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Sample records for department chief complaint

  1. Using Chief Complaint in Addition to Diagnosis Codes to Identify Falls in the Emergency Department.

    Science.gov (United States)

    Patterson, Brian W; Smith, Maureen A; Repplinger, Michael D; Pulia, Michael S; Svenson, James E; Kim, Michael K; Shah, Manish N

    2017-09-01

    To compare incidence of falls in an emergency department (ED) cohort using a traditional International Classification of Diseases, Ninth Revision (ICD-9) code-based scheme and an expanded definition that included chief complaint information and to examine the clinical characteristics of visits "missed" in the ICD-9-based scheme. Retrospective electronic record review. Academic medical center ED. Individuals aged 65 and older seen in the ED between January 1, 2013, and September 30, 2015. Two fall definitions were applied (individually and together) to the cohort: an ICD-9-based definition and a chief complaint definition. Admission rates and 30-day mortality (per encounter) were measured for each definition. Twenty-three thousand eight hundred eighty older adult visits occurred during the study period. Using the most-inclusive definition (ICD-9 code or chief complaint indicating a fall), 4,363 visits (18%) were fall related. Of these visits, 3,506 (80%) met the ICD-9 definition for a fall-related visit, and 2,664 (61%) met the chief complaint definition. Of visits meeting the chief complaint definition, 857 (19.6%) were missed when applying the ICD-9 definition alone. Encounters missed using the ICD-9 definition were less likely to lead to an admission (42.9%, 95% confidence interval (CI) = 39.7-46.3%) than those identified (54.4%, 95% CI = 52.7-56.0%). Identifying individuals in the ED who have fallen based on diagnosis codes underestimates the true burden of falls. Individuals missed according to the code-based definition were less likely to have been admitted than those who were captured. These findings call attention to the value of using chief complaint information to identify individuals who have fallen in the ED-for research, clinical care, or policy reasons. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  2. Emergency Department Chief Complaint and Diagnosis Data to Detect Influenza-Like Illness with an Electronic Medical Record

    Science.gov (United States)

    May, Larissa S.; Griffin, Beth Ann; Bauers, Nicole Maier; Jain, Arvind; Mitchum, Marsha; Sikka, Neal; Carim, Marianne; Stoto, Michael A.

    2010-01-01

    Background: The purpose of syndromic surveillance is early detection of a disease outbreak. Such systems rely on the earliest data, usually chief complaint. The growing use of electronic medical records (EMR) raises the possibility that other data, such as emergency department (ED) diagnosis, may provide more specific information without significant delay, and might be more effective in detecting outbreaks if mechanisms are in place to monitor and report these data. Objective: The purpose of this study is to characterize the added value of the primary ICD-9 diagnosis assigned at the time of ED disposition compared to the chief complaint for patients with influenza-like illness (ILI). Methods: The study was a retrospective analysis of the EMR of a single urban, academic ED with an annual census of over 60, 000 patients per year from June 2005 through May 2006. We evaluate the objective in two ways. First, we characterize the proportion of patients whose ED diagnosis is inconsistent with their chief complaint and the variation by complaint. Second, by comparing time series and applying syndromic detection algorithms, we determine which complaints and diagnoses are the best indicators for the start of the influenza season when compared to the Centers for Disease Control regional data for Influenza-Like Illness for the 2005 to 2006 influenza season using three syndromic surveillance algorithms: univariate cumulative sum (CUSUM), exponentially weighted CUSUM, and multivariate CUSUM. Results: In the first analysis, 29% of patients had a different diagnosis at the time of disposition than suggested by their chief complaint. In the second analysis, complaints and diagnoses consistent with pneumonia, viral illness and upper respiratory infection were together found to be good indicators of the start of the influenza season based on temporal comparison with regional data. In all examples, the diagnosis data outperformed the chief-complaint data. Conclusion: Both analyses

  3. Frequency of Migraine as a Chief Complaint in Otolaryngology Outpatient Practice

    Science.gov (United States)

    Muhammad Ali, Maria; Al Zayer, Maha

    2015-01-01

    Objective. To identify the frequency of typical (headache and dizziness) and common atypical (ear fullness, pressure, pain, tinnitus, facial fullness, and nasal congestion) migraine symptoms as chief complaints among patients presenting to otolaryngology clinic. Methods. This is a descriptive study of prospectively collected data from a general otolaryngology practice. Typical migraine presentations were diagnosed by applying international headache society (IHS) criteria for migraine headache and Neuhauser's criteria for migrainous vertigo. Atypical otologic and rhinologic migraine symptoms were diagnosed using individualized criteria. Charts were reviewed at 6-month interval from the first presentation. Results. Out of 1002 consecutive patients, 10.8% presented with “migrainous chief complaint.” All migrainous chief complaint patients had a history of headache but not all of them presented with headache. Corrected female to male ratio in the migraine group was 3 to 1; age distributions were significantly different between the migraine and nonmigraine groups by applying t-test. Out of the atypical complaints, 86% of the patients had a history of concomitant typical presentation. Conclusion. Actual diagnostic criteria for migraine do not satisfy the diversity of its presentation. Investigating the history of migraine is enough to diagnose most atypical presentations. Sound knowledge about migraine seems essential for any ENT practitioner. PMID:25695049

  4. Providing Student Health Services at Sea: A Survey of Chief Complaints Onboard a Maritime Academy Training Ship

    Science.gov (United States)

    Kue, Ricky; Cukor, Jeffrey; Fredrickson, Anne

    2009-01-01

    Objective: The authors describe the epidemiology of infirmary chief complaints aboard a collegiate maritime training ship. Participants: They assessed patients (N = 646 visits) evaluated by the "USTS Enterprise" medical department during a 44-day sea term from January to February 2007. Methods: The authors conducted a retrospective chart review of…

  5. Computed tomographic scanning in patients presenting with chief complaint of headache without focal neurological signs

    International Nuclear Information System (INIS)

    Halim, A.; Khalid, W.; Haq, A.U.

    2017-01-01

    To determine the frequency of positive computed tomographic (CT)scan findings in patients presenting at PNS Shifa Hospital Karachi with chief complaint of headache without focal neurological signs. Study Design: Cross sectional descriptive study. Place and Duration of Study: The study was conducted at the Radiology department, PNS Shifa Hospital Karachi from Dec 2011 to Jun 2012. Patients and Methods: This cross-sectional descriptive study included referred patients with complaint of headache of one month duration or more without focal neurological signs. No gender restriction was considered and patients of age more than 14 years were included. Patients with headache due to other known clinical disorders such as intracranial neoplasm and stroke were excluded. Patients with focal neurological signs such as hemiparesis, cerebellar signs and cranial nerve palsies were also excluded from the study. A total of 105 patients were included in the study through non probability consecutive sampling. Informed written consent was taken from the patients by explaining all the risks and benefits of the study and use of data for research and publication. Plain CT scan brain was done by trained CT technician and reporting of CT scan was done by consultant radiologist. CT scan was done on Toshiba Scanner Aquilion-64 CT Scan machine. The imaging protocol consisted of appropriately angled continuous 5mm thick axial slices for the posterior fossa and 10 mm thick slices for the rest of brain from the base of skull to the vertex. Data was collected through a specially structured proforma. Confidentiality of the patients record was maintained. Results: Majority of the patients were between 31-40 years of age i.e. 29.52 percent (n=31) and mean and SD was calculated as 34.24 +- 8.72 years, 54.29 percent (n=57) females and 45.71 percent (n=48) male patients, frequency of positive CT scan findings in patients with chief complaint of headache without focal neurological signs was recorded as

  6. Know your audience: analysis of chief complaints at clinica esperanza, a student-run free clinic in memphis, tennessee.

    Science.gov (United States)

    Cesari, Whitney A; Vaikunth, Sumeet S; Lewis, Jim B; Panda, Mukta

    2012-10-01

    To identify the chief complaints and demographics at Clinica Esperanza, a student-run free clinic for an underserved Hispanic population. A retrospective chart review of patient files from 2005 through 2010 was undertaken, as approved by the University of Tennessee Health Science Center's Institutional Review Board. From 2005 through 2010, Clinica Esperanza fielded 2551 patient visits, consisting of 951 unique patients, 609 females and 342 males. Mean age was 34 years, and 60% of patients presented once, while 13% followed up for 1 year, 9% for 2 years, 6% for 3, 6% for 4, and 4% for 5. "Pap smear," "abdominal pain," and "follow-up lab results" ranked, in order, as the 3 top chief complaints. Resulting data have led to several improvements. The clinic has remained open weekly to improve patient continuity. With the top 10 chief complaints identified, they are better addressed. More funding is allocated for speculums and proper training of Pap smear technique. Systematic reporting of lab results is being implemented. Physical therapists and pharmacists now participate to address musculoskeletal and medication-based needs, respectively. A volunteer gastroenterologist has been recruited to provide specialized care for abdominal pain. An electrocardiogram machine is now used to evaluate chest pain. To improve student-patient communication, online language learning modules have been created. Based on these data, improvements in health care services have been made, including better continuity, emphasis on top chief complaints, and provider education in medical Spanish. Future plans include on-site pharmacy, smoother referrals, and similar clinics on the University of Tennessee Health Science Center's other campuses.

  7. [An etiological analysis of 367 neurological outpatients with complaint of vertigo].

    Science.gov (United States)

    Qiu, Feng; Qi, Xiao-Kun

    2012-05-01

    To explore the etiology of patients with chief complaint of vertigo in the department of neurology in order to reduce the rate of misdiagnosis. A total of 367 patients with chief complaint of vertigo in our department of neurology were followed up. The associated medical history, symptoms and physical examination were obtained. The main diagnoses for the 367 patients were benign paroxysmal positional vertigo (BPPV) (219, 59.7%), posterior circulation ischemia (PCI) (65, 17.7%), migraine (31, 8.4%), hypertension (18, 4.9%) and psychogenic vertigo (17, 4.6%). Presentation of vertigo can be clinically diagnosed in most diseases, with the most common cause of BPPV. Combination of the prominent clinical features, physical examinations and especially Dix-Hallpike maneuver may guide the general physicians to a most proper cause of vertigo.

  8. Complaints from emergency department patients largely result from treatment and communication problems.

    Science.gov (United States)

    Taylor, David McD; Wolfe, Rory; Cameron, Peter A

    2002-03-01

    Emergency department patient complaints are often justified and may lead to apology, remedial action or compensation. The aim of the present study was to analyse emergency department patient complaints in order to identify procedures or practices that require change and to make recommendations for intervention strategies aimed at decreasing complaint rates. We undertook a retrospective analysis of patient complaints from 36 Victorian emergency departments during a 61 month period. Data were obtained from the Health Complaint Information Program (Health Services Commissioner). In all, 2,419 emergency department patients complained about a total of 3,418 separate issues (15.4% of all issues from all hospital departments). Of these, 1,157 complaints (47.80%) were received by telephone and 829 (34.3%) were received by letter; 1,526 (63.1 %) complaints were made by a person other than the patient. Highest complaint rates were received from patients who were female, born in non-English-speaking countries and very young or very old. One thousand one hundred and forty-one issues (33.4%) related to patient treatment, including inadequate treatment (329 issues) and inadequate diagnosis (249 issues); 1079 (31.6%) issues related to communication, including poor staff attitude, discourtesy and rudeness (444 issues); 407 (11.9%) issues related to delay in treatment. Overall, 2516 issues (73.6%) were resolved satisfactorily, usually by explanation or apology. Only 59 issues (1.7%) resulted in a procedure or policy change. Remedial action was taken in 109 issues (3.2%) and compensation was paid to eight patients. Communication remains a significant factor in emergency department patient dissatisfaction. While patient complaints have resulted in major changes to policy and procedure, research and intervention strategies into communication problems are indicated. In the short term, focused staff training is recommended.

  9. High frequency of cardiac and behavioral complaints as presenting symptoms of hyperthyroidism in children.

    Science.gov (United States)

    Loomba-Albrecht, Lindsey A; Bremer, Andrew A; Styne, Dennis M; Glaser, Nicole S

    2011-01-01

    Descriptive data characterizing the frequency of various chief complaints and presenting symptomatology in children with hyperthyroidism are lacking. Furthermore, difficulties in recognizing atypical presentations may delay diagnosis and increase morbidity. We performed a retrospective review of the medical records of 76 children with hyperthyroidism to characterize their chief complaints at initial presentation to care and document other presenting symptomatology. Cardiac symptoms were the most frequent chief complaint, accounting for 23% of presenting complaints. Major mood and behavior disturbances were also frequently present (21%), but were infrequently cited as the chief complaint (6%). This study is the first to describe chief complaints separately from the other signs and symptoms of hyperthyroidism noted at the time of presentation to medical attention. Cardiac complaints were the most common: however, complaints associated with behavioral and mood disorders also occurred frequently. Clinicians should be aware of these presentations so that hyperthyroidism is diagnosed promptly to avoid morbidity associated with delayed diagnosis.

  10. Evaluation of emergency medical text processor, a system for cleaning chief complaint text data.

    Science.gov (United States)

    Travers, Debbie A; Haas, Stephanie W

    2004-11-01

    Emergency Medical Text Processor (EMT-P) version 1, a natural language processing system that cleans emergency department text (e.g., chst pn, chest pai), was developed to maximize extraction of standard terms (e.g., chest pain). The authors compared the number of standard terms extracted from raw chief complaint (CC) data with that for CC data cleaned with EMT-P and evaluated the accuracy of EMT-P. This cross-sectional observation study included CC text entries for all emergency department visits to three tertiary care centers in 2001. Terms were extracted from CC entries before and after cleaning with EMT-P. Descriptive statistics included number and percentage of all entries (tokens) and all unique entries (types) that matched a standard term from the Unified Medical Language System (UMLS). An expert panel rated the accuracy of the CC-UMLS term matches; inter-rater reliability was measured with kappa. The authors collected 203,509 CC entry tokens, of which 63,946 were unique entry types. For the raw data, 89,337 tokens (44%) and 5,081 types (8%) matched a standard term. After EMT-P cleaning, 168,050 tokens (83%) and 44,430 types (69%) matched a standard term. The expert panel reached consensus on 201 of the 222 CC-UMLS term matches reviewed (kappa=0.69-0.72). Ninety-six percent of the 201 matches were rated equivalent or related. Thirty-eight percent of the nonmatches were found to match UMLS concepts. EMT-P version 1 is relatively accurate, and cleaning with EMT-P improved the CC-UMLS term match rate over raw data. The authors identified areas for improvement in future EMT-P versions and issues to be resolved in developing a standard CC terminology.

  11. Admissions to emergency department may be classified into specific complaint categories

    DEFF Research Database (Denmark)

    Carter-Storch, Rasmus; Frydkjær-Olsen, Ulrik; Mogensen, Christian Backer

    2014-01-01

    INTRODUCTION: In the emergency departments (ED), a heterogeneous mix of patients is seen. The aim of this study was to establish a limited number of categories of complaints and symptoms covering the majority of admissions in a Danish ED and to quantify the volume of cases in each category...... covering all patient complaints was produced. Presumptive diagnoses and categories with frequencies less than 1% were pooled with other groups, unless keeping them was clinically relevant. RESULTS: Among the 9,863 patients, 49% were medical, 31% surgical, 15% orthopaedic and 5% vascular surgical patients....... In 35% of cases, the patients were referred with a presumptive diagnosis, in 65% with a complaint or a symptom; and 11,031 complaints were placed in 13 main categories, 77 subcategories and 44 presumptive diagnoses. This aggregation resulted in 99 groups holding less than 1% of the patients' complaints...

  12. Prof. John Wood, Chief Executive Designate, Dr Gordon Walker, Directorate, Chief Executive, Prof. Ken J. Peach, Head of the Particle Physics Department, CLRC Rutherford Appleton Laboratory, United Kingdom

    CERN Multimedia

    Patrice Loïez

    2001-01-01

    L. to. r.: Dr. Ian Wilson, CLIC Deputy Study Leader, Prof. Ken J. Peach, Head of the Particle Physics Department, Prof. John Wood, Chief Executive Designate, Dr. Gordon Walker, Directorate, Chief Executive

  13. Syndromic surveillance: hospital emergency department participation during the Kentucky Derby Festival.

    Science.gov (United States)

    Carrico, Ruth; Goss, Linda

    2005-01-01

    Electronic syndromic surveillance may have value in detecting emerging pathogens or a biological weapons release. Hospitals that have an agile process to evaluate chief complaints of patients seeking emergency care may be able to more quickly identify subtle changes in the community's health. An easily adaptable prototype system was developed to monitor emergency department patient visits during the Kentucky Derby Festival in Louisville, Kentucky, from April 16-May 14, 2002. Use of the system was continued during the same festival periods in 2003 and 2004. Twelve area hospitals in Louisville, Kentucky, participated in a prospective analysis of the chief symptoms of patients who sought care in the emergency department during the Kentucky Derby Festival during 2002. Six hospitals were classified as computer record groups (CRG) and used their existing computerized record capabilities. The other 6 hospitals used a personal digital assistant (PDA) with customized software (PDA group). Data were evaluated by the health department epidemiologist using SaTScan, a modified version of a cancer cluster detection program, to look for clusters of cases above baseline over time and by Zip code. All 12 hospitals were able to collect and provide data elements during the study period. The 6 CRG hospitals were able to perform daily data transmission; however, 3 CRG hospitals were unable to interpret their data because it was transmitted in pure text format. In contrast, data from all 6 PDA group hospitals were interpretable. Real-time data analysis was compared with post-event data, and it was found that the real-time evaluation correctly identified no unusual disease activity during the study period. The 12 hospitals participating in this study demonstrated that community-wide surveillance using computerized data was possible and that the 6 study hospitals using a PDA could quickly interpret emergency department patients' chief complaints. The emergency department chief complaints

  14. Assessment of a Chief Complaint–Based Curriculum for Resident Education in Geriatric Emergency Medicine

    Directory of Open Access Journals (Sweden)

    Robert L Muelleman

    2011-05-01

    Full Text Available Introduction: We hypothesized that a geriatric chief complaint–based didactic curriculum would improve resident documentation of elderly patient care in the emergency department (ED. Methods: A geriatric chief complaint curriculum addressing the 3 most common chief complaints—abdominal pain, weakness, and falls—was developed and presented. A pre- and postcurriculum implementation chart review assessed resident documentation of the 5 components of geriatric ED care: 1 differential diagnosis/patient evaluation considering atypical presentations, 2 determination of baseline function, 3 chronic care facility/caregiver communication, 4 cognitive assessment, and 5 assessment of polypharmacy. A single reviewer assessed 5 pre- and 5 postimplementation charts for each of 18 residents included in the study. We calculated 95% confidence and determined that statistical significance was determined by a 2-tailed z test for 2 proportions, with statistical significance at 0.003 by Bonferroni correction. Results: For falls, resident documentation improved significantly for 1 of 5 measures. For abdominal pain, 2 of 5 components improved. For weakness, 3 of 5 components improved. Conclusion: A geriatric chief complaint–based curriculum improved emergency medicine resident documentation for the care of elderly patients in the ED compared with a non–age-specific chief complaint–based curriculum. [West J Emerg Med. 2011;12(4:484–488.

  15. Owen Barwell - Chief Financial Officer | NREL

    Science.gov (United States)

    Owen Barwell - Chief Financial Officer Owen Barwell - Chief Financial Officer A photo of Owen , analysis, and management. He previously served as the Acting Chief Financial Officer and Deputy Chief Financial Officer of the U.S. Department of Energy (DOE), where he was directly responsible for DOE's

  16. 7 CFR 2.70 - Deputy Chief Economist.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Deputy Chief Economist. 2.70 Section 2.70 Agriculture... GENERAL OFFICERS OF THE DEPARTMENT Delegations of Authority by the Chief Economist § 2.70 Deputy Chief Economist. Pursuant to § 2.29, the following delegation of authority is made by the Chief Economist to the...

  17. 6 CFR 13.7 - Complaint.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Complaint. 13.7 Section 13.7 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.7 Complaint. (a) On or after the date the Department of Justice approves the issuance of a Complaint in accordance...

  18. Analysis of Factors and Medical Errors Involved in Patient Complaints in a European Emergency Department

    Directory of Open Access Journals (Sweden)

    Pauline Haroutunian

    2017-12-01

    Full Text Available Introduction: Patients’ complaints from Emergency Departments (ED are frequent and can be used as a quality assurance indicator. Objective: Factors contributing to patients’ complaints (PCs in the emergency department were analyzed.  Methods: It was a retrospective cohort study, the qualitative variables of patients’ complaints visiting ED of a university hospital were compared with Chi-Square and t test tests. Results: Eighty-five PC were analyzed. The factors contributing to PC were: communication (n=26, length of stay (LOS (n=24, diagnostic errors (n=21, comfort and privacy issues (n=7, pain management (n=6, inappropriate treatment (n=6, delay of care and billing issues (n=3. PCs were more frequent when patients were managed by residents, during night shifts, weekends, Saturdays, Mondays, January and June. Moreover, the factors contributing to diagnostic errors were due to poor communication, non-adherence to guidelines and lack of systematic proofreading of X-rays. In 98% of cases, disputes were resolved by apology and explanation and three cases resulted in financial compensation. Conclusion: Poor communication, LOS and medical errors are factors contributing to PCs. Improving communication, resolving issues leading to slow health care provision, adequate staffing and supervision of trainees may reduce PCs.

  19. Advanced nursing interventions and length of stay in the emergency department.

    Science.gov (United States)

    Stauber, Mary A

    2013-05-01

    Over the past 15 years, emergency departments have become overcrowded, with prolonged wait times and an extended length of stay (LOS). These factors cause delay in treatment, which reduces quality of care and increases the potential for adverse events. One suggestion to decrease LOS in the emergency department is to implement advanced nursing interventions (ANIs) at triage. The study purpose was to determine whether there was a difference in ED LOS between patients presenting with a chief complaint of abdominal pain who received ANIs at triage and patients who did not receive ANIs at triage. A retrospective chart review was performed to determine the ED LOS (mean time in department and mean time in room [TIR]). The convenience sample included ED patients who presented to a large Midwestern academic medical center's emergency department with a chief complaint of abdominal pain and Emergency Severity Index level 3. Independent-samples t tests were used to determine whether there was any statistical difference in LOS between the two groups. Cohen's d statistic was used to determine effect size. Implementation of ANIs at triage for patients with low-acuity abdominal pain resulted in an increased time in department and a decreased TIR with a medium effect size. A reduction in TIR optimizes bed availability in the emergency department. Low-acuity patients spend less time occupying an ED bed, which preserves limited bed space for the sickest patients. Results of diagnostic tests are often available by the time the patient is placed in a room, facilitating early medical decision making and decreasing treatment time. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  20. Diagnostic findings in infants presenting to a pediatric emergency department for lethargy or feeding complaints.

    Science.gov (United States)

    Webb, Tara; Nugent, Melodee; Simpson, Pippa; Melzer-Lange, Marlene

    2014-03-01

    Lethargy is a common complaint among infants in the pediatric emergency department (ED), yet there is little data to guide appropriate evaluation. The objectives of the study were (1) to determine the frequency of diagnoses requiring intervention/monitoring and (2) to identify predictors of these diagnoses. A retrospective chart review of patients aged 0 to 6 months with a chief complaint of lethargy or poor feeding from January 2004 to December 2009 was performed. Patients were excluded if they had a fever, hypothermia, a chronic medical condition, or a history of trauma. Charts were reviewed by a single investigator; 10% were reviewed by a second investigator for agreement. History, examination, laboratory and radiology results, ED and inpatient diagnoses, as well as return visits within 7 days were recorded. Frequencies of diagnoses and interventions were described, and history and examination findings associated with these categories were determined. Two hundred seventy-two patients were included; 34 patients (12.5%; 95% confidence interval [CI], 8.8%-17%) required intervention/monitoring. These patients were classified into 6 categories. Eighteen had hematologic disorders (6.6%; 95% CI, 4.0%-10.3%), 8 had dehydration (2.9%; 95% CI, 1.3%-5.7%), 2 had intracranial bleeds (0.7%; 95% CI, 0.09%-2.6%), 3 had serious bacterial infections (1%; 95% CI, 0.2%-3.2%), 1 had a cardiac disorder (0.4%; 95% CI, 0.009%-2%), and 2 had neurologic disorders (0.7%; 95% CI, 0.9%-2.6%). Of the patients, 76% had conditions that were clinically evident (dehydration and hyperbilirubinemia requiring phototherapy). The patients with cardiac disorders, neurologic disorders, and intracranial bleeds all had abnormal examination findings in the ED. The 3 patients with serious bacterial infections were younger than 2 months of age and ill appearing; all had urinary tract infections. Infants with lethargy or poor feeding who require an intervention are likely to have conditions that are

  1. Physician’s changes in management of return visits to the Emergency Department

    Directory of Open Access Journals (Sweden)

    Adrianna Long

    2016-06-01

    Full Text Available Return visits to the Emergency Department (ED are estimated between 2-3.1%, which impacts ED care costs and wait times. Adverse events for unscheduled return visits (URVs have been reported to be as high as 30%. The objective of this study was to characterize the attitudes and management of Emergency Medicine (EM physicians regarding patients presenting with the same chief complaint to the ED for an URV. An online survey questionnaire was developed and sent to 160 accredited EM Graduate Medical Education programs in the United States. The questionnaire consisted of case vignettes wherein providers were asked to submit what orders they would place for each scenario. The mean numbers of tests and treatments were compared from initial visit to repeat visit with same chief complaint. Physicians also provided feedback regarding their management of URVs. There were estimated 6988 eligible participants with 397 responses (response rate 5.7%. There was a statistical significance (P<0.001 in provider management of URVs with pediatric fever, but there was no statistical significance for management of the other chief complaints. There were 77% of physicians that felt an increased work up is warranted for URVs. The results of this study indicate that majority of EM residents and staff working in training programs feel that they should approach the management of URV patients with a more extensive workup despite no clinical change. These findings suggest that further analysis should be performed regarding provider management of URVs and the associated healthcare costs.

  2. Pattern of presenting complaints recorded as near-drowning events in emergency departments: a national surveillance study from Pakistan.

    Science.gov (United States)

    He, Siran; Lunnen, Jeffrey C; Zia, Nukhba; Khan, Uzma; Shamim, Khusro; Hyder, Adnan A

    2015-01-01

    Drowning is a heavy burden on the health systems of many countries, including Pakistan. To date, no effective large-scale surveillance has been in place to estimate rates of drowning and near-drowning in Pakistan. The Pakistan National Emergency Department Surveillance (Pak-NEDS) study aimed to fill this gap. Patients who presented with a complaint of "near-drowning" were analyzed to explore patterns of true near-drowning (unintentional) and intentional injuries that led to the "near-drowning" complaint. Bivariate analysis was done to establish patterns among patients treated in emergency departments, including socio-demographic information, injury-related information, accompanying injuries, and emergency department resource utilization. A total of 133 patients (0.2% of all injury patients) with "near-drowning" as presenting complaints were recorded by the Pak-NEDS system. True near-drowning (50.0%) and intentional injuries that led to "near-drowning" complaints (50.0%) differed in nature of injuries. The highest proportion of true near-drowning incidents occurred among patients aged between 25-44 years (47.5%), and among males (77.5%). True near-drowning patients usually had other accompanying complaints, such as lower limb injury (40.0%). Very few patients were transported by ambulance (5.0%), and triage was done for 15% of patients. Eleven (27.5%) true near-drowning patients received cardiopulmonary resuscitation. There was major under-reporting of drowning and near-drowning cases in the surveillance study. The etiology of near-drowning cases should be further studied. Patients who experienced non-fatal drownings were more commonly sent for medical care due to other accompanying conditions, rather than near-drowning event itself. There is also need for recognizing true near-drowning incidents. The results of this study provide information on data source selection, site location, emergency care standardization, and multi-sector collaboration for future drowning

  3. 7 CFR 2.29 - Chief Economist.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Chief Economist. 2.29 Section 2.29 Agriculture Office... Economist. (a) The following delegations of authority are made by the Secretary of Agriculture to the Chief Economist: (1) Related to economic analysis. (i) Coordinate economic analyses of, and review Department...

  4. 7 CFR 2.75 - Deputy Chief Financial Officer.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Deputy Chief Financial Officer. 2.75 Section 2.75... AND GENERAL OFFICERS OF THE DEPARTMENT Delegations of Authority by the Chief Financial Officer § 2.75 Deputy Chief Financial Officer. Pursuant to § 2.28, the following delegation of authority is made by the...

  5. 25 CFR 11.1000 - Complaint.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Complaint. 11.1000 Section 11.1000 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER COURTS OF INDIAN OFFENSES AND LAW AND ORDER CODE Juvenile Offender Procedure § 11.1000 Complaint. A complaint must be filed by a law enforcement officer or...

  6. 8 CFR 1003.104 - Filing of complaints; preliminary inquiries; resolutions; referral of complaints.

    Science.gov (United States)

    2010-01-01

    ... authorities within the Department to ensure that neither the disciplinary process nor criminal prosecutions... Professional Conduct for Practitioners-Rules and Procedures § 1003.104 Filing of complaints; preliminary... Immigration Courts shall be filed with the EOIR disciplinary counsel. Disciplinary complaints must be...

  7. 78 FR 50052 - Chief of Engineers Environmental Advisory Board; Meeting

    Science.gov (United States)

    2013-08-16

    ... DEPARTMENT OF DEFENSE Department of the Army; Corps of Engineers Chief of Engineers Environmental... Environmental Advisory Board (EAB). Date: September 11, 2013. Time: 9:00 a.m. through 12:00 p.m. Location: Room... Agenda: The Board will advise the Chief of Engineers on environmental policy, identification and...

  8. 20 CFR 658.412 - Complaint resolution.

    Science.gov (United States)

    2010-04-01

    ... Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Job Service Complaint System State Agency Js Complaint System § 658.412... satisfaction with the outcome, or (2) The complainant chooses not to elevate the complaint to the next level of...

  9. 75 FR 15430 - Chief Joseph Hatchery Program

    Science.gov (United States)

    2010-03-29

    ... production program and hatchery facilities. The National Oceanic and Atmospheric Administration's National... DEPARTMENT OF ENERGY Bonneville Power Administration Chief Joseph Hatchery Program AGENCY: Bonneville Power Administration (BPA), Department of Energy (DOE). ACTION: Notice of availability of Record...

  10. 12 CFR 528.8 - Complaints.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Complaints. 528.8 Section 528.8 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY NONDISCRIMINATION REQUIREMENTS § 528.8... of Thrift Supervision, Washington, DC 20552 for processing under Office regulations. Complaints...

  11. CHIEF OF STAFF FINANCE

    African Journals Online (AJOL)

    The fifth Chief of Staff Division, namely Finance, is the end result of ... 1946 was able to report in 1948 that there had ... the same time however, the Secretary referred ... mended that because 'the existing dual arrange- ... tigate the division of functions in the Department. ... randum discussing the different arguments sur-.

  12. Longitudinal trends in the treatment of abdominal pain in an academic emergency department.

    Science.gov (United States)

    Cinar, Orhan; Jay, Loni; Fosnocht, David; Carey, Jessica; Rogers, LeGrand; Carey, Adrienne; Horne, Benjamin; Madsen, Troy

    2013-09-01

    Abdominal pain is a top chief complaint of patients presenting to Emergency Departments (ED). Historically, uncertainty surrounded correct management. Evidence has shown adequate analgesia does not obscure the diagnosis, making it the standard of care. We sought to evaluate trends in treatment of abdominal pain in an academic ED during a 10-year period. We prospectively evaluated a convenience sample of patients in an urban academic tertiary care hospital ED from September 2000 through April 2010. Adult patients presenting with a chief complaint of abdominal pain were included in this study. Analgesic administration rates and times, pain scores, and patient satisfaction at discharge were analyzed to evaluate trends by year. There were 2,646 patients presenting with abdominal pain who were enrolled during the study period. Rates of analgesic administration generally increased each year from 39.9% in 2000 to 65.5% in 2010 (p value for trend trend of increase in analgesic administration. In patients presenting to the ED with abdominal pain, analgesia administration increased and time to medication decreased during the 10-year period. Despite overall improvements in satisfaction, significant numbers of patients presenting with abdominal pain still reported moderate to severe pain at discharge. Copyright © 2013 Elsevier Inc. All rights reserved.

  13. 6 CFR 13.8 - Service of Complaint.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Service of Complaint. 13.8 Section 13.8 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.8 Service of Complaint. (a) Service of a Complaint must be Made by certified or registered mail or by...

  14. 45 CFR 98.32 - Parental complaints.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Parental complaints. 98.32 Section 98.32 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND Program Operations (Child Care Services)-Parental Rights and Responsibilities § 98.32 Parental complaints...

  15. 8 CFR 1003.9 - Office of the Chief Immigration Judge.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Office of the Chief Immigration Judge. 1003.9 Section 1003.9 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE GENERAL PROVISIONS EXECUTIVE OFFICE FOR IMMIGRATION REVIEW Office of the Chief Immigration Judge...

  16. The network organisation of consumer complaints

    Science.gov (United States)

    Rocha, L. E. C.; Holme, P.

    2010-07-01

    Interaction between consumers and companies can create conflict. When a consensus is unreachable there are legal authorities to resolve the case. This letter is a study of data from the Brazilian Department of Justice from which we build a bipartite network of categories of complaints linked to the companies receiving those complaints. We find the complaint categories organised in an hierarchical way where companies only get complaints of lower degree if they already got complaints of higher degree. The fraction of resolved complaints for a company appears to be nearly independent of the equity of the company but is positively correlated with the total number of complaints received. We construct feature vectors based on the edge-weight —the weight of an edge represents the times complaints of a category have been filed against that company— and use these vectors to study the similarity between the categories of complaints. From this analysis, we obtain trees mapping the hierarchical organisation of the complaints. We also apply principal component analysis to the set of feature vectors concluding that a reduction of the dimensionality of these from 8827 to 27 gives an optimal hierarchical representation.

  17. Pain management in the emergency department and its relationship to patient satisfaction.

    Science.gov (United States)

    Downey, La Vonne A; Zun, Leslie S

    2010-10-01

    Pain is the most common reason due to which patients come to the emergency department (ED). The purpose of this study was to measure the correlation, if any, between pain reduction and the level of satisfaction in patients who presented to the ED with pain as their chief complaint. This study used a randomly selected group of patients who presented to the ED with pain of 4 or more on the Visual Analogue Pain Scale (VAS) as their chief complaint to a level one adult and pediatric trauma center. Instruments that were used in this study were the VAS, Brief Pain Inventory (BPI), and the Medical Interview Satisfaction Scale (MISS). They were administered to patients by research fellows in the treatment rooms. Statistical analysis included frequencies, descriptive, and linear regression. This study was approved by the Internal Review Board. A total of 159 patients were enrolled in the study. All patients were given some type of treatment for their pain upon arrival to the ED. A logistic regression showed a significant relationship to reduction in pain by 40% or more and customer service questions. A reduction in perceived pain levels does directly relate to several indicators of customer service. Patients who experienced pain relief during their stay in the ED had significant increases in distress relief, rapport with their doctor, and intent to comply with given instructions.

  18. 49 CFR 1111.6 - Satisfaction of complaint.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Satisfaction of complaint. 1111.6 Section 1111.6 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION BOARD, DEPARTMENT OF TRANSPORTATION RULES OF PRACTICE COMPLAINT AND INVESTIGATION PROCEDURES § 1111.6 Satisfaction of...

  19. 22 CFR 96.70 - Operation of the Complaint Registry.

    Science.gov (United States)

    2010-04-01

    ... AND APPROVAL OF PERSONS UNDER THE INTERCOUNTRY ADOPTION ACT OF 2000 (IAA) Oversight Through Review of... resolution of complaints; (4) Generate reports designed to show possible patterns of complaints; and (5... will be accessible through the Department's website to persons who wish to file complaints. Such forms...

  20. 7 CFR 1924.259 - Handling dwelling construction complaints.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 12 2010-01-01 2010-01-01 false Handling dwelling construction complaints. 1924.259 Section 1924.259 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING... Construction Defects § 1924.259 Handling dwelling construction complaints. This section describes the procedure...

  1. Pain management in the emergency department and its relationship to patient satisfaction

    Directory of Open Access Journals (Sweden)

    Downey La Vonne

    2010-01-01

    Full Text Available Background : Pain is the most common reason due to which patients come to the emergency department (ED. Aim : The purpose of this study was to measure the correlation, if any, between pain reduction and the level of satisfaction in patients who presented to the ED with pain as their chief complaint. Materials and Methods : This study used a randomly selected group of patients who presented to the ED with pain of 4 or more on the Visual Analogue Pain Scale (VAS as their chief complaint to a level one adult and pediatric trauma center. Instruments that were used in this study were the VAS, Brief Pain Inventory (BPI, and the Medical Interview Satisfaction Scale (MISS. They were administered to patients by research fellows in the treatment rooms. Statistical analysis included frequencies, descriptive, and linear regression. This study was approved by the Internal Review Board. Results : A total of 159 patients were enrolled in the study. All patients were given some type of treatment for their pain upon arrival to the ED. A logistic regression showed a significant relationship to reduction in pain by 40% or more and customer service questions. Conclusions : A reduction in perceived pain levels does directly relate to several indicators of customer service. Patients who experienced pain relief during their stay in the ED had significant increases in distress relief, rapport with their doctor, and intent to comply with given instructions.

  2. 32 CFR 865.121 - Complaints concerning decisional documents and index entries.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Complaints concerning decisional documents and index entries. 865.121 Section 865.121 National Defense Department of Defense (Continued) DEPARTMENT OF... Board § 865.121 Complaints concerning decisional documents and index entries. Former members of the Air...

  3. 78 FR 53014 - Proposed Information Collection (Principles of Excellence Complaint Intake Questionnaire...

    Science.gov (United States)

    2013-08-27

    ... to comment on a proposed information collection titled ``Principles of Excellence Complaint Intake... leveraging the systems architecture of the Department of Defense's Complaint System. FOR FURTHER INFORMATION... DEPARTMENT OF VETERANS AFFAIRS [OMB Control No. 2900-NEW] Proposed Information Collection...

  4. 28 CFR 0.118 - Office of Chief Administrative Hearing Officer.

    Science.gov (United States)

    2010-07-01

    ... Officer. 0.118 Section 0.118 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Executive Office for Immigration Review § 0.118 Office of Chief Administrative Hearing... Law Judges in performance of their duties in accordance with 8 U.S.C. 1324 A and B. ...

  5. Managing complaints in health and social care.

    Science.gov (United States)

    Holmes-Bonney, Kathy

    2010-04-01

    An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur.

  6. [Complaint to the disciplinary board about a resident].

    Science.gov (United States)

    Linthorst, Gabor E; Lauw, Fanny N; Hanekamp, Lilian A; Hoekstra, Joost B L

    2014-01-01

    We describe the course of two complaints that were filed by patients to the Dutch Medical Disciplinary Board against two internal medicine residents. In the procedure following the complaints the supervisor and the teacher were actively involved, which resulted in one complaint being dropped. We describe the importance of adequate moral support in such cases, as the complaint may lead to loss of work satisfaction or self-esteem, especially for those in training. We make some recommendations on how the resident and the supervisor/head of the department should engage in complaints filed to the Medical Disciplinary Board. In addition, we suggest that routine 'error-meetings' may help to provide an open atmosphere where disclosure of errors and the various procedures at the hospital or disciplinary boards are promoted.

  7. 6 CFR 13.6 - Prerequisites for issuing a Complaint.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Prerequisites for issuing a Complaint. 13.6 Section 13.6 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.6 Prerequisites for issuing a Complaint. (a) The Reviewing Official may issue a...

  8. 12 CFR 1710.17 - Certification of disclosures by chief executive officer and chief financial officer.

    Science.gov (United States)

    2010-01-01

    ... officer and chief financial officer. 1710.17 Section 1710.17 Banks and Banking OFFICE OF FEDERAL HOUSING... Corporate Practices and Procedures § 1710.17 Certification of disclosures by chief executive officer and chief financial officer. The chief executive officer and the chief financial officer of an Enterprise...

  9. Management of headache disorders in the Emergency Department setting.

    Science.gov (United States)

    Pari, Elisa; Rinaldi, Fabrizio; Gipponi, Stefano; Venturelli, Elisabetta; Liberini, Paolo; Rao, Renata; Padovani, Alessandro

    2015-07-01

    Headache is a common presenting complaint in the Emergency Department. The aim of this study was to delineate the demographic profile of patients presenting a chief complaint of headache and to assess the application of diagnostic algorithms for the management of these patients. We examined patients admitted to the Spedali Civili Hospital ED between January 2005 and December 2009 who complained of headache not related to trauma and all patients hospitalized for headache in Neurological Clinic, from ED, between January 2008 and December 2009. 7495 patients were examined at ED for headaches. 72 % of patients were discharged, 22 % were admitted. From 2005 to 2009, there was a definite decrease in the rate of hospitalization due to headache (15 vs 9.9 % in Department of Neurology and 26 vs 18.9 % in all Departments). Considering the decrease year by year, this reduction was significant from 2007 to 2008, when the algorithms were adopted. The most common diagnosis in the ED was "Non-specific headache" (41 %), followed by "Primary headaches and complications of primary headaches" (20.8 %), "Secondary headaches not associated with risk of serious disease" (20.4 %) and "Secondary headache associated with risk of serious disease" (5 %). Over 2-year period (2008-2009) we found an increase in the diagnosis of "Primary headaches and complications of primary headaches" and "Secondary headaches associated with risk of serious disease" compared with a decrease of "nonspecific headache" and "secondary headaches not associated with risk of serious disease". The use of the diagnostic algorithms and collaborative network between the ED and the Headache Center can improve the management of patients with headache in ED.

  10. 77 FR 61468 - Delegation by the Chief Financial Officer to the Comptroller of Certain Authorities Under the CFO...

    Science.gov (United States)

    2012-10-09

    ... DEPARTMENT OF STATE [Delegation of Authority No. 345] Delegation by the Chief Financial Officer to... the Chief Financial Officer Act, 31 U.S.C. 901 et seq., and by the designation from the President... time. Notwithstanding this delegation of authority, the Chief Financial Officer may at any time...

  11. 29 CFR 1921.3 - Complaints.

    Science.gov (United States)

    2010-07-01

    ... Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) RULES OF PRACTICE IN ENFORCEMENT PROCEEDINGS UNDER SECTION 41 OF THE LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT Prehearing Procedures § 1921.3 Complaints. (a) Issuance. The Deputy Solicitor of Labor shall...

  12. 21 CFR 17.5 - Complaint.

    Science.gov (United States)

    2010-04-01

    ... AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL CIVIL MONEY PENALTIES... all administrative civil money penalty actions by serving on the respondent(s) a complaint signed by... Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061...

  13. 10 CFR 13.6 - Prerequisities for issuing a complaint.

    Science.gov (United States)

    2010-01-01

    ... amount of money, or the value of property or services, demanded or requested. [56 FR 47135, Sept. 18... time such claim is submitted (as defined in paragraph (b) of this section), the amount of money or the... complaint. (a) The reviewing official may issue a complaint under § 13.7 only if— (1) The Department of...

  14. 76 FR 15939 - Proposed Information Collection; Comment Request; Complaint of Discrimination Based on Sexual...

    Science.gov (United States)

    2011-03-22

    ...; Complaint of Discrimination Based on Sexual Orientation Against the U.S. Department of Commerce AGENCY... discriminatory treatment based on sexual orientation by the Department of Commerce or one of its subagencies... form the basis of the complaint. The complainant is also required to provide an address and phone...

  15. 75 FR 64714 - Meeting of the Chief of Naval Operations Executive Panel

    Science.gov (United States)

    2010-10-20

    ... recommendations of the Subcommittee on Navy's Role in Ballistic Missile Defense. The meeting will consist of discussions of Navy's role in ballistic missile defense, development of the global missile defense network and... DEPARTMENT OF DEFENSE Department of the Navy Meeting of the Chief of Naval Operations Executive...

  16. 75 FR 49357 - United States Department of Agriculture Research Misconduct Regulations for Extramural Research

    Science.gov (United States)

    2010-08-13

    ... DEPARTMENT OF AGRICULTURE Office of the Chief Financial Officer 7 CFR Part 3022 RIN 0524-AA34...: Office of the Chief Financial Officer, USDA. ACTION: Final rule. SUMMARY: The Office of the Chief.... Holladay, Acting Chief Financial Officer. Thomas J. Vilsack, Secretary, U.S. Department of Agriculture. [FR...

  17. 48 CFR 422.1406 - Complaint procedures.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Complaint procedures. 422.1406 Section 422.1406 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Employment of Workers With Disabilities 422...

  18. 32 CFR 806b.4 - Privacy Act complaints.

    Science.gov (United States)

    2010-07-01

    ... be identified, the local Privacy Act officer will assume these duties. Issues that cannot be resolved... 32 National Defense 6 2010-07-01 2010-07-01 false Privacy Act complaints. 806b.4 Section 806b.4 National Defense Department of Defense (Continued) DEPARTMENT OF THE AIR FORCE ADMINISTRATION PRIVACY ACT...

  19. 75 FR 69432 - Ross Bachofer v. Calpine Corporation; Notice of Complaint

    Science.gov (United States)

    2010-11-12

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-3-000] Ross Bachofer v. Calpine Corporation; Notice of Complaint November 4, 2010. Take notice that on October 26, 2010, pursuant... Federal Power Act, 16 U.S.C. 2824c, Ross Bachofer (Complainant) filed a complaint against Calpine...

  20. 28 CFR 42.606 - General rules concerning EEOC action on complaints.

    Science.gov (United States)

    2010-07-01

    ... title VII and the Equal Pay Act, the date such a complaint was received by an agency shall be deemed the... 28 Judicial Administration 1 2010-07-01 2010-07-01 false General rules concerning EEOC action on complaints. 42.606 Section 42.606 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL...

  1. 34 CFR 299.10 - What complaint procedures shall an SEA adopt?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What complaint procedures shall an SEA adopt? 299.10 Section 299.10 Education Regulations of the Offices of the Department of Education OFFICE OF ELEMENTARY... complaint procedures shall an SEA adopt? (a) General. An SEA shall adopt written procedures, consistent with...

  2. iComplaints

    Data.gov (United States)

    US Agency for International Development — iComplaints is a web-based Equal Employment Opportunity (EEO) complaint tracking and reporting system. The Office of Equal Opportunity Programs uses iComplaints to...

  3. Lieutenant Chief Warden Districts

    Data.gov (United States)

    Vermont Center for Geographic Information — This dataset is a representation overlay of Lieutenant Chief Warden Districts (areas of responsibility). The Vermont Lieutenant Chief Warden Districts layer is part...

  4. 14 CFR 385.18 - Authority of the Chief, Coordination Section, Documentary Services Division.

    Science.gov (United States)

    2010-01-01

    ... SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ORGANIZATION STAFF ASSIGNMENTS AND REVIEW OF ACTION UNDER ASSIGNMENTS Assignment of Functions to Staff Members § 385.18 Authority of the Chief...

  5. First dental visit of a child

    Directory of Open Access Journals (Sweden)

    Meera R

    2008-10-01

    Full Text Available Objectives: The aim of the study was to assess the common chief complaints of the Indian children and the average age group at which they report for in their first dental visit. Materials and Methods: A retrospective study was carried out using the case records of 716 children who reported to the postgraduate section of Department of Pediatric dentistry, Meenakshi Ammal Dental College, Chennai, in 2007. The age groups of the children were divided into three categories 0-3 years, 3-6 years and 6-12 years. The various chief complaints were categorised as follows, Orientation to prevention, Routine visit, Deposits / Discoloration, Habits, Unerupted / Missing or Extra Tooth, Pain, Dental caries, Malocclusion, Trauma, others. The average age group and most common complaint at the first dental visit was assessed. A prospective study was done in January 2008, were 215 children were screened. The assessment was made as explained above. Results: Retrospective study Maximum number of children who reported for their first dental visit was between 6-12 years (59.08%. Most common chief complaint for the visit was pain (42.04%. Second common complaint being dental caries (28.49%. Prospective study Maximum number of children who reported for their first dental visit was between 6-12 years (69.77%. Most common chief complaint was dental caries (34.88%. Second common complaint being pain (27.91%. Conclusion: Children report for the first dental visit most commonly only after 6 years and for complaints like pain and dental caries. Orientation to prevention is not considered and preventive dentistry is yet to reach the common population in India.

  6. 46 CFR 15.820 - Chief engineer.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Chief engineer. 15.820 Section 15.820 Shipping COAST... Computations § 15.820 Chief engineer. (a) There must be an individual holding an MMC or license endorsed as chief engineer or other credential authorizing service as chief engineer employed on board the following...

  7. 7 CFR 2.28 - Chief Financial Officer.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 1 2010-01-01 2010-01-01 false Chief Financial Officer. 2.28 Section 2.28 Agriculture....28 Chief Financial Officer. (a) The Chief Financial Officer, under the supervision of the Secretary, is responsible for executing the duties enumerated for agency Chief Financial Officers in the Chief...

