Patterson, Brian W; Smith, Maureen A; Repplinger, Michael D; Pulia, Michael S; Svenson, James E; Kim, Michael K; Shah, Manish N
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.
May, Larissa S.; Griffin, Beth Ann; Bauers, Nicole Maier; Jain, Arvind; Mitchum, Marsha; Sikka, Neal; Carim, Marianne; Stoto, Michael A.
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
Kue, Ricky; Cukor, Jeffrey; Fredrickson, Anne
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…
Halim, A.; Khalid, W.; Haq, A.U.
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
Muhammad Ali, Maria; Al Zayer, Maha
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
Travers, Debbie A; Haas, Stephanie W
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.
Cesari, Whitney A; Vaikunth, Sumeet S; Lewis, Jim B; Panda, Mukta
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.
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
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
Taylor, David McD; Wolfe, Rory; Cameron, Peter A
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.
Carter-Storch, Rasmus; Frydkjær-Olsen, Ulrik; Mogensen, Christian Backer
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...
Webb, Tara; Nugent, Melodee; Simpson, Pippa; Melzer-Lange, Marlene
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
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.
He, Siran; Lunnen, Jeffrey C; Zia, Nukhba; Khan, Uzma; Shamim, Khusro; Hyder, Adnan A
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
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
Beglinger, Bettina; Rohacek, Martin; Ackermann, Selina; Hertwig, Ralph; Karakoumis-Ilsemann, Julia; Boutellier, Susanne; Geigy, Nicolas; Nickel, Christian; Bingisser, Roland
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.
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
Hanney, Stephen R; González-Block, Miguel A
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
Boulis, Sherif; Khanduja, P Kristina; Downey, Kristi; Friedman, Zeev
The abuse of substances available to anesthesiologists in their workspace is a potentially lethal occupational hazard. Our primary objective was to define the prevalence of substance abuse cases among Canadian anesthesiologists at university-affiliated hospitals. Our secondary aim was to describe the current management of confirmed cases, rehabilitation procedures being offered, and preventative strategies being employed. We conducted a cross-sectional electronic survey of all Canadian anesthesia residency program directors and site chiefs at university-affiliated hospitals. Data analysis was performed using descriptive statistics. The survey response rate was 54% (53/98). Substance abuse was reported as 1.6% for residents and 0.3% for clinical fellows over a ten-year period ending in June 2014. Fentanyl was abused in nine of 24 reported cases. At present, one of 22 respondents (4.5%) reported a formal education program on substance abuse for faculty members, and 72% described mandatory education for residents. The majority of participants did not perceive substance abuse as a growing problem. Seventy-one percent of respondents indicated that methods for controlled-drug handling had changed in the previous ten years; however, 66% did not think that the incidence of controlled substance abuse could be decreased further by more stringent measures. Only 21% of respondents supported the introduction of random urine drug testing. The prevalence of substance abuse among Canadian anesthesiologists and the substances abused appear comparable with data from the United States, with residents being the group most often affected. Early recognition and treatment of chemically dependent anesthesiologists remain imperfect.
Chervenak, Frank A; McCullough, Laurence B
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.
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-.
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
Fishman, Jordan E; Pang, John Henry Y; Losee, Joseph E; Rubin, J Peter; Nguyen, Vu T
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.
... 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...
Loomba-Albrecht, Lindsey A; Bremer, Andrew A; Styne, Dennis M; Glaser, Nicole S
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.
... 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...
Qiu, Feng; Qi, Xiao-Kun
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.
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...
... 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...
Robert L Muelleman
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.
... 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...
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
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
... 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...
... 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...
... 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...
Benthien, G. W; Barach, D; Hobbs, S. L
.... 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...
... 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...
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 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.
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.
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.
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.
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.
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...
Federal Communications Commission — Individual informal consumer complaint data detailing complaints filed with the Consumer Help Center beginning October 31, 2014. This data represents information...
Cleusa Maria Andrade Scroferneke
Full Text Available O artigo propõe, a partir da análise comparativa dos resultados da pesquisa realizada junto a Hospitais Universitários Brasileiros e Espanhóis, discutir sobre a relevância das ‘ouvidorias’ virtuais como espaço de interlocução, como lugar de comunicação,tendo o Paradigma da Complexidade (Morin, 2005, 2001 como opção de Método. Os procedimentos metodológicos envolvem levantamento bibliográfico, acompanhamento e análise mensal dos sites/portais dos Hospitais em relação à nomenclatura de ‘ouvidorias’ virtuais, acessibilidade, formas de contato, presença [ou não] de mídias sociais. Trata-se de um recorte de uma pesquisa mais ampla que conta com o apoio do Conselho Nacional de Desenvolvimento Científico e Tecnológico/ CNPq e da Universidade. / Based on the comparative analysis of results of research conducted in Brazilian and Spanish University Hospitals, this article aims to discuss the relevance of online “complaints departments” as a space for dialogue and communication using the paradigm of Complexity (Morin, 2005, 2001 as a method option. The methodological procedures adopted included a literature review, questionnaires, monthly monitoring and analysis of Hospital websites/portals in relation to the nomenclature of online “complaint departments”, accessibility, points of contact, and presence (or not of social media. It forms part of a broader study supported by the National Council of Scientific and Technological Development /CNPq and the University.
Sep 20, 2016 ... Department of Biological and Environmental Sciences, Kibabii University. Abstract. This study ... Key Words: Climate Change, Regional Circulation Model, PRECIS, Bungoma County ... by different computer models is much.
... 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...
... 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...
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.
Rocha, L. E. C.; Holme, P.
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.
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...
... 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...
... 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...
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.
Carrico, Ruth; Goss, Linda
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
... 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...
... 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...
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.
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.
... 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...
... 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...
... 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...
Raviglione, Mario C.
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)
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,...
... 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...
... 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...
... 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...
... 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...
... 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...
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
... 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...
... 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...
... 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...
De Baranchuk, J Z; Dayan, A; Gomez, A; Grimaldi, S; Morra, A
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.
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
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.
... 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...
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...
Grøntved, A M; Karup, P
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...
... 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...
Warner, Christopher H; Rachal, James; Breitbach, Jill; Higgins, Michael; Warner, Carolynn; Bobo, William
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.
Linthorst, Gabor E; Lauw, Fanny N; Hanekamp, Lilian A; Hoekstra, Joost B L
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 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...
...; 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...
... 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...
Serup, Jørgen; Carlsen, Katrina Hutton; Sepehri, Mitra
Tattoos cause a broad range of clinical problems. Mild complaints, especially sensitivity to sun, are very common and seen in 1/5 of cases. Medical complications are dominated by allergy to tattoo pigment haptens or haptens generated in the skin, especially in red tattoos but also in blue and green...... tattoos. Symptoms are major and can be compared to cumbersome pruritic skin diseases. Tattoo allergies and local reactions show distinct clinical manifestations, with plaque-like, excessive hyperkeratotic, ulcero-necrotic, lymphopathic, neuro-sensory, and scar patterns. Reactions in black tattoos......) transferred by tattooing remain a significant risk needing active prevention. It is noteworthy that cancer arising in tattoos, in regional lymph nodes, and in other organs due to tattoo pigments and ingredients has not been detected or noted as a significant clinical problem hitherto, despite millions...
... 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...
Corcoran, Mary; Jones, Rebecca
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…
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;.
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).
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
Colwell, Christopher B; Pons, Peter T; Pi, Randy
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.
Stauber, Mary A
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 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...
... 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...
... 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...
... 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. ...
... 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...
Downey, La Vonne A; Zun, Leslie S
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.
Downey La Vonne
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.
Cinar, Orhan; Jay, Loni; Fosnocht, David; Carey, Jessica; Rogers, LeGrand; Carey, Adrienne; Horne, Benjamin; Madsen, Troy
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.
... 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...
Shukla, P. K.
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)
Lasher, William F.; Grigsby, Gwen; Sullivan, Charlotte
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)
Calver, Richard A.; Vogler, Daniel E.
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…
Samuels, Christina A.
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…
Kruikemeier, S.; Coppen, R.; Friele, R.D.
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
... 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...
... 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...
... 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...
... 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...
... 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...
... 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...
... 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...
Hansen, Torben; Wilke, Ricky; Zaichkowsky, Judy
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...
... 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...
...) 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...
Applegren, Nathan D; Kraus, Chadd K
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.
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.
Moorhouse, Andy T; Waddington, David C; Adams, Mags D
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.
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,.
Dekker, J.; Valk, R.W.A. van der; Verhaak, P.F.M.
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
... 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...
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
... 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...
... 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...
... 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...
... 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...
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Webb, Willard J; Poole, Walter S
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...
Pari, Elisa; Rinaldi, Fabrizio; Gipponi, Stefano; Venturelli, Elisabetta; Liberini, Paolo; Rao, Renata; Padovani, Alessandro
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.
Ozsarac, Murat; Karcioglu, Ozgur; Ayrik, Cuneyt; Bozkurt, Seyran; Turkcuer, Ibrahim; Gumrukcu, Serhat
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.
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
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
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
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…
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)
This Note is issued by the Chief Inspector of Her Majesty's Inspectorate of Pollution (HMIP) as one of a series providing guidance for processes prescribed for integrated pollution control in Regulations made under Section 2 of the United Kingdom Environmental Protection Act 1990. It covers the burning of solid fuel manufactured from or comprised of tyres, tyre rubber or similar rubber waste primarily for the purpose of producing energy, in an appliance with a net rated thermal input of 3 megawatts or more. The note includes: a list of prescribed substances most likely to be present in releases to the environment by the processes considered; release limits for release to air, water and land; an outline of techniques for pollution abatement; monitoring requirements. (Author)
... 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...
... 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...
Pedersen, Christian Sejer; Møller, Henrik; Persson-Waye, Kerstin
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....
editor signals change and in turn this induces in some people expectation, hope of improvement and maybe radical revolution. Others cower and hope for stability, continuation of the same and as little outward sign of change as possible. So I should like to signal that I hope to satisfy both camps. The Editor-in-Chief is primarily a guardian of the journal and should change nothing that does not need changing. Maintaining a standard at the same level is a valuable achievement in itself. This is no different from taking on any other leadership role such as in a team or department. One has to lead by consensus and with respect for the position. Conversely there are things I would like to see improved (otherwise I should not have been hired) and I commit to attempting these but in a spirit of cooperation with the Board, the publisher (IOP), IPEM and the readership. Any other approach would be doomed anyway. So, what would I like to see changed? Dare I say anything too strongly upfront? Like Alun six years ago I would like there to be more debate via correspondence but this depends on the readers to do more writing along these lines. Personally I feel PMB, like many journals, has developed to the point where most readers sadly can understand only a small fraction of its contents. I have talked to older readers who said they regularly used to read all or half of the journal. Now many of us can manage only the papers in our specialty. Yet this is somewhat inevitable as medical physics has progressed from a fledgling science to the vast activity it is today, topics have become deeply complicated and we cannot and should not reverse the clock. To address this, I would like to see authors provide some form of `intelligible lay-scientific summary' of their paper as a condition of its publication. I think readers would then enjoy reading all, not just some, of these and maybe become attracted to other areas than the ones in which they currently work. I would like to see the
Reis, Cátia; Mestre, Catarina; Canhão, Helena; Gradwell, David; Paiva, Teresa
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.
