Corps of Engineers, Department of the Army, Department of Defense — The Joint Airborne Lidar Bathymetry Technical Center of Expertise (JALBTCX) has performed a coastal survey along the Gulf of Mexico coastline of MS in 2004. The data...

Alabama 2004 Lidar Coverage, USACE National Coastal Mapping Program

Data.gov (United States)

Army Corps of Engineers, Department of the Army, Department of Defense — The Joint Airborne Lidar Bathymetry Technical Center of Expertise (JALBTCX) has performed a coastal survey along the Gulf of Mexico in the summer of 2004. The data...

Florida 2004 Lidar Coverage, USACE National Coastal Mapping Program

Data.gov (United States)

Army Corps of Engineers, Department of the Army, Department of Defense — The Joint Airborne Lidar Bathymetry Technical Center of Expertise (JALBTCX) has performed a coastal survey along the Gulf of Mexico in the summer of 2004. The data...

US Support Program Topical Meetings 1999 to 2008

Energy Technology Data Exchange (ETDEWEB)

Pepper,S.

2008-06-10

In 1999, the International Safeguards Project Office began organizing topical workshops to explore technical issues facing the International Atomic Energy Agency's Department of Safeguards. Representatives from IAEA member states including the United States, national laboratories and companies were invited to the workshops to discuss the technical issues. In some cases professional facilitators were hired to lead the discussions and in some cases business gaming techniques were employed. Since 1999, the following topics have been addressed Data Communication Technologies (1999), Information Security (2000), Design and Testing for High Reliability (2001), Standardization and Integration of Unattended and Remote Monitoring Systems (2002), Roadmapping: Surveillance (2003), IAEA Seals Technology Roadmapping Workshop (2004), Turning Information Into Knowledge (2004), Safeguards Tools of the Future (2005), and Advanced Sensors for Safeguards (2007). This paper will review the scope of the workshops and summarize their results.

Gefinex 400S (Sampo) EM-soundings at Olkiluoto 2008

International Nuclear Information System (INIS)

Jokinen, T.; Lehtimaeki, J.

2008-09-01

In the beginning of June 2008 Geological Survey of Finland (GTK) carried out electromagnetic frequency soundings with Gefinex 400S equipment (Sampo) in the vicinity of ONKALO at the Olkiluoto site investigation area. The same soundings sites were first time measured and marked in 2004 and has been repeated after it yearly in the same season. The aim of the measurements is to monitor the changes of groundwater conditions by the changes of the electric conductivity of the earth at ONKALO and repository area. The measurements form two 1400 m long broadside profiles, which have 200 m mutual distance and 200 m station separation. The profiles have been measured using 200, 500, and 800 m coil separations. Because of the strong electromagnetic noise all planned sites (48) could not be measured. In 2008 the measurements were performed at the sites that were successful in 2007 (43 soundings). The numerous power lines and cables in the area generate local disturbances on the sounding curves, but the signal/noise also with long coil separations and the repeatability of the results is reasonably good. However, most suitable for monitoring purposes are the sites without strong surficial 3D effects. Comparison of the results of 2004 to 2008 surveys shows differences on some ARD (Apparent resistivity-depth) curves. Those are mainly results of the modified man-made structures. The effects of changes in groundwater conditions are obviously slight. (orig.)

Análise clínica e epidemiológica das internações hospitalares de idosos decorrentes de intoxicações e efeitos adversos de medicamentos, Brasil, de 2004 a 2008 Clinical and epidemiological analysis of hospitalizations of elderly due to poisoning and adverse effects of medications, Brazil from 2004 to 2008

Directory of Open Access Journals (Sweden)

Tatiana Cruz de Paula

2012-12-01

concomitant use of several drugs, administration errors, physiological changes in the body that alter the pharmacodynamics and pharmacokinetics. In order to determine the main therapeutic classes involved in hospital admissions of elderly people due to intoxication and adverse drug effects, as well as major health problems related to these events, 9,793 hospitalizations of people aged 60 or over registered in the Hospital Information System of the Unified Health System (SIH-SUS in the period of 2004 to 2008 were analyzed. Unspecified drugs, systemic antibiotics, psychotropics, psychoactives, antiepileptics, sedatives, hypnotics and antiparkinsonians accounted for 57% of the total of admissions analyzed. Injuries and falls were the main health problems related to intoxication and adverse drug effects. Hospitalizations due to injuries were associated with analgesic, antipyretic and antirheumatic non-opioid. Falls were associated with systemic antibiotics, contradicting studies which point out psychotropic drugs as the main drug involved in these events. The results reflect the growing trend of problems associated with drug use by elderly people. It was verified that the consumption profile alone is not sufficient to explain the concentration of cases of the major therapeutic classes. We suggest the adoption of more effective programs of pharmacovigilance, capable of intervening at different stages of drug use: prescribing, dispensing, marketing, administration and compliance.

Critical Care Pharmacist Market Perceptions: Comparison of Critical Care Program Directors and Directors of Pharmacy.

Science.gov (United States)

Hager, David R; Persaud, Rosemary A; Naseman, Ryan W; Choudhary, Kavish; Carter, Kristen E; Hansen, Amanda

2017-05-01

Background: While hospital beds continue to decline as patients previously treated as inpatients are stabilized in ambulatory settings, the number of critical care beds available in the United States continues to rise. Growth in pharmacy student graduation, postgraduate year 2 critical care (PGY2 CC) residency programs, and positions has also increased. There is a perception that the critical care trained pharmacist market is saturated, yet this has not been evaluated since the rise in pharmacy graduates and residency programs. Purpose: To describe the current perception of critical care residency program directors (CC RPDs) and directors of pharmacy (DOPs) on the critical care pharmacist job market and to evaluate critical care postresidency placement and anticipated changes in PGY2 CC programs. Methods: Two electronic surveys were distributed from October 2015 to November 2015 through Vizient/University HealthSystem Consortium, American Society of Health-System Pharmacists (ASHP), Society of Critical Care Medicine, and American College of Clinical Pharmacy listservs to target 2 groups of respondents: CC RPDs and DOPs. Questions were based on the ASHP Pharmacy Forecast and the Pharmacy Workforce Center's Aggregate Demand Index and were intended to identify perceptions of the critical care market of the 2 groups. Results: Of 116 CC RPDs, there were 66 respondents (56.9% response rate). Respondents have observed an increase in applicants; however, they do not anticipate increasing the number of positions in the next 5 years. The overall perception is that there is a balance in supply and demand in the critical care trained pharmacist market. A total of 82 DOPs responded to the survey. Turnover of critical care pharmacists within respondent organizations is expected to be low. Although a majority of DOPs plan to expand residency training positions, only 9% expect to increase positions in critical care PGY2 training. Overall, DOP respondents indicated a balance of

Early Careerist Interest and Participation in Health Care Leadership Development Programs.

Science.gov (United States)

Thompson, Jon M; Temple, April

2015-01-01

Health care organizations are increasingly embracing leadership development programs. These programs include a variety of specific activities, such as formally structured leadership development, as well as mentoring, personal development and coaching, 360-degree feedback, and job enlargement, in order to increase the leadership skills of managers and high-potential staff. However, there is a lack of information on how early careerists in health care management view these programs and the degree to which they participate. This article reports on a study undertaken to determine how early careerists working in health care organizations view leadership development programs and their participation in such programs offered by their employers. Study findings are based on a survey of 126 early careerists who are graduates of an undergraduate health services administration program. We found varying levels of interest and participation in specific leadership development activities. In addition, we found that respondents with graduate degrees and those with higher compensation were more likely to participate in selected leadership development program activities. Implications of study findings for health care organizations and early careerists in the offering of, and participation in, leadership development programs are discussed.

NATURAL BARRIERS TARGETED THRUST FY 2004 PROJECTS

International Nuclear Information System (INIS)

NA

2005-01-01

This booklet contains project descriptions of work performed by the Department of Energy (DOE), Office of Civilian Radioactive Waste Management (OCRWM), Office of Science and Technology and International's (OSTandI) Natural Barriers Targeted Thrust during Fiscal Year (FY) 2004. The Natural Barriers Targeted Thrust is part of OSTandI's Science and Technology Program which supports the OCRWM mission to manage and dispose of high-level radioactive waste and spent nuclear fuel in a manner that protects health, safety, and the environment; enhances national and energy security; and merits public confidence. In general, the projects described will continue beyond FY 2004 assuming that the technical work remains relevant to the proposed Yucca Mountain Repository and sufficient funding is made available to the Science and Technology Program

Institutional delivery in India, 2004-14: unravelling the equity-enhancing contributions of the public sector.

Science.gov (United States)

Joe, William; Perkins, Jessica M; Kumar, Saroj; Rajpal, Sunil; Subramanian, S V

2018-06-01

To achieve faster and equitable improvements in maternal and child health outcomes, the government of India launched the National Rural Health Mission in 2005. This paper describes the equity-enhancing role of the public sector in increasing use of institutional delivery care services in India between 2004 and 2014. Information on 24 661 births from nationally representative survey data for 2004 and 2014 is analysed. Concentration index is computed to describe socioeconomic-rank-related relative inequalities in institutional delivery and decomposition is used to assess the contributions of public and private sectors in overall socioeconomic inequality. Multilevel logistic regression is applied to examine the changes in socioeconomic gradient between 2004 and 2014. The analysis finds that utilization of institutional delivery care in India increased from 43% in 2004 to 83% in 2014. The bulk of the increase was in public sector use (21% in 2004 to 53% in 2014) with a modest increase in private sector use (22% in 2004 to 30% in 2014). The shift from a pro-rich to pro-poor distribution of public sector use is confirmed. Decomposition analysis indicates that 51% of these reductions in socioeconomic inequality are associated with improved pro-poor distribution of public sector births. Multilevel logistic regressions confirm the disappearance of a wealth-based gradient in public sector births between 2004 and 2014. We conclude that public health investments in India have significantly contributed towards an equitable increase in the coverage of institutional delivery care. Sustained policy efforts are necessary, however, with an emphasis on education, sociocultural and geographical factors to ensure universal coverage of institutional delivery care services in India.

Critical Care Organizations: Building and Integrating Academic Programs.

Science.gov (United States)

Moore, Jason E; Oropello, John M; Stoltzfus, Daniel; Masur, Henry; Coopersmith, Craig M; Nates, Joseph; Doig, Christopher; Christman, John; Hite, R Duncan; Angus, Derek C; Pastores, Stephen M; Kvetan, Vladimir

2018-04-01

Academic medical centers in North America are expanding their missions from the traditional triad of patient care, research, and education to include the broader issue of healthcare delivery improvement. In recent years, integrated Critical Care Organizations have developed within academic centers to better meet the challenges of this broadening mission. The goal of this article was to provide interested administrators and intensivists with the proper resources, lines of communication, and organizational approach to accomplish integration and Critical Care Organization formation effectively. The Academic Critical Care Organization Building section workgroup of the taskforce established regular monthly conference calls to reach consensus on the development of a toolkit utilizing methods proven to advance the development of their own academic Critical Care Organizations. Relevant medical literature was reviewed by literature search. Materials from federal agencies and other national organizations were accessed through the Internet. The Society of Critical Care Medicine convened a taskforce entitled "Academic Leaders in Critical Care Medicine" on February 22, 2016 at the 45th Critical Care Congress using the expertise of successful leaders of advanced governance Critical Care Organizations in North America to develop a toolkit for advancing Critical Care Organizations. Key elements of an academic Critical Care Organization are outlined. The vital missions of multidisciplinary patient care, safety, and quality are linked to the research, education, and professional development missions that enhance the value of such organizations. Core features, benefits, barriers, and recommendations for integration of academic programs within Critical Care Organizations are described. Selected readings and resources to successfully implement the recommendations are provided. Communication with medical school and hospital leadership is discussed. We present the rationale for critical

Fast-track program in laparoscopic liver surgery: Theory or fact?

Science.gov (United States)

Sánchez-Pérez, Belinda; Aranda-Narváez, José Manuel; Suárez-Muñoz, Miguel Angel; Eladel-Delfresno, Moises; Fernández-Aguilar, José Luis; Pérez-Daga, Jose Antonio; Pulido-Roa, Ysabel; Santoyo-Santoyo, Julio

2012-11-27

To analyze our results after the introduction of a fast-track (FT) program after laparoscopic liver surgery in our Hepatobiliarypancreatic Unit. All patients (43) undergoing laparoscopic liver surgery between March 2004 and March 2010 were included and divided into two consecutive groups: Control group (CG) from March 2004 until December 2006 with traditional perioperative cares (17 patients) and fast-track group (FTG) from January 2007 until March 2010 with FT program cares (26 patients). Primary endpoint was the influence of the program on the postoperative stay, the amount of re-admissions, morbidity and mortality. Secondarily we considered duration of surgery, use of drains, conversion to open surgery, intensive cares needs and transfusion. Both groups were homogeneous in age and sex. No differences in technique, time of surgery or conversion to open surgery were found, but more malignant diseases were operated in the FTG, and then transfusions were higher in FTG. Readmissions and morbidity were similar in both groups, without mortality. Postoperative stay was similar, with a median of 3 for CG vs 2.5 for FTG. However, the 80.8% of patients from FTG left the hospital within the first 3 d after surgery (58.8% for CG). The introduction of a FT program after laparoscopic liver surgery improves the recovery of patients without increasing complications or re-admissions, which leads to a reduction of the stay and costs.

Seer 2008 Session III Discussant Remarks

Science.gov (United States)

Medina, Jacquie

2009-01-01

Three research abstracts dealt with program outcomes and the factors that affect them. Morgan (2008) dealt with the potential influence of sensation-seeking personality traits on perceived risk and perceived competence in adventure experiences. Two abstracts by Bobilya, Akey, and Mitchell, Jr. (2008) and Austin, Martin, Mittelstaedt, Schanning,…

Influence of Japan's 2004 postgraduate training on ophthalmologist location choice, supply and distribution.

Science.gov (United States)

Sakai-Bizmark, Rie; Goto, Rei; Hiragi, Shusuke; Tamura, Hiroshi

2018-03-27

Highly-competent patient care is paramount to medicine. Quality training and patient accessibility to physicians with a wide range of specializations is essential. Yet, poor quality of life for physicians cannot be ignored, being detrimental to patient care and leading to personnel leaving the medical profession. In 2004, the Japanese government reformed postgraduate training for medical graduates, adding a 2-year, hands-on rotation through different specialties before the specialization residency was begun. Residents could now choose practice location, but it sparked concerns that physician distribution disparities had been created. Japanese media reported that residents were choosing specialties deemed to offer a higher quality of life, like Ophthalmology or Dermatology, over underserved areas like Obstetrics or Cardiology. To explore the consequences of Japan's policy efforts, through the residency reform in 2004, to improve physician training, analyzing ophthalmologist supply and distribution in the context of providing the best possible patient care and access while maintaining physician quality of life. Using secondary data, we analyzed changes in ophthalmologist supply at the secondary tier of medical care (STM). We applied ordinary least-squares regression models to ophthalmologist density to reflect community factors such as residential quality and access to further professional development, to serve as predictors of ophthalmologist supply. Coefficient equality tests examined predictor differences before and after 2004. Similar analyses were conducted for all physicians excluding ophthalmologists (other physicians). Ophthalmologist coverage in top and bottom 10% of STMs revealed supply inequalities. Change in ophthalmologist supply was inversely associated with baseline ophthalmologist density before (P supply were not associated with baseline other physician density before 2004 (P = 0.5), but positively associated after 2004 (P supply in STMs were

PREVALENCIA DEL SUICIDIO FEMENINO EN EL QUINDÍO, 1989-2008 - PREVALENCE OF FEMALE SUICIDE IN QUINDIO, 1989-2008

Directory of Open Access Journals (Sweden)

ÓSCAR MEDINA PEREZ

2009-06-01

Full Text Available This study is aimed to determine the prevalence of female suicide in the department of Quindio in the years 1989-2008. Regarding this, the database of the Sectional Health Institute of Quindio (ISSQ was used. 117 cases of female suicide were reported in the 20 documented years, the most widely used method was intoxication with a prevalence of 51.5%, followed byhanging with 21.2%. The highest rates are found in the period of five years between 1999-2003, period when the department was recovered from the 1999 earthquake. In the period of five years between 2004-2008, the highest rates were between 10 and 19 years old, with a rate of 7.2, and these numbers increased because the group of 10 to 14 years old presented a rate of 4.6.

The effect of health and dental insurance on US children's dental care utilization for urgent and non-urgent dental problems - 2008.

Science.gov (United States)

Naavaal, Shillpa; Barker, Laurie K; Griffin, Susan O

2017-12-01

We examined the association between utilization of care for a dental problem (utilization-DP) and parent-reported dental problem (DP) urgency among children with DP by type of health care insurance coverage. We used weighted 2008 National Health Interview Survey data from 2,834 children, aged 2-17 years with at least one DP within the 6 months preceding survey. Explanatory variables were selected based on Andersen's model of healthcare utilization. Need was considered urgent if DP included toothache, bleeding gums, broken or missing teeth, broken or missing filling, or decayed teeth and otherwise as non-urgent. The primary enabling variable, insurance, had four categories: none, private health no dental coverage (PHND), private health and dental (PHD), or Medicaid/State Children's Health Insurance Program (SCHIP). Predisposing variables included sociodemographic characteristics. We used bivariate and multivariate analyses to identify explanatory variables' association with utilization-DP. Using logistic regression, we obtained adjusted estimates of utilization-DP by urgency for each insurance category. In bivariate analyses, utilization-DP was associated with both insurance and urgency. In multivariate analyses, the difference in percent utilizing care for an urgent versus non-urgent DP among children covered by Medicaid/SCHIP was 32 percentage points; PHD, 25 percentage points; PHND, 12 percentage points; and no insurance, 14 percentage points. The difference in utilization by DP urgency was higher for children with Medicaid/SCHIP compared with either PHND or uninsured children. Expansion of Medicaid/SCHIP may permit children to receive care for urgent DPs who otherwise may not, due to lack of dental insurance. © 2016 American Association of Public Health Dentistry.