  8. Operational circular No. 9 – Principles and procedures governing complaints of harassment

    CERN Multimedia

    HR Department

    2011-01-01

    Operational Circular No. 9 entitled "Principles and Procedures Governing Complaints of Harassment", approved by the Director-General following discussion in the Standing Concertation Committee meeting on 21 March 2011, is available on the intranet site of the Human Resources Department: https://cern.ch/hr-docs/opcirc/opcirc.asp Operational Circular No. 9 is applicable to any person working at or on behalf of CERN. It cancels and replaces Administrative Circular No. 32 entitled "Principles and Procedures Governing Complaints of Harassment” of February 2000. Department Head Office

  9. Physician's first clinical impression of emergency department patients with nonspecific complaints is associated with morbidity and mortality.

    Science.gov (United States)

    Beglinger, Bettina; Rohacek, Martin; Ackermann, Selina; Hertwig, Ralph; Karakoumis-Ilsemann, Julia; Boutellier, Susanne; Geigy, Nicolas; Nickel, Christian; Bingisser, Roland

    2015-02-01

    The association between the physician's first clinical impression of a patient with nonspecific complaints and morbidity and mortality is unknown. The aim was to evaluate the association of the physician's first clinical impression with acute morbidity and mortality. We conducted a prospective observational study with a 30-day follow-up. This study was performed at the emergency departments (EDs) of 1 secondary and 1 tertiary care hospital, from May 2007 to February 2011. The first clinical impression ("looking ill"), expressed on a numerical rating scale from 0 to 100, age, sex, and the Charlson Comorbidity Index (CCI) were evaluated. The association was determined between these variables and acute morbidity and mortality, together with receiver operating characteristics, and validity. Of 217,699 presentations to the ED, a total of 1278 adult nontrauma patients with nonspecific complaints were enrolled by a study team. No patient was lost to follow-up. A total of 84 (6.6%) patients died during follow-up, and 742 (58.0%) patients were classified as suffering from acute morbidity. The variable "looking ill" was significantly associated with mortality and morbidity (per 10 point increase, odds ratio 1.23, 95% confidence interval [CI] 1.12-1.34, P first impression, with or without additional variables such as age, male sex, and CCI, was associated with morbidity and mortality. This might help in the decision to perform further diagnostic tests and to hospitalize ED patients.

  10. Current perspectives on chief residents in psychiatry.

    Science.gov (United States)

    Warner, Christopher H; Rachal, James; Breitbach, Jill; Higgins, Michael; Warner, Carolynn; Bobo, William

    2007-01-01

    The authors examine qualitative data from outgoing chief residents in psychiatry from the 2004-2005 academic year to 1) determine common characteristics between programs, 2) examine the residents' perspectives on their experiences, and 3) determine their common leadership qualities. The authors sent out self-report surveys via e-mail to 89 outgoing chief residents who attended the APA/Lilly Chief Resident Executive Leadership Program. Fifty-three (60%) chief residents responded. Although most chief residents are senior residents, over 20% are in their third postgraduate year. Two-thirds of programs have more than one chief resident each year. Most chief residents believe that their "participating" leadership style, existing leadership skills, and interpersonal skills contributed to their overall positive experiences. Successfully performing duties as a chief resident entails functioning in a variety of roles and demands attention to leadership qualities of the individual. Developing existing leadership skills, clarifying expectations, and providing mentorship to chief residents will ensure successful transition into practice, and the advancement of the field of psychiatry.

  11. 6 CFR 13.11 - Referral of Complaint and answer to the ALJ.

    Science.gov (United States)

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Referral of Complaint and answer to the ALJ. 13.11 Section 13.11 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY PROGRAM FRAUD CIVIL REMEDIES § 13.11 Referral of Complaint and answer to the ALJ. Upon receipt of an answer, the...

  12. 33 CFR 211.13 - Approval of the Office of the Chief of Engineers.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Approval of the Office of the Chief of Engineers. 211.13 Section 211.13 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Disposal of Real Estate...

  13. Red flag in the emergency department: fracture and primary failure of a prosthetic valve.

    Science.gov (United States)

    Ozsarac, Murat; Karcioglu, Ozgur; Ayrik, Cuneyt; Bozkurt, Seyran; Turkcuer, Ibrahim; Gumrukcu, Serhat

    2005-07-01

    This case report concerns a patient with fracture and primary dysfunction of a prosthetic valve. A 40-year-old man presented to the Emergency Department with a chief complaint of breakthrough pleuritic back pain and shortness of breath. Past surgical history was significant only for an aortic valve replacement and mitral valve replacement performed 16 years prior. The transthoracic echocardiography raised suspicion of prosthesis malposition. The patient was taken to the operating room by cardiothoracic surgeons for valve replacement. Operative findings revealed that a prosthetic valve leaflet in the mitral position had broken off. Primary prosthetic valve failure should not be overlooked in the differential diagnosis of patients with valve replacement and a rapidly deteriorating clinical course. Emergency echocardiography is a guide to convenient diagnosis and management. Early surgical consultation and early reparative surgery might prevent unnecessary morbidity and mortality.

  14. 20 CFR 658.401 - Types of complaints handled by the JS complaint system.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Types of complaints handled by the JS... § 658.401 Types of complaints handled by the JS complaint system. (a)(1) The types of complaints (JS related complaints) which shall be handled to resolution by the JS complaint system are as follows: (i...

  15. 77 FR 63308 - J. William Foley Incorporated v. United Illuminating Company; Notice of Complaint

    Science.gov (United States)

    2012-10-16

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL12-106-000] J. William Foley Incorporated v. United Illuminating Company; Notice of Complaint Take notice that on October 5...) and 825(e), J. William Foley Incorporated (Complainant) filed a formal complaint against United...

  16. Patients’ experience on complaint handling; a comparison between Complaint Committees and Disciplinary Boards.

    NARCIS (Netherlands)

    Kruikemeier, S.; Coppen, R.; Friele, R.D.

    2009-01-01

    Background: Handling patient complaints about health care issues is important. However, many patients who lodge a complaint are dissatisfied with the way their complaints are dealt with. In the Netherlands, there are two institutions to lodge a complaint: the Complaints Committee and the

  17. About the Joint Chiefs of Staff

    Science.gov (United States)

    Skip to main content (Press Enter). Toggle navigation Joint Chiefs of Staff Joint Chiefs of Staff Joint Chiefs of Staff Facebook Twitter YouTube Flickr Blog Instagram Search JCS: Search Search Search JCS: Search Home Media News Photos Videos Publications About The Joint Staff Chairman Vice Chairman

  18. 7 CFR 1700.27 - Chief of Staff.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Chief of Staff. 1700.27 Section 1700.27 Agriculture... GENERAL INFORMATION Agency Organization and Functions § 1700.27 Chief of Staff. The Chief of Staff aids and assists the Administrator and the Deputy Administrator. The Chief of Staff advises the...

  19. Going Beyond the Norm: The Case for Incorporating Evaluative Mediation into Department of Defense Employment Discrimination Complaints

    Science.gov (United States)

    2017-03-01

    System: Investigation of Equal Employment Opportunity Complaints (2015). 10 Protected information can include social security numbers, date of birth...complaint based on illegal discrimination with the Equal Opportunity Office. Evaluative mediation involves having a mediator with expertise in labor and...employment law evaluate the complaint’s strengths and weaknesses and help the parties reach resolution based on this evaluation. The Equal Employment

  20. 43 CFR 422.6 - Responsibilities of the Chief Law Enforcement Officer.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Responsibilities of the Chief Law Enforcement Officer. 422.6 Section 422.6 Public Lands: Interior Regulations Relating to Public Lands BUREAU OF RECLAMATION, DEPARTMENT OF THE INTERIOR LAW ENFORCEMENT AUTHORITY AT BUREAU OF RECLAMATION PROJECTS Responsibilities § 422.6 Responsibilities of...

  1. Transformational Leadership: The Chief Nursing Officer Role in Leading Quality and Patient Safety.

    Science.gov (United States)

    Jones, Pam; Polancich, Shea; Steaban, Robin; Feistritzer, Nancye; Poe, Terri

    This department column highlights leadership perspectives of quality and patient safety practice. The purpose of this article is to provide strategic direction for transformational quality and safety leadership as the chief nursing officer (CNO) within the academic medical center environment.

  2. 77 FR 24192 - SIG Energy, LLLP v. California Independent System Operator Corporation; Notice of Complaint

    Science.gov (United States)

    2012-04-23

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL12-55-000] SIG Energy, LLLP v. California Independent System Operator Corporation; Notice of Complaint Take notice that on.... 824(e) and 825(e), SIG Energy, LLLP (Complainant) filed a formal complaint against the California...

  3. Characterizing functional complaints in patients seeking outpatient low-vision services in the United States.

    Science.gov (United States)

    Brown, Jamie C; Goldstein, Judith E; Chan, Tiffany L; Massof, Robert; Ramulu, Pradeep

    2014-08-01

    To characterize functional complaints of new low-vision rehabilitation patients. Prospective observational study. The Low Vision Rehabilitation Outcomes Study recruited 819 patients between 2008 and 2011 from 28 clinical centers in the United States. New patients referred for low-vision rehabilitation were asked, "What are your chief complaints about your vision?" before their appointment. Full patient statements were transcribed as free text. Two methods assessed whether statements indicated difficulty in each of 13 functional categories: (1) assessment by 2 masked clinicians reading the statement, and (2) a computerized search of the text for specific words or word fragments. Logistic regression models were used to predict the influence of age, gender, and visual acuity on the likelihood of reporting a complaint in each functional category. Prevalence and risk factors for patient concerns within various functional categories. Reading was the most common functional complaint (66.4% of patients). Other functional difficulties expressed by at least 10% of patients included driving (27.8%), using visual assistive equipment (17.5%), mobility (16.3%), performing in-home activities (15.1%), lighting and glare (11.7%), and facial recognition and social interactions (10.3%). Good agreement was noted between the masked clinician graders and the computerized algorithm for categorization of functional complaints (median κ of 0.84 across the 13 categories). Multivariate logistic regression models demonstrated that the likelihood of reading difficulties increased mildly with age (odds ratio, 1.4 per 10-year increment in age; 95% confidence interval, 1.3-1.6), but did not differ with visual acuity (P = 0.09). Additionally, men were more likely to report driving difficulties and difficulties related to lighting, whereas women were more likely to report difficulty with either in-home activities or facial recognition or social interaction (Pvision therapy. Copyright © 2014

  4. The identification, management, and prevention of conflict with faculty and fellows: A practical ethical guide for department chairs and division chiefs.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2007-12-01

    The relationship between chairs and divisions chiefs with faculty colleagues in departments of obstetrics and gynecology has important but heretofore unexplored ethical dimensions. Based on the ethical concept of fiduciary responsibility and contractual obligations, this paper provides ethically justified practical guidance for academic physician leaders in the identification, management, and prevention of conflicts in their relationships with faculty colleagues. The framework is developed in contrast with the fiduciary-contractual dimensions of the physician-patient relationship and is articulated in terms of the ethical principles of beneficence, respect for autonomy, and justice. The distinctive nature of the academic physician leader-colleague relationship is that beneficence-based obligations and justice-based obligations to colleagues can often justifiably override autonomy-based obligations to colleagues, about which it is crucial for academic leaders to be transparent in making and implementing leadership decisions.

  5. Restricting youth suicide: behavioral health patients in an urban pediatric emergency department.

    Science.gov (United States)

    Rogers, Steven C; DiVietro, Susan; Borrup, Kevin; Brinkley, Ashika; Kaminer, Yifrah; Lapidus, Garry

    2014-09-01

    Suicide is the third leading cause of death among individuals age 10 years to 19 years in the United States. Adolescents with suicidal behaviors are often cared for in emergency departments (EDs)/trauma centers and are at an increased risk for subsequent suicide. Many institutions do not have standard procedures to prevent future self-harm. Lethal means restriction (LMR) counseling is an evidence-based suicide prevention strategy that informs families to restrict access to potentially fatal items and has demonstrated efficacy in preventing suicide. The objectives of this study were to examine suicidal behavior among behavioral health patients in a pediatric ED and to assess the use of LMR by hospital staff. A sample of 298 pediatric patients was randomly selected from the population of behavioral health patients treated at the ED from January 1 through December 31, 2012 (n = 2,294). Descriptive data include demographics (age, sex, race/ethnicity, etc,), chief complaint, current and past psychiatric history, primary diagnosis, disposition, alcohol/drug abuse, and documentation of any LMR counseling provided in the ED. Of the 298 patients, 52% were female, 47% were white, and 76% were in the custody of their parents. Behavior/out of control was the most common chief complaint (43%). The most common diagnoses were mood disorder (25%) and depression (20%). Thirty-four percent of the patients had suicidal ideation, 22% had a suicide plan, 32% had documented suicidal behavior, and 25% of the patients reported having access to lethal means. However, only 4% of the total patient population received any LMR counseling, and only 15% of those with access to lethal means had received LMR counseling. Providing a safe environment for adolescents at risk for suicidal behaviors should be a priority for all families/caretakers and should be encouraged by health care providers. The ED is a key point of entry into services for suicidal youth and presents an opportunity to implement

  6. Emergency Department Visits at the End of Life of Patients With Terminal Cancer: Pattern, Causes, and Avoidability.

    Science.gov (United States)

    Alsirafy, Samy A; Raheem, Ahmad A; Al-Zahrani, Abdullah S; Mohammed, Amrallah A; Sherisher, Mohamed A; El-Kashif, Amr T; Ghanem, Hafez M

    2016-08-01

    Frequent emergency department visits (EDVs) by patients with terminal cancer indicates aggressive care. The pattern and causes of EDVs in 154 patients with terminal cancer were investigated. The EDVs that started during working hours and ended by home discharge were considered avoidable. During the last 3 months of life, 77% of patients had at least 1 EDV. In total, 309 EDVs were analyzed. The EDVs occurred out of hour in 67%, extended for an average of 3.6 hours, and ended by hospitalization in 52%. The most common chief complaints were pain (46%), dyspnea (13%), and vomiting (12%). The EDVs were considered avoidable in 19% of the visits. The majority of patients with terminal cancer visit the ED before death, mainly because of uncontrolled symptoms. A significant proportion of EDVs at the end of life is potentially avoidable. © The Author(s) 2015.

  7. Infectious Gastroenteritis and the Need for Strict Contact Precaution Procedures in Adults Presenting in the Emergency Department

    DEFF Research Database (Denmark)

    Skyum, Florence; Andersen, Vibeke; Chen, Ming

    2018-01-01

    BACKGROUND: Acute infectious gastroenteritis requires contact precautions to prevent spreading. On acute admission the cause of diarrhoea is unknown, so the decision of whom to isolate has to be made on clinical information with a risk of inexpedient use of contact precautions. AIM: The aims...... of the study were to investigate how often gastroenteritis occurs, and thus the isolation indication has to be assessed, in Danish emergency departments, and how often patients have to remain on contact precaution according to the results of the faecal samples. METHODS: This Danish register based retrospective......: Among 66,885 acute admissions 4.3% patients had at least one feature of gastroenteritis: admission with a chief complaint of diarrhoea (1.6%); faecal sample microbiology examination (2.8%); discharged with a gastroenteritis diagnosis (1.7%). 19% of those who had a faecal sample tested were norovirus...

  8. 46 CFR 11.553 - Chief Engineer (OSV).

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Chief Engineer (OSV). 11.553 Section 11.553 Shipping... OFFICER ENDORSEMENTS Professional Requirements for Engineer Officer § 11.553 Chief Engineer (OSV). (a) Except as provided by paragraph (b) of this section, to qualify for an endorsement as Chief engineer (OSV...

  9. Does the use of bedside pelvic ultrasound decrease length of stay in the emergency department?

    Science.gov (United States)

    Thamburaj, Ravi; Sivitz, Adam

    2013-01-01

    Diagnostic ultrasounds by emergency medicine (EM) and pediatric emergency medicine (PEM) physicians have increased because of ultrasonography training during residency and fellowship. The availability of ultrasound in radiology departments is limited or difficult to obtain especially during nighttime hours. Studies have shown that EM physicians can accurately perform goal-directed ultrasound after appropriate training. The goal of this study was to compare the length of stay for patients receiving an ultrasound to confirm intrauterine pregnancies. The hypothesis of this study is that a bedside ultrasound by a trained EM/PEM physician can reduce length of stay in the emergency department (ED) by 1 hour. This was a case cohort retrospective review for patients aged 13 to 21 years who received pelvic ultrasounds in the ED during 2007. Each patient was placed into 1 of 2 groups. Group 1 received bedside ultrasounds done by institutionally credentialed EM/PEM attending physicians. Group 2 received radiology department ultrasound only. Each group had subanalysis done including chief complaint, time of presentation, time to completion of ultrasound, length of stay, diagnosis, and disposition. Daytime was defined as presentation between 7 AM and 9 PM when radiology ultrasound technologists were routinely available. We studied 330 patients, with 244 patients (74%) in the bedside ultrasound group. The demographics of both groups showed no difference in age, presenting complaints, discharge diagnoses, and ultimate disposition. Group 1 had a significant reduction (P ultrasound compared with group 2 (mean, 82 minutes [range, 1-901 minutes] vs 149 minutes [range, 7-506 minutes]) and length of stay (142 [16-2268] vs. 230 [16-844]). Of those presenting during the day (66%), group 1 showed a significant reduction in length of stay (P ultrasound by trained EM/PEM physicians produced a significant reduction in length of stay in the ED, regardless of radiology ultrasound technologist

  10. Technical structure of Complaint Poetry Until 3 A.H

    Directory of Open Access Journals (Sweden)

    2010-12-01

    Full Text Available Technical structure of Complaint Poetry Until 3 A.H       * Gholam Abbas Rezai   * * Sherafat Karimi     Abstract   Complaint refers to the poetic works in which the poet talks about the Vehemence of his/her painful feeling. It is the description of pains, personal and social problems and in a way is confiding whatever has annoyed his/her soul and body. Complaint can be categorized into social and personal ones. The personal complaints composed at the time of Islam were generally complaining about the Time, death, aging and separation from the beloved. This was due to the poets' shallow viewpoint on life and their nihilistic inclinations. These subjects were still present in first three centuries and were added by new subjects such as complaining about sensual desires.   The general characteristic, style, structure and elements of meaning were simplicity in word and meaning , sincere and ample feeling, using many words with denotative meanings, utilizing maxims, proverbs and wise sayings, rhetorical statements, rich cadence (musical tones, as well as uniformity and simple imagination. Complaint is an independent poetic technique which as a result of the close relation to other sorts of poetic subjects is threaded through various sorts of elegy and sometimes is composed as an independent elegy.     Key words : Complaint Poetry Structure Style Poetic Subject       * Associate Professor, Department of Arabic Language and Literature, university of Tehran . E-mail: GHREZAEE@UT.AC.IR .   ** PhD .candidate university of Tehran .E-mail: KARIMI.SHARAFAT@yahoo.com

  11. 31 CFR 223.19 - Informal hearing on agency complaints.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Informal hearing on agency complaints. 223.19 Section 223.19 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE SURETY COMPANIES DOING BUSINESS...

  12. 6 CFR 7.10 - Authority of the Chief Security Officer, Office of Security.

    Science.gov (United States)

    2010-01-01

    ...) Direct and administer DHS implementation and compliance with the National Industrial Security Program in... 6 Domestic Security 1 2010-01-01 2010-01-01 false Authority of the Chief Security Officer, Office of Security. 7.10 Section 7.10 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE...

  13. Casuística de pacientes com queixa principal de alta estatura atendidos em serviço de referência em Salvador, Bahia Analysis of patients with chief complaint of tall stature seen at a referral hospital in Salvador, Bahia, Brazil

    Directory of Open Access Journals (Sweden)

    Crésio Alves

    2008-12-01

    Full Text Available OBJETIVO: Descrever uma casuística de pacientes atendidos em serviço de referência em endocrinologia pediátrica com queixa principal de alta estatura. MÉTODOS: Revisão de prontuários de 1.980 pacientes atendidos no período de janeiro de 2003 a janeiro de 2007, incluindo apenas os indivíduos cuja queixa principal, na primeira consulta, fosse sua alta estatura. RESULTADOS: Foram encontrados 16 pacientes (0,8% do total de primeiras consultas. Destes, 12 preenchiam critérios diagnósticos de alta estatura (escore Z do indicador estatura para idade-ZE/I>2. Sete (58% eram do sexo masculino. A idade em primeira consulta variou entre 3 anos e 4 meses e 13 anos e 3 meses. O ZE/I variou de 2,18 a 5,99 e a altura-alvo, de -1,10 a 1,24. Em relação às causas da alta estatura, concluiu-se que: sete pacientes (58% tinham alta estatura familiar; dois (17% idiopática e três (25% sofriam de causas patológicas (síndrome de Marfan em um e adenoma hipofisário em dois deles. Nos quatro demais, o ZE/I variou de 1,86 a 1,98, não preenchendo critérios para alta estatura. Nestes, a etiologia do crescimento excessivo foi idiopática em dois, familiar em um e causado pela síndrome de Weaver em outro. CONCLUSÕES: A distribuição das etiologias de pacientes avaliados com a queixa de alta estatura está de acordo com a literatura, que relata ser familiar a principal causa. Embora alta estatura seja uma queixa principal pouco freqüente no consultório de endocrinologia pediátrica, a investigação deve ser cuidadosa a fim de se afastarem causas patológicas, que constituíram 25% dos casos.OBJECTIVE: To describe patients followed at a referral service in pediatric endocrinology with the chief complaint of tall stature. METHODS: Chart review of 1,980 patients evaluated from January 2003 to January 2007, being selected only individuals whose main complaint in the first consultation was tall stature. RESULTS: 16 patients were selected (0.8% and 12 of them

  14. Chief Financial Officer FY 1997 status report and five-year plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    The Chief Financial Officers Act of 1990 (CFO Act) establishes the legal framework for improved Federal financial management. The Act requires the agency CFO to prepare, and annually revise, a plan to implement the Office of Management and Budget (OMB) Federal Financial Management Status Report and Five-Year Plan. This is the sixth Status Report and Five-Year Plan submission to OMB by the Department of Energy (DOE). Financial management at the Department operates in an environment of Government-wide efforts to improve financial management and implements legislation and administrative provisions which stress the need for change. This report sets forth the Department`s plans for financial management improvements in the coming years. It also highlights several new initiatives completed or currently underway that will significantly improve the overall effectiveness of financial management at the Department of Energy.

  15. A good complaints system

    African Journals Online (AJOL)

    system for handling complaints. While complaints often provide invaluable feedback on an individual's performance, they also offer dissatisfied patients an opportunity to air their views. Even if a complaint .... Communications Manager, Medical. Protection Society, Victoria House,. 2 Victoria Place, Leeds, UK. Pieter Carstens.

  16. 78 FR 1851 - New England States Committee on Electricity v. ISO New England Inc.; Notice of Complaint

    Science.gov (United States)

    2013-01-09

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-34-000] New England States Committee on Electricity v. ISO New England Inc.; Notice of Complaint Take notice that on December... (Complainant) filed a formal complaint against ISO New England Inc. (Respondent) alleging that the Respondent's...

  17. 18 December 2013 - P. Kron Chairman and Chief Executive Officer of ALSTOM signing the Guest Book with the Director-General R. Heuer and visiting the LHC tunnel at Point 1 with Technology Department Head F. Bordry. Accompanied by P. Fassnacht throughout.

    CERN Multimedia

    Jean-Claude Gadmer

    2013-01-01

    18 December 2013 - P. Kron Chairman and Chief Executive Officer of ALSTOM signing the Guest Book with the Director-General R. Heuer and visiting the LHC tunnel at Point 1 with Technology Department Head F. Bordry. Accompanied by P. Fassnacht throughout.

  18. A procedure for the assessment of low frequency noise complaints.

    Science.gov (United States)

    Moorhouse, Andy T; Waddington, David C; Adams, Mags D

    2009-09-01

    The development and application of a procedure for the assessment of low frequency noise (LFN) complaints are described. The development of the assessment method included laboratory tests addressing low frequency hearing threshold and the effect on acceptability of fluctuation, and field measurements complemented with interview-based questionnaires. Environmental health departments then conducted a series of six trials with genuine "live" LFN complaints to test the workability and usefulness of the procedure. The procedure includes guidance notes and a pro-forma report with step-by-step instructions. It does not provide a prescriptive indicator of nuisance but rather gives a systematic procedure to help environmental health practitioners to form their own opinion. Examples of field measurements and application of the procedure are presented. The procedure and examples are likely to be of particular interest to environmental health practitioners involved in the assessment of LFN complaints.

  19. Improving the Timeliness of Equal Employment Opportunity Complaint Processing in Department of Defense

    Science.gov (United States)

    2015-01-01

    1964 (Title VII) and the Pregnancy Discrimination Act amendment to Title VII, the Equal Pay Act of 1963, the Age Discrimi- nation in Employment Act of...Act of 1964 (Title VII) and the Pregnancy Discrimination Act amendment to Title VII, the Equal Pay Act of 1963, the Age Discrimination in...EEO programs uti - lize training on the EEO complaint process and framing of claims and that they use more-structured investigation requests

  20. Complaints against an EMS system.

    Science.gov (United States)

    Colwell, Christopher B; Pons, Peter T; Pi, Randy

    2003-11-01

    Complaints against Emergency Medical Services (EMS) agencies represent a concerning and potentially time-consuming problem for all involved in the delivery of prehospital emergency medical care. The objective of this study was to identify the source of complaints against an EMS system to help focus quality and performance improvement and customer service efforts. We conducted a retrospective review of complaints filed against a busy urban EMS agency over a 6-year period. All complaints were included, totaled by season and by year, and categorized by originator and nature of the complaint. A total of 286 complaints were registered during the 6-year period, with an average of 48 per year and 9.3 per 10,000 responses. The most common originators of complaints were patients (53%) followed by medical personnel (19%) and family members or friends (12%). Rude behavior accounted for 23% of the complaints registered, followed by technical skills (20%), transport problems (18%), and loss of belongings (13%). The identification of areas of dissatisfaction will allow focused quality and performance improvement programs directed at customer service and risk management.

  1. Test of variables of attention (TOVA as a predictor of early attention complaints, an antecedent to dementia

    Directory of Open Access Journals (Sweden)

    Eric R Braverman

    2010-10-01

    Full Text Available Eric R Braverman1,5, Amanda Lih-Chuan Chen2, Thomas JH Chen3, John D Schoolfield4, Alison Notaro5, Dasha Braverman5, Mallory Kerner5, Seth H Blum6 , Vanessa Arcuri5, Michael Varshavskiy5, Uma Damle5 , B William Downs7, Roger L Waite7, Marlene Oscar-Berman8, John Giordano9 , Kenneth Blum5,6,7,101Division of Neurological Surgery, Weill Cornell College of Medicine, New York, NY, USA; 2Department of Engineering and Management of Advanced Technology, 3Department of Occupational Safety and Health, Chang Jung Christian University, Tainan, Taiwan Republic of China; 4Department of Periodontics, University of Texas, Health Science Center, San Antonio, TX, USA; 5PATH Research Foundation, New York, NY, USA; 6Department of Nutritional Genomics, Synaptamine, Inc., San Antonio, TX, USA; 7Department of Personalized Medicine, LifeGen, Inc., La Jolla, CA, USA; 8Boston University School of Medicine, Boston VA, Boston, MA, USA; 9Department of Holistic Medicine, G & G Holistic Addiction Treatment Center, North Miami Beach, FL, USA; 10Department of Physiology and Pharmacology, University of Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USAAbstract: The goal of this study was to determine if impairments detected by the test of variables of attention (TOVA may be used to predict early attention complaints and memory impairments accurately in a clinical setting. We performed a statistical analysis of outcomes in a patient population screened for attention deficit hyperactivity disorder or attention complaints, processing errors as measured by TOVA and the Wechsler Memory Scale (WMS-III results. Attention deficit disorder (ADD checklists, constructed using the Diagnostic and Statistical Manual of Mental Disorders 4th Edition criteria, which were completed by patients at PATH Medical, revealed that 72.8% of the patients had more than one attention complaint out of a total of 16 complaints, and 41.5% had more than five complaints. For the 128

  2. Official Website of the Joint Chiefs of Staff

    Science.gov (United States)

    Skip to main content (Press Enter). Toggle navigation Joint Chiefs of Staff Joint Chiefs of Staff Joint Chiefs of Staff Facebook Twitter YouTube Flickr Blog Instagram Search JCS: Search Search Search JCS: Search Home Media News Photos Videos Publications About The Joint Staff Chairman Vice Chairman

  3. Dental visits to a North Carolina emergency department: a painful problem.

    Science.gov (United States)

    Hocker, Michael B; Villani, John J; Borawski, Joseph B; Evans, Christopher S; Nelson, Scott M; Gerardo, Charles J; Limkakeng, Alex T

    2012-01-01

    Emergency departments (EDs) act as the safety net and alternative care site for patients without insurance who have dental pain. We conducted a retrospective chart review of visits to an urban teaching hospital ED over a 12-month period, looking at patients who presented with a chief complaint or ICD code indicating dental pain, toothache, or dental abscess. The number of visits to this ED by patients with a dental complaint was 1,013, representing approximately 1.3% of all visits to this ED. Dental patients had a mean age of 32 (+/- 13) years, and 60% of all dental visits were made by African Americans. Dental patients were more likely to be self-pay than all other ED patients (61% versus 22%, P dental ED visits (97%), the patient was treated and discharged; at most visits (90%) no dental procedure was performed. ED treatment typically consisted of pain control and antibiotics; at 81% of visits, the patient received an opiate prescription on discharge, and at 69% of visits, the patient received an antibiotic prescription on discharge. This retrospective chart review covered a limited period of time, included only patients at a large urban academic medical center, and did not incorporate follow-up analysis. Although they make up a small percentage of all ED visits, dental ED visits are more common among the uninsured, seldom result in definitive care or hospital admission, and often result in prescription of an opioid or antibiotic. These findings are cause for concern and have implications for public policy.

  4. 29 CFR 1977.9 - Complaints under or related to the Act.

    Science.gov (United States)

    2010-07-01

    ..., DEPARTMENT OF LABOR (CONTINUED) DISCRIMINATION AGAINST EMPLOYEES EXERCISING RIGHTS UNDER THE WILLIAMS-STEIGER.... (a) Discharge of, or discrimination against, an employee because the employee has filed “any... workplace, as distinguished from complaints touching only upon general public safety and health. (c) Further...

  5. 78 FR 46938 - St. Paul Park Refining Co. LLC v. Enbridge Pipelines (North Dakota) LLC; Notice of Complaint

    Science.gov (United States)

    2013-08-02

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. OR13-28-000] St. Paul Park..., 2013, St. Paul Park Refining Co. LLC (Complainant) filed a formal complaint against Enbridge Pipelines... regulatory basis. St. Paul Park Refining Co. LLC certifies that copies of the complaint were served on the...

  6. Chief, National Guard Bureau - Leadership - The National Guard

    Science.gov (United States)

    the ARNG Deputy Director of the ARNG Chief of Staff of the ARNG Command Chief Warrant Officer of the the ANG Chief of Staff of the ARNG CCW Officer of the ARNG CSM of the ARNG Bottom Links National Guard Civic Leader's Guide ARNG Vision 2020 Posture Statement Strategic Direction CNGB ARNG Financial Report

  7. 46 CFR 2.20-40 - Chief engineer's reports.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Chief engineer's reports. 2.20-40 Section 2.20-40... INSPECTIONS Reports and Forms § 2.20-40 Chief engineer's reports. (a) Repairs to boilers and pressure vessels. The chief engineer is required to report any repairs to boilers or unfired pressure vessels in...

  8. 20 CFR 655.806 - Who may file a complaint and how is it processed?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Who may file a complaint and how is it processed? 655.806 Section 655.806 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF... local telephone directories, and on the Department's informational site on the Internet at http://www...

  9. 29 CFR 793.9 - “Chief engineer.”

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false âChief engineer.â 793.9 Section 793.9 Labor Regulations... Exemption § 793.9 “Chief engineer.” A chief engineer is an employee who primarily supervises the operation... such engineer may be employed, and in some cases he may be assisted by part-time workers from other...

  10. BEHAVIOR ANALYSIS OF CONSUMER COMPLAINT

    Directory of Open Access Journals (Sweden)

    Andrie Prasetyo

    2016-05-01

    Full Text Available Complaining is one form of communication for consumers to express their dissatisfaction. Understanding the consumer complaint behavior is an important thing for businesses; however, it is not easy to do. The initial step in understanding this behavior of consumer complaints is to map consumers based on their behavior of complaints and analyze the factors that influence this. This study examines the complaint behavior of consumers in Cibubur who have experienced dissatisfaction with a product.  The objectives of this study are to map the consumer complaint behavior and identify its relationship with various factors such as consumer demographics, personality, attitude to businesses, attribution of the causes of dissatisfaction, and product attributes. A crosstab descriptive analysis method was used to map the consumers, while the Pearson correlation analysis methods was used to analyze consumer complaint behavioral relationships with various factors. The results of this study indicated that consumers in Cibubur based on their complaint behavior are classified into four groups: passive, voicers, irates and activist. The passive consumers dominate the category with a percentage of 49%.  The voicers, irates, and activist belong to the complaining type and are dominated by young women, with high levels of education and income. Keywords: consumer complaint behavior, product, crosstab, pearson correlation

  11. CGB - Consumer Complaints Data

    Data.gov (United States)

    Federal Communications Commission — Individual informal consumer complaint data detailing complaints filed with the Consumer Help Center beginning October 31, 2014. This data represents information...

  12. 44 CFR 11.17 - Referral to Department of Justice.

    Science.gov (United States)

    2010-10-01

    ... Justice. 11.17 Section 11.17 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Referral to Department of Justice. When Department of Justice approval or consultation is required under § 11.16, the referral or request shall be transmitted to the Department of Justice by the Chief Counsel...

  13. Complaints and satisfaction after uvulopalatopharyngoplasty

    DEFF Research Database (Denmark)

    Grøntved, A M; Karup, P

    2000-01-01

    A questionnaire administered 2 years after classical laser uvulopalatopharyngoplasty (UPPP) showed that 42% of 69 patients had complaints. Most of the complaints, however, were comparatively minor. The most frequent complaint was a tendency to nasal regurgitation (13%), although only two patients...

  14. Re-attenders to the emergency department of a major urban hospital serving a population of 290,000.

    LENUS (Irish Health Repository)

    Ramasubbu, B

    2015-01-01

    The national Emergency Medicine Programme (EMP) in Ireland, defines a re-attender as any patient re-presenting to the Emergency Department (ED) within 28 days with the same chief complaint. A retrospective, electronic patient record audit was carried out on all re-attenders to Connolly ED during November 2012. There were 2919 attendances made up from 2530 patients; 230 patients re-attended a total of 389 times. The re-attendance rate was 13% (389\\/2919). 63 (27%) were frequent presenters. There was a significantly higher admission rate at second attendance than first (89 (39%) vs 39 (17%), p < 0.001). 25% (57\\/230) of patients \\'left before completion of treatment\\' (LBCT) at first attendance (significantly higher than the number at second attendance (p < 0.01)). 14\\/57 (25%) of those who LBCT at first attendance required admission at second attendance. 28\\/89 (31%) of second attendance admissions were failed discharges from first attendance. Reasons for re-attendance are multi-factorial and include both patient and departmental factors.

  15. 29 CFR 20.10 - Responsibilities of the Chief Financial Officer.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Responsibilities of the Chief Financial Officer. 20.10... to Credit Reporting Agencies § 20.10 Responsibilities of the Chief Financial Officer. The Chief... guidelines and instructions, which he or she may deem appropriate. The Chief Financial Officer shall also...

  16. 29 CFR 20.37 - Responsibilities of the Chief Financial Officer.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Responsibilities of the Chief Financial Officer. 20.37....37 Responsibilities of the Chief Financial Officer. The Chief Financial Officer, or his or her..., which he or she may deem appropriate. The Chief Financial Officer shall also take such administrative...

  17. Consumer Complaints and Company Market Value

    Directory of Open Access Journals (Sweden)

    Danny Pimentel Claro

    2014-07-01

    Full Text Available Consumer complaints affect company market value and common sense suggests that a negative impact is expected. However, do complaints always negatively impact company market value? We hypothesize in this study that complaints may have a non-linear effect on market value. Positive (e.g. avoiding high costs to solve complaints and negative (e.g. speedy and intense diffusion tradeoffs may occur given the level of complaints. To test our non-linear hypothesis, a panel data was collected from cell phone service providers from 2005 to 2013. The results supported our tradeoff rationale. Low levels of complaints allow for companies to increase market value, while high levels of complaints cause increasing harm to market value. The sample, model and period considered in this study, indicates a level of 0.49 complaints per thousand consumers as the threshold for a shift in tradeoffs. The effects on market value become increasingly negative when trying to make reductions to move below this level, due to negative tradeoffs.

  18. 29 CFR 20.62 - Responsibilities of the Chief Financial Officer.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Responsibilities of the Chief Financial Officer. 20.62... Administrative Costs § 20.62 Responsibilities of the Chief Financial Officer. The Chief Financial Officer, or his... instructions, which he or she may deem appropriate. The Chief Financial Officer shall also take such...

  19. 29 CFR 20.90 - Responsibilities of the Chief Financial Officer.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Responsibilities of the Chief Financial Officer. 20.90... Responsibilities of the Chief Financial Officer. The Chief Financial Officer, or his or her designee, shall provide... appropriate. The Chief Financial Officer shall also take such administrative steps as may be appropriate to...

  20. Use of musculoskeletal ultrasonography in the diagnosis of pes anserine tendinitis: a case report.

    Science.gov (United States)

    Valley, V T; Shermer, C D

    2001-01-01

    A 45-year-old woman presented to the Emergency Department with a chief complaint of acute, nontraumatic medial knee pain. Musculoskeletal ultrasonography was performed, and the diagnosis of pes anserine tendinitis was elucidated. A discussion of this clinical entity, the characteristic ultrasonographic findings, and therapy follow in this case report.

  1. History of the Joint Chiefs of Staff: The Joint Chiefs of Staff and the War in Vietnam, 1971-1973

    National Research Council Canada - National Science Library

    Webb, Willard J; Poole, Walter S

    2007-01-01

    The series of five volumes titled "The Joint Chiefs of Staff and the War in Vietnam" covers the activities of the Joint Chiefs of Staff with regard to Vietnam from 1945 to the final withdrawal of U.S...

  2. 46 CFR 35.25-5 - Repairs of boilers and unfired pressure vessels and reports of repairs or accidents by chief...

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Repairs of boilers and unfired pressure vessels and..., DEPARTMENT OF HOMELAND SECURITY TANK VESSELS OPERATIONS Engine Department § 35.25-5 Repairs of boilers and... any repairs to boilers or unfired pressure vessels, the chief engineer shall submit a report covering...

  3. 28 CFR 0.117 - Office of Chief Immigration Judge.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Office of Chief Immigration Judge. 0.117... Executive Office for Immigration Review § 0.117 Office of Chief Immigration Judge. The Chief Immigration Judge shall provide general supervision to the Immigration Judges in performance of their duties in...

  4. 46 CFR 11.542 - Endorsement as chief engineer (MODU).

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Endorsement as chief engineer (MODU). 11.542 Section 11... REQUIREMENTS FOR OFFICER ENDORSEMENTS Professional Requirements for Engineer Officer § 11.542 Endorsement as chief engineer (MODU). To qualify for an endorsement as chief engineer (MODU) an applicant must: (a...

  5. The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments.

    Science.gov (United States)

    Leider, Jonathon P; Castrucci, Brian C; Harris, Jenine K; Hearne, Shelley

    2015-08-06

    The relationship between policy networks and policy development among local health departments (LHDs) is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer) in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD). Connectedness was highest among local health officials (density = .55), and slightly lower for chief science officers (d = .33) and chiefs of policy (d = .29). After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic) and tenure were the most significant predictors of formation of network ties. Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

  6. 29 CFR 1614.302 - Mixed case complaints.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Mixed case complaints. 1614.302 Section 1614.302 Labor... EMPLOYMENT OPPORTUNITY Related Processes § 1614.302 Mixed case complaints. (a) Definitions—(1) Mixed case complaint. A mixed case complaint is a complaint of employment discrimination filed with a federal agency...

  7. 47 CFR 54.704 - The Administrator's Chief Executive Officer.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false The Administrator's Chief Executive Officer. 54... Administrator shall nominate by consensus a Chief Executive Officer. The Board of Directors shall submit the... Administrator's Chief Executive Officer. (3) If the Board of Directors does not reach consensus on a nominee or...

  8. 39 CFR 3030.10 - Complaint contents.

    Science.gov (United States)

    2010-07-01

    ... Initial Pleadings § 3030.10 Complaint contents. (a) A complaint must: (1) Set forth the facts and... to be similarly affected by the issues involved in the complaint, if applicable; (5) State the nature...

  9. Cybercom Chief Details U.S. Cyber Threats

    Science.gov (United States)

    Security Robots Lasers RSS Feed Cybercom Chief Details U.S. Cyber Threats - December 2, 2014 Navy Adm . Rogers, the commander of U.S. Cyber Command, director of the National Security Agency and chief of the Framework for Cyber Sharing But before Cybercom can help commercial companies deal with cyber criminals and

  10. Chief officer misconduct in policing: an exploratory study

    OpenAIRE

    Hales, Gavin; May, Tiggey; Belur, J.; Hough, Mike

    2015-01-01

    Key findings\\ud This study has examined cases of alleged misconduct involving chief police officers and staff.\\ud The aim was to describe the nature of cases that have come to light, examine the perceived\\ud pathways that led to misconduct, and suggest ways of mitigating the risks of misconduct. The\\ud study is based on interviews with key stakeholders and with investigating officers in chief\\ud officer misconduct cases since April 2008. These cases involved only a small minority of chief\\ud ...

  11. 29 CFR 825.401 - Filing a complaint with the Federal Government.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Filing a complaint with the Federal Government. 825.401 Section 825.401 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR OTHER LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Enforcement Mechanisms § 825.401 Filing a...

  12. [Winter surveillance of cold exposure effects on health among the homeless population in the Paris area: data from the Coordinated Health Surveillance of Emergency Department network (Organisation de la surveillance coordonnée des urgences [Oscour(®)])].

    Science.gov (United States)

    Rouquette, A; Mandereau-Bruno, L; Baffert, E; Laaidi, K; Josseran, L; Isnard, H

    2011-12-01

    A program for helping homeless individuals in winter is implemented from November 1(st) to March 31(st) each year in France. Its aim is to prevent morbidity and mortality in this population during cold spells and periods of severe cold. A health surveillance system of the homeless population in the Paris area has been proposed to evaluate the effectiveness of the program and to alert decision-makers if an unusual increase in cold-weather effects is observed. The goal of this study was the creation of an indicator for the proposed surveillance system based on emergency department activity in the Paris area (Oscour(®) Network - Organisation de la surveillance coordonnée des urgences). The winter 2007-2008 computer medical files of 11 emergency departments in the Paris area were examined to confirm diagnosis and ascertain patient-homelessness for each patient visit which was selected from the Oscour(®) database by the patient chief-complaint or diagnosis code referring to hypothermia or frostbites. The proposed indicator is based on the maximization of three criteria: the positive predictive value, the proportion of people identified as being homeless and the number of emergency department visits. A Shewhart control chart was applied to the indicator for the four winters between 2005 and 2009 in the Paris area. Values beyond the statistical threshold would indicate a need for an adjustment to the program strategy. Two hundred and sixteen medical files were analyzed. An indicator was created, "number of emergency department visits of 15 to 69-years-old persons with chief-complaint or diagnosis code referring to hypothermia". It had a positive predictive value estimated near 85 % and identified 61.7 % people as being homeless. In the winter of 2008-2009, the statistical threshold was reached in December during the first cold spell, and again at the beginning of January during a period of severe cold. Our results support the use of this health indicator

  13. Window of Opportunity for New Disease Surveillance: Developing Keyword Lists for Monitoring Mental Health and Injury Through Syndromic Surveillance.

    Science.gov (United States)

    Lauper, Ursula; Chen, Jian-Hua; Lin, Shao

    2017-04-01

    Studies have documented the impact that hurricanes have on mental health and injury rates before, during, and after the event. Since timely tracking of these disease patterns is crucial to disaster planning, response, and recovery, syndromic surveillance keyword filters were developed by the New York State Department of Health to study the short- and long-term impacts of Hurricane Sandy. Emergency department syndromic surveillance is recognized as a valuable tool for informing public health activities during and immediately following a disaster. Data typically consist of daily visit reports from hospital emergency departments (EDs) of basic patient data and free-text chief complaints. To develop keyword lists, comparisons were made with existing CDC categories and then integrated with lists from the New York City and New Jersey health departments in a collaborative effort. Two comprehensive lists were developed, each containing multiple subcategories and over 100 keywords for both mental health and injury. The data classifiers using these keywords were used to assess impacts of Sandy on mental health and injuries in New York State. The lists will be validated by comparing the ED chief complaint keyword with the final ICD diagnosis code. (Disaster Med Public Health Preparedness. 2017;11:173-178).

  14. The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments

    Directory of Open Access Journals (Sweden)

    Jonathon P. Leider

    2015-08-01

    Full Text Available Background: The relationship between policy networks and policy development among local health departments (LHDs is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. Methods: This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. Results: All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD. Connectedness was highest among local health officials (density = .55, and slightly lower for chief science officers (d = .33 and chiefs of policy (d = .29. After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic and tenure were the most significant predictors of formation of network ties. Conclusion: Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

  15. Hot complaint intelligent classification based on text mining

    Directory of Open Access Journals (Sweden)

    XIA Haifeng

    2013-10-01

    Full Text Available The complaint recognizer system plays an important role in making sure the correct classification of the hot complaint,improving the service quantity of telecommunications industry.The customers’ complaint in telecommunications industry has its special particularity which should be done in limited time,which cause the error in classification of hot complaint.The paper presents a model of complaint hot intelligent classification based on text mining,which can classify the hot complaint in the correct level of the complaint navigation.The examples show that the model can be efficient to classify the text of the complaint.

  16. CHIEF 2004 Users Manual

    National Research Council Canada - National Science Library

    Benthien, G. W; Barach, D; Hobbs, S. L

    2004-01-01

    .... The program was tested on machines running Windows 95/98 , Windows NT, and COMPACT UNIX. The CHIEF program was originally developed in the 1960s to compute the acoustic radiation from an arbitrary shaped radiating body...

  17. The contribution of embarrassment to phobic dental anxiety: a qualitative research study

    DEFF Research Database (Denmark)

    Moore, R.; Brødsgaard, I.; Rosenberg, N.

    2004-01-01

    . Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness...... status or perceived neglect, often (n = 9) with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority......-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment intensity ratings were positively correlated with years of avoidance and degree of mouth-hiding behaviors. Embarrassment is a complex dental anxiety manifestation with qualitative differences by complaint...

  18. Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma

    Directory of Open Access Journals (Sweden)

    Erica Escarcega

    2017-07-01

    Full Text Available Subacute endocarditis often presents with an indolent course. A potentially lethal form generated by infection with Abiotrophia defectiva may be easily overlooked early in its presentation. This report discusses the case of an 18-year-old male discovered to have severe endocarditis after presenting to the emergency department with the chief complaint of foot pain.

  19. Complaint Attitudes and Behavior in Academic Libraries

    Directory of Open Access Journals (Sweden)

    Shiao-Feng Su

    2012-12-01

    Full Text Available After experiencing library service failure, the user may directly or indirectly voice his/her complaint, which is the best prescription to improve library public services. The paper explores the academic librarians and users’ attitudes towards complaints. Through surveying six hundred students from twenty universities and applying descriptive and inferential statistical techniques, the study investigates student users’ complaint preference and behavior afterwards, and perception of complaint handling and outcome. The study reports and compares their attitudes and perspectives towards library complaints. It further examines the differences in attitudes and behavior intention among respondents who had prior experience in filing complaints at libraries, did not complain, and had no prior experience in service failure. An ultimate analysis was made to contrast the user’s perception towards complaint handling of the library and of for-profit organization. [Article content in Chinese

  20. Research on the actual condition on the licensed chief engineers of radiation

    International Nuclear Information System (INIS)

    1976-01-01

    A research on the actual condition on the licensed chief engineers of radiation was performed on October, 1975. Question cards were sent to 2915 facilities in Japan, and answers came back from 2850 facilities. Answers report the size of each facility, number of employee, number of chief engineers in charge, age of chief engineers, appointment authority, responsibility, improvement of working condition of chief engineer, and assistant officer for chief engineer. The number of worker is 62,456 in 2,769 facilities. The number of chief engineer in charge is 3,286 containing 579 doctor and/or dentist. The age of chief in 80 percent facilities is above 31. System of management of radiation safety was also investigated. (Kato, T.)