Alsirafy, Samy A; Raheem, Ahmad A; Al-Zahrani, Abdullah S; Mohammed, Amrallah A; Sherisher, Mohamed A; El-Kashif, Amr T; Ghanem, Hafez M
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.
Skyum, Florence; Andersen, Vibeke; Chen, Ming
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...
It is a pleasure and an honour for me to be taking over as Editor-in-Chief of Measurement Science and Technology. MST is well known across research communities worldwide as a leading journal in which to publish new techniques and instrumentation. It has gained this enviable position largely because of the excellent guidance of its Editorial Board and dedicated staff at Institute of Physics Publishing over many years. I want to highlight in particular the contribution of the outgoing Editor Peter Hauptmann, and other Editors before him, in making the journal truly international. We thank Peter immensely for all his hard work in leading the journal, having exceptionally served two terms, each of five years. I come into the post of Editor at a very interesting and challenging time for research. The global recession is leading to cuts in research funding in many countries, researchers and their outputs are coming under closer scrutiny than ever before, and more is being expected of them. Journals play a critical role in monitoring and maintaining research standards, but we should be careful not to assume that journal Impact Factor is the sole measure of research quality. Although expediency may sometimes demand it, Impact Factor, as practitioners know, is subject dependent. One of the great things about science and technology for me is its level playing field. The key point is still innovation no matter where the work is done or where it is published. MST has a long pedigree of being the natural home of the highest quality papers from leading researchers wishing to report novel instrumentation and techniques. 2013 will mark the 90th anniversary of MST and we look forward to celebrating in style its sustained success. I recall with pride the first paper I published in Journal of Physics E: Scientific Instruments (as MST was previously titled) back in 1977. The paper reported the design and application of an early fluorescence lifetime spectrometer that I had constructed
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 | Logisticsâº the Joint Staff Chief Information Officer (CIO), the J-6 provides business class Information
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
... 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...
... 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...
... 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...
Danny Pimentel Claro
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.
de Zwart, B. C.; Broersen, J. P.; van der Beek, A. J.; Frings-Dresen, M. H.; van Dijk, F. J.
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
...: 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...
... 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...
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.
Nguyen, H Bryant; Thomson, Carey C; Kaminski, Naftali; Schnapp, Lynn M; Madison, J Mark; Glenny, Robb W; Dixon, Anne E
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.
Hales, Gavin; May, Tiggey; Belur, J.; Hough, Mike
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 ...
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
Klein, Lauren R; Martel, Marc L; Driver, Brian E; Reing, Mackenzie; Cole, Jon B
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.
Marc L. Martel
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.
Goldman, Ran D; Scolnik, Dennis
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.
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.
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
Brown, Jamie C; Goldstein, Judith E; Chan, Tiffany L; Massof, Robert; Ramulu, Pradeep
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
.... 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...
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.
... (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...
Freitag, T R; Freitag, W
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).
Thamburaj, Ravi; Sivitz, Adam
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
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.
... 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...
... 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...
Beaupert, Fleur; Carney, Terry; Chiarella, Mary; Satchell, Claudette; Walton, Merrilyn; Bennett, Belinda; Kelly, Patrick
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.
while under review by the Journal." At the end I have a pleasure to frankly appreciate to Professor Jan Erik Johnsson, from Technical University of Denmark, Lyngby, for his contribution, as member of the International Advisory Board from the very beginning, to the scientific scope and orientation of the Journal, and to the quality of the papers published in more than 15 years. I am sorry that his wish was not to be member of the International Advisory Board, since he was retired. In the name of Editorial Boards of the journal Thermal Science I wish to him many nice activities in his free time. Finally, I am happy that, following the wish of Prof. Arun Mujumdar, the world known scientist and member of our International Advisory Board, that I can pay your attention to the link: http://serve.me.nus.edu.sg/arun/E_books.htm, where you can download many interesting e-books, and review of the activity of the Minerals, Metals and Materials Technology Centre, of the Faculty of Engineering, National University of Singapore. April, 2011 Professor Simeon Oka, Ph. D. Editor-in-chief
... 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...
S, Birkeland; RD, Christensen; N, Damsbo
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....
, in his hands, the expansion continued and the transition to electronic production took place. In 2005, an agreement was signed with IOP Publishing and the bustling production work of the in-house team moved abroad to Bristol, leaving just the Editor-in-Chief to man the ship at the Royal Swedish Academy of Sciences. In 2011, however, as Roger prepared to step down, submissions had reached astounding levels as is evident from figure 1: that year, almost 1500 manuscripts were received by Physica Scripta, now acknowledged to be amongst the fastest growing journals in IOP Publishing, when measured in these terms. The year on year increase stands at 20% and, once again, of the extensive range of topics covered, condensed matter physics had been identified as the subject area in most need of attention because the burden of reviewing had become too great for one editor to oversee alone. Thus, when I joined Physica Scripta in January of this year, securing new External Editors for this field was perceived to be the most urgent task. It is, therefore, with the greatest of pleasure that I am able to announce the arrival of two new editors for this section: Professors David Keen and Tapio Rantala. Physica Scripta statistics Figure 1. The annual submissions made to Physica Scripta in recent years have rocketed and the rejection rate (given as a percentage) has increased rapidly. The modest increase in the number of articles accepted (shaded in blue) reflects a deliberate policy to augment the scientific quality. Professor Rantala has been selected by the Finnish Physical Society to replace Professor Matti Manninen, who is stepping down as the Finnish representative on the journal's Editorial Board. Professor Rantala is a prominent theorist and has been engaged in active research in a number of fields. In his early work, he was interested in surface science and molecular physics, however his expertise is predominantly in the domain of solid or materials physics related to
Zambon, Fabiana; Moreti, Felipe; Behlau, Mara
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.
Jon M. Truby
Highness the Emir, Sheikh Hamad bin Khalifa Al Thani, for this vision. I am grateful to all of those involved in the production of this and future issues, and hope the demands of our readers are met. May the journal continue to be a success. Dr. Jon M. Truby Ph.D, Editor-in-Chief
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
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.
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
... 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...
... 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...
... 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...
... 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...
... 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...
... 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...
... 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...
... 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...
..., 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...
..., 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...
... 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...
... 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...
... 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...
Pires, Carolina; Silva, Dina; Maroco, João; Ginó, Sandra; Mendes, Tiago; Schmand, Ben A.; Guerreiro, Manuela; de Mendonça, Alexandre
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
Paul, J A; van Dijk, F J; Frings-Dresen, M H
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.
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)
Jason C. Mills
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.
Full Text Available Dear readers of the journal Thermal Science This year we have for the first time a Supplement issue. There are many reasons for introducing Supplement issues besides the four regular issues in the Volume each year. This will be editorial policy in the next years. This year we have great increase of the number of submitted papers, and at the same time very interesting proposals of distinguished researchers to dedicate whole issue to the some modern and interesting scientific topics. The only solution is to have, one or more, Supplement issues in the year. Supplement issue to the Vol. 14, 2010, has several important characteristics. Supplement issue 2010, is devoted to the 50th anniversary of the Faculty of Mechanical Engineering, University of Kragujevac, Serbia. In the issue are presented the most important scientific and engineering results achieved in last several years by the Department of energy and process engineering of the Faculty. Some of the papers selected for this issue present also the results achieved in joint research of researchers of this Department and researches from other Universities in Serbia. To distinguish 50th anniversary of some research and education institution is the best opportunity to fulfil one of the main tasks of the journal Thermal Science, proposed even at the very beginning of the foundation of this journal, namely, to promote the best scientific results achieved in Serbia, and later also in the South-East European countries. If for education of the qualified researcher is necessary 10-15 years, for scientific institution to become mature, and to give recognized scientific results it is necessary to pass two or three in house made generations of the researchers. For this process about 50 years is necessary, and this is the reason why we accepted proposal of the Dean Professor Dr. Miroslav Babić, to devote one issue of the journal Thermal Science to the part of the scientific results achieved by the researcher
... 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...
Walker, Nicholas J; Crantford, John C; Rudolph, Megan A; David, Lisa R
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
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
Oxler, K F
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.
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...
... 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 ...
Jones, Courtney M C; Wasserman, Erin B; Li, Timmy; Amidon, Ashley; Abbott, Marissa; Shah, Manish N
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.
Breslin, Kristen; Tuchman, Lisa; Hayes, Katie L; Badolato, Gia; Goyal, Monika K
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.
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
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
It is with great pleasure that I present to you the 2008 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. Also included are some financial comparisons with other DOE Laboratories and a glossary of commonly used acronyms.
Hamilton, Charles Nigel
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
...) 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...
... 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...
... 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...
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 ...
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.
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 ...
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.
Henningsen, Anne Folke
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 -...
... 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...
... 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...
Paul, J. A.; van Dijk, F. J.; Frings-Dresen, M. H.
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
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,
J.J. Luime (Jolanda)
textabstractShoulder complaints are expressed in a variety of symptoms. In many cases, the prominent symptom is pain. In some cases, pain is present most of the day and frequently also at night. In other cases, it is provoked primarily by physical activities. Often it is accompanied
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...
Vaessen, T.J.A.; Overeem, S.; Sitskoorn, M.M.
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
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,
... 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...
....gov or from the Office of the Secretary. SUPPLEMENTARY INFORMATION: The text of the Complaint appears... the harness secured but with her head tilted back and her neck hyperextended. Her face was pressed... Generation Two model, increased the font size of the warning, and changed the text of the warning label to...
science. Included herein is a collection of original refereed research papers by well-established researchers in the field of nonlinear science. We hope that these papers will prove to be a timely and valuable reference for researchers in this area. Analytical approach to thermal science is challenging and promising, and is playing an even more important role in optimal design of various thermal problems. Considering this fact, selection of the papers for this special issue has the aim to show illustrating approaches to various thermal problems by various methods including fractal geometry and fractional calculus, and the present special issue can be used as paradigms for many other applications. I am deeply grateful to the Guest editors, Professor Ji-Huan He (now with National Engineering Laboratory of Modern Silk, Soochow University, Suzhow, China and Professor Lianchun Zheng (Department of Mathematics and Mechanics, University of Science and Technology Beijing, Beijing, China, for excellent paper selection, the job which is at the same time highly professional and delicate. I am sure, that readers will obtain realistic insight in how to apply the methods presented in this special issue to various problems.