EVALUACIÓN DE LOS PROYECTOS DE MECANISMO DE DESARROLLO LIMPIO PRESENTADOS A LA UNFCCC: LOS CRITERIOS DE SOSTENIBILIDAD ENTRE 2004 Y 2008

Directory of Open Access Journals (Sweden)

JAVIER SABOGAL AGUILAR

2010-01-01

Full Text Available El cambio climático es visto como uno de los problemas ambientales con mayores impactos sobre los sistemas humanos y naturales. La preocupación social sobre esta problemática es creciente como resultado del aumento de evidencia científi ca y fenómenos catastrófi cos, por lo que se ha buscado una respuesta antrópica (Sabogal, 2007. Los proyectos de Mecanismo de Desarrollo Limpio (MDL hacen parte de la propuesta de solución, generando una contribución a la mitigación de Gases Efecto Invernadero (GEI, sin embargo, contrario a la normatividad del Protocolo de Kioto, su impacto no es tan claro en términos de sostenibilidad. El presente artículo evalúa la presencia y el cumplimiento del objetivo de sostenibilidad en los proyectos de MDL presentados al Convención Marco de las Naciones Unidas sobre el Cambio Climático y el Protocolo de Kyoto (UNFCCC,para el periodo comprendido entre 2004 y 2008, identifi cando tendencias globales y planteando recomendaciones de mejoramiento en la aplicación del mecanismo.

Multidisciplinary acute care research organization (MACRO): if you build it, they will come.

Science.gov (United States)

Early, Barbara J; Huang, David T; Callaway, Clifton W; Zenati, Mazen; Angus, Derek C; Gunn, Scott R; Yealy, Donald M; Unikel, Daniel; Billiar, Timothy R; Peitzman, Andrew B; Sperry, Jason L

2013-07-01

Clinical research will increasingly play a core role in the evolution and growth of acute care surgery program development across the country. What constitutes an efficient and effective clinical research infrastructure in the current fiscal and academic environment remains obscure. We sought to characterize the effects of implementation of a multidisciplinary acute care research organization (MACRO) at a busy tertiary referral university setting. In 2008, to minimize redundancy and cost as well as to maximize existing resources promoting acute care research, MACRO was created, unifying clinical research infrastructure among the Departments of Critical Care Medicine, Emergency Medicine, and Surgery. During the periods 2008 to 2012, we performed a retrospective analysis and determined volume of clinical studies, patient enrollment for both observational and interventional trials, and staff growth since MACRO's origination and characterized changes over time. From 2008 to 2011, the volume of patients enrolled in clinical studies, which MACRO facilitates has significantly increased more than 300%. The percentage of interventional/observational trials has remained stable during the same period (50-60%). Staff has increased from 6 coordinators to 10, with an additional 15 research associates allowing 24/7 service. With this significant growth, MACRO has become financially self-sufficient, and additional outside departments now seek MACRO's services. Appropriate organization of acute care clinical research infrastructure minimizes redundancy and can promote sustainable, efficient growth in the current academic environment. Further studies are required to determine if similar models can be successful at other acute care surgery programs.

Associations between state minimum wage policy and health care access: a multi-level analysis of the 2004 Behavioral Risk Factor survey.

Science.gov (United States)

McCarrier, Kelly P; Martin, Diane P; Ralston, James D; Zimmerman, Frederick J

2010-05-01

Minimum wage policies have been advanced as mechanisms to improve the economic conditions of the working poor. Both positive and negative effects of such policies on health care access have been hypothesized, but associations have yet to be thoroughly tested. To examine whether the presence of minimum wage policies in excess of the federal standard of $5.15 per hour was associated with health care access indicators among low-skilled adults of working age, a cross-sectional analysis of 2004 Behavioral Risk Factor Surveillance System data was conducted. Self-reported health insurance status and experience with cost-related barriers to needed medical care were adjusted in multi-level logistic regression models to control for potential confounding at the state, county, and individual levels. State-level wage policy was not found to be associated with insurance status or unmet medical need in the models, providing early evidence that increased minimum wage rates may neither strengthen nor weaken access to care as previously predicted.

Bayesian inversion of data from effusive volcanic eruptions using physics-based models: Application to Mount St. Helens 2004--2008

Science.gov (United States)

Anderson, Kyle; Segall, Paul

2013-01-01

Physics-based models of volcanic eruptions can directly link magmatic processes with diverse, time-varying geophysical observations, and when used in an inverse procedure make it possible to bring all available information to bear on estimating properties of the volcanic system. We develop a technique for inverting geodetic, extrusive flux, and other types of data using a physics-based model of an effusive silicic volcanic eruption to estimate the geometry, pressure, depth, and volatile content of a magma chamber, and properties of the conduit linking the chamber to the surface. A Bayesian inverse formulation makes it possible to easily incorporate independent information into the inversion, such as petrologic estimates of melt water content, and yields probabilistic estimates for model parameters and other properties of the volcano. Probability distributions are sampled using a Markov-Chain Monte Carlo algorithm. We apply the technique using GPS and extrusion data from the 2004–2008 eruption of Mount St. Helens. In contrast to more traditional inversions such as those involving geodetic data alone in combination with kinematic forward models, this technique is able to provide constraint on properties of the magma, including its volatile content, and on the absolute volume and pressure of the magma chamber. Results suggest a large chamber of >40 km3 with a centroid depth of 11–18 km and a dissolved water content at the top of the chamber of 2.6–4.9 wt%.

Integrated Status and Effectiveness Monitoring Program - Entiat River Rotary Screw Traps, Snorkel Surveys, and Steelhead Redd Surveys, 2008-2009.

Energy Technology Data Exchange (ETDEWEB)

Nelle, R.D.; Desgroseillier, Tom; Cotter, Michael [U.S. Fish and Wildlife Service

2009-04-14

The USFWS Mid-Columbia River Fishery Resource Office (MCRFRO) operated two rotary screw traps on the Entiat River as part of the Integrated Status and Effectiveness Monitoring Program from March through November of 2008. Along with the smolt traps, juvenile emigrants were also captured at remote locations throughout the Entiat watershed and its major tributary, the Mad River. A total of 16,782 wild salmonids were PIT tagged during the study period. Of this, 3,961(23.6%) were wild Oncorhynchus mykiss, 6,987 (41.6%) were wild spring run O. tshawytscha, and 5,591 (33.3%) were identified as wild O. tshawytscha of unknown run. Rotary screw trap efficiencies averaged 40.3% at the upper (Rkm 11.0) trap and 7.8% for the lower (Rkm 2.0) trap. These efficiencies were pooled for emigrant O. tshawytscha and O. mykiss. The MCRFRO conducted effectiveness monitoring snorkel surveys at 24 sites during the winter period and 30 sites during the summer and fall periods of 2008 as part of the Integrated Status and Effectiveness Monitoring Program in the Entiat River. The 2008 steelhead spawning grounds surveys were conducted weekly in the main Entiat River from rkm 1.1 to 44.2. A total of 222 steelhead redds were identified over the period from February 28 to June 16 2008 with April being the peak spawning month. Approximately 80% of the steelhead redds were located downstream of the rkm 26.

What Do High-Risk Patients Value? Perspectives on a Care Management Program.

Science.gov (United States)

Ganguli, Ishani; Orav, E John; Weil, Eric; Ferris, Timothy G; Vogeli, Christine

2018-01-01

There is growing interest in coordinating care for high-risk patients through care management programs despite inconsistent results on cost reduction. Early evidence suggests patient-centered benefits, but we know little about how participants engage with the programs and what aspects they value. To explore care management program participants' awareness and perceived utility of program offerings. Cross-sectional telephone survey administered December 2015-January 2016. Patients enrolled in a Boston-area primary care-based care management program. Our main outcome was the number of topics in which patients reported having "very helpful" interactions with their care team in the past year. We analyzed awareness of one's care manager as an intermediate outcome, and then as a primary predictor of the main outcome, along with patient demographics, years in the program, attitudes, and worries as secondary predictors. The survey response rate was 45.8% (n = 1220); non-respondents were similar to respondents. More respondents reported worrying about family (72.8%) or financial issues (52.5%) than about their own health (41.6%). Seventy-four percent reported care manager awareness, particularly women (OR 1.33, 95% CI 1.01-1.77) and those with more years in the program (OR 1.16, 95% CI 1.03-1.30). While interaction rates ranged from 19.8% to 72.4% across topics, 81.3% rated at least one interaction as very helpful. Those who were aware of their care manager reported very helpful interactions on more topics (OR 2.77, 95% CI 2.15-3.56), as did women (OR 1.25, 95% CI 1.00-1.55), younger respondents (OR 0.98 for older age, 95% CI 0.97-0.99), and those with higher risk scores (OR 1.04, 95% CI 1.02-1.06), preference for deferring treatment decisions to doctors (OR 2.00, 95% CI 1.60-2.50), and reported control over their health (OR 1.67, 95% CI 1.33-2.10). High-risk patients reported helpful interactions with their care team around medical and social determinants of health

Day Care Legal Handbook: Legal Aspects of Organizing and Operating Day Care Programs.

Science.gov (United States)

Aikman, William F.

This guide for providers of day care services presents information on business regulations and other legal considerations affecting for-profit and not-for-profit day care programs. Three basic topics covered are: (1) choosing the type of organization (sole proprietorship, partnership or corporation), (2) forming the organization, and (3) operating…

Activity report 2004; Rapport d'activite 2004

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-04-01

Constituted by a public and commercial establishment, the French National Radioactive Waste Management Agency (ANDRA) is responsible for the long term management of radioactive waste. This activity report presents the three missions of the ANDRA during the year 2004. The industrial mission deals with the Aube center disposal and the Manche center disposal facilities and the collection effort concerning the diffuse nuclear waste. The research mission focuses on the presentation of several topics: the repository design by studying various potential architectures, the reversibility and the safety assessment under operating conditions and the description of the behavior of repository at various space and time scales. The last mission concerns the information and the communication program. (A.L.B.)

Optical Monitoring of 3C 66A in 1994–2008 J. Tao1,∗ , JH Fan2, BC ...

Indian Academy of Sciences (India)

sive multiwavelength Whole Earth Blazar Telescope monitoring campaign from. 2003–2004 and from 2007–2008. 2. Observations and data reduction. The observations presented here were obtained with a 1.56-m telescope at SHAO from 13 December 1994 to 9 November 2008. Typical integration times were 120 s.

Do Generous Unemployment Benefit Programs Reduce Suicide Rates? A State Fixed-Effect Analysis Covering 1968–2008

Science.gov (United States)

Cylus, Jonathan; Glymour, M. Maria; Avendano, Mauricio

2014-01-01

The recent economic recession has led to increases in suicide, but whether US state unemployment insurance programs ameliorate this association has not been examined. Exploiting US state variations in the generosity of benefit programs between 1968 and 2008, we tested the hypothesis that more generous unemployment benefit programs reduce the impact of economic downturns on suicide. Using state linear fixed-effect models, we found a negative additive interaction between unemployment rates and benefits among the US working-age (20–64 years) population (β = −0.57, 95% confidence interval: −0.86, −0.27; P unemployment rates on suicide is offset by the presence of generous state unemployment benefit programs, though estimated effects are small in magnitude. PMID:24939978

National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

Science.gov (United States)

Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

2017-12-01

To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

German diabetes management programs improve quality of care and curb costs.

Science.gov (United States)

Stock, Stephanie; Drabik, Anna; Büscher, Guido; Graf, Christian; Ullrich, Walter; Gerber, Andreas; Lauterbach, Karl W; Lüngen, Markus

2010-12-01

This paper reports the results of a large-scale analysis of a nationwide disease management program in Germany for patients with diabetes mellitus. The German program differs markedly from "classic" disease management in the United States. Although it combines important hallmarks of vendor-based disease management and the Chronic Care Model, the German program is based in primary care practices and carried out by physicians, and it draws on their personal relationships with patients to promote adherence to treatment goals and self-management. After four years of follow-up, overall mortality for patients and drug and hospital costs were all significantly lower for patients who participated in the program compared to other insured patients with similar health profiles who were not in the program. These results suggest that the German disease management program is a successful strategy for improving chronic illness care.

An integrated program to train local health care providers to meet post-disaster mental health needs Programa integrado para entrenar a proveedores de servicios sanitarios locales a satisfacer las necesidades de salud mental después de un desastre

OpenAIRE

Stan Kutcher; Sonia Chehil; Thorne Roberts

2005-01-01

This paper describes a post-disaster mental health training program developed by the International Section of the Department of Psychiatry at Dalhousie University (Halifax, Canada) and delivered in Grenada after Hurricane Ivan struck the country in September 2004. This train-the-trainer program used an integrated community health model to help local health care providers develop the necessary skills for the identification and evidenced-based treatment of mental disorders occurring after a nat...

Laboratory Directed Research and Development Program Assessment for FY 2008

Energy Technology Data Exchange (ETDEWEB)

Looney, J P; Fox, K J

2008-03-31

Brookhaven National Laboratory (BNL) is a multidisciplinary Laboratory that carries out basic and applied research in the physical, biomedical, and environmental sciences, and in selected energy technologies. It is managed by Brookhaven Science Associates, LLC, (BSA) under contract with the U. S. Department of Energy (DOE). BNL's Fiscal Year 2008 spending was $531.6 million. There are approximately 2,800 employees, and another 4,300 guest scientists and students who come each year to use the Laboratory's facilities and work with the staff. The BNL Laboratory Directed Research and Development (LDRD) Program reports its status to the U.S. Department of Energy (DOE) annually in March, as required by DOE Order 413.2B, 'Laboratory Directed Research and Development,' April 19, 2006, and the Roles, Responsibilities, and Guidelines for Laboratory Directed Research and Development at the Department of Energy/National Nuclear Security Administration Laboratories dated June 13, 2006. The goals and objectives of BNL's LDRD Program can be inferred from the Program's stated purposes. These are to (1) encourage and support the development of new ideas and technology, (2) promote the early exploration and exploitation of creative and innovative concepts, and (3) develop new 'fundable' R&D projects and programs. The emphasis is clearly articulated by BNL to be on supporting exploratory research 'which could lead to new programs, projects, and directions' for the Laboratory. To be a premier scientific Laboratory, BNL must continuously foster groundbreaking scientific research and renew its research agenda. The competition for LDRD funds stimulates Laboratory scientists to think in new and creative ways, which becomes a major factor in achieving and maintaining research excellence and a means to address National needs within the overall mission of the DOE and BNL. By fostering high-risk, exploratory research, the LDRD program helps

American Psychological Association: Annual Report, 2008

Science.gov (United States)

American Psychologist, 2009

2009-01-01

This article presents the 2008 annual reports from the various directorates and offices of the American Psychological Association (APA). In 2008, APA continued to work on initiatives, programs, and products that lend value to the member's psychology career, support the future of their discipline, and serve the public. APA's goal is to strengthen…

Working Together to Connect Care: a metropolitan tertiary emergency department and community care program.

Science.gov (United States)

Harcourt, Debra; McDonald, Clancy; Cartlidge-Gann, Leonie; Burke, John

2017-03-02

Objective Frequent attendance by people to an emergency department (ED) is a global concern. A collaborative partnership between an ED and the primary and community healthcare sectors has the potential to improve care for the person who frequently attends the ED. The aims of the Working Together to Connect Care program are to decrease the number of presentations by providing focused community support and to integrate all healthcare services with the goal of achieving positive, patient-centred and directed outcomes. Methods A retrospective analysis of ED data for 2014 and 2015 was used to ascertain the characteristics of the potential program cohort. The definition used to identify a 'frequent attendee' was more than four presentations to an ED in 1 month. This analysis was used to develop the processes now known as the Working Together to Connect Care program. This program includes participant identification by applying the definition, flagging of potential participants in the ED IT system, case review and referral to community services by ED staff, case conferencing facilitated within the ED and individualised, patient centred case management provided by government and non-government community services. Results Two months after the date of commencement of the Working Together to Connect Care program there are 31 active participants in the program: 10 are on the Mental Health pathway, and one is on the No Consent pathway. On average there are three people recruited to the program every week. The establishment of a new program for supporting frequent attendees of an ED has had its challenges. Identifying systems that support people in their community has been an early positive outcome of this project. Conclusion It is expected that data regarding the number of ED presentations, potential fiscal savings and client outcomes will be available in 2017. What is known about the topic? Frequent attendance at EDs is a global issue and although the number of 'super users' is

Creating a successful culturally sensitive home care program.

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Blanter, R; Page, P M

1995-12-01

Providing quality home care services to immigrants requires an integrated, holistic approach that genuinely addresses language and cultural differences. One home care agency in Massachusetts developed a team-oriented, culturally sensitive outreach program that ensures non-English-speaking patients the same level of service that the general population receives.

Treatment initiation, program attrition and patient treatment outcomes associated with scale-up and decentralization of HIV care in rural Malawi.