  1. Psychological complaints reported by sexually abused children during criminal investigations: Istanbul example.

    Science.gov (United States)

    Doğangün, Burak; Gönültaş, Burak M; Uzun-Oğuz, Esin; Oral, Gökhan; Öztürk, Meral

    2016-06-01

    The present study aims at describing the psychological complaints reported, as a part of the criminal investigation process, by the victims of sexual abuse as a part of the criminal investigation process, without attempting at reaching a medical diagnosis; and it discusses the relation of these reports with variables such as victim's gender, age and relation to the offender, type and duration of abuse, and parental marital status of the victim. Data is obtained from the statements of childhood sexual abuse (CSA) victims under the age of 15, as taken by Istanbul Juvenile Justice Department between the years 2009 and 2012. The sample consists of 175 cases with a total of 202 victim statements. Through the use of content analysis, the main and sub-categories of themes of the statements were determined. By means of the evaluation of the psychological condition of victims, we evaluated them in two categories: psychological complaints including self-harm and risk taking behaviors and psychological complaints with no self-harm and risk taking behaviors. The statistical analyses yield significant relations between the psychological complaints and children's parental marital status. Analysis of initial statements of sexual abuse victims is important as it may greatly contribute to professionals diagnosing and treating psychological complaints of these victims. It is essential that victims of sexual abuse should receive immediate psychological support starting with the criminal investigation process. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Analysis of indoor air pollutants checklist using environmetric technique for health risk assessment of sick building complaint in nonindustrial workplace

    Directory of Open Access Journals (Sweden)

    Syazwan AI

    2012-09-01

    workplace setting.Design: A cross-sectional study based on a participatory occupational health program conducted by the National Institute of Occupational Safety and Health (Malaysia and Universiti Putra Malaysia.Method: A modified version of the indoor environmental checklist published by the Department of Occupational Health and Safety, based on the literature and discussion with occupational health and safety professionals, was used in the evaluation process. Summated scores were given according to the cluster analysis and principal component analysis in the characterization of risk. Environmetric techniques was used to classify the risk of variables in the checklist. Identification of the possible source of item pollutants was also evaluated from a semiquantitative approach.Result: Hierarchical agglomerative cluster analysis resulted in the grouping of factorial components into three clusters (high complaint, moderate-high complaint, moderate complaint, which were further analyzed by discriminant analysis. From this, 15 major variables that influence indoor air quality were determined. Principal component analysis of each cluster revealed that the main factors influencing the high complaint group were fungal-related problems, chemical indoor dispersion, detergent, renovation, thermal comfort, and location of fresh air intake. The moderate-high complaint group showed significant high loading on ventilation, air filters, and smoking-related activities. The moderate complaint group showed high loading on dampness, odor, and thermal comfort.Conclusion: This semiquantitative assessment, which graded risk from low to high based on the intensity of the problem, shows promising and reliable results. It should be used as an important tool in the preliminary assessment of indoor air quality and as a categorizing method for further IAQ investigations and complaints procedures.Keywords: office, indoor environment quality, indoor air quality assessor, Industry Code of Practice on

  3. Air Compliance Complaint Database (ACCD)

    Data.gov (United States)

    U.S. Environmental Protection Agency — THIS DATA ASSET NO LONGER ACTIVE: This is metadata documentation for the Region 7 Air Compliance Complaint Database (ACCD) which logs all air pollution complaints...

  4. The chief data officer handbook for data governance

    CERN Document Server

    Soares, Sunil

    2015-01-01

    A practical guide for today's chief data officers to define and manage data governance programs   The relatively new role of chief data officer (CDO) has been created to address the issue of managing a company's data as a strategic asset, but the problem is that there is no universally accepted "playbook" for this role. Magnifying the challenge is the rapidly increasing volume and complexity of data, as well as regulatory compliance as it relates to data. In this book, Sunil Soares provides a practical guide for today's chief data officers to manage data as an asset while delivering the truste

  5. The Impact of a Case of Ebola Virus Disease on Emergency Department Visits in Metropolitan Dallas-Fort Worth, TX, July, 2013-July, 2015: An Interrupted Time Series Analysis.

    Science.gov (United States)

    Molinari, Noelle-Angelique M; LeBlanc, Tanya Telfair; Stephens, William

    2018-03-20

    The first Ebola virus disease (EVD) case in the United States (US) was confirmed September 30, 2014 in a man 45 years old. This event created considerable media attention and there was fear of an EVD outbreak in the US. This study examined whether emergency department (ED) visits changed in metropolitan Dallas-Fort Worth--, Texas (DFW) after this EVD case was confirmed. Using Texas Health Services Region 2/3 syndromic surveillance data and focusing on DFW, interrupted time series analyses were conducted using segmented regression models with autoregressive errors for overall ED visits and rates of several chief complaints, including fever with gastrointestinal distress (FGI). Date of fatal case confirmation was the "event." Results indicated the event was highly significant for ED visits overall (Pcapacity as well as for public health messaging in the wake of a public health emergency.

  6. 49 CFR 800.28 - Delegation to the Chief Financial Officer.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Delegation to the Chief Financial Officer. 800.28... Authority to Staff Members § 800.28 Delegation to the Chief Financial Officer. The Board delegates to the Chief Financial Officer the authority to settle claims for money damages of $2,500 or less against the...

  7. Rancang Bangun STIKI Class Facilities E-Complaint

    Directory of Open Access Journals (Sweden)

    Ni Kadek Ariasih

    2017-08-01

    Full Text Available STMIK STIKOM Indonesia is one of the institutions in the field of computer-based education. In order to support the effectiveness of the implementation of teaching and learning activities that take place, it is need a service that support the availability of adequate class facilities and complaints services if there are constraints on facilities in the classroom. So far, the management of complaints complaints against classroom facilities or in the labarotorium which is handled by the Household Management Section is still on manua basis. In terms of record and handle complaints it is required information system which called STIKI Class Facilities E-Complaint. This system can assist the Household Management Section in monitoring complaints from the condition of existing room facilities if experiencing problems and also can improve the quality of service in handling complaints. The software development process model used is prototype and Web-based model with PHP and MySQL database.

  8. 46 CFR 97.45-1 - Master and chief engineer responsible.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Master and chief engineer responsible. 97.45-1 Section... VESSELS OPERATIONS Carrying of Excess Steam § 97.45-1 Master and chief engineer responsible. It shall be the duty of the master and the chief engineer of any vessel to require that a steam pressure is not...

  9. 46 CFR 502.62 - Complaints and fee.

    Science.gov (United States)

    2010-10-01

    ... Proceedings; Pleadings; Motions; Replies § 502.62 Complaints and fee. (a) The complaint must be verified and... reparation is sought and the nature of the proceeding so requires, the complaint shall set forth: the ports...

  10. Sensitivity and Specificity of Empiric Treatment for Sexually Transmitted Infections in a Pediatric Emergency Department.

    Science.gov (United States)

    Breslin, Kristen; Tuchman, Lisa; Hayes, Katie L; Badolato, Gia; Goyal, Monika K

    2017-10-01

    To determine test characteristics of provider judgment for empiric antibiotic provision to patients undergoing testing for a sexually transmitted infection. We conducted a retrospective cross-sectional electronic health record review of all patients aged 13-19 years who had Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) testing sent from an urban, academic pediatric emergency department in 2012. We abstracted data, including patient demographics, chief complaint, sexually transmitted infection test results, and treatment. We calculated test characteristics comparing clinician judgment for presumptive treatment for a sexually transmitted infection with the reference standard of the actual results of testing for a sexually transmitted infection. Of 1223 patient visits meeting inclusion criteria, 284 (23.2%) had a positive GC and/or CT test result. Empiric treatment was provided in 615 encounters (50.3%). Provider judgment for presumptive treatment had an overall sensitivity of 67.6% (95% CI, 61.8-73.0) and a specificity of 55% (95% CI, 51.7-58.2) for accurate GC and/or CT detection. Many adolescents tested for GC and CT receive empiric treatment at the initial emergency department visit. Provider judgment may lack sufficient sensitivity and specificity for identifying infected patients, resulting in the potential for undertreatment of true disease, overtreatment of uninfected patients, or both. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. 15 January 2010 - Vice-Chancellor & Chief Executive C. Snowden, University of Surrey, United Kingdom and Mrs Snowden visiting ALICE exhibition and experimental undeground area with Collabortion Spokesperson J. Schukraft and Beams Department Head P. Collier; Signature of the guest book with CERN Director-General R. Heuer.

    CERN Multimedia

    Maximilien Brice

    2010-01-01

    15 January 2010 - Vice-Chancellor & Chief Executive C. Snowden, University of Surrey, United Kingdom and Mrs Snowden visiting ALICE exhibition and experimental undeground area with Collabortion Spokesperson J. Schukraft and Beams Department Head P. Collier; Signature of the guest book with CERN Director-General R. Heuer.

  12. Chairman of the DELL Board of Directors and Chief Executive Officer Michael S. Dell with CERN Director-General R. Heuer and in front of the ATLAS detector (centre) with ATLAS Deputy Spokesperson A. Lankford (left) and Information Technology Department Head F. Hemmer on 26th January 2010.

    CERN Multimedia

    Maximilien Brice

    2010-01-01

    Chairman of the DELL Board of Directors and Chief Executive Officer Michael S. Dell with CERN Director-General R. Heuer and in front of the ATLAS detector (centre) with ATLAS Deputy Spokesperson A. Lankford (left) and Information Technology Department Head F. Hemmer on 26th January 2010.

  13. 78 FR 64064 - Agency Information Collection (Principles of Excellence Complaint System Intake) Activity Under...

    Science.gov (United States)

    2013-10-25

    ... Administration (VBA), Department of Veterans Affairs, will submit the collection of information abstracted below... architecture with each agency only having access to their data. The complainants will access the complaint... by the complainant. Authorized law enforcement officials who have been granted access to the FTC...

  14. 76 FR 52731 - On-Line Complaint Form for Service-Related Issues in Air Transportation

    Science.gov (United States)

    2011-08-23

    ... for Service-Related Issues in Air Transportation AGENCY: Office of the Secretary, Department of... consumer protection and civil rights laws and regulations related to air transportation. The Enforcement... travelers, and to ensure safe and adequate service in air transportation. Filing a complaint using a web...

  15. [Highlights of hospital-based internal medicine in 2010: chief residents' perspective].

    Science.gov (United States)

    Uhlmann, Marc; Burnard, Jérôme; Cosma Rochat, Monica; Gabus, Vincent; Micheloud, Valérie Geiser; Gobin, Niels; Laurent, Jean-Christophe; Marino, Laura; Méan, Marie; Merz, Laurent; Regamey, Julien; Stadelmann, Raphaël

    2011-02-02

    Applying knowledge acquired from recent medical studies to patient care poses a daily challenge to physicians. Chief residents from the Department of Internal Medicine at the University Hospital of Lausanne carried out a review of some of the issues they considered important. The conclusions of these various publications may have a significant impact on the daily practice of hospital-based internal medicine. Modern medicine based on scientific studies is a reminder that in spite of the essential importance of clinical experience, it is crucial to confront it with the results of relevant publications from the medical literature.

  16. Joint Chiefs of Staff > About > The Joint Staff > Senior Enlisted Advisor

    Science.gov (United States)

    Skip to main content (Press Enter). Toggle navigation Joint Chiefs of Staff Joint Chiefs of Staff Joint Chiefs of Staff Facebook Twitter YouTube Flickr Blog Instagram Search JCS: Search Search Search JCS: Search Home Media News Photos Videos Publications About The Joint Staff Chairman Vice Chairman

  17. 76 FR 67472 - Order of Succession for the Office of the Chief Information Officer

    Science.gov (United States)

    2011-11-01

    ...: Juanita Galbreath, Deputy Chief Information Officer for Cyber Security and Privacy, Office of the Chief...) Deputy Chief Information Officer, for IT Operations; (3) Deputy Chief Information Officer, for Cyber Security and Privacy; (4) Deputy Chief Information Officer, for Business and IT Modernization. These...

  18. 77 FR 43071 - MPS Customer Group v. Maine Public Service Company; Notice of Complaint

    Science.gov (United States)

    2012-07-23

    ..., MPS Customer Group (Complainant) filed a formal complaint against Maine Public Service Company (MPS or... document is added to a subscribed docket(s). For assistance with any FERC Online service, please email... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL12-84-000] MPS Customer...

  19. Psychosocial working conditions and cognitive complaints among Swedish employees.

    Directory of Open Access Journals (Sweden)

    Cecilia U D Stenfors

    Full Text Available BACKGROUND: Cognitive complaints involving problems with concentration, memory, decision-making and thinking are relatively common in the work force. The sensitivity of both subjective and objective cognitive functioning to common psychiatric conditions, stress levels and to cognitive load makes it plausible that psychosocial working conditions play a role in cognitive complaints. Thus, this study aimed to test the associations between psychosocial work factors and cognitive complaints in nationally representative samples of the Swedish work force. Cross-sectional (n = 9751 and prospective (n = 3644; two time points two years apart sequential multiple regression analyses were run, adjusting for general confounders, depressive- and sleeping problems. Additional prospective analyses were run adjusting for baseline cognitive complaints. CROSS/SECTIONAL RESULTS: High quantitative demands, information and communication technology (ICT demands, under qualification and conflicts were positively associated with cognitive complaints, while social support, good resources at work and over qualification were negatively associated with cognitive complaints in all models. Skill discretion and decision authority were weakly associated with cognitive complaints. Conflicts were more strongly associated with cognitive complaints in women than in men, after adjustment for general confounders. PROSPECTIVE RESULTS: Quantitative job demands, ICT demands and under qualification were positively associated with future cognitive complaints in all models, including when adjusted for baseline cognitive complaints. Decision authority was weakly positively associated with future cognitive complaints, only after adjustment for depressive- and sleeping problems respectively. Social support was negatively associated with future cognitive complaints after adjustment for general confounders and baseline cognitive complaints. Skill discretion and resources were negatively

  20. Outcomes Analysis of Chief Cosmetic Clinic Over 13 Years.

    Science.gov (United States)

    Walker, Nicholas J; Crantford, John C; Rudolph, Megan A; David, Lisa R

    2018-06-01

    Adequate resident training in aesthetic surgery has become increasingly important with rising demand. Chief resident aesthetic clinics allow hands on experience with an appropriate amount of autonomy. The purpose of this study was to compare resident cosmetic clinic outcomes to those reported in the literature. Furthermore, we sought to assess how effective these clinics can be in preparing residents in performing common aesthetic surgery procedures. A retrospective chart review of 326 patients and 714 aesthetic procedures in our chief cosmetic clinic over a 13-year period was performed, and complication and revision rates were recorded. In addition, an electronic survey was sent to 26 prior chief residents regarding their experience and impressions of the chief resident aesthetic clinic. A total of 713 procedures were performed on 326 patients. Patient ages ranged from 5 to 75 years old (mean, 40.8 years old) with a mean follow-up of 76.2 days. On average, there were 56 procedures performed per year. Of the 714 total procedures performed, there were 136 minor procedures and 578 major procedures. Of the 136 minor procedures, there were no complications and there was 1 revision of a cosmetic injection. Of the 578 major procedures, the overall complication rate was 6.1% and the revision rate was 12.8%. Complication and revision rates for each individual surgery were further analyzed and compared with the literature. The complication rates for these procedures fell within the reference ranges reported. In regards to the chief resident survey, there was a 77% response rate. All respondents reported that the chief resident clinic positively affected their residency education and future practice. Ninety percent of respondents felt "very comfortable" performing facelifts, body contouring, and aesthetic breast surgery. No respondents completed a subsequent cosmetic fellowship, and 60% stated that their positive experience in chief clinic contributed to their decision not

  1. [Somatic complaints, emotional awareness and maladjustment in schoolchildren].

    Science.gov (United States)

    Ordóñez, A; Maganto, C; González, R

    2015-05-01

    Somatic complaints are common in childhood. Research has shown their relationship with emotional awareness and maladjustment. The study had three objectives: 1) to analyze the prevalence of somatic complaints; 2) To explore the relationships between the variables evaluated: somatic complaints, differentiating emotions, verbal sharing of emotions, not hiding emotions, body awareness, attending to others' emotions, analysis of emotions, and personal, social, family, and school maladjustments; and 3) To identify predictors of somatic complaints. The study included a total of 1,134 randomly selected schoolchildren of both sexes between 10-12 years old (M=10.99; SD=0.88). The Somatic Complaint List, Emotional Awareness Questionnaire, and Self-reported Multifactor Test of Childhood Adaptation were used to gather information. The results showed that the prevalence of somatic complaints was 90.2%, with fatigue, headache and stomachache being the most frequently. Dizziness and headache were more common in girls, and the frequency of complaints decreases with age. Somatic complaints are negatively related to emotional awareness, and positively related to maladjustment. The variables that contribute the most to the prediction of somatic complaints are personal maladjustment (25.1%) and differentiating emotions (2.5%). The study shows that personal maladjustment is the best predictor of somatic complaints; the more emotional awareness and better adapted the child, the fewer somatic complaints they lodge. Childhood is a stage with significant physical discomfort. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  2. Health complaints among subjects involved in oil cleanup operations during oil spillage from a Greek tanker "Tasman Spirit".

    Science.gov (United States)

    Meo, Sultan Ayoub; Al-Drees, Abdul Majeed; Rasheed, Shahzad; Meo, Imran Mu; Al-Saadi, Muslim M; Ghani, Hamza A; Alkandari, Jasem Ramadan

    2009-01-01

    Oil spillage in the sea water is a disaster for marine life and humans in the vicinity. The study aimed at investigating health complaints among subjects involved in oil cleanup operations during a spillage from a Greek oil tanker "Tasman Spirit". The project was conducted under the supervision of the Department of Physiology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. The study concerned the respiratory and general health complaints in 50 apparently healthy, non-smoking male workers exposed to crude oil during oil cleanup operations. The exposed group was matched with a similar number of male, non-smoking controls. The health complaints were evaluated based on a comprehensive interview. The subjects involved in oil cleanup operations had significantly higher rates of health complaints including cough (38%), runny nose (36%), eye irritation/redness (32%), sore throat (28%), headache (28%), nausea (24%) and general illness (18%), compared to their matched controls. Air pollution due to crude oil spillage into sea water may cause respiratory and general health complaints in workers involved in oil cleanup operations.

  3. 20 CFR 658.421 - Handling of JS-related complaints.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Handling of JS-related complaints. 658.421... ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Job Service Complaint System Federal Js Complaint System § 658.421 Handling of JS-related complaints. (a) No JS-related complaint shall be handled at the...

  4. 47 CFR 76.1402 - CPST rate complaints.

    Science.gov (United States)

    2010-10-01

    ... local franchise authority may file rate complaints with the Commission within 180 days of the effective... that increase the local franchise authority receives more than one subscriber complaint concerning the increase. (b) Before filing a rate complaint with the Commission, the local franchise authority must first...

  5. Shoulder complaints after nerve sparing neck dissections

    NARCIS (Netherlands)

    van Wilgen, CP; Dijkstra, PU; van der Laan, BFAM; Plukker, JTM; Roodenburg, JLN

    The purpose of the study was to analyse the prevalence of shoulder complaints after nerve sparing neck dissection at least I year after surgery, and to analyse the influence of radiation therapy on shoulder complaints. Patients were interviewed for shoulder complaints, and patients filled out the

  6. Regulating healthcare complaints: a literature review.

    Science.gov (United States)

    Beaupert, Fleur; Carney, Terry; Chiarella, Mary; Satchell, Claudette; Walton, Merrilyn; Bennett, Belinda; Kelly, Patrick

    2014-01-01

    The purpose of this paper is to explore approaches to the regulation of healthcare complaints and disciplinary processes. A literature review was conducted across Medline, Sociological Abstracts, Web of Science, Google Scholar and the health, law and social sciences collections of Informit, using terms tapping both the complaints process and regulation generally. A total of 118 papers dealing with regulation of health complaints or disciplinary proceedings were located. The review reveals a shift away from self-regulation towards greater external oversight, including innovative regulatory approaches including "networked governance and flexible or "responsive" regulation. It reports growing interest in adoption of strategic and responsive approaches to health complaints governance, by rejecting traditional legal forms in favor of more strategic and responsive forms, taking account of the complexity of adverse health events by tailoring responses to individual circumstances of complainants and their local environments. The challenge of how to collect and harness complaints data to improve the quality of healthcare at a systemic level warrants further research. Scope also exists for researching health complaints commissions and other "meta-regulatory" bodies to explore how to make these processes fairer and better able to meet the complex needs of complainants, health professionals, health services and society.

  7. 25 CFR 141.59 - Customer complaint procedures.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Customer complaint procedures. 141.59 Section 141.59... THE NAVAJO, HOPI AND ZUNI RESERVATIONS Enforcement Powers, Procedures and Remedies § 141.59 Customer complaint procedures. (a) Any customer of a licensee may file a complaint with the Commissioner alleging...

  8. 24 CFR 28.20 - Request for approval by the Department of Justice.

    Science.gov (United States)

    2010-04-01

    ... Department of Justice. 28.20 Section 28.20 Housing and Urban Development Office of the Secretary, Department....20 Request for approval by the Department of Justice. (a) If the General Counsel or designee... written request to the Department of Justice for approval to issue a complaint under § 28.25. (b) The...

  9. 77 FR 51023 - R. Gordon Gooch v. Colonial Pipeline Company; Notice of Complaint

    Science.gov (United States)

    2012-08-23

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. OR12-24-000] R. Gordon Gooch...)), and section 343.2 of the Commission's regulations (18 CFR 343.2 (2012)), R. Gordon Gooch (Complainant..., and 100.6.0, as set forth more fully in the complaint. R. Gordon Gooch states that a copy of the...

  10. Leadership Primer for Current and Aspiring Pulmonary, Critical Care, and Sleep Medicine Academic Division Chiefs.

    Science.gov (United States)

    Nguyen, H Bryant; Thomson, Carey C; Kaminski, Naftali; Schnapp, Lynn M; Madison, J Mark; Glenny, Robb W; Dixon, Anne E

    2018-02-27

    An academic medical career traditionally revolves around patient care, teaching, and scholarly projects. Thus, when an opportunity for a leadership role arises, such as Division Chief, the new leader is often unprepared with little or no formal leadership training. In this article, academic leaders of the Association of Pulmonary, Critical Care and Sleep Division Directors reviewed several leadership concepts adapted from the business sector and applied years of their experience to aid new division chiefs with their first day on the job. The first 90 days are highlighted to include accomplishing the early wins, performing a division Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, establishing division rapport, redefining the division infrastructure, avoiding conflicts, and managing their relationship with the department chair. The five levels of leadership applicable to academic medicine are discussed: position, permission, production, people, and pinnacle. Finally, emotional intelligence and behavior styles crucial to leadership success are reviewed.

  11. Emergency Department Frequent Users for Acute Alcohol Intoxication.

    Science.gov (United States)

    Klein, Lauren R; Martel, Marc L; Driver, Brian E; Reing, Mackenzie; Cole, Jon B

    2018-03-01

    A subset of frequent users of emergency services are those who use the emergency department (ED) for acute alcohol intoxication. This population and their ED encounters have not been previously described. This was a retrospective, observational, cohort study of patients presenting to the ED for acute alcohol intoxication between 2012 and 2016. We collected all data from the electronic medical record. Frequent users for alcohol intoxication were defined as those with greater than 20 visits for acute intoxication without additional medical chief complaints in the previous 12 months. We used descriptive statistics to evaluate characteristics of frequent users for alcohol intoxication, as well as their ED encounters. We identified 32,121 patient encounters. Of those, 325 patients were defined as frequent users for alcohol intoxication, comprising 11,370 of the encounters during the study period. The median maximum number of encounters per person for alcohol intoxication in a one-year period was 47 encounters (range 20 to 169). Frequent users were older (47 years vs. 39 years), and more commonly male (86% vs. 71%). Frequent users for alcohol intoxication had higher rates of medical and psychiatric comorbidities including liver disease, chronic kidney disease, ischemic vascular disease, dementia, chronic obstructive pulmonary disease, history of traumatic brain injury, schizophrenia, and bipolar disorder. In this study, we identified a group of ED frequent users who use the ED for acute alcohol intoxication. This population had higher rates of medical and psychiatric comorbidities compared to non-frequent users.

  12. Chief Human Capital Officers Council (CHCOC)'s Members and Assistants

    Data.gov (United States)

    Office of Personnel Management — List of members of the Chief Human Capital Officers Council (CHCOC): Federal Chief Human Capital Officers (CHCOs) and Deputy CHCOs, as well as the council's chair,...

  13. 78 FR 21928 - Demand Response Coalition v. PJM Interconnection, L.L.C.; Notice of Complaint

    Science.gov (United States)

    2013-04-12

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-57-000] Demand Response... Demand Response Coalition \\1\\ (Complainant) filed a formal complaint against the PJM Interconnection, L.L... Plan Enhancements'') violate section 205 of the FPA and are therefore unenforceable. \\1\\ The Demand...

  14. The Effect of Older Age on EMS Use for Transportation to an Emergency Department.

    Science.gov (United States)

    Jones, Courtney M C; Wasserman, Erin B; Li, Timmy; Amidon, Ashley; Abbott, Marissa; Shah, Manish N

    2017-06-01

    Introduction Previous studies have found that older adults are more likely to use Emergency Medical Services (EMS) than younger adults, but the reasons for this remain understudied. Hypothesis/Problem This study aimed to determine if older age is associated with using EMS for transportation to an emergency department (ED) after controlling for confounding variables. A cross-sectional survey study was conducted at a large academic medical center. Data on previous medical history, chief complaint, self-perceived illness severity, demographic information, and mode of arrival to the ED were collected on all subjects. Those who arrived to the ED via EMS also were asked reasons why they opted to call an ambulance for their illness/injury. Descriptive statistics were used to quantify survey responses, and multivariable regression was used to assess the independent effect of age on mode of ED arrival. Data from 1,058 subjects were analyzed, 449 (42%) of whom arrived to the ED via EMS. Compared to adultstransportation to the ED via ambulance; however, this effect is attenuated by number of chronic medical conditions and history of depression. Additional research is needed to account for confounders unmeasured in this study and to elucidate reasons for the increased frequency of EMS use among older adults. Jones CMC , Wasserman EB , Li T , Amidon A , Abbott M , Shah MN . The effect of older age on EMS use for transportation to an emergency department. Prehosp Disaster Med. 2017;32(3):261-268.

  15. 28 CFR 68.3 - Service of complaint, notice of hearing, written orders, and decisions.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Service of complaint, notice of hearing, written orders, and decisions. 68.3 Section 68.3 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED..., registered agent for service of process of a corporate party, or attorney or representative of record of a...

  16. 20 CFR 901.36 - Service of complaint and other papers.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Service of complaint and other papers. 901.36... Termination of Enrollment § 901.36 Service of complaint and other papers. (a) Complaint. The complaint or a... papers other than complaint. Any paper other than the complaint may be served upon the respondent as...

  17. Managing hypopituitarism in emergency departments.

    Science.gov (United States)

    Welsh, Jeanette

    2015-10-01

    Healthcare professionals manage patients with a vast range of conditions, but often specialise and acquire expertise in specific disease processes. Emergency and pre-hospital clinicians care for patients with various conditions for short periods of time, so have less opportunity to become familiar with more unusual conditions, yet it is vital that they have some knowledge and understanding of these. Patients with rare conditions can present at emergency departments with common complaints, but the effect of their original diagnosis on the presenting complaint may be overlooked or underestimated. This article uses a case study to describe the experience of one patient who presented with vomiting, but who also had hypopituitarism and therefore required specific management she did not at first receive. The article describes hypopituitarism and the initial management of patients with this condition who become unwell, and discusses how the trust responded to the patient's complaint to improve patient safety and care. It has been written with the full participation and consent of the patient and her husband.

  18. Acute vision loss: a fuzzy presentation of sarcoidosis.

    Science.gov (United States)

    Austin, Andrea L; Day, Luke T; Bishop, Frank M

    2013-04-01

    Acute vision loss is a devastating problem for patients and a challenging diagnostic dilemma for Emergency Physicians. This chief complaint is one in which we must be adept at quickly evaluating and initiating either care or referral. This case reviews the approach to acute vision loss and shows the importance of expanding the differential in atypical and complex presentations. A 31-year-old, previously healthy, white woman presented to the Emergency Department (ED) with 1 day of painless right eye vision loss. Ocular ultrasound and slit-lamp examination were unremarkable. Fundoscopic examination revealed retinal hemorrhages and papillitis. Her chest X-ray study was significant for bilateral hilar adenopathy, and subsequent lymph node biopsy confirmed the diagnosis of sarcoidosis. Although sarcoidosis is more common in African Americans, it must be considered in all patients in the appropriate clinical context. Sarcoidosis is an important diagnosis to include on the differential of many chief complaints that present to the ED, including acute vision loss and dyspnea. Published by Elsevier Inc.

  19. Rate and predictors of serious neurologic causes of dizziness in the emergency department.

    Science.gov (United States)

    Navi, Babak B; Kamel, Hooman; Shah, Maulik P; Grossman, Aaron W; Wong, Christine; Poisson, Sharon N; Whetstone, William D; Josephson, S Andrew; Johnston, S Claiborne; Kim, Anthony S

    2012-11-01

    To describe the rate and predictors of central nervous system (CNS) disease in emergency department (ED) patients with dizziness in the modern era of neuroimaging. We retrospectively reviewed the medical records of all adults presenting between January 1, 2007, and December 31, 2009, to an academic ED for a primary triage complaint of dizziness, vertigo, or imbalance. The final diagnosis for the cause of dizziness was independently assigned by 2 neurologists, with a third neurologist resolving any disagreements. The primary outcome was a composite of ischemic stroke, intracranial hemorrhage, transient ischemic attack, seizure, brain tumor, demyelinating disease, and CNS infection. Univariate and multivariate logistic regression were used to assess the association between clinical variables and serious CNS causes of dizziness. Of 907 patients experiencing dizziness (mean age, 59 years; 58% women [n=529]), 49 (5%) had a serious neurologic diagnosis, including 37 cerebrovascular events. Dizziness was often caused by benign conditions, such as peripheral vertigo (294 patients [32%]) or orthostatic hypotension (121 patients [13%]). Age 60 years or older (odds ratio [OR], 5.7; 95% confidence interval [CI], 2.5-11.2), a chief complaint of imbalance (OR, 5.9; 95% CI, 2.3-15.2), and any focal examination abnormality (OR, 5.9; 95% CI, 3.1-11.2) were independently associated with serious neurologic diagnoses, whereas isolated dizziness symptoms were inversely associated (OR, 0.2; 95% CI, 0.0-0.7). Dizziness in the ED is generally benign, although a substantial fraction of patients harbor serious neurologic disease. Clinical suspicion should be heightened for patients with advanced age, imbalance, or focal deficits. Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  20. Chiefs and the State in independent Zambia : exploring the Zambian national press

    NARCIS (Netherlands)

    Binsbergen, van W.M.J.

    1987-01-01

    Zambia is among the few African countries where chiefs occupy an honorable position at the national level, and where a House of Chiefs is established, complementary to Parliament. This paper examines the relationship between chiefs and the central government on the basis of an analysis of newspaper

  1. Curriculum Design and Implementation of the Emergency Medicine Chief Resident Incubator.

    Science.gov (United States)

    Gisondi, Michael A; Chou, Adaira; Joshi, Nikita; Sheehy, Margaret K; Zaver, Fareen; Chan, Teresa M; Riddell, Jeffrey; Sifford, Derek P; Lin, Michelle

    2018-02-24

    Background Chief residents receive minimal formal training in preparation for their administrative responsibilities. There is a lack of professional development programs specifically designed for chief residents. Objective In 2015, Academic Life in Emergency Medicine designed and implemented an annual, year-long, training program and virtual community of practice for chief residents in emergency medicine (EM). This study describes the curriculum design process and reports measures of learner engagement during the first two cycles of the curriculum. Methods Kern's Six-Step Approach for curriculum development informed key decisions in the design and implementation of the Chief Resident Incubator. The resultant curriculum was created using constructivist social learning theory, with specific objectives that emphasized the needs for a virtual community of practice, longitudinal content delivery, mentorship for participants, and the facilitation of multicenter digital scholarship. The 12-month curriculum included 11 key administrative or professional development domains, delivered using a combination of digital communications platforms. Primary outcomes measures included markers of learner engagement with the online curriculum, recognized as modified Kirkpatrick Level One outcomes for digital learning. Results An average of 206 chief residents annually enrolled in the first two years of the curriculum, with an overall participation by 33% (75/227) of the allopathic EM residency programs in the United States (U.S.). There was a high level of learner engagement, with an average 13,414 messages posted per year. There were also 42 small group teaching sessions held online, which included 39 faculty and 149 chief residents. The monthly e-newsletter had a 50.7% open rate. Digital scholarship totaled 23 online publications in two years, with 67 chief resident co-authors and 21 faculty co-authors. Conclusions The Chief Resident Incubator is a virtual community of practice that

  2. Chief Editors’ Introduction

    Directory of Open Access Journals (Sweden)

    Kerry Carrington

    2015-12-01

    Full Text Available It has been a great year for the journal:  our most successful ever. This edition marks three years of publication of the International Journal for Crime, Justice and Social Democracy. In 2015 the journal was selected for inclusion into Scopus and Web of Science data bases. This is a terrific success story and testimony to the high quality of the articles, the editorship, the reviewing and the international readership of the journal. We are grateful as ever to our distinguished International Editorial Board and all our reviewers who are anonymous to readers and authors due to the norms of blind peer reviewing. We also thank the out-going foundational co-editor-in-chief Reece Walters for his efforts in making this journal the success it is. The journal has now surpassed 150,000 abstract views and 100,000 full PDF downloads. This journal is one of only a few in the world of criminology to support fully on-line free-to-download articles, and to promote creative commons copyright: that is, authors’ rights to reproduce their own material. We support the democratisation of knowledge and are delighted to be leaders in high quality international journal publishing.Download the PDF file here for the Chief Editors’ introduction to this issue and be motivated by the eclectic and impressive range of topics offered by our contributors to read further.

  3. Functional abdominal complaints in pre-school children: Parental reports of health-related quality of life

    NARCIS (Netherlands)

    R. Oostenbrink (Rianne); H.P. Jongman (Henri); J.M. Landgraf (Jeanne); H. Raat (Hein); H.A. Moll (Henriëtte)

    2010-01-01

    textabstractPurpose The aim of this study is to assess the influence of functional abdominal complaints (FAC) on health-related quality of life in a group of Dutch pre-school children. Methods Parents of children aged up to 6.0 visiting the outpatient pediatric department, Erasmus MC-Sophia,

  4. Sleep complaints and fatigue of airline pilots.

    Science.gov (United States)

    Reis, Cátia; Mestre, Catarina; Canhão, Helena; Gradwell, David; Paiva, Teresa

    2016-01-01

    This work aimed to determine daytime sleepiness and sleep complaints prevalence and the corresponding influence on perceived fatigue and to evaluate the influence of sociodemographic parameters and labour variables on sleep complaints, sleepiness and fatigue. A questionnaire was developed including socio-economic and labour issues and instruments, focused in sleep and fatigue. The response rate was 32% and the final sample had 435 pilots. The prevalence of sleep complaints was 34.9%, daytime sleepiness 59.3% and fatigue 90.6%. The high prevalence of sleep complaints, sleepiness and fatigue was disclosed in pilots, with those who fly short/medium having an added risk of fatigue.

  5. Developing emergency department-based education about emergency contraception: adolescent preferences.

    Science.gov (United States)

    Mollen, Cynthia J; Miller, Melissa K; Hayes, Katie L; Wittink, Marsha N; Barg, Frances K

    2013-11-01

    The objective was to identify adolescent preferences for emergency department (ED)-based education about emergency contraception. This was a cross-sectional computerized survey, using adaptive conjoint analysis (ACA). Patients were eligible if they were females ages 14 through 19 years old and were seeking care in one of two urban EDs. Patients were excluded if they were too ill to participate in the survey or if they were non-English speaking. Participants completed a computerized survey that used ACA, a technique that can be used to assess patients' relative preferences for services. ACA uses the individual's answers to update and refine questions through trade-off comparisons, so that each respondent answers a customized set of questions. The survey assessed preferences for the following attributes of emergency contraception education: who should deliver the education, if anyone (e.g., nurse, doctor); how the education should be delivered (e.g., by a person or via video); how often the education should be offered if patients were to frequent the ED (e.g., every time or only when asking for it); length (e.g., 5 minutes, 10 minutes); and chief complaint that would trigger the education (e.g., headache or stomach pain). A total of 223 patients were enrolled (37.2% at Hospital 1 and 62.8% at Hospital 2). The mean (±SD) age of the participants was 16.1 (±1.3) years. Just over half (55%) reported a history of sexual activity; 8% reported a history of pregnancy. Overall, the participants preferred education that was delivered by a person, specifically a doctor or nurse. They preferred a slightly longer education session and preferred education directed at patients seeking care in the ED for complaints potentially related to sexual activity. Adolescents have specific preferences for how education about emergency contraception would best serve their needs. This information can inform clinicians as they work to improve adolescents' knowledge about pregnancy prevention

  6. Clinical pattern of gynaecological / early pregnancy complaints and ...

    African Journals Online (AJOL)

    complaints of vaginal bleeding with or without pains, history of amenorrhea or infertility ; clinical and ultrasound impressions of early pregnancy complaints including ectopic pregnancies and pelvic inflammatory diseases (PID) with exclusion of uro-genital and gastrointestinal complaints/ cases. Pregnancies greater than 12 ...

  7. 20 CFR 658.416 - Action on JS-related complaints.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Action on JS-related complaints. 658.416... ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Job Service Complaint System State Agency Js Complaint System § 658.416 Action on JS-related complaints. (a) The appropriate State agency official handling an...

  8. Annual report of the Chief Executive Officer of ARPANSA, 1998-1999

    International Nuclear Information System (INIS)

    1999-12-01

    This is the first annual report of the Chief Executive Officer (CEO) of the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). It addresses the Requirements for Departmental Annual Reports issued by the Department of Prime Minister and Cabinet as updated in May 1999, as well as the annual reporting requirements of the Australian Radiation Protection and Nuclear Safety (ARPANS) Act 1998 . The report contains: a corporate overview which details the functions of ARPANSA, its corporate plan and organisational structure; a report on performance against the functions of ARPANSA and an account of some of the achievements of its achievements during the year under review; appendixes containing statistical and financial information on the performance and administration of ARPANSA as well as the financial statements for the Nuclear Safety Bureau and ARPANSA. An index showing compliance with the annual reporting requirements of the Department of Prime Minister and Cabinet is at Appendix 4F.Copyright (1999) Commonwealth of Australia

  9. 75 FR 32458 - TC Ravenswood, LLC v. New York Independent System Operator, Inc.; Notice of Complaint

    Science.gov (United States)

    2010-06-08

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL10-70-000] TC Ravenswood... 385.206, TC Ravenswood, LLC (Complainant) filed a complaint against New York Independent System Operator, Inc. (NYISO) (Respondent), requesting FERC order the NYISO to reimburse TC Ravenswood, LLC, as...

  10. Complaint in Shahriyar’s poems

    Directory of Open Access Journals (Sweden)

    Yadoolah Nasroolahi

    2016-06-01

    Full Text Available Abstract Complaint (as a type of Gravamen is one of the sub-genres of lyrical literature in which the poet or the writer expresses his/her personal feelings that are mostly used to express the emotions, the woes or complaints of the environment, the friends and society and mostly it depicts the frustration, despair and deprivation of the suffered, sensitive poet. This type of poetry, more or less, regular or sporadic, is reflected in the poetry of the past poets of Iran in the form of “HasbiyyehSorayi” as type of Complaint. According to the researchers, Complaintcan be divided into five kinds: philosophical, mystical, personal, social and political.  In Social Complaint, Shahriyar posits himself against the social ills such as corruption, degradation, illiteracy positions, expressing his criticism in the form of woes and poems. A part of Shahriyar’s complaining and criticizing is about the incorrect attitude of the cosmopolitan residents of the capital city of Tehran against the townspeople, disclosing the defects and shortcomings of the environment and the city of Tehran through various methods. In the political Complaints, the poet examines the failures and the frustrations caused by the Constitutional Revolution, the repressive dictatorship and his hated and antipathy from the political actions of that time. Of course, due to the interconnectedness of social and political issues, this of issue of Bath Ashshekva is interwoven with the poet’s poem. The personal Complaint incorporates the poet’s illness and aging that is derived from the poet’s natural passage of his life. The poet’s enormous spiritual and psychological sufferings are caused by his frustration in the abortive love affair that shows itself in the form of the lover’s complains of love, life, fortunate, old and young ages. We can call these types of grievances as unparalleled. They can make Shahriyar frustrated with love and alienation. In his mystical grievances

  11. Characterization of cholecystokinin receptors on guinea pig gastric chief cell membranes

    International Nuclear Information System (INIS)

    Matozaki, T.; Sakamoto, C.; Nagao, M.; Nishisaki, H.; Konda, Y.; Nakano, O.; Matsuda, K.; Wada, K.; Suzuki, T.; Kasuga, M.

    1991-01-01

    The binding of cholecystokinin (CCK) to its receptors on guinea pig gastric chief cell membranes were characterized by the use of 125 I-CCK-octapeptide (CCK8). At 30 degrees C optimal binding was obtained at acidic pH in the presence of Mg2+, while Na+ reduced the binding. In contrast to reports on pancreatic and brain CCK receptors, scatchard analysis of CCK binding to chief cell membranes revealed two classes of binding sites. Whereas, in the presence of a non-hydrolyzable GTP analog, GTP gamma S, only a low affinity site of CCK binding was observed. Chief cell receptors recognized CCK analogs, with an order of potency of: CCK8 greater than gastrin-I greater than CCK4. Although all CCK receptor antagonists tested (dibutyryl cyclic GMP, L-364718 and CR1409) inhibited labeled CCK binding to chief cell membranes, the relative potencies of these antagonists in terms of inhibiting labeled CCK binding were different from those observed in either pancreatic membranes or brain membranes. The results indicate, therefore, that on gastric chief cell membranes there exist specific CCK receptors, which are coupled to G protein. Furthermore, chief cell CCK receptors may be distinct from pancreatic or brain type CCK receptors

  12. Underdosing of acetaminophen by parents and emergency department utilization.

    Science.gov (United States)

    Goldman, Ran D; Scolnik, Dennis

    2004-02-01

    Fever is a common reason for parents to seek medical attention for their children. We conducted this study to document accuracy of parental administration of acetaminophen and to identify if parents who did not give an optimal dose would have decided not to come to the emergency department (ED) if the fever had diminished at home. A cross-sectional study including 248 caregivers of children who had a chief complaint of fever and had been given acetaminophen in the preceding 24 hours were interviewed. Enrollment was 86%. One hundred parents (47%) gave acetaminophen in the recommended dose, 26 parents (12%) gave an overdose, and 87 (41%) gave an underdose of acetaminophen. Half of the parents (54%) would not have come to the ED if the fever had subsided after using the antipyretic treatment at home. Children with significantly higher maximal temperature at home would not have been taken to the ED if fever had subsided. Parents who speak English as the primary language at home gave the recommended dose of acetaminophen more frequently than non-English-speaking parents. A significant portion of our population gives an underdose of acetaminophen, reflecting lack of knowledge or misuse. Based on parental reports, the majority of visits for fever might have been prevented, if parents had been successful in their effort to reduce temperature to below of what they considered as fever, but factors other than underdosing of acetaminophen probably encourage parents of febrile children to visit the ED.

  13. 20 CFR 405.30 - Discrimination complaints.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Discrimination complaints. 405.30 Section 405... INITIAL DISABILITY CLAIMS Introduction, General Description, and Definitions § 405.30 Discrimination... that an adjudicator has improperly discriminated against you, you may file a discrimination complaint...

  14. [Gestalt therapy of complaints].

    Science.gov (United States)

    De Baranchuk, J Z; Dayan, A; Gomez, A; Grimaldi, S; Morra, A

    1980-03-01

    People can express their suffering voicing it, complaining with their body, with gestures, movements; for alerts eyes it is even more comprehensive and true than words. Complaints that human beings are capable of expressing are not so many, there are only a handful, and this work intends to be exhaustive in its exposition. It is possible to complain against third persons. It is also possible to do so against oneself assuming either the intransigent attitude of a father who judges a son who does not fulfill his expectancies, or as a son who resents the paternal demands which he feels he cannot comply. Other kind of complaints include physical symptoms, either isolated (cephalea, dysnea, urticaria) or constituting syndromes or illnesses. Losses suffered are also a source of complaints, whatever the lost object might be (person, situation, material things or a part of oneself). It can be mourned because of its absence, or else by feeling guilty of the real or imaginary damage inflicted or else by feeling indisolubly linked to it with a phantom tie. Other types of complaints are the feeling of dependancy towards something oppressive, be it a substance, such as alcohol, smoking, drugs or overeating, or it may be a person or a situation. In view of the compulsive addiction characteristics with which the subject lives, it is possible to assimilate this dependancy and the feeling of oppression and damage to the link with a toxic.

  15. Office complaint redressal committee | About IASc | Indian Academy ...

    Indian Academy of Sciences (India)

    Office complaint redressal committee. CIRCULAR. In terms of the guidelines issued by DoPT vide its office memorandum dated 13.02.1998 an appropriate complaint mechanism should be created in every organization for redressal of the complaint in connection with sexual harassment of working women. Accordingly ...

  16. Psychosocial explanations of complaints in Dutch general practice

    NARCIS (Netherlands)

    Joosten, A; Mazeland, H; Meyboom-de Jong, B

    BACKGROUND: Dutch GPs are frequently consulted by patients presenting physical complaints which have a psychosocial cause. Until now, this type of complaint has often been the subject of study, but the way in which psychosocial explanations for complaints are broached and discussed has not yet been

  17. Chief, Treasury Operations | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The Chief provides coaching and supervision to a team of financial analysts. ... Approving and posting monthly journal entries, reconciliations and analysis; .... that include both quantitative and qualitative measures on unit performance;.

  18. Examining 30-day COPD readmissions through the emergency department

    Directory of Open Access Journals (Sweden)

    Rezaee ME

    2017-12-01

    Full Text Available Michael E Rezaee,1 Charlotte E Ward,2,3 Bonita Nuanez,1 Daniel A Rezaee,4 Jeffrey Ditkoff,1,5 Alexandra Halalau1,6 1Oakland University William Beaumont School of Medicine, Rochester, MI, 2Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, 3Center for Health Statistics, University of Chicago, Chicago, IL, 4Primary Care, Brigham and Women’s Hospital, Boston, MA, 5Emergency Medicine, 6Internal Medicine, Beaumont Health, Royal Oak, MI, USA Background: Thirty-day readmission in COPD is common and costly, but potentially preventable. The emergency department (ED may be a setting for COPD readmission reduction efforts.Objective: To better understand COPD readmission through the ED, ascertain factors associated with 30-day readmission through the ED, and identify subgroups of patients with COPD for readmission reduction interventions.Patients and methods: A retrospective cohort study was conducted from January 2009 to September 2015 in patients with COPD of age ≥18 years. Electronic health record data were abstracted for information available to admitting providers in the ED. The primary outcome was readmission through the ED within 30 days of discharge from an index admission for COPD. Logistic regression was used to examine the relationship between potential risk factors and 30-day readmission.Results: The study involved 1,574 patients who presented to the ED within 30 days on an index admission for COPD. Of these, 82.2% were readmitted through the ED. Charlson score (odds ratio [OR]: 3.6; 95% CI: 2.9–4.4, a chief complaint of breathing difficulty (OR: 1.6; 95% CI: 1.1–2.6, outpatient utilization of albuterol (OR: 4.1; 95% CI: 2.6–6.4, fluticasone/salmeterol (OR: 2.3; 95% CI: 1.3–4.2, inhaled steroids (OR: 3.8; 95% CI: 1.3–10.7, and tiotropium (OR: 1.8; 95% CI: 1.0–3.2, as well as arterial blood gas (OR: 4.4; 95% CI: 1.3–15.1 and B-type natriuretic peptide (OR: 2.2; 95% CI: 1.4–3.5 testing in the

  19. 77 FR 70796 - Privacy Act of 1974; Retirement of Department of Homeland Security Transportation Security...

    Science.gov (United States)

    2012-11-27

    ... privacy issues, please contact: Jonathan Cantor, (202-343-1717), Acting Chief Privacy Officer, Privacy... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary Privacy Act of 1974; Retirement of Department of Homeland Security Transportation Security Administration System of Records AGENCY: Privacy...

  20. Machiavelli and the Chief Resident.

    Science.gov (United States)

    Raviglione, Mario C.

    1990-01-01

    Precepts from Machiavelli's "The Prince" are used in giving advice to chief residents on how to balance their responsibilities in working for the welfare of both the housestaff and the institution. Subject discussions include the difficulties of introducing change, setting good examples, and supervising former colleagues and peers. (GLR)

  1. Complying with US and European complaint handling requirements.

    Science.gov (United States)

    Donawa, M E

    1997-09-01

    The importance of customer complaints for providing valuable information on the use of medical devices is clearly reflected in United States (US) and European quality system requirements for handling complaints. However, there are significant differences in US and European complaint handling requirements. This article will discuss those differences and methods for ensuring compliance.