Doğangün, Burak; Gönültaş, Burak M; Uzun-Oğuz, Esin; Oral, Gökhan; Öztürk, Meral
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.
Molinari, Noelle-Angelique M; LeBlanc, Tanya Telfair; Stephens, William
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.
... SNAP or as a retail vendor in the Special Supplemental Nutrition Program for Women, Infants, and... of a debarment or suspension action; or (5) Violation of the provisions of the Drug-Free Workplace... the debarment is for a violation of the provisions of the Drug-Free Workplace Act of 1988, your period...
Center EAC Emergency Action Committee (DoS) FAH Foreign Affairs Handbook FAM Foreign Affairs Manual FARC Fuerzas Armadas Revolucionarias de...in accordance with JP 5-0 and ADP 5-0, the author limited the tools and detail normally used in war-gaming. However, the author will invite numerous...exceeded the combat search and rescue capabilities of that component and requires the efforts of two or more components of the joint force. Normally
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
... 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 ...
Thommen, P J; Emery, R J
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
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
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 ...
... 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 ...
... 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...
... 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...
... 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...
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 ...
Donawa, M E
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.
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
... 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...
Hocker, Michael B; Villani, John J; Borawski, Joseph B; Evans, Christopher S; Nelson, Scott M; Gerardo, Charles J; Limkakeng, Alex T
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.
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
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.
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.
... 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...
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,...
PURCAREA, Ioan Matei; NEGRICEA, Costel Iliuta
Digital is the new normal today, the digitally transformation allowing step by step a closer connection with customers, and accordingly answer to the new requirements of the supply chain management. The rules of engagement are changed by the digital lives of customers, the digital leaders creating value across physical/digital products, services, and experience. Chief Marketing Officer (CMO) is proving a more devoted personal attention and a more directly involvement in digital initiatives, t...
Rogers, Steven C; DiVietro, Susan; Borrup, Kevin; Brinkley, Ashika; Kaminer, Yifrah; Lapidus, Garry
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
Englebright, Jane; Perlin, Jonathan
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.
@@ 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.
Scott M. Alter
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.
Bermejo, Isaac; Nicolaus, Leonhard; Kriston, Levente; Hölzel, Lars; Härter, Martin
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.
Ni Kadek Ariasih
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.
Binsbergen, van W.M.J.
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
... 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...
... 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...
... 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...
... 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...
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
... 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...
... 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...
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
2007 was a year of progress and challenges for the Office of the Chief Financial Officer (OCFO). I believe that with the addition of a new Controller, the OCFO senior management team is stronger than ever. With the new Controller on board, the senior management team spent two intensive days updating our strategic plan for the next five years ending in 2012, while making sure that we continue to execute on our existing strategic initiatives. In 2007 the Budget Office, teaming with Human Resources, worked diligently with our colleagues on campus to reengineer the Multi-Location Appointment (MLA) process, making it easier for our Principal Investigators (PIs) to work simultaneously between the Laboratory and UC campuses. The hiring of a point-of-contact in Human Resources to administer the program will also make the process flow smoother. In order to increase our financial flexibility, the OCFO worked with the Department of Energy (DOE) to win approval to reduce the burden rates on research and development (R&D) subcontracts and Intra-University Transfers (IUT). The Budget Office also performed a 'return on investment' (ROI) analysis to secure UCRP funding for a much needed vocational rehabilitation counselor. This new counselor now works with employees who are on medical leave to ensure that they can return to work in a more timely fashion, or if not able to return, usher them through the various options available to them. Under the direction of the new Controller, PriceWaterhouse Coopers (PWC) performed their annual audit of the Laboratory's financial data and reported positive results. In partnership with the Financial Policy and Training Office, the Controller's Office also helped to launch self-assessments of some of our financial processes, including timekeeping and resource adjustments. These self assessments were conducted to promote efficiencies and mitigate risk. In some cases they provided assurance that our practices are sound, and in
Hankin, Abigail; Wei, Stanley; Foreman, Juron; Houry, Debra
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
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
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.)
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.
Franz, M; Schepank, H; Schellberg, D
Prevalence and course of psychogenically influenced symptoms in neurology and their dependence on age and gender are reported. The epidemiological basis of the data is a long-term follow-up investigation of a high-risk population for about 10 years (n = 240): the Mannheim Cohort Study on Epidemiology of Psychogenic Disorders. Seven psychogenic symptoms of neurologic relevance (headache, lumbar and cervical vertebral complaints, functional vertigo, hyperkinesias, pareses, sleep and concentration disturbances) are characterized in regard to frequency, course and diagnostic significance.
The mining administration of the Land Brandenburg abandoned its traditional self-image in order to be able to cope with the challenges presented by a modern and future-oriented mining industry. The reinstatement of the Chief Mines Inspectorate of the Land Brandenburg opened up a chance of breaking up obsolete administrative structures and, instead, giving this entity a Corporate Identity as its foundation. The inspectorate considers Corporate Identity as the way of making its work understood both internally and to the exterior. (orig.) [de
Borman, J S
Stress among chief nurse executives (CNEs) can result from the desire to meet work-related responsibilities and maintain a satisfying personal life. The purpose of this research was to determine if the stress level that results from balancing work-related and personal-life time pressures differs among CNEs by gender. CNEs experienced moderate levels of strain; gender differences were apparent. The research findings demonstrate that the influence of gender within a female-dominated profession is consistent not with the gender norms of females, but with the gender norms seen within the larger society.
Papadimos, Thomas J; Marco, Alan P
Hospital chief executive oficers (CEOs) have demanding jobs in which they must, at tims, function as if they are potentates of small principalities. Their ability to elicit loyalty and allegiance, hand out discipline and praise, foster alliances with other organizations, and commit the occasional hostile yet (it is hoped) successful foray onto a competitor's turf are skills that must be mastered for success and longevity. We have taken the thoughts and strategies of the Renaissance political master, Niccolo Machiavelli, and applied them to the modern hospital CEO for whom we feel they still hold elements of wisdom and guidance.
Pabulo Henrique Rampelotto
Full Text Available It is my great pleasure to serve as the new Editor-in-Chief of Life, a journal concerned with fundamental questions on the origins and nature of life, evolution of biosystems and astrobiology. With my experience as Executive Editor, Senior Editor and Guest Editor of so many successful special issues (some of them in MDPI journals [1–6], I am committed to making the journal a success, with the launch of exciting special issues, publication of high quality papers, as well as inclusion of the journal in major indexing and abstracting services. In this editorial, I present my view and plans for the journal.
In March, a review team consisting of CFOs from other national laboratories, industry, and members of the University of California Office of the President (UCOP) convened for three days to conduct a comprehensive peer review of the OCFO. This was the first time in almost a decade that the financial operations of the Laboratory had been reviewed. The Committee relayed their observations on our strengths, and their very thoughtful recommendations for improvement, which we are actively pursuing. These improvements, when implemented, will benefit the entire Laboratory for many years to come. The complete report is available on the OCFO website (www.lbl.gov/Workplace/CFO). In August, the senior management team of the OCFO participated in a strategic planning retreat. The purpose of the two and a half day exercise was, of course, to update our strategic plan, but instead of spending days developing a written document, we enlisted the expertise of a seasoned journalist who also happens to be a very talented graphic artist. He listened carefully to our ideas and committed them to a visual roadmap. All members of the OCFO, Business Managers, and the Laboratory Leadership Team reviewed this draft roadmap. By having a completely visual strategic plan that is posted widely throughout the OCFO, all employees can easily see and identify with the goals that we are all working towards. FY2010 was an extraordinary year. The Laboratory welcomed its seventh Director, Dr. Paul Alivisatos, who wasted no time communicating his vision and priorities for Berkeley Lab. They include five very ambitious initiatives: Carbon Cycle 2.0, The Next Generation Light Source, a Safe and Efficient Lab, Building Community, and Space. In response, the Office of the Chief Financial Officer (OCFO) developed twelve specific initiatives that align completely with these five priorities. We will be very focused on these in the coming fiscal year, but for now, let's review what happened in FY2010. FY2010
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
de Vries, U.M.R.T.
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
Jellesma, F. C.; Rieffe, C.J.; Meerum Terwogt, M.
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
... 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...
... 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...
R. Oostenbrink (Rianne); H.P. Jongman (Henri); J.M. Landgraf (Jeanne); H. Raat (Hein); H.A. Moll (Henriëtte)
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,
... 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...
... 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...
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.
Ni Kadek Ariasih; I Made Gede Sri Artha
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...
Nelson Oly Ndubisi
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.
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
Risø National Laboratory, Roskilde
The activities of the Metallurgy Department at Risø during 1981 are described. The work is presented in three chapters: General Materials Research, Technology and Materials Development, Fuel Elements. Furthermore, a survey is given of the department's participation in international collaboration...
Eric R Braverman
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
Ballard, Elizabeth D; Horowitz, Lisa M; Jobes, David A; Wagner, Barry M; Pao, Maryland; Teach, Stephen J
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.
Ordóñez, A; Maganto, C; González, R
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.
This paper reports that the American Gas Association has rebutted complaints that natural gas prices have dropped at the wellhead but not at the burner tip. AGA Pres. Mike Baly the an association study of the issue found that all classes of customers paid less for gas in 1991 than they did in 1984, when gas prices were at their peak. He the, the study also shows that 100% of the wellhead price decline has been passed through to natural gas consumers in the form of lower retail prices. Baly the the average cost of gas delivered to all customers classes fell by $1.12/Mcf from 1984 to 1991, which exceeds the $1.10/Mcf decline in average wellhead prices during the same period
... 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...
... 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...
... 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...
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
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
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 ...
... 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...
... 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...
Polonski, G J
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.
... 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...
... 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...
... 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...
Bendall-Lyon, D; Powers, T L
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.
... 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...
... 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...
... 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...
... 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...
... 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...
Bouwman, R.J.R.; Bomhoff, Manja; Robben, Paul; Friele, R.D.
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
... 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...
Knox, G.; van Oest, R.D.
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
... 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...
... 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...
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.
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.
... 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...