Directory of Open Access Journals (Sweden)

Megan McGuire

Full Text Available OBJECTIVE: To describe patient antiretroviral therapy (cART outcomes associated with intensive decentralization of services in a rural HIV program in Malawi. METHODS: Longitudinal analysis of data from HIV-infected patients starting cART between August 2001 and December 2008 and of a cross-sectional immunovirological assessment conducted 12 (±2 months after therapy start. One-year mortality, lost to follow-up, and attrition (deaths and lost to follow-up rates were estimated with exact Poisson 95% confidence intervals (CI by type of care delivery and year of initiation. Association of virological suppression (<50 copies/mL and immunological success (CD4 gain ≥100 cells/µL, with type of care was investigated using multiple logistic regression. RESULTS: During the study period, 4322 cART patients received centralized care and 11,090 decentralized care. At therapy start, patients treated in decentralized health facilities had higher median CD4 count levels (167 vs. 130 cell/µL, P<0.0001 than other patients. Two years after cART start, program attrition was lower in decentralized than centralized facilities (9.9 per 100 person-years, 95% CI: 9.5-10.4 vs. 20.8 per 100 person-years, 95% CI: 19.7-22.0. One year after treatment start, differences in immunological success (adjusted OR=1.23, 95% CI: 0.83-1.83, and viral suppression (adjusted OR=0.80, 95% CI: 0.56-1.14 between patients followed at centralized and decentralized facilities were not statistically significant. CONCLUSIONS: In rural Malawi, 1- and 2-year program attrition was lower in decentralized than in centralized health facilities and no statistically significant differences in one-year immunovirological outcomes were observed between the two health care levels. Longer follow-up is needed to confirm these results.

End-of-life care in the United States: policy issues and model programs of integrated care

Directory of Open Access Journals (Sweden)

Joshua M. Wiener

2003-05-01

Full Text Available Background: End-of-life care financing and delivery in the United States is fragmented and uncoordinated, with little integration of acute and long-term care services. Objective: To assess policy issues involving end-of-life care, especially involving the hospice benefit, and to analyse model programs of integrated care for people who are dying. Methods: The study conducted structured interviews with stakeholders and experts in end-of-life care and with administrators of model programs in the United States, which were nominated by the experts. Results: The two major public insurance programs—Medicare and Medicaid—finance the vast majority of end-of-life care. Both programs offer a hospice benefit, which has several shortcomings, including requiring physicians to make a prognosis of a six month life expectancy and insisting that patients give up curative treatment—two steps which are difficult for doctors and patients to make—and payment levels that may be too low. In addition, quality of care initiatives for nursing homes and hospice sometimes conflict. Four innovative health systems have overcome these barriers to provide palliative services to beneficiaries in their last year of life. Three of these health systems are managed care plans which receive capitated payments. These providers integrate health, long-term and palliative care using an interdisciplinary team approach to management of services. The fourth provider is a hospice that provides palliative services to beneficiaries of all ages, including those who have not elected hospice care. Conclusions: End-of-life care is deficient in the United States. Public payers could use their market power to improve care through a number of strategies.

NATURAL BARRIERS TARGETED THRUST FY 2004 PROJECTS

Energy Technology Data Exchange (ETDEWEB)

NA

2005-07-27

This booklet contains project descriptions of work performed by the Department of Energy (DOE), Office of Civilian Radioactive Waste Management (OCRWM), Office of Science and Technology and International's (OST&I) Natural Barriers Targeted Thrust during Fiscal Year (FY) 2004. The Natural Barriers Targeted Thrust is part of OST&I's Science and Technology Program which supports the OCRWM mission to manage and dispose of high-level radioactive waste and spent nuclear fuel in a manner that protects health, safety, and the environment; enhances national and energy security; and merits public confidence. In general, the projects described will continue beyond FY 2004 assuming that the technical work remains relevant to the proposed Yucca Mountain Repository and sufficient funding is made available to the Science and Technology Program.

Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004-2012.

Science.gov (United States)

Hamel, Donald J; Sankalé, Jean-Louis; Samuels, Jay Osi; Sarr, Abdoulaye D; Chaplin, Beth; Ofuche, Eke; Meloni, Seema T; Okonkwo, Prosper; Kanki, Phyllis J

From 2004-2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President's Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations. Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings. Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories. Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other laboratories in resource-limited settings.

Annual Site Environmental Report: 2008 (ASER)

International Nuclear Information System (INIS)

Sabba, D.

2009-01-01

This report provides information about environmental programs during the calendar year of 2008 at the SLAC National Accelerator Laboratory (SLAC), Menlo Park, California. Activities that span the calendar year, i.e., stormwater monitoring covering the winter season of 2008/2009 (October 2008 through May 2009), are also included. Production of an annual site environmental report (ASER) is a requirement established by the United States Department of Energy (DOE) for all management and operating (M and O) contractors throughout the DOE complex. SLAC is a federally-funded research and development center with Stanford University as the M and O contractor. Under Executive Order (EO) 13423, Strengthening Federal Environmental, Energy, and Transportation Management, and DOE Order 450.1A, Environmental Protection Program, SLAC effectively implements and integrates the key elements of an Environmental Management System (EMS) to achieve the site's integrated safety and environmental management system goals. For normal daily activities, SLAC managers and supervisors are responsible for ensuring that policies and procedures are understood and followed so that: (1) Worker safety and health are protected; (2) The environment is protected; and (3) Compliance is ensured. Throughout 2008, SLAC continued to improve its management systems. These systems provided a structured framework for SLAC to implement 'greening of the government' initiatives such as EO 13423 and DOE Orders 450.1A and 430.2B. Overall, management systems at SLAC are effective, supporting compliance with all relevant statutory and regulatory requirements. SLAC continues to demonstrate significant progress in implementing and integrating EMS into day-to-day operations and construction activities at SLAC. The annual management review and ranking of environmental aspects were completed this year by SLAC's EMS Steering Committee, the Environmental Safety Committee (ESC), and twelve objectives and targets were

Annual Site Environmental Report: 2008 (ASER)

Energy Technology Data Exchange (ETDEWEB)

Sabba, D.

2009-11-09

This report provides information about environmental programs during the calendar year of 2008 at the SLAC National Accelerator Laboratory (SLAC), Menlo Park, California. Activities that span the calendar year, i.e., stormwater monitoring covering the winter season of 2008/2009 (October 2008 through May 2009), are also included. Production of an annual site environmental report (ASER) is a requirement established by the United States Department of Energy (DOE) for all management and operating (M&O) contractors throughout the DOE complex. SLAC is a federally-funded research and development center with Stanford University as the M&O contractor. Under Executive Order (EO) 13423, Strengthening Federal Environmental, Energy, and Transportation Management, and DOE Order 450.1A, Environmental Protection Program, SLAC effectively implements and integrates the key elements of an Environmental Management System (EMS) to achieve the site's integrated safety and environmental management system goals. For normal daily activities, SLAC managers and supervisors are responsible for ensuring that policies and procedures are understood and followed so that: (1) Worker safety and health are protected; (2) The environment is protected; and (3) Compliance is ensured. Throughout 2008, SLAC continued to improve its management systems. These systems provided a structured framework for SLAC to implement 'greening of the government' initiatives such as EO 13423 and DOE Orders 450.1A and 430.2B. Overall, management systems at SLAC are effective, supporting compliance with all relevant statutory and regulatory requirements. SLAC continues to demonstrate significant progress in implementing and integrating EMS into day-to-day operations and construction activities at SLAC. The annual management review and ranking of environmental aspects were completed this year by SLAC's EMS Steering Committee, the Environmental Safety Committee (ESC), and twelve objectives and targets

Implementation of a comprehensive pharmaceutical care program for an underserved population.

Science.gov (United States)

Mascardo, Lisa A; Spading, Kimberly A; Abramowitz, Paul W

2012-07-15

The implementation of a prescription benefit program for low-income patients emphasizing clinical pharmacist services and strict formulary control is described, with a review of program expenditures and cost avoidance. In 2006, University of Iowa Hospitals and Clinics (UIHC) launched a program to provide a limited prescription benefit to indigent patients under the IowaCare Medicaid demonstration waiver. Sudden dramatic growth in IowaCare enrollment, combined with sharp budget cuts, forced UIHC pharmacy leaders to implement creative cost-control strategies: (1) the establishment of an ambulatory care clinic staffed by a clinical pharmacy specialist, (2) increased reliance on an almost exclusively generic formulary, (3) collaboration with social services staff to help secure medication assistance for patients requiring brand-name drugs, (4) optimized purchasing through the federal 340B Drug Pricing Program, and (5) the imposition of medication copayments and mailing fees for prescription refills. Now in its seventh year, the UIHC pharmacy program has expanded indigent patients' access to pharmaceutical care services while reducing their use of hospital and emergency room services and lowering program medication costs by an estimated 50% (from $2.6 million in fiscal year 2009 to $1.3 million in fiscal year 2010). The UIHC ambulatory care pharmacy implemented a prescription program in collaboration with social service workers to address the medication needs of the state's low-income and uninsured patients in a fiscally responsible manner by managing purchasing contracts, revising a generic formulary, implementing copayments and mailing fees, and reviewing medication profiles.

Price and healthfulness of snacks in 32 YMCA after-school programs in 4 US metropolitan areas, 2006-2008.

Science.gov (United States)

Mozaffarian, Rebecca S; Andry, Analisa; Lee, Rebekka M; Wiecha, Jean L; Gortmaker, Steven L

2012-01-01

A common perception is that healthful foods are more expensive than less healthful foods. We assessed the cost of beverages and foods served at YMCA after-school programs, determined whether healthful snacks were more expensive, and identified inexpensive, healthful options. We collected daily snack menus from 32 YMCAs nationwide from 2006 to 2008 and derived prices of beverages and foods from the US Department of Agriculture price database. Multiple linear regression was used to assess associations of healthful snacks and of beverage and food groups with price (n = 1,294 snack-days). We identified repeatedly served healthful snacks consistent with Child and Adult Care Food Program guidelines and reimbursement rate ($0.74/snack). On average, healthful snacks were approximately 50% more expensive than less healthful snacks ($0.26/snack; SE, 0.08; P = .003). Compared to water, 100% juice significantly increased average snack price, after controlling for other variables in the model. Similarly, compared to refined grains with trans fats, refined grains without trans fat significantly increased snack price, as did fruit and canned or frozen vegetables. Fresh vegetables (mostly carrots or celery) or whole grains did not alter price. Twenty-two repeatedly served snacks met nutrition guidelines and the reimbursement rate. In this sample of after-school programs, healthful snacks were typically more expensive than less healthful options; however, we identified many healthful snacks served at or below the price of less healthful options. Substituting tap water for 100% juice yielded price savings that could be used toward purchasing more healthful foods (eg, an apple). Our findings have practical implications for selecting snacks that meet health and reimbursement guidelines.

Inventory compilation of F-gases 2008. Data on HFCs, PFCs, and SF{sub 6} for the national emissions reporting under the Framework Convention on Climate Change for the reporting year 2008; Emissionen fluorierter Treibhausgase in Deutschland 2008. Inventarermittlung der F-Gase 2008 Daten von HFKW, FKW und SF6 fuer die nationale Emissionsberichterstattung gemaess Klimarahmenkonvnention fuer das Berichtsjahr 2008

Energy Technology Data Exchange (ETDEWEB)

Schwarz, Winfried [Oeko-Recherche Buero fuer Umweltforschung und -beratung GmbH, Frankfurt/Main (Germany)

2010-06-15

This report presents the 2008 data on the German emissions of the fluorinated greenhouse gases HFCs, PFCs, and SF{sub 6} (F-gases) to be entered into the ZSE (Centralised System of Emissions at the German Environmental Agency). The overall emissions of HFCs, PFCs, and SF6 have doubled from 1995 to 2008, from 3,241 to 7,202 metric tons. In terms of global warming, the emissions in 2008 exceeded again the 1995 level, with 18.0 vs. 15.5 million tons CO{sub 2} equivalent. Against the previous your, the emissions in metric units have decreased the first time since 1995, however the global warming emissions, have increased by further 0.7 million t CO{sub 2} equivalent. PFC emissions remained in 2008 at the 2007 level although they show a constant down trend from 1995 onwards. Emissions of SF6, which had decreased before 2002, are increasing again from 2003/04. HFC emissions, which continue rising since 1995, stopped growing in 2008 due to a consumption drop in the foam sector. They represent almost two thirds of the total German F-gas emissions. However, only refrigeration and air conditioning are still substantial applications of HFCs, while in the formerly large application sectors of CFCs and HCFCs, such as hard foam, fire extinguishers, and aerosols, natural fluids are being used widely, today. In stationary refrigeration and mobile air conditioning, the upward trend in HFCs emissions was still ongoing in 2008. Section I of this report presents the F-gas emissions data for 2008, in addition to those in 1995, 2000, 2004, and 2007. In section II the data sources of survey are documented. Section III presents the F-gas emissions 1995 - 2008 in detailed tables, by individual sectors. (orig.)

[The admission to Nursing Homes and Home care services of elderly patients: analysis of the trend from 2008 to 2011 in a North Italian district].

Science.gov (United States)

Caporale, Loretta; Czaplejewicz, Monika; Odasmini, Bruna

2014-01-01

The effects of the economic crisis impact on several aspects, included the use of health and social services. To analyze the effects of the economic recession on the request of in-home and long run social-health services. Retrospective research. The databases of a In-home Nursing Service, the Social Services and the Welfare area of a Social-Health Local Service in North of Italy have been consulted, with reference to the period between 31st December 2008 to 31st December 2011. From 2008 to 2011 the users supported by the In-Home Nursing Service increased by 30.3% while a decrease in the waiting lists for public and private nursing homes was observed. The users of In-Home Assistance Service decreased by 11%, as well as recipients of In-Home Meal Service (33%). Since 2008, the number of regional economic allowance beneficiaries dramatically increased; these allowances are dispensed as a support to In-Home Nursing Service and to social frailty. Profound changes of the offer and use of long term care services is evident. The endurance of this trend could impair the In-Home Nursing Services ability to answer to health needs of citizens. Health care professionals should strengthen the educational interventions to improve the level of patients'self care.

Implementing the Namaste Care Program for residents with advanced dementia: exploring the perceptions of families and staff in UK care homes.

Science.gov (United States)

Stacpoole, Min; Hockley, Jo; Thompsell, Amanda; Simard, Joyce; Volicer, Ladislav

2017-10-01

Increasing numbers of older people with advanced dementia are cared for in care homes. No cure is available, so research focused on improving quality of life and quality of care for people with dementia is needed to support them to live and die well. The Namaste Care programme is a multi-dimensional care program with sensory, psycho-social and spiritual components intended to enhance quality of life and quality of care for people with advanced dementia. The aim of the study was to establish whether the Namaste Care program can be implemented in UK care homes; and what effect Namaste Care has on the quality of life of residents with advanced dementia, their families and staff. This article explores the qualitative findings of the study, reporting the effect of the programme on the families of people with advanced dementia and care home staff, and presenting their perceptions of change in care. An organisational action research methodology was used. Focus groups and interviews were undertaken pre/post implementation of the Namaste Care program. The researcher kept a reflective diary recording data on the process of change. A comments book was available to staff and relatives in each care home. Data was analysed thematically within each care home and then across all care homes. Six care homes were recruited in south London: one withdrew before the study was underway. Of the five remaining care homes, four achieved a full Namaste Care program. One care home did not achieve the full program during the study, and another discontinued Namaste Care when the study ended. Every home experienced management disruption during the study. Namaste Care challenged normal routinised care for older people with advanced dementia. The characteristics of care uncovered before Namaste was implemented were: chaos and confusion, rushing around, lack of trust, and rewarding care. After the programme was implemented these perceptions were transformed, and themes of calmness, reaching out to

Development and validation of an online interactive, multimedia wound care algorithms program.

Science.gov (United States)

Beitz, Janice M; van Rijswijk, Lia

2012-01-01

To provide education based on evidence-based and validated wound care algorithms we designed and implemented an interactive, Web-based learning program for teaching wound care. A mixed methods quantitative pilot study design with qualitative components was used to test and ascertain the ease of use, validity, and reliability of the online program. A convenience sample of 56 RN wound experts (formally educated, certified in wound care, or both) participated. The interactive, online program consists of a user introduction, interactive assessment of 15 acute and chronic wound photos, user feedback about the percentage correct, partially correct, or incorrect algorithm and dressing choices and a user survey. After giving consent, participants accessed the online program, provided answers to the demographic survey, and completed the assessment module and photographic test, along with a posttest survey. The construct validity of the online interactive program was strong. Eighty-five percent (85%) of algorithm and 87% of dressing choices were fully correct even though some programming design issues were identified. Online study results were consistently better than previously conducted comparable paper-pencil study results. Using a 5-point Likert-type scale, participants rated the program's value and ease of use as 3.88 (valuable to very valuable) and 3.97 (easy to very easy), respectively. Similarly the research process was described qualitatively as "enjoyable" and "exciting." This digital program was well received indicating its "perceived benefits" for nonexpert users, which may help reduce barriers to implementing safe, evidence-based care. Ongoing research using larger sample sizes may help refine the program or algorithms while identifying clinician educational needs. Initial design imperfections and programming problems identified also underscored the importance of testing all paper and Web-based programs designed to educate health care professionals or guide

Health-care provider screening for tobacco smoking and advice to quit - 17 countries, 2008-2011.