  2. Lyme Disease: Emergency Department Considerations.

    Science.gov (United States)

    Applegren, Nathan D; Kraus, Chadd K

    2017-06-01

    Lyme disease (LD) is the most common vector-borne illness in North America. Reported cases of LD have increased from approximately 10,000 cases annually in 1991 to >25,000 cases in 2014. Greater recognition, enhanced surveillance, and public education have contributed to the increased prevalence, as have geographic expansion and the number of infected ticks. Cases are reported primarily in the Northeastern United States, Wisconsin, and Minnesota, with children having the highest incidence of LD among all age groups. The increased incidence and prevalence of LD in the United States makes it increasingly more common for patients to present to the emergency department (ED) for tick bites and LD-related chief complaints, such as the characteristic erythema migrans skin manifestation. We sought to review the etiology of LD, describe its clinical presentations and sequela, and provide a practical classification and approach to ED management of patients with LD-related presentations. In this review, ED considerations for LD are presented and clinical presentations and management of the disease at different stages is discussed. Delayed sequelae that have significant morbidity, including Lyme carditis and Lyme neuroborreliosis, are discussed. Diagnostic tests and management are described in detail. The increasing prevalence and growing geographic reach of Lyme disease makes it critically important for emergency physicians to consider the diagnosis in patients presenting with symptoms suggestive of LD and to initiate appropriate treatment to minimize the potential of delayed sequelae. Special consideration should be made for the epidemiology of LD and a high clinical suspicion should be present for patients in endemic areas or with known exposures to ticks. Emergency physicians can play a critical role in the recognition, diagnosis, and treatment of LD. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. EPA iComplaints

    Data.gov (United States)

    U.S. Environmental Protection Agency — The iComplaints system is an enterprise-level COTS (Commercial Off-The-Shelf) product that provides all of the funtionality required to collect, track, manage,...

  4. Rancang Bangun STIKI Class Facilities E-Complaint

    OpenAIRE

    Ni Kadek Ariasih; I Made Gede Sri Artha

    2017-01-01

    STMIK STIKOM Indonesia is one of the institutions in the field of computer-based education. In order to support the effectiveness of the implementation of teaching and learning activities that take place, it is need a service that support the availability of adequate class facilities and complaints services if there are constraints on facilities in the classroom. So far, the management of complaints complaints against classroom facilities or in the labarotorium which is handled by the Househo...

  5. NHS trust chief executives as heroes?

    Science.gov (United States)

    Learmonth, M

    2001-01-01

    This paper presents a reading of the transcripts of interviews with NHS Trust Chief Executives. Using a poststructuralist understanding of the interviews, it privileges a reading that (ironically) represents these Chief Executives as heroes. Following the classic hero story line, they leave the civilized order of home and journey into a threatening wilderness where they encounter dangerous and magical things but overcome them all because of their masculine characteristics such as rationality, strength and resourcefulness. One way in which these stories can be understood to have significance is that they (misleadingly but powerfully) portray management as obvious and necessary by evocatively drawing on a myth of ancient origin. The piece concludes with some reflections on the ontological implications of the analysis and reflexive comments on the production of truth as a problem.

  6. Work load and musculoskeletal complaints during pregnancy.

    Science.gov (United States)

    Paul, J A; van Dijk, F J; Frings-Dresen, M H

    1994-06-01

    Many pregnant women have musculoskeletal complaints, the onset and aggravation of which are thought to be associated with their activity or work postures. The purpose of this paper was to obtain more insight into the influence of pregnancy on the load of the musculoskeletal system at work to provide a better basis for preventing complaints. To this end, literature pertinent to a model called "work load of the musculoskeletal system" was reviewed. The model was developed to describe how work contributes to musculoskeletal complaints. It was found that pregnancy causes changes in a worker's characteristics. These changes can lead to changes in the work situation, activity pattern, and postural characteristics and possibly result in a change in work load. In addition, physical changes such as weight gain increase the work load in a given posture. The load-bearing capacity of the musculoskeletal system decreases due to pregnancy. The changes in load and the decrease in load-bearing capacity singly or simultaneously increase the risk of musculoskeletal complaints. The multifactorial cause of musculoskeletal complaints during pregnancy reveals various possibilities for prevention.

  7. The Eighth Stage of Information Management: Information Resources Management (IRM) vs. Knowledge Management (KM), and the Chief Information Officer (CIO) vs. the Chief Knowledge Officer (CKO).

    Science.gov (United States)

    Chen, Rui

    1998-01-01

    Describes the characteristics of the transfer point of information management to knowledge management (KM), what information resources management (IRM) does, and compares information and knowledge management and the roles of chief information officer (CIO) and chief knowledge officer (CKO). (PEN)

  8. 77 FR 73646 - Essar Steel Minnesota, LLC v. Great Lakes Gas Transmission Limited Partnership; Notice of Complaint

    Science.gov (United States)

    2012-12-11

    ... Transmission Limited Partnership (Respondent), alleging that the Respondent has failed to comply with the... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. RP13-313-000] Essar Steel Minnesota, LLC v. Great Lakes Gas Transmission Limited Partnership; Notice of Complaint Take notice that on...

  9. 75 FR 18828 - PSEG Power Connecticut LLC, Complainant v. ISO New England Inc., Respondent; Notice of Complaint

    Science.gov (United States)

    2010-04-13

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL10-58-000] PSEG Power Connecticut LLC, Complainant v. ISO New England Inc., Respondent; Notice of Complaint April 6, 2010. Take... ISO New England Inc. (Respondent) challenging the justness and reasonableness of the Respondent's...

  10. How Retailers Handle Complaint Management

    DEFF Research Database (Denmark)

    Hansen, Torben; Wilke, Ricky; Zaichkowsky, Judy

    2009-01-01

    This article fills a gap in the literature by providing insight about the handling of complaint management (CM) across a large cross section of retailers in the grocery, furniture, electronic and auto sectors. Determinants of retailers’ CM handling are investigated and insight is gained as to the......This article fills a gap in the literature by providing insight about the handling of complaint management (CM) across a large cross section of retailers in the grocery, furniture, electronic and auto sectors. Determinants of retailers’ CM handling are investigated and insight is gained...... as to the links between CM and redress of consumers’ complaints. The results suggest that retailers who attach large negative consequences to consumer dissatisfaction are more likely than other retailers to develop a positive strategic view on customer complaining, but at the same time an increase in perceived...

  11. Joint Chiefs of Staff > Directorates > J6 | C4 & Cyber

    Science.gov (United States)

    Joint Staff Structure Joint Staff Inspector General Origin of Joint Concepts U.S. Code | Joint Chiefs of Management J1 | Manpower and Personnel J2 | Joint Staff Intelligence J3 | Operations J4 | Logistics► the Joint Staff Chief Information Officer (CIO), the J-6 provides business class Information

  12. Emergency Department Frequent Users for Acute Alcohol Intoxication

    Directory of Open Access Journals (Sweden)

    Marc L. Martel

    2018-02-01

    Full Text Available Introduction: A subset of frequent users of emergency services are those who use the emergency department (ED for acute alcohol intoxication. This population and their ED encounters have not been previously described. Methods: This was a retrospective, observational, cohort study of patients presenting to the ED for acute alcohol intoxication between 2012 and 2016. We collected all data from the electronic medical record. Frequent users for alcohol intoxication were defined as those with greater than 20 visits for acute intoxication without additional medical chief complaints in the previous 12 months. We used descriptive statistics to evaluate characteristics of frequent users for alcohol intoxication, as well as their ED encounters. Results: We identified 32,121 patient encounters. Of those, 325 patients were defined as frequent users for alcohol intoxication, comprising 11,370 of the encounters during the study period. The median maximum number of encounters per person for alcohol intoxication in a one-year period was 47 encounters (range 20 to 169. Frequent users were older (47 years vs. 39 years, and more commonly male (86% vs. 71%. Frequent users for alcohol intoxication had higher rates of medical and psychiatric comorbidities including liver disease, chronic kidney disease, ischemic vascular disease, dementia, chronic obstructive pulmonary disease, history of traumatic brain injury, schizophrenia, and bipolar disorder. Conclusion: In this study, we identified a group of ED frequent users who use the ED for acute alcohol intoxication. This population had higher rates of medical and psychiatric comorbidities compared to non-frequent users.

  13. 76 FR 53935 - Delegation Authority for the Office of the Chief Financial Officer

    Science.gov (United States)

    2011-08-30

    ... Office of the Chief Financial Officer AGENCY: Office of the Secretary, HUD. ACTION: Notice of delegation of authority. SUMMARY: In this notice, the Secretary of HUD, pursuant to the Chief Financial Officers Act of 1990 (CFO Act), which established the position of the Chief Financial Officer within HUD, is...

  14. U. S. Department of Education Information Resources Management (IRM) Strategic Plan, FY2010-2014. Version 1.5

    Science.gov (United States)

    US Department of Education, 2010

    2010-01-01

    The Chief Information Officer (CIO) at the U.S. Department of Education (the Department) has primary responsibility to ensure that Information Technology (IT) is acquired and information resources are managed in a manner consistent with statutory, regulatory, and Departmental requirements and priorities. This Department Information Resources…

  15. Correlates of Women's Chief Executive Status: Comparisons with Men Chief Executives and Women Top Managers.

    Science.gov (United States)

    Tharenou, Phyllis

    1995-01-01

    In Australia, a sample of 50 female and 52 male chief executive officers (CEOs) and 53 top women managers was drawn from a larger survey. Results showed interpersonal and organizational situation factors (such as female management hierarchy, personal encouragement) were more associated with women CEOs' status. Status was less related to…

  16. 21 CFR 111.560 - What requirements apply to the review and investigation of a product complaint?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false What requirements apply to the review and investigation of a product complaint? 111.560 Section 111.560 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING...

  17. Middle Manager Role of the Chief Medical Resident: An Organizational Psychologist’s Perspective

    OpenAIRE

    Berg, David Nelson; Huot, Stephen Joseph

    2007-01-01

    The role of the chief resident in internal medicine is examined through the eyes of an organizational psychologist who, over a 3-year period, met with each of 6 groups of chief residents for an average of 1 hour a week over the 12 months of the job. Based on this experience, the chief resident job is conceptualized as a middle management role with 4 distinct types of tasks: up work, down work, lateral work, and internal work. Core challenges facing the chief residents at each stage of the chi...

  18. Chief Knowledge Officers? Perceptions, Pitfalls, & Potential.

    Science.gov (United States)

    Corcoran, Mary; Jones, Rebecca

    1997-01-01

    Argues that few librarians possess the needed competencies to fill the role of "chief knowledge officer" or "knowledge executive." Outlines executive competencies required: communications, leadership, experience, financial management, customer focus, entrepreneurial insight, and information technology grounding; examines gaps…

  19. 20 CFR 658.414 - Referral of non-JS-related complaints.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Referral of non-JS-related complaints. 658... ADMINISTRATIVE PROVISIONS GOVERNING THE JOB SERVICE SYSTEM Job Service Complaint System State Agency Js Complaint System § 658.414 Referral of non-JS-related complaints. (a) To facilitate the operation of the...

  20. Clinical pattern of gynecological/early pregnancy complaints and the ...

    African Journals Online (AJOL)

    ... complaints of vaginal bleeding, with or without pain, history of amenorrhea or infertility, clinical and ultrasound impression of early pregnancy complaints, including ectopic pregnancies and pelvic inflammatory diseases (PID), with exclusion of urogenital and gastrointestinal complaints/cases. Pregnancies greater than 12 ...

  1. Coping strategies in teachers with vocal complaint.

    Science.gov (United States)

    Zambon, Fabiana; Moreti, Felipe; Behlau, Mara

    2014-05-01

    To understand the coping strategies used by teachers with vocal complaints, compare the differences between those who seek and those who do not seek voice therapy, and investigate the relationships among coping and voice perceptual analysis, coping and signs and symptoms of voice, and coping and participation restrictions and limitations in vocal activities. Cross-sectional nonrandomized prospective study with control group. Ninety female teachers participated in the study, of similar ages, divided into three groups: group 1 (G1) comprised 30 teachers with vocal complaints who sought voice therapy, group 2 (G2) comprised 30 teachers with vocal complaints who never sought voice therapy, and group 3 (G3) comprised 30 teachers without vocal complaints. The following analysis were conducted: identification and characterization questionnaire, addressing personal and occupational description, recording speech material for voice perceptual analysis, Voice Signs and Symptoms Questionnaire, Voice Activity and Participation Profile (VAPP), and Voice Disability Coping Questionnaire (VDCQ)-Brazilian Version. In relation to the voice perceptual analysis, there was statistically significant difference between the groups with vocal complaint (G1+G2), which had showed voices with mild-to-moderate deviation, and the group without vocal complaint (G1), which showed voices within the normal variability of voice quality (mean for G1 = 49.9, G2 = 43.7, and G3 = 32.3, P Teachers with vocal complaints who looked for voice therapy use more coping strategies. Moreover, they present a tendency to use more problem-focused coping strategies. Voice symptoms prompt the teachers into seeking treatment; however, they are not correlated with the coping itself. In general, the higher the perception of limitation and restriction of participating in vocal activities, the greater the use of coping strategies. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  2. Profile and prevalence of hearing complaints in the elderly

    Directory of Open Access Journals (Sweden)

    Magda Aline Bauer

    Full Text Available Abstract Introduction: Hearing is essential for the processing of acoustic information and the understanding of speech signals. Hearing loss may be associated with cognitive decline, depression and reduced functionality. Objective: To analyze the prevalence of hearing complaints in elderly individuals from Rio Grande do Sul and describe the profile of the study participants with and without hearing complaints. Methods: 7315 elderly individuals interviewed in their homes, in 59 cities in the state of Rio Grande do Sul, Brazil, participated in the study. Inclusion criteria were age 60 years or older and answering the question on auditory self-perception. For statistical purposes, the chi-square test and logistic regression were performed to assess the correlations between variables. Results: 139 elderly individuals who did not answer the question on auditory self-perception and 9 who self-reported hearing loss were excluded, totaling 7167 elderly participants. Hearing loss complaint rate was 28% (2011 among the elderly, showing differences between genders, ethnicity, income, and social participation. The mean age of the elderly without hearing complaints was 69.44 (±6.91 and among those with complaint, 72.8 (±7.75 years. Elderly individuals without hearing complaints had 5.10 (±3.78 years of formal education compared to 4.48 (±3.49 years among those who had complaints. Multiple logistic regression observed that protective factors for hearing complaints were: higher level of schooling, contributing to the family income and having received health care in the last six months. Risk factors for hearing complaints were: older age, male gender, experiencing difficulty in leaving home and carrying out social activities. Conclusions: Among the elderly population of the state of Rio Grande do Sul, the prevalence of hearing complaints reached 28%. The complaint is more often present in elderly men who did not participate in the generation of family

  3. 22 CFR 18.10 - Service of complaint and other papers.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Service of complaint and other papers. 18.10... CONFLICT OF INTEREST Administrative Enforcement Proceedings § 18.10 Service of complaint and other papers.... (b) Service of papers other than complaint. Any paper other than the complaint may be served upon a...

  4. 20 CFR 658.415 - Transferring complaints to proper JS office.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Transferring complaints to proper JS office... Agency Js Complaint System § 658.415 Transferring complaints to proper JS office. (a) Where a JS-related... local office serving the area in which the employer is located. Where a JS-related complaint deals with...

  5. 29 CFR 6.41 - Referral to Chief Administrative Law Judge.

    Science.gov (United States)

    2010-07-01

    ... Administrative Law Judge to conduct such hearings as may be necessary to decide the disputed matters. A copy of... 29 Labor 1 2010-07-01 2010-07-01 true Referral to Chief Administrative Law Judge. 6.41 Section 6... Substantial Interest Proceedings § 6.41 Referral to Chief Administrative Law Judge. (a) Upon timely receipt of...

  6. 46 CFR 196.45-1 - Master and chief engineer responsible.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Master and chief engineer responsible. 196.45-1 Section... VESSELS OPERATIONS Carrying of Excess Steam § 196.45-1 Master and chief engineer responsible. (a) It shall be the duty of the master and the engineer in charge of the boilers of any vessel to require that a...

  7. 46 CFR 78.55-1 - Master and chief engineer responsible.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 3 2010-10-01 2010-10-01 false Master and chief engineer responsible. 78.55-1 Section... OPERATIONS Carrying of Excess Steam § 78.55-1 Master and chief engineer responsible. It shall be the duty of the master and the engineer in charge of the boilers of any vessel to require that a steam pressure is...

  8. Lower urinary tract dysfunction in patients with dysautonomia.

    Science.gov (United States)

    Aubin, Melissa St; Shridharani, Anand; Barboi, Alexandru C; Guralnick, Michael L; Jaradeh, Safwan S; Prieto, Thomas E; O'Connor, R Corey

    2015-12-01

    With the goal of better defining the types of bladder dysfunction observed in this population, we present the chief urologic complaints, results of urodynamic studies, and treatments of patients with dysautonomia-related urinary symptoms. All patients with dysautonomia referred to our neurourology clinic between 2005 and 2015 for management of lower urinary tract dysfunction were retrospectively reviewed. Each patient's chief urologic complaint was recorded and used to initially characterize the bladder storage or voiding symptoms. Patient evaluation included history and physical examination, urinalysis, post void bladder ultrasound, and urodynamic studies. Successful treatment modalities that subjectively or objectively improved symptoms were recorded. Of 815 patients with the diagnosis of dysautonomia, 82 (10 %) were referred for evaluation of lower urinary tract dysfunction. Mean age was 47 years (range 12-83) and 84 % were female. The chief complaint was urinary urgency ± incontinence in 61 % and hesitancy in 23 % of patients. Urodynamic findings demonstrated detrusor overactivity ± incontinence in 50 % of patients, although chief complaint did not reliably predict objective findings. Successful objective and subjective treatments were multimodal and typically non-operative. Lower urinary tract dysfunction may develop in at least 10 % of patients with dysautonomia, predominantly females. Bladder storage or voiding complaints do not reliably predict urodynamic findings. Urodynamically, most patients exhibited detrusor overactivity. The majority of patients were successfully managed with medical or physical therapy.

  9. Patient complaints in healthcare services in Vietnam’s health system

    Directory of Open Access Journals (Sweden)

    Bui Thi Thu Ha

    2015-10-01

    Full Text Available Background: There is growing recognition of patient rights in health sectors around the world. Patients’ right to complain in hospitals, often visible in legislative and regulatory protocols, can be an important information source for service quality improvement and achievement of better health outcomes. However, empirical evidence on complaint processes is scarce, particularly in the developing countries. To contribute in addressing this gap, we investigated patients’ complaint handling processes and the main influences on their implementation in public hospitals in Vietnam. Methods: The study was conducted in two provinces of Vietnam. We focused specifically on the implementation of the Law on Complaints and Denunciations and the Ministry of Health regulation on resolving complaints in the health sector. The data were collected using document review and in-depth interviews with key respondents. Framework approach was used for data analysis, guided by a conceptual framework and aided by qualitative data analysis software. Results: Five steps of complaint handling were implemented, which varied in practice between the provinces. Four groups of factors influenced the procedures: (1 insufficient investment in complaint handling procedures; (2 limited monitoring of complaint processes; (3 patients’ low awareness of, and perceived lack of power to change, complaint procedures and (4 autonomization pressures on local health facilities. While the existence of complaint handling processes is evident in the health system in Vietnam, their utilization was often limited. Different factors which constrained the implementation and use of complaint regulations included health system–related issues as well as social and cultural influences. Conclusion: The study aimed to contribute to improved understanding of complaint handling processes and the key factors influencing these processes in public hospitals in Vietnam. Specific policy implications for

  10. The system chief nurse executive role: sign of the changing times?

    Science.gov (United States)

    Clark, Joan Shinkus

    2012-01-01

    As the health care system landscape continues to evolve toward more integrated care, a trend toward consolidation of hospitals into larger systems continues. The systems are more than the traditional hospital-centric structures, as acute care becomes just one component to a larger system that includes ambulatory care, acute and post-acute care, chronic disease and end-of-life management, and all structures in between. To provide leadership in these new models, there have been an increasing number of system chief nurse executives hired both to facilitate the integration of care and to align and standardize nursing practice across the continuum. By definition, the role of the system chief nurse executive differs from that of the entity chief nursing officer. A crosswalk is presented that describes the differences between the roles and reflects on the implication for system chief nurse executives during our changing times.

  11. 75 FR 11191 - Privacy Act of 1974; Retirement of Department of Homeland Security Federal Emergency Management...

    Science.gov (United States)

    2010-03-10

    ... 20472. For privacy issues please contact: Mary Ellen Callahan (703-235- 0780), Chief Privacy Officer... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary Privacy Act of 1974; Retirement of Department of Homeland Security Federal Emergency Management Agency System of Records AGENCY: Privacy Office...

  12. Integration Telegram Bot on E-Complaint Applications in College

    Science.gov (United States)

    Rosid, M. A.; Rachmadany, A.; Multazam, M. T.; Nandiyanto, A. B. D.; Abdullah, A. G.; Widiaty, I.

    2018-01-01

    Internet of Things (IoT) has influenced human life where IoT internet connectivity extending from human-to-humans to human-to-machine or machine-to-machine. With this research field, it will be created a technology and concepts that allow humans to communicate with machines for a specific purpose. This research aimed to integrate between application service of the telegram sender with application of e-complaint at a college. With this application, users do not need to visit the Url of the E-compliant application; but, they can be accessed simply by submitting a complaint via Telegram, and then the complaint will be forwarded to the E-complaint Application. From the test results, e-complaint integration with Telegram Bot has been run in accordance with the design. Telegram Bot is made able to provide convenience to the user in this academician to submit a complaint, besides the telegram bot provides the user interaction with the usual interface used by people everyday on their smartphones. Thus, with this system, the complained work unit can immediately make improvements since all the complaints process can be delivered rapidly.

  13. Redefining NHS complaint handling--the real challenge.

    Science.gov (United States)

    Seelos, L; Adamson, C

    1994-01-01

    More and more organizations find that a constructive and open dialogue with their customers can be an effective strategy for building long-term customer relations. In this context, it has been recognized that effective complaint-contact handling can make a significant contribution to organizations' attempts to maximize customer satisfaction and loyalty. Within the NHS, an intellectual awareness exists that effective complaint/contact handling can contribute to making services more efficient and cost-effective by developing customer-oriented improvement initiatives. Recent efforts have focused on redefining NHS complaint-handling procedures to make them more user-friendly and effective for both NHS employees and customers. Discusses the challenges associated with opening up the NHS to customer feedback. Highlights potential weaknesses in the current approach and argues that the real challenge is for NHS managers to facilitate a culture change that moves the NHS away from a long-established defensive complaint handling practice.

  14. An analysis of 20 years of radiation-related health care complaints in Texas for the purposes of quality improvement.

    Science.gov (United States)

    Thommen, P J; Emery, R J

    2006-05-01

    In an effort to reveal the possible underlying causes of radiation-related health care complaints in the State of Texas, complaint data were evaluated using historical Texas Department of Health-Bureau of Radiation Control (TDH-BRC) reports. A major aim of the study was to generate a summary of the most commonly reported complaints that might be generalized to health care providers using sources of radiation across Texas. A generalizable list of common complaints would be a valuable tool for education and prevention programs, serving to possibly reduce the overall incidence of radiation-related medical complaints. Descriptive text summary reports of complaints were obtained from the TDH-BRC for the 20-y period inclusive of 1981 to 2001. The information was systematically coded into a computerized database. During the 20-y period of study, 481 health care-related complaints were identified, with approximately 74% consisting of claims of an "uncredentialed technician" (39%), "overexposure" (21%), or "regulatory violation" (14%). The most common categories of complaints imply some patient understanding or knowledge of the credentialing requirements of workers, the applicable dose limits, or the regulatory requirements associated with medical procedures. Since it is unlikely that an average patient would be aware of such issues, the findings suggest the complaints are not actually indications of the inappropriate uses of radiation, but are rather based on the patient's broader perception of services rendered. Most of the complaints levied during the period of study were done so anonymously (58%) and were levied against a generic facility (61%) rather than a specific technician (5%), doctor (4%), or student (1%). Approximately 61% of the complaints resulted in the issuance of a notice of violation upon investigation by the TDH-BRC, but the available data did not permit definitive linkage between the initial complaint and the violation issued. Taken in aggregate, the

  15. Characteristics of complaints resulting in disciplinary actions against Danish GPs

    DEFF Research Database (Denmark)

    S, Birkeland; RD, Christensen; N, Damsbo

    2013-01-01

    The risk of being disciplined in connection with a complaint case causes distress to most general practitioners. The present study examined the characteristics of complaint cases resulting in disciplinary action.......The risk of being disciplined in connection with a complaint case causes distress to most general practitioners. The present study examined the characteristics of complaint cases resulting in disciplinary action....

  16. [Culture sensitive analysis of psychosomatic complaints in migrants in Germany].

    Science.gov (United States)

    Bermejo, Isaac; Nicolaus, Leonhard; Kriston, Levente; Hölzel, Lars; Härter, Martin

    2012-05-01

    To ensure an adequate health care of migrants, differentiated information on the association of cultural background and migration related factors and psychosomatic complaints are necessary. Cross-sectional questionnaire based survey regarding psychosomatic complaints of migrants from Turkey (n = 77), Italy (n = 95), and Spain (n = 67) and ethnic German resettled from the states of the former Soviet Union (n = 196). Questionnaires distributed by non-health specific counselling agencies of welfare associations. The cultural background was a relevant factor for psychosomatic complaints, showing higher complaints in Turkish and ethnic German resettled migrants, also compared to a sample of age corresponding Germans. In contrast, Spanish and Italian migrants showed a lower risk for psychosomatic complaints. Also gender, feeling unwell in Germany and fatalism showed a significant association with psychosomatic complaints. Migrants in Germany do not have per se a higher risk for psychosomatic complaints. A distinct differentiation by cultural background is necessary. © Georg Thieme Verlag KG Stuttgart · New York.

  17. 47 CFR 76.1606 - Rate change while complaint pending.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Rate change while complaint pending. 76.1606... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1606 Rate change while complaint pending. A regulated cable operator that proposes to change any rate while a cable service tier complaint is pending...

  18. CREW CHIEF: A computer graphics simulation of an aircraft maintenance technician

    Science.gov (United States)

    Aume, Nilss M.

    1990-01-01

    Approximately 35 percent of the lifetime cost of a military system is spent for maintenance. Excessive repair time is caused by not considering maintenance during design. Problems are usually discovered only after a mock-up has been constructed, when it is too late to make changes. CREW CHIEF will reduce the incidence of such problems by catching design defects in the early design stages. CREW CHIEF is a computer graphic human factors evaluation system interfaced to commercial computer aided design (CAD) systems. It creates a three dimensional man model, either male or female, large or small, with various types of clothing and in several postures. It can perform analyses for physical accessibility, strength capability with tools, visual access, and strength capability for manual materials handling. The designer would produce a drawing on his CAD system and introduce CREW CHIEF in it. CREW CHIEF's analyses would then indicate places where problems could be foreseen and corrected before the design is frozen.

  19. 76 FR 53939 - Order of Succession for the Office of the Chief Financial Officer

    Science.gov (United States)

    2011-08-30

    ... Office of the Chief Financial Officer AGENCY: Office of the Secretary, HUD. ACTION: Notice of Order of... Chief Financial Officer. This Order of Succession supersedes all prior Orders of Succession for the Office of the Chief Financial Officer. DATES: Effective Date: August 19, 2011. FOR FURTHER INFORMATION...

  20. Memory Complaints Associated with Seeking Clinical Care

    Science.gov (United States)

    Pires, Carolina; Silva, Dina; Maroco, João; Ginó, Sandra; Mendes, Tiago; Schmand, Ben A.; Guerreiro, Manuela; de Mendonça, Alexandre

    2012-01-01

    Diagnosis of mild cognitive impairment relies on the presence of memory complaints. However, memory complaints are very frequent in healthy people. The objective of this study was to determine the severity and type of memory difficulties presented by elderly patients who seek for clinical help, as compared to the memory difficulties reported by subjects in the community. Assessment of subjective memory complaints was done with the subjective memory complaints scale (SMC). The mini-mental state examination was used for general cognitive evaluation and the geriatric depression scale for the assessment of depressive symptoms. Eight-hundred and seventy-one nondemented subjects older than 50 years were included. Participants in the clinical setting had a higher total SMC score (10.3 ± 4.2) than those in the community (5.1 ± 3.0). Item 3 of the SMC, Do you ever forget names of family members or friends? contributed significantly more to the variance of the total SMC score in the clinical sample (18%) as compared to the community sample (11%). Forgetting names of family members or friends plays an important role in subjective memory complaints in the clinical setting. This symptom is possibly perceived as particularly worrisome and likely drives people to seek for clinical help. PMID:22536537

  1. Feasibility of an innovative third-year chief resident system: an internal medicine residency leadership study

    Directory of Open Access Journals (Sweden)

    Victor O. Kolade

    2014-07-01

    Full Text Available Introduction: The role of the internal medicine chief resident includes various administrative, academic, social, and educational responsibilities, fulfillment of which prepares residents for further leadership tasks. However, the chief resident position has historically only been held by a few residents. As fourth-year chief residents are becoming less common, we considered a new model for rotating third-year residents as the chief resident. Methods: Online surveys were given to all 29 internal medicine residents in a single university-based program after implementation of a leadership curriculum and specific job description for the third-year chief resident. Chief residents evaluated themselves on various aspects of leadership. Participation was voluntary. Descriptive statistics were generated using SPSS version 21. Results: Thirteen junior (first- or second-year resident responses reported that the chief residents elicited input from others (mean rating 6.8, were committed to the team (6.8, resolved conflict (6.7, ensured efficiency, organization and productivity of the team (6.7, participated actively (7.0, and managed resources (6.6. Responses from senior residents averaged 1 point higher for each item; this pattern repeated itself in teaching evaluations. Chief resident self-evaluators were more comfortable running a morning report (8.4 than with being chief resident (5.8. Conclusion: The feasibility of preparing internal medicine residents for leadership roles through a rotating PGY-3 (postgraduate year chief residency curriculum was explored at a small internal medicine residency, and we suggest extending the study to include other programs.

  2. Urgensi Pengaturan Perkara Constitutional Complaint Dalam Kewenangan Mahkamah Konstitusi

    Directory of Open Access Journals (Sweden)

    Rahmat Muhajir Nugroho

    2016-02-01

    Full Text Available This study aimed to evaluate the mechanism for settling disputes in the Constitutional Court containing elements of constitutional complaint. In particular, this study focused on two things: first assessing the urgency/ importance of the idea of setting constitutional complaint in the Constitutional Court's authority. Secondly, to formulate recommendations on setting constitutional complaint in the Constitutional Court's authority. The method used in this research is descriptive qualitative. This type of research is a doctrinal law. This research studied the concept and implementation of the judicial settlement of cases that contain elements of constitutional complaint (complaint constitution by the Constitutional Court. The conclusion of this study is an important constitutional complaint mechanism is contained within the competence of the Constitutional Court to solve problems of injustice experienced by citizens as a result of public policies undertaken by the government in a broad sense, namely the executive, legislature and judiciary. Setting constitutional complaint within the competence of the Constitutional Court does not have to be explicitly stipulated in the constitution, but enough in the explanation of the Constitutional Court Act. That is not to add direct authority of the Court, but expand the meaning of the authority of the Court in testing the law.

  3. 26th February 2009 - US Google Vice President and Chief Internet Evangelist V. Cerf signing the guest book with Director for research and Computing S. Bertolucci; visiting ATLAS control room and experimental area with Collaboration Spokesperson P. Jenni.

    CERN Multimedia

    Maximilien Brice

    2009-01-01

    HI-0902038 05: IT Department Head, F. Hemmer; US Google Vice President and Chief Internet Evangelist V. Cerf; Computing Security Officer and Colloquium Convenor D. R. Myers; Member of the Internet Society Advisory Council F. Flückiger; Director for Research and Scientific Computing, S. Bertolucci ; Honorary Staff Member, B. Segal. HI-0902038 16: Computing Security Officer and Colloquium Convenor D. R. Myers; UC Irvine, ATLAS Deputy Spokesperson elect A. J. Lankford; US Google Vice President and Chief Internet Evangelist V. Cerf; ATLAS Collaboration Spokesperson P. Jenni; IT Department Head, F. Hemmer.

  4. A 30-month study of patient complaints at a major Australian hospital.

    Science.gov (United States)

    Anderson, K; Allan, D; Finucane, P

    2001-12-01

    Health practitioners often regard complaints about the quality of patient care in a negative light. However, complaints can indicate strategies to improve care. Therefore, an audit was undertaken of all formal complaints about patient care at a major Australian hospital over a 30-month period. The profile of complainants, the reasons for complaints, and the outcome were analysed. A total of 1308 complaints, concerning the care of 1267 patients, were received. The complaint rate was 1.12 per 1000 occasions of service. In all, 57% of complaints were lodged by advocates and 71% of complaints related to poor communication or to the treatment provided. In 97% of occasions, an explanation and/or an apology resulted. To date, no complaint has proceeded to litigation. Complaints are potentially useful quality assurance tools and can identify remediable system flaws. Health professionals and employers should understand why patients complain and be able to respond appropriately.

  5. The Changing Role of the Chief on a California Indian Reservation.

    Science.gov (United States)

    Miller, Virginia P.

    1989-01-01

    Discusses the Yuki Indian chief's aboriginal role as leader, decision maker, and group coordinator and how that role, revived by Indian agents, served acculturation forces when the Yuki became reservation Indians. Describes how chiefs, relatively progressive and acculturated individuals, were effective middlemen between the agents and Indians.…

  6. Selection related to musculoskeletal complaints among employees

    NARCIS (Netherlands)

    de Zwart, B. C.; Broersen, J. P.; van der Beek, A. J.; Frings-Dresen, M. H.; van Dijk, F. J.

    1997-01-01

    To (a) describe differences in the outcome of cross sectional and longitudinal analysis on musculoskeletal complaints relative to age and work demands, and (b) to assess the entrance and drop out selection on musculoskeletal complaints among groups of employees relative to age and work demands. A

  7. A Commander in Chief's Network-Centric Odyssey

    National Research Council Canada - National Science Library

    Copley, E

    2002-01-01

    .... Each Armed Service has begun training and equipping its force using the tenets of Network-Centric Operations, but those forces come together for the first time under the combatant Commander-in-Chief...

  8. 5 CFR 1201.122 - Filing complaint; serving documents on parties.

    Science.gov (United States)

    2010-01-01

    ... Disciplinary Actions § 1201.122 Filing complaint; serving documents on parties. (a) Place of filing. A Special Counsel complaint seeking disciplinary action under 5 U.S.C. 1215(a)(1) (including a complaint alleging a...

  9. The chief nurse executive role in large healthcare systems.

    Science.gov (United States)

    Englebright, Jane; Perlin, Jonathan

    2008-01-01

    Community hospitals are most frequently led by nonclinicians. Although some may have employed physician leaders, most often clinical leadership is provided by a chief nurse executive (CNE) or chief nursing officer. Clinical leadership of community hospital and health systems may similarly be provided by a system-level nursing executive or, often, by a council of facility CNEs. The increasingly competitive healthcare environment in which value-based purchasing of healthcare and pay-for-performance programs demand improved clinical performance for financial success has led to reconsideration of whether a council model can provide either the leadership or adequate attention to clinical (and operational) improvement. In turn, community hospitals and health systems look to CNE or chief nursing officer roles at the highest level of the organization as resources that are able to segue between the clinical and operational domains, translating clinical performance demands into operating strategies and tactics. This article explores CNE characteristics required for success in these increasingly responsible and visible roles.

  10. Metaplasia in the Stomach Arises From Gastric Chief Cells

    Directory of Open Access Journals (Sweden)

    Jason C. Mills

    2017-07-01

    Full Text Available The development of intestinal-type gastric cancer is preceded by loss of parietal cells (oxyntic atrophy and the induction of metaplastic cell lineages in the gastric mucosa. For example, mouse models have shown that spasmolytic polypeptide-expressing metaplasia can develop following oxyntic atrophy through transdifferentiation of zymogen-secreting chief cells. Evolution of spasmolytic polypeptide-expressing metaplasia from chief cells occurs via a coordinated dismantling of their secretory apparatus and reprogramming of their transcriptome. Increasing evidence suggests that the process of chief cell reprogramming requires the influence of inflammatory cytokines and requires both zymogen granule autophagy and alterations in gene transcription. It is likely that spasmolytic polypeptide-expressing metaplasia is a physiological repair mechanism that is similar to those that occur in other tissues (eg, pancreas for recruiting reparative progenitor cells in response to mucosal wounds. Chronic inflammation can induce a recurring pattern of persistent reprogramming/metaplasia that increases the risk for neoplasia.

  11. 5 CFR 1201.123 - Contents of complaint.

    Science.gov (United States)

    2010-01-01

    ... AND PROCEDURES Procedures for Original Jurisdiction Cases Special Counsel Disciplinary Actions § 1201... to file briefs, memoranda, or both in any disciplinary action complaint the Special Counsel brings... actions listed below, he or she must file a written complaint in accordance with § 1201.122 of this part...

  12. CNPC Appoints Chief Experts for Important Technological Projects

    Institute of Scientific and Technical Information of China (English)

    Zhao Jianzhong

    2006-01-01

    @@ On June 27th, China National Petroleum Corporation (CNPC) held a public recruitment to appoint chief experts in Beijing for its important technological projects, which is the first time for CNPC to appoint chief managers by the means of competitive recruitment. This recruitment covers four projects, such as drilling, logging, geophysical survey and ground engineering with 15 projects. Of those,there are 8 drilling projects, which make up 50 percent of all the important technological projects for public recruitment. CNPC expects to further boost the chief expert responsibility system and promote the research and development (R&D) of technological project on the basis of the public recruitment. The company completes the recruitment following the procedure of making announcement, conducting competitive recruitment and giving publicity. On July 25th, the appointment ceremony was held by CNPC and 15 experts were awarded the certificates. CNPC is entering a new stage for the implementation of the technology and talent strategy for the 11th Five-Year Plan. What's more, a new management mode is taking shape for the technological project and for the construction of technological personnel pool.

  13. 20 CFR 658.410 - Establishment of State agency JS complaint system.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Establishment of State agency JS complaint... Agency Js Complaint System § 658.410 Establishment of State agency JS complaint system. (a) Each State... State Administrator shall have overall responsibility for the operation of the State agency JS complaint...

  14. Environmental Assessment: Disposition of Chiefs’ Circle Residential Structures

    Science.gov (United States)

    2012-04-27

    five structures ranged from Page 4 of 5  $200,000 (with bricks removed) to $500,000 (with bricks intact). Mike Ford, CEO of NewTown Macon, echoed Mr...feasibility 25-Jul-08 and practicality of moving the Chief’s Circle duplexes Mike Ford NewTown Macon 23-Jul-08 478-722-9909 President of NewTown Macon...Daniel.Chavira@ Gave a tour of Chiefs’ Circle huntcompanies.com Not interested in using the houses Bob Sharples RAFB 26-Oct-10 robert.sharples

  15. SOLVING CUSTOMER COMPLAINTS: A STUDY OF MULTIPLE COMMERCIAL SETTINGS

    Directory of Open Access Journals (Sweden)

    Gurau Calin

    2012-12-01

    Full Text Available Theme: Many reports stress the importance of solving customer complaints in order to maintain customer satisfaction, but also to learn from mistakes and further improve the customer service. However, relatively few empirical studies have been conducted regarding the effect of complains handling activities on customer satisfaction and on company-customer relationships. Objectives of research: This paper attempts to identify the main elements of the complaints handling strategy that are considered essential for customers, and their effect on customer satisfaction. Literature analysis/previous research: Previous studies define a complaint as a conflict between a consumer and a business organisation in which the fairness of the resolution procedures, the interpersonal communication and behaviour, and the outcome of the complaint resolution process are the principal evaluative criteria used by the customer. In our opinion, a complaint is not necessary a conflict, however, it can create a conflict between a customer and a business organisation, when the answer to the consumer’s complaint is not satisfactory. Therefore, the way in which business organisations deal with consumer complaints can significantly influence the consumers’ level of satisfaction and loyalty. Research methodology: The empirical analysis of primary data collected through face-to-face interviews with 150 French customers provides a detailed picture of the specific elements of complains handling which are perceived as important in four different settings defined in relation to the perceived importance of the product or service, and the emergency of the experienced problem. Results: The identified elements of the complaint-handling procedure have a variable importance from one element to the other, and in the context of various complaint situations. This finding highlights the fact that, depending on each situation, the factors that will determine customer

  16. 29 CFR 793.11 - Combination announcer, news editor and chief engineer.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Combination announcer, news editor and chief engineer. 793... OF CERTAIN RADIO AND TELEVISION STATION EMPLOYEES FROM OVERTIME PAY REQUIREMENTS UNDER SECTION 13(b... editor and chief engineer. The 13(b)(9) exemption, as was made clear during the debate on the amendment...

  17. 77 FR 72846 - H.Q. Energy Services (U.S.) Inc. v. ISO New England Inc.; Notice of Complaint

    Science.gov (United States)

    2012-12-06

    ... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL13-25-000] H.Q. Energy Services (U.S.) Inc. v. ISO New England Inc.; Notice of Complaint Take notice that on November 28, 2012... ISO New England Inc. (Respondent), requesting the Commission to issue an order requiring the...

  18. Department of Defense International Space Cooperation Strategy

    Science.gov (United States)

    2017-01-01

    Commands’ regional exercise programs fully integrate appropriate allies’ and partners’ space operations. d. In close coordination with USSTRA TCOM...partners to develop basic operational capabilities through advanced and integrated training programs to grow a sophisticated coalition space cadre. b...1-2600 "’l. ., 5 Lui/ !.Y. 4’/ ,_ , MEMORANDUM FOR SECRETARIES OF THE MILITARY DEPARTMENTS CHAIRMAN OF THE JOINT CHIEFS OF STAFF UNDER SECRET

  19. Inspector General Complaints

    Science.gov (United States)

    to file an online IG complaint. Active Duty Resources dfas logo Defense Finance Accounting Service Inspector General Air Force Reserve Resources dfas logo Defense Finance Accounting Service ARPC Air Reserve National Guard Resources dfas logo Defense Finance Accounting Service VPC-GR myPers AFPC Air Force Review

  20. 12 CFR 268.302 - Mixed case complaints.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Mixed case complaints. 268.302 Section 268.302... RULES REGARDING EQUAL OPPORTUNITY Related Processes § 268.302 Mixed case complaints. A mixed case... discrimination or it may contain additional allegations that the MSPB has jurisdiction to address. A mixed case...

  1. 12 CFR 227.2 - Consumer complaint procedure.

    Science.gov (United States)

    2010-01-01

    ... convenience of the user, the revised text is set forth as follows: § 227.2 Consumer-complaint procedure. (a... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Consumer complaint procedure. 227.2 Section 227... SYSTEM UNFAIR OR DECEPTIVE ACTS OR PRACTICES (REGULATION AA) General Provisions § 227.2 Consumer...

  2. 77 FR 37558 - Disclosure of Certain Credit Card Complaint Data

    Science.gov (United States)

    2012-06-22

    ... Certain Credit Card Complaint Data AGENCY: Bureau of Consumer Financial Protection. ACTION: Notice of... Bureau plans to exercise its discretion to publicly disclose certain credit card complaint data that do not include personally identifiable information. The Bureau receives credit card complaints from...

  3. Research chief wants to make science matter

    CERN Multimedia

    König, R

    1999-01-01

    The new research chief of the European Union, Phillippe Busquin wants to move science into the heart of EU decision-taking. He would like to make European research more 'cohesive, focused, mobile and multilateral' (2 pages).

  4. The role of complaint management in the service recovery process.

    Science.gov (United States)

    Bendall-Lyon, D; Powers, T L

    2001-05-01

    Patient satisfaction and retention can be influenced by the development of an effective service recovery program that can identify complaints and remedy failure points in the service system. Patient complaints provide organizations with an opportunity to resolve unsatisfactory situations and to track complaint data for quality improvement purposes. Service recovery is an important and effective customer retention tool. One way an organization can ensure repeat business is by developing a strong customer service program that includes service recovery as an essential component. The concept of service recovery involves the service provider taking responsive action to "recover" lost or dissatisfied customers and convert them into satisfied customers. Service recovery has proven to be cost-effective in other service industries. The complaint management process involves six steps that organizations can use to influence effective service recovery: (1) encourage complaints as a quality improvement tool; (2) establish a team of representatives to handle complaints; (3) resolve customer problems quickly and effectively; (4) develop a complaint database; (5) commit to identifying failure points in the service system; and (6) track trends and use information to improve service processes. Customer retention is enhanced when an organization can reclaim disgruntled patients through the development of effective service recovery programs. Health care organizations can become more customer oriented by taking advantage of the information provided by patient complaints, increasing patient satisfaction and retention in the process.

  5. 29 CFR 471.12 - What are the procedures to be followed when a violation is found during a complaint investigation...

    Science.gov (United States)

    2010-07-01

    ... Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR NOTIFICATION OF EMPLOYEE RIGHTS UNDER FEDERAL LABOR LAWS OBLIGATIONS OF FEDERAL CONTRACTORS AND SUBCONTRACTORS; NOTIFICATION OF EMPLOYEE RIGHTS UNDER FEDERAL LABOR LAWS General Enforcement; Compliance Review and Complaint Procedures § 471.12...

  6. 31 CFR 8.55 - Contents of complaint.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Contents of complaint. 8.55 Section 8.55 Money and Finance: Treasury Office of the Secretary of the Treasury PRACTICE BEFORE THE BUREAU OF... he or she is able to prepare a defense. (b) Demand for answer. The complaint will give notification...

  7. Establishment of the Department of Anaesthesia at Harvard Medical School-1969.

    Science.gov (United States)

    Mizrahi, Ilan; Desai, Sukumar P

    2016-02-01

    The first academic departments of anesthesia were established in the United States at the University of Wisconsin-Madison in 1927, with Ralph M. Waters named as chairman, and in the UK at Oxford University in 1937, with Robert Macintosh as chairman. Compared to these early departments, more than 3 decades would pass before Harvard Medical School decided it was time to establish a department of anaesthesia, in 1969. We examine the forces on both sides of the issue, for and against, and how they played out in the late 1960s. Published articles, books, interviews, and biographical and autobiographical notes as well as primary source documents such as reports of department and medical school committee meetings were examined to obtain information relevant to our investigation. The late 1960s were an ideal time for the chiefs of anesthesia at the various Harvard teaching hospitals to make a strong argument in favor of establishment of an independent department of anaesthesia. Although strongly opposed by Francis Daniels Moore, Chief of Surgery at Peter Bent Brigham Hospital, an independent department at Harvard was established in 1969. The recognition of anesthesia as a distinctive specialty at universities across the country as well as the specific concerns over administration, hiring, and the future of the clinical service in the 1960s provided overwhelming support for the establishment of a separate, free-standing department of anaesthesia at one of the most tradition-bound universities in the United States-Harvard. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Pathways to Academic Leadership in Plastic Surgery: A Nationwide Survey of Program Directors, Division Chiefs, and Department Chairs of Plastic Surgery.

    Science.gov (United States)

    Fishman, Jordan E; Pang, John Henry Y; Losee, Joseph E; Rubin, J Peter; Nguyen, Vu T

    2018-06-01

    Many aspire to leadership in academic plastic surgery yet there is no well-documented pathway. Information regarding plastic surgery residencies and program directors was obtained from the American Medical Association's FREIDA database. The division chief or department chair (academic head) of every academic plastic surgery program was identified. One Internet-based survey was distributed to academic heads; another, to program directors. Ninety academic heads were identified, 35 of whom also serve as program director. Sixty-seven unique program directors were identified. There was a 51 percent academic head response rate and a 65 percent program director response rate. Academic plastic surgery is overwhelmingly administered by midcareer men. The average program director was appointed at age 45 and has served for 7 years. She or he was trained through the independent track, completed additional training in hand surgery, and is a full professor. She or he publishes two or three peer-reviewed manuscripts per year and spends 9 hours per week in administration. The average academic head was appointed at age 45 and has held the position for 12 years. She or he was trained in the independent model, completed fellowship training, and is a full professor. She or he publishes five peer-reviewed manuscripts per year and spends 12 hours per week involved in administration. Program directors and academic heads serve nonoverlapping roles. Few program directors will advance to the role of academic head. Successful applicants to the program director position often serve as an associate program director and are seen as motivated resident educators. In contrast, those faculty members selected for the academic head role are academically accomplished administrators with business acumen.

  9. 75 FR 7979 - Privacy Act of 1974: Implementation of Exemptions; Department of Homeland Security/ALL-027 The...

    Science.gov (United States)

    2010-02-23

    ... privacy issues please contact: Mary Ellen Callahan (703-235-0780), Chief Privacy Officer, Privacy Office...] Privacy Act of 1974: Implementation of Exemptions; Department of Homeland Security/ALL-027 The History of the Department of Homeland Security System of Records AGENCY: Privacy Office, DHS. ACTION: Notice of...

  10. 76 FR 69031 - Order of Succession for the Office of the Chief Human Capital Officer

    Science.gov (United States)

    2011-11-07

    ... Office of the Chief Human Capital Officer AGENCY: Office of the Chief Human Capital Officer, HUD. ACTION: Notice of order of succession. SUMMARY: In this notice, the Chief Human Capital Officer for the... Human Capital Officer. DATES: Effective Date: October 20, 2011. FOR FURTHER INFORMATION CONTACT: Lynette...