Williams, Kim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)
Fiscal Year 2012 was a year of progress and change in the Office of the Chief Financial Officer (OCFO) organization. The notable accomplishments outlined below strengthened the quality of the OCFO’s stewardship and services in support of the scientific mission of Lawrence Berkeley National Laboratory (LBNL). Three strategies were key to this progress: organizational transformation aligned with our goals; process redesign and effective use of technology to improve efficiency, and innovative solutions to meet new challenges. Over the next year we will continue to apply these strategies to further enhance our contributions to the Lab’s scientific mission. What follows is the budget, funding and costs for the office for FY 2012.
The SBL Chief is expected to establish a strong research program in structural biology/biophysics in addition to providing leadership of the SBL and the structural biology community in the NCI Intramural Program. Applicants should hold a Ph.D., M.D./Ph.D., or equivalent doctoral degree in a relevant discipline, and should possess outstanding communication skills and documented leadership experience. Tenured faculty or industrial scientists of equivalent rank with a demonstrated commitment to structural biophysics should apply. Salary will be commensurate with experience and accomplishments. This position is not restricted to U.S. citizens. A full civil service package of benefits (including health insurance, life insurance, and retirement) is available. This position is subject to a background investigation. The NIH is dedicated to building a diverse community in its training and employment programs.
Elizabeta Krstić Vukelja
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.
Berg, David Nelson; Huot, Stephen Joseph
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...
Meo, Sultan Ayoub; Al-Drees, Abdul Majeed; Rasheed, Shahzad; Meo, Imran Mu; Al-Saadi, Muslim M; Ghani, Hamza A; Alkandari, Jasem Ramadan
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.
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.
Zink, Korie L; Perry, Marcia; London, Kory; Floto, Olivia; Bassin, Benjamin; Burkhardt, John; Santen, Sally A
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.
... 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...
Mark H.R. Bussin
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.
[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(®)])].
Rouquette, A; Mandereau-Bruno, L; Baffert, E; Laaidi, K; Josseran, L; Isnard, H
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
Oct 31, 2016 ... Department of Urban and Regional Planning, University of Ibadan, Oyo State, Nigeria. 2 ... Geospatial techniques were used for this study; data from primary and secondary source ... development, for instance, Nigeria cities .... (road network, road medians and water ..... Countries: A Case Study of Nigeria.
This report summarizes the activities in 1978 of some of the groups within the Electronics Department. The work covered includes plant protection and operator studies, reliability techniques, application of nuclear techniques to mineral exploration, applied laser physics, computing and, lastly, research instrumentation. (author)
Rosid, M. A.; Rachmadany, A.; Multazam, M. T.; Nandiyanto, A. B. D.; Abdullah, A. G.; Widiaty, I.
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.
Rahmat Muhajir Nugroho
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.
Abt, Helmut A.
Effective 1999 July 1, all new manuscripts for Part 1 of The Astrophysical Journal and The Astrophysical Journal Supplement Series should be sent to Dr. Robert C. Kennicutt, Editor-in-Chief The Astrophysical Journal Steward Observatory University of Arizona Tucson, AZ 85721-0065 The other means of contact are telephone, (520) 621-5145 FAX, (520) 621-5153 and e-mail, firstname.lastname@example.org. For express packages please use the street address of 933 North Cherry Avenue. Dr. Kennicutt will be assisted by several of my loyal coworkers, who will move across the street. Manuscripts received before July 1 will be handled by the current editor until most of their problems have been resolved, at which point the remainder will be sent to Dr. Kennicutt's office. Manuscripts for the Letters should, as before, be sent directly to Dr. Alex Dalgarno at the Center for Astrophysics in Cambridge, MA. We are fortunate that a person with as much experience in research and proven good judgment as Dr. Kennicutt is willing to accept this difficult and time-consuming responsibility. He will be only the seventh Managing Editor or Editor-in-Chief that this Journal has had in its 104 years. Please give him the cooperation and help that you have given the current editor. It has been my privilege to work for 28 years with many of the best astrophysicists in the world and to publish their papers. This was done with the help of the AAS Publications Board and AAS officers, the efforts of Peter Boyce and Evan Owens who made the on-line edition of the Journal possible, three Associate Editors, a score of Scientific Editors, a hardworking staff of six in Tucson, up to 25 production controllers and manuscript editors at the University of Chicago Press, and the thousands of astronomers throughout the world who served as referees. The original masthead called this journal ``An International Review of Spectroscopy and Astronomical Physics.'' That subtitle is no longer appropriate because we do not publish
Abt, Helmut A.
Effective 1999 July 1, all new manuscripts for Part 1 of The Astrophysical Journal and The Astrophysical Journal Supplement Series should be sent to Dr. Robert C. Kennicutt, Jr., Editor-in-Chief The Astrophysical Journal Steward Observatory University of Arizona Tucson, AZ 85721-0065 The other means of contact are telephone, (520) 621-5145 FAX, (520) 621-5153 and e-mail, email@example.com. For express packages please use the street address of 933 North Cherry Avenue. Dr. Kennicutt will be assisted by several of my loyal coworkers, who will move across the street. Manuscripts received before July 1 will be handled by the current editor until most of their problems have been resolved, at which point the remainder will be sent to Dr. Kennicutt's office. Manuscripts for the Letters should, as before, be sent directly to Dr. Alex Dalgarno at the Center for Astrophysics in Cambridge, MA. We are fortunate that a person with as much experience in research and proven good judgment as Dr. Kennicutt is willing to accept this difficult and time-consuming responsibility. He will be only the seventh Managing Editor or Editor-in-Chief that this Journal has had in its 104 years. Please give him the cooperation and help that you have given the current editor. It has been my privilege to work for 28 years with many of the best astrophysicists in the world and to publish their papers. This was done with the help of the AAS Publications Board and AAS officers, the efforts of Peter Boyce and Evan Owens who made the on-line edition of the Journal possible, three Associate Editors, a score of Scientific Editors, a hardworking staff of six in Tucson, up to 25 production controllers and manuscript editors at the University of Chicago Press, and the thousands of astronomers throughout the world who served as referees. The original masthead called this journal ``An International Review of Spectroscopy and Astronomical Physics.'' That subtitle is no longer appropriate because we do not
Fokkens, W. J.
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
Wiggins, Lori A.
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…
Sredl, Darlene; Peng, Niang-Huei
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 ...
... 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...
... 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...
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.
... 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...
... 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...
... 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...
... 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...
... 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...
... 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...
Reiter, Lisa Rose
"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…
Miller, Virginia P.
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.…
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 consumerâ€™s complaint is not satisfactory. Therefore, the way in which business organisations deal with consumer complaints can significantly influence the consumersâ€™ 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
Mareeswari, V.; Gopalakrishnan, V.
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.
The successful Chief Executive Officer (CEO) will have recognized the benefits of, and have implemented, a total quality assurance program. The quality assurance program will be adequately defined in policies and procedures such that managers and supervisors of each organizational element understand their primary and supporting roles in carrying out an effective quality assurance program. The traditional practice of having all quality assurance activities reside in a quality assurance organization will have been cast aside. Instead, the quality assurance activities necessary to achieve and assure the quality of the desired end product will have been defined and assigned to responsible organization elements. The quality assurance organization's primary role will be to define the total quality assurance program, insure that the achieving and assuring functions are assigned in policies and procedures, conduct training necessary to have management and supervisors understand the total quality assurance program, measure the effectiveness of the program and feedback measurement data for improvements in the program. The successful CEO will have implemented a quality assurance program that provides for a graded approach for application of the program based upon the importance of the intended use of the product or service. The successful CEO will rely heavily on the scheduled progress reports and assessments to measure the pulse of his organization's successes and improvement needs. This paper will describe suggested approaches for the Quality Assurance Manager to implement a quality assurance program which results in his corporation's CEO being a supporter of and a driving force in the implementation of the quality assurance program
Informatics competency adoption is a recognized issue across nursing roles in digital health practice settings. Further, it has been suggested that the health system's inability to reap the promised benefits of electronic health/patient records is, in part, a manifestation of inadequate development of informatics competency by chief nurse executives (CNEs) and other clinicians (Amendola 2008; Simpson 2013). This paper will focus on CNE informatics competency and nursing knowledge development as it pertains to the Big Data revolution. With the paper's aim of showing how CNEs armed with informatics competency can harness the full potential of Big Data offering new opportunities for nursing knowledge development in their clinical transformation roles as eHealth project sponsors. It is proposed that informatics-savvy CNEs are the new transformational leaders of the digital age who will have the advantage to successfully advocate for nurses in leading 21st-century health systems. Also, transformational CNEs armed with informatics competency will position nurses and the nursing profession to achieve its future vision, where nurses are perceived by patients and professionals alike as knowledge workers, providing the leadership essential for safe, quality care and demonstrating nursing's unique contributions to fiscal health through clinically relevant, evidence-based practices (McBride 2005b). Copyright © 2016 Longwoods Publishing.
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.
Victor O. Kolade
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.
McPhillips, Heather A; Frohna, John G; Murad, M Hassan; Batra, Maneesh; Panda, Mukta; Miller, Marsha A; Brigham, Timothy P; Doughty, Robert A
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
TIn the autumn of 2010 I became the Editor-in Chief of European Journal of Physics (EJP). EJP is a place for teachers, instructors and professors to exchange their views on teaching physics at university level and share their experience. It is general opinion that no good research is possible without connection with good, high-quality teaching, at the university level in particular. Therefore excellence in physics teaching is important to the physics community. European Journal of Physics is proud of its contribution to achieving this goal. As Editor-in-Chief, I will continue to work to this general objective of the journal. We will publish articles on specific topics in physics, stressing originality of presentation and suitability for use in students'laboratories, lectures and physics teaching in general. We will also publish more pedagogical papers presenting the achievements of particular teaching methods. In addition, we will continue to publish special sections on particular areas of physics, as well as the annual special section on physics competitions. European Journal of Physics is in good shape. Due to the work of the previous editors and the publisher, the readership is high and growing steadily, and many excellent papers are being submitted and published. I hope that this positive trend for the journal will continue, and I will do my best to keep to this high standard. A few words about myself. I work in the Institute of Physics in Warsaw, Poland. My main research interests are in theoretical quantum optics and I have published about 80 research papers on this topic. For many years I was involved in teaching physics at university and in high school. I am a co-author of a textbook on physics for high-school students and of a problem book in quantum mechanics. For the last ten years, I have been involved in the International Physics Olympiad and over the last few years I have been a member of the Editorial Board of European Journal of Physics.
Seelos, L; Adamson, C
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.