Science.gov (United States)

2013-11-22

Tobacco use is the leading cause of preventable mortality in the world. Article 14 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) states that countries should promote cessation of tobacco use and adequate treatment for tobacco dependence. Health-care providers asking all patients about their tobacco use and advising tobacco users to quit are evidence-based strategies that increase tobacco abstinence. This report examines the proportion of tobacco smokers in 17 countries responding to the Global Adult Tobacco Survey (GATS) who saw a health-care provider in the past year and who reported that a health-care provider asked them about smoking and advised them to quit. Respondents were tobacco smokers aged ≥15 years surveyed during 2008-2011 in Bangladesh, Brazil, China, Egypt, India, Indonesia, Malaysia, Mexico, Philippines, Poland, Romania, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam. The proportion of smokers who had visited a health-care provider during the previous 12 months ranged from 21.6% in Egypt to 62.3% in Poland. Among these, the proportion reporting that a health-care provider asked if they smoked ranged from 34.9% in Vietnam to 82.1% in Romania. Among those screened for tobacco use, those who reported their health-care providers advised them to quit ranged from 17.3% in Mexico to 67.3% in Romania. In most countries, persons aged ≥45 years were more likely to report being screened and advised to quit than were persons aged ≤24 years. Health-care providers should identify smokers and provide advice and assistance in quitting at each visit as an adjunct to effective community interventions (e.g., increased price of tobacco products; smoke-free policies, mass media campaigns, and tobacco quitlines).

Revised Master Plan for the Hood River Production Program, Technical Report 2008.

Energy Technology Data Exchange (ETDEWEB)

Oregon Department of Fish and Wildlife; Confederated Tribes of the Warm Springs Reservation

2008-04-28

The Hood River Production Program (HRPP) is a Bonneville Power Administration (BPA) funded program initiated as a mitigation measure for Columbia River hydrosystem effects on anadromous fish. The HRPP began in the early 1990s with the release of spring Chinook and winter steelhead smolts into the basin. Prior to implementation, co-managers, including the Confederated Tribes of the Warm Springs Reservation and the Oregon Department of Fish and Wildlife drafted the Hood River Production Master Plan (O'Toole and ODFW 1991a; O'Toole and ODFW 1991b) and the Pelton Ladder Master Plan (Smith and CTWSR 1991). Both documents were completed in 1991 and subsequently approved by the Council in 1992 and authorized through a BPA-led Environmental Impact Statement in 1996. In 2003, a 10-year programmatic review was conducted for BPA-funded programs in the Hood River (Underwood et al. 2003). The primary objective of the HRPP Review (Review) was to determine if program goals were being met, and if modifications to program activities would be necessary in order to meet or revise program goals. In 2003, an agreement was signed between PacifiCorp and resource managers to remove the Powerdale Dam (RM 10) and associated adult trapping facility by 2010. The HRPP program has been dependant on the adult trap to collect broodstock for the hatchery programs; therefore, upon the dam's removal, some sort of replacement for the trap would be needed to continue the HRPP. At the same time the Hood River Subbasin Plan (Coccoli 2004) was being written and prompted the co-managers to considered future direction of the program. This included revising the numerical adult fish objectives based on the assimilated data and output from several models run on the Hood River system. In response to the Review as well as the Subbasin Plan, and intensive monitoring and evaluation of the current program, the HRPP co-managers determined the spring Chinook program was not achieving the HRPP

Calendar year 2004 annual site environmental report:Sandia National Laboratories, Albuquerque, New Mexico.

Energy Technology Data Exchange (ETDEWEB)

Montoya, Amber L.; Goering, Teresa Lynn; Wagner, Katrina; Koss, Susan I.; Salinas, Stephanie A.

2005-09-01

Sandia National Laboratories, New Mexico (SNL/NM) is a government-owned, contractor-operated facility owned by the U.S. Department of Energy (DOE), National Nuclear Security Administration (NNSA) and managed by the Sandia Site Office (SSO), Albuquerque, New Mexico. Sandia Corporation, a wholly-owned subsidiary of Lockheed Martin Corporation, operates SNL/NM. This annual report summarizes data and the compliance status of Sandia Corporation's environmental protection and monitoring programs through December 31, 2004. Major environmental programs include air quality, water quality, groundwater protection, terrestrial surveillance, waste management, pollution prevention (P2), environmental restoration (ER), oil and chemical spill prevention, and the National Environmental Policy Act (NEPA). Environmental monitoring and surveillance programs are required by DOE Order 450.1, Environmental Protection Program (DOE 2005) and DOE Order 231.1A, Environment, Safety, and Health Reporting (DOE 2004a). (DOE 2004a).

Association between food assistance program participation and overweight.

Science.gov (United States)

Chaparro, M Pia; Bernabe-Ortiz, Antonio; Harrison, Gail G

2014-12-01

OBJECTIVE The objective of this study was to investigate the association between food assistance program participation and overweight/obesity according to poverty level. METHODS A cross-sectional analysis of data from 46,217 non-pregnant and non-lactating women in Lima, Peru was conducted; these data were obtained from nationally representative surveys from the years 2003, 2004, 2006, and 2008-2010. The dependent variable was overweight/obesity, and the independent variable was food assistance program participation. Poisson regression was used to stratify the data by family socioeconomic level, area of residence (Lima versus the rest of the country; urban versus rural), and survey year (2003-2006 versus 2008-2010). The models were adjusted for age, education level, urbanization, and survey year. RESULTS Food assistance program participation was associated with an increased risk of overweight/obesity in women living in homes without poverty indicators [prevalence ratio (PR) = 1.29; 95% confidence interval (CI) 1.06;1.57]. When stratified by area of residence, similar associations were observed for women living in Lima and urban areas; no associations were found between food assistance program participation and overweight/obesity among women living outside of Lima or in rural areas, regardless of the poverty status. CONCLUSIONS Food assistance program participation was associated with overweight/obesity in non-poor women. Additional studies are required in countries facing both aspects of malnutrition.

Association between food assistance program participation and overweight

Directory of Open Access Journals (Sweden)

M Pia Chaparro

2014-12-01

Full Text Available OBJECTIVE The objective of this study was to investigate the association between food assistance program participation and overweight/obesity according to poverty level. METHODS A cross-sectional analysis of data from 46,217 non-pregnant and non-lactating women in Lima, Peru was conducted; these data were obtained from nationally representative surveys from the years 2003, 2004, 2006, and 2008-2010. The dependent variable was overweight/obesity, and the independent variable was food assistance program participation. Poisson regression was used to stratify the data by family socioeconomic level, area of residence (Lima versus the rest of the country; urban versus rural, and survey year (2003-2006 versus 2008-2010. The models were adjusted for age, education level, urbanization, and survey year. RESULTS Food assistance program participation was associated with an increased risk of overweight/obesity in women living in homes without poverty indicators [prevalence ratio (PR = 1.29; 95% confidence interval (CI 1.06;1.57]. When stratified by area of residence, similar associations were observed for women living in Lima and urban areas; no associations were found between food assistance program participation and overweight/obesity among women living outside of Lima or in rural areas, regardless of the poverty status. CONCLUSIONS Food assistance program participation was associated with overweight/obesity in non-poor women. Additional studies are required in countries facing both aspects of malnutrition.

Trends and Characteristics of United States Out-of-Hospital Births 2004-2014: New Information on Risk Status and Access to Care.

Science.gov (United States)

MacDorman, Marian F; Declercq, Eugene

2016-06-01

Out-of-hospital births are increasing in the United States. Our purpose was to examine trends in out-of-hospital births from 2004 to 2014, and to analyze newly available data on risk status and access to care. Newly available data from the revised birth certificate for 47 states and Washington, DC, were used to examine out-of-hospital births by characteristics and to compare them with hospital births. Trends from 2004 to 2014 were also examined. Out-of-hospital births increased by 72 percent, from 0.87 percent of United States births in 2004 to 1.50 percent in 2014. Compared with mothers who had hospital births, those with out-of-hospital births had lower prepregnancy obesity (12.5% vs 25.0%) and smoking (2.8% vs 8.5%) rates, and higher college graduation (39.3% vs 30.0%) and breastfeeding initiation (94.3% vs 80.8%) rates. Among planned home births, 67.1 percent were self-paid, compared with 31.9 percent of birth center and 3.4 percent of hospital births. Vaginal births after cesarean (VBACs) comprised 4.6 percent of planned home births and 1.6 percent of hospital and birth center births. Sociodemographic and medical risk status of out-of-hospital births improved substantially from 2004 to 2014. Improvements in risk status of out-of-hospital births from 2004 to 2014 suggest that appropriate selection of low-risk women is improving. High rates of self-pay for the costs of out-of-hospital birth suggest serious gaps in insurance coverage, whereas higher-than-average rates of VBAC could reflect lack of access to hospital VBACs. Mandating private insurance and Medicaid coverage could substantially improve access to out-of-hospital births. Improving access to hospital VBACs might reduce the number of out-of-hospital VBACs. © 2016 Wiley Periodicals, Inc.

Cost Analysis and Policy Implications of a Pediatric Palliative Care Program.

Science.gov (United States)

Gans, Daphna; Hadler, Max W; Chen, Xiao; Wu, Shang-Hua; Dimand, Robert; Abramson, Jill M; Ferrell, Betty; Diamant, Allison L; Kominski, Gerald F

2016-09-01

In 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child's life expectancy. We assessed the change from before PFC enrollment to the enrolled period in 1) health care costs per enrollee per month (PEPM), 2) costs by service type and diagnosis category, and 3) health care utilization (days of inpatient care and length of hospital stay). A pre-post analysis compared enrollees' health care costs and utilization up to 24 months before enrollment with their costs during participation in the pilot, from January 2010 through December 2012. Analyses were conducted using paid Medicaid claims and program enrollment data. The average PEPM health care costs of program enrollees decreased by $3331 from before their participation in PFC to the enrolled period, driven by a reduction in inpatient costs of $4897 PEPM. PFC enrollees experienced a nearly 50% reduction in the average number of inpatient days per month, from 4.2 to 2.3. Average length of stay per hospitalization dropped from an average of 16.7 days before enrollment to 6.5 days while in the program. Through the provision of home-based therapeutic services, 24/7 access to medical advice, and enhanced, personally tailored care coordination, PFC demonstrated an effective way to reduce costs for children with life-limiting conditions by moving from costly inpatient care to more coordinated and less expensive outpatient care. PFC's home-based care strategy is a cost-effective model for pediatric palliative care elsewhere. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Nevada Test Site Environmental Report 2004

International Nuclear Information System (INIS)

BECHTEL NEVADA

2005-01-01

The ''Nevada Test Site Environmental Report 2004'' was prepared by Bechtel Nevada (BN) to meet the information needs of the public and the requirements and guidelines of the U.S. Department of Energy (DOE) for annual site environmental reports. This Executive Summary presents the purpose of the document, the major programs conducted at the Nevada Test Site (NTS), NTS key environmental initiatives, radiological releases and potential doses to the public resulting from site operations, a summary of non-radiological releases, implementation status of the NTS Environmental Management System, and significant environmental accomplishments. Much of the content of this Executive Summary is also presented in a separate stand-alone pamphlet titled ''Nevada Test Site Environmental Report Summary 2004''. It was produced this year to provide a more cost-effective and wider distribution of a hardcopy summary of the ''Nevada Test Site Environmental Report 2004'' to interested DOE stakeholders

Stepped care for depression and anxiety: from primary care to specialized mental health care: a randomised controlled trial testing the effectiveness of a stepped care program among primary care patients with mood or anxiety disorders

Directory of Open Access Journals (Sweden)

Seekles Wike

2009-06-01

Full Text Available Abstract Background Mood and anxiety disorders are highly prevalent and have a large impact on the lives of the affected individuals. Therefore, optimal treatment of these disorders is highly important. In this study we will examine the effectiveness of a stepped care program for primary care patients with mood and anxiety disorders. A stepped care program is characterized by different treatment steps that are arranged in order of increasing intensity. Methods This study is a randomised controlled trial with two conditions: stepped care and care as usual, whereby the latter forms the control group. The stepped care program consists of four evidence based interventions: (1 Watchful waiting, (2 Guided self-help, (3 Problem Solving Treatment and (4 Medication and/or specialized mental health care. The study population consists of primary care attendees aged 18–65 years. Screeners are sent to all patients of the participating general practitioners. Individuals with a Diagnostic and Statistical Manual of mental disorders (DSM diagnosis of major depression, dysthymia, panic disorder (with or without agoraphobia, generalized anxiety disorder, or social phobia are included as well as individuals with minor depression and anxiety disorders. Primary focus is the reduction of depressive and anxiety symptoms. Both conditions are monitored at 8, 16 and 24 weeks. Discussion This study evaluates the effectiveness of a stepped care program for patients with depressive and anxiety disorder. If effective, a stepped care program can form a worthwhile alternative for care as usual. Strengths and limitations of this study are discussed. Trial Registration Current Controlled Trails: ISRCTN17831610.

Treatment initiation, program attrition and patient treatment outcomes associated with scale-up and decentralization of HIV care in rural Malawi.

Science.gov (United States)

McGuire, Megan; Pinoges, Loretxu; Kanapathipillai, Rupa; Munyenyembe, Tamika; Huckabee, Martha; Makombe, Simon; Szumilin, Elisabeth; Heinzelmann, Annette; Pujades-Rodríguez, Mar

2012-01-01

To describe patient antiretroviral therapy (cART) outcomes associated with intensive decentralization of services in a rural HIV program in Malawi. Longitudinal analysis of data from HIV-infected patients starting cART between August 2001 and December 2008 and of a cross-sectional immunovirological assessment conducted 12 (±2) months after therapy start. One-year mortality, lost to follow-up, and attrition (deaths and lost to follow-up) rates were estimated with exact Poisson 95% confidence intervals (CI) by type of care delivery and year of initiation. Association of virological suppression (centralized care and 11,090 decentralized care. At therapy start, patients treated in decentralized health facilities had higher median CD4 count levels (167 vs. 130 cell/µL, Pdecentralized than centralized facilities (9.9 per 100 person-years, 95% CI: 9.5-10.4 vs. 20.8 per 100 person-years, 95% CI: 19.7-22.0). One year after treatment start, differences in immunological success (adjusted OR=1.23, 95% CI: 0.83-1.83), and viral suppression (adjusted OR=0.80, 95% CI: 0.56-1.14) between patients followed at centralized and decentralized facilities were not statistically significant. In rural Malawi, 1- and 2-year program attrition was lower in decentralized than in centralized health facilities and no statistically significant differences in one-year immunovirological outcomes were observed between the two health care levels. Longer follow-up is needed to confirm these results.

Neurocritical care education during neurology residency: AAN survey of US program directors.

Science.gov (United States)

Sheth, K N; Drogan, O; Manno, E; Geocadin, R G; Ziai, W

2012-05-29

Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents.

Health care resource use and costs among patients with cushing disease.

Science.gov (United States)

Swearingen, Brooke; Wu, Ning; Chen, Shih-Yin; Pulgar, Sonia; Biller, Beverly M K

2011-01-01

To assess health care costs associated with Cushing disease and to determine changes in overall and comorbidity-related costs after surgical treatment. In this retrospective cohort study, patients with Cushing disease were identified from insurance claims databases by International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes for Cushing syndrome (255.0) and either benign pituitary adenomas (227.3) or hypophysectomy (07.6×) between 2004 and 2008. Each patient with Cushing disease was age- and sex-matched with 4 patients with nonfunctioning pituitary adenomas and 10 population control subjects. Comorbid conditions and annual direct health care costs were assessed within each calendar year. Postoperative changes in health care costs and comorbidity-related costs were compared between patients presumed to be in remission and those with presumed persistent disease. Of 877 identified patients with Cushing disease, 79% were female and the average age was 43.4 years. Hypertension, diabetes mellitus, and hyperlipidemia were more common among patients with Cushing disease than in patients with nonfunctioning pituitary adenomas or in control patients (PCushing disease had significantly higher total health care costs (2008: $26 440 [Cushing disease] vs $13 708 [nonfunctioning pituitary adenomas] vs $5954 [population control], Pdisease-related costs with remission. A significant increase in postoperative health care costs was observed in those patients not in remission. Patients with Cushing disease had more comorbidities than patients with nonfunctioning pituitary adenomas or control patients and incurred significantly higher annual health care costs; these costs decreased after successful surgery and increased after unsuccessful surgery.

Do generous unemployment benefit programs reduce suicide rates? A state fixed-effect analysis covering 1968-2008.

Science.gov (United States)

Cylus, Jonathan; Glymour, M Maria; Avendano, Mauricio

2014-07-01

The recent economic recession has led to increases in suicide, but whether US state unemployment insurance programs ameliorate this association has not been examined. Exploiting US state variations in the generosity of benefit programs between 1968 and 2008, we tested the hypothesis that more generous unemployment benefit programs reduce the impact of economic downturns on suicide. Using state linear fixed-effect models, we found a negative additive interaction between unemployment rates and benefits among the US working-age (20-64 years) population (β = -0.57, 95% confidence interval: -0.86, -0.27; P unemployment rates on suicide is offset by the presence of generous state unemployment benefit programs, though estimated effects are small in magnitude. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Impact of a New Palliative Care Program on Health System Finances: An Analysis of the Palliative Care Program Inpatient Unit and Consultations at Johns Hopkins Medical Institutions.