  11. Professor Sir Mark Walport Government Chief Scientific Adviser Head of Government Science and Engineering Profession Chief Executive Designate of UK Research and Innovation United Kingdom of Great Britain and Northern Ireland

    CERN Multimedia

    Bennett, Sophia Elizabeth

    2017-01-01

    Professor Sir Mark Walport Government Chief Scientific Adviser Head of Government Science and Engineering Profession Chief Executive Designate of UK Research and Innovation United Kingdom of Great Britain and Northern Ireland

  12. The Chief Financial Officer and Government Relations.

    Science.gov (United States)

    Lasher, William F.; Grigsby, Gwen; Sullivan, Charlotte

    1999-01-01

    Examines the work of the college or university chief financial officer (CFO) in government relations, focusing on the CFO's responsibilities, methods of working with state legislatures, pitfalls in legislative relations, and special problems faced by institutions in capital cities. (Author/MSE)

  13. EVALUATING GENDER DIFFERENCES IN THE COMPLAINT BEHAVIOR OF MALAYSIAN CONSUMERS

    Directory of Open Access Journals (Sweden)

    Nelson Oly Ndubisi

    2007-01-01

    Full Text Available The aim of this paper is to investigate whether male and female Malaysian consumers differ in their dissatisfaction complaint behavior and its aftermath. The study examines the moderation effect of gender in the relationship between public complaint behavior, private complaint behavior and customer defection. Data for the study was collected from 218 randomly selected customers of retail banks in Malaysia. The results show that public and private complaints are significantly associated with defection. These findings are generic across sex-type. Theoretical and managerial implications of the findings are discussed.

  14. Development and Application of Syndromic Surveillance for Severe Weather Events Following Hurricane Sandy.

    Science.gov (United States)

    Tsai, Stella; Hamby, Teresa; Chu, Alvin; Gleason, Jessie A; Goodrow, Gabrielle M; Gu, Hui; Lifshitz, Edward; Fagliano, Jerald A

    2016-06-01

    Following Hurricane Superstorm Sandy, the New Jersey Department of Health (NJDOH) developed indicators to enhance syndromic surveillance for extreme weather events in EpiCenter, an online system that collects and analyzes real-time chief complaint emergency department (ED) data and classifies each visit by indicator or syndrome. These severe weather indicators were finalized by using 2 steps: (1) key word inclusion by review of chief complaints from cases where diagnostic codes met selection criteria and (2) key word exclusion by evaluating cases with key words of interest that lacked selected diagnostic codes. Graphs compared 1-month, 3-month, and 1-year periods of 8 Hurricane Sandy-related severe weather event indicators against the same period in the following year. Spikes in overall ED visits were observed immediately after the hurricane for carbon monoxide (CO) poisoning, the 3 disrupted outpatient medical care indicators, asthma, and methadone-related substance use. Zip code level scan statistics indicated clusters of CO poisoning and increased medicine refill needs during the 2 weeks after Hurricane Sandy. CO poisoning clusters were identified in areas with power outages of 4 days or longer. This endeavor gave the NJDOH a clearer picture of the effects of Hurricane Sandy and yielded valuable state preparation information to monitor the effects of future severe weather events. (Disaster Med Public Health Preparedness. 2016;10:463-471).

  15. Can we predict cognitive deficits based on cognitive complaints?

    Directory of Open Access Journals (Sweden)

    Ewa Małgorzata Szepietowska

    2017-03-01

    Full Text Available Objective: The aim of the study was to determine whether the intensity of cognitive complaints can, in conjunction with other selected variables, predict the general level of cognitive functions evaluated with the Montreal Cognitive Assessment (MoCA test. Current reports do not show clear conclusions on this subject. Some data indicate that cognitive complaints have a predictive value for low scores in standardised tasks, suggesting cognitive dysfunction (e.g. mild cognitive impairment. Other data, however, do not support the predictive role of complaints, and show no relationship to exist between the complaints and the results of cognitive tests. Material and methods: The study included 118 adults (58 women and 60 men. We used the MoCA test, a self-report questionnaire assessing the intensity of cognitive complaints (Patient-Reported Outcomes in Cognitive Impairment – PROCOG and Dysexecutive Questionnaire/Self – DEX-S, and selected subtests of the Wechsler Adult Intelligence Scale-Revised (WAIS-R PL. On the basis of the results from the MoCA test, two separate groups were created, one comprising respondents with lower results, and one – those who obtained scores indicating a normal level of cognitive function. We compared these groups according to the severity of the complaints and the results obtained with the other methods. Logistic regression analysis was performed taking into account the independent variables (gender, age, result in PROCOG, DEX-S, and neurological condition and the dependent variable (dichotomized result in MoCA. Results: Groups with different levels of performance in MoCA differed in regards of some cognitive abilities and the severity of complaints related to semantic memory, anxiety associated with a sense of deficit and loss of skills, but provided similar self-assessments regarding the efficiency of episodic memory, long-term memory, social skills and executive functions. The severity of complaints does not allow

  16. Complaint-severity and cervical spine problems successfully classified patients with shoulder complaints

    NARCIS (Netherlands)

    Groenier, KH; de Winter, AF; Winters, JC; de Vet, HCW; Meyboom-de Jong, B

    Objective: To construct a classification of patients with shoulder complaints based on their physical examination. To investigate (1) the interobserver reliability, (2) to what extent the setting in which the patients were recruited, and demographic and clinical characteristics are related to the

  17. 77 FR 37616 - Disclosure of Consumer Complaint Data

    Science.gov (United States)

    2012-06-22

    ... Protection Bureau, at (202) 435-7700. SUPPLEMENTARY INFORMATION: I. Background A. Credit Card Policy... disclosure of data from consumer complaints about financial products and services other than credit cards... Statement'') describing its plans to disclose consumer credit card complaint data. The present notice (the...

  18. 78 FR 21218 - Disclosure of Consumer Complaint Data

    Science.gov (United States)

    2013-04-10

    ... companies, consumer groups, and trade associations to obtain feedback prior to beginning to accept new types... industry group suggesting distinguishing company response categories according to the type of company and... contains certain fields for each unique \\3\\ complaint \\4\\--complaints about other types of consumer...

  19. Comparison AHP and SAW to promotion of head major department SMK Muhammadiyah 04 Medan

    Science.gov (United States)

    Saputra, M.; Sitompul, O. S.; Sihombing, P.

    2018-04-01

    Decision Support System (DSS) is a system that can help a person to make informed decisions about various types of choices that are performed accurately and in accordance with the desired goals. Many problems can be solved by using decision support systems. In this journal the decision support system is used to assist the Chief of Muhammadiyah Medan branch in the selection of the department chief. The criteria used for the election of department chiefs are: Loyalty, Job Performance, Responsibility, Obedience, Honesty, Cooperation, Education, and Leadership. The selection promotion process consists of Analytical Hierarchy Process (AHP) and Simple Additive Weighting (SAW) methods. The data were obtained through teacher assessment questionnaires by principals and colleagues. The results of this study used a comparison with two decision methods namely SAW method and AHP method so that the decision maker (principal) is more appropriate in the determination of candidates who will be elected head of department at school. The final result of this research is the first rank obtained by muhammad musa with weight value on AHP method (0.274) and weight value on SAW method (0.993), alvin syahrin with weight value on AHP method (0.241) and weight value on SAW method (0.883), noviyanti with weight value on AHP method (0.193) and weight value on SAW method (0.707). So the conclusion on the research that is by using SAW method the value of weight produced more accurate.

  20. Visual Complaints and Eye Problems in Orchestral Musicians.

    Science.gov (United States)

    Beckers, Henny Jm; van Kooten-Noordzij, Marina Aw; de Crom, Ronald Mpc; Schouten, Jan Sag; Webers, Carroll Ab

    2016-09-01

    To study visual complaints and eye diseases among professional and amateur orchestral musicians in the Netherlands. In this observational study, members from professional and amateur symphony or wind orchestras were asked to complete a questionnaire collecting demographic data, musical, medical, and family history, and data on present visual complaints and/or eye diseases. Questions about playing in the orchestra were also asked. Data from 70 professionals and 48 amateurs showed that most musicians needed glasses or contact lenses for playing in the orchestra (61% of the professionals, 63% of the amateurs). A majority (66% of professionals, 71% of amateurs) had visited an ophthalmologist at least once during their lifetime, and 10% of the professionals and 23% of the amateurs were currently under treatment of an ophthalmologist. Visual complaints while playing in the orchestra were quite common and included poor lighting conditions, problems with reading small notes, blurred vision, tired eyes, and itching or burning eyes. Professional musicians especially reported adverse effects of eye complaints encountered in the orchestra for daily life; 35% got tired earlier and 33% felt that they could not adequately perform their tasks in the orchestra. The results show that visual complaints and eye problems probably are quite common among orchestral musicians and therefore warrant further interest and research.

  1. Emotion Analysis of Telephone Complaints from Customer Based on Affective Computing

    OpenAIRE

    Gong, Shuangping; Dai, Yonghui; Ji, Jun; Wang, Jinzhao; Sun, Hai

    2015-01-01

    Customer complaint has been the important feedback for modern enterprises to improve their product and service quality as well as the customer's loyalty. As one of the commonly used manners in customer complaint, telephone communication carries rich emotional information of speeches, which provides valuable resources for perceiving the customer's satisfaction and studying the complaint handling skills. This paper studies the characteristics of telephone complaint speeches and proposes an anal...

  2. Screening for violence risk factors identifies young adults at risk for return emergency department visit for injury.

    Science.gov (United States)

    Hankin, Abigail; Wei, Stanley; Foreman, Juron; Houry, Debra

    2014-08-01

    Homicide is the second leading cause of death among youth aged 15-24. Prior cross-sectional studies, in non-healthcare settings, have reported exposure to community violence, peer behavior, and delinquency as risk factors for violent injury. However, longitudinal cohort studies have not been performed to evaluate the temporal or predictive relationship between these risk factors and emergency department (ED) visits for injuries among at-risk youth. The objective was to assess whether self-reported exposure to violence risk factors in young adults can be used to predict future ED visits for injuries over a 1-year period. This prospective cohort study was performed in the ED of a Southeastern US Level I trauma center. Eligible participants were patients aged 18-24, presenting for any chief complaint. We excluded patients if they were critically ill, incarcerated, or could not read English. Initial recruitment occurred over a 6-month period, by a research assistant in the ED for 3-5 days per week, with shifts scheduled such that they included weekends and weekdays, over the hours from 8AM-8PM. At the time of initial contact in the ED, patients were asked to complete a written questionnaire, consisting of previously validated instruments measuring the following risk factors: a) aggression, b) perceived likelihood of violence, c) recent violent behavior, d) peer behavior, e) community exposure to violence, and f) positive future outlook. At 12 months following the initial ED visit, the participants' medical records were reviewed to identify any subsequent ED visits for injury-related complaints. We analyzed data with chi-square and logistic regression analyses. Three hundred thirty-two patients were approached, of whom 300 patients consented. Participants' average age was 21.1 years, with 60.1% female, 86.0% African American. After controlling for participant gender, ethnicity, or injury complaint at time of first visit, return visits for injuries were significantly

  3. On Non-Frattini Chief Factors and Solvability of Finite Groups

    Indian Academy of Sciences (India)

    A subgroup of a group is said to be a semi C A P ∗ -subgroup of if there is a chief series 1 = G 0 < G 1 < ⋯ < G m = G of such that for every non-Frattini chief factor G i / G i − 1 , H either covers G i / G i − 1 or avoids G i / G i − 1 . In this paper, some sufficient conditions for a normal subgroup of a finite group to be ...

  4. 20 CFR 655.185 - Job service complaint system; enforcement of work contracts.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Job service complaint system; enforcement of... Job service complaint system; enforcement of work contracts. (a) Filing with DOL. Complaints arising under this subpart must be filed through the Job Service Complaint System, as described in 20 CFR part...

  5. Complaint go: an online complaint registration system using web services and android

    Science.gov (United States)

    Mareeswari, V.; Gopalakrishnan, V.

    2017-11-01

    In numerous nations, there are city bodies that are the nearby representing bodies that help keep up and run urban communities. These administering bodies are for the most part called MC (Municipal Cooperation). The MC may need to introduce edit cameras and other observation gadgets to guarantee the city is running easily and productively. It is imperative for an MC to know the deficiencies occurring inside the city. As of now, this must be for all intents and purposes conceivable by introducing sensors/cameras and so forth or enabling nationals to straightforwardly address them. The everyday operations and working of the city are taken care by administering bodies which are known as Government Authorities. Presently keeping in mind the end goal to keep up the huge city requires that the Government Authority should know about any issue or deficiency either through (sensors/CCTV cameras) or by enabling the nationals to grumble about these issues. The second choice is generally granted on the grounds that it gives the best possible substantial data. The GA by and large enables its residents to enlist their grievance through a few mediums. In this application, the citizens are facilitated to send the complaints directly from their smartphone to the higher officials. Many APIs are functioning as the web services which are really essential to make it easier to register a complaint such as Google Places API to detect your current location and show that in Map. The Web portal is used to process various complaints well supported with different web services.

  6. Patient-reported denials, appeals, and complaints: associations with overall plan ratings.

    Science.gov (United States)

    Quigley, Denise D; Haviland, Amelia M; Dembosky, Jacob W; Klein, David J; Elliott, Marc N

    2018-03-01

    To assess whether Medicare patients' reports of denied care, appeals/complaints, and satisfactory resolution were associated with ratings of their health plan or care. Retrospective analysis of 2010 Medicare Advantage Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data. Multivariate linear regression of data from 154,766 respondents (61.1% response rate) tested the association of beneficiary ratings of plan and care with beneficiary reports of denied care, appeals, complaints, and complaint resolution, adjusting for beneficiary demographics. Beneficiaries who reported being denied needed care rated their plans and care significantly less positively, by 17.2 points (on a 100-point scale) and 9.1 points, respectively. Filing an appeal was not statistically significantly associated with further lower ratings. Beneficiaries who filed a complaint that was satisfactorily resolved gave slightly lower ratings of plans (-3.4 points) and care (-2.5 points) than those not filing a complaint (P plans. Our results suggest that beneficiaries may attribute the actions that lead to complaints or denials to plans more than to the care they received. Successful complaint resolution and utilization management review might eliminate most deficits associated with complaints and denied care, consistent with the service recovery paradox. High rates of complaints and denied care might identify areas that need improved utilization management review, customer service, and quality improvement. Among those reporting being denied care, filing an appeal was not associated with lower patient ratings of plan or care.

  7. Using an Emergency Department Syndromic Surveillance System to Evaluate Reporting of Potential Rabies Exposures, Illinois, 2013-2015.

    Science.gov (United States)

    Bemis, Kelley; Frias, Mabel; Patel, Megan Toth; Christiansen, Demian

    Mandatory reporting of potential rabies exposures and initiation of postexposure prophylaxis (PEP) allow local health authorities to monitor PEP administration for errors. Our objectives were to use an emergency department (ED) syndromic surveillance system to (1) estimate reporting compliance for exposure to rabies in suburban Cook County, Illinois, and (2) initiate interventions to improve reporting and reassess compliance. We queried ED records from 45 acute care hospitals in Cook County and surrounding areas from January 1, 2013, through June 30, 2015, for chief complaints or discharge diagnoses pertaining to rabies, PEP, or contact with a wild mammal (eg, bat, raccoon, skunk, fox, or coyote). We matched patients with ≥1 ED visit for potential rabies exposure to people with potential rabies exposure reported to the Cook County Department of Public Health. We considered nonmatches to have unreported exposures. We then initiated active surveillance in July 2015, disseminated education on reporting requirements in August and September 2015, and reassessed reporting completeness from July 2015 through February 2016. Of 248 patients with rabies-related ED visits from January 2013 through June 2015, 63 (25.4%) were reported. After interventions were implemented to increase reporting compliance, 53 of 98 (54.1%) patients with rabies-related ED visits from July 2015 through February 2016 were reported. Patients with ED visits for potential rabies exposure were twice as likely to be reported postintervention than preintervention (risk ratio = 2.1; 95% CI, 1.6-2.8). The volume of potential rabies exposure cases reported to the health department from July 2015 through February 2016 increased by 252% versus the previous year. Potential rabies exposures and PEP initiation are underreported in suburban Cook County. ED syndromic surveillance records can be used to estimate reporting compliance and conduct active surveillance.

  8. How to appoint a new chief nurse, win friends and influence people.

    Science.gov (United States)

    Butterworth, Tony

    2004-07-01

    OUR CHIEF nurse for England, Sarah Mullally, has announced her intention to leave the NHS and the search is on for her replacement. Speculation on who it will be is rife; this is an opportune moment therefore to reflect on the ideal qualities of the new chief nursing officer (CNO) for England.

  9. Science Ideals and Science Careers in a University Biology Department

    Science.gov (United States)

    Long, David E.

    2014-01-01

    In an ethnographic study set within a biology department of a public university in the United States, incongruity between the ideals and practice of science education are investigated. Against the background of religious conservative students' complaints about evolution in the curriculum, biology faculty describe their political intents for…

  10. Enhancing teamwork between chief residents and residency program directors: description and outcomes of an experiential workshop.

    Science.gov (United States)

    McPhillips, Heather A; Frohna, John G; Murad, M Hassan; Batra, Maneesh; Panda, Mukta; Miller, Marsha A; Brigham, Timothy P; Doughty, Robert A

    2011-12-01

    An effective working relationship between chief residents and residency program directors is critical to a residency program's success. Despite the importance of this relationship, few studies have explored the characteristics of an effective program director-chief resident partnership or how to facilitate collaboration between the 2 roles, which collectively are important to program quality and resident satisfaction. We describe the development and impact of a novel workshop that paired program directors with their incoming chief residents to facilitate improved partnerships. The Accreditation Council for Graduate Medical Education sponsored a full-day workshop for residency program directors and their incoming chief residents. Sessions focused on increased understanding of personality styles, using experiential learning, and open communication between chief residents and program directors, related to feedback and expectations of each other. Participants completed an anonymous survey immediately after the workshop and again 8 months later to assess its long-term impact. Participants found the workshop to be a valuable experience, with comments revealing common themes. Program directors and chief residents expect each other to act as a role model for the residents, be approachable and available, and to be transparent and fair in their decision-making processes; both groups wanted feedback on performance and clear expectations from each other for roles and responsibilities; and both groups identified the need to be innovative and supportive of changes in the program. Respondents to the follow-up survey reported that workshop participation improved their relationships with their co-chiefs and program directors. Participation in this experiential workshop improved the working relationships between chief residents and program directors. The themes that were identified can be used to foster communication between incoming chief residents and residency directors and to

  11. Identifying Adolescents at Highly Elevated Risk for Suicidal Behavior in the Emergency Department

    Science.gov (United States)

    Berona, Johnny; Czyz, Ewa; Horwitz, Adam G.; Gipson, Polly Y.

    2015-01-01

    Abstract Objective: The feasibility and concurrent validity of adolescent suicide risk screening in medical emergency departments (EDs) has been documented. The objectives of this short-term prospective study of adolescents who screened positive for suicide risk in the ED were: 1) to examine adolescents' rate of suicidal behavior during the 2 months following their ED visits and compare it with reported rates for psychiatric samples; and 2) to identify possible predictors of acute risk for suicidal behavior in this at-risk sample. Method: Participants were 81 adolescents, ages 14–19 years, seeking services for psychiatric and nonpsychiatric chief complaints, who screened positive for suicide risk because of recent suicidal ideation, a suicide attempt, and/or depression plus alcohol or substance misuse. A comprehensive assessment of suicidal behavior, using the Columbia-Suicide Severity Rating Scale, was conducted at baseline and 2 month follow-up. Results: Six adolescents (7.4%) reported a suicide attempt and 15 (18.5%) engaged in some type of suicidal behavior (actual, aborted, or interrupted suicide attempt; preparatory behavior) during the 2 months following their ED visit. These rates suggest that this screen identified a high-risk sample. Furthermore, adolescents who screened positive for suicidal ideation and/or attempt plus depression and alcohol/substance misuse were most likely to engage in future suicidal behavior (38.9%). Conclusions: In this study, use of a higher screen threshold (multiple suicide risk factors) showed promise for identifying highly elevated acute risk for suicidal behavior. PMID:25746114

  12. 77 FR 22293 - Renewal of Department of Defense Federal Advisory Committees

    Science.gov (United States)

    2012-04-13

    ... it is renewing the charter for the Department of Defense Board of Actuaries (hereafter referred to as... professional actuaries who are members of the Society of Actuaries. Board members shall be appointed by the... Chief Actuary shall serve as a non-voting advisor and the Executive Secretary for the Board. Each Board...

  13. Quality Service Evaluation through the System of Complaints and Praise

    Directory of Open Access Journals (Sweden)

    Elizabeta Krstić Vukelja

    2014-01-01

    Full Text Available Complaint, as the expression of customer dissatisfaction with the quality of products or services, is very valuable information. Well-built system for collecting, processing and analysis of complaints allows organizations to create the information base for making decisions based on facts. This data base provides an effective adoption and implementation of measures for continuous improvement of products/services quality. To make the system work effectively, it is necessary to continuously use the same methodology for collecting and processing complaints to be able constant comparisons from period to period. Greater investment in quality of products/services does not mean reducing the number of complaints in the same time due to the effects of the phenomenon of “unrealistic expectations”. In addition to complaints, a valuable source of information on customer satisfaction is the system of praise.

  14. 17 CFR 200.17 - Chief Management Analyst.

    Science.gov (United States)

    2010-04-01

    ...) Organizational structures and delegations of authority; (d) Management information systems and concepts; and (e... 17 Commodity and Securities Exchanges 2 2010-04-01 2010-04-01 false Chief Management Analyst. 200...; CONDUCT AND ETHICS; AND INFORMATION AND REQUESTS Organization and Program Management General Organization...

  15. Analysis of indoor air pollutants checklist using environmetric technique for health risk assessment of sick building complaint in nonindustrial workplace.

    Science.gov (United States)

    Syazwan, Ai; Rafee, B Mohd; Juahir, Hafizan; Azman, Azf; Nizar, Am; Izwyn, Z; Syahidatussyakirah, K; Muhaimin, Aa; Yunos, Ma Syafiq; Anita, Ar; Hanafiah, J Muhamad; Shaharuddin, Ms; Ibthisham, A Mohd; Hasmadi, I Mohd; Azhar, Mn Mohamad; Azizan, Hs; Zulfadhli, I; Othman, J; Rozalini, M; Kamarul, Ft

    2012-01-01

    To analyze and characterize a multidisciplinary, integrated indoor air quality checklist for evaluating the health risk of building occupants in a nonindustrial workplace setting. A cross-sectional study based on a participatory occupational health program conducted by the National Institute of Occupational Safety and Health (Malaysia) and Universiti Putra Malaysia. A modified version of the indoor environmental checklist published by the Department of Occupational Health and Safety, based on the literature and discussion with occupational health and safety professionals, was used in the evaluation process. Summated scores were given according to the cluster analysis and principal component analysis in the characterization of risk. Environmetric techniques was used to classify the risk of variables in the checklist. Identification of the possible source of item pollutants was also evaluated from a semiquantitative approach. Hierarchical agglomerative cluster analysis resulted in the grouping of factorial components into three clusters (high complaint, moderate-high complaint, moderate complaint), which were further analyzed by discriminant analysis. From this, 15 major variables that influence indoor air quality were determined. Principal component analysis of each cluster revealed that the main factors influencing the high complaint group were fungal-related problems, chemical indoor dispersion, detergent, renovation, thermal comfort, and location of fresh air intake. The moderate-high complaint group showed significant high loading on ventilation, air filters, and smoking-related activities. The moderate complaint group showed high loading on dampness, odor, and thermal comfort. This semiquantitative assessment, which graded risk from low to high based on the intensity of the problem, shows promising and reliable results. It should be used as an important tool in the preliminary assessment of indoor air quality and as a categorizing method for further IAQ

  16. Anaesthesiologists, fees and complaints to the Health Professions ...

    African Journals Online (AJOL)

    Does the Health Professions Council of South Africa (HPCSA) receive more complaints about anaesthesiologists than any other speciality, and if they do, are these complaints mainly restricted to billing issues, i.e. relating to the financial consent process or costs? Although disputed, and subsequently corrected, the South ...

  17. 5 CFR 1201.124 - Rights; answer to complaint.

    Science.gov (United States)

    2010-01-01

    ... PRACTICES AND PROCEDURES Procedures for Original Jurisdiction Cases Special Counsel Disciplinary Actions... Special Counsel files a complaint proposing a disciplinary action against an employee under 5 U.S.C. 1215... Counsel disciplinary action complaint may file an answer with the Clerk of the Board within 35 days of the...

  18. 19 CFR 210.53 - Motion filed after complaint.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Motion filed after complaint. 210.53 Section 210.53 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.53 Motion filed after complaint. (a) A...

  19. Text mining to decipher free-response consumer complaints: insights from the NHTSA vehicle owner's complaint database.

    Science.gov (United States)

    Ghazizadeh, Mahtab; McDonald, Anthony D; Lee, John D

    2014-09-01

    This study applies text mining to extract clusters of vehicle problems and associated trends from free-response data in the National Highway Traffic Safety Administration's vehicle owner's complaint database. As the automotive industry adopts new technologies, it is important to systematically assess the effect of these changes on traffic safety. Driving simulators, naturalistic driving data, and crash databases all contribute to a better understanding of how drivers respond to changing vehicle technology, but other approaches, such as automated analysis of incident reports, are needed. Free-response data from incidents representing two severity levels (fatal incidents and incidents involving injury) were analyzed using a text mining approach: latent semantic analysis (LSA). LSA and hierarchical clustering identified clusters of complaints for each severity level, which were compared and analyzed across time. Cluster analysis identified eight clusters of fatal incidents and six clusters of incidents involving injury. Comparisons showed that although the airbag clusters across the two severity levels have the same most frequent terms, the circumstances around the incidents differ. The time trends show clear increases in complaints surrounding the Ford/Firestone tire recall and the Toyota unintended acceleration recall. Increases in complaints may be partially driven by these recall announcements and the associated media attention. Text mining can reveal useful information from free-response databases that would otherwise be prohibitively time-consuming and difficult to summarize manually. Text mining can extend human analysis capabilities for large free-response databases to support earlier detection of problems and more timely safety interventions.

  20. Mixed reaction to science department proposal

    Science.gov (United States)

    The recommendation last month by a presidential commission that a federal Department of Science and Technology be created to encompass “major civilian research and development (R&D) agencies” has elicited a mixed reaction from members of the geophysical sciences community.The Commission on Industrial Competitiveness, created by President Ronald Reagan in June 1983 to study ways to strengthen the ability of the United States to compete in a global marketplace, recommended establishment of a Cabinet-level science department “to promote national interest in and policies for research and technological innovation.” The commission, chaired by John A. Young, president of the Hewlett-Packard Company, was composed primarily of presidents and chief executive officers of major technology corporations but also included members of academia and government. Creation of a federal science and technology 'department is one of many suggestions contained in the commission's final report, Global Competition: The New Reality.

  1. Consumer evaluation of complaint handling in the Dutch health insurance market.

    Science.gov (United States)

    Wendel, Sonja; de Jong, Judith D; Curfs, Emile C

    2011-11-15

    How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not influence consumer satisfaction evaluations and

  2. Consumer evaluation of complaint handling in the Dutch health insurance market

    Directory of Open Access Journals (Sweden)

    Wendel Sonja

    2011-11-01

    Full Text Available Abstract Background How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. Methods A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. Results Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. Conclusions Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and

  3. Consumer evaluation of complaint handling in the Dutch health insurance market

    Science.gov (United States)

    2011-01-01

    Background How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. Methods A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. Results Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. Conclusions Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not

  4. ANTECEDENCE DAN CONSEQUENCES DARI SATISFACTION WITH RECOVERY TERHADAP FUTURE COMPLAINT INTENTIONS

    Directory of Open Access Journals (Sweden)

    Franciskus Maya Praba

    2008-10-01

    Full Text Available The background of this research is managers need to analyze that customer service failure can arise customer complaint. It must be managed by service recovery to get customer satisfaction. Future complaint intentions has relationship with customer satisfaction. Every company need to investigate which is the compatible perceived justice to applied. The objective of this research is to investigate service recovery effects toward customer satisfaction, especially perceived justice ( interactional, procedural, distributive and how justice effects customer satisfaction and future complaint intentions. The design of this research applies to customer Bank BCA in Semarang which is has variants occupation and the questionnaires were spreaded away to 100 respondents by using purposive sampling. The result of this research are interactional justice and procedural justice has more influence on future complaint intentions. Despite, distributive justice and satisfaction with recovery decrease future complaint intentions. Keywords: Antacedence, satisfaction with recovery, future complaint intentions

  5. "Let Me Tell You About My…" Provider Self-Disclosure in the Emergency Department Builds Patient Rapport.

    Science.gov (United States)

    Zink, Korie L; Perry, Marcia; London, Kory; Floto, Olivia; Bassin, Benjamin; Burkhardt, John; Santen, Sally A

    2017-01-01

    As patients become increasingly involved in their medical care, physician-patient communication gains importance. A previous study showed that physician self-disclosure (SD) of personal information by primary care providers decreased patient rating of the provider communication skills. The objective of this study was to explore the incidence and impact of emergency department (ED) provider self-disclosure on patients' rating of provider communication skills. A survey was administered to 520 adult patients or parents of pediatric patients in a large tertiary care ED during the summer of 2014. The instrument asked patients whether the provider self-disclosed and subsequently asked patients to rate providers' communication skills. We compared patients' ratings of communication measurements between encounters where self-disclosure occurred to those where it did not. Patients reported provider SD in 18.9% of interactions. Provider SD was associated with more positive patient perception of provider communication skills (pself-disclosure (47.1%). Patients reported that they would like to hear about their providers' experiences with a similar chief complaint (64.4% of patients), their providers' education (49%), family (33%), personal life (21%) or an injury/ailment unlike their own (18%). Patients responded that providers self-disclose to make patients comfortable/at ease and to build rapport. Provider self-disclosure in the ED is common and is associated with higher ratings of provider communication, rapport, and patient satisfaction.

  6. Achieving patient satisfaction: resolving patient complaints.

    Science.gov (United States)

    Oxler, K F

    1997-07-01

    Patients demand to be active participants on and partners with the health care team to design their care regimen. Patients bring unique perceptions and expectations and use these to evaluate service quality and satisfaction. If customer satisfaction is not achieved and a patient complaint results, staff must have the skills to respond and launch a service recovery program. Service recovery, when done with style and panache, can retain loyal customers. Achieving patient satisfaction and resolving patient complaints require commitment from top leadership and commitment from providers to dedicate the time to understand their patients' needs.

  7. Association of positive responses to suicide screening questions with hospital admission and repeated emergency department visits in children and adolescents.

    Science.gov (United States)

    Ballard, Elizabeth D; Horowitz, Lisa M; Jobes, David A; Wagner, Barry M; Pao, Maryland; Teach, Stephen J

    2013-10-01

    Although validated suicide screening tools exist for use among children and adolescents presenting to emergency departments (EDs), the associations between screening positive for suicide risk and immediate psychiatric hospital admission or subsequent ED use, stratified by age, have not been examined. This is a retrospective cohort study of a consecutive case series of patients aged 8 to 18 years presenting with psychiatric chief complaints during a 9-month period to a single urban tertiary care pediatric ED. Eligible patients were administered a subset of questions from the Risk of Suicide Questionnaire. Outcomes included the odds of psychiatric hospitalization at the index visit and repeated ED visits for psychiatric complaints within the following year, stratified by age. Of the 568 patients presenting during the study period, responses to suicide screening questions were available for 442 patients (78%). A total of 159 (36%) of 442 were hospitalized and 130 (29%) of 442 had 1 or more ED visits within the following year. The proportion of patients providing positive responses to 1 or more suicide screening questions did not differ between patients aged 8 to 12 years and those aged 13 to 18 years (77/154 [50%] vs 137/288 [48%], P = 0.63). A positive response to 1 or more of the questions was significantly associated with increased odds of psychiatric hospitalization in the older age group [adjusted odds ratio, 3.82; 95% confidence interval, 2.24-6.54) and with repeated visits to the ED in the younger age group (adjusted odds ratio, 3.55 95% confidence interval, 1.68-7.50). Positive responses to suicide screening questions were associated with acute psychiatric hospitalization and repeated ED visits. Suicide screening in a pediatric ED may identify children and adolescents with increased need of psychiatric resources.

  8. Hyperventilation complaints in music performance anxiety among classical music students.

    Science.gov (United States)

    Studer, Regina; Danuser, Brigitta; Hildebrandt, Horst; Arial, Marc; Gomez, Patrick

    2011-06-01

    Despite the importance of respiration and hyperventilation in anxiety disorders, research on breathing disturbances associated with hyperventilation is rare in the field of music performance anxiety (MPA, also known as stage fright). The only comparable study in this area reported a positive correlation between negative feelings of MPA and hyperventilation complaints during performance. The goals of this study were (a) to extend these previous findings to the period before performance, (b) to test whether a positive correlation also exists between hyperventilation complaints and the experience of stage fright as a problem, (c) to investigate instrument-specific symptom reporting, and (d) to confirm gender differences in negative feelings of MPA and hyperventilation complaints reported in other studies. We assessed 169 university students of classical music with a questionnaire comprising: the State-Trait Anxiety Inventory for negative feelings of MPA, the Nijmegen Questionnaire for hyperventilation complaints, and a single item for the experience of stage fright as a problem. We found a significant positive correlation between hyperventilation complaints and negative feelings of MPA before performance and a significant positive correlation between hyperventilation complaints and the experience of stage fright as a problem. Wind musicians/singers reported a significantly higher frequency of respiratory symptoms than other musicians. Furthermore, women scored significantly higher on hyperventilation complaints and negative feelings of MPA. These results further the findings of previous reports by suggesting that breathing disturbances associated with hyperventilation may play a role in MPA prior to going on stage. Experimental studies are needed to confirm whether hyperventilation complaints associated with negative feelings of MPA manifest themselves at the physiological level. Copyright © 2010 Elsevier Inc. All rights reserved.

  9. Department of Labor

    Science.gov (United States)

    ... Assistant Secretary for Policy (OASP) Office of the Chief Financial Officer (OCFO) Office of Disability Employment Policy (ODEP) Office ... Assistant Secretary for Policy (OASP) Office of the Chief Financial Officer (OCFO) Office of Disability Employment Policy (ODEP) Office ...

  10. 75 FR 1001 - U.S. Chief Financial Officer Council; Grants Policy Committee (GPC)

    Science.gov (United States)

    2010-01-07

    ... NATIONAL SCIENCE FOUNDATION U.S. Chief Financial Officer Council; Grants Policy Committee (GPC... committee of the U.S. Chief Financial Officers (CFO) Council. The Office of Management and Budget (OMB... Government. The GPC is charged with improving the management of federal financial assistance government-wide...

  11. Low-frequency-noise complaints

    DEFF Research Database (Denmark)

    Pedersen, Christian Sejer; Møller, Henrik; Persson-Waye, Kerstin

    2008-01-01

    From 203 cases of low-frequency complaints a random selection of twenty-one cases were investigated. The main aim of the investigation was to answer the question whether the annoyance is caused by an external physical sound or by a physically non-existing sound, i.e. low-frequency tinnitus. Noise...... of the complainants are annoyed by a physical sound (20-180 Hz), while others suffer from low-frequency tinnitus (perceived frequency 40-100 Hz). Physical sound at frequencies below 20 Hz (infrasound) is not responsible for the annoyance - or at all audible - in any of the investigated cases, and none...... of the complainants has extraordinary hearing sensitivity at low frequencies. For comparable cases of low-frequency noise complaints in general, it is anticipated that physical sound is responsible in a substantial part of the cases, while low-frequency tinnitus is responsible in another substantial part of the cases....

  12. Interpersonal complaints regarding cancer care through a gender lens.

    Science.gov (United States)

    Olsson, Erik Masao

    2016-07-11

    Purpose - The purpose of this paper is to investigate healthcare customer complaints concerning interpersonal matters in cancer care. Design/methodology/approach - Complaints from cancer patients and their relatives (n=116) that dealt with interpersonal matters registered between 2009 and 2011 at four local Patients' Advisory Committees in Western Sweden were sampled and analyzed using qualitative content analysis. Findings - Complaints concerned lack of information and consideration from healthcare providers. Lack of empathy and civility also caused dissatisfaction, the latter particularly for women. Relatives complained that they did not feel included in the care process or were not offered proper support. Most complaints by relatives were filed by a female relative and concerned a male patient. Research limitations/implications - Information about patient demographics other than gender could not be investigated due to database limitations. Hence, factors such as age, country of birth, and geographical residence were not included for analysis. In addition, neither the type nor stage of cancer among the sampled patients was able to be addressed. Practical implications - Patient complaints should not only be viewed as a post-consumption judgment, but also as a service interaction activity. This may require healthcare providers to enhance their interpersonal skills, allowing patients and relatives to provide feedback during service interaction to satisfactorily address dissatisfaction. Visualizing gender disparities may help healthcare providers prevent stereotypical encounters. In addition, the provider should be invited to participate in the customer's value creating network, which may also include knowledge and skills from other sources, such as relatives. Originality/value - Value co-creation offers a different view on patient complaints. Incorporating social construction into value co-creation may reveal socially constructed disparities. The paper provides

  13. Chief Business Officers' Functions: Responsibilities and Importance.

    Science.gov (United States)

    Calver, Richard A.; Vogler, Daniel E.

    1985-01-01

    Reports on a survey of 177 chief business officers of public community colleges regarding their responsibilities and the importance they assigned to various role functions. Highlights findings concerning the perceived importance of fiscal/financial duties; endowments as a job function; role in shared planning; and personal attention given to…

  14. Clinical characteristics of Burkitt's lymphoma from three regions in ...

    African Journals Online (AJOL)

    ... following parameters were documented: chief complaint(s); physical examination, specifically pallor, jaundice, oedema, lymphadenopathy, presence of masses, splenomegaly and hepatomegaly. Reports of evaluation of chest radiograph, abdominal ultrasound/scan, bone marrow aspiration, cerebral spinal fluid cytology, ...

  15. Drinking water turbidity and emergency department visits for gastrointestinal illness in New York City, 2002-2009.

    Directory of Open Access Journals (Sweden)

    Jennifer L Hsieh

    Full Text Available Studies have examined whether there is a relationship between drinking water turbidity and gastrointestinal (GI illness indicators, and results have varied possibly due to differences in methods and study settings.As part of a water security improvement project we conducted a retrospective analysis of the relationship between drinking water turbidity and GI illness in New York City (NYC based on emergency department chief complaint syndromic data that are available in near-real-time.We used a Poisson time-series model to estimate the relationship of turbidity measured at distribution system and source water sites to diarrhea emergency department (ED visits in NYC during 2002-2009. The analysis assessed age groups and was stratified by season and adjusted for sub-seasonal temporal trends, year-to-year variation, ambient temperature, day-of-week, and holidays.Seasonal variation unrelated to turbidity dominated (~90% deviance the variation of daily diarrhea ED visits, with an additional 0.4% deviance explained with turbidity. Small yet significant multi-day lagged associations were found between NYC turbidity and diarrhea ED visits in the spring only, with approximately 5% excess risk per inter-quartile-range of NYC turbidity peaking at a 6 day lag. This association was strongest among those aged 0-4 years and was explained by the variation in source water turbidity.Integrated analysis of turbidity and syndromic surveillance data, as part of overall drinking water surveillance, may be useful for enhanced situational awareness of possible risk factors that can contribute to GI illness. Elucidating the causes of turbidity-GI illness associations including seasonal and regional variations would be necessary to further inform surveillance needs.

  16. Drinking water turbidity and emergency department visits for gastrointestinal illness in New York City, 2002-2009.

    Science.gov (United States)

    Hsieh, Jennifer L; Nguyen, Trang Quyen; Matte, Thomas; Ito, Kazuhiko

    2015-01-01

    Studies have examined whether there is a relationship between drinking water turbidity and gastrointestinal (GI) illness indicators, and results have varied possibly due to differences in methods and study settings. As part of a water security improvement project we conducted a retrospective analysis of the relationship between drinking water turbidity and GI illness in New York City (NYC) based on emergency department chief complaint syndromic data that are available in near-real-time. We used a Poisson time-series model to estimate the relationship of turbidity measured at distribution system and source water sites to diarrhea emergency department (ED) visits in NYC during 2002-2009. The analysis assessed age groups and was stratified by season and adjusted for sub-seasonal temporal trends, year-to-year variation, ambient temperature, day-of-week, and holidays. Seasonal variation unrelated to turbidity dominated (~90% deviance) the variation of daily diarrhea ED visits, with an additional 0.4% deviance explained with turbidity. Small yet significant multi-day lagged associations were found between NYC turbidity and diarrhea ED visits in the spring only, with approximately 5% excess risk per inter-quartile-range of NYC turbidity peaking at a 6 day lag. This association was strongest among those aged 0-4 years and was explained by the variation in source water turbidity. Integrated analysis of turbidity and syndromic surveillance data, as part of overall drinking water surveillance, may be useful for enhanced situational awareness of possible risk factors that can contribute to GI illness. Elucidating the causes of turbidity-GI illness associations including seasonal and regional variations would be necessary to further inform surveillance needs.

  17. Some complaints of seniors to the state of physical health

    Directory of Open Access Journals (Sweden)

    Khokhlova L.A.

    2010-05-01

    Full Text Available Results are considered screening test student relatively complaints about a feel. In an experiment took part a 165 student 9 and 11 classes. It is marked that at a student 9 classes of complaints about a feel anymore. The most widespread diseases among schoolboys are respirator diseases (quinsy, cold, cough. Also complaints take place about frequent fatigueability and head pains after completion of educational process.

  18. 20 CFR 658.411 - Filing and assignment of JS-related complaints.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Filing and assignment of JS-related... Agency Js Complaint System § 658.411 Filing and assignment of JS-related complaints. (a) JS-related... office personnel shall be as follows: (1) All JS-related complaints filed with a local office, and...

  19. Classifying patients' complaints for regulatory purposes : A Pilot Study

    NARCIS (Netherlands)

    Bouwman, R.J.R.; Bomhoff, Manja; Robben, Paul; Friele, R.D.

    2018-01-01

    Objectives: It is assumed that classifying and aggregated reporting of patients' complaints by regulators helps to identify problem areas, to respond better to patients and increase public accountability. This pilot study addresses what a classification of complaints in a regulatory setting

  20. 20 CFR 658.420 - Establishment of JS complaint system at the ETA regional office.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Establishment of JS complaint system at the... Complaint System Federal Js Complaint System § 658.420 Establishment of JS complaint system at the ETA regional office. (a) Each Regional Administrator shall establish and maintain a JS complaint system at the...

  1. Correlation between temperature satisfaction and unsolicited complaint rates in commercial buildings.

    Science.gov (United States)

    Wang, D; Federspiel, C C; Arens, E

    2005-02-01

    This paper analyzes the relation between temperature satisfaction ratings expressed on a questionnaire and unsolicited complaint rates recorded in a maintenance database. The key findings are as follows: (i) the satisfaction ratings and complaint rates are negatively correlated with a moderate magnitude (r(s) = -0.31 to -0.36), and the correlation is statistically significant (P = 0.01-0.005), and (ii) the percent dissatisfied with temperature and the complaint rate are positively correlated with moderate magnitude (r(s) = 0.31-0.36), and the correlation is statistically significant (P = 0.01-0.004). Both data sets contain 'real-world' measures of temperature satisfaction, with the complaints contributing directly to the cost of operations and maintenance. The relationship between two validates a new method of assessing the economic cost of thermal discomfort in commercial buildings. Complaints in commercial buildings indicate occupants' dissatisfaction to their environments. It not only deteriorates occupants' performance and organization productivity, but also increases building maintenance and operating cost. Nailing economic consequences of complaints will enable monetary comparison of discomfort cost with building and operating costs. This comparison may be desirable for building owners and tenants to make well-informed decisions on construction, rental, and retrofit. It may also be used to evaluate complaint diagnostic and eliminating techniques.

  2. Relationship between hearing complaint and hearing loss among older people

    Directory of Open Access Journals (Sweden)

    Teixeira, Adriane Ribeiro

    2009-03-01

    Full Text Available Introduction: Presbycusis is a public health problem. Despite its high prevalence, many elders do not have their hearing ability investigated periodically, because they do not have a specific complaint. Objective: To check whether there is a relationship between the complaint and the presence of hearing loss in elder people. Method: Transversal study in elders from a neighborhood in the city of Canoas, Rio Grande do Sul. After the definition of the neighborhood's geographic boundaries, all houses were visited, the older people's addresses were ascertained and the invitations to take part in the research were provided. A questionnaire survey was applied which had a question about hearing loss complaint and air-conducted hearing thresholds were obtained and studied. Out of the 72 identified elders 50 elders agreed to participate, 35 (70% women, and 15 (30% men. Results: It was confirmed that only 12 (24% elders showed a specific complaint of hearing loss, although 33 (66% elders showed slight, moderate, severe and profound hearing losses. Conclusion: Data analysis confirmed there was no relationship between the complaint and the presence of hearing loss in the assessed group, and demonstrated the need to forward the elders for audiological evaluation even without any specific complaint.

  3. The Complaint Letter and Response.

    Science.gov (United States)

    Shukla, P. K.

    1998-01-01

    Describes an assignment in which students write a letter of complaint, and discusses how this assignment aids students in seeing the importance of effective written communication to their daily lives. (SR)

  4. Recovery of Work-Related Stress: Complaint Reduction and Work-Resumption are Relatively Independent Processes.

    Science.gov (United States)

    de Vente, Wieke; Kamphuis, Jan Henk; Blonk, Roland W B; Emmelkamp, Paul M G

    2015-09-01

    The process of recovery from work-related stress, consisting of complaint reduction and work-resumption, is not yet fully understood. The aim of this study was to investigate predictors of complaint reduction and work-resumption, as well as testing complaint reduction as a mediator in the association between predictors and work-resumption. Seventy-one patients on sickness-leave because of work-related stress complaints were followed over a period of 13 months. Predictors comprised personal (demographics, coping, cognitions), work-related (job-characteristics, social support), and illness-related (complaint duration, absence duration) variables. Dependent variables were distress complaints, burnout complaints, and work-resumption. Complaints reduced considerably over time to borderline clinical levels and work-resumption increased to 68% at 13 months. Predictors of stronger reduction of distress complaints were male gender, less working hours, less decision authority, more co-worker support, and shorter absence duration. Predictors of stronger reduction of burnout complaints were male gender, lower age, high education, less avoidant coping, less decision authority, more job security, and more co-worker support. Predictors of work-resumption were lower age and stronger reduction of burnout complaints. No indication for a mediating role of burnout complaints between the predictor age and work-resumption was found. Complaint reduction and work-resumption are relatively independent processes. Symptom reduction is influenced by individual and work-related characteristics, which holds promise for a multidisciplinary treatment approach for work-related stress.

  5. Customer complaints and recovery effectiveness : A customer base approach

    NARCIS (Netherlands)

    Knox, G.; van Oest, R.D.

    2014-01-01

    Although customer complaints are a well-studied aspect of business, no study has measured the impact of actual complaints and recoveries on subsequent customer purchasing. The authors develop a customer base model to investigate the effectiveness of recovery in preventing customer churn. They

  6. Characteristics of complaints resulting in disciplinary actions against Danish GPs.

    Science.gov (United States)

    Birkeland, Søren; Depont Christensen, Rene; Damsbo, Niels; Kragstrup, Jakob

    2013-09-01

    The risk of being disciplined in connection with a complaint case causes distress to most general practitioners. The present study examined the characteristics of complaint cases resulting in disciplinary action. The Danish Patients' Complaints Board's decisions concerning general practice in 2007 were examined. Information on the motives for complaining, as well as patient and general practitioner characteristics, was extracted and the association with case outcome (disciplinary or no disciplinary action) was analysed. Variables included complaint motives, patient gender and age, urgency of illness, cancer diagnosis, healthcare settings (daytime or out-of-hours services), and general practitioner gender and professional seniority. Cases where the complaint motives involved a wish for placement of responsibility (OR = 2.35, p = 0.01) or a wish for a review of the general practitioner's competence (OR = 1.95, p = 0.02) were associated with increased odds of the general practitioner being disciplined. The odds of discipline decreased when the complaint was motivated by a feeling of being devalued (OR = 0.39, p = 0.02) or a request for an explanation (OR = 0.46, p = 0.01). With regard to patient and general practitioner characteristics, higher general practitioner professional seniority was associated with increased odds of discipline (OR = 1.97 per 20 additional years of professional seniority, p = 0.01). None of the other characteristics was statistically significantly associated with discipline in the multiple logistic regression model. Complaint motives and professional seniority were associated with decision outcomes. Further research is needed on the impact of professional seniority on performance.

  7. Diagnosis of Aortic Dissection in Emergency Department Patients is Rare

    Directory of Open Access Journals (Sweden)

    Scott M. Alter

    2015-10-01

    Full Text Available Introduction: Aortic dissection is a rare event. While the most frequent symptom is chest pain, that is a common emergency department (ED chief complaint and other diseases causing chest pain occur much more often. Furthermore, 20% of dissections are without chest pain and 6% are painless. For these reasons, diagnosing dissections may be challenging. Our goal was to determine the number of total ED and atraumatic chest pain patients for every aortic dissection diagnosed by emergency physicians. Methods: Design: Retrospective cohort. Setting: 33 suburban and urban New York and New Jersey EDs with annual visits between 8,000 and 80,000. Participants: Consecutive patients seen by emergency physicians from 1-1-1996 through 12-31-2010. Observations: We identified aortic dissection and atraumatic chest pain patients using the International Classification of Diseases 9th Revision and Clinical Modification codes. We then calculated the number of total ED and atraumatic chest pain patients for every aortic dissection, along with 95% confidence intervals (CIs. Results: From a database of 9.5 million ED visits, we identified 782 aortic dissections or one for every 12,200 (95% CI [11,400-13,100] visits. The mean age of dissection patients was 66±16 years and 38% were female. There were 763,000 (8% with atraumatic chest pain diagnoses. Thus, there is one dissection for every 980 (95% CI [910-1,050] atraumatic chest pain patients. Conclusion: The diagnosis of aortic dissections by emergency physicians is rare and challenging. An emergency physician seeing 3,000 to 4,000 patients a year would diagnose an aortic dissection approximately every three to four years.