... THE CORPORATE AND CRIMINAL FRAUD ACCOUNTABILITY ACT OF 2002, TITLE VIII OF THE SARBANES-OXLEY ACT OF... communication will be considered to be the date of filing; if the complaint is filed in person, by hand-delivery...
van Rijsbergen, M.W.A.; Mark, R.E.; de Kort, P.L.; Sitskoorn, M.M.
Background Most studies to date have assessed poststroke cognitive impairment objectively, whereas less attention is paid to subjective cognitive complaints (SCC). We, therefore, systematically searched the literature to summarize and evaluate the current knowledge about poststroke SCC. Methods
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
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
Bennett, Sophia Elizabeth
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
Suryawan, I Nengah; Putra Yadnya, Ida Bagus; Puspani, Ida Ayu Made
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...
Studer, Regina; Danuser, Brigitta; Hildebrandt, Horst; Arial, Marc; Gomez, Patrick
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.
Michelle M. Lilly; Melissa J. London; Mary C. Mercer
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...
Hsieh, Sophie Yahui
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.
Teixeira, Adriane Ribeiro
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.
On 1 January, 2004, I assumed the position of Editor-in-Chief of Journal of Physics D: Applied Physics. I will start by saying that I will do my best to justify the confidence of the journal management and publishing staff in my abilities. I was fortunate to have been able to work, as an Editorial Board member, with my predecessor, the previous Editor-in-Chief, Professor Allister Ferguson. Allister has provided a high degree of intellectual stewardship for the journal in the last five years. He has made the job appear a worthy challenge for me. I therefore take this opportunity to thank Allister on behalf of the Editorial Board and publishing staff of the journal. Several other factors contributed to my decision to accept this position. The first is the group of people who actually go about the business of publishing. The Senior Publisher, Nicola Gulley (and her predecessor Sophy Le Masurier); the Managing Editor, Jill Membrey; the Publishing Administrators, Nina Blakesley and Sarah Towell; the Production Editor, Katie Gerrard and their office staff form an amazing group and have managed to make the operation of the journal incredibly efficient. An index of this is the speed with which incoming manuscripts are processed. The average time between the receipt of a manuscript and its web publication, if accepted, is 130 days. This is three to five times shorter than for most other journals. A factor that contributes to this success is a responsive pool of referees that the publishing staff have as a valuable resource. Ultimately, the standard bearers of any journal are the referees. Therefore, a grateful `thank you' is due from all of us at J. Phys. D to all our referees, who diligently perform this honourable task. The Associate Editors of the journal, Professors Lawler, Margaritondo and O'Grady, also provide immense scientific leadership. They help in defining new directions for the journal and in the publishing process. Last, but not least, a remarkable asset of
Baldwin, Casey; Pearl, Andrea; Laramie, Matthew; Rohrback, John; Phillips, Pat; Wolf, Keith
The Chief Joseph Hatchery is the fourth hatchery obligated under the Grand Coulee Dam/Dry Falls project, originating in the 1940s. Leavenworth, Entiat, and Winthrop National Fish Hatcheries were built and operated as mitigation for salmon blockage at Grand Coulee Dam, but the fourth hatchery was not built, and the obligation was nearly forgotten. After the Colville Tribes successfully collaborated with the United States to resurrect the project, planning of the hatchery began in 2001 and construction was completed in 2013. The monitoring program began in 2012 and adult Chinook Salmon were brought on station for the first time in June 2013. BPA is the primary funding source for CJH, and the Mid-Columbia PUDs (Douglas, Grant and Chelan County) have entered into cost-share agreements with the tribes and BPA in order to meet some of their mitigation obligations. The CJH production level was set at 60% in 2013 in order to train staff and test hatchery facility systems during the first year of operation. Leavenworth National Fish Hatchery (LNFH) provided 422 Spring Chinook broodstock in June, 2013; representing the official beginning of CJH operations. In July and August the CCT used a purse seine vessel to collect 814 summer/fall Chinook as broodstock that were a continuation and expansion of the previous Similkameen Pond program. In-hatchery survival for most life stages exceeded survival targets and, as of April 2014, the program was on track to exceed the 60% production target for its start-up year. The CJH monitoring project collected field data to determine Chinook population status, trend, and hatchery effectiveness centered on five major activities; 1) rotary screw traps (juvenile outmigration, natural-origin smolt PIT tagging) 2) beach seine (naturalorigin smolt PIT tagging) 3) lower Okanogan adult fish pilot weir (adult escapement, proportion of hatchery-origin spawners [pHOS], broodstock) 4) spawning ground surveys (redd and carcass surveys)(viable salmonid
... DHS Idea Combating Human Trafficking Visa Waiver Program Immigration Case Status REAL ID Forms Online Safety Online ... the National Terrorism Advisory System (NTAS) Find Training Opportunities File a Travel Complaint (DHS TRIP) Do you ...
Long, David E.
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…
Gisondi, Michael A; Chou, Adaira; Joshi, Nikita; Sheehy, Margaret K; Zaver, Fareen; Chan, Teresa M; Riddell, Jeffrey; Sifford, Derek P; Lin, Michelle
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
... 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...
... 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...
... 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...
... 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 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...
... 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...
... 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...
Ewa Małgorzata Szepietowska
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
Mollen, Cynthia J; Miller, Melissa K; Hayes, Katie L; Wittink, Marsha N; Barg, Frances K
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
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
Kondis, Jamie S; Muenzer, Jared; Luhmann, Janet D
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.
Gardner, Robert Andrew; Brewer, Kori L; Langston, Dennis B
Emergency department (ED) patients with chronic pain challenge providers to make quick and accurate assessments without an in-depth pain management consultation. Emergency physicians need reliable means to determine which patients may receive opioid therapy without exacerbating opioid use disorder (OUD). Eighty-nine ED patients with a chief complaint of chronic pain were enrolled. Researchers administered questionnaires and reviewed medical and state prescription monitoring database information. Participants were classified as either OUD or non-OUD. Statistical analysis included a bivariate analysis comparing differences between groups and multivariate logistic regression evaluating ORs. The 45 participants categorised as OUD had a higher proportion of documented or reported psychiatric diagnoses (p=0.049), preference of opioid treatment (p = 0.005), current oxycodone prescription (p = 0.043), borrowed pain medicine (p=0.004) and non-authorised dose increase (pOUD group to have an increased number of opioid prescriptions (p=0.005) and pills (p=0.010). Participants who borrowed pain medicine and engaged in non-authorised dose increase were 5.2 (p=0.025, 95% CI 1.24 to 21.9) and 6.1 times (p=0.001, 95% CI 1.55 to 24.1) more likely to have OUD, respectively. Major limitations of our study include a small sample size, self-reported measures and convenience sample which may introduce selection bias. Patients with chronic pain with OUD have distinguishable characteristics. Emergency physicians should consider such evidence-based variables prior to opioid therapy to ameliorate the opioid crisis and limit implicit bias. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Neuenschwander, James F; Hiestand, Brian C; Peacock, W Frank; Billings, John M; Sondrup, Cole; Hummel, John D; Abraham, William T
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.
Ridgway, Jessica P; Almirol, Ellen A; Bender, Alvie; Richardson, Andrew; Schmitt, Jessica; Friedman, Eleanor; Lancki, Nicola; Leroux, Ivan; Pieroni, Nina; Dehlin, Jessica; Schneider, John A
Emergency Departments (EDs) have the potential to play a crucial role in HIV prevention by identifying and linking high-risk HIV-negative clients to preexposure prophylaxis (PrEP) care, but it is difficult to perform HIV risk assessment for all ED patients. We aimed to develop and implement an electronic risk score to identify ED patients who are potential candidates for PrEP. Using electronic medical record (EMR) data, we used logistic regression to model the outcome of PrEP eligibility. We converted the model into an electronic risk score and incorporated it into the EMR. The risk score is automatically calculated at triage. For patients whose risk score is above a given threshold, an automated electronic alert is sent to an HIV prevention counselor who performs real time HIV prevention counseling, risk assessment, and PrEP linkage as appropriate. The electronic risk score includes the following EMR variables: age, gender, gender of sexual partner, chief complaint, and positive test for sexually transmitted infection in the prior 6 months. A risk score ≥21 has specificity of 80.6% and sensitivity of 50%. In the first 5.5 months of implementation, the alert fired for 180 patients, 34.4% (62/180) of whom were women. Of the 51 patients who completed risk assessment, 68.6% (35/51) were interested in PrEP, 17.6% (9/51) scheduled a PrEP appointment, and 7.8% (4/51) successfully initiated PrEP. The measured number of successful PrEP initiations is likely an underestimate, as it does include patients who initiated PrEP with outside providers or referred acquaintances for PrEP care.
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.
Arias, Sarah A; Boudreaux, Edwin D; Segal, Daniel L; Miller, Ivan; Camargo, Carlos A; Betz, Marian E
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.
Quinley, Kelly E; Falck, Ailsa; Kallan, Michael J; Datner, Elizabeth M; Carr, Brendan G; Schreiber, Courtney A
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.
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.
Berona, Johnny; Czyz, Ewa; Horwitz, Adam G.; Gipson, Polly Y.
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
Anderson, K; Allan, D; Finucane, P
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.
Birkeland, Søren; Depont Christensen, Rene; Damsbo, Niels; Kragstrup, Jakob
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.