Science.gov (United States)

Isenberg, Sarina R; Lu, Chunhua; McQuade, John; Chan, Kelvin K W; Gill, Natasha; Cardamone, Michael; Torto, Deirdre; Langbaum, Terry; Razzak, Rab; Smith, Thomas J

2017-05-01

Palliative care inpatient units (PCUs) can improve symptoms, family perception of care, and lower per-diem costs compared with usual care. In March 2013, Johns Hopkins Medical Institutions (JHMI) added a PCU to the palliative care (PC) program. We studied the financial impact of the PC program on JHMI from March 2013 to March 2014. This study considered three components of the PC program: PCU, PC consultations, and professional fees. Using 13 months of admissions data, the team calculated the per-day variable cost pre-PCU (ie, in another hospital unit) and after transfer to the PCU. These fees were multiplied by the number of patients transferred to the PCU and by the average length of stay in the PCU. Consultation savings were estimated using established methods. Professional fees assumed a collection rate of 50%. The total positive financial impact of the PC program was $3,488,863.17. There were 153 transfers to the PCU, 60% with cancer, and an average length of stay of 5.11 days. The daily loss pretransfer to the PCU of $1,797.67 was reduced to $1,345.34 in the PCU (-25%). The PCU saved JHMI $353,645.17 in variable costs, or $452.33 per transfer. Cost savings for PC consultations in the hospital, 60% with cancer, were estimated at $2,765,218. $370,000 was collected in professional fees savings. The PCU and PC program had a favorable impact on JHMI while providing expert patient-centered care. As JHMI moves to an accountable care organization model, value-based patient-centered care and increased intensive care unit availability are desirable.

Evaluation of the support schemes of The District Heating Program during the period 2008 to 2011; Evaluering av stoetteprogrammene for fjernvarme i perioden 2008 til 2011

Energy Technology Data Exchange (ETDEWEB)

Lindland, Odd Ivar; Johansen, Staale; Holstad, Jon; Vennes, Wenche; Kallset, Eirik

2012-11-01

The District Heating Program as they are designed today, are evaluated after four years of operation, to see if the program works as intended and meet the goals that were set up at the start of 2008. It is also seen in the evaluation of the development of district heating market in the period, to see if there are trends and changes in the regulatory framework that makes it appropriate to make changes to the programs. Users 'perception of the program and the programs' direct and indirect influence on the development of district heating market is also considered. The PricewaterhouseCoopers AS (PwC) has carried out the evaluation, commissioned by Enova. PwC has conducted Internet-based surveys and interviewed actors in various roles within the district. PwC concluded that the goals that were set at the input of the program period is reached. Energy results were higher than expected, while there is a trend that Enova have to pay more and more for the projects. The number of applications and projects has remained fairly stable, while projects have been smaller in size and extent. (eb)

Determinación de la Composición Corporal en la preselección cubana de Baloncesto Femenino durante un cuatrienio, 2004-2008

Directory of Open Access Journals (Sweden)

Noemí Roig Méndez

2009-03-01

Full Text Available Se realizó un estudio longitudinal de tendencia con carácter  retrospectivo a  29 atletas de baloncesto de élite que pertenecieron y pertenecen a la preselección nacional de baloncesto femenino en el periodo 2004-2008. Se caracterizaron a todas las atletas tomando como base las mediciones hechas en el cuatrienio olímpico de los juegos de Beijing 2008. El patrón de proporcionalidad fue descrito para el sexo femenino, para esto se utilizaron 10 medidas antropométricas. Peso, talla y las variables de la composición corporal (Método de Carter –Yuhazs, fueron evaluadas por año del ciclo olímpico y por roles de desempeño.  Se  llevó  a  cabo  un  análisis  del  %  de  grasa  y  del  índice  de sustancia corporal activa (AKS en cada periodo. La  composición corporal no arrojó diferencias significativas, el peso  y talla promedio de las atletas en este periodo estuvo alrededor de 76.68 kg y 181,24 cm. Los roles arrojaron diferencias entre pivo, defensa y delanteras en las variables que más valor adaptativo representan para la posición, con tendencias que se ajustan a las encontradas en la literatura. El % de grasa y el AKS no se ajustaron a las antiguas referencias establecidas para equipos nacionales de esta disciplina en el sexo femenino. Los valores de % de grasa por Yuhazs  introducidos servirán como referencias para las generaciones venideras.

Innovation in Rehabilitation Services and Clinical Programs for Health Care

Directory of Open Access Journals (Sweden)

Asghar Dadkhah

2014-06-01

Full Text Available Rehabilitation program is a critical piece of clinical care strategy in order to accelerate healing and improve quality of life to the fullest extent possible. An innovated program should have 3 inspiring concepts: Seek inspire and Advance. Seeking and evaluating is a breakthrough technology, innovative methodology and emerging trend in the healthcare industry. The program should inspire clinicians to critically evaluate and implement the highest standards of care. Also an innovated program should advance clinical program development to maximize opportunities for first to market positioning and community partnerships. The scope of program can be from psycho-rehabilitation to predictor in addiction (1-3, Cognitive and motor rehabilitation researchers are quite concerned about system wide biases that may impair development of innovative rehabilitation techniques. In this issue ....

Suicides, mental health care and interdisciplinary specialised addiction services in the Agder counties 2004-13.

Science.gov (United States)

Haaland, Vegard Øksendal; Bjørkholt, Marianne; Freuchen, Anne; Ness, Ewa; Walby, Fredrik A

2017-10-03

Most of those who commit suicide suffer from one or more mental disorders. We wished to identify the proportion that had been in contact with mental health care or interdisciplinary specialised addiction services during their lifetime and in the year prior to their death, and to describe characteristics of these patients. Information on suicides in the Agder counties in the years 2004–2013 was retrieved from the Cause of Death Registry. Patient records from Sørlandet Hospital were reviewed with the aid of a structured form. Altogether 329 suicides were included in the study. Of these, 66.6 % had at some point in life been in contact with mental health care or interdisciplinary specialised addiction services, 46.2 % during the year preceding their suicide. Altogether 28.6 % were actively undergoing treatment. The proportion who had been in contact in the preceding year tended to be lower among patients younger than 20 when compared to other age groups. Among those who had completed their treatment, there were more patients with adaptation disorder than in the group that remained in treatment; among those who remained in treatment there were more patients with psychotic disorders than among those who had completed their treatment. A higher proportion of those who committed suicide in the Agder counties were in contact with mental health care and interdisciplinary specialised addiction services than what has been found in equivalent international studies. The findings underscore the need to develop effective measures to prevent suicides in these groups of patients.

The Impact of a Primary Care Education Program Regarding Cancer Survivorship Care Plans: Results from an Engineering, Primary Care, and Oncology Collaborative for Survivorship Health.

Science.gov (United States)

Donohue, SarahMaria; Haine, James E; Li, Zhanhai; Trowbridge, Elizabeth R; Kamnetz, Sandra A; Feldstein, David A; Sosman, James M; Wilke, Lee G; Sesto, Mary E; Tevaarwerk, Amye J

2017-09-20

Survivorship care plans (SCPs) have been recommended as tools to improve care coordination and outcomes for cancer survivors. SCPs are increasingly being provided to survivors and their primary care providers. However, most primary care providers remain unaware of SCPs, limiting their potential benefit. Best practices for educating primary care providers regarding SCP existence and content are needed. We developed an education program to inform primary care providers of the existence, content, and potential uses for SCPs. The education program consisted of a 15-min presentation highlighting SCP basics presented at mandatory primary care faculty meetings. An anonymous survey was electronically administered via email (n = 287 addresses) to evaluate experience with and basic knowledge of SCPs pre- and post-education. A total of 101 primary care advanced practice providers (APPs) and physicians (35% response rate) completed the baseline survey with only 23% reporting prior receipt of a SCP. Only 9% could identify the SCP location within the electronic health record (EHR). Following the education program, primary care physicians and APPs demonstrated a significant improvement in SCP knowledge, including improvement in their ability to locate one within the EHR (9 vs 59%, p educational program containing information about SCP existence, content, and location in the EHR increased primary care physician and APP knowledge in these areas, which are prerequisites for using SCP in clinical practice.

Characteristics of diabetes care in an institutional network of health services Medellin. 2005-2008

Directory of Open Access Journals (Sweden)

Sandra M. Agudelo

2011-05-01

Full Text Available Because of its severity, frequency and increasing social and economic impact, Diabetes Mellitus (DM is considered the third priority health problem in the world. Although to date there is no curative treatment, it does have effective measures to reduce its occurrence and limit its complications. Objective: to describe the control program of diabetes in a statewide network of health services in regard to clinical variables, the epidemiology of population served and the control actions, in order to identify strategies for improvement. Methodology: operational research based on secondary data. We reviewed the general conditions of operation of the program based on records of patient care. We studied a random sample of medical records of patients served by the control program of diabetes care units in the network.The results were validated in a meeting with officials of the institution. Results: we detected flaws and points of improvement in the performance of the control program that resulted in specific recommendations for the institutional network. Other failures are due to rules that hinder health system monitoring and control of the DM at the first level. Conclusion:the review of medical records reveals important problems about registration, monitoring and control of diabetics. Other regulatory and contractual provisions of the colombian health system were identified as restrictions that prevent the program to control hyperglycemia and early detection of renal damage. These restrictions could be affecting the programs of control of diabetes in other institutions of the country that are subject to the same rules

Effects of CO{sub 2} sanitation program for buildings 2008. Expert opinion; Effekte des CO{sub 2}-Gebaeudesanierungsprogramms 2008. Gutachten

Energy Technology Data Exchange (ETDEWEB)

Clausnitzer, Klaus-Dieter; Gabriel, Juergen; Eilmes, Sabine [Bremer Energie-Institut, Bremen (Germany); Diefenbach, Nikolaus; Loga, Tobias [Institut Wohnen und Umwelt GmbH, Darmstadt (Germany); Wosniok, Werner [Bremen Univ. (Germany). Inst. fuer Statistik

2008-07-01

The climate protection, the securing of the power supply as well as the enabling of payable energy costs belong to the central tasks to the policy. In the year 2006, the working group consisting of the Bremen Energie Institute (Bremen, Federal Republic of Energy), Institute Wohnen und Umwelt GmbH (Darmstadt, Federal Republic of Germany) and the Institute for Statistics of the University of Bremen (Bremen, Federal Republic of Germany) was ordered to develop a model for the estimation of the positive effects of the CO{sub 2} sanitation program for buildings according to the reduction of CO{sub 2}, conservation of final energy, employment, progress in modernization and saving of heating cost. In the expert opinion under consideration, the influences are stated for the case of loan and grant for the year 2008.

A Strength Training Program for Primary Care Patients, Central Pennsylvania, 2012

Science.gov (United States)

Patel, Vijay A.; Kraschnewski, Jennifer L.; Rovniak, Liza S.; Messina, Dino A.; Stuckey, Heather L.; Curry, William J.; Chuang, Cynthia H.; Sherwood, Lisa L.; Hess, Stacy L.

2014-01-01

Introduction Primary care providers can recommend strength training programs to use “Exercise as Medicine,” yet few studies have examined the interest of primary care patients in these programs. Methods We conducted a cross-sectional survey of primary care patients in central Pennsylvania. Interest in participating in free group-based strength training and weight control programs was assessed, in addition to patient demographics, medical history, and quality of life. Results Among 414 patients, most (61.0%) were aged 54 or older, and 64.0% were female. More patients were interested in a strength training program (55.3%) than in a weight control program (45.4%). Nearly three-quarters (72.8%) of those reporting 10 or more days of poor physical health were interested in a strength training program compared with 49.5% of those reporting no days of poor physical health. After adjusting for potential confounders, those reporting poorer physical health had 2.7 greater odds (95% confidence interval, 1.4–5.1) of being interested in a strength training program compared with those reporting better physical health. Patients with hypertension, diabetes, or high cholesterol were not more interested in a strength training program than those without these conditions. Conclusion Primary care practices may consider offering or referring patients to community-based strength training programs. This study observed high levels of interest in these widely available programs. Practices may also consider screening and referring those with poorer physical health, as they may be the most interested and have the most to gain from participating. PMID:24967829

Use of interferon-gamma release assays in a health care worker screening program: experience from a tertiary care centre in the United States.

Science.gov (United States)

Joshi, Manish; Monson, Thomas P; Woods, Gail L

2012-01-01

Interferon-gamma release assays including the QuantiFERON-TB Gold In-Tube test (QFT-GIT [Cellestis Ltd, Australia]) may be used in place of the tuberculin skin test (TST) in surveillance programs for Mycobacterium tuberculosis infection control. However, data on performance and practicality of the QFT-GIT in such programs for health care workers (HCWs) are limited. To assess the performance, practicality and reversion rate of the QFT-GIT among HCWs at a tertiary health care institution in the United States. Retrospective chart review of HCWs at Central Arkansas Veterans Healthcare System (Arkansas, USA) who underwent QFT-GIT testing as a part of their employee screening between November 1, 2008 and October 31, 2009. QFT-GIT was used to screen 3290 HCWs. The initial QFT-GIT was interpreted as positive for 129 (3.9%) HCWs, negative for 3155 (95.9%) and indeterminate for six (0.2%). Testing with QFT-GIT was repeated in 45 HCWs who had positive results on the initial test. The QFT-GIT reverted to negative in 18 (40.0%) HCWs, all of whom had negative TST status and initial interferon-gamma values of 0.35 IU⁄mL to 2.0 IU⁄mL. The QFT-GIT test is feasible in large health care setting as an alternative to TST for M tuberculosis infection screening in HCWs but is not free from challenges. The major concerns are the high number of positive test results and high reversion rates on repeat testing, illustrating poor short-term reproducibility of positive QFT-GIT test results. These results suggest adopting a borderline zone between interferon-gamma values of 0.35 IU⁄mL to 2.0 IU⁄mL, and cautious clinical interpretation of values in this range.

Institutional plan FY 2004 - FY 2008

International Nuclear Information System (INIS)

Beggs, S. D.

2004-01-01

Argonne's mission is to serve DOE and national security by advancing the frontiers of knowledge, by creating and operating forefront scientific user facilities, and by providing innovative and effective approaches and solutions to energy, environmental, and security challenges to national and global well-being, in the near and long term, as a contributing member of the DOE laboratory system. We contribute significantly to DOE's mission in science, energy resources, environmental stewardship, and national security, with lead roles in the areas of science, operation of scientific facilities, and energy. In accomplishing our mission, we partner with DOE, other federal laboratories and agencies, the academic community, and the private sector. Argonne is pursuing ten visionary strategic goals to deliver extraordinary science and technology with significant value to the nation: (1) Develop the technologies and infrastructure needed to produce, store, and distribute hydrogen fuel. (2) Close the nuclear fuel cycle, reducing the cost of nuclear waste disposal by billions of dollars and disposing of weapons-grade plutonium and actinides. (3) Develop advanced nuclear power technologies that are safe, economical, proliferation-resistant, and environmentally sustainable. (4) Plan, design, construct, and operate the Rare Isotope Accelerator (RIA) and make fundamental discoveries in nuclear physics and astrophysics. (5) Construct and operate the Center for Nanoscale Materials and create innovative materials with valuable commercial properties. (6) Lead the Genomes to Life team that focuses on protein production and related proteomics; implement computational biology to build fundamental understanding of living systems. (7) Realize the full potential of scientific simulation to solve mission-related problems, through leading-edge research on systems architecture and software, parallel programming and numerical tools, distributed computing, and computational science applications

CARE07 Coordinated Accelerator Research in Europe

CERN Multimedia

2007-01-01

Annual Meeting, at CERN, 29-31 October 2007 The CARE project started on 1st January 2004 and will end on 31st December 2008. At the end of each year, the progress and status of its activities are reported in a general meeting. This year, the meeting takes place at CERN. The CARE objective is to generate structured and integrated European cooperation in the field of accelerator research and related R&D. The programme includes the most advanced scientific and technological developments, relevant to accelerator research for particle physics. It is articulated around three Networking Activities and four Joint Activities. The Networking Activities ELAN, BENE and HHH aim to better coordinate R&D efforts at the European level and to strengthen Europe’s ability to produce intense and high-energy particle beams (electrons and positrons, muons and neutrinos, protons and ions, respectively). The Joint Activities, SRF, PHIN, HIPPI and NED, aim at technical developments on s...

CARE07 Coordinated Accelerator Research in Europe

CERN Multimedia

2007-01-01

Annual Meeting, at CERN, 29-31 October 2007 The CARE project started on 1st January 2004 and will end on 31st December 2008. At the end of each year, the progress and status of its activities are reported in a general meeting. This year, the meeting is taking place at CERN. The CARE objective is to generate structured and integrated European cooperation in the field of accelerator research and related R&D. The programme includes the most advanced scientific and technological developments, relevant to accelerator research for particle physics. It is articulated around three Networking Activities and four Joint Activities. The Networking Activities ELAN, BENE and HHH aim to better coordinate R&D efforts at the European level and to strengthen Europe’s ability to produce intense and high-energy particle beams (electrons and positrons, muons and neutrinos, protons and ions, respectively). The Joint Activities, SRF, PHIN, HIPPI and NED, aim at technical developments ...

Annual results 2004; Resultats annuels 2004

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

This 2004 annual evaluation of the french RTE company (electric power transport network) provides information on the 2004 results on: institutional information, financial results, customers and market, industrial resources, environment and consultation, human resources and international aspects. (A.L.B.)

Abortion-care education in Japanese nurse practitioner and midwifery programs: a national survey.