  8. Shoulder complaints in patients with reflex sympathetic dystrophy of the upper extremity.

    Science.gov (United States)

    Veldman, P H; Goris, R J

    1995-03-01

    Five hundred forty-one patients with reflex sympathetic dystrophy (RSD) of the upper extremity were prospectively studied. One hundred fifteen patients complained of pain and/or limited range of motion in the shoulder. Shoulder complaints more often occurred in women (p = .01); age and etiology were not different from patients with RSD without shoulder complaints. Physical examination showed a tendinitis of one or both tendons of the biceps muscle in 109 patients. Seventy one patients were treated with local injection of bupivacaine followed by methylprednisolone. This resulted in permanent relief of complaints in 34 patients, temporary or moderate relief in 31, no difference in 3, increase of complaints in 1 patient, and in 2 patients results were not documented. We conclude that shoulder complaints in RSD occur in a minority of patients and more often in female patients. There are no predisposing factors. The pathophysiologic mechanism for developing shoulder complaints remains unknown. In most cases complaints can be attributed to a bicipital tendinitis for which local injection of bupivacaine followed by prednisolone are both diagnostic and therapeutic.

  9. A pilot study of implantable cardiac device interrogation by emergency department personnel.

    Science.gov (United States)

    Neuenschwander, James F; Hiestand, Brian C; Peacock, W Frank; Billings, John M; Sondrup, Cole; Hummel, John D; Abraham, William T

    2014-03-01

    Implanted devices (eg, pacemakers and defibrillators) provide valuable information and may be interrogated to obtain diagnostic information and to direct management. During admission to an emergency department (ED), significant time and cost are spent waiting for device manufacturer representatives or cardiologists to access the data. If ED personnel could safely interrogate implanted devices, more rapid disposition could occur, thus leading to potentially better outcomes at a reduced cost. This was a pilot study examining the feasibility of ED device interrogation. This was a prospective convenience sample study of patients presenting to the ED with any chief complaint and who had an implantable device capable of being interrogated by a Medtronic reader. After obtaining informed consent, study patients underwent device interrogation by ED research personnel. After reviewing the device data, the physician documented their opinions of the value of data in aiding care. Patients were followed up at intervals ranging from 30 days out to 1 year to determine adverse events relating to interrogation. Forty-four patients underwent device interrogation. Their mean age was 56 ± 14.7 years (range, 28-83), 75% (33/44) were male and 75% (33/44) were hospitalized from the ED. The interrogations took less than 10 minutes 89% of the time. In 60% of the cases, ED physicians reported the data-assisted patient care. No adverse events were reported relating to the ED interrogations. In this pilot study, we found that ED personnel can safely and quickly interrogate implantable devices to obtain potentially useful clinical data.

  10. Complaints and compliments assessment in developing service delivery measurement

    Directory of Open Access Journals (Sweden)

    Norshahrizan Nordin

    2018-05-01

    Full Text Available Excellent healthcare services delivered to patients would not necessarily entail an excellent patient service fulfillment, fulfill patient expectations, and attain high satisfaction levels. Hence, patient satisfaction is multifactorial and difficult to measure. Appliance of satisfaction model, service dissatisfaction and satisfaction feedback are able to translate the nonlinear attributes for a more accurate service dissatisfaction and satisfaction feedback assessment. Service recipients of experienced Inpatient and Outpatient (IOPs can be translated into levels of compliments and complaints to describe degrees of patient satisfaction and dissatisfaction, respectively. Compliments and complaints voiced by patients should be taken seriously. As a result, the translation of service satisfaction and service dissatisfaction based on compliments and complaints from patients in the form of satisfaction index SCi and dissatisfaction index SCa introduced a new theoretical concept of concurrent and balance measurement in evaluating customer (VOC or VOPs feedback. In normal practice, the service improvement is usually based on complaints or dissatisfaction aspect, but the compliments or satisfaction aspect on the same service delivery was always neglected. In this study, the formulation which was based on a non-linear assessment, not only amplified the effectiveness in communicating patients’ compliments and complaints in a more receptive manner but also corresponded with Kano model.

  11. Citizen Complaints about Environmental Pollution: A Survey Study in Suzhou, China

    Directory of Open Access Journals (Sweden)

    Xianbing Liu

    2011-01-01

    Full Text Available This paper discusses environmental complaints made by citizens living close to industrial polluters in China. Data collected from a questionnaire survey in Suzhou City is used for the analysis. The results confirm a marginal level of citizen environmental complaints in the study area at present. Meaningful findings include the fact that citizens have a tendency to complain collectively, and that perception of the level of environmental information provided by companies significantly determines a citizen’s likelihood of lodging environmental complaints. Therefore, the disclosure of corporate environmental information must be emphasized continuously; citizens must be encouraged to correctly understand the environmental performance of companies so that they might make appropriate complaints. Governments need to show their support for citizen-led environmental complaint initiatives. The successful cases would convince them to keep a closer eye on their neighbouring polluters.

  12. 'Knowledge for better health' revisited - the increasing significance of health research systems: a review by departing Editors-in-Chief.

    Science.gov (United States)

    Hanney, Stephen R; González-Block, Miguel A

    2017-10-02

    How can nations organise research investments to obtain the best bundle of knowledge and the maximum level of improved health, spread as equitably as possible? This question was the central focus of a major initiative from WHO led by Prof Tikki Pang, which resulted in a range of developments, including the publication of a conceptual framework for national health research systems - Knowledge for better health - in 2003, and in the founding of the journal Health Research Policy and Systems (HARPS). As Editors-in-Chief of the journal since 2006, we mark our retirement by tracking both the progress of the journal and the development of national health research systems. HARPS has maintained its focus on a range of central themes that are key components of a national health research system in any country. These include building capacity to conduct and use health research, identifying appropriate priorities, securing funds and allocating them accountably, producing scientifically valid research outputs, promoting the use of research in polices and practice in order to improve health, and monitoring and evaluating the health research system. Some of the themes covered in HARPS are now receiving increased attention and, for example, with the assessment of research impact and development of knowledge translation platforms, the journal has covered their progress throughout that expansion of interest. In addition, there is increasing recognition of new imperatives, including the importance of promoting gender equality in health research if benefits are to be maximised. In this Editorial, we outline some of the diverse and developing perspectives considered within each theme, as well as considering how they are held together by the growing desire to build effective health research systems in all countries.From 2003 until mid-June 2017, HARPS published 590 articles on the above and related themes, with authors being located in 76 countries. We present quantitative data tracing

  13. 29 CFR 1977.15 - Filing of complaint for discrimination.

    Science.gov (United States)

    2010-07-01

    ... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Procedures § 1977.15 Filing of complaint for discrimination. (a) Who... 1977.15 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... required. (c) Place of filing. Complaint should be filed with the Area Director (Occupational Safety and...

  14. 76 FR 18954 - Privacy Act of 1974: Implementation of Exemptions; Department of Homeland Security Federal...

    Science.gov (United States)

    2011-04-06

    ... issues please contact: Mary Ellen Callahan (703-235- 0780), Chief Privacy Officer, Privacy Office...] Privacy Act of 1974: Implementation of Exemptions; Department of Homeland Security Federal Emergency Management Agency DHS/FEMA-011 Training and Exercise Program Records System of Records AGENCY: Privacy Office...

  15. 47 CFR 76.950 - Complaints regarding cable programming service rates.

    Science.gov (United States)

    2010-10-01

    ... cable programming service. The franchise authority may file a complaint with the Commission only upon receipt of more than one subscriber complaint made to the franchise authority within 90 days after the...

  16. Susceptibility of the MMPI-2-RF neurological complaints and cognitive complaints scales to over-reporting in simulated head injury.

    Science.gov (United States)

    Bolinger, Elizabeth; Reese, Caitlin; Suhr, Julie; Larrabee, Glenn J

    2014-02-01

    We examined the effect of simulated head injury on scores on the Neurological Complaints (NUC) and Cognitive Complaints (COG) scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). Young adults with a history of mild head injury were randomly assigned to simulate head injury or give their best effort on a battery of neuropsychological tests, including the MMPI-2-RF. Simulators who also showed poor effort on performance validity tests (PVTs) were compared with controls who showed valid performance on PVTs. Results showed that both scales, but especially NUC, are elevated in individuals simulating head injury, with medium to large effect sizes. Although both scales were highly correlated with all MMPI-2-RF over-reporting validity scales, the relationship of Response Bias Scale to both NUC and COG was much stronger in the simulators than controls. Even accounting for over-reporting on the MMPI-2-RF, NUC was related to general somatic complaints regardless of group membership, whereas COG was related to both psychological distress and somatic complaints in the control group only. Neither scale was related to actual neuropsychological performance, regardless of group membership. Overall, results provide further evidence that self-reported cognitive symptoms can be due to many causes, not necessarily cognitive impairment, and can be exaggerated in a non-credible manner.

  17. 43 CFR 4.2 - Membership of appeals boards; decisions, functions of Chief Judges.

    Science.gov (United States)

    2010-10-01

    ... direct that an appeal may be decided by a panel of any two Administrative Judges of the Board, but if..., functions of Chief Judges. 4.2 Section 4.2 Public Lands: Interior Office of the Secretary of the Interior... appeals boards; decisions, functions of Chief Judges. (a) The Appeals Boards consist of regular members...

  18. Using complaints to enhance quality improvement: developing an analytical tool.

    Science.gov (United States)

    Hsieh, Sophie Yahui

    2012-01-01

    This study aims to construct an instrument for identifying certain attributes or capabilities that might enable healthcare staff to use complaints to improve service quality. PubMed and ProQuest were searched, which in turn expanded access to other literature. Three paramount dimensions emerged for healthcare quality management systems: managerial, operational, and technical (MOT). The paper reveals that the managerial dimension relates to quality improvement program infrastructure. It contains strategy, structure, leadership, people and culture. The operational dimension relates to implementation processes: organizational changes and barriers when using complaints to enhance quality. The technical dimension emphasizes the skills, techniques or information systems required to achieve successfully continuous quality improvement. The MOT model was developed by drawing from the relevant literature. However, individuals have different training, interests and experiences and, therefore, there will be variance between researchers when generating the MOT model. The MOT components can be the guidelines for examining whether patient complaints are used to improve service quality. However, the model needs testing and validating by conducting further research before becoming a theory. Empirical studies on patient complaints did not identify any analytical tool that could be used to explore how complaints can drive quality improvement. This study developed an instrument for identifying certain attributes or capabilities that might enable healthcare professionals to use complaints and improve service quality.

  19. 40 CFR 7.180 - Mediation of age discrimination complaints.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Mediation of age discrimination... Discrimination Prohibited on the Basis of Age § 7.180 Mediation of age discrimination complaints. (a) The OCR will refer all accepted complaints alleging age discrimination to the Mediation Agency designated by...

  20. 29 CFR 1954.20 - Complaints about State program administration.

    Science.gov (United States)

    2010-07-01

    ... pattern of delays in processing cases, of inadequate workplace inspections, or the granting of variances... investigation should be made, he shall cause such investigation, including any workplace inspection, to be made... complaints received on the same or similar issues and whether the complaints relate to safety and health...

  1. Memory complaints in subjective cognitive impairment, amnestic mild cognitive impairment and mild Alzheimer's disease.

    Science.gov (United States)

    Ryu, Seon Young; Lee, Sang Bong; Kim, Tae Woo; Lee, Taek Jun

    2016-12-01

    Memory complaints are a frequent phenomenon in elderly individuals and can lead to opportunistic help-seeking behavior. The aim of this study was to compare different aspects of memory complaints (i.e., prospective versus retrospective complaints) in individuals with subjective cognitive impairment (SCI), amnestic mild cognitive impairment (aMCI), and mild Alzheimer's disease (AD). The study included a total of 115 participants (mean age: 68.82 ± 8.83 years) with SCI (n = 34), aMCI (n = 46), and mild AD (n = 35). Memory complaints were assessed using the Prospective and Retrospective Memory Questionnaire (PRMQ), which consists of 16 items that describe everyday memory failure of both prospective memory (PM) and retrospective memory (RM). For aMCI and AD subjects, informants also completed an informant-rating of the PRMQ. All participants completed detailed neuropsychological tests. Results show that PM complaints were equivalent among the three groups. However, RM complaints differed. Specifically, RM complaints in aMCI were higher than SCI, but similar to AD. Informant-reported memory complaints were higher for AD than aMCI. Our study suggests that RM complaints of memory complaints may be helpful in discriminating between SCI and aMCI, but both PM and RM complaints are of limited value in differentiating aMCI from AD.

  2. Executive functioning complaints and escitalopram treatment response in late-life depression.

    Science.gov (United States)

    Manning, Kevin J; Alexopoulos, George S; Banerjee, Samprit; Morimoto, Sarah Shizuko; Seirup, Joanna K; Klimstra, Sibel A; Yuen, Genevieve; Kanellopoulos, Theodora; Gunning-Dixon, Faith

    2015-05-01

    Executive dysfunction may play a key role in the pathophysiology of late-life depression. Executive dysfunction can be assessed with cognitive tests and subjective report of difficulties with executive skills. The present study investigated the association between subjective report of executive functioning complaints and time to escitalopram treatment response in older adults with major depressive disorder (MDD). 100 older adults with MDD (58 with executive functioning complaints and 42 without executive functioning complaints) completed a 12-week trial of escitalopram. Treatment response over 12 weeks, as measured by repeated Hamilton Depression Rating Scale scores, was compared for adults with and without executive complaints using mixed-effects modeling. Mixed effects analysis revealed a significant group × time interaction, F(1, 523.34) = 6.00, p = 0.01. Depressed older adults who reported executive functioning complaints at baseline demonstrated a slower response to escitalopram treatment than those without executive functioning complaints. Self-report of executive functioning difficulties may be a useful prognostic indicator for subsequent speed of response to antidepressant medication. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. Waiver Given for New York Schools Chief

    Science.gov (United States)

    Samuels, Christina A.

    2010-01-01

    The author reports on a promise to name a chief academic officer as second in charge of the New York City schools which paved the way for Cathleen P. Black to succeed Joel I. Klein as the district's next chancellor. The compromise plan, announced amid intensifying debate over her selection by Mayor Michael R. Bloomberg, won a state waiver…

  4. Health complaints and regulatory reform: Implications for vulnerable populations?

    Science.gov (United States)

    Carney, Terry; Beaupert, Fleur; Chiarella, Mary; Bennett, Belinda; Walton, Merrilyn; Kelly, Patrick J; Satchell, Claudette S

    2016-03-01

    Complaints and disciplinary processes play a significant role in health professional regulation. Many countries are transitioning from models of self-regulation to greater external oversight through systems including meta-regulation, responsive (risk-based) regulation, and "networked governance". Such systems harness, in differing ways, public, private, professional and non-governmental bodies to exert influence over the conduct of health professionals and services. Interesting literature is emerging regarding complainants' motivations and experiences, the impact of complaints processes on health professionals, and identification of features such as complainant and health professional profiles, types of complaints and outcomes. This article concentrates on studies identifying vulnerable groups and their participation in health care regulatory systems.

  5. 22 CFR 35.6 - Prerequisites for issuing a complaint.

    Science.gov (United States)

    2010-04-01

    ... this section), the amount of money or the value of property or services demanded or requested in... simultaneously, regardless of the amount of money, or the value of property or services, demanded or requested. ... § 35.6 Prerequisites for issuing a complaint. (a) The reviewing official may issue a complaint under...

  6. 10 CFR 1013.6 - Prerequisites for issuing a complaint.

    Science.gov (United States)

    2010-01-01

    ... in paragraph (b) of this section), the amount of money or the value of property or services demanded... that are unrelated or were not submitted simultaneously, regardless of the amount of money, or the... § 1013.6 Prerequisites for issuing a complaint. (a) The reviewing official may issue a complaint under...

  7. 78 FR 59082 - Privacy Act of 1974; Department of Transportation, Federal Motor Carrier Safety Administration...

    Science.gov (United States)

    2013-09-25

    ..., [email protected] . For privacy issues please contact: Claire W. Barrett, Departmental Chief... DEPARTMENT OF TRANSPORTATION Office of the Secretary [Docket No. FMCSA-2013-0306] Privacy Act of... Administration (FMCSA), DOT. ACTION: Notice to amend a system of records. SUMMARY: In accordance with the Privacy...

  8. Commander in chief : FDR's battle with Churchill, 1943

    NARCIS (Netherlands)

    Hamilton, Charles Nigel

    2016-01-01

    Commander in Chief is een deelbiografie van president Franklin Delano Roosevelt waarin Roosevelts rol als opperbevelhebber van de gewapende strijdkrachten van de Verenigde Staten in de Tweede Wereldoorlog het hoofdthema is. Het boek concentreert zich op het jaar 1943: een jaar waaraan biografen van

  9. Narrator-in-Chief

    DEFF Research Database (Denmark)

    Herron, Mark A.

    . The use of narratives of and by presidents in the White House can be seen as an essential part of the ceremonial role of the presidency. This use of narratives in epideictic speech has increased with modern day interests in the domestic life of the president, and the use of visual mass media......The dissertation Narrator-in-Chief: The Narrative Rhetoric of Barack Obama seeks to show how the concept of “narrative” can be used in rhetorical criticism of presidential speeches, particularly when considering the speeches and the biographical text, Dreams from My Father (1995), of Barack Obama...... as a communication platform for the president. While this has been described as a negative development (Stuckey, 1991; Salmon, 2010) this dissertation argues that narrative rhetoric should not be seen only as a negative part of political rhetoric, but also as a possibly vital way to educate the audience on issues...

  10. Complaint studies: Methodological considerations and a result

    DEFF Research Database (Denmark)

    Juhl, Hans Jørn; Poulsen, Carsten Stig; Thøgersen, John

    The purpose of this paper is twofold. Firstly we present in a non-technical form some of the measurement problems involved in interpreting consumer complaint data and secondly we provide some empirical results based upon a complaint study carried out in Denmark in 2002. Several measurement models...... are developed, ranging from the Rasch model via latent structure analysis with several correlated latent variables to suggestions about a comprehensive framework, combining Fishbein-Ajzen's Theory of Planned Behaviour and latent trait models. The empirical results show that the propensity to complain in Denmark...

  11. 20 CFR 655.1316 - Job Service Complaint System; enforcement of work contracts.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Job Service Complaint System; enforcement of... for Temporary Agricultural Employment in the United States (H-2A Workers) § 655.1316 Job Service... through the Job Service Complaint System, as described in 20 CFR part 658, Subpart E. Complaints which...

  12. CEO- CNE Relationships: Building an Evidence-Base of Chief Nursing Executive Replacement Costs

    OpenAIRE

    Sredl, Darlene; Peng, Niang-Huei

    2010-01-01

    OBJECTIVE: Explore professional relationships between Chief Nurse Executives (CNEs) and Chief Executive Officers (CEOs); CNE ethnic diversity; and CNE replacement costs. BACKGROUND: Theoretical frameworks - Marilyn Ray's Theory of Bureaucratic Caring, and Turkel's Theory of Relational Complexity espousing economic as well as caring variables. METHODS: Exploratory mixed-method descriptive design using CNE mailed survey. RESULTS: CNE- cited opportunities for maintaining a positive relationship ...

  13. Impact on Quality of Life in Dermatology Patients Attending an Emergency Department.

    Science.gov (United States)

    Alegre-Sánchez, A; de Perosanz-Lobo, D; Pascual-Sánchez, A; Pindado-Ortega, C; Fonda-Pascual, P; Moreno-Arrones, Ó M; Jaén-Olasolo, P

    2017-12-01

    Dermatological complaints have been estimated to represent up to 5-10% of all the visits to emergency departments. The main objective of our study was to determine how affected is the Health related Quality of Life (HRQL) in a series of patients attending an emergency department due to skin symptoms. A prospective study during one month (July 2016) was conducted in a hospital with full-time on-call dermatologists. The Short-Form SF-12v2 Health Survey and the Dermatology Life Quality Index (DLQI) were offered to all the patients over 18 years old attending the emergency department with cutaneous complaints. Clinical and epidemiological characteristics were also collected. In total 108 patients completed the study. Mean age found was 45.1±16.1 years. Mean DLQI score found was 10.56±6.12. Fifty-three patients (49%) had a score of 11 or higher in the DLQI questionnaire. Most affected subscales were "Symptoms and Feelings" in DLQI scale and "Overall Health" and "Vitality" for the SF-12. A very significant difference (p<0.0001) was found between women's (12.4±5.7) and men's (7.5±5.6) DLQI mean score (mean difference of 4.9; 95% confidence interval of the difference: 2.7-7.1). Patients visiting emergency units with cutaneous complaints seem to feel a moderate-large impact on their quality of life which is mainly related to the symptoms and feelings that they are experiencing. This impact is significantly higher among women. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Missed Fractures in Infants Presenting to the Emergency Department With Fussiness.

    Science.gov (United States)

    Kondis, Jamie S; Muenzer, Jared; Luhmann, Janet D

    2017-08-01

    The aim of this study was to evaluate incidence of prior fussy emergency visits in infants with subsequently diagnosed fractures suggestive of abuse. This was a retrospective chart review of infants younger than 6 months who presented to the pediatric emergency department (ED) between January 1, 2006, and December 31, 2011. Inclusion criteria included age 0 to 6 months, discharge diagnosis including "fracture," "broken" (or break), or "trauma" or any child abuse diagnosis or chief complaint of "fussy" or "crying" as documented in the electronic medical record by the triage nurse. Three thousand seven hundred thirty-two charts were reviewed, and 279 infants with fractures were identified. Eighteen (6.5%) of 279 infants had a prior ED visit for fussiness without an obvious source. Of these, 2 had a witnessed event causing their fracture, and therefore the fracture was not considered concerning for abuse. The remaining 16 had fractures concerning for abuse. Mean age was 2.5 (SD, 1.2) months. Fifteen (83%) of 18 infants were 3 months or younger at the time of the fussy visit. The mean interval between the first and second ED visits was 27 days (median, 20 days). Thirty-nine percent were evaluated by a pediatric emergency medicine-trained physician during their initial fussy visit, whereas 78% were evaluated by pediatric emergency medicine-trained physician during their subsequent visit. Most common injuries were multiple types of fractures followed by extremity and rib fractures. Fractures concerning for child abuse are an important cause of unexplained fussiness in infants presenting to the pediatric ED. A high index of suspicion is essential for prompt diagnosis and likely prevention of other abuse.

  15. Branchial cleft cyst: A case report and review of literature.

    Science.gov (United States)

    Chavan, Surekha; Deshmukh, Revati; Karande, Prasad; Ingale, Yeshwant

    2014-01-01

    First branchial cleft anomaly is a rare disease of the head and neck. Because of its rarity, first branchial cleft anomaly is often misdiagnosed and results in inappropriate management. In this article, we present a case of type II first branchial cleft anomaly. A middle-aged woman who had suffered from swelling on lower jaw visited our department with the chief complaint of a swelling. She underwent complete excision of the lesion with preservation of the facial nerve. The patient recovered well and had no recurrence at 1-year of follow up.

  16. Psychological factors are associated with subjective cognitive complaints 2 months post-stroke.

    Science.gov (United States)

    Nijsse, Britta; van Heugten, Caroline M; van Mierlo, Marloes L; Post, Marcel W M; de Kort, Paul L M; Visser-Meily, Johanna M A

    2017-01-01

    The aim of this study was to investigate which psychological factors are related to post-stroke subjective cognitive complaints, taking into account the influence of demographic and stroke-related characteristics, cognitive deficits and emotional problems. In this cross-sectional study, 350 patients were assessed at 2 months post-stroke, using the Checklist for Cognitive and Emotional consequences following stroke (CLCE-24) to identify cognitive complaints. Psychological factors were: proactive coping, passive coping, self-efficacy, optimism, pessimism, extraversion, and neuroticism. Associations between CLCE-24 cognition score and psychological factors, emotional problems (depressive symptoms and anxiety), cognitive deficits, and demographic and stroke characteristics were examined using Spearman correlations and multiple regression analyses. Results showed that 2 months post-stroke, 270 patients (68.4%) reported at least one cognitive complaint. Age, sex, presence of recurrent stroke(s), comorbidity, cognitive deficits, depressive symptoms, anxiety, and all psychological factors were significantly associated with the CLCE-24 cognition score in bivariate analyses. Multiple regression analysis showed that psychological factors explained 34.7% of the variance of cognitive complaints independently, and 8.5% (p psychological factors, proactive coping was independently associated with cognitive complaints (p cognitive complaints. Because cognitive complaints are common after stroke and are associated with psychological factors, it is important to focus on these factors in rehabilitation programmes.

  17. The changing role of the hospital chief financial officer.

    Science.gov (United States)

    Freitag, T R; Freitag, W

    1980-01-01

    Things are changing. That statement is obviously true of things political, economic and scientific. Not surprisingly, therefore, the statement applies to the activities, responsibilities, qualifications and, ultimately, status of the hospital chief financial officer (CFO).

  18. Office of the Chief Financial Officer Annual Report 2009

    Energy Technology Data Exchange (ETDEWEB)

    Fernandez, Jeffrey

    2009-12-15

    Presented is the 2009 Chief Financial Officer's Annual Report. The data included in this report has been compiled from the Budget Office, the Controller, Procurement and Property Management and the Sponsored Projects Office.

  19. Subjective memory complaints and their relation with verbal fluency in active older people.

    Science.gov (United States)

    Bernardes, Flavia Rodrigues; Machado, Camila Kretzer; Souza, Monique Coan; Machado, Marcos José; Belaunde, Aline Megumi Arakawa

    2017-05-22

    To verify subjective memory complaints and their relation to verbal fluency in older people participating in community groups. An epidemiological quantitative study performed in community groups for older people in Florianópolis, state of Santa Catarina, Brazil. Data were collected by structured interview using the Memory Complaint Questionnaire (MAC-Q) and the Verbal Fluency Test (VFT) by semantic categories "animals/minute". For an inferential descriptive analysis, data with p people in question and added to the questionnaire). We found no relation between subjective memory complaints and verbal fluency of active older people. Mnemonic complaints were correlated to the negative perception of memory and to the duration of the complaint. However, subjective memory complaints were an indicator for those individuals with negative perception of memory, being one aspect that must be considered in older people's speech when investigating a possible cognitive deterioration. Such data can assist in formulating public health care policies aimed at older people in the city, which emphasizes the importance of verifying subjective memory complaints in this population.

  20. 20 CFR 658.422 - Handling of non-JS-related complaints by the Regional Administrator.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Handling of non-JS-related complaints by the... Federal Js Complaint System § 658.422 Handling of non-JS-related complaints by the Regional Administrator. (a) Each non-JS-related complaint filed by an MSFW alleging violations of employment related laws...

  1. Subjective memory complaints are associated with brain activation supporting successful memory encoding.

    Science.gov (United States)

    Hayes, Jessica M; Tang, Lingfei; Viviano, Raymond P; van Rooden, Sanneke; Ofen, Noa; Damoiseaux, Jessica S

    2017-12-01

    Subjective memory complaints, the perceived decline in cognitive abilities in the absence of clinical deficits, may precede Alzheimer's disease. Individuals with subjective memory complaints show differential brain activation during memory encoding; however, whether such differences contribute to successful memory formation remains unclear. Here, we investigated how subsequent memory effects, activation which is greater for hits than misses during an encoding task, differed between healthy older adults aged 50 to 85 years with (n = 23) and without (n = 41) memory complaints. Older adults with memory complaints, compared to those without, showed lower subsequent memory effects in the occipital lobe, superior parietal lobe, and posterior cingulate cortex. In addition, older adults with more memory complaints showed a more negative subsequent memory effects in areas of the default mode network, including the posterior cingulate cortex, precuneus, and ventromedial prefrontal cortex. Our findings suggest that for successful memory formation, older adults with subjective memory complaints rely on distinct neural mechanisms which may reflect an overall decreased task-directed attention. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. EDITORIAL: Outgoing Editor-in-Chief Outgoing Editor-in-Chief

    Science.gov (United States)

    Hauptmann, Peter

    2012-01-01

    I started in 2002 as Editor-in-Chief of a well established journal—MST (Measurement Science and Technology). It was a time when modern means of communication offered new opportunities for the scientific community—for all scientists and engineers whether at universities, in industry or at other institutions—to access better quality information in a shorter time. This development helped us to be more efficient in our daily scientific work and to anticipate new trends faster than before. A flood of information was created by different search engines. A few online journals or journals published in emerging countries with a similar profile to MST appeared on the market. MST had to provide new answers in response to these developments. In 2002 I postulated two requirements to the journal. Firstly, the publisher has to be up to date. My impression over the years has been that IOPP is excellently organized. That has made it easier for the board members and all our reviewers to concentrate on the scientific aspects of our input to the journal. During all my visits to Bristol or my contacts with the IOPP staff I always met very professional and enthusiastic staff members. They have not only supported and encouraged the ideas and initiatives of the Editorial Board members, but they have also worked hard on establishing one of the most effective journal operations in the field of measurement science and technology. Many authors are well aware of this. Thus I am able to declare that the first requirement for a successful journal has been met. Secondly, the scientific level has to be high and the journal should attract readers from all over the world. This task was the responsibility of the Editorial Board members and of myself. Our strategy was on the one hand to ensure continuity in MST but on the other hand to be open to new trends and developments. Examples of these new aspects of the journal are fields like micro- and nanometrology, measurement techniques for

  3. Phenomenological characterization of memory complaints in preclinical and prodromal Alzheimer's disease.

    Science.gov (United States)

    Buckley, Rachel F; Ellis, Kathryn A; Ames, David; Rowe, Christopher C; Lautenschlager, Nicola T; Maruff, Paul; Villemagne, Victor L; Macaulay, S Lance; Szoeke, Cassandra; Martins, Ralph N; Masters, Colin L; Savage, Greg; Rainey-Smith, Stephanie R; Rembach, Alan; Saling, Michael M

    2015-07-01

    To explore the subjective experience of memory change in groups at risk of dementia (those with mild cognitive impairment MCI or high β-amyloid (Aβ+) burden) to determine the existence of potential phenomenological typologies. We recruited 123 healthy controls (HC) and individuals with MCI from the Australian Imaging, Biomarker and Lifestyle (AIBL) study. Sixty-7 (HC = 47,MCI = 20) had Aβ scans available for analysis. Semistructured interviews were administered, transcribed, and meaningful phrases extracted from transcripts. Twelve themes were defined and compared across diagnostic status and Aβ status. MCI endorsed more complaints of burdensome coping strategies, increasing frequency, sense of predomination, poor contextualization, progression, dependency, impact on affect, and dismissive attitudes. HCAβ+ acknowledged a progressive memory decline compared to HCAβ-, while MCIAβ+ expressed more burdensome coping strategies, dismissive attitudes, and dependency comparative to either healthy group. Depression was more likely to be related to complaint themes in HCs, while complaint themes were associated with poorer list-learning performance in individuals with MCI. Complaint themes in those with MCI align with the MCI symptom complex, particularly when accompanied with high Aβ load. Healthy Aβ+ individuals acknowledged progressive memory change, suggesting they are aware of memory changes not yet detectable via neuropsychological measures. Depressive symptomatology associated with HC complaints, suggesting certain themes are affect-driven, while complaints in MCI are associated with organically driven functional impairment. Qualitative analysis of SMCs can inform the earliest clinical manifestations of Alzheimer's disease. Our findings can inform diagnostic approaches to the clinical evaluation of memory complaints in the nondemented elderly. (c) 2015 APA, all rights reserved).

  4. Memory complaints are frequent but qualitatively different in young and elderly healthy people

    NARCIS (Netherlands)

    Ginó, Sandra; Mendes, Tiago; Maroco, João; Ribeiro, Filipa; Schmand, Ben A.; de Mendonça, Alexandre; Guerreiro, Manuela

    2010-01-01

    BACKGROUND: Subjective memory complaints are frequently reported by the elderly. There is less information about the characterization of subjective memory complaints in young people. OBJECTIVE: To determine different memory complaints between young and elderly people with the use of the Subjective

  5. Memory complaints are frequent but qualitatively different in young and elderly healthy people

    NARCIS (Netherlands)

    Ginó, S.; Mendes, T.; Maroco, J.; Ribeiro, F.; Schmand, B.A.; de Mendonca, A.; Guerreiro, M.

    2010-01-01

    Background: Subjective memory complaints are frequently reported by the elderly. There is less information about the characterization of subjective memory complaints in young people. Objective: To determine different memory complaints between young and elderly people with the use of the Subjective

  6. The Joint Chiefs of Staff and National Policy: 1965-1968 (History of the Joint Chiefs of Staff)

    Science.gov (United States)

    2012-01-01

    car- rier would stop at Rio de Janeiro instead. When the Roosevelt was returning from war duties, early in 1967, the Navy directed that sailors "go...advice. On 28 April Representative Mendel Rivers (D, SC), Chairman of the Committee on Armed Services, introduced a bill lengthening the terms of...Reporting favorably, Rivers ’ Committee stated that "the sole objective... is to permit members of the Joint Chiefs of Staff to advise the Congress, as well

  7. 39 CFR 4.5 - Assistant Postmasters General, General Counsel, Judicial Officer, Chief Postal Inspector.

    Science.gov (United States)

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Assistant Postmasters General, General Counsel, Judicial Officer, Chief Postal Inspector. 4.5 Section 4.5 Postal Service UNITED STATES POSTAL SERVICE THE... Counsel, a Judicial Officer, a Chief Postal Inspector, and such number of officers, described in 39 U.S.C...

  8. Shoulder complaints in wheelchair athletes: A systematic review.

    Directory of Open Access Journals (Sweden)

    Omar W Heyward

    Full Text Available In recent years the popularity of disabled sports and competition among disabled athletes has grown considerably. With this rise in exposure of, and participation in wheelchair sports comes an increase in related stressors, including musculoskeletal load. External mechanical loading may increase the risk of shoulder complaints. The objective of this literature review was to 1 identify and describe the prevalence and/or incidence of shoulder complaints in wheelchair athletes in the literature, to 2 examine the factors and underlying mechanisms that could be potentially involved, and 3 provide some insights into the development of preventative measures.A literature search was conducted using PubMed, Scopus and Embase databases, to identify relevant published articles. All articles in the English language that contained any type of shoulder complaint in relation with a wheelchair sports player, at any level of status (recreational to elite, of any sport, were included. Articles were excluded if they did not include any statistical analysis. Articles that included studies with wheelchair athletes in combination with athletes of other disability sports were excluded in order to be able to differentiate between the two. Narrative, exploratory and case studies were also excluded. Two reviewers independently assessed articles for inclusion. Thirteen articles matched the selection criteria. These were judged on their quality by use of an adapted version of the Webster checklist.Of the included studies the overall quality was low. A relatively high prevalence of complaints was found, ranging from 16% to 76%. Pain was found to be a common complaint in wheelchair athletes. Based on the current literature the cause of shoulder problems is difficult to identify and is likely multifactorial, nevertheless characteristics of the user (i.e. increased years of disability, age and BMI were shown to increase risk. Preventative measures were indistinct. There may be

  9. 49 CFR 805.735-26 - Employee's complaint on filing requirements.

    Science.gov (United States)

    2010-10-01

    ...) NATIONAL TRANSPORTATION SAFETY BOARD EMPLOYEE RESPONSIBILITIES AND CONDUCT § 805.735-26 Employee's complaint on filing requirements. An employee who believes that his position has been improperly included... 49 Transportation 7 2010-10-01 2010-10-01 false Employee's complaint on filing requirements. 805...

  10. Complaint Speech Act of Hotel and Restaurant Guests

    OpenAIRE

    Suryawan, I Nengah; Putra Yadnya, Ida Bagus; Puspani, Ida Ayu Made

    2016-01-01

    This paper is aimed at analyzing how complaint speech act of hotel and restaurant guests are performed and responded based on categories of speech acts and how they are performed considering the aspects of acts: locutionary, illocutionary, and perlocutionary. The method and technique of collecting data in this study is documentation method in which the data were collected using the technique of note taking and were qualitatively analyzed. The findings show that complaint of hotel and restaura...

  11. Health complaints among nurses working near MRI scanners-A descriptive pilot study

    International Nuclear Information System (INIS)

    Wilen, Jonna; Vocht, Frank de

    2011-01-01

    A questionnaire-based descriptive pilot study was conducted among all nurses routinely working with MRI in the Northern part of Sweden to provide an indication of the self-reported prevalence of health complaints related to working with MRI systems. Fifty-nine nurses (88% response rate), with on average 8 (±6) years experience with MRI scanning procedures, returned the questionnaire. In total, 9 nurses (15%) reported regularly experiencing at least one of the health complaints (1-5% for specific health complaints) attributed to arise or be aggravated by their presence in the MRI scanning room. Stratification of the results indicated that reporting of adverse symptoms was not related to the level of occupational workload/stress. However, reporting of health complaints was related to the strength of the magnet(s) the nurses worked with, with 57% of symptoms reported by those nurses working with the strongest systems (both 1.5 and 3 T scanners in this population). Although this descriptive study did not include a control population and was based on self-reporting of health complaints, these data indicate that the prevalence of reported health complaints is not related to perceived work load or occupational stress, but does confirm data from other occupational sectors and indicates that the prevalence of adverse health complaints increases with the strength of the MRI system for nurses as well.

  12. Complaints about noise from windmills

    International Nuclear Information System (INIS)

    1992-10-01

    With the aim of examining the subject of noise made by windmills and discovering the characteristics that are commonly found with regard to complaints in this respect, 10 cases were selected from a total of 40 in order to carry out a critical examination of the matter. The chosen cases were concerned with both small and medium-sized wind turbines located in groups or standing alone. The authors of the complaints lived within a distance of 160-166 meters from the cited windmills which could be described as producing an average amount of noise in relation to their size. It was clear from available material (including telephone interviews) that noise was experienced as being the most disturbing, although light-flashing from turbine blades, shadowing and aesthetic considerations related to scenic location were also named. In most cases the noise was so distressing that it influenced people's decisions on whether, or where, to go outside their homes and whether or not to open their windows. Most complaints were about machine noise and other audible tones, and about half of them concerned the swish of turning blades. Most people were especially bothered when the wind did not blow so hard (so that the wind in the trees etc. was not so loud). The persistancy of the noise generated was considered to contribute most to the depreciation of life quality. It was found that the amount of irritation coincided with noise loads of L r at a wind velocity of 5 or 8 m/s. A table is presented to illustrate registered noise conditions. (AB)

  13. Psychiatry chief resident opinions toward basic and clinical neuroscience training and practice.

    Science.gov (United States)

    Bennett, Jeffrey I; Handa, Kamna; Mahajan, Aman; Deotale, Pravesh

    2014-04-01

    The authors queried attendees to a chief resident conference on whether program education and training in neuroscience or in translating neuroscience research into practice is sufficient and what changes are needed. The authors developed and administered a 26-item voluntary questionnaire to each attendee at the Chief Residents' Leadership Conference at the American Psychiatric Association 2013 annual meeting in San Francisco, CA. Out of 94 attendees, 55 completed and returned questionnaires (58.5%). A majority of respondents stated that their program provided adequate training in neuroscience (61.8%); opportunities for neuroscience research existed for them (78.2%), but that their program did not prepare them for translating future neuroscience research findings into clinical practice (78.9%) or educate them on the NIMH Research Domain Criteria (83.3%). A majority of respondents stated that the ACGME should require a specific neuroscience curriculum (79.6%). Chief residents believe that curricular and cultural change is needed in psychiatry residency neuroscience education.

  14. Gender differences dominate sleep disorder patients' body problem complaints

    Directory of Open Access Journals (Sweden)

    Ted L. Rosenthal

    1994-12-01

    Full Text Available We studied it age, gender, diagnostic status, and psychiatric features affected 291 consecutive sleep disorder patient's body complaints on a brief checklist. Gender had a strong impact on all four (tested dependent measures, with women reporting more distress than men. Age produced significant regressions on two measures, with younger patients complaining more than older. Presence of psychiatric features was associated with more complaints on one dependent measure - previously found to reflect internal medicine patients' emotional distress. The results of regression analyses were largely supported by follow-up ANOVAs. However, contrasting insomniac versus hypersomniac versus all other sleep disorder diagnoses did not affect body complaints on any dependent measure. The results caution against combining males and females to compare self-reported distress between sleep disorders.

  15. The contribution of embarrassment to phobic dental anxiety: a qualitative research study.

    Science.gov (United States)

    Moore, Rod; Brødsgaard, Inger; Rosenberg, Nicole

    2004-04-19

    Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. Subjects (Ss) were consecutive specialist clinic patients, 16 men, 14 women, 20-65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9) with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment intensity ratings were positively correlated with years of

  16. Customer satisfaction and complaint behaviour

    African Journals Online (AJOL)

    kirstam

    emotions resulting from the dissatisfaction and their coping strategies in the form of .... clothes or their complaint behaviour in cases of dissatisfaction. ... However, quality is a complex and multi-dimensional concept, which is relative ...... Exploring the importance of aesthetics', Journal of Fashion Marketing and Management,.

  17. 10 CFR 708.4 - What employee complaints are not covered?

    Science.gov (United States)

    2010-01-01

    ... a complaint against your employer under this part if: (a) The complaint is based on race, color... you, acting without direction from your employer, deliberately caused, or in which you knowingly... for Contractor Employees (Ethics);” or (3) State or other applicable law, including final and binding...

  18. Patient Complaints Emphasize Non-Technical Aspects of Care at a Tertiary Referral Hospital

    Directory of Open Access Journals (Sweden)

    John King

    2017-03-01

    Full Text Available Background:Patient concerns represent opportunities for improvement in orthopaedic care. Thisstudy’s objectiveis to identify the nature and prevalence of unsolicited patient complaints regarding orthopaedic care ata tertiary referral hospital. The primary null hypothesis that there are no demographic factors associatedwith complaint types was tested. Secondarily we determined if the overall complaint number and typesdifferedby year.Methods:Complaints to the hospital ombudsperson by orthopaedic patients between January 1997 and June 2013 werereviewed. All 1118 complaints were categorized: access and availability, humaneness and disrespect, communication,expectations of care and treatment, distrust, billing and research.Results:Patients between 40 and 60 years of age filed the most complaints in all categories except distrust(more common in patients over age 80 and research. Women were slightly more likely to address access andavailability, humaneness, disrespect, and billing compared to men. The overall number of complaints peakedin 1999. The most common issue was access and availability followed by communication, and humaneness/disrespect.Conclusion:Half of concerns voiced by patients addressed interpersonal issues. The largest category was related toaccess and availability. Quality improvement efforts can address technology to improve access and availability as wellas empathy and communication strategies.

  19. 21 CFR 211.198 - Complaint files.

    Science.gov (United States)

    2010-04-01

    ... CURRENT GOOD MANUFACTURING PRACTICE FOR FINISHED PHARMACEUTICALS Records and Reports § 211.198 Complaint... for exemption under § 211.137, such written records shall be maintained for 3 years after distribution...

  20. Advancing the Use of Emergency Department Syndromic Surveillance Data, New York City, 2012-2016.

    Science.gov (United States)

    Lall, Ramona; Abdelnabi, Jasmine; Ngai, Stephanie; Parton, Hilary B; Saunders, Kelly; Sell, Jessica; Wahnich, Amanda; Weiss, Don; Mathes, Robert W

    The use of syndromic surveillance has expanded from its initial purpose of bioterrorism detection. We present 6 use cases from New York City that demonstrate the value of syndromic surveillance for public health response and decision making across a broad range of health outcomes: synthetic cannabinoid drug use, heat-related illness, suspected meningococcal disease, medical needs after severe weather, asthma exacerbation after a building collapse, and Ebola-like illness in travelers returning from West Africa. The New York City syndromic surveillance system receives data on patient visits from all emergency departments (EDs) in the city. The data are used to assign syndrome categories based on the chief complaint and discharge diagnosis, and analytic methods are used to monitor geographic and temporal trends and detect clusters. For all 6 use cases, syndromic surveillance using ED data provided actionable information. Syndromic surveillance helped detect a rise in synthetic cannabinoid-related ED visits, prompting a public health investigation and action. Surveillance of heat-related illness indicated increasing health effects of severe weather and led to more urgent public health messaging. Surveillance of meningitis-related ED visits helped identify unreported cases of culture-negative meningococcal disease. Syndromic surveillance also proved useful for assessing a surge of methadone-related ED visits after Superstorm Sandy, provided reassurance of no localized increases in asthma after a building collapse, and augmented traditional disease reporting during the West African Ebola outbreak. Sharing syndromic surveillance use cases can foster new ideas and build capacity for public health preparedness and response.

  1. The Global Roundtable of Chief Economists highlights global trends ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2017-11-30

    Nov 30, 2017 ... Co-hosted by Ted Chu, chief economist of IFC, World Bank Group, and ... and the difficulty of constructing reliable control groups to assess the impact of bank interventions. ... Blood on the Stone Ian Smillie in his own words.

  2. Canada files WTO complaint against EC.

    Science.gov (United States)

    2000-01-01

    In December 1998, Canada filed a complaint alleging that the European Communities (EC) had adopted regulations that amounted to a scheme to extend patent terms, limited to pharmaceutical and agricultural chemical products.

  3. 76 FR 12745 - Privacy Act of 1974; Department of Homeland Security Office of Operations Coordination and...

    Science.gov (United States)

    2011-03-08

    ... 20528. For privacy issues please contact: Mary Ellen Callahan (703-235-0780), Chief Privacy Officer... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary [Docket No. DHS-2010-0055] Privacy Act of... Operations Center Tracker and Senior Watch Officer Logs System of Records AGENCY: Privacy Office, DHS. ACTION...

  4. Increased number of ear-nose-throat malpractice complaints in Denmark

    DEFF Research Database (Denmark)

    Nikoghosyan-Bossen, Gohar; Hauberg, Agnes; Homøe, Preben

    2012-01-01

    Danish ear, nose and throat (ENT) physicians have little knowledge of the type of decisions made at the Danish National Board of Patients' Complaints (NBPC). The aim of this study was to analyze and describe the epidemiology of ENT malpractice complaints by showing their distribution and volume i...

  5. A comparative study on the prevalence of musculoskeletal complaints among musicians and non-musicians

    Directory of Open Access Journals (Sweden)

    Kok Laura M

    2013-01-01

    Full Text Available Abstract Background Research comparing the frequency of musculoskeletal complaints between musicians and non-musicians is scarce. The aim of this study was to compare the prevalence of musculoskeletal complaints between musicians and non-musicians. Methods A cross-sectional study in 3215 students from three music academies (n = 345 and one medical school (n = 2870 in The Netherlands was performed, using an electronic questionnaire. The questionnaire included socio-demographic characteristics, use of music instruments and the occurrence of musculoskeletal complaints in six body regions. Questions were related to musculoskeletal complaints over the last twelve months and at the time of the questionnaire. Chi-square, t-tests and Kruskal-Wallis tests were used for comparison between the two groups. The association between musculoskeletal complaints and possible predictors was analyzed using a logistic and Poisson regression. Results Eighty-seven music academy students and 503 medical students returned the questionnaire, of which respectively eighty-three and 494 were included in the study. Seventy-four music academy students (89.2% reported one or more musculoskeletal complaints during the last twelve months, compared to 384 (77.9% medical students (p = 0.019. Moreover 52 music academy students (62.7% and 211 medical students (42.7% reported current musculoskeletal complaints (p = 0.001. The Odds ratio (OR for the development of musculoskeletal complaints during the last twelve months in music academy students versus medical students is 2.33 (95% CI 1.61–3.05, p = 0.022. The OR at the time of the questionnaire is 2.25 (95% CI 1.77–2.73, p = 0.001. The total number of complaints have been modeled by employing a Poisson regression; the results show that non-musicians have on average less complaints than musicians (p = 0.01. The adjusted means are 2.90 (95% CI 2.18–3.63 and 1.83 (95% CI 1.63–2.04 respectively for

  6. Chiefs, chieftaincies, chiefdoms, and chiefly confederacies: power in the evolution of political systems

    OpenAIRE

    Earle, Timothy

    2011-01-01

    Chiefdom is a social category, continuous with non-stratified social groups and states. The defining process of chiefdoms is an emergent political economy that mobilized resources used to finance institutions of rule and social stratification. Chiefdoms are highly variable, but they are all about power. This article reviews concepts of chiefs, chiefdoms and chiefly confederacies, and illustrates how Polynesian chiefdoms operated prior to state formation. The chief is a political actor seeking...

  7. 22 CFR 96.72 - Referral of complaints to the Secretary and other authorities.

    Science.gov (United States)

    2010-04-01

    ... Through Review of Complaints § 96.72 Referral of complaints to the Secretary and other authorities. (a) An... authority, the Attorney General, or other law enforcement authorities any substantiated complaints that involve conduct that is: (1) Subject to the civil or criminal penalties imposed by section 404 of the IAA...

  8. 76 FR 30227 - On behalf of the Accessibility Committee of the Federal Chief Information Officers Council...