Olsson, Erik Masao
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
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On 1 January 2012 I will be assuming the position of Editor-in-Chief of the journal Semiconductor Science and Technology (SST). I am flattered by the confidence expressed in my ability to carry out this challenging job and I will try hard to justify this confidence. The previous Editor-in-Chief, Laurens Molenkamp, University of Würzburg, Germany, has worked tirelessly for the last ten years and has done an excellent job for the journal. Everyone at the journal is profoundly grateful for his leadership and for his achievements In 2012 several new members will join the Editorial Board: Professor Deli Wang (University of California, San Diego) with considerable expertise in semiconductor nanowires, Professor Saskia Fischer (Humboldt University, Berlin, Germany) with a background in semiconductor quantum devices, and Professor Erwin Kessels (Eindhoven University of Technology, Netherlands) with extensive experience in plasma processing of thin films and gate oxides. In particular, I want to express my gratitude to Professor Israel Bar-Joseph (Weizmann Institute of Science, Israel) and Professor Maria Tamargo (The City College of New York, USA), who will leave next year and who have vigorously served the Editorial Board for years. The journal has recently introduced a fast-track option for manuscripts. This option is a high-quality, high-profile outlet for new and important research across all areas of semiconductor research. Authors can expect to receive referee reports in less than 20 days from submission. Once accepted, you can expect the articles to be online within two or three weeks from acceptance and to be published in print in less than a month. Furthermore, all fast-track communications published in 2011 will be free to read for ten years. More detailed information on fast-track publication can be found on the following webpage: http://iopscience.iop.org/0268-1242/page/Fast track communications It is encouraging to see that since the journal introduced pre
Alpert, J J; Levenson, S M; Osman, C J; James, S
Many organizations make efforts to identify future pediatric leaders, often focusing on chief residents (CRs). Identifying future leaders is an issue of great importance not only to the ultimate success of the organization but also to the profession. Because little is known regarding whether completing a CR predicts future leadership in medicine, we sought to determine if former pediatric CRs when compared with pediatric residents who were not CRs reported more often that they were leaders in their profession. Twenty-four pediatric training programs stratified by resident size (36) and geography (East, South, Midwest, and West) were selected randomly from the Graduate Medical Education Directory (American Medical Association, Chicago, IL). Program directors were contacted by mail and telephone and asked to provide their housestaff rosters from 1965-1985. The resulting resident sample was surveyed by questionnaire in 1995. Fifteen of 17 program directors (88%) who possessed the requested data provided 1965-1985 rosters yielding a sample of 963 residents. Fifty-five percent of the resident sample (533) responded. Fifty-eight of the respondents had not completed a pediatric residency, leaving a survey sample of 475. Thirty-four percent (163) were CRs. The sample had a mean age of 47, 67% were male and 87% married. Fellowships were completed by 51%. More former CRs compared with non-CRs (75% vs 64%), more former fellows than non-fellows (75% vs 60%) and more males than females (74% vs 55%) reported they were professional leaders. These associations persisted in a logistic regression that controlled for CR status, gender, marital status, and fellowship status as leadership predictors. Former CRs, former fellows, and men were, respectively, 1.8, 2.3, and 2.3 times more likely to report professional leadership. Pediatric residents who were former CRs and/or fellows, and males were more likely to report professional leadership. Although men were more likely to report
US Department of Education, 2010
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…
Joseph Nowak, a resident of Ware Mass. and Chief Operator of the Upper Blackstone Water Pollution Abatement District (District) in Milbury, Mass., was honored by EPA with a 2016 Regional Wastewater Treatment Plant Operator of the Year Excellence Award.
.... This Letort Paper examines how four Chairmen Joint Chiefs of Staff from 1990 to 2005 used a strategic planning system to enable them to meet their statutory responsibilities specified in Title 10 US...
Aume, Nilss M.
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.
Dustin Price, a resident of Berwick Maine and the Chief Operator of the Seabrook, N.H. Wastewater Treatment Plant, was honored by EPA with a 2016 Regional Wastewater Treatment Plant Operator of the Year Excellence Award.
Clark, Joan Shinkus
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.
... 1066-001, ``Establishment of the Office of the Chief Scientist.'' OCS exists to provide leadership and... the Small Business Regulatory Fairness Enforcement Act, 5 U.S.C. 801 et seq., and thus is exempt from...
... of the Chief Information Officer; Submission for OMB Review; Temporary Contractor Information... information collection requirement regarding temporary contractor information worksheet. A notice was... for temporary contractors as a result of the American Recovery and Reinvestment Act of 2009 (Public...
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
... 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...
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.
Beckers, Henny Jm; van Kooten-Noordzij, Marina Aw; de Crom, Ronald Mpc; Schouten, Jan Sag; Webers, Carroll Ab
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.
Hsieh, Jennifer L; Nguyen, Trang Quyen; Matte, Thomas; Ito, Kazuhiko
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.
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.
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...
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 ...
Claude Louis Sommé was born in Paris in 1772. After surgical studies between 1790 and 1792, he successfully embraced a military career in the armies of Napoleon at different fronts and in several hospitals. In 1806 he submitted his doctoral thesis at the Special Medical School of Strasburg, Dissertation upon Pain. The same year he presented his dismissal from he imperial armies and became chief-surgeon at the St Elisabeth hospital of Antwerp where he stayed on duty until his death in 1855. Sommé wrote a lot of medical books: surgical, anatomical and physiological. After the battle of Waterloo one third of the injured soldiers were transferred to Antwerp and were attended in his department. He also played an important role as a professor at the Primary Medical School of Antwerp. Sommé also created the botanical garden of Antwerp, close to the hospital.
... United States, Territories, possessions, and the Commonwealth of Puerto Rico. (c) Delegated authority... parcel and which constitute small tracts of additional land needed in connection with projects for which... “general purpose” space from the General Services Administration and the Post Office Department and all...
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.
Matozaki, T.; Sakamoto, C.; Nagao, M.; Nishisaki, H.; Konda, Y.; Nakano, O.; Matsuda, K.; Wada, K.; Suzuki, T.; Kasuga, M.
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
Ted L. Rosenthal
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.
Lilly, Michelle M; London, Melissa J; Mercer, Mary C
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.
Nilsen, Stein Tore; Malterud, Kirsti; Werner, Erik L.
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...
Carney, Terry; Beaupert, Fleur; Chiarella, Mary; Bennett, Belinda; Walton, Merrilyn; Kelly, Patrick J; Satchell, Claudette S
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.
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.
Gardner, Jason S.
As I begin my tenure as Editor-in-Chief of Journal of Physics: Condensed Matter (JPCM), I look upon this opportunity as both an honour and a real challenge. The journal is in great shape thanks to the work of my predecessors, Marshall Stoneham and David Ferry. The journal's solid reputation is based largely on the work these gentlemen have done over the past decade. The other main reason for the success of JPCM is the amazing staff in Bristol; keep up the good work, please. When discussing the journal with scientists from all corners of the globe, one thing is always mentioned—JPCM is a very reliable journal with well-written, high-quality papers, and a fast but rigorous peer-review process that provides fair, detailed and constructive referee reports for the benefit of authors. This is due almost entirely to our great authors and referees; we rely on them every day—thank you. As the new Editor-in-Chief I hope to continue to improve still further the journal's status in condensed matter science. As mentioned above, our reputation is excellent, but the reality is that we live in a world of bibliometrics and rankings. Over the past few years JPCM has been repositioned as a journal at the forefront of condensed matter physics, and the impact of the journal should increase further as a result of continued emphasis on commissioning in cutting-edge areas identified by the Editorial Board and the journal team. In addition to regular papers, JPCM has a number of other content streams that authors and readers can benefit from. Fast track communications (FTCs) offer exceptionally fast publication for work of the highest impact and urgency. By their select nature, FTCs benefit from personal treatment by the Editorial Board and the average receipt-to-first-decision time is just 11 days (the average receipt-to-publication time is just 45 days). Topical reviews in JPCM make the journal one of the most authoritative sources of review content for condensed matter physics
Leider, Jonathon P; Castrucci, Brian C; Harris, Jenine K; Hearne, Shelley
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.
Jonathon P. Leider
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.
... attending; (5) A description of the nature of the problem of the child relating to the proposed or refused initiation or change, including facts relating to the problem; and (6) A proposed resolution of the problem... section, the hearing officer must make a determination on the face of the due process complaint of whether...
LAURENS, RRP; WIT, HP; EBELS, T
In a randomised study, we investigated the sound production of mechanical heart valve prostheses and the complaints related to this sound. The CarboMedics, Bjork-Shiley monostrut and StJude Medical prostheses were compared. A-weighted levels of the pulse-like sound produced by the prosthesis were
Skorobogatova, Natalija; Žemaitienė, Nida; Šmigelskas, Kastytis; Tamelienė, Rasa
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.
... complaint. At the end of this process, the issuer reports to Consumer Response how it has addressed the... Proceedings (``OAEP'') discloses every month in its Air Travel Consumer Report.\\11\\ Unlike NHTSA, OAEP does... the OEAP began publishing the Air Travel Consumer Report.\\13\\ Outside reviewers have also publicized...
Wang, Chiachih D. C.; Scalise, Dominick A.; Barajas-Munoz, I. Alejandro; Julio, Kathy; Gomez, Ayleen
This study investigated adult attachment and acculturation frameworks of reported psychosomatic complaints related to perceived discrimination among a sample of Latino/Hispanic university students (N = 160). The model supported by the data suggests that attachment anxiety, acculturation toward the dominant cultural norms, and adherence to…
Newson, Rachel S.; Kemps, Eva B.
The current study investigated the nature of subjective cognitive complaints of older adults in relation to a broad array of individual cognitive functions known to decline with age. A 60-item questionnaire was developed to examine: (1) whether older adults experience problems with these cognitive functions (problems with cognition); (2) the…
... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Answer to the complaint. 22.15 Section 22.15 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL CONSOLIDATED RULES OF... respondent has any knowledge. Where respondent has no knowledge of a particular factual allegation and so...
Bos, J; Mol, E.; Visser, B.; Frings-Dresen, M.H.W.
Objectives: The purpose of the present study was threefold: (1) to compare the work demands on firefighters (FFs) and office workers (OWs), (2) to compare the prevalence of health complaints and disabilities in the work situation in these two groups, and (3) to explore the effect of work demands on
... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Satisfaction of complaint. 12... RELATING TO REPARATIONS General Information and Preliminary Consideration of Pleadings § 12.17 Satisfaction... as the complainant will accept in satisfaction of his claim; and (b) by submitting to the Commission...
... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Contents of complaint. 15.737-12 Section 15.737-12 Money and Finance: Treasury Office of the Secretary of the Treasury POST EMPLOYMENT... charges against him/her so that the respondent is able to prepare a defense. (b) Demand for answer. In the...
... available to it, or both. (b) The complainant shall have the burden of establishing a prima facie case that... denial was lawful, once a prima facie case is established by the complainant. (c) The Commission shall... complaint if it determines that the complainant has not established a prima facie case, or that the rate...
... any person on the employee's behalf, a complaint alleging a violation of section 405. (b) Nature of... with the OSHA Area Director responsible for enforcement activities in the geographical area where the employee resides or was employed, but filing with any OSHA officer or employee is sufficient. Addresses and...
... violations. (c) Place of Filing. The complaint should be filed with the OSHA Area Director responsible for... by an employer in violation of any of the statutes listed in § 24.100(a) may file, or have filed by... with any OSHA officer or employee. Addresses and telephone numbers for these officials are set forth in...
... constitute the violations. (c) Place of filing. The complaint should be filed with the OSHA Area Director... or she has been discriminated against by an employer in violation of the Act may file, or have filed..., but may be filed with any OSHA officer or employee. Addresses and telephone numbers for these...
... subcontractor of an air carrier in violation of the Act may file, or have filed by any person on the employee's... acts and omissions, with pertinent dates, which are believed to constitute the violations. (c) Place of filing. The complaint should be filed with the OSHA Area Director responsible for enforcement activities...