Science.gov (United States)

Mizuno, Maki

2014-01-01

While various reports have been published concerning ethical dilemmas in nursing and midwifery, and while many nurses and midwives struggle with the conflict between personal feelings raised by abortion and the duties of their position, few studies investigate the extent and conditions of abortion-care education for registered nurses (RNs) and certified nurse-midwives (CNMs) in Japan. To describe Japanese abortion-care education programs and to investigate program directors' or other relevant persons' perceptions of abortion-care education. Descriptive study was used to determine the extent of abortion-care education programs and the respondents' perceptions of abortion-care education. All 228 Japanese nursing and/or midwifery schools were invited to participate in the study. The response rate was 33.8% (n=77). Response rate varied by program type: 18.4% (n=45) for nursing programs and 29.0% (n=32) for midwifery programs. A confidential survey requesting information about curricular coverage of ten reproductive health topics related to abortion was mailed to program directors. The results show that the majority of CNM and RN programs surveyed offer didactic exposure to instruction in family planning and contraception, emergency contraception, legal considerations, and possible medical complications. However, few programs offer clinical exposure to all 10 topics. Of the respondents, 36% reported that lack of time and the low priority given to abortion-care education were issues of curriculum priority. As for educational materials, few textbooks or guidebooks exist on abortion care in Japan, and most educators use general nursing textbooks to cover this topic. Regardless of interest in or intention to provide abortion services as part of their practice, all providers of abortion-care education need to be knowledgeable about the full range of reproductive health options, including family planning and abortion, and to be able to convey this information to clients

Cost and utilisation of hospital based delivery care in Empowered Action Group (EAG) states of India.

Science.gov (United States)

Mohanty, Sanjay K; Srivastava, Akanksha

2013-10-01

Large scale investment in the National Rural Health Mission is expected to increase the utilization and reduce the cost of maternal care in public health centres in India. The objective of this paper is to examine recent trends in the utilization and cost of hospital based delivery care in the Empowered Action Group (EAG) states of India. The unit data from the District Level Household Survey 3, 2007-2008 is used in the analyses. The coverage and the cost of hospital based delivery at constant price is analyzed for five consecutive years preceding the survey. Descriptive and multivariate analyses are used to understand the socio-economic differentials in cost and utilization of delivery care. During 2004-2008, the utilization of delivery care from public health centres has increased in all the eight EAG states. Adjusting for inflation, the household cost of delivery care has declined for the poor, less educated and in public health centres in the EAG states. The cost of delivery care in private health centres has not shown any significant changes across the states. Results of the multivariate analyses suggest that time, state, place of residence, economic status; educational attainment and delivery characteristics of mother are significant predictors of hospital based delivery care in India. The study demonstrates the utility of public spending on health care and provides a thrust to the ongoing debate on universal health coverage in India.

Adequacy of antenatal care and its relationship with low birth weight in Botucatu, Sao Paulo, Brazil: a case-control study

OpenAIRE

Fonseca, Cátia Regina Branco da [UNESP; Louzada Strufaldi, Maria Wany; Carvalho, Lidia Raquel de [UNESP; Puccini, Rosana Fiorini [UNESP

2014-01-01

Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. the purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil.Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the...

North Carolina 2004 Lidar Coverage, USACE National Coastal Mapping Program

Data.gov (United States)

Army Corps of Engineers, Department of the Army, Department of Defense — The Joint Airborne Lidar Bathymetry Technical Center of Expertise (JALBTCX) has performed a coastal survey along the Atlantic coast of NC in 2004. The data types...

Changes in diagnosed diabetes, obesity, and physical inactivity prevalence in US counties, 2004-2012.

Science.gov (United States)

Geiss, Linda S; Kirtland, Karen; Lin, Ji; Shrestha, Sundar; Thompson, Ted; Albright, Ann; Gregg, Edward W

2017-01-01

Recent studies suggest that prevalence of diagnosed diabetes in the United States reached a plateau or slowed around 2008, and that this change coincided with obesity plateaus and increases in physical activity. However, national estimates can obscure important variations in geographic subgroups. We examine whether a slowing or leveling off in diagnosed diabetes, obesity, and leisure time physical inactivity prevalence is also evident across the 3143 counties of the United States. We used publicly available county estimates of the age-adjusted prevalence of diagnosed diabetes, obesity, and leisure-time physical inactivity, which were generated by the Centers for Disease Control and Prevention (CDC). Using a Bayesian multilevel regression that included random effects by county and year and applied cubic splines to smooth these estimates over time, we estimated the average annual percentage point change (APPC) from 2004 to 2008 and from 2008 to 2012 for diabetes, obesity, and physical inactivity prevalence in each county. Compared to 2004-2008, the median APPCs for diabetes, obesity, and physical inactivity were lower in 2008-2012 (diabetes APPC difference = 0.16, 95%CI 0.14, 0.18; obesity APPC difference = 0.65, 95%CI 0.59, 0.70; physical inactivity APPC difference = 0.43, 95%CI 0.37, 0.48). APPCs and APPC differences between time periods varied among counties and U.S. regions. Despite improvements, levels of these risk factors remained high with most counties merely slowing rather than reversing, which suggests that all counties would likely benefit from reductions in these risk factors. The diversity of trajectories in the prevalence of these risk factors across counties underscores the continued need to identify high risk areas and populations for preventive interventions. Awareness of how these factors are changing might assist local policy makers in targeting and tracking the impact of efforts to reduce diabetes, obesity and physical inactivity.

National hospital discharge survey: 2004 annual summary with detailed diagnosis and procedure data.

Science.gov (United States)

Kozak, Lola Jean; DeFrances, Carol Jean; Hall, Margaret Jean

2006-10-01

This report presents 2004 national estimates and selected trend data on the use of nonfederal short-stay hospitals in the United States. Estimates are provided by selected patient and hospital characteristics, diagnoses, and surgical and nonsurgical procedures performed. Estimates of diagnoses and procedures are presented according to International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually since 1965. In 2004, data were collected for approximately 371,000 discharges. Of the 476 eligible nonfederal short-stay hospitals in the sample, 439 (92 percent) responded to the survey. An estimated 34.9 million inpatients were discharged from nonfederal short-stay hospitals in 2004. They used 167.9 million days of care and had an average length of stay of 4.8 days. Hospital use by age ranged from 4.3 million days of care for patients 5-14 years of age to 31.8 million days of care for 75-84 year olds. Almost a third of patients 85 years and over were discharged from hospitals to long-term care institutions. Diseases of the circulatory system was the leading diagnostic category for males. Childbirth was the leading category for females, followed by circulatory diseases. The proportion of HIV discharges who were 40 years of age and over increased from 40 percent in 1995 to 67 percent in 2004. The rate of cardiac catheterizations was higher for males than for females and higher for patients 65-74 and 75-84 years of age than for older or younger groups. The average length of stay for both vaginal and cesarean deliveries decreased from 1980 through 1995 but stays for vaginal deliveries increased 24 percent during the period from 1995 to 2004.

Activity report 2004; Rapport d'activite 2004

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-04-01

Constituted by a public and commercial establishment, the French National Radioactive Waste Management Agency (ANDRA) is responsible for the long term management of radioactive waste. This activity report presents the three missions of the ANDRA during the year 2004. The industrial mission deals with the Aube center disposal and the Manche center disposal facilities and the collection effort concerning the diffuse nuclear waste. The research mission focuses on the presentation of several topics: the repository design by studying various potential architectures, the reversibility and the safety assessment under operating conditions and the description of the behavior of repository at various space and time scales. The last mission concerns the information and the communication program. (A.L.B.)

Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice.

Science.gov (United States)

Wiler, Jennifer L; Granovsky, Michael; Cantrill, Stephen V; Newell, Richard; Venkatesh, Arjun K; Schuur, Jeremiah D

2016-03-01

In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician's to focus on quality of care measures and report quality performance for the first time. Initially termed "The Physician Voluntary Reporting Program," various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the "traditional PQRS" reporting program and the newer "Value Modifier" program (VM). For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians.

Annual report 2004

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-07-01

This reports represents all the activities and accomplishments of Philippine Nuclear Research Institute (PNRI) for the calendar year 2004 which cited the accomplishments of nuclear research and development programs that focused on the safe and peaceful uses of nuclear techniques, materials and process to contribute to the government's efforts in increasing agricultural and industrial productivity as well as ensuring health security and safeguarding the environment, also the PNRI, as the Philippine focal agency for atomic matters, serves as a link between IAEA and government and private entities using atomic energy in the country.

Annual report 2004

International Nuclear Information System (INIS)

2005-01-01

This reports represents all the activities and accomplishments of Philippine Nuclear Research Institute (PNRI) for the calendar year 2004 which cited the accomplishments of nuclear research and development programs that focused on the safe and peaceful uses of nuclear techniques, materials and process to contribute to the government's efforts in increasing agricultural and industrial productivity as well as ensuring health security and safeguarding the environment, also the PNRI, as the Philippine focal agency for atomic matters, serves as a link between IAEA and government and private entities using atomic energy in the country

Nevada Test Site Environmental Report 2004

Energy Technology Data Exchange (ETDEWEB)

BECHTEL NEVADA

2005-10-01

The ''Nevada Test Site Environmental Report 2004'' was prepared by Bechtel Nevada (BN) to meet the information needs of the public and the requirements and guidelines of the U.S. Department of Energy (DOE) for annual site environmental reports. This Executive Summary presents the purpose of the document, the major programs conducted at the Nevada Test Site (NTS), NTS key environmental initiatives, radiological releases and potential doses to the public resulting from site operations, a summary of non-radiological releases, implementation status of the NTS Environmental Management System, and significant environmental accomplishments. Much of the content of this Executive Summary is also presented in a separate stand-alone pamphlet titled ''Nevada Test Site Environmental Report Summary 2004''. It was produced this year to provide a more cost-effective and wider distribution of a hardcopy summary of the ''Nevada Test Site Environmental Report 2004'' to interested DOE stakeholders.

Geochemistry of seafloor hydrothermal vent fluids at EPR 9°50'N: Time series data from 2004-2016

Science.gov (United States)

Scheuermann, P.; Pester, N. J.; Tutolo, B. M.; Simmons, S. F.; Seyfried, W. E., Jr.

2017-12-01

Hydrothermal fluids were collected from vent sites along the East Pacific Rise (EPR) at 9°50'N in 2004, 2008 and 2016 in isobaric gas-tight titanium samplers. These dates bracket the seafloor eruption that occurred at EPR 9°50'N between 2005 and 2006. The reported data focus on P vent and Bio9, as these vents were active during all three sampling periods. The concentration of aqueous volatiles reached maxima at both vents in 2008. At P vent, CO2, H2, and H2S were 124 mM/kg, 0.55 mM/kg and 12.2 mM/kg, respectively. The concentrations at Bio9 in 2008 were, 106 mM/kg CO2, 1.1 mM/kg H2, and 12.6 mM/kg H2S. Fe and Mn concentrations were the highest at both vent sites in 2004, and then decreased in 2008 and again in 2016. The range at P vent was 1.5-6.3 mM/kg Fe and 315-1212 uM/kg Mn, while at Bio9 the concentrations were 1.6-3.7 mM/kg Fe and 301-650 uM/kg Mn. The trends in CO2, H2, and H2S at P vent (2008 and 2016) and Bio9 (all years) are consistent with changes in subsurface pressure and temperature as a result of the eruption that alter the conditions at which dissolved components partition between vapor and liquid phases in the NaCl-H2O system. The trend in Fe and Mn concentrations is surprising and highlights the complex partitioning behavior of these elements in systems in which the concentrations are controlled by fluid-mineral equilibria as well as phase separation. Between 2004 and 2008, fluids at P vent transitioned from single-phase (535 mM/kg Cl) to a low-density vapor (370 mM/kg). Upon phase separation, the concentrations of H2S and H2 increased, while Fe and Mn concentrations decreased considerably. These changes highlight the importance of phase separation on controlling mass transfer from the crust to overlying ocean. In contrast to the other aqueous volatiles, CH4 concentrations in 2008 (47 µM) were lower or equal to concentrations in 2004 or 2016, 50-100 µM. CH4 is decoupled from the effects of phase separation, and is likely extracted from fluid

Iranian nuclear program: who decides in Tehran. Interview with Mrs Azadeh Kian-Thiebaut, April 9, 2008

International Nuclear Information System (INIS)

Hautecouverture, Benjamin

2008-01-01

Mrs Azadeh Kian-Thiebaut is Professor of Sociology at Paris VII University, and researcher at the CNRS Laboratory 'Iranian and Indian Worlds'. In this interview, Mrs Azadeh Kian-Thiebaut explains the mysteries of the Iranian government, the decision-making process and the possible lines of tension regarding the Iranian nuclear program in the context of parliamentary elections (March 14 - April 25, 2008), and about a year before the next presidential elections (June 2009)

Geriatric Foot Care: A Model Educational Program for Mid-Level Practitioners.

Science.gov (United States)

Suggs, Patricia K.; Krissak, Ruth; Caruso, Frank; Teasdall, Robert

2002-01-01

An educational program on geriatric foot care was completed by 59 nurse practitioners, 12 physicians' assistants, and 1 physician. The 3 1/2 day program included interactive sessions, observation, and hands-on patient care. Posttest results and 6-month follow-up showed significant knowledge increases and incorporation of learning into practice.…

Intervención educativa sobre la atención a niños de madres adolescentes: Hospital Ginecoobstétrico Guanabacoa, 2002-2008 Educational intervention on the attention to adolescent mothers' children: Gyneco-Obstetric Hospital of Guanabacoa, 2002-2008

Directory of Open Access Journals (Sweden)

Rosa María Alonso Uría

2010-12-01

Full Text Available El embarazo en la adolescencia constituye un problema de salud por su inmadurez en la esfera reproductiva y en la atención al niño. Se realizó una intervención educativa a 253 madres adolescentes en el Hospital Ginecoobstétrico de Guanabacoa durante el período 2002-2008 para identificar conocimientos y preparación de las madres adolescentes para la atención de sus hijos y diseñar un programa educativo a través técnicas de exploración cualitativa, diseñándose el programa educativo aplicado durante los tres primeros años de vida de sus hijos. El contenido del programa se basó en: cuidados generales del neonato, lactancia materna, crecimiento y desarrollo, nutrición, accidentes, inmunizaciones, incorporación estudio y/o trabajo. Las madres adolescentes presentaron bajos niveles de conocimiento y falta de habilidades en el cuidado de sus hijos. La aplicación del programa educativo contribuyó a la transformación en estilos de vida más saludables de la madre adolescente y una mejor atención de sus hijos.Pregnancy in adolescents is a major problem due to immaturity in the reproductive system and baby care inability. An educative intervention was carried out in the "Gyneco-Obstetric Hospital of Guanabacoa" from 2002 to 2008. The research included 253 adolescent mothers to identify preparation and knowledge for baby care. An educative program was designed and applied during the first three years of the babies" life. The content of the program was based on general care of the newborn, breastfeeding, growth and development, nutrition, accidents, vaccination and work or study incorporation. Adolescent mothers showed low levels of knowledge and lack of abilities for baby care. The application of the educative program helped to develop healthier life styles in the adolescent mother and a better care for babies.

Healthcare organization-education partnerships and career ladder programs for health care workers.

Science.gov (United States)

Dill, Janette S; Chuang, Emmeline; Morgan, Jennifer C

2014-12-01

Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization. Copyright © 2014 Elsevier Ltd. All rights reserved.

Disease-Specific Care: Spine Surgery Program Development.

Science.gov (United States)

Koerner, Katie; Franker, Lauren; Douglas, Barbara; Medero, Edgardo; Bromeland, Jennifer

2017-10-01

Minimal literature exists describing the process for development of a Joint Commission comprehensive spine surgery program within a community hospital health system. Components of a comprehensive program include structured communication across care settings, preoperative education, quality outcomes tracking, and patient follow-up. Organizations obtaining disease-specific certification must have clear knowledge of the planning, time, and overall commitment, essential to developing a successful program. Health systems benefit from disease-specific certification because of their commitment to a higher standard of service. Certification standards establish a framework for organizational structure and management and provide institutions a competitive edge in the marketplace. A framework for the development of a spine surgery program is described to help guide organizations seeking disease-specific certification. In developing a comprehensive program, it is critical to define the program's mission and vision, identify key stakeholders, implement clinical practice guidelines, and evaluate program outcomes.

Primary care provider perceptions of intake transition records and shared care with outpatient cardiac rehabilitation programs

Directory of Open Access Journals (Sweden)

Jamnik Veronica

2011-09-01

Full Text Available Abstract Background While it is recommended that records are kept between primary care providers (PCPs and specialists during patient transitions from hospital to community care, this communication is not currently standardized. We aimed to assess the transmission of cardiac rehabilitation (CR program intake transition records to PCPs and to explore PCPs' needs in communication with CR programs and for intake transition record content. Method 144 PCPs of consenting enrollees from 8 regional and urban Ontario CR programs participated in this cross-sectional study. Intake transition records were tracked from the CR program to the PCP's office. Sixty-six PCPs participated in structured telephone interviews. Results Sixty-eight (47.6% PCPs received a CR intake transition record. Fifty-eight (87.9% PCPs desired intake transition records, with most wanting it transmitted via fax (n = 52, 78.8%. On a 5-point Likert scale, PCPs strongly agreed that the CR transition record met their needs for providing patient care (4.32 ± 0.61, with 48 (76.2% reporting that it improved their management of patients' cardiac risk. PCPs rated the following elements as most important to include in an intake transition record: clinical status (4.67 ± 0.64, exercise test results (4.61 ± 0.52, and the proposed patient care plan (4.59 ± 0.71. Conclusions Less than half of intake transition records are reaching PCPs, revealing a large gap in continuity of patient care. PCP responses should be used to develop an evidence-based intake transition record, and procedures should be implemented to ensure high-quality transitional care.

Reckoning HIV/AIDS care: A longitudinal study of community home ...

African Journals Online (AJOL)

To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting), we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, our analysis ...