    Science.gov (United States)

    2011-05-24

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2011-0041] On behalf of the Accessibility Committee of the Federal Chief Information Officers Council; Listening Session Regarding Improving the Accessibility of Government Information AGENCY: Federal Chief Information Officers Council, Social Security...

  9. Experience counts: The chief justice, management tenure, and strategic behavior on the U.S. Supreme Court

    Directory of Open Access Journals (Sweden)

    Joseph Daniel Ura

    2016-04-01

    Full Text Available We develop and test a theoretical account of the effect of management tenure on the strategic behavior of the chief justice of the United States. Substantial evidence from literatures on learning models and public management indicate that tenure (length of service is positively related to management performance in public organizations. This suggests that the chief justice’s tenure in office should be positively related to efficiency in the use of the chief justice’s formal powers. We assess this hypothesis by replicating and extending Johnson et al.’s study of chief justice Burger’s conference voting behavior. The data support our management tenure hypothesis, showing that Burger used greater discretion in reserving his conference vote over time as he became more adept at discriminating between circumstances when the tactic was strategically valuable and when it was not.

  10. Psychosocial complaints and physical therapy.

    NARCIS (Netherlands)

    Dekker, J.; Valk, R.W.A. van der; Verhaak, P.F.M.

    1995-01-01

    The aim of this study was to describe the disorders and the treatment of patients whose complaints were evaluated as being solely somatic in nature, as being somatic and having psychosocial consequences, or as being (at least partially) of a psychosocial origin. Data were used from a survey on

  11. 78 FR 4138 - Chief of Engineers Environmental Advisory Board; Meeting

    Science.gov (United States)

    2013-01-18

    ... (SDOCH), 401 West Washington Street, Phoenix, AZ 85003-21178. Agenda: The Board will advise the Chief of... interested person may attend. However, all attendees will enter and exit SDOCH through the appropriate...

  12. Privatising Consumer Complaints : An analysis of a patient’s complaints procedure in the Netherlands

    NARCIS (Netherlands)

    de Vries, U.M.R.T.

    2006-01-01

    This article analyzes a type of ADR seeking to resolve complaints of consumers and in particular of hospital patients. In doing so, it aims to establish how this type of procedure differs from “normal” litigation and why it proves to be successful. It aims to show that its success is not only due to

  13. Teaching Complaint and Adjustment Letters--And Tact (My Favorite Assignment).

    Science.gov (United States)

    Deimling, Paula

    1992-01-01

    Describes a three-part assignment in which each student writes a complaint letter and an adjustment letter responding to another student's complaint letter. Discusses how the third part of the assignment--journal entries--allows students to formulate their own criteria for excellent letters based upon their reactions to the letters they receive.…

  14. Inside Back Cover | Chief | Ghana Journal of Linguistics

    African Journals Online (AJOL)

    All areas of linguistics are invited – the journal is not limited to articles on languages of or in Ghana or Africa. ALL CONTRIBUTIONS must be submitted in English (except for special issues reserved for African languages), in electronic format to the current Editor-in-Chief, via our website at https://gjl.laghana.org. Authors ...

  15. The effect of continuing professional development on public complaints: a case-control study.

    Science.gov (United States)

    Wenghofer, Elizabeth F; Campbell, Craig; Marlow, Bernard; Kam, Sophia M; Carter, Lorraine; McCauley, William

    2015-03-01

    This study aimed to investigate the relationship between participation in different types of continuing professional development (CPD), and incidences and types of public complaint against physicians. Cases included physicians against whom complaints were made by members of the public to the medical regulatory body in Ontario, Canada, the College of Physicians and Surgeons of Ontario (CPSO), during 2008 and 2009. The control cohort included physicians against whom no complaints were documented during the same period. We focused on complaints related to physician communication, quality of care and professionalism. The CPD data included all Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC) CPD programme activities reported by the case and control physicians. Multivariate logistic regression models were used to determine if the independent variable, reported participation in CPD, was associated with the dependent variable, the complaints-related status of the physician in the year following reported CPD activities. A total of 2792 physicians were included in the study. There was a significant relationship between participation in CPD, type of CPD and type of complaint received. Analysis indicated that physicians who reported overall participation in CPD activities were significantly less likely (odds ratio 0.604; p = 0.028) to receive quality of care-related complaints than those who did not report participating in CPD. Additionally, participation in group-based CPD was less likely (OR 0.681; p = 0.041) to result in quality of care-related complaints. The findings demonstrate a positive relationship between participation in the national CPD programmes of the CFPC and RCPSC, and lower numbers of public complaints received by the CPSO. As certification bodies and regulators alike are increasingly mandating CPD, they are encouraged to continually evaluate the effectiveness of their programmes to maximise

  16. Patient complaints as a means to improve quality of hospital care. Results of a qualitative content analysis

    Science.gov (United States)

    Hoffmann, Susanne; Dreher-Hummel, Thomas; Dollinger, Claudia; Frei, Irena Anna

    2018-04-01

    Background: Many hospitals have defined procedures for a complaint management. A systematic analysis of patient complaints helps to identify similar complaints and patterns so that targeted improvement measures can be derived (Gallagher & Mazor, 2015). Aim: Our three-month, nurse-led practice development project aimed 1) to identify complaints regarding communication issues, 2) to systemise and prioritise complaints regarding communication issues, and 3) to derive clinic-specific recommendations for improvement. Method: We analysed 273 complaints of patients documented by the quality management (secondary data analysis). Using content analysis and applying the coding taxonomy for inpatient complaints by Reader, Gillespie and Roberts (2014), we distinguished communication-related complaints. By further inductive differentiation of these complaints, we identified patterns and prioritised fields of action. Results: We identified 186 communication-related complaints divided into 16 subcategories. For each subcategory, improvement interventions were derived, discussed and prioritised. Conclusions: Thus, patient complaints provided an excellent opportunity for reflection and workplace learning for nurses. The analysis gave impulse to exemplify the subject “person-centered care” for nurses.

  17. Work-focused cognitive behavioral intervention for psychological complaints in patients on sick leave due to work-related stress: Results from a randomized controlled trial.

    Science.gov (United States)

    Dalgaard, Vita Ligaya; Andersen, Lars Peter Sønderbo; Andersen, Johan Hviid; Willert, Morten Vejs; Carstensen, Ole; Glasscock, David John

    2017-08-22

    Work-related stress is a global problem with negative implications for individuals and society. The purpose of the current study was to evaluate a stress management intervention for patients on sick leave due to work-related stress complaints using a three-armed randomized controlled design. Participants were patients referred from three municipalities to the regional Department of Occupational Medicine. Inclusion criteria were: 1) sick leave due to work-related stress complaints, 2) a diagnosis of adjustment disorder or reactions to severe stress (ICD 10 code: F43,2 - F 43,9 not PTSD) or mild depressive episode (F 32.0). Through a double randomization procedure patients (n = 163) were randomized to either an intervention group (n = 58), a 'control group A' receiving a clinical examination (n = 56), or 'control group B' (n = 49) receiving no offers at the department. The intervention comprised six sessions of individual cognitive behavioral therapy and the offer of a small workplace intervention. Questionnaire data were analyzed with multivariate repeated measurements analysis. Primary outcomes assessed were perceived stress and general mental health. Secondary outcomes were sleep quality and cognitive failures. Follow-up was at four and 10 months after baseline. Complaints were significantly reduced in all groups over time. No group effects were observed between the intervention group and control group A that was clinically assessed. Significant group effects were found for perceived stress and memory when comparing the intervention group to group B, but most likely not due to an intervention effect. Psychological complaints improved substantially over time in all groups, but there was no significant treatment effect on any outcomes when the intervention group was compared to control group A that received a clinical assessment. ISRCTN ISRCTN91404229. Registered 03 August 2012 (retrospectively registered).

  18. 77 FR 20474 - Delegation of Authority; Delegation of Authority No. 24 to the Chief Operating Officer

    Science.gov (United States)

    2012-04-04

    ... SMALL BUSINESS ADMINISTRATION Delegation of Authority; Delegation of Authority No. 24 to the Chief Operating Officer AGENCY: U.S. Small Business Administration. ACTION: Notice of delegation of authority... planning; and disaster preparedness policy. Section A. Delegation of Authority No. 24 to the Chief...

  19. Depression, Suicidal Ideation, and Suicidal Attempt Presenting to the Emergency Department: Differences Between These Cohorts

    Directory of Open Access Journals (Sweden)

    Wirachin Hoonpongsimanont

    2014-03-01

    Full Text Available Introduction: The World Health Organization estimates that one million people die by suicide every year. Few studies have looked at factors associated with disposition in patients with chief complaints of depression, suicidal ideation (SI and suicidal attempts (SA who present to the emergency department (ED. Our objective was to assess individual determinants associated with ED disposition of patients in depressed patients presenting to the ED. Methods: We conducted a retrospective study using the National Hospital Ambulatory Medical Care Survey from 2006 to 2008. We used logistic regression to identify factors associated with discharge, in SI, SA and depression patients. Independent variables included socio-demographic information, vital signs, mode of arrival, insurance status, place of residence and concomitant psychiatric diagnosis. Results: Of the 93,030 subjects, 2,314 met the inclusion criteria (1,362 depression, 353 SI and 599 SA. Patients who arrived by ambulance were less likely to be discharged (odds ratio [OR] 0.63, 95% confidence interval [CI] 0.43-0.92. Hispanic patients and patients age 15 to 29 were likely to be discharged (OR 1.61, 95% CI 1.16-2.24 and OR 1.55, 95% CI 1.15-2.10 respectively. Insurance status and housing status were not significantly associated patient was being discharge from EDs. Conclusion: The Hispanic population had higher discharge rates, but the reasons are yet to be explored. Patients with SA and SI are discharged less frequently than those with depression, regardless of insurance type or housing status. [West J Emerg Med. 2014;15(2:211–216.

  20. Systematic analysis of ear-nose-throat malpractice complaints may be beneficial for patient safety

    DEFF Research Database (Denmark)

    Nikoghosyan-Bossen, Gohar; Hauberg, Agnes; Homøe, Preben

    2012-01-01

    The analysis of malpractice complaints can provide valuable information on patient safety. This study offers a detailed examination of the backgrounds concerning reasons and outcomes of ear, nose and throat (ENT) malpractice complaints handled by the National Board of Patients' Complaints (NBPC),...

  1. 75 FR 39184 - Privacy Act of 1974: Implementation of Exemptions; Department of Homeland Security/ALL-029 Civil...

    Science.gov (United States)

    2010-07-08

    ... questions and privacy issues please contact: Mary Ellen Callahan (703-235-0780), Chief Privacy Officer... Secretary 6 CFR Part 5 [Docket No. DHS-2010-0034] Privacy Act of 1974: Implementation of Exemptions...: Privacy Office, DHS. ACTION: Notice of proposed rulemaking. SUMMARY: The Department of Homeland Security...

  2. 47 CFR 76.1713 - Complaint resolution.

    Science.gov (United States)

    2010-10-01

    ... local franchising authority and the cable system operator. ... system operators shall establish a process for resolving complaints from subscribers about the quality of... for inspection by the Commission and franchising authorities, upon request. These records shall be...

  3. Customer complaints: a managed care firm's best weapon in CQI.

    Science.gov (United States)

    Polonski, G J

    1995-01-01

    Encouraging customer feedback and developing an automated customer complaint system are two essential steps a health plan must take if it wishes to develop a balanced relationship with the customer. The author explores how the right attitude and appropriate action can ensure that both customers and the company reap the benefits of a comprehensive customer complaint system.

  4. Emotion Analysis of Telephone Complaints from Customer Based on Affective Computing.

    Science.gov (United States)

    Gong, Shuangping; Dai, Yonghui; Ji, Jun; Wang, Jinzhao; Sun, Hai

    2015-01-01

    Customer complaint has been the important feedback for modern enterprises to improve their product and service quality as well as the customer's loyalty. As one of the commonly used manners in customer complaint, telephone communication carries rich emotional information of speeches, which provides valuable resources for perceiving the customer's satisfaction and studying the complaint handling skills. This paper studies the characteristics of telephone complaint speeches and proposes an analysis method based on affective computing technology, which can recognize the dynamic changes of customer emotions from the conversations between the service staff and the customer. The recognition process includes speaker recognition, emotional feature parameter extraction, and dynamic emotion recognition. Experimental results show that this method is effective and can reach high recognition rates of happy and angry states. It has been successfully applied to the operation quality and service administration in telecom and Internet service company.

  5. Emotion Analysis of Telephone Complaints from Customer Based on Affective Computing

    Directory of Open Access Journals (Sweden)

    Shuangping Gong

    2015-01-01

    Full Text Available Customer complaint has been the important feedback for modern enterprises to improve their product and service quality as well as the customer’s loyalty. As one of the commonly used manners in customer complaint, telephone communication carries rich emotional information of speeches, which provides valuable resources for perceiving the customer’s satisfaction and studying the complaint handling skills. This paper studies the characteristics of telephone complaint speeches and proposes an analysis method based on affective computing technology, which can recognize the dynamic changes of customer emotions from the conversations between the service staff and the customer. The recognition process includes speaker recognition, emotional feature parameter extraction, and dynamic emotion recognition. Experimental results show that this method is effective and can reach high recognition rates of happy and angry states. It has been successfully applied to the operation quality and service administration in telecom and Internet service company.

  6. The Self-Perceived Leadership Styles of Chief State School Officers and Models of Educational Governance

    Science.gov (United States)

    Wiggins, Lori A.

    2013-01-01

    This study examined the leadership styles of the chief state school officers of the United States and the District of Columbia. The entire population of 51 chief state school officers was surveyed and a response rate of 60% was obtained. The study examined the relationship between the leadership style, select demographic variables, and the…

  7. The Somatic Complaints List: Validation of a self-report questionnaire assessing somatic complaints in children

    NARCIS (Netherlands)

    Jellesma, F. C.; Rieffe, C.J.; Meerum Terwogt, M.

    2007-01-01

    Objective: To evaluate the Somatic Complaint List (SCL) in children. Method: At T1, 365 fourth and 352 fifth graders completed the SCL, the Children's Somatization Inventory (CSI-C), and the Mood Questionnaire. Parents (n=564) completed the parental form of the CSI-C (CSI-P). Six months later, the

  8. Customers’ Complaints and its Determinants: The Case of a Training Educational Hospital in Iran

    Directory of Open Access Journals (Sweden)

    Hossein Ebrahimipour

    2013-11-01

    Full Text Available BackgroundToday, despite the efforts of the medical community and healthcare staff along with the advancements in medical technology, patients’ dissatisfaction and complaints have been increased. The present study aimed at making a survey on the patients’ complaints in a large training hospital affiliated to Mashhad University of Medical Sciences (MUMS. MethodsThis descriptive, cross-sectional study was conducted on written and verbal complaints of patients and their relatives in a tertiary (specialty and sub-specialty training hospital. All the recorded patients’ complaints, from March to December 2012, were reviewed. Data were categorized and analyzed using descriptive statistics by Microsoft Excel 2007. ResultsA total of 233 complaints were reviewed, of which 46.35%, 31.34% and 22.31%, respectively, were verbal, written and made on the phone. The main reasons for complaints were accessibility to medical staff (21.46%, communication failures (20.17% and dissatisfaction with the provided care (14.59%. Thirty one (13.31% cases were solved at first place, 194 (83.26% referred to the complaints from the committee and 3.43% referred to the legal authorities. The average response time was about six to seven days. ConclusionThe findings of the study suggest that sufficient availability of medical staff, improvement in communication skills and paying attention to the patients’ needs and expectations may reduce complaints from public health facilities.

  9. Bullying behavior and associations with psychosomatic complaints and depression in victims

    NARCIS (Netherlands)

    Fekkes, M.; Pijpers, F.I.M.; Verloove-Vanhorick, S.P.

    2004-01-01

    Objectives: To assess the association between bullying behavior and a wide variety of psychosomatic health complaints and depression. Study design: In a cross-sectional study, 2766 elementary school children age 9 to 12 years filled out a questionnaire on bullying behavior and health complaints.

  10. High prevalence of self-reported shoulder complaints after thyroid carcinoma surgery

    NARCIS (Netherlands)

    Roerink, S.H.P.P.; Coolen, L.; Schenning, M.E.; Husson, O.; Smit, J.W.A.; Marres, H.A.; Wilt, J.H.W. de; Netea-Maier, R.T.

    2017-01-01

    BACKGROUND: Shoulder complaints are frequently reported after surgical treatment for thyroid carcinoma. However, no specific literature on this topic is available for these patients and, hence, its impact on quality of life (QOL) is unknown and there are no known predictors of shoulder complaints in

  11. Screen-based activities and physical complaints among adolescents from the Nordic countries

    Directory of Open Access Journals (Sweden)

    Bjarnason Thoroddur

    2010-06-01

    Full Text Available Abstract Background A positive association between time spent on sedentary screen-based activities and physical complaints has been reported, but the cumulative association between different types of screen-based activities and physical complaints has not been examined thoroughly. Methods The cross-sectional association between screen-based activity and physical complaints (backache and headache among students was examined in a sample of 31022 adolescents from Denmark, Sweden, Norway, Finland, Iceland and Greenland, as part of the Health behaviour in school-aged children 2005/06 (HBSC study. Daily hours spent on screen-based activities and levels of physical complaints were assessed using self-reports. Results Logistic regression analysis indicated that computer use, computer gaming and TV viewing contributed uniquely to prediction of weekly backache and headache. The magnitude of associations was consistent across types of screen based activities, and across gender. Conclusion The observed associations indicate that time spent on screen-based activity is a contributing factor to physical complaints among young people, and that effects accumulate across different types of screen-based activities.

  12. Disparities in Treatment of Older Adults with Suicide Risk in the Emergency Department.

    Science.gov (United States)

    Arias, Sarah A; Boudreaux, Edwin D; Segal, Daniel L; Miller, Ivan; Camargo, Carlos A; Betz, Marian E

    2017-10-01

    We described characteristics and treatment received for older (≥60 years) vs younger (adult emergency department (ED) patients with suicide risk. Retrospective chart review. An ED with universal screening for suicide risk. Eligible charts included a random sample of adults (≥18 years) who screened positive for suicidal ideation (SI) in past 2 weeks and/or a suicide attempt (SA) within the past 6 months. Visit dates were from May 2014 to September 2016. A total of 800 charts were reviewed, with oversampling of older adults. Of the 200 older adults sampled, fewer older adults compared to younger adults (n = 600) had a chief complaint involving psychiatric behavior (53% vs 70%) or self-harm behavior (26% vs 36%). Although a higher number of older adults (93%) had documentation of current SI compared to younger adults (79%), fewer older adults (17%) reported SA in the past 2 weeks compared to younger adults (23%). Of those with a positive suicide screen who were discharged home, less than half of older adults received a mental health evaluation during their visit (42%, 95% CI 34-52) compared to 66% (95% CI 61-70) of younger adults who met the same criteria. Similarly, fewer older, than younger, adult patients with current SI/SA received referral resources (34%; 95% CI 26-43; vs 60%; 95% CI 55-65). Significantly fewer suicidal older adult patients who were discharged home received a mental health evaluation when compared to similar younger adults. These findings highlight an important area for improvement in the treatment of older adults at risk for suicide. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  13. Recovery of Work-Related Stress: Complaint Reduction and Work-Resumption are Relatively Independent Processes

    NARCIS (Netherlands)

    Vente, W. de; Kamphuis, J.H.; Blonk, R.W.; Emmelkamp, P.M.

    2015-01-01

    Purpose The process of recovery from work-related stress, consisting of complaint reduction and work-resumption, is not yet fully understood. The aim of this study was to investigate predictors of complaint reduction and work-resumption, as well as testing complaint reduction as a mediator in the

  14. Recovery of work-related stress: Complaint reduction and work-resumption are relatively independent processes

    NARCIS (Netherlands)

    de Vente, W.; Kamphuis, J.H.; Blonk, R.W.B.; Emmelkamp, P.M.G.

    2015-01-01

    Purpose: The process of recovery from work-related stress, consisting of complaint reduction and work-resumption, is not yet fully understood. The aim of this study was to investigate predictors of complaint reduction and work-resumption, as well as testing complaint reduction as a mediator in the

  15. Associations between long commutes and subjective health complaints among railway workers in Norway

    Directory of Open Access Journals (Sweden)

    Terhi Urhonen

    2016-12-01

    Full Text Available Commuting is an important aspect of daily life for many employees, but there is little knowledge of how this affects individual commuters' health and well-being. The authors investigated the relationship between commuting and subjective health complaints, using data from a web-based questionnaire. In a sample of 2126 railway employees, 644 (30.3% had long commute times. A 29-item inventory was used to measure the number and degree of the subjective health complaints. Those who commuted 60 min or more each way were characterized by significantly higher numbers and degrees of subjective health complaints compared with their peers with short commutes. The mean number of complaints was 7.5 among the former group and 6.4 for the latter group (p = 0.009. In a regression model, in which the authors controlled for age, gender, education, self-rated health, and coping, the employees with long commutes reported more complaints than those with short commutes. Significant associations were found between those with long commutes and the number and degree of incidences of self-reported musculoskeletal pain, pseudo-neurologic complaints, and gastrointestinal problems. Commuters who had had long commutes for more than 10 years reported more gastrointestinal and musculoskeletal complaints than those with long commutes for less than 2 years. Also, commuters with long commutes spent less time with their families and leisure activities compared with those with short commutes. The authors conclude that the association between long commute times and higher levels of subjective health complaints should attract the attention of transport planners, employers, and public health policymaker.

  16. PROFESSIONAL CODES OF CONDUCT IN PSYCHOLOGY: DESCRIPTIVE STUDY OF COMPLAINTS REVIEWED BY THE COPC ETHICS COMMITTEE

    Directory of Open Access Journals (Sweden)

    Mila Arch

    2013-09-01

    Full Text Available In recent decades a significant increase has been observed in the number of complaints filed with ethical committees. The possibility of being the subject of a complaint is therefore a growing concern for professionals. However, research on ethics and codes of conduct in psychology is still very limited and real data on the complaints filed with Ethics Committees against psychologists are practically nonexistent. This article describes the results of a descriptive analysis of the complaints reviewed by the COPC Ethics Committee from 1998 to 2011. A total of 324 complaints were filed, but only 20% led to opening disciplinary proceedings, the judicial context being the professional area in which the highest percentage of complaints were filed (85%. Among the most prevalent reasons for complaints were making assessments without prior examination and partiality.

  17. 76 FR 49500 - Privacy Act of 1974; Department of Homeland Security United States Coast Guard-020 Substance...

    Science.gov (United States)

    2011-08-10

    ... 7101 Washington, DC 20593. For privacy issues please contact: Mary Ellen Callahan (703-235-0780), Chief... DEPARTMENT OF HOMELAND SECURITY Office of the Secretary [Docket No. DHS-2011-0053] Privacy Act of... Treatment Program System of Records AGENCY: Privacy Office, DHS. ACTION: Notice of Privacy Act system of...

  18. WEATHER CONDITIONS AND COMPLAINTS IN FIBROMYALGIA

    NARCIS (Netherlands)

    DEBLECOURT, ACE; KNIPPING, AA; DEVOOGD, N; VANRIJSWIJK, MH

    1993-01-01

    Patients with musculoskeletal disorders, including fibromyalgia syndrome (FS), often state that weather conditions modulate their complaints. There have been a few studies concerning this issue, but the results appear to be contradictory. We tried to relate the subjective symptoms of pain,

  19. WEATHER CONDITIONS AND COMPLAINTS IN FIBROMYALGIA

    NARCIS (Netherlands)

    DEBLECOURT, ACE; KNIPPING, AA; DEVOOGD, N; VANRIJSWIJK, MH

    Patients with musculoskeletal disorders, including fibromyalgia syndrome (FS), often state that weather conditions modulate their complaints. There have been a few studies concerning this issue, but the results appear to be contradictory. We tried to relate the subjective symptoms of pain,

  20. Cognitive complaints in obstructive sleep apnea

    NARCIS (Netherlands)

    Vaessen, T.J.A.; Overeem, S.; Sitskoorn, M.M.

    2015-01-01

    Obstructive sleep apnea (OSA) is associated with impairments in cognitive functioning. Although cognitive complaints are related to quality of life, work productivity and health care expenditures, most research and all reviews have focused exclusively on objective cognitive functioning so far. In

  1. 48 CFR 22.1406 - Complaint procedures.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Complaint procedures. 22.1406 Section 22.1406 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS APPLICATION OF LABOR LAWS TO GOVERNMENT ACQUISITIONS Employment of Workers with...

  2. The Relationship Between Sleep Complaints, Depression and Executive Functions on Older Adults

    Directory of Open Access Journals (Sweden)

    Katie Moraes Almondes

    2016-10-01

    Full Text Available Aim: In this manuscript, we report data on the association between executive functions screened by Frontal Assessment Battery, Five Digit Test and Digit Span with self-reported depressive symptoms and sleep complaints in nondemented older adults. Methods: A total sample of 95 nondemented older adults performed Geriatric Depression Scale short version, Frontal Assessment Battery, Five Digit Test, Digit Span and clinical interview. We split participants in groups stratified by age according to: young-old (60-69 years of age, old-old (70-79 years and oldest-old (> 80 years and compared these three groups on the sociodemographic characteristics and executive functions performance. We carried out Poisson regression with robust error variance to verify sleep complaints and depression effects on executive functions performance. Gender, age, years of formal education, use of antidepressants and of benzodiazepines were considered as confounding variables, taking into account executive functions as dependent and sleep complaints and depression as independent variables. Results: Controlling the effect of age, gender, years of formal education, use of benzodiazepines and of antidepressants there was a significant influence of depression in motor programming, inhibitory control and working memory. Individuals without depression show motor programming scores 68,4% higher, inhibitory control scores 3 times greater and working memory scores also 3 times greater than individuals without depression. There was a significant influence of sleep complaints in phonemic fluency, motor programming, inhibitory control and working memory. Individuals without sleep complaints show phonemic fluency scores 2 times greater than, motor programming scores 85,9% higher, inhibitory control scores 3 times greater and working memory scores also 3 times greater than individuals without sleep complaints.Conclusions: Sleep complaints are associated with phonemic fluency, motor

  3. Cryotherapy for treatment of mouth mucocele

    Directory of Open Access Journals (Sweden)

    Kamaldeep K Aulakh

    2016-01-01

    Full Text Available A mucocele is a common salivary gland disorder that most commonly affects young adults. A 35-year-old female patient reported to the Department of Oral and Maxillofacial Surgery, with the chief complaint of swelling on the left side of floor of mouth. The aim of this case report is to present the management of mucocele present in floor of the mouth in a young female patient using liquid nitrogen cryosurgery. The present case report has also discussed mechanism of action, current protocol of cryosurgery with emphasis on clinical pros and cons along with the clinical outcomes.

  4. Managing mild casualties in mass-casualty incidents: lessons learned from an aborted terrorist attack.

    Science.gov (United States)

    Bloch, Yuval H; Leiba, Adi; Veaacnin, Nurit; Paizer, Yohanan; Schwartz, Dagan; Kraskas, Ahuva; Weiss, Gali; Goldberg, Avishay; Bar-Dayan, Yaron

    2007-01-01

    Mildly injured and "worried well" patients can have profound effects on the management of a mass-casualty incident. The objective of this study is to describe the characteristics and lessons learned from an event that occurred on 28 August 2005 near the central bus station in Beer-Sheva, Israel. The unique profile of injuries allows for the examination of the medical and operational aspects of the management of mild casualties. Data were collected during and after the event, using patient records and formal debriefings. They were processed focusing on the characteristics of patient complaints, medical response, and the dynamics of admission. A total of 64 patients presented to the local emergency department, including two critical casualties. The remaining 62 patients were mildly injured or suffered from stress. Patient presentation to the emergency department was bi-phasic; during the first two hours following the attack (i.e., early phase), the rate of arrival was high (one patient every three minutes), and anxiety was the most frequent chief complaint. During the second phase, the rate of arrival was lower (one patient every 27 minutes), and the typical chief complaint was somatic. Additionally, tinnitus and complaints related to minor trauma also were recorded frequently. Psychiatric consultation was obtained for 58 (91%) of the patients. Social services were involved in the care of 47 of the patients (73%). Otolaryngology and surgery consultations were obtained for 45% and 44%, respectively. The need for some medical specialties (e.g., surgery and orthopedics) mainly was during the first phase, whereas others, mainly psychiatry and otolaryngology, were needed during both phases. Only 13 patients (20%) needed a consultation from internal medicine. Following a terrorist attack, a large number of mildly injured victims and those experiencing stress are to be expected, without a direct relation to the effectiveness of the attack. Mildly injured patients tend to

  5. Subjective memory complaint only relates to verbal episodic memory performance in mild cognitive impairment.

    Science.gov (United States)

    Gifford, Katherine A; Liu, Dandan; Damon, Stephen M; Chapman, William G; Romano Iii, Raymond R; Samuels, Lauren R; Lu, Zengqi; Jefferson, Angela L

    2015-01-01

    A cognitive concern from the patient, informant, or clinician is required for the diagnosis of mild cognitive impairment (MCI); however, the cognitive and neuroanatomical correlates of complaint are poorly understood. We assessed how self-complaint relates to cognitive and neuroimaging measures in older adults with MCI. MCI participants were drawn from the Alzheimer's Disease Neuroimaging Initiative and dichotomized into two groups based on the presence of self-reported memory complaint (no complaint n = 191, 77 ± 7 years; complaint n = 206, 73 ± 8 years). Cognitive outcomes included episodic memory, executive functioning, information processing speed, and language. Imaging outcomes included regional lobar volumes (frontal, parietal, temporal, cingulate) and specific medial temporal lobe structures (hippocampal volume, entorhinal cortex thickness, parahippocampal gyrus thickness). Linear regressions, adjusting for age, gender, race, education, Mini-Mental State Examination score, mood, and apolipoprotein E4 status, found that cognitive complaint related to immediate (β = -1.07, p memory performances assessed on a serial list learning task (β = -1.06, p = 0.001) but no other cognitive measures or neuroimaging markers. Self-reported memory concern was unrelated to structural neuroimaging markers of atrophy and measures of information processing speed, executive functioning, or language. In contrast, subjective memory complaint related to objective verbal episodic learning performance. Future research is warranted to better understand the relation between cognitive complaint and surrogate markers of abnormal brain aging, including Alzheimer's disease, across the cognitive aging spectrum.

  6. Subjective memory complaint only relates to verbal episodic memory performance in mild cognitive impairment

    Science.gov (United States)

    Gifford, Katherine A.; Liu, Dandan; Damon, Stephen M.; Chapman, William G.; Romano, Raymond R.; Samuels, Lauren R.; Lu, Zengqi; Jefferson, Angela L.

    2015-01-01

    Background A cognitive concern from the patient, informant, or clinician is required for the diagnosis of mild cognitive impairment (MCI); however, the cognitive and neuroanatomical correlates of complaint are poorly understood. Objective We assessed how self-complaint relates to cognitive and neuroimaging measures in older adults with MCI. Method MCI participants were drawn from the Alzheimer’s Disease Neuroimaging Initiative and dichotomized into two groups based on the presence of self-reported memory complaint (no complaint n=191, 77±7 years; complaint n=206, 73±8 years). Cognitive outcomes included episodic memory, executive functioning, information processing speed, and language. Imaging outcomes included regional lobar volumes (frontal, parietal, temporal, cingulate) and specific medial temporal lobe structures (hippocampal volume, entorhinal cortex thickness, parahippocampal gyrus thickness). Results Linear regressions, adjusting for age, gender, race, education, Mini-Mental State Examination score, mood, and apolipoprotein E-4 status, found that cognitive complaint related to immediate (β=−1.07, pmemory performances assessed on a serial list learning task (β=−1.06, p=0.001) but no other cognitive measures or neuroimaging markers. Conclusions Self-reported memory concern was unrelated to structural neuroimaging markers of atrophy and measures of information processing speed, executive functioning, or language. In contrast, subjective memory complaint related to objective verbal episodic learning performance. Future research is warranted to better understand the relation between cognitive complaint and surrogate markers of abnormal brain aging, including Alzheimer’s disease, across the cognitive aging spectrum. PMID:25281602

  7. 32 CFR 70.10 - Complaints concerning decisional documents and index entries.

    Science.gov (United States)

    2010-07-01

    ... declining to list that aspect of the service record as an issue. (v) Guidance as to other types of complaints. The following guidance governs other specified types of complaints: (A) The Stipulation of... noted in the decisional document or index entries: (Authentication) Attachment 2—Joint Service Review...

  8. 45 CFR 2554.48 - Can the administrative complaint be settled voluntarily?

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Can the administrative complaint be settled voluntarily? 2554.48 Section 2554.48 Public Welfare Regulations Relating to Public Welfare (Continued... Appeals § 2554.48 Can the administrative complaint be settled voluntarily? (a) Parties may make offers of...

  9. 75 FR 38824 - Privacy Act of 1974; Department of Homeland Security/ALL-029 Civil Rights and Civil Liberties...

    Science.gov (United States)

    2010-07-06

    ... civil rights, civil liberties, such as profiling on the basis of race, ethnicity, or religion, by.../ religion (CRCL does not solicit this information, it is tracked if individuals provide it); Allegation... Officer and Chief Freedom of Information Act Officer, Department of Homeland Security, 245 Murray Drive...

  10. Significance of non-specific complaints in asymptomatic cerebral infarction. Approach based on the cerebral circulation

    Energy Technology Data Exchange (ETDEWEB)

    Sakayori, Osamu; Kitamura, Shin; Nagazumi, Atsushi; Terashi, Akirou [Nippon Medical School, Tokyo (Japan)

    1997-10-01

    Seventy-three cases with asymptomatic cerebral infarction detected by MR scanning and 80 cases of past stroke patients were evaluated. The regional cerebral blood flow (CBF) using the SPECT, idoine-123-IMP autoradiography (ARG) method was measured. Twenty-two patients with non-specific complaints (dizziness, numbness of the extremities, headache, etc.) without cerebrovascular risk factors were also examined as controls. Fifty-two percent of the asymptomatic infarction cases had non-specific complaints. The regional CBF in all cerebral non-specific complaints showed significantly lower values as compared to the controls. There was no difference in CBF values between the asymptomatic infarction cases with non-specific complaints and the past stroke patients. Among the asymptomatic infarction patients, cases with both non-specific complaints and hypertension displayed significantly lower CBF values, especially in the frontal and temporal cortical regions, than did cases without non-specific complaints or hypertension. These findings suggest that the patient`s complaints should be taken into consideration when determining the clinical treatment of asymptomatic infarction. (author)

  11. Customers' attributional judgments towards complaint handling in airline service: a confirmatory study based on attribution theory.

    Science.gov (United States)

    Chiou, Wen-Bin

    2007-06-01

    Besides flight safety, complaint handling plays a crucial role in airline service. Based upon Kelley's attribution theory, in the present study customers' attributions were examined under different conditions of complaint handling by the airlines. There were 531 passengers (216 women; ages 21 to 63 years, M = 41.5, SD = 11.1) with experiences of customer complaints who were recruited while awaiting boarding. Participants received one hypothetical scenario of three attributional conditions about complaint handling and then reported their attributional judgments. The findings indicated that the passengers were most likely to attribute the company's complaint handling to unconditional compliance when the airline company reacted to customer complaints under low distinctiveness, high consistency, and when consensus among the airlines was low. On the other hand, most passengers attributed the company's complaint handling to conditional compliance under the conditions in which distinctiveness, consistency, and consensus were all high. The results provide further insights into how different policies of complaint management affect customers' attributions. Future directions and managerial implications are also discussed.

  12. Post-Affirmative Action: A Phenomenological Study of Admission Initiatives by Chief Diversity Officers to Support Diversity

    Science.gov (United States)

    Gichuru, Margaret

    2010-01-01

    The purpose of this phenomenological study was to explore the experiences of chief diversity officers (CDOs) and how they enhanced admission of minority students in the post-affirmative action era. Six chief diversity officers, who played a pivotal leadership role in diversity of their respective campuses, described their experiences. Using…

  13. Depression, Anxiety and Somatic Complaints in Colombian Children Living in Rural Communities

    Directory of Open Access Journals (Sweden)

    Ruby C. Castilla Puentes

    2013-08-01

    Full Text Available Introduction: In Colombia, children are frequently exposed to traumatic events; however, there are no data regarding the impact on depression, anxiety and somatic correlates of such exposure in children living in rural communities. Objective: To investigate the somatic complaints and symptoms of depression and anxiety among children exposed to traumatic events in a rural community of Colombia. Methods: Design: Cross-Sectional study. Participants: Two hundred and ninety-three Colombian children aged eight to 18 years. Main Outcome Measures: Standardized measures were administered to assess children's depression, anxiety, physical symptoms and exposure to traumatic events. Depression: CDI (Children's Depression Inventory; anxiety: SCARED (The Screen for Child Anxiety Related Emotional Disorders; somatic complaints: CBCL (Child Behavior Checklist, Somatic Complaints scale and reporting traumatic events during the K-SADS-PL (Diagnostic Interview for Children and Adolescents. Results: Ninety-one of the 293 children (31.1% reported somatic complaints. The most common somatic complaint was in the gastrointestinal category (35/91. One hundred and seventy eight children (60.5% had observed traumatic events, including homicides during the last month. Two hundred five (69.9% of the children showed depressive symptom profiles above established norms, and 239 (81.6% exhibited anxiety symptoms according to their own reports. The correlation between depression and traumatic events, anxiety and somatic complaints, and between anxiety and depression were statistically significant (p<0.005. Conclusions: As the first study of its kind in children living in rural communities in Colombia, it demonstrates a clear impact of traumatic events on mental health. Information that somatic complaints are commonly an expression of underlying depression and anxiety may facilitate the treatment and thereby help avoid unnecessary medical workups and sequelae from traumatized

  14. Department of Housing and Urban Development, Office of Lead Hazard Control and Healthy Homes

    Science.gov (United States)

    ... Offices Center for Faith-based and Neighborhood Partnerships Chief Financial Officer Chief Human Capital Officer Chief Information Officer Chief ... Offices Center for Faith-based and Neighborhood Partnerships Chief Financial Officer Chief Human Capital Officer Chief Information Officer Chief ...

  15. Subthreshold depression and subjective cognitive complaints in Parkinson's disease.

    Science.gov (United States)

    Santangelo, G; Vitale, C; Trojano, L; Angrisano, M G; Picillo, M; Errico, D; Agosti, V; Grossi, D; Barone, P

    2014-03-01

    Subthreshold depression (SubD) is characterized by clinically relevant depressive symptoms not meeting criteria for major depression. The possible association of SubD with subjective cognitive complaints and/or objective cognitive impairments was investigated in a sample of consecutive, non-demented Parkinson's disease (PD) outpatients. Amongst 115 patients, SubD was identified in 30 patients, major depression in 33; 36 patients were classified as non-depressed. Enrolled patients were administered tests and questionnaires validated in PD for assessing objective and subjective cognitive dysfunctions. On objective cognitive measures SubD patients did not differ from non-depressed patients, whereas depressed patients achieved significantly lower scores than the other two groups. SubD and depressed patients reported more cognitive complaints than non-depressed patients. SubD is a non-motor aspect of PD that is not related to objective cognitive deficits but is associated with subjective cognitive complaints, thus impacting on patients' well-being. © 2013 The Author(s) European Journal of Neurology © 2013 EFNS.

  16. Resident complaints about the nursing home food service: relationship to cognitive status.

    Science.gov (United States)

    Simmons, Sandra F; Cleeton, Patrick; Porchak, Tracy

    2009-05-01

    Most nursing home (NH) residents are not interviewed about their satisfaction with the food service due to cognitive impairment. The purpose of this study was to determine the proportion of NH residents able to complete a structured interview to assess food complaints when no cognitive status criteria were used to exclude residents from interview. Eighty-nine percent of 163 residents were able and willing to complete the interview, and 65% expressed complaints about the NH food service. Residents who expressed complaints ate less of their meals, had less cognitive impairment, and had more depressive symptoms than those who did not. This study shows that the majority of NH residents are able to reliably answer questions about their satisfaction with the food service, regardless of cognitive status, and the presence of complaints is related to poor meal intake and depressive symptoms.

  17. GPs' negotiation strategies regarding sick leave for subjective health complaints

    DEFF Research Database (Denmark)

    Nilsen, Stein Tore; Malterud, Kirsti; Werner, Erik L.

    2015-01-01

    Objectives: To explore general practitioners ’(GPs’) specific negotiation strategies regarding sick-leave issues with patientssuffering from subjective health complaints. Design: Focus-group study. Setting: Nine focus-group interviews in three citiesin different regions of Norway. Participants: 48...... GPs (31 men, 17 women; age 32–65), participating in a course dealing with diagnostic practice and assessment of sickness certifi cates related to patients with subjective health complaints. Results: TheGPs identified some specific strategies that they claimed to apply when dealing with the question...... to sick leave. Conclusions and implications: GPs seem to have a conscious approach to negotiations of sickness certification, as they report applying specific strategies to limit the duration of sick leave due to subjective health complaints. This give-and-take way of handling sick leave negotiations has...

  18. Stress, Visual and Musculoskeletal Complaints in Open Plan Office Staff

    Directory of Open Access Journals (Sweden)

    Vangelova K.

    2014-06-01

    Full Text Available The aim of the study was to identify the main ergonomic and organizational risks contributing to stress, visual and musculoskeletal disorders in open plan office workers. A total of 73 subjects of mean age 28.3 ±4.7 years were studied. Measurements of salivary cortisol and self-ratings for strain, fatigue, stress symptoms, visual and musculoskeletal complaints were performed. The work places were organized well, but the studied staff reported high work load and time pressure. The data showed higher cortisol levels during the workday under time pressure. High incidence of visual and musculoskeletal complaints mainly in the region of the back and the neck were found, associated with flickering and blinks on the screen monitors and overtime. Optimizing workplace organization could help reduce stress and health complaints of office staff.

  19. 78 FR 36520 - U.S. Department of Agriculture Multi-Family Housing Section 515-Underserved Counties and Colonias...

    Science.gov (United States)

    2013-06-18

    ...-Discrimination Statement The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers..., gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or... activities.) If you wish to file a Civil Rights program complaint of discrimination, complete the USDA...

  20. Molar Pregnancy in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Masterson, Lori

    2009-11-01

    Full Text Available A 15-year-old female presented to the emergency department with complaints of vaginal bleeding. She was pale, anxious, cool and clammy with tachycardic, thready peripheral pulses and hemoglobin of 2.4g/dL. Her abdomen was gravid appearing, approximately early to mid-second trimester in size. Pelvic examination revealed 2 cm open cervical os with spontaneous discharge of blood, clots and a copious amount of champagne-colored grapelike spongy material. After 2L boluses of normal saline and two units of crossmatched blood, patient was transported to the operating room. Surgical pathology confirmed a complete hydatidiform mole.[West J Emerg Med. 2009;10(4:295-296.

  1. Self-perception, complaints and vocal quality among undergraduate students enrolled in a Pedagogy course.

    Science.gov (United States)

    Fabron, Eliana Maria Gradim; Regaçone, Simone Fiuza; Marino, Viviane Cristina de Castro; Mastria, Marina Ludovico; Motonaga, Suely Mayumi; Sebastião, Luciana Tavares

    2015-01-01

    To compare the vocal self-perception and vocal complaints reported by two groups of students of the pedagogy course (freshmen and graduates); to relate the vocal self-perception to the vocal complaints for these groups; and to compare the voice quality of the students from these groups through perceptual auditory assessment and acoustic analysis. Initially, 89 students from the pedagogy course answered a questionnaire about self-perceived voice quality and vocal complaints. In a second phase, auditory-perceptual evaluation and acoustic analyses of 48 participants were made through voice recordings of sustained vowel emission and poem reading. The most reported vocal complaints were fatigue while using the voice, sore throat, effort to speak, irritation or burning in the throat, hoarseness, tightness in the neck, and variations of voice throughout the day. There was a higher occurrence of complaints from graduates than from freshmen, with significant differences for four of the nine complaints. It was also possible to observe the relationship between vocal self-perception and complaints reported by these students. No significant differences were observed in the results of auditory-perceptual evaluation; however, some graduates had their voices evaluated with higher severity of deviation of normalcy. During acoustic analysis no difference was observed between groups. The increase in vocal demand by the graduates may have caused the greatest number and diversity of vocal complaints, and several of them are related to the self-assessment of voice quality. The auditory-perceptual evaluation and acoustic analysis showed no deviations in their voice.

  2. Increased Working Memory-Related Brain Activity in Middle-Aged Women with Cognitive Complaints

    OpenAIRE

    Dumas, Julie A.; Kutz, Amanda M.; McDonald, Brenna C.; R.Naylor, Magdalena; Pfaff, Ashley C.; Saykin, Andrew J.; Newhouse, Paul A.

    2012-01-01

    Individuals who report subjective cognitive complaints but perform normally on neuropsychological tests may be at increased risk for pathological cognitive aging. The current study examined the effects of the presence of subjective cognitive complaints on functional brain activity during a working memory task in a sample of middle-aged postmenopausal women. Twenty-three postmenopausal women aged 50–60 completed a cognitive complaint battery of questionnaires. Using 20% of items endorsed as th...

  3. Chief Zibi Sidinane: Negotiating Moravian Christianity and Settlements in 'Nomansland'

    DEFF Research Database (Denmark)

    Henningsen, Anne Folke

    2009-01-01

    I artiklen analyseres de komplicerede forhandlinger, strategier og magtkampe, der knyttede sig til etablering af kristne missionsstationer i slutningen af 1800-tallet i det østlige Sydafrika. De implicerede herrnhutiske missionærer og konvertitter - som artiklens hovedperson Chief Zibi Sidinane -...

  4. Office characteristics and dry eye complaints in European workers : The OFFICAIR study

    NARCIS (Netherlands)

    de Kluizenaar, Y; Roda, C.; Dijkstra, NE; Fossati, S; Mandin, C; Mihucz, VG; Hänninen, O; de Oliveira Fernandes, E; Silva, GV; Carrer, P; Bartzis, J; Bluijssen, P.M.

    2016-01-01

    Objectives Ocular discomfort is a prevalent health complaint in offices. It is hypothesized that, in addition to individual and occupational factors, the buildings' indoor environment may affect eye complaints. However, insight in potential building-related causal factors, needed to allow

  5. Intolerance of uncertainty, cognitive complaints, and cancer-related distress in prostate cancer survivors.

    Science.gov (United States)

    Eisenberg, Stacy A; Kurita, Keiko; Taylor-Ford, Megan; Agus, David B; Gross, Mitchell E; Meyerowitz, Beth E

    2015-02-01

    Prostate cancer survivors have reported cognitive complaints following treatment, and these difficulties may be associated with survivors' ongoing cancer-related distress. Intolerance of uncertainty may exacerbate this hypothesized relationship by predisposing individuals to approach uncertain situations such as cancer survivorship in an inflexible and negative manner. We investigated whether greater cognitive complaints and higher intolerance of uncertainty would interact in their relation to more cancer-related distress symptoms. This cross-sectional, questionnaire-based study included 67 prostate cancer survivors who were 3 to 5 years post treatment. Hierarchical multiple regression analyses tested the extent to which intolerance of uncertainty, cognitive complaints, and their interaction were associated with cancer-related distress (measured with the Impact of Event Scale-Revised; IES-R) after adjusting for age, education, physical symptoms, and fear of cancer recurrence. Intolerance of uncertainty was positively associated with the IES-R avoidance and hyperarousal subscales. More cognitive complaints were associated with higher scores on the IES-R hyperarousal subscale. The interaction of intolerance of uncertainty and cognitive complaints was significantly associated with IES-R intrusion, such that greater cognitive complaints were associated with greater intrusive thoughts in survivors high in intolerance of uncertainty but not those low in it. Prostate cancer survivors who report cognitive difficulties or who find uncertainty uncomfortable and unacceptable may be at greater risk for cancer-related distress, even 3 to 5 years after completing treatment. It may be beneficial to address both cognitive complaints and intolerance of uncertainty in psychosocial interventions. Copyright © 2014 John Wiley & Sons, Ltd.

  6. Sexual Victimization and Somatic Complaints in Pregnancy: Examination of Depression as a Mediator.

    Science.gov (United States)

    Littleton, Heather

    2015-01-01

    Research suggests that women with histories of sexual victimization are more likely to experience somatic complaints in pregnancy. However, prior studies have been limited by homogenous samples, have primarily only examined the relationship of childhood sexual abuse (CSA) to somatic complaints, and have not examined potential mechanisms explaining this association. Thus, the current study examined the relationship between lifetime sexual victimization history and somatic complaints in pregnancy in an ethnically diverse sample of pregnant women. Additionally, depressive symptoms were examined as a mediator of the sexual victimization-somatic complaints relationship. Women were recruited from the waiting room of a university-affiliated obstetrics-gynecology clinic to complete a study of psychological health and negative sexual experiences. The 407 currently pregnant participants who completed measures of their sexual victimization history, depressive symptoms, and somatic complaints were primarily African American (53.6%), low to middle income (75.4%), and reported an unplanned pregnancy (72%). A total of 27.7% of women had a history of CSA and/or adolescent/adult sexual assault. Mediation analyses using bootstrapping supported depression as a significant mediator of the relationship between sexual victimization and somatic complaints, with a medium-sized effect (κ(2) = .09). Having a history of sexual victimization is associated with risk for poor mental and physical health during pregnancy. There are likely multiple mechanisms explaining the association between sexual victimization and somatic complaints in pregnancy, which should be investigated in future research. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  7. A cross-sectional study of psychological complaints and quality of life in severely injured patients.