Palm, W.M.; Ferrarini, L.; van der Flier, W.M.; Westendorp, R.G.J.; Bollen, E.L.E.M.; Middelkoop, H.A.M.; Milles, J.R.; van der Grond, J.; van Buchem, M.A.
Purpose To evaluate ventricular shape differences along the complete surface of the lateral and third ventricles of persons with subjective memory complaints (MC). Materials and Methods We included 28 controls and 21 persons with MC. FLAIR, T2, and PD-weighted brain MRI scans were acquired at 1.5
A. Sajjad (Ayesha); S.S. Mirza (Saira); M.L.P. Portegies (Marileen); M.J. Bos (Michiel); A. Hofman (Albert); P.J. Koudstaal (Peter Jan); H.W. Tiemeier (Henning); M.A. Ikram (Arfan)
textabstractBackground and Purpose-Persons with cognitive impairment, as assessed by cognitive tests, are at a higher risk of stroke. Subjective memory complaints might be an earlier marker for stroke, especially in persons with higher education. Their cognitive reserve might mask their cognitive
The highest reported taboo theme was homosexuality, followed by tattooing or piercing, and abortion. There is a significant positive correlation between health complaints of the students and taboo themes in their families. The findings call for intensified efforts on enlightenment (life skills) programmes designed to ...
Groot, I.J.M. de; Witte, L.P de
OBJECTIVE: While life expectancy is improving for persons with spinal muscular atrophy, new physical complaints may arise. To investigate this, we studied persons with a long duration and severe course (high functional limitations) of the disease. DESIGN: Cross-sectional descriptive study.
Roelen, C.A.M.; Schreuder, K.J.; Koopmans, P.C.; Groothoff, J.W.
Background Illness and illness behaviour are important problems in the Dutch workforce. Illness has been associated with job demands, with high demands relating to poorer health. It has not been reported whether subjective health complaints relate to job demands. Aims To investigate whether
The Application for Tips and Complaints System collects information on potential violators. Learn how this data is collected in the system, how it will be used, access to the data, the purpose of data collection, and record retention policies for this data
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Quality complaints. 51-6.11 Section 51-6.11 Public Contracts and Property Management Other Provisions Relating to Public... commodities received from Defense Logistics Agency supply centers, General Services Administration supply...
Roelen, Corne A. M.; Koopmans, Petra C.; Groothoff, Johan W.
Objective: The Dutch population is healthy in terms of living and working conditions, but the levels of subjective health complaints (SHC) and sickness absence are high in the Dutch workforce. Are SHC related to sickness absence? Participants: The study population included the personnel of four
Migueza, S.A.; Hallbeck, M.S.; Vink, P.
A participatory ergonomics approach is used to create a new work environment, which is aimed at reducing neck complaints in a cell phone assembly. The participatory ergonomics program included an initiative, problem identification, a selection of solutions, an implementation and evaluation.
... within ten days after the interview their personal written statements concerning the problem; (4) Place... shall take necessary action to: (1) Interview, as appropriate, all parties concerned to obtain information relevant to the problems or complaints; (2) Place a written summary of each interview in the ASW's...
de Vente, Wieke; Kamphuis, Jan Henk; Blonk, Roland W B; Emmelkamp, Paul M G
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.
Darmanin Ellul R
Full Text Available Objective: To investigate self-reported health complaints and the use of medicines among adolescents in Malta.Methods: A self-administered questionnaire was used to survey self-reported health complaints, the use and the sources of medicines that had been accessed, during the preceding 3 months among adolescents attending secondary schools in Malta. A stratified random sample design generated a sample size of 514 students. The health complaints and use of medicines that were investigated included ear problems/hay fever/cold/cough, headache, skin problems, sport injuries, indigestion/diarrhoea/constipation, eye problems and menstrual pain (for girls. The use of vitamins and antibiotics was also investigated. Results: A total of 477 students participated in the final data collection. Correct information was submitted by 474 students, (aged 14-16 years, who formed the analytical sample, of which 53.8% were girls. The students reported a mean number of 2.70 (SD = 1.39 out of a total of 7 health complaints and 90.3% reported using at least 1 medicine during the preceding 3 months. The community pharmacy was cited as the most commonly accessed source for most of the medicines that were investigated. A proportion of 24.3% of the students had taken at least 1 medicine without adult guidance during the preceding 3 months. Almost 10% of those who had taken antibiotics, had accessed them from the home medicine cabinet.Conclusion: A high proportion of adolescents in Malta reported the use of medicines to alleviate the symptoms of common health complaints. This result is concordant with previous research carried out in the United Kingdom, Germany, Slovakia and Kuwait. A considerable proportion of students in this study had obtained medicines without adult guidance and accessed antibiotics from the home medicine cabinet. This highlights the importance of carefully designed education programs for adolescents that will integrate information about the proper use
Bolinger, Elizabeth; Reese, Caitlin; Suhr, Julie; Larrabee, Glenn J
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.
Ghazizadeh, Mahtab; McDonald, Anthony D; Lee, John D
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.
... 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...
... INTERNATIONAL TRADE COMMISSION [DN 2884] Certain Audiovisual Components and Products Containing.... International Trade Commission has received a complaint entitled Certain Audiovisual Components and Products... audiovisual components and products containing the same. The complaint names as respondents Funai Electric...
... INTERNATIONAL TRADE COMMISSION [DN 2884] Certain Audiovisual Components and Products Containing.... International Trade Commission has received a complaint entitled Certain Audiovisual Components and Products... audiovisual components and products containing the same. The complaint names as respondents Funai Electric...
... complaint names as respondent Apple Inc. of CA. The complainant, proposed respondents, other interested... behalf of S3 Graphics Co., Ltd. and S3 Graphics Inc. on September 23, 2011. The complaint alleges...
.... The complaint names as respondent Apple Inc. of CA. The complainant, proposed respondents, other... Commission has received a complaint filed on behalf of VIA Technologies Inc., IP-First, LLC and Centaur...
Gong, Shuangping; Dai, Yonghui; Ji, Jun; Wang, Jinzhao; Sun, Hai
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...
Muise, Robert J; Yerushalmi, David
Attempting to play the role of King Solomon in his PPACA decision, Chief Justice John Roberts split the baby perversely by ruling it was not a tax under the Anti-Injunction Act, which would have likely deprived the Court of jurisdiction to hear this pre-enforcement challenge to the individual mandate, but it was a tax for taxing and spending purposes even though Congress said it was a "penalty" and not a tax. And the Chief Justice had to twist further his "wisdom" to hold that it was not an unconstitutional direct tax, even though that is exactly what it is, if it is a tax in the first instance.
... 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...
... 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...
... 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...
... 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...
Nikoghosyan-Bossen, Gohar; Hauberg, Agnes; Homøe, Preben
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),...
Ginó, Sandra; Mendes, Tiago; Maroco, João; Ribeiro, Filipa; Schmand, Ben A.; de Mendonça, Alexandre; Guerreiro, Manuela
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
Ginó, S.; Mendes, T.; Maroco, J.; Ribeiro, F.; Schmand, B.A.; de Mendonca, A.; Guerreiro, M.
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
Vente, W. de; Kamphuis, J.H.; Blonk, R.W.; Emmelkamp, P.M.
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
de Vente, W.; Kamphuis, J.H.; Blonk, R.W.B.; Emmelkamp, P.M.G.
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
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
Department of Homeland Security — State and Local Public Health Departments in the United States Governmental public health departments are responsible for creating and maintaining conditions that...
April, Michael D; Oliver, Joshua J; Davis, William T; Ong, David; Simon, Erica M; Ng, Patrick C; Hunter, Curtis J
We compare aromatherapy with inhaled isopropyl alcohol versus oral ondansetron for treating nausea among emergency department (ED) patients not requiring immediate intravenous access. In a randomized, blinded, placebo-controlled trial, we enrolled a convenience sample of adults presenting to an urban tertiary care ED with chief complaints including nausea or vomiting. We randomized subjects to 1 of 3 arms: inhaled isopropyl alcohol and 4 mg oral ondansetron, inhaled isopropyl alcohol and oral placebo, and inhaled saline solution placebo and 4 mg oral ondansetron. The primary outcome was mean nausea reduction measured by a 0- to 100-mm visual analog scale from enrollment to 30 minutes postintervention. Secondary outcomes included receipt of rescue antiemetic medications and adverse events. We enrolled 122 subjects, of whom 120 (98.3%) completed the study. Of randomized subjects, 40 received inhaled isopropyl alcohol and oral ondansetron, 41 received inhaled isopropyl alcohol and oral placebo, and 41 received inhaled saline solution placebo and oral ondansetron. The mean decrease in nausea visual analog scale score in each arm was 30 mm (95% confidence interval [CI] 22 to 37 mm), 32 mm (95% CI 25 to 39 mm), and 9 mm (95% CI 5 to 14 mm), respectively. The proportions of subjects who received rescue antiemetic therapy in each arm were 27.5% (95% CI 14.6% to 43.9%), 25.0% (95% CI 12.7% to 41.2%), and 45.0% (95% CI 29.3% to 61.5%), respectively. There were no adverse events. Among ED patients with acute nausea and not requiring immediate intravenous access, aromatherapy with or without oral ondansetron provides greater nausea relief than oral ondansetron alone. Copyright © 2018 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.
... 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...