Internação domiciliar: o perfil dos pacientes assistidos pelo Programa HU em Casa Home care: profile of patients attended by a home care program

Directory of Open Access Journals (Sweden)

Daniella Reis Barbosa Martelli

2011-01-01

Full Text Available Internação domiciliar é uma modalidade de atendimento à saúde que está se transformando em uma alternativa importante para minimizar alguns dos principais problemas inerentes aos sistemas de saúde vigentes, especialmente os da rede pública. O objetivo do estudo foi descrever o perfil sociodemográfico e clínico da população assistida pelo Programa de Internação Domiciliar (PID HU em Casa do Hospital Universitário Clemente de Faria da Universidade Estadual de Montes Claros. O estudo foi descritivo e retrospectivo por meio da análise de prontuários, realizada de maio de 2005 a maio de 2008. Foram analisados 137 pacientes, sendo 75 do gênero feminino (54,7% e 62 do masculino (45,3%. O grupo de 61 a 80 anos foi mais prevalente (37,2% e 73% dos pacientes residiam em bairros periféricos do município de Montes Claros-MG. Dos agravos mais comuns na primeira internação, a pneumonia foi prevalente, 22 casos (16,1%. A maioria dos pacientes foi encaminhada ao PID pela clinica médica (84,7%, com intervalo de maior prevalência de duas a três internações (42,4%. Do total de pacientes, 120 (87,6% permaneceram internados por 16 a 30 dias e 51,8% não necessitaram passar novamente pelo PID para uma segunda internação. Com relação à resolutividade clínica, 130 (94,9% tiveram alta clínica, no PID, na primeira internação. O PID mostrou-se ser um programa de alta resolutividade, atendendo mais ao público idoso feminino, de baixa renda e com períodos de internação relativamente curtos.The home care is a modality of health care which is becoming an important alternative to minimize some of mainly relevant problems of world health, especially the public health network. This paper aimed to describe the socio-demographic and clinical population assisted by the Home Care Program HU em Casa, of the University Hospital Clemente de Faria, Universidade Estadual de Montes Claros. It is a descriptive and retrospective study analyzing

Decrease in use of manual vacuum aspiration in postabortion care in Malawi: a cross-sectional study from three public hospitals, 2008-2012.

Directory of Open Access Journals (Sweden)

Maria L Odland

Full Text Available OBJECTIVES: To investigate the use of manual vacuum aspiration in postabortion care in Malawi between 2008-2012. METHODS: A retrospective cross-sectional study was done at the referral hospital Queen Elisabeth Central Hospital, and the two district hospitals of Chiradzulu and Mangochi. The data were collected simultaneously at the three sites from Feb-March 2013. All records available for women admitted to the gynaecological ward from 2008-2012 were reviewed. Women who had undergone surgical uterine evacuation after incomplete abortion were included and the use of manual vacuum aspiration versus sharp curettage was analysed. RESULTS: Altogether, 5121 women were included. One third (34.2% of first trimester abortions were treated with manual vacuum aspiration, while all others were treated with sharp curettage. There were significant differences between the hospitals and between years. Overall there was an increase in the use of manual vacuum aspiration from 2008 (19.7% to 2009 (31.0%, with a rapid decline after 2010 (28.5% ending at only 4.9% in 2012. Conversely there was an increase in use of sharp curettage in all hospitals from 2010 to 2012. CONCLUSION: Use of manual vacuum aspiration as part of the postabortion care in Malawi is rather low, and decreased from 2010 to 2012, while the use of sharp curettage became more frequent. This is in contrast with current international guidelines.

Report of the Ethics Committee, 2008

Science.gov (United States)

American Psychologist, 2009

2009-01-01

In accordance with the bylaws of the American Psychological Association (APA), the Ethics Committee reports regularly to the membership regarding the number and types of ethics complaints investigated and the major programs undertaken. In 2008, ethics adjudication, ethics education and consultation, convention programs, ethics publications,…

Producción científica sobre derechos sexuales y reproductivos, Colombia 1994-2004 A scientific review about sexual and reproductive rights on Colombia, 1994-2004

OpenAIRE

Doris Elena Ospina Muñoz; Rosa Amalia Castaño López

2009-01-01

Estudio realizado entre julio/2005 y julio/2008 siguiendo la Base de Productos Nacionales de COLCIENCIAS (X-acta). Objetivo: caracterizar el conocimiento producido sobre derechos sexuales y reproductivos en Colombia durante 1994-2004. Metodología: se consulta X-acta utilizando descriptores. Los artículos son organizados en tres grupos según la revista en que se publican: nacionales indexadas (T1), nacionales no indexadas (T2), extranjeras (T3). Se construyen categorías. Resultados: se identif...

Measuring and explaining health and health care inequalities in Jamaica, 2004 and 2007 Medición e interpretación de las desigualdades en la salud y la atención sanitaria en Jamaica, 2004 y 2007

Directory of Open Access Journals (Sweden)

Ewan Scott

2013-02-01

Full Text Available OBJECTIVE: This study addresses the need to measure and explain the inequalities and inequities of Jamaica's health system to generate evidence to support policy development, monitoring, and evaluation. METHODS: The nationally representative Jamaica Survey of Living Conditions data sets for 2004 and 2007 were used to produce concentration curves and concentration indices for three health outcome variables (probability of any illness or injury, duration of latest episode of -illness, and self-assessed health status and two health care utilization variables (probability of a curative visit to a health practitioner and number of curative visits to measure income-related inequalities. Their standardized counterparts were used to measure inequities. Decomposition of the concentration index provides a basis for explaining the contributions of socioeconomic and demographic factors to overall inequalities. RESULTS: Probability of illness and duration of illness were concentrated among the poor, while there was a distinct pro-rich inequality with respect to utilization of heath care services. These inequalities and inequities became more pronounced over the period 2004 - 2007. The level of household welfare was found to be the single most significant factor contributing to these inequalities. Other significant contributing factors were unemployment and rural location for health outcomes and insurance coverage for utilization of services. CONCLUSIONS: In spite of measures taken ostensibly to address health equity in Jamaica, income-related inequalities in health outcomes and health care have increased and the population group that needs health services most is using them least. These findings suggest a need for more innovative programs geared toward improving equity in health in Jamaica.OBJETIVO. Medir y explicar las desigualdades y las inequidades del sistema de -salud de Jamaica a fin de obtener evidencia que apoye el desarrollo, el seguimiento y la

Geology and assessment of undiscovered oil and gas resources of the Yukon Flats Basin Province, 2008

Science.gov (United States)

Bird, Kenneth J.; Stanley, Richard G.; Moore, Thomas E.; Gautier, Donald L.

2017-12-22

The hydrocarbon potential of the Yukon Flats Basin Province in Central Alaska was assessed in 2004 as part of an update to the National Oil and Gas Assessment. Three assessment units (AUs) were identified and assessed using a methodology somewhat different than that of the 2008 Circum-Arctic Resource Appraisal (CARA). An important difference in the methodology of the two assessments is that the 2004 assessment specified a minimum accumulation size of 0.5 million barrels of oil equivalent (MMBOE), whereas the 2008 CARA assessment specified a minimum size of 50 MMBOE. The 2004 assessment concluded that >95 percent of the estimated mean undiscovered oil and gas resources occur in a single AU, the Tertiary Sandstone AU. This is also the only AU of the three that extends north of the Arctic Circle.For the CARA project, the number of oil and gas accumulations in the 2004 assessment of the Tertiary Sandstone AU was re-evaluated in terms of the >50-MMBOE minimum accumulation size. By this analysis, and assuming the resource to be evenly distributed across the AU, 0.23 oil fields and 1.20 gas fields larger than 50 MMBOE are expected in the part of the AU north of the Arctic Circle. The geology suggests, however, that the area north of the Arctic Circle has a lower potential for oil and gas accumulations than the area to the south where the sedimentary section is thicker, larger volumes of hydrocarbons may have been generated, and potential structural traps are probably more abundant. Because of the low potential implied for the area of the AU north of the Arctic Circle, the Yukon Flats Tertiary Sandstone AU was not quantitatively assessed for the 2008 CARA.

WIPP 2004 Site Environmental Report

Energy Technology Data Exchange (ETDEWEB)

None, None

2005-09-30

The mission of Waste Isolation Pilot Plant (WIPP) is to safely and permanently dispose of transuranic (TRU) radioactive waste generated by the production of nuclear weapons and other activities related to the national defense of the United States (U.S.). In 2004, 8,839 cubic meters (m3) of TRU waste were emplaced at WIPP. From the first receipt of waste in March 1999 through the end of 2004, 25,809 m3 of TRU waste had been emplaced at WIPP. The U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) and Washington TRU Solutions LLC (WTS) are dedicated to maintaining high quality management of WIPP environmental resources. DOE Order 450.1, Environmental Protection Program; DOE Order 231.1A, Environment, Safety, and Health Reporting; and DOE Order 5400.5, Radiation Protection of the Public and Environment, require that the environment at and near DOE facilities be monitored to ensure the safety and health of the public and the environment. This Waste Isolation Pilot Plant 2004 Site Environmental Report (SER) summarizes environmental data from 2004 that characterize environmental management performance and demonstrate compliance with applicable federal and state regulations. This report was prepared in accordance with DOE Order 231.1A, and Guidance for the Preparation of DOE Annual Site Environmental Reports (ASERs) for Calendar Year 2004 (DOE, 2005). The order and the guidance require that DOE facilities submit an annual SER to the DOE Headquarters Office of the Assistant Secretary for Environment, Safety, and Health. The WIPP Hazardous Waste Facility Permit (HWFP) further requires that the SER be provided to the New Mexico Environment Department (NMED).

WIPP 2004 Site Environmental Report

International Nuclear Information System (INIS)

2005-01-01

The mission of Waste Isolation Pilot Plant (WIPP) is to safely and permanently dispose of transuranic (TRU) radioactive waste generated by the production of nuclear weapons and other activities related to the national defense of the United States (U.S.). In 2004, 8,839 cubic meters (m3) of TRU waste were emplaced at WIPP. From the first receipt of waste in March 1999 through the end of 2004, 25,809 m3 of TRU waste had been emplaced at WIPP. The U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) and Washington TRU Solutions LLC (WTS) are dedicated to maintaining high quality management of WIPP environmental resources. DOE Order 450.1, Environmental Protection Program; DOE Order 231.1A, Environment, Safety, and Health Reporting; and DOE Order 5400.5, Radiation Protection of the Public and Environment, require that the environment at and near DOE facilities be monitored to ensure the safety and health of the public and the environment. This Waste Isolation Pilot Plant 2004 Site Environmental Report (SER) summarizes environmental data from 2004 that characterize environmental management performance and demonstrate compliance with applicable federal and state regulations. This report was prepared in accordance with DOE Order 231.1A, and Guidance for the Preparation of DOE Annual Site Environmental Reports (ASERs) for Calendar Year 2004 (DOE, 2005). The order and the guidance require that DOE facilities submit an annual SER to the DOE Headquarters Office of the Assistant Secretary for Environment, Safety, and Health. The WIPP Hazardous Waste Facility Permit (HWFP) further requires that the SER be provided to the New Mexico Environment Department (NMED).

Building laboratory capacity to support HIV care in Nigeria: Harvard/APIN PEPFAR, 2004–2012

Science.gov (United States)

Hamel, Donald J.; Sankalé, Jean-Louis; Samuels, Jay Osi; Sarr, Abdoulaye D.; Chaplin, Beth; Ofuche, Eke; Meloni, Seema T.; Okonkwo, Prosper; Kanki, Phyllis J.

2015-01-01

Introduction From 2004–2012, the Harvard/AIDS Prevention Initiative in Nigeria, funded through the US President’s Emergency Plan for AIDS Relief programme, scaled up HIV care and treatment services in Nigeria. We describe the methodologies and collaborative processes developed to improve laboratory capacity significantly in a resource-limited setting. These methods were implemented at 35 clinic and laboratory locations. Methods Systems were established and modified to optimise numerous laboratory processes. These included strategies for clinic selection and management, equipment and reagent procurement, supply chains, laboratory renovations, equipment maintenance, electronic data management, quality development programmes and trainings. Results Over the eight-year programme, laboratories supported 160 000 patients receiving HIV care in Nigeria, delivering over 2.5 million test results, including regular viral load quantitation. External quality assurance systems were established for CD4+ cell count enumeration, blood chemistries and viral load monitoring. Laboratory equipment platforms were improved and standardised and use of point-of-care analysers was expanded. Laboratory training workshops supported laboratories toward increasing staff skills and improving overall quality. Participation in a World Health Organisation-led African laboratory quality improvement system resulted in significant gains in quality measures at five laboratories. Conclusions Targeted implementation of laboratory development processes, during simultaneous scale-up of HIV treatment programmes in a resource-limited setting, can elicit meaningful gains in laboratory quality and capacity. Systems to improve the physical laboratory environment, develop laboratory staff, create improvements to reduce costs and increase quality are available for future health and laboratory strengthening programmes. We hope that the strategies employed may inform and encourage the development of other

Laparoscopic colonic surgery in Denmark 2004-2007

DEFF Research Database (Denmark)

Schulze, S.; Iversen, M.G.; Bendixen, A.

2008-01-01

OBJECTIVE: Laparoscopic colonic surgery was introduced about 15 years ago and has together with the evidence-based 'fast-track' methodology improved early postoperative outcome. The purpose of this study was to asses the organization and early outcome after laparoscopic colonic surgery in Denmark...... of laparoscopic colonic surgery but probably performed in too many low volume departments. Laparoscopic colonic surgery should be monitored and further advances secured by adjustment of perioperative care to fast-track care Udgivelsesdato: 2008/11...

Health care management of sickness certification tasks: results from two surveys to physicians.

Science.gov (United States)

Lindholm, Christina; von Knorring, Mia; Arrelöv, Britt; Nilsson, Gunnar; Hinas, Elin; Alexanderson, Kristina

2013-05-23

Health care in general and physicians in particular, play an important role in patients' sickness certification processes. However, a lack of management within health care regarding how sickness certification is carried out has been identified in Sweden. A variety of interventions to increase the quality of sickness certification were introduced by the government and County Councils. Some of these measures were specifically aimed at strengthening health care management of sickness certification; e.g. policy making and management support. The aim was to describe to what extent physicians in different medical specialties had access to a joint policy regarding sickness certification in their clinical settings and experienced management support in carrying out sickness certification. A descriptive study, based on data from two cross-sectional questionnaires sent to all physicians in the Stockholm County regarding their sickness certification practice. Criteria for inclusion in this study were working in a clinical setting, being a board-certified specialist, sickness certification consultations at least a few times a year. These criteria were met by 2497 physicians in 2004 and 2204 physicians in 2008. Proportions were calculated regarding access to policy and management support, stratified according to medical specialty. The proportions of physicians working in clinical settings with a well-established policy regarding sickness certification were generally low both in 2004 and 2008, but varied greatly between different types of medical specialties (from 6.1% to 46.9%). Also, reports of access to substantial management support regarding sickness certification varied greatly between medical specialties (from 10.5% to 48.8%). More than one third of the physicians reported having no such management support. Most physicians did not work in a clinical setting with a well-established policy on sickness certification tasks, nor did they experience substantial support from

Introducing priority setting and resource allocation in home and community care programs.

Science.gov (United States)

Urquhart, Bonnie; Mitton, Craig; Peacock, Stuart

2008-01-01

To use evidence from research to identify and implement priority setting and resource allocation that incorporates both ethical practices and economic principles. Program budgeting and marginal analysis (PBMA) is based on two key economic principles: opportunity cost (i.e. doing one thing instead of another) and the margin (i.e. resource allocation should result in maximum benefit for available resources). An ethical framework for priority setting and resource allocation known as Accountability for Reasonableness (A4R) focuses on making sure that resource allocations are based on a fair decision-making process. It includes the following four conditions: publicity; relevance; appeals; and enforcement. More recent literature on the topic suggests that a fifth condition, that of empowerment, should be added to the Framework. The 2007-08 operating budget for Home and Community Care, excluding the residential sector, was developed using PBMA and incorporating the A4R conditions. Recommendations developed using PBMA were forwarded to the Executive Committee, approved and implemented for the 2007-08 fiscal year operating budget. In addition there were two projects approved for approximately $200,000. PBMA is an improvement over previous practice. Managers of Home and Community Care are committed to using the process for the 2008-09 fiscal year operating budget and expanding its use to include mental health and addictions services. In addition, managers of public health prevention and promotion services are considering using the process.

Simplified tools for measuring retention in care in antiretroviral treatment program in Ethiopia: cohort and current retention in care.

Science.gov (United States)

Assefa, Yibeltal; Worku, Alemayehu; Wouters, Edwin; Koole, Olivier; Haile Mariam, Damen; Van Damme, Wim

2012-01-01

Patient retention in care is a critical challenge for antiretroviral treatment programs. This is mainly because retention in care is related to adherence to treatment and patient survival. It is therefore imperative that health facilities and programs measure patient retention in care. However, the currently available tools, such as Kaplan Meier, for measuring retention in care have a lot of practical limitations. The objective of this study was to develop simplified tools for measuring retention in care. Retrospective cohort data were collected from patient registers in nine health facilities in Ethiopia. Retention in care was the primary outcome for the study. Tools were developed to measure "current retention" in care during a specific period of time for a specific "ART-age group" and "cohort retention" in care among patients who were followed for the last "Y" number of years on ART. "Probability of retention" based on the tool for "cohort retention" in care was compared with "probability of retention" based on Kaplan Meier. We found that the new tools enable to measure "current retention" and "cohort retention" in care. We also found that the tools were easy to use and did not require advanced statistical skills. Both "current retention" and "cohort retention" are lower among patients in the first two "ART-age groups" and "ART-age cohorts" than in subsequent "ART-age groups" and "ART-age cohorts". The "probability of retention" based on the new tools were found to be similar to the "probability of retention" based on Kaplan Meier. The simplified tools for "current retention" and "cohort retention" will enable practitioners and program managers to measure and monitor rates of retention in care easily and appropriately. We therefore recommend that health facilities and programs start to use these tools in their efforts to improve retention in care and patient outcomes.