    Science.gov (United States)

    van Delft-Schreurs, C C H M; van Bergen, J J M; van de Sande, P; Verhofstad, M H J; de Vries, J; de Jongh, M A C

    2014-05-01

    The purpose of this study was to examine the incidence of psychological complaints and the relationship of these complaints with the quality of life (QOL) and accident- and patient-related factors among severely injured patients after the rehabilitation phase. Patients of 18 years or older with an injury severity score above 15 were included 15-53 months after their accident. Accident and patient characteristics were obtained from questionnaires and the trauma registry. Several questionnaires (Hospital Anxiety and Depression Scale, Impact of Events Scale, and Cognitive Failure Questionnaire) were used to determine the symptoms of psychological problems (anxiety or depression, post-traumatic stress disorder, or subjective cognitive complaints, respectively). The World Health Organization Quality of Life-Bref was used to determine QOL. A reference group of the Dutch general population was used for comparison of QOL scores. The participation rate was 62 % (n = 173). At the time of the study, 30.1 % (n = 52) of the investigated patients had psychological complaints. No relation between psychological complaints and somatic severity or type of injury was found. Patients who were employed before the accident or resumed working reported less psychological complaints. Use of any medication before the accident and treatment for pre-accidental psychological problems were positively related to psychological complaints afterwards. QOL of severely injured patients was impaired in comparison with the general Dutch population, but only for those with psychological complaints. Psychological complaints seem to be an important and underestimated factor for a decreased QOL among severely injured patients.

  8. Predictors of Obesity and Physical Health Complaints Among 911 Telecommunicators

    OpenAIRE

    Michelle M. Lilly; Melissa J. London; Mary C. Mercer

    2016-01-01

    Background: This study aims to: (1) examine rates of obesity and physical health complaints among 911 telecommunicators; and (2) document the role of emotion dysregulation, psychological inflexibility, duty-related distress and dissociation, and psychopathology in predicting obesity and physical health complaints in this population. Methods: The sample consisted of 911 telecommunicators from across the country (N = 758). Participants completed an online survey assessing their mental and ph...

  9. Validation of ICD-9 Codes for Stable Miscarriage in the Emergency Department.

    Science.gov (United States)

    Quinley, Kelly E; Falck, Ailsa; Kallan, Michael J; Datner, Elizabeth M; Carr, Brendan G; Schreiber, Courtney A

    2015-07-01

    International Classification of Disease, Ninth Revision (ICD-9) diagnosis codes have not been validated for identifying cases of missed abortion where a pregnancy is no longer viable but the cervical os remains closed. Our goal was to assess whether ICD-9 code "632" for missed abortion has high sensitivity and positive predictive value (PPV) in identifying patients in the emergency department (ED) with cases of stable early pregnancy failure (EPF). We studied females ages 13-50 years presenting to the ED of an urban academic medical center. We approached our analysis from two perspectives, evaluating both the sensitivity and PPV of ICD-9 code "632" in identifying patients with stable EPF. All patients with chief complaints "pregnant and bleeding" or "pregnant and cramping" over a 12-month period were identified. We randomly reviewed two months of patient visits and calculated the sensitivity of ICD-9 code "632" for true cases of stable miscarriage. To establish the PPV of ICD-9 code "632" for capturing missed abortions, we identified patients whose visits from the same time period were assigned ICD-9 code "632," and identified those with actual cases of stable EPF. We reviewed 310 patient records (17.6% of 1,762 sampled). Thirteen of 31 patient records assigned ICD-9 code for missed abortion correctly identified cases of stable EPF (sensitivity=41.9%), and 140 of the 142 patients without EPF were not assigned the ICD-9 code "632"(specificity=98.6%). Of the 52 eligible patients identified by ICD-9 code "632," 39 cases met the criteria for stable EPF (PPV=75.0%). ICD-9 code "632" has low sensitivity for identifying stable EPF, but its high specificity and moderately high PPV are valuable for studying cases of stable EPF in epidemiologic studies using administrative data.

  10. The contribution of embarrassment to phobic dental anxiety: a qualitative research study

    Directory of Open Access Journals (Sweden)

    Rosenberg Nicole

    2004-04-01

    Full Text Available Abstract Background Embarrassment is emphasized, yet scantily described as a factor in extreme dental anxiety or phobia. Present study aimed to describe details of social aspects of anxiety in dental situations, especially focusing on embarrassment phenomena. Methods Subjects (Ss were consecutive specialist clinic patients, 16 men, 14 women, 20–65 yr, who avoided treatment mean 12.7 yr due to anxiety. Electronic patient records and transcribed initial assessment and exit interviews were analyzed using QSR"N4" software to aid in exploring contexts related to social aspects of dental anxiety and embarrassment phenomena. Qualitative findings were co-validated with tests of association between embarrassment intensity ratings, years of treatment avoidance, and mouth-hiding behavioral ratings. Results Embarrassment was a complaint in all but three cases. Chief complaints in the sample: 30% had fear of pain; 47% cited powerlessness in relation to dental social situations, some specific to embarrassment and 23% named co-morbid psychosocial dysfunction due to effects of sexual abuse, general anxiety, gagging, fainting or panic attacks. Intense embarrassment was manifested in both clinical and non-clinical situations due to poor dental status or perceived neglect, often (n = 9 with fear of negative social evaluation as chief complaint. These nine cases were qualitatively different from other cases with chief complaints of social powerlessness associated with conditioned distrust of dentists and their negative behaviors. The majority of embarrassed Ss to some degree inhibited smiling/laughing by hiding with lips, hands or changed head position. Secrecy, taboo-thinking, and mouth-hiding were associated with intense embarrassment. Especially after many years of avoidance, embarrassment phenomena lead to feelings of self-punishment, poor self-image/esteem and in some cases personality changes in a vicious circle of anxiety and avoidance. Embarrassment

  11. Numerical experiments using CHIEF to treat the nonuniqueness in solving acoustic axisymmetric exterior problems via boundary integral equations

    Directory of Open Access Journals (Sweden)

    Adel A.K. Mohsen

    2010-07-01

    Full Text Available The problem of nonuniqueness (NU of the solution of exterior acoustic problems via boundary integral equations is discussed in this article. The efficient implementation of the CHIEF (Combined Helmholtz Integral Equations Formulation method to axisymmetric problems is studied. Interior axial fields are used to indicate the solution error and to select proper CHIEF points. The procedure makes full use of LU-decomposition as well as the forward solution derived in the solution. Implementations of the procedure for hard spheres are presented. Accurate results are obtained up to a normalised radius of ka = 20.983, using only one CHIEF point. The radiation from a uniformly vibrating sphere is also considered. Accurate results for ka up to 16.927 are obtained using two CHIEF points.

  12. The Role of the Chief Student Affairs Officer in Promoting the Jesuit Mission of the University

    Science.gov (United States)

    Reiter, Lisa Rose

    2012-01-01

    "The Role of the Chief Student Affairs Officer in Promoting the Jesuit Mission of the University" is a qualitative comparative case study of three lay (non-cleric, non-Jesuit) chief student affairs officers employed in three U.S. Jesuit higher educational institutions. As the number of Jesuits decreases, a significant question is how the…

  13. Changes in Editorial board Rhinology, Prof. Valerie Lund demits office as Editor in Chief of Rhinology

    NARCIS (Netherlands)

    Fokkens, W. J.

    2014-01-01

    At the Editorial Board Meeting of Rhinology Valerie Lund indicated that she has decided to emit office as Editor in Chief of Rhinology. She became a member of the editorial board in 1993, a co-editor with Prof. Bert Huizing in 1999 and Editor in Chief in 2004. She leaves with our grateful thanks for

  14. 29 CFR 37.88 - Who may contact CRC about a complaint?

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Who may contact CRC about a complaint? 37.88 Section 37.88... PROVISIONS OF THE WORKFORCE INVESTMENT ACT OF 1998 (WIA) Compliance Procedures § 37.88 Who may contact CRC... contact CRC for information about the complaint. The Director will determine what information, if any...

  15. Hospital-Confirmed Acute Myocardial Infarction: Prehospital Identification Using the Medical Priority Dispatch System.

    Science.gov (United States)

    Clawson, Jeff J; Gardett, Isabel; Scott, Greg; Fivaz, Conrad; Barron, Tracey; Broadbent, Meghan; Olola, Christopher

    2018-02-01

    Introduction Early recognition of an acute myocardial infarction (AMI) can increase the patient's likelihood of survival. As the first point of contact for patients accessing medical care through emergency services, emergency medical dispatchers (EMDs) represent the earliest potential identification point for AMIs. The objective of the study was to determine how AMI cases were coded and prioritized at the dispatch point, and also to describe the distribution of these cases by patient age and gender. Hypothesis/Problem No studies currently exist that describe the EMD's ability to correctly triage AMIs into Advanced Life Support (ALS) response tiers. The retrospective descriptive study utilized data from three sources: emergency medical dispatch, Emergency Medical Services (EMS), and emergency departments (EDs)/hospitals. The primary outcome measure was the distributions of AMI cases, as categorized by Chief Complaint Protocol, dispatch priority code and level, and patient age and gender. The EMS and ED/hospital data came from the Utah Department of Health (UDoH), Salt Lake City, Utah. Dispatch data came from two emergency communication centers covering the entirety of Salt Lake City and Salt Lake County, Utah. Overall, 89.9% of all the AMIs (n=606) were coded in one of the three highest dispatch priority levels, all of which call for ALS response (called CHARLIE, DELTA, and ECHO in the studied system). The percentage of AMIs significantly increased for patients aged 35 years and older, and varied significantly by gender, dispatch level, and chief complaint. A total of 85.7% of all deaths occurred among patients aged 55 years and older, and 88.9% of the deaths were handled in the ALS-recommended priority levels. Acute myocardial infarctions may present as a variety of clinical symptoms, and the study findings demonstrated that more than one-half were identified as having chief complaints of Chest Pain or Breathing Problems at the dispatch point, followed by Sick

  16. Chief Executive Officer and Chief Financial Officer compensation relationship to company performance in state-owned entities

    Directory of Open Access Journals (Sweden)

    Mark H.R. Bussin

    2017-10-01

    Full Text Available Background: Optimal contracting continues to dominate boardroom and dinner discussions worldwide in light of the 2008 global financial crisis and especially in South Africa, due to the growing income gap. Increased scrutiny is being placed on South African state-owned entities (SOEs, as a result of the seemingly poor performance of SOEs. Some of the SOEs are reported to have received financial bailouts from taxpayers’ money, while executives are raking in millions of rands in remuneration, provoking some concerns on the alignment of executive pay to company performance in SOEs. Aim: The study will assist remuneration committees and policymakers in the structuring of executive pay in SOEs to ensure alignment to company performance. Setting: The study sought to assess, based on empirical evidence, if there is a positive relationship between Chief Executive Officer (CEO and Chief Financial Officer (CFO remuneration and company performance in South African SOEs in the period between 2010 and 2014. All 21 Schedule 2 SOEs were included in the study. Methods: The research was a quantitative archival research methodology. Correlation and multiple regression analysis were the main statistical techniques used in this study. Results: Contrary to popular media, a positive relationship between CEO and CFO remuneration (fixed pay and short-term incentives and company performance in SOEs was observed. Company size appears to be the key determiner of fixed pay in SOEs. The positive relationship was mainly noted on absolute profitability measurements like EBITDA (earnings before interest and tax and depreciation and amortisation and net profit. Conclusion: SOE remuneration committees and policymakers should maintain the positive relationship; however, more emphasis should be placed on financial efficiency measurements so as to enhance efficiencies in SOEs.

  17. Professional Burnout and Concurrent Health Complaints in Neonatal Nursing.

    Science.gov (United States)

    Skorobogatova, Natalija; Žemaitienė, Nida; Šmigelskas, Kastytis; Tamelienė, Rasa

    2017-01-01

    The aim of this study was to analyze nurses' professional burnout and health complaints and the relationship between the two components. The anonymous survey included 94 neonatal intensive care nurses from two centers of perinatology. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used to evaluate professional burnout; it consisted of 3 components, Emotional Exhaustion, Depersonalization, and Personal Accomplishments, with 22 items in total. Health complaints were evaluated by 21 items, where nurses were asked to report the occurrence of symptoms within the last year. Scale means were presented with standard deviations (SD). Inferential analysis was conducted with multivariate logistic regression, adjusting for age, residence, and work experience. The mean score of professional burnout on the Emotional Exhaustion subscale was 14.4 (SD=7.91), Depersonalization 3.8 (SD=4.75), and Personal Accomplishment 29.1 (SD=10.12). The health assessment revealed that sleeplessness, lack of rest, nervousness, and tiredness were the most common complaints. The regression analysis revealed that tiredness was independently associated with significantly increased odds of professional burnout (OR=4.1). In our study, more than half of the nurses in neonatal intensive care had moderate or high levels of emotional exhaustion, while levels of depersonalization were significantly lower. In contrast, the level of personal accomplishment was low in more than half of the nurses. The most common health complaints were sleep disturbances, nervousness, and tiredness. Tiredness was most strongly associated with professional burnout.

  18. [Hierarchical structure of authors collaboration. An analysis of papers on imaging diagnosis published by hospital radiology departments in Comunidad Valenciana (1994-2001)].

    Science.gov (United States)

    Miguel-Dasit, A; Martí-Bonmatí, L; Sanfeliu, P; Aleixandre, R; Valderrama, J C

    2005-06-01

    Analyze the different contribution of hierarchical categories in the papers published by radiologists of hospitals belonging to Comunidad Valenciana along the period 1994-2001, as well as their distribution in the different journals. For the recovery of the papers sample we have designed specific search profiles for EMI and Medline databases. Hierarchical category of the authors was identified through personal interviews. We have analyzed 417 works, with 1,321 authors distributed in the following form: chief of service, 8.8%; chief of section, 12.4%; assistant physician, 50.7%, and resident, 28%. Hierarchical groupings with participation of residents were more consistent for publishing papers along all the study period (1994-2001). Higher percentage of papers (21%) corresponded to grouping. Radiología was the most productive journal (42% papers). All results were statistically significant (p Comunidad Valenciana hospitals showed an active participation in research papers published along the period 1994-2001, in collaboration with the rest of the hierarchical categories, basically with the assistant physician. Assistant physicians contributed most of papers. Chief of section and chief of department contributed fifth of papers.

  19. Self-perceived memory complaints predict progression to Alzheimer disease. The LADIS study

    DEFF Research Database (Denmark)

    Verdelho, Ana; Madureira, Sofia; Moleiro, Carla

    2011-01-01

    the follow-up (ß = 2.7, p = 0.008; HR = 15.5, CI 95% [2.04, 117.6]), independently of other confounders, namely depressive symptoms, WMC severity, medial temporal lobe atrophy, and global cognition status at baseline. Self perceived memory complaints did not predict vascular dementia. In the LADIS study......Memory complaints are frequent in the elderly but its implications in cognition over time remain a controversial issue. Our objective was to evaluate the risk of self perceived memory complaints in the evolution for future dementia. The LADIS (Leukoaraiosis and Disability) prospective multinational...... battery. Dementia and subtypes of dementia were classified. Self perceived memory complaints in independent elderly were collected during the interview. MRI was performed at entry and at the end of the study. 639 subjects were included (74.1 ± 5 years old, 55% women, 9.6 ± 3.8 years of schooling). At end...

  20. 76 FR 2805 - Delegation of Authority to the Chief Accountant

    Science.gov (United States)

    2011-01-18

    ... SECURITIES AND EXCHANGE COMMISSION 17 CFR Part 200 [Release No. 34-63699] Delegation of Authority... such determination. This delegation is intended to conserve Commission resources and to maintain the... 19, the Commission is amending its rules governing delegations of authority to the Chief Accountant...

  1. 32 CFR 13.3 - Office of the Chief Defense Counsel.

    Science.gov (United States)

    2010-07-01

    ... COMMISSIONS RESPONSIBILITIES OF THE CHIEF DEFENSE COUNSEL, DETAILED DEFENSE COUNSEL, AND CIVILIAN DEFENSE... II of the Affidavit And Agreement By Civilian Defense Counsel at Appendix B to 32 CFR part 14. (5... incur confidentiality obligations in the context of fulfilling their supervisory responsibilities with...

  2. 76 FR 81485 - Chief of Engineers Environmental Advisory Board; Meeting

    Science.gov (United States)

    2011-12-28

    ... the potential effects of climate change. Following the discussions and presentations there will be a public comment period. FOR FURTHER INFORMATION CONTACT: Mr. John C. Furry, Designated Federal Officer... (202) 512-6000. Agenda: The Board will advise the Chief of Engineers on environmental policy...

  3. THE COMPLAINT ABOUT THE PROTRACTION OF PROCEEDINGS

    Directory of Open Access Journals (Sweden)

    Vlad-Silviu STANCIU

    2015-07-01

    Full Text Available The complaint about the protraction of proceedings (“contestaţia privind tergiversarea judecății” has the role of sanctioning the passivity of the court of law which does not use the means necessary for correcting irregular conduct, or even worse, it disregards the legal provisions requiring a certain conduct from the court itself. The complaint about the protraction of proceedings should not be seen as a possibility to sanction the judge empowered to solve the case. This appeal is actually a remedy provided by law, intended to correct those situations in which the court of law is causing undue delay to the cases, or even more, it doesn`t take the necessary measures for protecting the right to a fair trial within a reasonable and foreseeable time.

  4. 77 FR 31161 - Designation of Officers of the Millennium Challenge Corporation To Act as Chief Executive Officer...

    Science.gov (United States)

    2012-05-25

    ... of May 21, 2012 Designation of Officers of the Millennium Challenge Corporation To Act as Chief Executive Officer of the Millennium Challenge Corporation Memorandum for the Chief Executive Officer of the... following officers of the Millennium Challenge Corporation (MCC), in the order listed, shall act as and...

  5. Predictors of Obesity and Physical Health Complaints Among 911 Telecommunicators.

    Science.gov (United States)

    Lilly, Michelle M; London, Melissa J; Mercer, Mary C

    2016-03-01

    This study aims to: (1) examine rates of obesity and physical health complaints among 911 telecommunicators; and (2) document the role of emotion dysregulation, psychological inflexibility, duty-related distress and dissociation, and psychopathology in predicting obesity and physical health complaints in this population. The sample consisted of 911 telecommunicators from across the country (N = 758). Participants completed an online survey assessing their mental and physical health functioning. A total of 82.5% of the sample reported a body mass index that fell within the overweight or obese category and an average of 17 physical health complaints within the past month. Peritraumatic reactions (distress and dissociation), emotion dysregulation, and psychological inflexibility had effects on physical health largely through psychopathology (alcohol abuse, post-traumatic stress disorder, and depression). Development of adapted prevention and intervention efforts with this population is needed.

  6. Treatment of gastric phytobezoars with Coca-Cola® given via oral route: a case report

    Directory of Open Access Journals (Sweden)

    Ertuğrul G

    2012-02-01

    Full Text Available Gökhan Ertuğrul1, Murat Coşkun1, Mahsuni Sevinç1, Fisun Ertuğrul2, Toygar Toydemir31Department of General Surgery, Düzce Atatürk State Hospital, Muncurlu, Düzce, Turkey; 2Department of Anaesthesiology and Reanimation, Düzce Atatürk State Hospital, Muncurlu, Düzce, Turkey; 3Department of General Surgery, İstanbul Surgery Hospital, Nisantasi, İstanbul, TurkeyBackground: A 43-year-old female patient presented with a chief complaint of upper abdominal pain. As her complaints had lasted for 1 month, an upper gastrointestinal system endoscopy was performed and discovered a bezoar in the stomach.Case presentation: The bezoar was quite hard and light green-yellow in color. Pathological examination revealed phytobezoar. The patient was hospitalized and given oral Coca-Cola® Zero for seven days at a dose of 500 mL three times daily.Conclusion: The upper gastrointestinal system endoscopy performed at the end of 7 days showed that the phytobezoar had softened and become smaller. The phytobezoar was broken into pieces with biopsy forceps and washing was applied, so the phytobezoar pieces could pass through the pylorus. The patient was discharged after the procedure without problem.Keywords: gastric phytobezoar, Coca-Cola, upper gastrointestinal system endoscopy

  7. Do subjective memory complaints herald the onset of mild cognitive impairment in Parkinson disease?

    Science.gov (United States)

    Erro, Roberto; Santangelo, Gabriella; Barone, Paolo; Picillo, Marina; Amboni, Marianna; Longo, Katia; Giordano, Flavio; Moccia, Marcello; Allocca, Roberto; Pellecchia, Maria Teresa; Vitale, Carmine

    2014-12-01

    Longitudinal studies on healthy participants have shown that subjective memory impairment (defined as subjective cognitive complaints with normal cognitive objective performance) might be a strong predictor of mild cognitive impairment (MCI). Parkinson disease (PD) also manifests cognitive disturbances, but whether subjective memory complaints may predict the development of MCI in PD has not yet been explored. We prospectively screened newly diagnosed, untreated patients with PD in order to evaluate whether subjective memory complaints may predict development of MCI over a 2-year follow-up evaluation. We enrolled 76 de novo untreated patients with PD. Of the 76 patients, 23 (30.3%) complained memory issues. Among the patients cognitively unimpaired at baseline, those with subjective complaints were more likely to develop MCI at follow-up. The regression model confirmed that presence of subjective memory complaints at baseline was an independent predictor of development of MCI at follow-up. This is the first prospective study to explore the relationship between subjective and objective cognitive deficits in newly diagnosed, untreated patients. Our results provide preliminary evidence that subjective memory complaints might predict future development of MCI. © The Author(s) 2014.

  8. Distance Learning Masters Students in the Department of Information Studies, University of Wales, Aberystwyth: Past, Present and Future

    Science.gov (United States)

    Preston, Hugh

    2005-01-01

    This paper examines the postgraduate student body studying by distance learning within the Department of Information Studies at the University of Wales, Aberystwyth. The demands of both students and employers have been the chief influences on the evolution of the specialist postgraduate programmes and also the later generalist and further…

  9. 29 CFR 471.10 - How will the Department determine whether a contractor is in compliance with Executive Order...

    Science.gov (United States)

    2010-07-01

    ... Relating to Labor OFFICE OF LABOR-MANAGEMENT STANDARDS, DEPARTMENT OF LABOR NOTIFICATION OF EMPLOYEE RIGHTS UNDER FEDERAL LABOR LAWS OBLIGATIONS OF FEDERAL CONTRACTORS AND SUBCONTRACTORS; NOTIFICATION OF EMPLOYEE RIGHTS UNDER FEDERAL LABOR LAWS General Enforcement; Compliance Review and Complaint Procedures § 471.10...

  10. [Cognitive complaints in people with human immunodeficiency virus in Spain: prevalence and related variables].

    Science.gov (United States)

    Muñoz-Moreno, José A; Fuster-Ruiz de Apodaca, Maria J; Fumaz, Carmina R; Ferrer, Maria J; Molero, Fernando; Jaen, Àngels; Clotet, Bonaventura; Dalmau, David

    2014-05-20

    Cognitive complaints have been scarcely studied in people with HIV in Spain. The aim of this research was to know the prevalence of cognitive complaints in HIV-infected people, as well as its potential relationships with demographic, clinical and psychological variables, in the era of combination antiretroviral therapies. Observational multicenter study developed in 4 hospitals and 10 NGOs, in which 791 people with HIV in Spain participated. A self-reported questionnaire was used to evaluate demographic and clinical variables, and an assessment of cognitive complaints, emotional status and quality of life variables was also included. Descriptive and inferential tests were used for statistical analyses. Almost half of the sample (49.8%) referred cognitive complaints, in 72.1% of them an association with interference on daily living activities was found. Memory and attention were the areas most prevalently perceived as affected. The existence of cognitive complaints correlated with a longer HIV infection, lower CD4+ cell count, undetectable viral load and worse quality of life. A discriminant analysis determined that depression, anxiety, older age, living with no partner and low education level allowed to classify optimally HIV-infected people with cognitive complaints. Self-reported cognitive complaints are frequent in people infected with HIV in the current era of combination antiretroviral therapies. This fact is related to emotional disturbances and poor quality of life, but also to impaired immunological and virological status. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  11. 29 CFR 1614.106 - Individual complaints.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 4 2010-07-01 2010-07-01 false Individual complaints. 1614.106 Section 1614.106 Labor... EMPLOYMENT OPPORTUNITY Agency Program To Promote Equal Employment Opportunity § 1614.106 Individual... individual and the agency and to describe generally the action(s) or practice(s) that form the basis of the...

  12. 46 CFR 11.518 - Service requirements for chief engineer (limited oceans) of steam and/or motor vessels.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Service requirements for chief engineer (limited oceans... Requirements for Engineer Officer § 11.518 Service requirements for chief engineer (limited oceans) of steam... engineer (limited oceans) of steam and/or motor vessels is five years total service in the engineroom of...

  13. Thallium myocardial scanning in the emergency department evaluation of chest pain

    International Nuclear Information System (INIS)

    Mace, S.E.

    1989-01-01

    Chest pain is a common complaint of patients seen in the emergency department. The causes are legion, and range from the non-life threatening to the potentially catastrophic. Thallium heart scanning was done prospectively in 20 patients with a ''classic'' history for myocardial infarction (eight patients) or atypical chest pain and/or associated symptoms plus an abnormal ECG (12 patients) to discern a subset of patients from whom thallium scintography may be indicated in the emergency department. Although further investigation is needed, our preliminary study suggests that myocardial scanning with thallium can be a safe, fairly rapid, and useful objective parameter in the emergency department detection of suspected myocardial infarction, and in differential diagnosis of chest pain when other data such as the history, physical examination, ECG, or enzymes are inconclusive

  14. Histopathological Study of Hysterectomy Operations in A University Clinic in Tehran From 2005 to 2009

    Directory of Open Access Journals (Sweden)

    Mahmoud Khaniki

    2011-06-01

    Full Text Available Objective: We intended to determine causes and histological pattern of hysterectomies in an Iranianpopulation.Materials and methods: Archived reports of pathology department of a university hospital dated March2005 to March 2009 were retrospectively reviewed. Age, chief complaint, type of operation includingabdominal, vaginal and subtotal hysterectomy, the indication of the operation and the pathology of thespecimen were retrieved from the records.Results: The average rate of hysterectomy was 219 per year. The average age of the patients was49.6±11.3. About 40% of cases aged 45-54 years. The main chief compliant was abnormal uterinebleeding (62.2%. The leading preoperative indication for hysterectomy operations were uterineleiomyoma (24.8% and then abnormal uterine bleeding and abdominal/pelvic mass. The most frequentpathologic findings were leiomyoma (22.0% and adenomyosis (12.1%. In 11.8% of hysterectomyspecimens no pathologic lesion was found.Conclusion: The hysterectomy is rather common in Iran with age dependent pattern of indications andcorresponding pathologies.

  15. 10 CFR 1.31 - Office of the Chief Financial Officer.

    Science.gov (United States)

    2010-01-01

    ... management policy including accounting principles and standards for the agency and provides policy guidance... accounting and financial management system, including an accounting system, and financial reporting and... 10 Energy 1 2010-01-01 2010-01-01 false Office of the Chief Financial Officer. 1.31 Section 1.31...

  16. Department of Energy multiprogram laboratories

    International Nuclear Information System (INIS)

    1982-09-01

    The Panel recommends the following major roles and missions for the laboratories: perform the Department's national trust fundamental research missions in the physical sciences, including high energy and nuclear physics, and the radiobiological sciences including nuclear medicine; sustain scientific staff core capabilities and specialized research facilities for laboratory research purposes and for use by other Federal agencies and the private sector; perform independent scientific and technical assessment or verification studies required by the Department; and perform generic research and development where it is judged to be in the public interest or where for economic or technical reasons industry does not choose to support it. Organizational efficiencies if implemented by the Department could contribute toward optimal performance of the laboratories. The Panel recommends that a high level official, such as a Deputy Under Secretary, be appointed to serve as Chief Laboratory Executive with authority to help determine and defend the research and development budget, to allocate resources, to decide where work is to be done, and to assess periodically laboratory performance. Laboratory directors should be given substantially more flexibility to deploy resources and to initiate or adapt programs within broad guidelines provided by the Department. The panel recommends the following actions to increase the usefulness of the laboratories and to promote technology transfer to the private sector: establish user groups for all major mission programs and facilities to ensure greater relevance for Department and laboratory efforts; allow the laboratories to do more reimbursable work for others (other Federal agencies, state and local governments, and industry) by relaxing constraints on such work; implement vigorously the recently liberalized patent policy; permit and encourage joint ventures with industry

  17. 12 CFR 268.105 - Individual complaints.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Individual complaints. 268.105 Section 268.105... RULES REGARDING EQUAL OPPORTUNITY Board Program To Promote Equal Opportunity § 268.105 Individual... individual and the Board and to describe generally the action(s) or practice(s) that form the basis of the...

  18. Evaluation of the Factors which Contribute to the Ocular Complaints in Computer Users.

    Science.gov (United States)

    Agarwal, Smita; Goel, Dishanter; Sharma, Anshu

    2013-02-01

    Use of information technology hardware given new heights to professional success rate and saves time but on the other hand its harmful effect has introduced an array of health related complaints causing hazards for our human health. Increased use of computers has led to an increase in the number of patients with ocular complaints which are being grouped together as computer vision syndrome (CVS). In view of that, this study was undertaken to find out the ocular complaints and the factors contributing to occurrence of such problems in computer users. To evaluate the factors contributing to Ocular complaints in computer users in Teerthanker Mahaveer University, Moradabad, U.P. India. Community-based cross-sectional study of 150 subjects who work on computer for varying period of time in Teerthanker Mahaveer University, Moradabad, Uttar Pradesh. Two hundred computer operators working in different institutes offices and bank of were selected randomly in Teerthanker Mahaveer University, Moradabad, and Uttar Pradesh. 16 were non responders 18 did not come for assessment and 16 were excluded due to complaints prior to computer use making no response rate Twenty-one did not participate in the study, making the no response rate 25%. Rest of the subjects (n = 150) were asked to fill a pre-tested questionnaire, after obtaining their verbal consent Depending on the average hours of usage in a day, they were categorized into three categories viz. 6 hrs of usage. All the responders were asked to come to the Ophthalmic OPD for further interview and assessment. Simple proportions and Chi-square test. Among the 150 subjects studied major ocular complaint reported in descending order were eyestrain. (53%). Occurrence of eye strain, ( 53.8%), itching ( 47.6%) and burning (66.7%) in subjects using computer for more than 6 hours. distance from computer screen with respect to eyes, use of antiglare screen, taking frequent breaks, use of LCD monitor and adjustment of brightness of

  19. EDITORIAL: New Editor-in-Chief for Nanotechnology New Editor-in-Chief for Nanotechnology

    Science.gov (United States)

    Couzin, Nina

    2009-01-01

    Nanotechnology is proud to announce the appointment of Professor Mark Reed, Yale University, as the new Editor-in-Chief from January 2009. Mark Reed holds the Harold Hodgkinson Chair of Engineering and Applied Science at Yale University. He has made significant contributions in the areas of quantum dots, electronic transport in nanoscale and mesoscopic systems, artificially structured materials and devices, and molecular electronics. Professor Reed has been associated with the journal as an Editorial Board member for a number of years and we are delighted that he has agreed to take on the scientific leadership of the journal in its 20th year. We also take the opportunity to thank Professor Mark Welland, Cambridge University, for his work as Editor-in-Chief since 2001, and for presiding over the re-launch and remarkable growth of the journal since then. Nanotechnology is unique in that it was the first peer-reviewed journal in the area of nanoscience, the first issue appearing in 1990. Since then it has established a distinguished publication record and has become a leading journal covering all aspects of nanoscale science and technology, as well as specializing in in-depth, comprehensive articles not seen in letter format journals. Published weekly and featuring subject sections, the journal is truly multidisciplinary in nature and is an excellent medium to quickly deliver your research results to readers worldwide. Nanotechnology is proud to be offering some of the fastest publication times around (less than three months on average from receipt to online publication). We offer free online access to all published papers for 30 days, ensuring that anyone with access to the internet will be able to read your paper. We were also the first journal to give our authors the opportunity to communicate their research to a wider audience through nanotechweb.org and other IOP websites. See the journal's homepage at www.iop.org/Journals/nano for more details. We are looking

  20. The evaluation of the causes of complaint to Khorramabad Medical Council Organization from 2006 to 2011

    Directory of Open Access Journals (Sweden)

    sedighe Nadri

    2013-05-01

    Full Text Available Background : Complaint against physicians is one of the problems that every physician may be subjected to it during practice. According to the existing statistics, the number of complaints is increasing in Iran. Identification of these causes may be effective in preventing such complaints. This research was conducted to identify the causes of complaints made to the Medical Council Organization of Khorramabad from 2006 to 2011. Materials and Methods: This study is descriptive cross-sectional and retrospective. To carry out the research, all of the complaints to the Medical Council Organization of Khorramabad from early 2006 to 2011, were studied. The required data were transferred from the files to the questionnaires. Finally, the collected data were entered into statistical software and analyzed with statistical tests. Results: In this research, 260 complaints made to the Medical Council Organization of Khorramabad were studied. A major part of the complaints was made against public hospitals(68.8%. The highest cause of complaints was recklessness(55.4%, while the lowest state was neglecting public regulations(21%. Of the 260 cases of complaints investigated by the preliminary committee, 80 cases (30.8% were recognized as negligence and 180 cases (69.2% were considered as non-negligence. According to the disciplinary committee, of the 260 cases, 61 cases (23.5% were recognized as negligence and 199 cases (76.5% were considered as non-negligence. Conclusion: Observing medical ethics and career commitment, establishing proper communication by physicians and treatment staff with patients and their companions, lack of exaggerating the treatment results, continuous study and updating medical knowledge, physician’s adequate skill and experience, lack of applying the methods which he has never passed their training courses, proper selection of patients, and obtaining the informed consent of patients and aquittance may lead to reduce the number of

  1. A Systematic Knowledge Management Approach Using Object-Oriented Theory in Customer Complaint Management

    Directory of Open Access Journals (Sweden)

    Wusheng Zhang

    2010-12-01

    Full Text Available Research into the effectiveness of customer complaint management has attracted researchers, yet there has been little discussion on customer complaint management in the context of systematic knowledge management approach particularly in the domain of hotel industry. This paper aims to address such gap through the application of object-oriented theory for which the notation of unified modelling language has been adopted for the representation of the concepts, objects, relationships and vocabularies in the domain. The paper used data from forty seven hotel management staff and academics in hospitalitymanagement to investigate lessons learned and best practices in customer complaint management and knowledge management. By providing insights into the potential of a knowledge management approach using object oriented theory, this study advances our understanding on how a knowledge management approach can systematically support the management of hotel customer complaints.

  2. From transformative learning to social change? Using action research to explore and improve informal complaints management in an NHS trust

    Directory of Open Access Journals (Sweden)

    Anki Odelius

    2015-05-01

    Full Text Available Background: The number of complaints from patients and/or carers concerning aspects of care has increased over time. Yet, in spite of a growing body of national and international literature on healthcare complaints, there is a lack of knowledge around how nurses and midwives manage informal complaints at ward level, or staff needs in relation to this. Aim: Using an action research approach with mixed methods, four phases and four cycles, the aim was to explore informal complaints management by nurses and midwives at ward level. We discuss the action research process primarily in connection with learning and service change, drawing from the qualitative data in this paper. Findings: The analysis of the collected qualitative data resulted in three main themes, related to the complexities of complaints and complaints management, staff support needs and the existing ambiguous complaints systems, which are hard for staff and service users to negotiate. The action research approach facilitated learning and change in participants in relation to complaints management, in the collaborating trust. Conclusions: The extant body of research on complaints does not sufficiently recognise the complexity of complaints and informal complaints management, or the complaints systems that are in place. Needs-based staff training can help support staff to manage informal complaints more effectively. Implications for practice: • There needs to be recognition of the complexities involved in complaints management • Complaints systems need to be clearer for the benefit of service users and staff • Staff need training and support that is tailored to their needs to improve their response to complaints, leading to a better patient experience • Limited interventions, informed by staff needs, can lead to change and act as a catalyst for a wider change in informal complaints management

  3. Reducing medical complaints and litigation in Malaysia: turning patients' voices into opportunities.

    Science.gov (United States)

    Kassim, Puteri Nemie Jahn

    2007-10-01

    One of the most important ironies of modern health care is that public expectations are rising faster than the ability of health services to meet them. Patients nowadays no longer want to be treated as passive recipients of medical care but as co-producers or partners able to manage their illnesses. Thus, it is not surprising that poor communication and failure to take into account the patient's perspective are at the heart of most formal complaints and legal actions in Malaysia. The difficulties of existing complaint procedures in Malaysia have become manifest over the years and this has been accentuated by patients becoming more willing to challenge the decisions of medical practitioners and health service management in court. To reduce the number of complaints and risks of litigation, a more patient-centred approach should be adopted. When patients voice their concern by making a complaint or inquiry, this should be seen as a unique source of information for health care services on why adverse events occur and how to prevent them. As well as reducing future harm to patients, better management of complaints should restore trust and reduce the risk of litigation, through open communication and a commitment to learn from the problem. The existing procedures for patients to be heard in Malaysia should be reviewed and incorporate features such as responsiveness, accessibility, impartiality, simplicity, speed and accountability.

  4. The chief information security officer insights, tools and survival skills

    CERN Document Server

    Kouns, Barry

    2011-01-01

    Chief Information Security Officers are bombarded with huge challenges every day, from recommending security applications to strategic thinking and business innovation. This guide describes the hard and soft skills that a successful CISO requires: not just a good knowledge of information security, but also attributes such as flexibility and communication skills.

  5. 77 FR 27267 - Submission of U.S. Carrier and Airport Tarmac Delay Contingency Plans to Department of...

    Science.gov (United States)

    2012-05-09

    ... also contain a description of how the carrier will: (1) Provide adequate food, potable water, restroom... , similar to the Department's current disability complaint reporting system, to enable covered U.S. airlines... to use the tarmac delay plan filing system, covered U.S. airlines and airports will need to register...

  6. Dr Julia King CBE FREng, Chief Executive Designate, Institute of Physics (United Kingdom), visiting the NA48 experiment.

    CERN Multimedia

    Patrice Loïez

    2002-01-01

    Photo 02: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (right) with A. Ceccucci and K. Peach. Photo 05: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (centre) with A. Ceccucci and C. Lazzeroni. Photo 08: Visiting the NA48 experiment, Dr Julia King, Chief Executive Designate, Institute of Physics (Britain and Ireland) (second from left) with (left to right) R. Barlow, J. Wood, N. McCubbin, K. Peach, A. Ceccucci, C. Lazzeroni, M. Patel and D. Munday.

  7. The impact of a temporary ice-rink on an emergency department service.

    LENUS (Irish Health Repository)

    Clarke, Heather J

    2012-02-03

    BACKGROUND: A temporary ice-rink opened close to Cork city for 6 weeks from 30 November 2003. During this time, a number of patients presented to the local emergency departments with ice-skating-related injuries. We documented these injuries. METHODS: All patients presenting to emergency departments in Cork city with ice-skating-related complaints were included. Information on age and sex, mechanism of injury, diagnosis, follow-up\\/disposition and ambulance service utilization was recorded. RESULTS: One hundred and twenty-five ice-rink-related attendances were reported at Cork emergency departments, representing 1.25% of total attendances. One hundred and twenty-three patients presented with skating-related injuries and two with medical complaints occurring at the ice-rink: 70.8% were female patients and 29.2% were male patients. In the 4-14-year age group, however, 48.5% were girls and 51.5% were boys. Most injuries were directly due to falls; 5.6% were due to skate blades. The commonest site of injury was the upper limb. Fractures and dislocations accounted for 53.9% of injuries, with 20.5% of these requiring orthopaedic admission. Lacerations and digital injuries accounted for 7.1%, with 11% of these required admission for surgery. One minor head injury was reported. 38.1% had soft tissue injuries. Fifteen patients were transported by ambulance. These attendances represented a minimum overall cost of 77,510 euro to the local health service. CONCLUSIONS: A temporary ice-rink had a significant impact on local emergency departments. Currently, there is no specific legislation in Ireland relating to public health and safety in ice-rinks. We recommend consultation with local public bodies before opening such facilities, and appropriate regulation.

  8. A Mutual Self- and Informant-Report of Cognitive Complaint Correlates with Neuropathological Outcomes in Mild Cognitive Impairment.

    Directory of Open Access Journals (Sweden)

    Katherine A Gifford

    Full Text Available This study examines whether different sources of cognitive complaint (i.e., self and informant predict Alzheimer's disease (AD neuropathology in elders with mild cognitive impairment (MCI.Data were drawn from the National Alzheimer's Coordinating Center Uniform and Neuropathology Datasets (observational studies for participants with a clinical diagnosis of MCI and postmortem examination (n = 1843, 74±8 years, 52% female. Cognitive complaint (0.9±0.5 years prior to autopsy was classified into four mutually exclusive groups: no complaint, self-only, informant-only, or mutual (both self and informant complaint. Postmortem neuropathological outcomes included amyloid plaques and neurofibrillary tangles. Proportional odds regression related complaint to neuropathology, adjusting for age, sex, race, education, depressed mood, cognition, APOE4 status, and last clinical visit to death interval.Mutual complaint related to increased likelihood of meeting NIA/Reagan Institute (OR = 6.58, p = 0.004 and Consortium to Establish a Registry for Alzheimer's Disease criteria (OR = 5.82, p = 0.03, and increased neurofibrillary tangles (OR = 3.70, p = 0.03, neuritic plaques (OR = 3.52, p = 0.03, and diffuse plaques (OR = 4.35, p = 0.02. Informant-only and self-only complaint was not associated with any neuropathological outcome (all p-values>0.12.In MCI, mutual cognitive complaint relates to AD pathology whereas self-only or informant-only complaint shows no relation to pathology. Findings support cognitive complaint as a marker of unhealthy brain aging and highlight the importance of obtaining informant corroboration to increase confidence of underlying pathological processes.

  9. 14 CFR 382.157 - What are carriers' obligations for recordkeeping and reporting on disability-related complaints?

    Science.gov (United States)

    2010-01-01

    ... the type of disability and nature of complaint. Data concerning a passenger's disability must be... NONDISCRIMINATION ON THE BASIS OF DISABILITY IN AIR TRAVEL Complaints and Enforcement Procedures § 382.157 What are... purposes of this section, a disability-related complaint means a specific written expression of...

  10. 10 CFR 708.14 - How much time does an employee have to file a complaint?

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false How much time does an employee have to file a complaint... Complaint Resolution Process § 708.14 How much time does an employee have to file a complaint? (a) You must... filing stops running on the day the internal grievance is filed and begins to run again on the earlier of...

  11. Customer complaints as a source of customer-focused process improvement: A constructive case study

    Directory of Open Access Journals (Sweden)

    Uusitalo, K.,

    2008-01-01

    Full Text Available Process-based thinking commonly focuses on enhancing the efficiency of processes, while it is often criticized for not paying enough attention to the customer. This paper argues that customer complaint information can be used as a basis for customer-focused process improvement. Thus, it is not enough to make the complaining customer satisfied, but the complaint information should also feed back to the actual processes where the fault causing the complaint arose and where it can be removed. The empirical component of the study includes the development of a novel construction to utilize customer complaints for process improvements, which was implemented in a large Finnish enterprise operating in the wholesale logistics environment. The results show benefits at both operational and strategic levels.

  12. Association between subjective memory complaints and nursing home placement: a four-year follow-up

    DEFF Research Database (Denmark)

    Waldorff, Frans Boch; Siersma, Volkert; Waldemar, Gunhild

    2009-01-01

    nursing home placements were observed. Subjective memory complaints were associated with an adjusted Hazard Ratio (HR) of 2.59 for nursing home placement. Other statistical significant covariates were MMSE depression...... (HR = 4.74). The effect of subjective memory complaints is seen to moderate when subjects are older. CONCLUSION: The data of this study indicated that in an elderly primary care population the presence of subjective memory complaints was a significant independent predictor for nursing home placement......OBJECTIVE: In order to evaluate whether elderly persons with subjective memory complaints may be regarded as a group of potentially vulnerable patients who need close follow-up, we investigated the risk of nursing home placement during a 4-year follow-up period. METHODS: Prospective cohort survey...

  13. Interdisciplinary treatment of a patient with multiple missing teeth and periodontitis.

    Science.gov (United States)

    Ahn, Jae-Chan; Lee, Jae-Hong; Yoon, Joon-Ho; Lee, Ji-Yeon; Kim, Jung-Hoon

    2018-02-01

    A 49-year-old woman with several missing and periodontically compromised teeth was referred to the orthodontic department of National Health Insurance Service Ilsan Hospital by the periodontic department for interdisciplinary treatment. Multiple posterior teeth had been extracted 10 days earlier. Her chief complaint was crowding of the anterior teeth, and she wanted to improve both esthetics and function. Orthodontic, periodontic, and prosthodontic treatments were undertaken in the proper timing and sequence with an interdisciplinary approach. As a result, improved periodontal health and a stable occlusion and vertical dimension were achieved. Although there were limited teeth and alveolar bone for anchorage, good esthetic and functional treatment results were obtained through the application of temporary anchorage devices and proper biomechanics. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  14. The equal accessibility to patient complaint measures

    DEFF Research Database (Denmark)

    Birkeland, Søren

    advice offices exist to guide complainants and the Danish Ombudsman claimed the duty to also provide interpreter assistance yet with no obligation to generally offer foreigner complaint information. Currently only little homepage information is available in English. More research is needed on complainant...

  15. Chief of staff finance | Lillie | Scientia Militaria: South African Journal ...

    African Journals Online (AJOL)

    Scientia Militaria: South African Journal of Military Studies. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 12, No 2 (1982) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Chief of staff finance. Ashley C ...

  16. 76 FR 38743 - Proposed Information Collection (Complaint of Employment Discrimination) Activity: Comment Request

    Science.gov (United States)

    2011-07-01

    ..., religion, gender, national origin age, physical or mental disability and/or reprisal for prior Equal Employment Opportunity activity complete VA Form 4939 to file a complaint of discrimination. Affected Public... (Complaint of Employment Discrimination) Activity: Comment Request AGENCY: Human Resources and Administration...

  17. Hunter′s syndrome: A case report

    Directory of Open Access Journals (Sweden)

    N S Savitha

    2015-01-01

    Full Text Available Hunter′s syndrome or mucopolysaccharidosis (MPS type II is an X-linked recessive mucopolysaccharide disorder caused by a defect in the metabolism of glycosaminoglycans (GAGs characterized by involvement of nervous, cardiovascular, respiratory, and mucoskeletal systems along with numerous oral manifestations. This is a case report of a 13-year-old boy referred to the Department of Pediatric Dentistry with a chief complaint of irregularly placed teeth from a general physician. Here we highlight the pivotal role of pediatric dentists in diagnosis and treatment planning for patients diagnosed with such systemic conditions and the provision of advanced dental care in the management of the same.

  18. Spontaneous Resolution of Primary Hyperparathyroidism in Parathyroid Adenoma

    Directory of Open Access Journals (Sweden)

    Sara J. Micale

    2012-01-01

    Full Text Available A 71 yo woman with primary hyperparathyroidism awaiting surgery because of significant hypercalcemia and hypercalciuria presented to the local emergency department with the chief complaints of discomfort in her neck, sore throat, and difficulty swallowing. She was found to be hypocalcemic with a calcium level of 8.1 mg/dL. She was seen by her endocrinologist three days later at which time serum calcium, iPTH, and serum phosphate levels were all within normal limits. Based on history and a series of ultrasounds the patient was diagnosed with spontaneous infarction of her parathyroid adenoma, which resulted in resolution of her primary hyperparathyroidism.

  19. Dental Emergencies: Management Strategies That Improve Outcomes [Digest].

    Science.gov (United States)

    Pedigo, Ryan Anthony; Zaurova, Milana

    2017-06-22

    Points & Pearls is a digest of Emergency Medicine Practice . Acute dental emergencies are a common chief complaint presenting to emergency departments, and they are increasing substantially in frequency. The diagnosis and management of dental emergencies is a core competency of the emergency clinician, and proper therapeutic strategies can significantly improve cosmetic and functional outcomes for patients. This issue provides a systematic review of the literature on common acute traumatic and atraumatic dental emergencies with a focus on the historical and physical examination findings that must be understood to identify life-threatening infections, relieve pain, salvage natural teeth, and communicate with specialists in the further management of patients after emergency treatment.

  20. Connective Heating Improvement for Emergency Fire Shelters (CHIEFS): Composition and Performance of Fire Shelter Concepts at Close-Out

    Science.gov (United States)

    Fody, Joshua M.; Daryabeigi, Kamran; Bruce, Walter E., III; Wells, John M.; Wusk, Mary E.; Calomino, Anthony M.; Miller, Steve D.

    2018-01-01

    Summary of highlights of the Convective Heating Improvement for Emergency Fire Shelters (CHIEFS) taskunder NASA. CHIEFS was tasked with providing the US Forest Service with an emergency fire shelter forimproved resistance to flame contact. Emphasis is on the final shelter designs at task close-out (end of FY17).