The First Department of the Federal Constitutional Court, in a decision of December 20, 1979, rejected the complaint of unconstitutionality brought against the decision of May 3, 1977 of the Rhineland-Palatinate Higher Administrative Court. The decision under attack had rescinded the halt of construction work on the Muelheim-Kaerlich Nuclear Power Station. The court argues, inter alia, that a violation of a basic civil right could also be involved, if the licensing authority neglected to take into account procedural rules under the Atomic Energy Act which had been passed by the Government in discharging its obligations to offer protection under Article 2, Para. 2 of the Basic Law. The present and direct involvement of the holder of a civil right could not be denied for the reason that hazards to life and health could arise only from the operation of a nuclear power plant, but not yet from measures preceding it. (HSCH) [de
Haidvogl, Max; Riley, David S; Heger, Marianne; Brien, Sara; Jong, Miek; Fischer, Michael; Lewith, George T; Jansen, Gerard; Thurneysen, André E
Background The aim of this study was to assess the effectiveness of homeopathy compared to conventional treatment in acute respiratory and ear complaints in a primary care setting. Methods The study was designed as an international, multi-centre, comparative cohort study of non-randomised design. Patients, presenting themselves with at least one chief complaint: acute (≤ 7 days) runny nose, sore throat, ear pain, sinus pain or cough, were recruited at 57 primary care practices in Austria (8), Germany (8), the Netherlands (7), Russia (6), Spain (6), Ukraine (4), United Kingdom (10) and the USA (8) and given either homeopathic or conventional treatment. Therapy outcome was measured by using the response rate, defined as the proportion of patients experiencing 'complete recovery' or 'major improvement' in each treatment group. The primary outcome criterion was the response rate after 14 days of therapy. Results Data of 1,577 patients were evaluated in the full analysis set of which 857 received homeopathic (H) and 720 conventional (C) treatment. The majority of patients in both groups reported their outcome after 14 days of treatment as complete recovery or major improvement (H: 86.9%; C: 86.0%; p = 0.0003 for non-inferiority testing). In the per-protocol set (H: 576 and C: 540 patients) similar results were obtained (H: 87.7%; C: 86.9%; p = 0.0019). Further subgroup analysis of the full analysis set showed no differences of response rates after 14 days in children (H: 88.5%; C: 84.5%) and adults (H: 85.6%; C: 86.6%). The unadjusted odds ratio (OR) of the primary outcome criterion was 1.40 (0.89–2.22) in children and 0.92 (0.63–1.34) in adults. Adjustments for demographic differences at baseline did not significantly alter the OR. The response rates after 7 and 28 days also showed no significant differences between both treatment groups. However, onset of improvement within the first 7 days after treatment was significantly faster upon homeopathic treatment both
The complainants lodged a constitutional complaint 'against the Federal German Bundestag, for remaining inactive in matters of the licensing and operation of nuclear installations', and filed a petition for a temporary order. The Federal Constitutional Court dismissed the petition and inflicted a fee of 500 DM to be paid by each complainant. From the headnotes: The petition is inadmissible. It is left open whether the underlying constitutional complaint is inadmissible, or unjustified. The petition is dismissed because the complainants can seek relief by resorting to the general courts of law. They can appeal to the administrative courts in matters covered by section 7 Atomic Energy Act, and may there state their opposition against the 'permissible risk philosophy'. (orig./HSCH) [de
Hiller, W; Goebel, G
Dimensions of psychological complaints due to chronic and disabling tinnitus were investigated by means of the Tinnitus Questionnaire (TQ), administered to a sample of 138 tinnitus sufferers who had been admitted to a psychosomatic hospital. Factor analysis revealed that tinnitus-related patterns of emotional and cognitive distress, intrusiveness, auditory perceptual difficulties, sleep disturbances, and somatic complaints can be differentiated. Cognitive distortions and inappropriate attitudes towards the tinnitus and it's personal consequences were found to be highly intercorrelated forming a subgroup within a broader and more general distress factor. The stability of the factor solution obtained was examined by systematically varying the number of factors to be extracted. Based on the results of this method, scales are proposed for the questionnaire which can be used in clinical and scientific work to specifically assess major areas of tinnitus-related distress and their degree of severity. Implications for a further evaluation of the instrument are discussed.
Nilsen, Stein; Malterud, Kirsti; Werner, Erik L; Maeland, Silje; Magnussen, Liv Heide
To explore general practitioners' (GPs') specific negotiation strategies regarding sick-leave issues with patients suffering from subjective health complaints. Focus-group study. Nine focus-group interviews in three cities in different regions of Norway. 48 GPs (31 men, 17 women; age 32-65), participating in a course dealing with diagnostic practice and assessment of sickness certificates related to patients with subjective health complaints. The GPs identified some specific strategies that they claimed to apply when dealing with the question of sick leave for patients with subjective health complaints. The first step would be to build an alliance with the patient by complying with the wish for sick leave, and at the same time searching for information to acquire the patient's perspective. This position would become the basis for the main goal: motivating the patient for a rapid return to work by pointing out the positive effects of staying at work, making legal and moral arguments, and warning against long-term sick leave. Additional solutions might also be applied, such as involving other stakeholders in this process to provide alternatives to sick leave. 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 been suggested by others to enhance return to work, and should be further encouraged. However, specific effectiveness of this strategy is yet to be proven, and further investigation into the actual dealings between doctor and patients in these complex encounters is needed.
Santangelo, G; Vitale, C; Trojano, L; Angrisano, M G; Picillo, M; Errico, D; Agosti, V; Grossi, D; Barone, P
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.
In this paper the results of air leakage control are described using air screen in the chief tunnels of some uranium mines. The air leakage decreases by 79-91% after using air screen. On the basis of mathematical treatment, the formulas for calculating the air resistance efficiency of air screen are presented
The purpose of this phenomenological study was to explore the lived experiences of Asian Americans who became chief executive officers (CEOs) of a California Community College District. This study discussed the experiences, the influence of Asian culture, the perception of Asian Americans, and the challenges encountered by Asian American CEOs. To…
... 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...
Studenberg, Heather Nicole Lancin
This dissertation examined chief student affairs officers' perceptions of institutional crisis management, preparedness, and response. A goal of this study was to uncover findings that can benefit crisis management protocols or best practices regarding crisis management team training, plan communications, and emergency management personnel on…
Buddeberg-Fischer, B; Spindler, A; Peter, Y; Buddeberg, C
Chief physicians play an important role for physicians' careers by providing advanced training and allocating time and research resources. This study examined which characteristics will help physicians to achieve a leadership position and how chief physicians conduct career promotion. All 532 chief physicians in Switzerland's German speaking cantons with medical schools were approached with a questionnaire covering professional motivation and personal attributes of career-oriented physicians career-promoting personal and institutional factors, and type of career promotion. 207 chief physicians (189 men, 18 women; participation rate 38.9 %;) participated. Respondents rated achievement motivation combined with professional interest and job enjoyment (intrinsic), and interest in advancement and social prestige (extrinsic motivation) as beneficial. Extraprofessional concerns such as family obligations and leisure interests were viewed as less important. Instrumental attributes were rated as advantageous. Expressive qualities were also seen as beneficial but less crucial. Ratings were independent of respondents' age, specialty, or type of workplace. The following personal factors were named: professional commitment, professional and social competence, goal orientation, endurance, and strength of character. The institutional factors referred to quality of training and teaching, a good work atmosphere, a transparent and flexible clinic structure. Career promotion was offered predominantly in the form of coaching, career planning, and support in job search. Career promotion should be more targeted and structured, e. g. be conducted in mentoring programmes, thus providing the prerequisites for a truly equal career promotion of female and male physicians.
L. to r.: Dr Austin Ball, Deputy Technical Coordinator, CMS experiment; Dr Roland Horisberger, Paul Scherrer Institute and CERN, CMS experiment; Dr Steve Thompson, Chief Executive, The Royal Society of New Zealand; Dr Michel Della Negra, Spokesman, CMS experiment and Dr Alick Macpherson, Paul Scherrer Institute and CERN, CMS experiment, in the CMS Silicon Tracker assembly hall.
Penrod, James I.; And Others
The monograph examines the literature of the last decade on the rise and role of the Chief Information Officer (CIO) in higher education, business, and health care and reports results of a 1989 survey of higher education CIOs. After a discussion of the origins of the CIO position and concept, chapter 2 presents a survey of the literature,…
Kessel, van W.M.J.; Oomen, B.
This article examines the position of traditional leaders in postapartheid South Africa. It first surveys changing perspectives of chieftaincy within the ANC and its allied movements. During the apartheid era, chiefs were maligned as puppets of bantustan rule. In ANC-related circles, it was widely
The purpose of this research was to explore the factors that contribute to a chief financial officer's (CFO) success and demise within a higher education setting. Relatively little attention has been given to the study of leadership in educational institutions (Vroom, 1983). Leadership defines what the future should look like, aligns people with…
Hannah, Charles Russell
The role of the chief financial officer (CFO) is critical to the effective leadership of U.S. four-year public colleges and universities. Self-awareness and the capacity to view situations simultaneously in multiple ways and from different perspectives are essential elements of CFO effectiveness and success in the higher education environment. The…
Wheeler, J R; Smith, D G
To understand better the financial management practices and strategies of modern health care organizations, we conducted interviews with chief financial officers (CFOs) of several leading health care systems. The constraints imposed on health care systems by both capital and product markets has made the role of the CFO a challenge.
D.A. Uhde (David Alexander); P. Klarner (Patricia); A. Tuschke (Anja)
markdownabstract__Research Question/Issue:__ Research on how boards govern individual top management team (TMT) members, i.e., senior executives aside from the CEO, is still scarce and fragmented. In this study, we review extant research on board monitoring of the Chief Financial Officer (CFO) - an
Jenkins, William A.
The characteristics and qualifications of chief financial officers (CFOs) of large public universities, the internal organizational relationships of CFOs, and their responsibilities were studied in 1983. Findings of a similar 1973 study are also considered. A total of 135 usable questionnaire responses provided information on age; sex; length of…
of Defense Chief Information Officer Home About DoD CIO Bios Organization DCIO C4&IIC DCIO IE , where she helps the organization serve as the DoD CIO focal point for the PPB&E process, including includes personnel management and congressional support. This organization underpins all of DoD CIO's
Bailey, E. Ann; Dickens, Cynthia S.
Reports on a qualitative study examining chief student affairs officers' (CSAOs) (N=30) perceptions of the impact of legalized casino gambling on student life, service delivery, and student affairs. Results indicate that CSAOs detected few changes in student behavior. Campuses close to casinos reported more dropouts and increases in student debt.…
Sevier, Robert A.
Few positions on a college campus have evolved more than that of the chief marketing officer (CMO). Even a few years ago, this person, and position, did not exist. Of late, however, as colleges and universities have begun to appreciate the potential that integrated marketing communications has to offer them, more and more institutions have begun…
... 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...
Anderson, George W.
The purpose of this study was to relate the strength of Chief Information Officer (CIO) transformational leadership behaviors to 1 of 5 computing platform operating systems (OSs) that may be selected for a firm's Enterprise Resource Planning (ERP) business system. Research shows executive leader behaviors may promote innovation through the use of…
... TRANSPORTATION (AVIATION PROCEEDINGS) ORGANIZATION STAFF ASSIGNMENTS AND REVIEW OF ACTION UNDER ASSIGNMENTS Assignment of Functions to Staff Members § 385.10 Authority of Chief Administrative Law Judge, Office of... Director, Office of International Aviation (or such staff member of the Office of International Aviation as...
INTERVIEW WITH MORLEY SAFER, CBS EVENING NEWS CORRESPONDENT 179 15 March Address to the West Point Society of the Monterrey Pennisula Founder’s Day...praisal of individual Service programs divorced Service Chief wearing two hats. While the Joint from Service advocacy of weapons systems. The Staff