Simplified tools for measuring retention in care in antiretroviral treatment program in Ethiopia: cohort and current retention in care.

Directory of Open Access Journals (Sweden)

Yibeltal Assefa

Full Text Available INTRODUCTION: Patient retention in care is a critical challenge for antiretroviral treatment programs. This is mainly because retention in care is related to adherence to treatment and patient survival. It is therefore imperative that health facilities and programs measure patient retention in care. However, the currently available tools, such as Kaplan Meier, for measuring retention in care have a lot of practical limitations. The objective of this study was to develop simplified tools for measuring retention in care. METHODS: Retrospective cohort data were collected from patient registers in nine health facilities in Ethiopia. Retention in care was the primary outcome for the study. Tools were developed to measure "current retention" in care during a specific period of time for a specific "ART-age group" and "cohort retention" in care among patients who were followed for the last "Y" number of years on ART. "Probability of retention" based on the tool for "cohort retention" in care was compared with "probability of retention" based on Kaplan Meier. RESULTS: We found that the new tools enable to measure "current retention" and "cohort retention" in care. We also found that the tools were easy to use and did not require advanced statistical skills. Both "current retention" and "cohort retention" are lower among patients in the first two "ART-age groups" and "ART-age cohorts" than in subsequent "ART-age groups" and "ART-age cohorts". The "probability of retention" based on the new tools were found to be similar to the "probability of retention" based on Kaplan Meier. CONCLUSION: The simplified tools for "current retention" and "cohort retention" will enable practitioners and program managers to measure and monitor rates of retention in care easily and appropriately. We therefore recommend that health facilities and programs start to use these tools in their efforts to improve retention in care and patient outcomes.

Integrated Safeguards and Security Management Self-Assessment 2004

Energy Technology Data Exchange (ETDEWEB)

Lunford, Dan; Ramsey, Dwayne

2005-04-01

In 2002 Ernest Orlando Lawrence Berkeley National Laboratory deployed the first Integrated Safeguards and Security Management (ISSM) Self-Assessment process, designed to measure the effect of the Laboratory's ISSM efforts. This process was recognized by DOE as a best practice and model program for self-assessment and training. In 2004, the second Self-Assessment was launched. The cornerstone of this process was an employee survey that was designed to meet several objectives: (1) Ensure that Laboratory assets are protected. (2) Provide a measurement of the Laboratory's current security status that can be compared against the 2002 Self-Assessment baseline. (3) Educate all Laboratory staff about security responsibilities, tools, and practices. (4) Provide security staff with feedback on the effectiveness of security programs. (5) Provide line management with the information they need to make informed decisions about security. This 2004 Self Assessment process began in July 2004 with every employee receiving an information packet and instructions for completing the ISSM survey. The Laboratory-wide survey contained questions designed to measure awareness and conformance to policy and best practices. The survey response was excellent--90% of Berkeley Lab employees completed the questionnaire. ISSM liaisons from each division followed up on the initial survey results with individual employees to improve awareness and resolve ambiguities uncovered by the questionnaire. As with the 2002 survey, the Self-Assessment produced immediate positive results for the ISSM program and revealed opportunities for longer-term corrective actions. Results of the questionnaire provided information for organizational profiles and an institutional summary. The overall level of security protection and awareness was very high--often above 90%. Post-survey work by the ISSM liaisons and line management consistently led to improved awareness and metrics, as shown by a comparison of

Management report 2004 CNEN - Brazilian Nuclear Energy Commission; Relatorio de gestao 2004 CNEN - Comissao Nacional de Energia Nuclear

Energy Technology Data Exchange (ETDEWEB)

NONE

2005-03-15

This document reports the results of the activity management of the Comissao Nacional de Energia Nuclear - CNEN - Brazil during the year of 2004, involving the Brazilian program of nuclear activities in the areas of nuclear safety, research and development, radiopharmaceutical production, institutional management, teaching, administration in general and miscellaneous.

Parents-CARE: a suicide prevention program for parents of at-risk youth.

Science.gov (United States)

Hooven, Carole

2013-02-01

Families play an important role in youth suicide prevention, as both a source of protection and a source of risk, and thus are an important target for adolescent suicide prevention programs. This article describes in detail Parents-CARE, a brief youth suicide prevention program for parents, for which effectiveness has been demonstrated. Engaging parents in preventive intervention can be challenging; therefore, the feasibility, acceptability, and relevance of the program to parents are examined. A total of 289 households participated in Parents-CARE. Parent attendance data and parent and interventionist process data are utilized to demonstrate the positive response by parents to the program. The Parents-CARE program was highly attended, and ratings demonstrate that parents were engaged in the program. Ratings show parents found the program both acceptable and relevant. Hence, the program described is promising for clinicians working with at-risk youth as they seek brief, accessible, and effective interventions that include parents in order to amplify the effects of an individual intervention approach. © 2013 Wiley Periodicals, Inc.

Microbiological point of care testing before antibiotic prescribing in primary care

DEFF Research Database (Denmark)

Haldrup, Steffen; Thomsen, Reimar W.; Bro, Flemming

2017-01-01

BACKGROUND: Point-of-care testing (POCT) in primary care may improve rational antibiotic prescribing. We examined use of POCT in Denmark, including patient- and general practitioner (GP)-related predictors. METHODS: We linked nationwide health care databases to assess POCT use (C-reactive protein...... (CRP), group A streptococcal (GAS) antigen swabs, bacteriological cultures, and urine test strips) per 1,000 overall GP consultations, 2004-2013. We computed odds ratios (OR) of POCT in patients prescribed antibiotics according to patient and GP age and sex, GP practice type, location, and workload....... RESULTS: The overall use of POCT in Denmark increased by 45.8% during 2004-2013, from 147.2 per 1,000 overall consultations to 214.8. CRP tests increased by 132%, bacteriological cultures by 101.7% while GAS swabs decreased by 8.6%. POCT preceded 28% of antibiotic prescriptions in 2004 increasing to 44...

The LNG industry - 2008

International Nuclear Information System (INIS)

2008-01-01

The average annual growth of the world primary energy consumption has been 2.2% over the last ten years, with the highest growth rate observed for 2004 (+4.7%). In 2007, world primary energy consumption registered a 2.4% increase, still exceeding the 10-year average but less than for the four previous years. As for the previous years, the Asia Pacific region shows the most important increase in volume for 2007, rising by 5% and accounting for two-third of the global growth (China alone accounts in 2007 for more than half of this global growth, as was already the case in 2005 and 2006). Over the last ten years, the world energy consumption rose from 8920 10 6 toe in 1998 to 11099 10 6 toe in 2007, a 24.4% overall increase. For the seventh year running, coal has increased its share of the overall energy market, up to 28.6%. It should be noted that nuclear power decreased by 2%, Germany and Japan accounting for more than 90% of this decline. The growth of natural gas consumption in 2007 (+3.1%) was higher than in 2006 (+2.4%). The US accounted for nearly half of the global increase. Strong growth was also observed in China (+19.9%), representing the second largest increment to world gas consumption. Inversely, the EU consumption decreased (-1.6%) for the second year in a row. The market share for natural gas remained stable in 2007 (23.8%) compared to 2006 (23.6%)(1). Estimates for the marketed production of natural gas in 2008(2) show a rise of about 3.4% over 2007. The share of LNG in the gas trade accounts for 27% of the total (excluding trade within the Former Soviet Union and United Arab Emirates). Details are given about: LNG contracts and trade, Contracts concluded in 2008, LNG imports - Sources of imports, Quantities received in 2008, LNG tankers, Ships delivered, Tanker distribution, Liquefaction plants, Re-gasification plants, Contracts in force in 2008, Spot and short term quantities received in 2008, Sea transportation routes, Liquefaction plants, Re

The Nordic maintenance care program

DEFF Research Database (Denmark)

Malmqvist, Stefan; Leboeuf-Yde, Charlotte

2009-01-01

of maintenance care. Previous studies have identified chiropractors' choices of case management strategies in response to different case scenarios. However, the rationale for these management strategies is not known. In other words, when presented with both the case, and different management strategies......Maintenance care is a well known concept among chiropractors, although there is little knowledge about its exact definition, its indications and usefulness. As an initial step in a research program on this phenomenon, it was necessary to identify chiropractors' rationale for their use......, there was consensus on how to match these, but if only the management strategies were provided, would chiropractors be able to define the cases to fit these strategies? The objective with this study was to investigate if there is a common pattern in Finnish chiropractors' case management of patients with low back...

Evaluation of a community-based falls prevention program in South Florida, 2008-2009.

Science.gov (United States)

Batra, Anamica; Melchior, Michael; Seff, Laura; Frederick, Newman; Palmer, Richard C

2012-01-01

Many older adults experience fear of falling, which may reduce participation in routine activities. A Matter of Balance (MOB) and Un Asunto de Equilibrio (ADE) workshops were offered in South Florida to reduce fear of falling and increase activity levels in older adults. The objectives of this study were to evaluate the effectiveness of the lay leader model of the programs in the first year of their implementation and to further report on participant outcome measures. We analyzed reach, adoption, and implementation data for participants who attended workshops between October 1, 2008, and December 31, 2009, who were aged 60 years or older, and who had both baseline and posttest outcome data. Workshops were in English and Spanish and consisted of 8 two-hour sessions. Participants completed a 7-item baseline and posttest questionnaire that consisted of a falls management scale, a social activity item, and modified version of Physician-Based Assessment and Counseling on Exercise. We analyzed outcome data on multiple characteristics using a general linear model. A class evaluation questionnaire measured participant satisfaction. Results for 562 participants who provided both baseline and posttest data showed significant improvement on 6 of 7 questions for MOB and all questions for ADE (P < .001). The 391 participants who provided evaluation data indicated that the programs were effective, beneficial, and well organized. Lay leaders successfully implemented the programs in community settings. The programs were effective in reducing fear of falling among older adults.

Empowering primary care workers to improve health services: results from Mozambique's leadership and management development program.

Science.gov (United States)

Perry, Cary

2008-07-23

This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The series of six articles has been contributed by Management Sciences for Health (MSH) and will be published article-by-article over the next few weeks. The third article presents a successful application in Mozambique of a leadership development program created by Management Sciences for Health (MSH). Through this program, managers from 40 countries have learned to work in teams to identify their priority challenges and act to implement effective responses. From 2003 to 2004, 11 health units in Nampula Province, participated in a leadership and management development program called the Challenges Program. This was following an assessment which found that the quality of health services was poor, and senior officials determined that the underlying cause was the lack of human resource capacity in leadership and management in a rapidly decentralizing health care system. The program was funded by the US Agency for International Development (USAID) and implemented in partnership between the Mozambican Ministry of Health (MOH) Provincial Directorate in Nampula and Management Sciences for Health (MSH). The Challenges Program used simple management and leadership tools to assist the health units and their communities to address health service challenges. An evaluation of the program in 2005 showed that 10 of 11 health centers improved health services over the year of the program. The Challenges Program used several strategies that contributed to successful outcomes. It integrated leadership strengthening into the day-to-day challenges that staff were facing in the health units. The second success factor in the Challenges Program was the creation of participatory teams. After the program, people no longer waited passively to be trained but instead proactively requested training in needed areas. MOH workers in Nampula reported

Empowering primary care workers to improve health services: results from Mozambique's leadership and management development program

Directory of Open Access Journals (Sweden)

Perry Cary

2008-07-01

Full Text Available Abstract This article is the third article in the Human Resources for Health journal's feature on the theme of leadership and management in public health. The series of six articles has been contributed by Management Sciences for Health (MSH and will be published article-by-article over the next few weeks. The third article presents a successful application in Mozambique of a leadership development program created by Management Sciences for Health (MSH. Through this program, managers from 40 countries have learned to work in teams to identify their priority challenges and act to implement effective responses. From 2003 to 2004, 11 health units in Nampula Province, participated in a leadership and management development program called the Challenges Program. This was following an assessment which found that the quality of health services was poor, and senior officials determined that the underlying cause was the lack of human resource capacity in leadership and management in a rapidly decentralizing health care system. The program was funded by the US Agency for International Development (USAID and implemented in partnership between the Mozambican Ministry of Health (MOH Provincial Directorate in Nampula and Management Sciences for Health (MSH. The Challenges Program used simple management and leadership tools to assist the health units and their communities to address health service challenges. An evaluation of the program in 2005 showed that 10 of 11 health centers improved health services over the year of the program. The Challenges Program used several strategies that contributed to successful outcomes. It integrated leadership strengthening into the day-to-day challenges that staff were facing in the health units. The second success factor in the Challenges Program was the creation of participatory teams. After the program, people no longer waited passively to be trained but instead proactively requested training in needed areas. MOH workers

ExCEL in Social Work: Excellence in Cancer Education & Leadership: An Oncology Social Work Response to the 2008 Institute of Medicine Report.

Science.gov (United States)

Otis-Green, Shirley; Jones, Barbara; Zebrack, Brad; Kilburn, Lisa; Altilio, Terry A; Ferrell, Betty

2015-09-01

ExCEL in Social Work: Excellence in Cancer Education & Leadership was a multi-year National Cancer Institute (NCI)-funded grant for the development and implementation of an innovative educational program for oncology social workers. The program's curriculum focused upon six core competencies of psychosocial-spiritual support necessary to meet the standard of care recommended by the 2008 Institute of Medicine (IOM) Report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The curriculum was delivered through a collaborative partnership between the City of Hope National Medical Center and the two leading professional organizations devoted exclusively to representing oncology social workers--the Association of Oncology Social Work and the Association of Pediatric Oncology Social Workers. Initial findings support the feasibility and acceptability of this tailored leadership skills-building program for participating oncology social workers.

Prevalence of health promotion programs in primary health care units in Brazil

Science.gov (United States)

Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi

2014-01-01

OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. PMID:25372175

Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

Directory of Open Access Journals (Sweden)

Michael J. Stewart

2013-02-01

Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice.  The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt. Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis. Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional

Successfully integrating aged care services: A review of the evidence and tools emerging from a long-term care program

Directory of Open Access Journals (Sweden)

Michael J. Stewart

2013-02-01

Full Text Available Background: Providing efficient and effective aged care services is one of the greatest public policy concerns currently facing governments. Increasing the integration of care services has the potential to provide many benefits including increased access, promoting greater efficiency, and improving care outcomes. There is little research, however, investigating how integrated aged care can be successfully achieved. The PRISMA (Program of Research to Integrate Services for the Maintenance of Autonomy project, from Quebec, Canada, is one of the most systematic and sustained bodies of research investigating the translation and outcomes of an integrated care policy into practice.  The PRISMA research program has run since 1988, yet there has been no independent systematic review of this work to draw out the lessons learnt.Methods: Narrative review of all literature emanating from the PRISMA project between 1988 and 2012. Researchers accessed an online list of all published papers from the program website. The reference lists of papers were hand searched to identify additional literature. Finally, Medline, Pubmed, EMBASE and Google Scholar indexing databases were searched using key terms and author names. Results were extracted into specially designed spread sheets for analysis.Results: 45 journal articles and two books authored or co-authored by the PRISMA team were identified. Research was primarily concerned with: the design, development and validation of screening and assessment tools; and results generated from their application. Both quasi-experimental and cross sectional analytic designs were used extensively. Contextually appropriate expert opinion was obtained using variations on the Delphi Method. Literature analysis revealed the structures, processes and outcomes which underpinned the implementation. PRISMA provides evidence that integrating care for older persons is beneficial to individuals through reducing incidence of functional

[Family Health Program and children palliative care: listening the relatives of technology dependent children].

Science.gov (United States)

Rabello, Cláudia Azevedo Ferreira Guimarães; Rodrigues, Paulo Henrique de Almeida

2010-03-01

This study discusses the creation of a new children palliative care program based on the Family Health Program, considering the level of care at home and yielding to family requests. The study focused on eighteen members of nine families of technology dependent children (TDC) who were hospital patients at Instituto Fernandes Figueira (IFF): four who are being assisted by its palliative care program Programa de Assistência Domiciliar Interdisciplinar (PADI); three who were inpatients waiting for inclusion in the Program, and finally two inpatients already included in PADI. PADI was chosen because it is the only child palliative care program in Brazil. The results are positive in regards to the connection established between the families and the health care team, the reception of the children, the explanation to the family concerning the disease, and the functional dynamics between the PADI and IFF. As negative points, difficulties arose as a result of the implementation of the program, from its continuity to the worsening or illness of the entire family. In conclusion, although the PADI is the IFF's way of discharging patients, the domiciliary cares taken by the Family Health Program, well articulated with the healthcare system, would be ideal for being the adequate assistance for such.

A mobility program for an inpatient acute care medical unit.

Science.gov (United States)

Wood, Winnie; Tschannen, Dana; Trotsky, Alyssa; Grunawalt, Julie; Adams, Danyell; Chang, Robert; Kendziora, Sandra; Diccion-MacDonald, Stephanie

2014-10-01

For many patients, hospitalization brings prolonged periods of bed rest, which are associated with such adverse health outcomes as increased length of stay, increased risk of falls, functional decline, and extended-care facility placement. Most studies of progressive or early mobility protocols designed to minimize these adverse effects have been geared toward specific patient populations and conducted by multidisciplinary teams in either ICUs or surgical units. Very few mobility programs have been developed for and implemented on acute care medical units. This evidence-based quality improvement project describes how a mobility program, devised for and put to use on a general medical unit in a large Midwestern academic health care system, improved patient outcomes.